People of means did not lack for medical options when they contracted the “foul disease” in early modern London. This book is not about people of means. However, an understanding of the experience of poverty and the pox demands a point of comparison. For that reason we should first consider the place of the foul disease within the oft-described medical marketplace of Stuart and Georgian London. If one had money to spend, what were their options? There is no doubt that there were plenty of customers for anyone who could relieve the suffering just described. There was a rich living to be made in the trade in pox-cures, and the powerful economic force of demand indeed spurred vibrant activity in London’s medical market. Few corners of the early modern medical market could challenge VD care for the range of therapies or providers. The range of the market response to the pox was driven, not just by the widespread incidence of the disease, but also because of the unique nature of the pox. Patients diagnosed foul tended to have particular demands that others who suffered from more banal ailments did not. Attempts to provide this huge customer base with services for these unique demands resulted in a rich range of medical services. Thus there were a wide array of options for the poxed, but they were frequently not cheap. And there is the rub. For early modern London had a two-tiered medical system, to use modern parlance; private fee-based care of the market existed alongside publicly funded care for the poor. The bulk of this book will explore the forms that such public care took. But to make the most sense of it we must first explore VD care in the private sector, and this means first studying care for middling and well-off Londoners.

In addition to the desire to ease their physical suffering, which all medical customers sought, venereal patients also made unique demands springing from the socio-cultural reactions specific to the pox, namely its stigma. There has been some disagreement regarding the relative stigma attached to the disease over the long period. Some scholars have asserted that early modern sensibilities regarded venereal infection with cavalier light-heartedness, particularly during the Restoration.