Betwixt The Sheets: The History of Sex, Scandal & Society - The Syphilis Explosion of the American Civil War

Episode Date: January 20, 2026

It's been estimated that between eight and twelve percent of soldiers contracted a venereal disease during the American Civil War. What on earth were they up to?Kathryn Olivarius is a Professor at Stanford. She joins Kate to discuss syphilis, why it spread so far during the war and how it's impact continued after the war ended.Kathryn is the author of 'Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom'.This episode was edited by Tim Arstall. The producer was Sophie Gee. The senior producer was Freddy Chick.Sign up to History Hit for hundreds of hours of original documentaries, with a new release every week and ad-free podcasts. Sign up at https://www.historyhit.com/subscribe.  All music from Epidemic Sounds.Betwixt the Sheets: History of Sex, Scandal & Society is a History Hit podcast. Hosted on Acast. See acast.com/privacy for more information.

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Sign up to join me in locations around the world and explore the past. just visit historyhit.com forward slash subscribe. Hello, my lovely betwixters, it's me, Kate Lister. You are back once again and you are listening to Betwix the Sheeds. So well done for being in the right place. I'm so pleased that you have made it once again. But before we can go any further, I do have to tell you, this is an adult podcast spoken by adults to other adults about adulty things in an

adulty way covering a range of adults, subjects, you should be an adult too. Actually, we are getting a bit grim today. We're talking about syphilis. So you might just not want to listen to something about, Pustulous, gangrenous, oh, needs, might not want to listen to that, in which case this is your fair dues warning. Get out now, we still can.

And for the rest of you that are still hanging around, should we get on with it? I think we shall. America in the 1860s was a particularly dangerous time to be around. I mean, looking at current global events, it's not doing too great right now, but in the 1860s, they were in the grip of a civil war, and that meant that every day brought a risk of being shot

or blasted or stabbed with a bayonet. And even if you weren't on the battlefield, your house was constantly at risk of destruction and food. Well, that was in short supply as well. And then there was another risk, a danger muted somewhat by the shame that it bought. So it flew under the radar, but it was no less devastating. Cephaless. Hello and welcome back to Betwixt the Sheets, the History of Sex Scandal and Society with me, Kate Lister. We've all been through COVID.

So we are a group of people that know a thing or two about a super spreader event. And in history, there are so many of these kind of events. Ones that wreaked horrendous devastation. And syphilis is definitely one of those. And it does tend to rear its ugly head around wartime. Perhaps it was the sheer volume of young men being away from home who were facing an impending cannon who thought, do you know what, I'm going to have a shag before I go.

That might have had something to do with the boom in syphilis. Well, today I'm joined by Stanford's Catherine Oliverius to find out about syphilis and civil war. Condoms at the ready betwixters, let's do this. Hello and welcome to betwixta sheets. It's only Catherine Oliverus. How are you doing? I'm excellent.

How are you doing? Oh, I'm thrilled to have you here. This is one of my favourite subjects, syphilis. Syphilis. The jokes write themselves almost. Don't they? But it's a fascinating subject, but as your research and what you do show,

it is formative in our history. Like, it's played such a huge part that is often unacknowledged in our global history, especially military history. Yes. And I feel like every day that I read sources that I'm sort of working on this book, I learn new things about syphilis. I learn new things about the ways in which this disease in particular, in fact, shaped so much of the culture and society of the 19th century and beyond. So the first question that I asked to all the guests is a bit of an origin story. How did you go from a little girl in rural America to somebody that studied syphilis for a living? What was that journey?

So I actually grew up in the UK and my family jokes that they would call a historical hypochondriac. I would come up from school and I would be obsessed. I would say, mom, I have leprosy. You know, mom, I have cholera. Mom, I have HIV AIDS. There were some that were a little bit more worrying than others perhaps when I'm, you know, seven and eight years old.

But when I went to university, I always knew that I loved history. My family thought that I would be a medical doctor. doctor. But alas, I'm the wrong kind of doctor. I'm one of those doctors to solve all your historical needs, not the medical ones. But I wrote my first book about yellow fever in the American South. And when you see disease in the archive, it can be kind of like a sort of earworm or something where suddenly you start to see it everywhere. And it's one of those funny things that I think a lot of historians can write disease off. They sort of consider it to be background noise, almost, that everyone in the past was sick or they had these ailments which were staggering and devastating,

But it's just not something that you have to take seriously as compared to the sort of more resonant political or economic stories. Whereas I consider this to be more like dark matter, that everyone gets sick, everyone gets ill. And we should dedicate as much time to thinking about how this shaped people, a sense of self, how it shaped society, how it shaped culture. And syphilis in the American Civil War, this is particularly fascinating. This isn't a history that I actually knew very much about. But this is your wheelhouse now. Yes. So I've been at Stanford for eight years. I teach 19th century U.S. history and teach a civil war, which is the war that was fought at the mid-century between 1861 and 1865, between the north and the south. And the result of this was at the end, four million people were emancipated from slavery. So this is the origin story war for many Americans, perhaps beyond the American Revolution. But also, this is a war in which 750,000 people died. This is a total war. This is a war in which we have sort of looks actually quite sort of recognizable to us,

in terms of the kind of weaponry and the kinds of tactics that were used. But also, we had this sort of astronomical death rate, the vast majority of which actually was from disease, not from bullets. And so this is a disease in which probably two-thirds of the war dead died from infections or typhus or camp diseases or one of the many different ailments that's always plagued militaries. I mean, all war is, by its nature, horrendously violent. But the American Civil War seems to have been like carnage on a scale that hadn't been seen before. Yes. And you get sort of some teasers of this with the Crimean War, for example, where we have this kind of misalignment, if you might call it, between tactics and weaponry. In past wars, you would have sort of men, you know, walking shoulder to

shoulder at Borodino or at Waterloo or one of these big battles. You have men sort of walking into fields shoulder to shoulder with muskets that also have a bayonet attached to them. Weaponry is not that accurate. And now what we're seeing in this war is actually the complete reversal of this, which is that artillery can be accurate up to half a mile. You have men running into, you know, shellfire. And mini balls also, the major bullet that hit you in the body, they will fragment and they will sort of fester because they can sort of lodge themselves in bone or in muscle and then cause infection. So this is another huge cause of death in war, a sepsis and then gangrene. I suppose another thing that's particularly nasty about the American Civil War is it was a civil war.

This is Americans turning against Americans. This isn't like an invading force. This is civilians fighting one another. Precisely. So this is the war that was fought. It's been called many things at different times near the war of northern aggression or the war between the states. This is definitely a civil war in which the American South, the Confederate States of America, self-styled nation. These are rebels who fought against the federal government.

And it really, especially in the border states, so in the sort of, if you can imagine the map of the United States, states, the sort of deep south states, which these go to the Confederacy, these are also states that are incredibly dependent on slave labor and on the laborer and enslaved people. And this is, you know, cotton, cotton, cotton, and sugar. And slavery is really this question that is increasingly dividing the north from the south, but especially in those border states. So in Kentucky, in Tennessee, Missouri, when we talk about a civil war, you know, dividing families, we're really talking about actual families where they'll be brothers who fight on both sides or fathers and sons who will fight on different sides and it really did tear apart family. Abraham Lincoln, who was president, of course, during this war, his wife, Mary Todd, she was from a southern slaveholding family and many of her

brothers fought for the Confederacy. So this is quite literally tearing families apart. It's hard to imagine America being so divided. Is it? Sorry. B.A. Kate Lister. So let's turn our attention then to syphilis. What is syphilis? It's got this kind of ring of like a historic leprosy. Like it's some weird, like a all like scurvy. It's something that happened in the past, but it's not as very much with us. What is it? So syphilis is, you're completely correct that this feels like a disease of the past, like scrofula or like leprosy exactly, these sort of ancient ailments. It's actually not that old of a disease or at least the sort of a way that it sprang onto the global scene in the late Middle Ages and it caused a lot of

havoc among various soldiers, soldiers in various military campaigns in Europe. And so syphilis is this disease that classically presents in three stages. So in the first stage, after infection, you will develop what is called a chanker. It's a little bump close to the side of infection. So that's generally on the groin. And you may notice this. You may not notice this. It might come very quickly. It might go away very quickly. But at this point, you are contagious. Once you've hit this primary stage, you're very contagious. And then people will progress into secondary syphilis in which you develop a rash generally that can be on your torso. It will eventually sometimes envelop your entire body, including the palms of your hands and

souls of your feet. You're also very contagious at this point as well. You develop high fevers, things like this. And then for some people, that will be the end of their journey with syphilis, it will stop there. But for about 30% of people, you'll progress to what we call tertiary syphilis. And this is the stage that probably most people are familiar with. This is the stuff of nightmares in which you develop often these sort of gums on your head, these depressions on your head, sometimes people will lose nose tissue, and so they'll lose, literally their nose will sort of disintegrate. Some people become extremely photosensitive and so have to wear sunglasses permanently. You have liver damage. You have damage to basically every one of your organs.

And then in some very serious cases, you develop neurocifilis, which means that you go insane. Or you develop general paralysis, general parisus, is what it was called in the past. and eventually this will lead into death, and it's a horrifying way to end. This is also until penicillin, so until the 1940s, this was incurable. So if you develop syphilis, there was no telling if you would progress to the very, you know, serious, dire third stage. And there was no telling, you know, if your symptoms would manifest in that way, because, you know, you might be lucky and, you know, it becomes latent and never really new to be to health problems later on, but it's indistinguishable from other issues that you may have. but many people developed these sort of tertiary symptoms, and it's just a horrifying way to die. And you die in shame as well, too, because there's no, again, there's no cure.

It's highly contagious. You could have given it to other people, including children that you have born. But also that because there's no cure, you kind of exist in this state of almost social death, actually, where in which you are shut out from the mainstream of society. So you're told by doctors not to get married or not to have sex. for five or six years if you develop symptoms of this. You're told that you shouldn't have children and you're facing all of these kind of social impediments. So in many ways it makes sense that people would, A, lie about their diagnosis if they had one or also lie to themselves about it, too, really just hoping against hope that you don't progress to that final third stage, that it's not

going to be the cause of your death, but also that this is something that you can sort of deny to yourself if possible because there's no social benefit to admitting you have it. And so much shame and stigma attack. I mean, we're still doing work around destigmatizing sexually transmitted diseases to this day. But syphilis seems particularly cruel because if it did progress, you can't hide that. Like if your nose is fallen off, you can't hide that. Yes. And there's something about syphilis that I find as historian sort of particularly poignant, I suppose, in which, you know, penicillin is a magical cure. This is an antibiotic. This is a magical cure for syphilis. So if you go to see a doctor and you take

pedicillin, you're basically good to go. And there's something about setting diseases where the cure is just on the horizon. It's, you know, just the next generation down. It's 10 years from when somebody gets it. And there's something very just devastating almost about seeing people in this sort of historical spot in which they would find little comfort in the idea that in 10 years and 20 years, there'll be a cure or there'll be a test or any of these things. It's, you know, it's talking about the sort of, when we talk about public health or the history of medicine, it can be easy to sort of think about the long arc and these magical cures, his magic bullets. But for individuals, of course, this is a lived experience that can cause incredible pain and suffering on an individual and familial level. There was no effective treatment, but mercury was a big one that was used for a very long time.

And I've asked this question to every history that we've had on of disease, because I'm never quite sure. does it do anything, Mercury? Because they used it for so long. Like, why did they keep using it? It's not helping. So this is a great question. And I've had the exact same question for many, many years because it's kind of the curell that's given for a great many diseases. So does it have an effect? The answer is yes and no. So mercury is highly toxic. And in some ways, you could kind of think of it as akin to it. a kind of chemotherapy and that it's, it kills a lot of things in your body and it might kill syphilis or it might kill yellow fever or it might kill smallpox, things like this. It might have a sort of a discernible effect for you. But it's actually highly talked, as I say, and it's one of the sort of marks of a good doctor in the 19th century and before that was their ability to mark the quote unquote therapeutic point, the crucial therapeutic point of when mercury was actually beneficial

versus when it was going to dip into being toxic and potentially even killing you, because it would be very easy to kill somebody by overprescribing them mercury. And the ways in which also it's, you know, people would ingest mercury, they would rub it on their body, they would vapor bathe in it. And you see this with a lot of people who have syphilis that they are literally sitting, you know, sort of vaporizing this and it's going all over their skin. It's incredibly painful. And of course, it causes, you know, your teeth to fall out eventually, your breath to become

very fetid. It can cause your hair to fall out. it can cause all sorts of other problems that keep mercury poisoning is highly toxic. It's very dangerous. So the answer is not a very satisfying one, which is that, you know, there's a reason why they kept using it, which is because it clearly had some kind of effect. And for some people, it was quote unquote therapeutic, though there was no one-to-one cure with disease and mercury being a cure. It just killed a lot of things. It had a kind of totalizing effect. And I suppose you might get into this correlation, is not causation type of a situation, because

if syphilis has its first appearance and then you get very poorly, but then it kind of dissipates into the body and becomes latent, you might be forgiven for thinking that the mercury you were taking had made it disappear, but it hasn't disappeared. Precisely. There's always this kind of chicken and egg question with the history of medicine where you think, well, you know, if you're looking for reasons to think that mercury was doing, it's bidding for you, I'm sure that there are plenty of them. And hindsight is 2020, but actually hindsight was not really 2020. So So if you, in the absence of sort of greater knowledge about germ theory or the ways in which syphilis or any other disease manifested in the body and the sort of its actual etiology

and the pathology of this disease, if you don't know that, then you can find all sorts of reasons to look to the mercury you took or Kalamel will be another one or a mercury-based tincture or one of the many other patent medicines that were available to consumers across North America, across Europe for most of the 19th century, which, you know, she would mail order away for something like Capparcila syrup or Radway's Remedy Relief. These are basically sort of alcohol-based treatments that a vast, vast majority of 19th century denizens were taking at some point in their lives to cure various omens. I'll be back with Catherine and syphilis after this short break.

Syphilis has always been an issue of quite grave concern to the military. Obviously, people are worried about public health and, you know, civilians general health. But in particular, what seems to crystallize this, is military issues. So before we move on to that, how poorly would you be in the initial stages of infection? Because I don't think the military really cared that you were going to maybe go mad to 10 years down the line. How sick would you be in that initial poorly bit? It's a great question. And it buried by person. So some people will have quite serious symptoms up through the sort of primary and secondary stages. It'll be quite obvious that they have syphilis because they have this rash. You might even see the chanker on their mouth or on their

groin, something like this if you're doing a medical exam, and you'll see this rash that they have over their body, and they'll be quite sickly. But some people could quite easily slip through their medical examination without this being detected. And I think you're exactly right, which is that syphilis is this kind of strange disease for militaries in that you're highly infectious, but it's not necessarily true that everyone will present with physically obvious symptoms. And of course, the incentives of the military are to have as many enlistees as possible. They care, of course, about the public health. They are aware, and you see this in many, many medical examiners, private diaries and their letters to each other when they're sort of doing these initial intaking medical exams in 1861.

They are writing to each other about this. There are things they are concerned about. And they know that, especially syphilis and gonorrhea, that these are diseases that will spread very quickly, if not checked. So they obviously don't want to have obviously contagious, obviously syphilitic men entering the army or the Navy, but they are also always balancing this against the greater imperative perhaps that they feel, which is to have as many people as possible enlist. Poorly enough for you to say, oh, I'm afraid I can't go over there and do that fighting sergeant. Yes. And so this is actually one of the things that I think is most interesting about how we see syphilis in the historical record with this war. So for two decades after the Civil War, various people were responsible for pooling field medical reports and hospital reports to try to develop a kind of larger medical picture of what happened during this war. And they produced six volumes, very thick volumes about field hospitals and all these sort of individual battles and casualties. It's an amazing document. There's only 55 words in these six volumes about syphilis directly. No. And it's only 55 words. And it's basically just as sort of straight up, you know, how many people.

55 times. Yeah. And the instruction manuals for medical examiners who are doing these intaking exams, there are these instruction manuals that say basically secondary syphilis is a cause for absolute rejection. But again, whether or not the medical doctors, these medical examiners are able to discern that quickly is it really depends on the person. But what is absolutely true is that very quickly when this war starts, you see these medical examiners really start to kind of become quite alarmed, actually, by the amount of syphilis they see in the general population. So before the war, this is a disease that was basically exclusively associated with poor people. Every

disease is basically associated with poor people. People who live in cities, especially in New York City, but also increasingly Chicago. And then, of course, with sex workers, too. This is a disease that is blamed almost entirely on sex workers and on loose morals and lewdness and this kind of culture of sexual promiscuity. And that's always how it's euphemized too. However, what these medical examiners are seeing very quickly is that it's not just, you know, men who live in Manhattan, who are poor, but they're seeing farmers boys. They're seeing the 40-year-old husbands with, you know, five children who are living in Illinois and farm corn. It's the real mismatch between what they think they're going to see and then what they actually do see, which is that syphilis

is much more widespread. Do you get a sense of the reaction of just them going, holy shit, they've all Got it. Yeah, and there was one medical examiner from Houston. Basically, he was a medical examiner for New York City below Houston. So downtown, very cool area now. And he says basically like, oh my gosh, literally one-tenth of all the people that I'm seeing have syphilis. Wow. Or he was doing, you know, he did I think 3,500 medical exams, and he saw an incredible amount of syphilis, just in the general population. And these are cases, remember, these are cases that he was able to actually see. And he could tell that these people had syphilis, especially early on in the war, again, the incentive for soldiers who were enlisting too, maybe some would say

I have syphilis because they didn't want to fight or they have some kind of ailment. But a lot of them, you know, this was everyone believed this would be a short war and there was a lot of social pressure to, you know, get through. So they're incentivized basically to lie about this to and get on their way and get enlisted. And so you have officers who are taking notes on what's going on in their regiments. They're seeing that a lot of their soldiers, their enlisted men, they are developing these symptoms by the summer of 1861, and they're becoming very concerned. They become concerned because this becomes then a question of, can we even fight this war? Like how, if we've all these sick people, they start to care when this impacts their ability to wage

and fight war effectively. And you see some officers in both the North and in the South becoming quite concerned with this quite quickly. So they're losing manpower. Exactly. That's the issue. Yeah. What tactic did the various authorities bring in with this one? Because if you fast forward another 60-ish years to the Second World War, the American approach to venereal disease and the troops is very much one of let's put our fingers in our ears and we'll sing very loudly. And if anyone does get sick, we're going to shout at them. We're going to shout at them a lot. Whereas the Germans were like, they rolled out that Germanic efficiency that they're so famous for. Like, right, everyone has condoms and everyone has instructions on how to use them and we will monitor

everything. But the Americans are just like, no, just don't do it. What was happening in the Civil War? What was the approach there? It's a mixture of both of those sort of approaches, in fact. So you have some officers who say, don't do it. Please do not sleep with sex workers. Do not sleep with each other. And they notice in every city, so in Washington, D.C., this is the nation's capital. There are hundreds of brothels, literally, hundreds. Wow. The one, in fact, closest to the White House was nicknamed the hospital, which suggests something. Yeah. Yeah, yeah. And also, the officers, they tend to talk about this is something that is impacting, you know, that venereal disease is something that's only impacting enlisted men. It's not true. The enlisted men made fun of the officers all the time,

and Pope sort of said, like, you know, they're the ones who were actually engaging in all of this misbehavior. Over the course of the war, there were 100,000 court marshals for all kinds of sexual misbehaviors. And this runs the gamut from sodomy, but also to rape and also sometimes to engaging with sex workers. But that really, you know, this happened much more than it was ever sort of hit the official record. Washington, D.C. has an explosion in the number of people who are engaged in sex work. So does Nashville. And Nashville is very important because this is the major sort of depot in the Western theater of this war. It's on the Ohio Mississippi Rivers. It's sort of at the confluence of these. So here we have, this is the big port city. And in fact,

the authorities, the union authorities in Nashville, they experiment with essentially trying to regulate sex work by introducing. And this, and this, you've seen this. And many wars in the fact, too, where they say there'll be weekly medical inspections of the women. Like the Contagious Diseases Act in Europe. Exactly. Exactly. Exactly. And also in this time, condoms exist. They're not widely used. And they would have been reused many times, too, which sort of treats the purpose for a disease like this. Exactly. So all but useless then, really. Exactly. Yeah. Why do you think? Because this happens, whenever you get war, you get women that go, I'm going to go on the game.

I'm going to start selling sex. Why do you think as a historian, do you suddenly see this explosion of sex for sale? You see it in the first world war, the second, all war, is it just, is it supply and demand? Is it that, because I've heard various explanations for it, that the women are suddenly left without a protector. This is the only thing they've got to turn to. What is going on? So I think it's a lot of things. And I think you're exactly right, which is that supply and demand is sort of a guiding principle here. Most certainly that is true. I also think if you read letters from women who are on the home front, and this is in the north, but especially in the south, where the currency is collapsing. There's increasingly little money in the economy. And there's also red riots

by 1863. It's not quite a famine, but people are starving. This is in many ways, this is the only ways that asset that women would have. And so you see a lot of women, especially in the south, who I don't think they would necessarily consider themselves to be sex workers in any kind of official, quote-unquote, sense. But they certainly are using this, using sex and engaging with sex work to really seek to, you know, protect their family, to feed themselves. They're bartering it essentially for protection, for sundry items. It's a really sort of mixed bag here in terms of the motivations of various people. And of course, too, when we're talking about sex in this war and there are various court-martials, again, for a men who committed sexual assault on women. But the ones that go to, these are, we only have

records actually for the Union Army, not for the Confederacy. In general, the records are much, much poorer for the South. But these crimes of rape against, you know, where men were found guilty of this and were hanged or executed or were punished for this, we're talking about mostly women in the North, white women, many of whom were also the wives of soldiers who were off at war to, but there's a sort of social profile of the people that were taken seriously for being sexually assaulted in this war. Whereas in the South,

there's widespread sexual assault, of course, especially of enslaved women, who would, for many reasons, not probably appear in the same kinds of records that would maybe capture, even this sort of small sliver of women in the North who were captured in this way. They would be sort of written off.

It would not be taken seriously and might not be seen as a crime. So the sexual constellation of this war is complicated and it's very idiosyncratic and it's also, of course, filled with violence and filled with venereal disease. So how is syphilis spoken about in the records then? Because you've already explained that this is an illness that was caught up with tremendous

amounts of shame. It's actually quite hard to identify a lot of the time as well. It can be mistaken for other things. What are your sources? What do you look for? Because, I mean, other diaries of people going, I definitely have syphilis. And this is my detailed account of my experiences. If anybody can find that one magical diary of the person saying, I have syphilis.

And here is all of my things. thoughts about this and how it impacts my identity. Please send it my way. I'll love you forever. That source does not exist. That's exactly correct. And so, you know, I'm a story of disease. And I wrote my first book about yellow fever. And if you survived yellow fever in New Orleans in 1830, you shouted this from the rooftop. You would put this sort of harrowing tale into every single, what are you wrote to business associates? You would write about it in your diary. You put it in your autobiography years later. It would be in, you know, you would try to sell your shorts in a newspaper. It's just a different thing entirely where when you have civilists, you don't write about it.

Quite understandably, you would not write about it in letters home to your mother or to your wife or to your girlfriend. You would, again, try really to lie to yourself. So as to sort of go about your day, feeling, you know, just hoping against hope that you can beat this and not be stricken and eventually progressed to tertiary syphilis. So how do you find this? So where is this in the actual record? There are some official places. So, for example, in this compendium of the diseases, the medical history of the Civil War, the six-volume compendium, these 55 words, there are some little sort of snippets of things that you can find,

little stories of doctors talking about gonorrhea, for example, or venereal disease that I would suspect are actually syphilis, but again, it's hard to tell in the historical record. And this is one of the most difficult parts for being a medical story, which is that diagnosing people through the ether of time is a really tricky thing, especially for a disease like syphilis, which is actually nicknamed the Great Imitator. It can resemble a great many things, and, you know, especially it's very easy to confuse with gonorrhea, but also sometimes with flu or with smallpox or other diseases that have perhaps similar symptoms. There are some official sources that note this. Then you have the records of these medical examiners. They kind of have a presence kind of snapshot

almost of what these armies were like going into the war. And then you do have various letters home of these soldiers who are writing home about what army of life is like. And they will write to their fathers and mothers. And they'll talk about quote unquote misbehavior and alcohol use and, you know, what army life is like at night. And they'll talk about syphilis and gonorrhea. They'll talk about what was called then the clap and pox. But it will not be something that afflicts them. It's always something that happens to somebody else. Yes, there's misbehavior, but don't you worry. I'm still keeping true to the gospel. I'm still a good question. I'm not misbehaving. I'm not being lewd. I'm a

abiding by the sort of Victorian morals that structured life in the mid-19th century. The sort of most interesting source, I think, to see the sort of truest picture are pension records that exist from after the war. So you can see in these records, oftentimes people will apply and reapply and reapply because initially if you had a binaural disease, that would be disqualifying for a pension. The laws were liberalized after the war, quite a bit after the war. They basically said that anybody who served for 90 days in the Union Army, no matter what their element was, whether it was, quote, unquote, self-inflicted, lecophilis, or it was, you know, a bullet wound or you had your leg amputated, you still qualified by the 1890s. But you can see in

these pension records, people are developing symptoms over time, where, you know, people are going deaf, people are going blind. And always the key word to look out for is rheumatism. This is, it's not a one-to-one, but rheumatism was the way in which people sort of spoke about the kinds of pains, the muscle pains that you would get. And it's not a one for one again. So plenty of people who had rheumatism had rheumatism. But if you're going to look for syphilis, this is often the sort of way into thinking about the whole case history. How did you crack that code? How did it? Like, when did the penny drop? Like, they can't all have rheumatism. Actually, I did not crack this code. Margaret Sanger did, in fact. And many, many female reformers

in the Gilded Age, they saw this connection to. So this becomes a major feminist issue after the war. And this is, you know, well before suffrage. But what? of the sort of rallying cries was that actually, you know, it's a travesty that women are married to these men who are infecting them with syphilis. And this becomes a sort of way in which a part of the WCTU, the women in Christian's temperance union, this becomes one of their sort of defining issues. And Margaret Sanger, who was a reformer in the 20th century, she says that no man under the age of 40 should have remitism categorically, that this should not exist. This becomes the kind of way that you can get medical treatment. It would be something on your medical record, your

pension record, but it wouldn't be syphilis. It's sort of a red flag for historians, and it was certainly a code word for people in the 19th century. I'll be back with Catherine and syphilis after this short break. So what did the various authorities do then? So they're quite shocked at the levels of this. It seems that it was significant before the war, we're going into the war, and I guess you can understand the attitude of like, well, I'm going to walk slowly towards a cannon. Maybe I'll have sex the night before. And so it explodes. But then what are they doing to try and curtail this? They attempt to regulate the brothels. You see that in Britain and in France and Italy. Was the treatment available? Not effective treatment. But what did they do about it? They couldn't do very much about it. The Union brass and the Confederacy, too, they sort of throw their hands up with this saying, like, you know, there are ways that we can try these experiments perhaps like they did in Nashville where they were seeking to basically regulate sex work by which that means. that they were blaming this solely on women.

There's some serious public health concerns here. Serious people are trying to curtail this problem. But really, what they are hoping for is that this war will end, and hopefully people will go home, and they won't be contagious, and that this will somehow sort of dissipate. And you have this data on this, as we've talked about, is really difficult to discern. But some of the best estimates from 1850, 1860,

suggests that maybe one in 15, maybe one in 20, adult American men had syphilis or gonorrhea at some point in their wives before the Civil War. It's basically impossible to do on a kind of global or a national or even on the state level. It's so hard to disambiguity because nobody was responsible for collecting this data. But fast forward to a generation or two after the war to 1900. And you have the American Public Health Association estimating that up to 20% of adult American men, and by adult American men, they mean over the age of 12, have had active syphilis at some point in a way. This is a huge, this is a, like a super spreader event that has never really been talked about in this way. So we had this basically a silent

epidemic. There's never been an epidemic of syphilis declared. The rate of infection is enormous, of course. This is huge. This is as close to basically a universal experience as you're going to get with the disease, except that it's one that is not talked about. So the military during the war, people know this is a problem, and they just basically say, well, we're going to just cross our fingers and hope that this is not a problem that explodes. And of course it did, but it did so in this really heartbreaking silent way where you can sort of see in records again, again, you don't have these letters from wives saying, I have syphilis, but you'll see women who, they get married after the war during what was called then a marriage boom. There was a huge uptick in the number of

marriages. You'll see that they, in the late 1860s, in the 1870s, they will have miscarriage after miscarriage. They'll give birth to children who are still born or who are deformed, or who are blind or who are deaf. And you can sort of see the mark of this disease intergenerationalally. The shame and the silence surrounding that shame spread in these really heartbreaking ways where you can see the tragedy playing out in these individual families. And one that's never acknowledged publicly by any kind of national border authority. Did they have lock hospitals or anything like that where they would send the soldiers?

Or was it just you're just going to have to go and fight the war with syphilis? Yes. there were venereal disease wards at certain hospitals, especially in Tennessee. And during this war, and this is true in also other wars to going with a Spanish-American war in 1898, but then also in various European wars, you'll see that there are ways in which they're seeking to isolate venereal disease from other ailments. For the most part, if you could fight, if you were not debilitated to a point where you couldn't fight, you would go back to the front line or you'd go back to your unit and then you'd be sort of integrated again. And maybe you wouldn't be fighting,

or if you weren't feeling well, maybe you'd be doing sort of duties around camp. That would mean that you could sort of take it a little bit easier. But again, there are some systems, but these systems are not working to contain this disease. But again, it's also really idiosyncratic where it's kind of up to the person who's in, you know, the commanding officer of this unit what they're going to do. Or it's up to this general over in, you know, the Virginia theater to figure out how they're going to solve their own sort of individual problem on their front and not think more systematically about the hundreds and hundreds of thousands, the millions of soldiers who were mobilized during this war. Plus the treatment, such as it was, Mercury, it's hell of expensive, isn't it?

They're not going to give that out to every single person that's fighting in this conflict. Yeah, and this is something that also when we talk about all disease in the 19th century and all disease today, in fact, too, there's a class element to so much of this, which is that, you know, if you were a poor person who had syphilis, you wouldn't go to a doctor necessarily because, A, you don't want them to go. confirm your diagnosis, but also because what are the treatments are going to give you? They're expensive. So you can afford that. And so, you know, a richer person might have access to more quote-unquote advanced therapies or to a medical professional who had some specific training in syphilis. But for soldiers in the war, too, they have very little control over their medical treatment, too. So Army is not, especially in the South two, they ran out of medical, basically any kind of medicine within a couple of years into the war. Again, this is a four-year war. It stretches on. But

they're seeking to basically to steal medical supplies from the Union Army. So we're talking about, you know, this is very expensive. And, you know, of course, also dosing mercury is kind of, it can debilitary too. So it has the sort of double effect, of course, of taking people out of the action anyways. So as a final question then, and we're into the realm of speculation here, but it's fun to speculate. If there had been a cure for syphilis or if syphilis and gonorrhoea and venerialists didn't exist, how would have impacted the outcome of that war? It's a great question. And I think probably that we would have seen if venereal disease didn't somehow exist, there would be some other way in which shame would be attached to disease in general, too. So they'd find a way to create this. But the thing that interests me most is not just the experience of having this disease in the war, but actually how this disease then goes out across the nation sort of like tentacles after this war. And in this way that is, again, it's very tragic to see because it's so much of this is happening in silence. somebody of the suffering happens sort of behind closed doors within individual families.

If you were given syphilis by your husband, this is a hugely shameful and heartbreaking thing on so many levels you have to deal with, not just medically, but also emotionally. And so some of the trauma of this war, the way that this keeps on sort of, you see these soldiers who really can't escape their war years. They are ashamed of their war experience because of cephalus. For them, the war never really ends. And it never ends to their families either, who live daily with the consequences of this infection. Catherine, you have been marvellous to talk to. I knew that you would be. And if people want to know more about you and your work, where can they find you?

I'm on X. You can find me there. I'd never really check it, but also my personal website, which is catherine olivarius.com. Well, thank you so much for dropping by. You've been phenomenal. Thank you. This has been a struggle to say fun when talking about... But, you know, take it or leave it. As much fun as syphilis can be.

Exactly, exactly. Thank you for listening. And thank you so much to Catherine for joining me. And if you like what you heard, don't forget to like review and follow along whatever it is you get your podcasts. Coming up, find out how filthy Leonardo, Da Vinci, Michelangelo and Machiavelli would have been in the Renaissance period. And if you'd like us to explore a subject or if you just wanted to say hello, then you can email us at betwixt at historyhit.com. This podcast was edited by Tim Arstall and produced by Sophie G. The Senior Producer was Freddie Chick.

Join me again, Betwixt the Sheets, The History of Sex Scandal and Society, a podcast by History Hit. This podcast contains music from Epidemic Sound.