A “queer” examination in Paris

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.

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.'” 

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:

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:

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:

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):

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, 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"]:

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:

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:

It is not surprising that, in this patriarchal scientific context, when Anne Lister talked to Dupuytren about her complaint, he spoke about procreation instead:

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: 

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 :

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:

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.

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:

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:

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: