Many Londoners could not avail themselves of the services that the market provided. This posed a problem. What can be done, lamented surgeon Charles Peter in 1693, for “those poor unhappy wretches where the Pox and Poverty are complicated”? In a sense, that is the central question of the remainder of this book. Such folk were not entirely without options in the seventeenth century, as scholars have sometimes presumed. One of their main options lay in one of the two royal hospitals that offered venereal care, St. Bartholomew’s and St. Thomas’s. However, contemporaries did not always see these as a desirable choice. An anonymous commentator criticized hospital foul wards, claiming that “more rude Ignorance, and slighter Management in curing this disease, has not been heard of, than in these places.” He went on to claim that “some that have undergone their common unctions there, and come forth uncured, have protested they had rather chuse to dye, than to return thither again.” In 1696 a doctor named Wall similarly described the “Despised Hospitals and Lock Nursery” that represented the only resort for paupers who had been taken advantage of by ruthless quacks who took their meager pennies and sold them phony cures.

Wall’s depiction of seventeenth-century hospital VD care is notable for its lack of a clear opinion; it is a description that, though brief, captures well the tension and difficulty inherent in trying to sum up early modern hospital provision in simple terms. On the one hand, Wall offered rather little hope to the “captives” who resorted to the foul wards, where they might find themselves “reduc’d . . . to a dribling Condition” by the substandard care and “slack attendance” that characterized hospital therapeutics. Yet despite that grim picture he also acknowledged that the foul wards still “furnish[ed] out more Mercy to the Afflicted” than the dog-eat-dog market from which paupers were excluded. Wall’s depiction is generally accurate, exaggeration notwithstanding. There can be no question that hospital patients faced inferior care when compared on many counts to the care available to paying patients. However, before gauging that care we must first acknowledge the absolutely impressive scope of both hospitals’ provision for venereal patients, which has been largely unrecognized. The royal hospitals steered quite significant resources towards tackling the complicated problems of poverty and the pox, and saw venereal patients as worthy objects of that significant charity.