A “queer” examination in Paris
Published on 24 January, 2024
In November 1824, Anne Lister consulted a renowned Parisian surgeon, Guillaume Dupuytren, hoping to cure a venereal disease. This kind of visit – and examination – was one that most 19th-century women were reluctant to undergo.
“Absolutely told Mrs. Barlow of being venerealized”¹, Anne Lister’s diary index reads on the 26th of November 1824. As she was “lovemaking” with her fellow pensioner at 24 Place Vendôme in Paris, Anne confided in her about the problem which had been worrying her for three years: she believed she had been infected by a venereal disease. Willing to help, Maria Barlow told Anne about “a famous man here who had made some great cures”²: the surgeon Guillaume Dupuytren whose practice was at 4 Place du Louvre.
Trigger warning: sexual content and situations involving potential assault
Estimated reading time: 40 minutes
This article describes active research and the facts and details included have and will continue to be updated as new information is uncovered. If you come across any other relevant information that can help clarify or expand the topics below, please get in touch.
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Portrait of Guillaume Dupuytren by François-Séraphin Delpech, circa 1842. Wellcome Collection. Attribution 4.0 International
(CC BY 4.0)
The “queer questions” of the King's surgeon
Guillaume Dupuytren was not just any doctor. He was the surgeon in chief at the Hotel Dieu since 1815, a professor at the Faculty of Medicine, a member of the Royal Academy of Medicine, and also the King’s chief surgeon. After an early morning round at the oldest Paris hospital, Dupuytren held private consultations from 10 or 11 am to 1 pm in his own residence, where Anne Lister consulted him on the 29th of November 1824³.
In August 1823, Anne had already consulted a Manchester surgeon, Mr. Simmons, and had managed to keep her vaginal discharges under control with injections of sulphate of zinc⁴. However, Anne lived in constant fear of infecting her lovers and was still bothered, as she explained – as well as she could in French – to Dupuytren:
“though I was cured or said to be so, there was a weakness left and a little discharge which was very uncomfortable.”
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0088
For the sake of propriety, Anne pretended to be a married woman in front of the physician. To achieve that, she put herself in the shoes of her lover Mariana Lawton – or “the lady who venerealized me” ⁵ back in 1821 –, “so that I could not forget my story”⁶. Having sex outside marriage was not something you would admit to at that time, even to a doctor. In fact, in the 19th century, French medical men like Dupuytren tended to act as moral guardians and to take over from priests in guiding people’s consciences and behaviours⁷.
As a result, Anne’s fake marriage played a more important role than she had planned during this first visit. The King’s surgeon asked a long list of “queer questions”⁸, focused more on the couple’s connections than her own health.
“Had he much intercourse with me?
No, never since I was ill, not these three years.
Why not?
(...)
Had he much difficulty when you were first married?
Yes, it was a fortnight before he could manage it.
Well, but, said Mr Dupuytren, you were unusually stait.
Aviez–vous des rapports frequents [did you have frequent sex]? Once a week? Once a fortnight?
Yes, said I, about so often at first, then once a fortnight and afterwards once a month till I was all at once ill and since then not at all.
How old are you?
Thirty two.
How old is he?
Fifty two.
How long married?
Eight or nine years.
He said I was young and it was very odd he had been so long without any connection with me."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
“Toucher, la femme debout” [Touching the standing woman] by Antoine Chazal, 1822. Source: BIU Santé Médecine
(ODC-BY, CC-BY 2.0)
Dupuytren was known for his very direct and authoritarian interrogations. “He almost always assumed that patients had some desire to hide the truth,” says Auguste-Théodore Vidal, in his Essai historique sur Dupuytren (1835). “He would ask questions to which his eye would imperiously dictate the answer. For example, he had a way of asking the question: 'Are you in pain?' to which the patient almost always replied 'no.'”
Section Footnotes
1. 26 Nov. 1824, SH:7/ML/E/8/0181
2. 27 Nov. 1824, SH:7/ML/E/8/0087
3. 29 Nov. 1824, SH:7/ML/E/8/0089
4. 29 Nov. 1824, SH:7/ML/E/8/0089
5. 30 Nov. 1824, SH:7/ML/E/8/0090
6. 27 June 1828, SH:7/ML/E/11/0025
7. Les médecins et la « nature féminine » au temps du Code civil, Yvonne Knibiehler (1976)
8. 27 June 1828, SH:7/ML/E/11/0025
Examination and Women's Modesty
“Toucher en position horizontale” [Touching in a horizontal position] by Antoine Chazal, 1822. Source: BIU Santé Médecine (ODC-BY, CC-BY 2.0)
Having to answer questions was one of the reasons why high-society women refrained from consulting doctors to solve their intimacy problems and they were very shy about having their bodies examined. Mariana Lawton categorically refused it, even when her health was deteriorating. Anne discussed it several times with Mariana’s brother, the doctor Stephen Belcombe:
"Said π- [Mariana] was as bad as ever. He agreed that the so constant use of alum was bad. I wished him to speak to her and tell her she ought to be examined."
Anne Lister, 29 Nov. 1825 - SH:7/ML/E/8/0164
Anne had already consented to this with Mr. Simmons – “I did not mind it much (...) strictly speaking, there is no real indelicacy in submitting to a thing of this kind when so necessary”⁹. She was torn between “the fear of venereal”¹⁰ and the hope it was something less serious and wanted some answers. But on that day in Paris, Anne was more reluctant:
"He said he must examine me. I said it was very disagreeable, could it be done without? He seemed a little impatient and said would I say yes or no? I very quietly asked if it was absolutely necessary. He said yes. Well then, said I, it must be done."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
In fact, Anne was worried that Dupuytren might see she was lying: “I was only afraid he should find out I was not married.”¹¹ Maria Barlow was also concerned that he might make other discoveries about Anne:
"Afraid the surgeon should mention there being such a person in Paris as myself. She thinks me partly man. Oh no, said I, I will manage all that, no examination will be necessary and shall call myself Madame, shall not give my address."
Anne Lister, 28 Nov. 1824 - SH:7/ML/E/8/0088
However, Anne could not avoid the examination, and she was indeed convinced that Dupuytren literally felt that she was somewhat different, as she confided to Mariana six months later: “insinuated that he seemed to think me singularly made, he had recommended that seringue, a manivelle, which might be used by a man.”¹² As for Mrs Barlow, she told her “all that had passed, except the examination.”¹³
Hoping to avoid this, Anne had even brought to Dupuytren some discharge on a handkerchief. She repeated the operation several times (she went back Place du Louvre four times):
"Shewed some discharge on a handkerchief I had put on the chemise I wore yesterday. He saw this and said there much discharge, he asked if it was ever at all green."
Anne Lister, 6 Dec. 1824 - SH:7/ML/E/8/0094
It was easy for Anne Lister to answer, as she kept track of her discharges in her diary, with signs she invented :
"this mark E shall stand for an injection of alum lotion"
Anne Lister, 8 Dec. 1821 - SH:7/ML/E/5/0070
"this mark O shall henceforward signify no discharge, one dot within it shall signify a little, two middling, three much etc."
Anne Lister, 26 May 1822 - SH:7/ML/E/6/0010
It was quite common for upper-class women, who wished to avoid doctors, to self-examine and monitor their vaginal discharges to assess the seriousness of their ailment.¹⁴ They also tried to cure themselves and sometimes shared prescriptions among themselves, much like Anne Lister did with Mariana Lawton, and, later, with Isabella Norcliffe, after infecting her. Women eventually exchanged names of discreet or reliable physicians when the symptoms or the pain became too severe, at the risk of it being too late. “The silence of women” and their “extreme reserve” always aggravated their ailments and “often made them incurable”, warned Joseph Vigarous in Cours élémentaire de maladies des femmes (1801). The renowned midwife Marie Anne Boivin, author of one of the most important gynaecologist books on 19th-Century Europe, also encouraged women to seek medical help :
"However painful the sacrifice of modesty required by this examination may be for the woman, it should only be avoided in cases where there is no reason to suspect a serious lesion, or one that could become serious."
Marie Anne Boivin, Traité pratique des maladies de l'utérus (1833)
However, she begged medical men to spare women as much moral embarrassment and physical pain as possible: “Is it necessary to prescribe here, even more than in any other exploration, the rules of decency and gentleness?”¹⁵ In fact, specialised medical literature provided guidelines to explore the vagina – or “conduit de la pudeur” [“conduit of modesty"]:
"In general, women should be touched while standing and clothed to protect their modesty."
Hippolyte Pauly, Maladies de l'utérus (1836).
The patient was not to be undressed or uncovered and even if Boivin believed that it was “more convenient” for her to lie down, many French doctors followed the “standing” method. It was also said that physicians should only “touch” women with their fingers and never lay eyes on them. “Explorations carried out by touch are less disturbing to women than those where sight is required”,¹⁶ believed Boivin. Therefore, the speculum, which required looking at the genitals, had to be avoided, even if that meant that certain conditions could go undetected.
Although Dupuytren praised Boivin's work (he even asked her to deliver his own daughter's baby), he did not seem to care much about her recommendations for women's comfort and modesty when he examined Anne:
"I unloosed my drawers, he sat down and I stood before him while he examined and felt the parts."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
Though he “inserted his finger higher but not so roughly as Mr. Simmons did”¹⁷, his examination looks and sounds more like a sexual assault than a medical act:
"It certainly did not hurt though at last I said it did a very little. He had bid me move backwards and forwards saying ‘Faites comme si vous aviez des rapports avec votre mari’ [act like you have intercourse with your husband]. On this crissabam [I was moving] a little. He of course thought it was modesty that prevented my doing it more (...)
[He said] so far from giving me pain, I seemed to have a nensation [sensation] of another kind, seemed to embrace the finger as if there was a sensation rather of pleasure. I truly said I was not conscious of it."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
Section Footnotes
9. 28 Aug. 1823, SH:7/ML/E/7/0060
10. 30 Sept. 1821, SH:7/ML/E/5/0068
11. 29 Nov. 1824, SH:7/ML/E/8/0089
12. 8 May 1826, SH:7/ML/E/9/0097
13. 29 Nov. 1824, SH:7/ML/E/8/0089
14. Le frisson et le baume, expériences féminines du corps au Siècle des Lumières, Nahema Hanafi (2023)
15. Marie Anne Boivin, Traité pratique des maladies de l'utérus (1833)
16. Marie Anne Boivin, Traité pratique des maladies de l'utérus (1833)
17. 29 Nov. 1824, SH:7/ML/E/8/0089
Dupuytren & the Medical patriarchy
Dupuytren presents King Charles X with one of his patients at the Hôtel-Dieu hospital, in Paris. Musée Carnavalet, Public domain, via Wikimedia Commons (CC-BY-4.0)
Even though he had a strong reputation as a surgeon and as an anatomist, Guillaume Dupuytren was not an expert in women’s intimate health. He did invent, in the 1820s, an improved version of a rudimentary and bruising speculum of that time but the handle he added was an improvement for medical men, not for women.
However, as gynaecology as we know it today did not yet exist at the beginning of the 19th century, those who performed deliveries or repaired lesions in the genitals were seen as the most competent.
Speculums of Récamier modified by Dupuytren. Source: Arsenal du diagnostic médical by Maurice Jeannel, p.336 (1877)
The midwife, Marie Anne Victoire Boivin (1773-1841). Aquatint by Bouchard. Wellcome Collection. Public Domain, (CC-BY-4.0).
"The preference that women commonly give to midwives or surgeons in cases of diseases affecting the genitals is all too often justified by the carelessness with which doctors physically examine the diseased parts, and by the inability of many of them to derive any benefit from such an examination."
Marie Anne Boivin, Traité pratique des maladies de l'utérus et de ses annexes (1833).
French medical men ensured midwives remained under their guardianship and often denigrated them. Monsieur Julliart, Anne's anatomy teacher, told her that except Boivin, who was “très savante” [very knowledgeable], “the women who study as sages femmes [midwives] are almost all bad women.”¹⁸ The goal was clear: keep control over women’s bodies.¹⁹
“Every female individual is created solely for propagation; her sexual organs are the root and foundation of her entire structure,” stated the influential anthropologist Julien-Joseph Virey in De la femme, sous ses rapports physiologique, moral et littéraire, a racist and misogynistic book about women that Anne Lister read with great interest – or rather excitement – in 1831.²⁰ This idea spread quickly in 19th-century France with the rise of capitalism:
"The creation of a heritage to be passed on to descendants requires the dissemination of ideas that define women in accordance with the role they have to play in the society of their time (...) It is through them that heirs are begotten and brought up. Anything that distracts her from this biological and moral role is violently condemned."
W. Bannour, L'idéologie du corps médical français au XIXe siècle (1993)
It is not surprising that, in this patriarchal scientific context, when Anne Lister talked to Dupuytren about her complaint, he spoke about procreation instead:
"He said there was very little discharge, I was perpectly [perfectly] well made pour avoir des enfans [to have children]."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
There was not much space for questions and discussion with the King’s surgeon, who could easily “lose his temper,” according to Vidal.²¹ Pierre-François Percy, another eminent surgeon of his time, even termed him “le premier des chirurgiens et le dernier des hommes” [First amongst surgeons and last amongst men].²² “There was something overwhelming in his answers that silenced even the most intrepid of callers,” says Vidal.²³ This included Anne Lister:
"When I asked him what apothecary he recommended, he said it was an extraordinary question. And asked what he thought the complaint was. Would you have me give you a long dissertation on it now? said he. He seemed rather cross altogether."
Anne Lister, 6 Dec. 1824 - SH:7/ML/E/8/0094
Section Footnotes
18. 7 April 1831, SH:7/ML/E/14/0047
19. Encyclopédie critique du genre. Under the direction of Juliette Rennes (2016)
20. 11 April 1831, SH:7/ML/E/14/0048
21. Essai historique sur Dupuytren, Auguste Théodore Vidal (1835)
22. L'Hôtel-Dieu de Paris, Charles Coury (1969)
23. Essai historique sur Dupuytren, Auguste Théodore Vidal (1835)
The “impure” venereal disease
Tragic consequence of frequenting brothels, caricature of a syphilitic, c.1800 Source: Paris Musée Collections. Public Domain.
Perhaps Dupuytren did not have clear answers for Anne? Gonorrhoea, leucorrhea, syphilis, 'fleurs blanches' (the whites), venereal diseases... there was at the time a great deal of confusion and unknowns around these ailments, as Anne and Madame de Rosny, who hosted her in 1828 in Paris, pointed out in one of their conversations :
"We then somehow got upon the venereal disorder, how it was mistaken in women for fleurs blanches etc. and caused all sorts of maladies [diseases]."
Anne Lister, 7 Jan. 1828 - SH:7/ML/E/10/0126
De la gonorrhée bénigne, ou sans virus venerien, et des fleurs blanches by J. L. Doussin-Dubreuil. Public Domain Mark. Source: Wellcome Collection.
Before the emergence of microbiology, it was difficult for medical men to tell whether female discharges were caused by a venereal virus or not. And their different theories mixed up science and morality. In De la Gonorrhée bénigne ou sans virus vénérien et des fleurs blanches, which Anne bought and read in May 1827,²⁴ the surgeon Doussin-Dubreuil blamed those affected by these discharges, guilty of “excesses in the pleasures of love, mainly in habits contrary to the intentions of nature,”²⁵ like masturbation. However, he reassured his readers that most discharges were not caused by the shameful venereal virus.
Venereal diseases were indeed stigmatised as being “those contracted by impure commerce”, according to Nysten's Dictionnaire de médecine, which Anne bought in 1830.²⁶ In a chapter with an eloquent title – “If libertinism can produce venereal disease” –, the anthropologist Julien-Joseph Virey stated that “when morals are generally perverted, and the bond of marriage is no longer respected (...) bachelors are numerous, and vices must spread more and more, especially among the rich and idle castes of society.”²⁷
Since the 16th century, medical writings had also amplified the idea that women, more than men, represented the danger and were the source of contamination. “A woman who had the venereal complaint was called a fireship,”²⁸ Maria told Anne that winter, repeating a confidence from her late husband, Captain Barlow. When Anne told Dupuytren she believed her husband had infected her, he got defensive and asked right away “how I knew it was a cause de mon mari [because of my husband].”²⁹ At any rate, the Hotel–Dieu chief surgeon dismissed the venereal cause very quickly, after a simple examination by touch:
"He said nothing was the matter, all was right, there was nothing venereal at all. I buttoned up."
Anne Lister, 29 Nov. 1824 - SH:7/ML/E/8/0089
Whilst he set aside the reviled term “venereal” and used “fleurs blanches” instead, Dupuytren did not seem to rule out a sexually transmitted infection. He once observed Anne’s mouth and gums, probably looking for chancroid ulcers, which were often considered to be a sign of venereal disease. Yet, the main indication that he was leaning towards this option was his prescription.
Section Footnotes
24. 19 May 1827, SH:7/ML/E/10/0094
25. De la Gonorrhée bénigne ou sans virus vénérien et des fleurs blanches, J-L Doussin-Dubreuil (1797)
26. 19 Feb. 1830, SH:7/ML/E/12/0167
27. De la femme, sous ses rapports physiologique, moral et littéraire, J-J Virey (1823)
28. 22 Jan. 1825, SH:7/ML/E/8/0119
29. 29 Nov. 1824, SH:7/ML/E/8/0089
“He had so mercurialized me”
Dupuytren asked Anne to stop taking zinc injections and prescribed a meagre diet, some hot baths, a tisane made of pearl barley and nitre... and mercury, strongly associated with the infamous venereal diseases since the 15th century. Anne disguised herself in Mrs. Barlow's cloak and shawl to go to the apothecary, but carried out willingly the plan, which was supposed to cure her in a few weeks only:
"The rubbing my mercury hand on queer last night and the bath might do good for I have not felt so much discharge tonight nor am I so hot and sore as yesterday."
Anne Lister, 8 Dec. 1824 - SH:7/ML/E/8/0096
Anne knew of mercury and its potential side effects but this did not prevent her from using it for other ailments (she rubbed some on her eyes in 1818)³⁰ and regularly heard about some friends or acquaintances using it as a cure, such as Miss Vallance in 1819.³¹ Mercury could be administered orally, rubbed into the skin, applied as a plaster, or the patient could be exposed to mercury vapour. Anne's friend Mr. Duffin – a York doctor who had also confusing theories about venereal diseases – told her in 1821 that there was “nothing but mercury for it.”³²
Treatment of syphilis by fumigation Nouvelle methode de traiter les maladies veneriennes par la fumigation Lalouette, Pierre Published: 1776. Source: Wellcome Collection. (CC-BY-4.0).
However, in the 19th century, the use of mercury was highly controversial. Though some medical men were still balancing its 'advantages and disadvantages' in the case of venereal diseases, others were campaigning for it to be banned:
"In the hands of the most skilful physician [the mercure] is never more than a knife in the hands of a child, or an arrow struck at random; since the doses suitable for the cure of each individual can never be specified, and their excess may cause such considerable damage to one or other precious organ that it cannot be repaired for the rest of life."
Important salutary advice based on experience to all friends of humanity against the use of mercury in venereal diseases, Franz Joseph von Besnard (1809)
If absorbed into the gastrointestinal tract, the mercury could indeed cause multiple ulcerations, nausea, toxic gastro-enteritis and bloody diarrhoea. This is perhaps what Anne described in May 1826 to Mariana:
"[Dupuytren] had so mercurialized me etc that it had brought on profuse bleedings. I used to sit on the pot and bleed like a stuck pig, always slept in my drawers when it came on, etc. etc.”
Anne Lister, 8 May 1826 - SH:7/ML/E/9/0097
Eventually, the mercury did not stop her discharges and Anne blamed it for weakening her even more. Yet, she still encouraged Mariana Lawton to consult Dupuytren in the following years. Anne trusted the King's surgeon... Even if the feeling was not mutual:
"Dupuytren had examined me, evidently did not believe the story of my being married.”
Anne Lister, 8 May 1826 - SH:7/ML/E/9/0097
Section Footnotes
30. 18 Feb. 1818, SH:7/ML/E/12/0167
31. 22 Oct. 1819, SH:7/ML/E/3/0104
32. 01 Oct. 1821, SH:7/ML/E/5/0068
33. reference
References
Traité pratique des maladies de l'utérus et de ses annexes, Marie Anne Boivin (1833)
L'idéologie du corps médical français au XIXe siècle, Wanda Bannour (1993)
L'Hôtel-Dieu de Paris, Charles Coury (1969)
De la Gonorrhée bénigne ou sans virus vénérien et des fleurs blanches, J-L Doussin-Dubreuil (1797)
Leçons orales de clinique chirurgicale faites à l'Hôtel-Dieu de Paris, le Baron Dupuytren (1834)
Le frisson et le baume, expériences féminines du corps au Siècle des Lumières, Nahema Hanafi (2023)
Le discours médical sur la femme : constantes et ruptures, Yvonne Knibiehler (1976)
Les médecins et la « nature féminine » au temps du Code civil, Yvonne Knibiehler (1976)
Dictionnaire de médecine et des sciences accessoires à la médecine, Pierre Hubert Nysten (1814)
Maladies de l'utérus, Hippolyte Pauly (1836)
Encyclopédie critique du genre. Sous la direction de Juliette Rennes (2016)
Essai historique sur Dupuytren, Auguste Théodore Vidal (1835)
Cours élémentaire de maladies des femmes, Joseph Vigarous (1801)
De la femme, sous ses rapports physiologique, moral et littéraire, J-J Virey (1823)
Important salutary advice based on experience to all friends of humanity against the use of mercury in venereal diseases, Franz Joseph von Besnard (1809)
Acknowledgments
Special thanks to the West Yorkshire Archive Service and the Anne Lister Code Breakers for the transcriptions of Anne Lister’s diaries, as well as to Steph Gallaway and Marlene Oliveira for their help in editing this article.
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