The Horrible History of Gonorrhoea

Summary

Betwixt The Sheets: The History of Sex, Scandal & Society
Episode Summary: "The Horrible History of Gonorrhoea"
Release Date: April 1, 2025
Host: Kate Lister
Guest: Kat Irving, Human Remains Conservator at Edinburgh's Surgeon Hall Museum

---

Introduction

In this gripping episode of Betwixt The Sheets, host Kate Lister delves into the unsettling history of gonorrhea, one of humanity's oldest and most persistent sexually transmitted infections (STIs). Joined by returning guest Kat Irving, a human remains conservator, the discussion navigates through the disease's origins, societal impacts, historical treatments, and the looming threat of antibiotic resistance.

---

Understanding Gonorrhea

Kate Lister opens the conversation by framing gonorrhea not just as a modern health concern but as a longstanding affliction with deep historical roots. She introduces Kat Irving, who explains her role at the Surgeons Hall Museums in Edinburgh:

Kat Irving [06:19]: "I work at Surgeons Hall Museums in Edinburgh, where I look after a collection of about 10,000 human remains, which range from full skeletons down to teeny tiny ear ossicles and literally everything in between."

What is Gonorrhea?

Gonorrhea is a sexually transmitted disease that has plagued humans for centuries. Kat provides a historical context:

Kat Irving [07:10]: "Gonorrhea is a sexually transmitted disease. It's been around for a long time. There's a mention of gonorrhea in the Bible, where it’s suggested that a running issue out of the flesh indicates uncleanness, possibly referencing gonorrhea’s symptom of pus discharge in men."

She further clarifies that gonorrhea is caused by bacteria, distinguishing it from syphilis, which is caused by a spirochete.

---

Historical Perspectives

Early Mentions and Legal Responses

Gonorrhea's historical presence is documented as far back as 1161 in England, where laws were enacted to curb its spread:

Kat Irving [12:12]: "In 1161 in England, laws were passed to stop the spread of the perilous infirmity of burning," referencing gonorrhea.

These laws primarily targeted women, reflecting a longstanding societal tendency to blame women for the spread of STIs.

Misogyny and Disease Blame

Kate and Kat discuss the pervasive misogyny intertwined with the history of gonorrhea:

Kat Irving [12:28]: "They blame the women for it."

Kate Lister [13:04]: "You can see this throughout the entire history of sexually transmitted infections that they are blaming badly behaved women."

This blame was partly due to the less obvious symptoms in women, making it easier to stigmatize female carriers.

---

Treatments Through the Ages

Mercury and Silver: Early Remedies

Before the advent of antibiotics, treatments for gonorrhea were both harsh and ineffective. Kat details the use of mercury and silver in historical treatments:

Kat Irving [15:35]: "Early treatments were mercury, as we talked about with syphilis. Another treatment was silver, particularly silver nitrate, used in solutions or solid forms like lunar caustic."

These treatments often involved painful procedures, such as introducing silver compounds into the urethra or applying calomel (a mercury-containing substance) to affected areas.

The Clap: Origin of the Term

The colloquial term "the clap" has several proposed origins. Kat outlines the most plausible theories:

Kat Irving [14:08]: "Some people think it's from the medieval red light district in Paris, which was called Le Clapier... Others believe it refers to the clapping sensation during painful urination."

Dr. Charles Bell and Urethral Strictures

In Edinburgh’s collection, numerous specimens exhibit urethral strictures caused by gonorrhea. Kat explains:

Kat Irving [28:13]: "We have shelves of penises with strictures, which are narrowings of the urethra due to scar tissue from infection."

Dr. Charles Bell's pioneering work involved treating these strictures using instruments like the bougie, a device designed to widen the urethra, often accompanied by the application of caustic substances to remove obstructions.

---

Impact on Society and the Military

Gonorrhea in Wartime

During both World Wars, gonorrhea significantly impacted military effectiveness. Kat reveals:

Kat Irving [16:01]: "Sexually transmitted diseases were a major problem with soldiers. Hundreds of thousands of man-hours were lost because people had to be discharged due to infections like gonorrhea and syphilis."

Punitive Treatments

Treatments were not only medically invasive but also punitive, aiming to humiliate and deter soldiers from contracting STIs:

Kat Irving [21:13]: "During the Second World War, soldiers were subjected to treatments where their penises and testicles were covered in calomel lotion and wrapped in wax paper."

These methods were brutal and often did little to effectively treat the infections, instead serving as a form of punishment and deterrent.

---

Modern Day Issues: Antibiotic Resistance

Rising Cases and Resistance

In recent years, gonorrhea cases have surged, with Europe experiencing a more than 300% increase since 2014. The critical issue now is antibiotic resistance:

Kat Irving [10:53]: "Gonorrhea is getting worse. Cases are on the rise, and it's becoming very, very antibiotic-resistant."

With only one effective antibiotic remaining, the threat of untreatable gonorrhea looms large.

Contributing Factors to Resistance

Several factors contribute to this resistance, including the transfer of resistant genes from throat bacteria to gonorrhea bacteria:

Kat Irving [11:20]: "Gonorrhea has had a relationship with other bacteria in the throat, so they've passed some of their resistant genes over. We're getting more and more antibiotic resistance."

Demographics Affected

Interestingly, the largest spike in gonorrhea cases is now among individuals over 60:

Kat Irving [27:19]: "The over 60s are seeing the largest spike. They don't have to worry about pregnancy, so they might be more relaxed about infection prevention."

---

Future Prospects and Research

Potential for a Vaccine

Despite the grim outlook, there is hope in the development of a gonorrhea vaccine:

Kat Irving [32:26]: "There's hope now that we can maybe find a vaccine. You give it to everyone at a certain age in school, and we'll all be okay."

Research on Antibiotic Resistance

Ongoing research aims to combat antibiotic resistance, but the path forward remains uncertain. Without effective treatments, society may face a resurgence of gonorrhea's historical horrors, including severe health complications and societal stigma.

---

Conclusion

Kate Lister and Kat Irving conclude by reflecting on the lessons learned from gonorrhea's history:

Kat Irving [32:59]: "Don't blame women for everything. There’s also the cautionary tale of John Hunter, who may have inadvertently infected himself with both gonorrhea and syphilis through flawed experiments."

The episode underscores the importance of responsible scientific research, gender equality in health discourse, and the urgent need for advancements in medical treatments to prevent gonorrhea from reverting to its historically devastating state.

---

Final Thoughts

This episode of Betwixt The Sheets serves as a stark reminder of the enduring challenges posed by sexually transmitted infections. Through riveting discussions and historical insights, Kate Lister and Kat Irving illuminate the dark past and precarious present of gonorrhea, urging listeners to recognize the importance of medical innovation and societal responsibility in combating this age-old disease.

---

Notable Quotes:

• Kat Irving [06:19]: “I look after a collection of about 10,000 human remains... a lot of these show various types of diseases.”

• Kate Lister [24:05]: “What have you done now in theaters the Chosen Last Supper get your tickets now.”

• Kate Lister [32:59]: “Don't blame women for everything.”

---

For More Information:

• Kat Irving: Follow her on Bluesky Instagram as @anatomical_Katie and visit Surgeons Hall Museums to explore their extensive human remains collection.

• Subscribe to History Hit: Access hundreds of original documentaries and ad-free podcasts at historyhit.com/subscribe.

---

Produced by:
Tom Delaghi (Editor)
Sophie G. (Producer)
Charlotte Long (Senior Producer)

Music by: Epidemic Sound

Transcript

[Kate Lister]

Hi, I'm your host Kate Lister. If you would like Betwixt the Sheets ad free and get early access, sign up to History Hit with a History Hit subscription. You can also watch hundreds of original documentaries with top history presenters and enjoy a new release every single week. Sign up now by visiting historyhit.com subscribe.

[Josie Santee]

Josie I'm Josie Santee, health coach, wellness editor and host of the Every Girl podcast where we cut through the noise with realistic, expert backed advice to help you thrive in every category of life while still loving the person that you already are. And part of loving yourself is being really authentic to you, including the clothes you wear. In partnership with Nordstrom, we're helping you update your spring wardrobe so your style is fit for your best self. Nordstrom brings you the season's most wanted brands like Skims, Mango Free People and Princess polly, all under $100. From trending Sneakers to beauty must haves, we've curated the styles that you'll wear on repeat this spring. Free shipping, free returns and in store pickup make it easier than ever. Shop now in stores [e-mail] Let me.

[Kat Irving]

Tell you the guy It's Holy Week.

[Kate Lister]

In Jerusalem and the city is rest. The people of Israel welcomed Jesus as king, his followers ready for revolution. But instead of taking the throne, Jesus turns the tables. Woe to you scribes and Pharisees.

[Kat Irving]

How will you escape being condemned to hell?

[Kate Lister]

Experience Holy Week like never before. What have you done now in theaters the Chosen Last Supper get your tickets now.

[Aura]

This podcast is brought to you by Aura. Imagine waking up to find your bank account drained, bills for loans you never took out, a warrant for your arrest, all because someone stole your identity. Hackers aren't waiting. Why are you? That's why we're thrilled to partner with Aura. Your personal data is a goldmine for hackers, and Aura helps lock it down. Aura monitors the dark Web, blocks data brokers from selling your information. Includes a VPN for private browsing and a password manager to secure your accounts before criminals break in. For a limited time, Aura is offering our listeners a 14 day free trial plus a dark web scan to check if your personal information has been leaked. All for [e-mail] safety. That's Aura.com safety to sign up and start protecting yourself and your loved ones. That's a U r a.com safety terms apply. Check the site for details.

[Kate Lister]

Hello my lovely betwixters. It's me, Kate Lister. This is Betwixt the Sheets. I am me, you are you, and I bet you know what's coming next. Here it is, the fair do's warning. This is an adult podcast spoken by adults to other adults about adulty things in an adulty way, covering a range of adult subjects. And you should be an adult, too. We are actually talking today about the history of gonorrhea. Okay, so it's a spicy one, but really this is more of a stomach warning. Like if you are listening to this and you're about to have, you know, some cheese on toast or possibly a pizza or a pasta dish, I don't think that this is going to go very well with it. So I would just give us a miss if I were you. Or at least for finish the food first. Right. On with the show. A battle is burning, literally burning across the world. The enemy has brought down many armies, indiscriminately scandalized communities for centuries and generally wrought havoc. And now it's getting even stronger to the one weapon we have that can defeat it. That's right. It's gonorrhea. What do you look for? A man.

[Kat Irving]

Oh, money.

[Kate Lister]

Of course. You're supposed to rise when an adult speaks to you. I make perfect copies of whatever my boss needs by just turning a knob and pushing the button. Yes, social courtesy does make a difference.

[Kat Irving]

Goodness, my beautiful dance. Goodness has nothing to do with it doing.

[Kate Lister]

Hello, and welcome back to Betwixt the Sheets, the history of sex scandal in society with me, Kate Lister. Cases of the sexually transmitted infection gonorrhea are surging across the world. In Europe, there has been an increase of more than 300% since 2014. And to make that even scarier, gonorrhoea is now becoming antibiotic resistant. There's only one antibiotic left that works, and that's starting to fail us. That is some scary shit right there. But when was gonorrhoea first recorded? How long has it been with us? Why do we call it the clap? And what bonkers treatments have been used to try and get rid of it over the years? Well, we are going to find out today with returning guest and all round badass Kat Irving, the human remains conservator from Edinburgh's Surgeon Hall Museum. All right, let's get those gloves on and get into it. Hello, and welcome back to Betwixt the Sheets. It's only Cat Irving. How are you doing?

[Kat Irving]

I'm very well. How are you, Kate?

[Kate Lister]

I am doing fabulously. The last time I saw you, we bumped into each other at an airport, didn't we?

[Kat Irving]

Yeah, Naples airport at an ungodly hour in the Morning.

[Kate Lister]

I was so tired that day, I half thought that you might have been some kind of sleep deprived hallucination, just wandered through the airport.

[Kat Irving]

I don't think I'd done anything to my hair or sort of like, you know, washed makeup out of my face at that point. So, you know, it wasn't a good time for me.

[Kate Lister]

You looked fabulous to me. But had I been a bit more altogether and not running empty, I might well have sat you down and spoken to you about the very topic we're talking about today, which is the history of gonorrhea. Just for our listeners, just tell us about some of the work that you do so they know who you are because it's so interesting and so fabulous.

[Kat Irving]

Well, I am a human remains conservator. I work at Surgeons Hall Museums in Edinburgh, where I look after a collection of about 10,000 human remains, which ranges from full skeletons down to teeny tiny ear ossicles and literally everything in between. And a lot of these show various types of diseases. And that's how I became very, very interested in a lot of different types of pathologies and how it presents itself on the body.

[Kate Lister]

It's an amazing museum. And we were doing some filming up there with history hit, and it was all they could do to actually get me in front of the camera and actually do the proper work. Because I was just running around. I just wanted to look at everything. I was like, there's a leg over here with a bullet in it. Somebody's ear is, oh, my God. It's absolutely wild. But we're talking about gonorrhea today. So I suppose the first thing I should ask you is a really starter question. What is it? What is gonorrhea?

[Kat Irving]

Gonorrhea is a sexually transmitted disease. It's been around for a long time. I mean, there are thought that there's a mention of gonorrhea in the Bible, and the Lord spake unto Moses and to Aaron, saying, speak to the children of Israel and say to them, when a man hath a running issue out of his flesh, because of his issue, he is unclean. And so some people have suggested that the running issue is gonorrhea, because one of the symptoms of gonorrhea in a man is that you produce pus out of your penis. So they thought that that's what they were talking about here.

[Kate Lister]

Wow.

[Kat Irving]

And Galen, a doctor from about 200 AD, he actually gives us the term gonorrhea and he says it's an involuntary escape of semen. So he's describing the pus.

[Kate Lister]

Okay.

[Kat Irving]

Gonorrhea actually means flow of seed.

[Kate Lister]

Nice, nice. Now, we have spoken to one another about syphilis on a few occasions and I remember everything that you said. But I definitely remember when you said it's a spirochete and that the actual bacteria that causes it is quite pretty. What is gonorrhea? Is that a spirochete as well?

[Kat Irving]

It's not a spirochet, it is a bacteria. But it doesn't have that pretty shape, of course, when you find out at the end of the 19th century about the bacteria itself. So, you know, at this point they've got no idea what's actually causing it. In fact, you know, these things that they're describing as gonorrhea in, you know, possibly in the Bible, possibly by Galen, they may actually be something else.

[Kate Lister]

So whatever, it's old, it's sexually transmitted. Can women get it too? How does it present in women?

[Kat Irving]

Women get it too. Sometimes you will get a discharge as a woman, not always. So it doesn't tend to be as obvious, you know, for women, the things tend to be a bit less so, a bit less showy, shall we say. So you might feel a sort of pain during sex. You might get pain in the bottom of your abdomen. Sometimes you have difficulty peeing, but less commonly than in men. And of course, in the long term it can cause things like pelvic inflammatory disease, which can then affect your fertility, but not things quite so obvious as in men.

[Kate Lister]

So it can cause pelvic inflammatory disease. Is this a disease that will clear up of its own accord without. I'm presuming that the course of treatment now is an antibiotic, but if you don't have that, as they didn't in the past, is it something that will run its course and go away? Or is it like syphilis? Once it's there, it's fucking there.

[Kat Irving]

It's not like syphilis, you know, it's not as bad as syphilis. And later on we can talk about some of the ways that it presents in surgeon's whole collection, which is different to syphilis, but in the long term, you know, if it doesn't clear up, if you don't have treatment, it will clear up. You know, it's infection, it's not getting deep inside you like syphilis does. But in women, as I say, pelvic inflammatory disease, it can cause long term problems with, you know, sort of periods, things like that, your fertility. In men, it can cause something called stricture. Of the urethra. It's basically scarring along the urethra, which can cause problems with peeing. And obviously, if you have problems with peeing, then that can have other backup issues. Literally backup issues because urine isn't coming out the bladder. So you can get bladder stones. You know, there are possibilities, if it's really severe, that your bladder will actually burst.

[Kate Lister]

Oh, that's horrible. Is gonorrhea one of the ones that makes it sting to pee, or is that something else?

[Kat Irving]

Yes, it will sting to pee. As I say, it doesn't happen in all cases, but a lot of cases you do get that women less so. But sometimes.

[Kate Lister]

And it's still with us today, isn't it? Gonorrhea? It's still very common.

[Kat Irving]

It's still very common, and it's getting worse.

[Kate Lister]

Really?

[Kat Irving]

Yeah. Cases are on the rise. In 2023, they had the highest recorded numbers of gonorrhea cases since records began in 1918. And that's incredible, because one of the problems is that while we can treat it with antibiotics now, it's becoming very, very, very antibiotic resistant.

[Kate Lister]

I've heard of that. Yeah. There was a case in Leeds of antibiotic. They call it super gonorrhea, didn't they?

[Kat Irving]

Yes. And that's become increasingly prevalent. So a lot of the antibiotics, things like penicillin that were used to treat gonorrhea don't do anything now. You know, they're not having the same effect. And one of the things with that is that gonorrhea's kind of had a little bit of relationship with other bacteria in the throat, so they passed some of their resistant genes over. So, yeah, we're getting more and more antibiotic resistance and gonorrhea.

[Kate Lister]

Shit. Oh, dear. Yeah. Wrap up, everybody, Wrap up. It is one of the oldest recognized sexually transmitted diseases, isn't it?

[Kat Irving]

Yeah. I mean, the first real mention, you know, I've said about some of those ancient things. In 1161 in England, you actually get laws which are passed to stop the spread of the perilous infirmity of burning. So again, that's. That's gonorrhea in law in 1161. France passes similar laws a bit later.

[Kate Lister]

What kind of things were these laws stopping people doing?

[Kat Irving]

Well, that's. That's quite interesting because it seems very vague what's going on.

[Kate Lister]

Just stop doing it.

[Kat Irving]

Yeah, yeah. Effectively, we're recognizing it's coming from sex, you know, largely that they're blaming the women for it.

[Kate Lister]

I was just about to ask you that.

[Kat Irving]

Yeah, yeah, of course, yeah. And especially once you get into World War I and World War II. You know, it's all terrible women that are causing our good soul not being able to fight again. Syphilis and gonorrhea, the same thing throughout history. It's women's fault.

[Kate Lister]

It's women's fault. So they have this idea. I'm not sure if this is the idea. Did they understand that it can be spread by both men and women or did they just have this idea of. It's the women who. I'm trying to like, understand what the joined up thinking is around this. Did they think that only women could spread it? Or like, what was that?

[Kat Irving]

Yeah, I mean, I think there was something because women weren't showing symptoms in the same way that men were. You know, they would sometimes have a bit of difficulty with peeing and things like that. But it's not as obvious, you know, the things that are going on they could often attribute to other things. It's not like all of a sudden you have sex and then you've got a big swollen pussy penis. So which that seemed very much like, oh, well, you went to this woman and then this is the problem. So there was. There was definitely. They could see something going on there.

[Kate Lister]

And you can see this throughout the entire history of sexually transmitted infections that they are blaming badly behaved women. And I've often looked at it and thought, like, there's always a rationale, even if it's a bonkers one, even if it's deeply misogynistic and completely off the chart. There's some way that they've rationalized this. And I think it's just that they blame women more for it. But like, as you've just said, maybe if they're not as symptomatic, that would actually make a bit more sense, wouldn't it? All right, so let's talk treatment then. So you've got gonorrhea. Give me some of the names for it as well. This is the one that's known as the clap, isn't it?

[Kat Irving]

The clap, yeah. And there are a couple of theories about why it's known as the clap.

[Kate Lister]

I bet all of them are horrible.

[Kat Irving]

Some people think it's from the medieval red light district in Paris, which was called Le Clapier, which rabbit holes from lots of small huts which sex workers were working out of. So some people think that's why it's called the clap. You know, you went to Le Clapier, you got this problem.

[Kate Lister]

That would make sense.

[Kat Irving]

Yeah. Some people think it's from the feeling that you got as you tried to pee. You know, you were trying to pee and you just got this kind of clapping sensation.

[Kate Lister]

Yeah, okay.

[Kat Irving]

But the one that does, even with the fact that I don't have a penis, that makes me sort of squeeze my legs together a bit, is the idea that, you know, to get rid of that pu. That you were producing your penis, what you did, you clapped.

[Kate Lister]

Oh, no. Yeah, you clapped the penis in between your hat. Oh.

[Kat Irving]

Some people say closing a book on.

[Kate Lister]

It, Kat, I'm not medical, but that's not gonna work, is it?

[Kat Irving]

I feel that that's gonna make things worse in many ways.

[Kate Lister]

Do you know who came up with that? That is the wife of somebody who's gone out and got a dose. And I totally read about this. This is what I've got to do. Put it in this book.

[Kat Irving]

We'll just do this. They'll be fine.

[Kate Lister]

You'll be ok. Oh, that is brutal. All right, so the clap. How might you have treated it? What were some of the cures? Not that they were cures, but what would they have done for you?

[Kat Irving]

Well, for a long time, there was a lot of debate whether gonorrhea and syphilis were actually the same thing. A lot of treatments, a lot of early treatments were mercury, you know, as we talked about with syphilis. And obviously mercury has its own problems, you know, and the Mary Rose, the ship, there are syringes that they think, well, for putting mercury into the penis of some of the sailors.

[Kate Lister]

Nice.

[Kat Irving]

That was one of the treatments. Another treatment was silver, particularly. Once they start to realize that syphilis and gonorrhea are actually different things, they will tend to use mercury more for syphilis and silver for gonorrhea. And at first it's silver nitrate. And you could have this as a sort of solution. You might drink it, you might bathe your genitalia in it. There was also a solid form of it and solid sil. It was often called lunar caustic. And that word caustic should give you the impression that this is not good. So lunar caustic would also be used for things like burning off warts. And you could introduce this into the urethra itself.

[Kate Lister]

So there's a lot of stuff going down urethras with injections, and that's going to get worse.

[Kat Irving]

Don't worry. Kate.

[Kate Lister]

Oh, God can. I'm endlessly fascinated by this one, and I'm pretty sure I've asked you this before, but like, mercury was used for Syphilis and gonorrhea for centuries. And obviously it doesn't work. We don't use it today. It doesn't work. But what did it do that made people think that it worked? Or was it just like they made a mistake for hundreds of years? Because I kind of think it must have done something that at least created the illusion it was helping somehow.

[Kat Irving]

Well, mercury does have an antimicrobial effect, so if you got it at the right time, you might be able to kill those bacteria off. But there's also the fact that, like we talked about with syphilis, syphilis has a period where you have a chancre and the chancre will just go away of its own accord. But that doesn't mean that the bacteria has gone away. So you might put some of this mercury onto your chancre and then it disappears and you go, oh, well, that's it. That's it done.

[Kate Lister]

Yeah.

[Kat Irving]

Put a mercury lotion on it and then that goes away. Oh, I'm fine now. And then you don't associate the symptoms you get much later with what happens, you know, five years ago after you just, you know, after you've been having sex.

[Kate Lister]

Silver's a weird one, isn't it?

[Kat Irving]

Silver. Silver's really, really interesting because silver's actually become a bit of a kind of an alternative therapy again today, was it? Yeah. So, you know, since the 1990s, there have been people who've been using colloidal silver for various things.

[Kate Lister]

Oh, this is ringing a bell, actually. Yeah.

[Kat Irving]

I went to get some eye drops for my dog recently, and we were in the car on the way back and my husband was. Was looking at the bottle and he was saying, oh, these have got silver in them.

[Kate Lister]

Okay.

[Kat Irving]

It does have, again, an antimicrobial effect. It will kill bacteria to a certain extent. But one of the other things about silver is that you actually have no use for it in your body. You know, it's not a thing that your body uses. It's not a thing you take in. It's also not a thing that your body has any way of excreting.

[Kate Lister]

Right.

[Kat Irving]

You know, you have your. Your pint of lager or whatever, your body metabolizes that through your liver and you get rid of the waste products. Your body has ways of getting rid of most things silver. It doesn't. The kidneys don't do anything. The liver don't do anything. So it builds up, and if you have a buildup of silver in your body, it deposits in various places and various membranes around the body and it starts to take on a sort of slate gray, bluish appearance. So if you have long term chronic exposure to silver, it can actually turn you blue.

[Kate Lister]

That's not the desired effect, is it?

[Kat Irving]

No. And this is permanent. There's no way of getting rid of it.

[Kate Lister]

Blue forever.

[Kat Irving]

Forever. So we have a kidney here in surgeon's hall, which is from somebody. It just says that they had been taking silver medicinally for some time. I'm going to imagine that some sort of sexually transmitted disease treatment, though we don't have that specified, but you can see it's got that bluish tinge to it. And if you go online, if you Google it, you will see people who have taken silver for the long term with blue skin.

[Kate Lister]

Was it just used to treat venereal disease or is silver being used to treat other stuff?

[Kat Irving]

It was used as a sort of a kind of generic treatment, but it really was like thought to be the thing for gonorrhea in the 19th century. In the late 19th century, a German scientist comes up with a new form of silver medicine, a silver protonate. And that becomes the standard treatment for gonorrhea until we get antibiotics. Being used widely in the 1940s. And a really, really interesting thing is that sexually transmitted diseases were a major problem with soldiers. Both the First World War and the Second World War, hundreds and hundreds of thousands of man hours were lost because people had to be discharged. Again, double entendre there. Discharged because of having sexually transmitted diseases. And one of the sort of prophylactic things they did during the Second World War, if there was sort of like anything that you'd done which might result in you having gonorrhea was that you would have this silver proteinate injected into the urethra and then you'd entire penis and testicles covered in calomel lotion. Calomel contains mercury. And then you would wrap the whole thing in wax paper, basically like baking paper. Whether or not this is having an effect, I mean, that's kind of second to the fact that everyone is going to know what you've been up to because you're going to have a crinkly cock. You know, that's going to. As you move around, people are going to know.

[Kate Lister]

Oh, going. I read a description of how they treated. It was one of these cephalus organorae or something in them. I think it was the First World War and it was that. I didn't read about the wax paper. That's new information. But it was that they basically filled the bladder with Disinfectant and water, which they injected through the urethra as well.

[Kat Irving]

Yeah, they really liked it to be warm water as well, like sort of 50 degrees. So, you know, that's going to be an added level of discomfort. The greater quantity that you could get up them, the more successful they thought this treatment would be.

[Kate Lister]

You can see now because when you hear statistics like over 50% of men fighting on the front had to take time away for an sti, probably our friend gonorrhea or syphilis, you kind of think, like, why? What were they doing? And I guess it's because they were lying in hospital being subjected to this.

[Kat Irving]

Yeah. I mean, it's awful, isn't it? You know, it feels like some form of torture in so many ways.

[Kate Lister]

I bet it was punitive as well. On purpose, though.

[Kat Irving]

Yes. Yeah, I definitely think there was that element as well.

[Kate Lister]

It would have been done to humiliate people, too, to stop them from doing it.

[Kat Irving]

Yeah. I mean, yeah, you kind of think that again, sort of the idea of having to go through this is going to put you off more, isn't it? It's. It's going to kill any. Any desire.

[Kate Lister]

I'll be back with Cat and gonorrhea after this short break.

[Kat Irving]

Nordstrom brings you the season's most wanted brands. Skims, Mango Free People, and Princess polly, all under $100. From trending Sneakers to beauty must haves, we've curated the styles you'll wear on repeat this spring. Free shipping, free returns and in store pickup. Make it easier than ever.

[Holly Fry]

Shop now in stores [e-mail] Our Skin Tells a story. Join me, Holly Fry, and a slate of incredible guests as we are all inspired by their journeys with psoriasis. Along with these uplifting and candid personal histories, we take a step back into the bizarre and occasionally poisonous history of our skin and how we take care of it. Whether you're looking for inspiration on your own skincare journey or are curious about these sometimes strange history of how we treat our skin, you'll find genuine, empathetic, transformative conversations here on our skin. Listen to our skin on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

[Kate Lister]

What. When do we start getting antibiotics and penicillin and things that can actually tackle this properly? And how does that have any kind of impact on soldiers? Cause that seems to have been a really, really big concern, and that's what was driving medical advancement, it seems to me. Is nations around the world going, we've got to keep soldiers Fighting fit. They can't be taking time off because they've got a droopy willy.

[Kat Irving]

I mean, there were huge campaigns, as I said, trying to keep the soldiers away from dangerous women in scare quotes.

[Kate Lister]

Fast women, loose women.

[Kat Irving]

Yeah. But in the 1920s, Alexander Fleming discovers penicillin. But the problem at that point is, you know, they recognize its potential, but there isn't a way of mass producing it. Got this idea, but they don't really know what to do. So it's only really in 1940s, you know, the beginning of the 1940s, they start to get methods of making more and more penicillin. So the very first uses of penicillin were actually to try and treat syphilis and gonorrhea for soldiers. And then after the war, when that's not the priority, it starts to get rolled out to the general public.

[Kate Lister]

Yeah, and it works, doesn't it? It is the much fabled silver bullet. And when you think of what people have been going through before, I mean, you know, just to go back briefly to the horrendous description of young lads lying in hospital beds having their bladders filled full of disinfectant and then their willy wrapped in, what was it, wax paper and chamomile lotion. And, like, the idea that you can.

[Kat Irving]

Just take a pill, it must be amazing. Yeah. I mean, you said silver bullet. It's better than that silver bullet that you had the opportunity to stick up your knob and burn things out. So it's. It's definitely, definitely the improvement.

[Kate Lister]

And how long does it last? Because I often think, like, maybe I'm oversimplifying things, but it seems like there was this brief period of about 10 years when HIV hadn't arrived. All STIs could be treated effectively with a dose of antibiotics. The pill turns up, so now you can have. There must have been just like a brief period where it was like, oh, my God, we can just fuck each other. This is amazing. Doesn't last how long until they start noticing antibiotic resistance coming through.

[Kat Irving]

Antibiotic resistance really starts to become a problem by the time you're getting to the end of the 20th century. So they're starting to get less and less antibiotics, which have the potential to sort out. And at first that's not too much of a problem because you're getting less STIs in general because, you know, there's no treatment for HIV aids, so people are being a wee bit more careful with things. So the spread of STIs does drop, but, you know, now we've got good treatments for HIV and AIDS, we've got PrEP, things like that. People start to be a bit less cautious and that's driving this rise with gonorrhea and syphilis.

[Kate Lister]

And largely. Well, it's not a favorite fact because it's not a good thing, but one of the demographics, seeing the largest spike in it are the over 60s.

[Kat Irving]

Yeah, I mean, that's it, isn't it? You know, at that point you. You don't have to worry about the pregnancy thing. So you over think that's it.

[Kate Lister]

So in your specimen collection in Edinburgh, what items have you got that you said that you've got? Blue kidneys. What else have you got that is from the history of gonorrhea? What? Give us a horrible description.

[Kat Irving]

Yeah, well, it's really interesting because obviously, you know, you've came up here and I've shown you some of the remains that we have which show syphilis. And syphilis looks horrific and you can see it on almost every part of the body. You know, we've got sort of palates, you know, in the mouth where they've got holes in, we've got big swollen bones, we've got skulls with huge ulcers, things like that. It's horrific and it's really dramatic on the body. What we have with gonorrhoea is shelf upon shelf upon shelf of penises with strictures.

[Kate Lister]

What's a stricture? Kat, tell us what a stricture is.

[Kat Irving]

This kind of narrowing of the urethra that stops you being able to pee and it's effectively kind of sort of scar tissue building up because of the infection. And we have a doctor called Charles Bell, he was an Edinburgh boy, but he ends up doing a lot of his work down in London and he became really, really interested in stricture of the penis. So a lot of the examples and as I said, we have a lot. I think. I think it's something like 47.

[Kate Lister]

It's a lot of penises in jars. It's amazing.

[Kat Irving]

Yeah, just as I say, just shelves of them. It feels like they go, you know, like it's just. You're just confronted with a wall of them in one particular portion of the store. He's really interested in this condition. In fact, he writes a book about it. A treata is on diseases of the urethra, the vesica urinaria, which is the bladder, the prostate and the rectum. And when it comes to stricture of the penis, he says the most common cause is gonorrhea. Though he does say that there might be a few other things that causes it. You know, if you have injury to the penis or something like that. This book's also got some really horrific chapter titles. Like, there's one of them, which is Symptoms to Be Dreaded as Indicating a bursting of the urethra.

[Kate Lister]

Oh, my God.

[Kat Irving]

And effectively, what he says is that things you really need to be worried about in case your urethra is going to burst is, you know, if you try really hard to pee and only a few drops come out, if the urine feels scalding hot. And then he says if you put your legs together and you feel like there's a tumour there, even though there isn't a tumour, this is the point when you've got to be worried about your urethra bursting.

[Kate Lister]

And what would they do for that? What would Dr. Bell have done for that?

[Kat Irving]

Well, you're the typical instrument in your fight against the urethral stricture is something called a bougie.

[Kate Lister]

Doesn't sound good.

[Kat Irving]

It's not. Takes its name from a pot in Algeria, and this pot was known for producing a really fine wax.

[Kate Lister]

I knew it.

[Kat Irving]

Bougie is actually the French word for candle. And so one of the main ways that you get this instrument is from a thread that's been dipped in some wax to make a sort of rod which you can adjust the thickness of, which would also be a little bit flexible. So you can probably see literally where this is going. So this would be something that you could. You could take various thicknesses and introduce them up to try and clear any blockages.

[Kate Lister]

And would that work?

[Kat Irving]

Well, I mean, you know, you can push things out of the way, you can get something so that the urine can actually flow. But of course, there is the possibility that as you're doing that, you're causing more scar tissue, which is then going to cause further problems down the line. And, of course, with this bougie, you could wrap it in linen so that you could then soak this in medicine. And I'm going to again, use scare quotes for medicine so that you can then stick that up to deliver the medicine to the correct place. The common medicine that was used was something called caustic. And again, this was something that you would literally burn the stricture away with. And this could a lunar caustic that we talked before, or it could be basically potassium hydroxide, which is a very strong alkaline. So, again, literally burning away anything that's gonna stop that urine from getting out.

[Kate Lister]

See, I Thought that when we were gonna come and talk about gonorrhea it would be like, yeah, it, you know, gives you a bit of a delay called maybe there's a bit of discharge. But like the long term effect of this is incredibly serious. Yeah, that is grim. Which brings me to talk about. We've got to talk about the future of Godaway then, because it's becoming antibiotic resistant, as you said, I think. Well, you can tell me, but is there only one type of antibiotic that is now effective against gonorrhea?

[Kat Irving]

Yeah, that's exactly it. There's only one type of antibiotic that can be used and even that is starting to have limited effects with certain cases. So there is a possibility that in the not too distant future we may have no treatment whatsoever.

[Kate Lister]

Like nothing at all.

[Kat Irving]

Yeah. And we may be going back to these times of having to catheterize people, things like that.

[Kate Lister]

If there are problems, there must be people researching this, Researching antibiotic resistance.

[Holly Fry]

Yeah.

[Kat Irving]

I mean, there's hope now that we can maybe find a vaccine. You give it to everyone at a certain age in school and we'll all be okay. So that would be a great, great thing.

[Kate Lister]

That would be, wouldn't it? But we are actually facing a future where there might be no treatment and this disease can be doing the horrible things that it's done in the past once more. So let everybody wrap up. Make sure that you're wearing condoms and just behave yourselves. As a final question, Cat, what do you think we have got to learn from the history of gonorrhea that is useful for us going forward?

[Kat Irving]

Oh, well, you know, I mean, I think the idea is don't blame women for everything. That's a good one when you're looking at these histories of STDs because that has been a common thing. There's an interesting story which I think is quite nice about gonorrhea, about John Hunter, the surgeon. He thinks that syphilis and gonorrhea are the same thing. So he experiments, he gets some gonorrhea pus and he introduces it onto a penis of somebody who doesn't have either syphilis or gonorrhoea. One on the foreskin, one on the glans. He thinks that where you're infected, that's what's going to affect whether you get syphilis or gonorrhea. And he discovers that the result is you get both. So he thinks this is proving that they're the same thing. It turns out that the person likely just had Both diseases.

[Kate Lister]

Oh God.

[Kat Irving]

Of course there is the question as well. Did he actually do this to his own penis?

[Kate Lister]

It sounds like something he would do, the amount that I know about this man.

[Kat Irving]

Yeah. So there's a chance that he did give himself both syphilis and gonorrhoea. So again, I think the idea of being slightly careful about your scientific experiments is a good lesson when you're looking at gonorrhea.

[Kate Lister]

Cat, you have been horrifying but marvellous as always. And if people want to know more about you and your work, where can they find you?

[Kat Irving]

You can find me on bluesky Instagram as anatomical Katie and you can find links from there to my website and.

[Kate Lister]

Go and see the museum collection because it is just, it's just absolutely mind blowing. But don't do it when you've got a hangover. That is not a good place to be. Thank you so much for coming to talk to us. You've been fabulous. Thank you.

[Kat Irving]

It's a pleasure as always to talk to you, Kate.

[Kate Lister]

Thank you for listening and thank you so much to Kat for joining me. And for those of you that are still listening to this, well done for getting through that. If you were impressed by what you heard, then maybe you could like review and follow along wherever it is that you get your podcasts. If there's another subject you'd like us to explore or if you just wanted to say hello, then you can email [e-mail] this podcast was edited by Tom Delaghi and produced by Sophie G. The senior producer was Charlotte Long. Join me again betwixt the Sheets for History of Sex Scandal in Society, a podcast by History Hit. This podcast contains music from Epidemic Sound.

[Josie Santee]

I'm Josie Santi, health coach, wellness editor and host of the Every Girl podcast where we cut through the noise with realistic, expert backed advice to help you thrive in every category of life life while still loving the person that you already are. And part of loving yourself is being really authentic to you. Including the clothes you wear. In partnership with Nordstrom, we're helping you update your spring wardrobe so your style is fit for your best self. Nordstrom brings you the season's most wanted brands like Skims, Mango Free People and Princess polly, all under $100. From trending sneakers to beauty must haves, we've curated the styles that you'll wear on repeat this spring. Free shipping, free returns and in store pickup make it easier than ever. Shop now in stores [e-mail] Our Skin Tells a story.

[Holly Fry]

Join me Holly Fry and a slate of incredible guests as we are all inspired by their journeys with psoriasis. Along with these uplifting and candid personal histories, we take a step back into the bizarre and occasionally poisonous history of our skin and how we take care of it. Whether you're looking for inspiration on your own skincare journey or are curious about the sometimes strange history of how we treat our skin, you'll find genuine, empathetic, transformative conversations here on our skin. Listen to our skin on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.