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In Shakespeare’s Timon of Athens, Timon urges prostitutes to spread syphilis throughout Athens. He implores the whores, Phrynia and Timandra, to:

 

Consumptions* sow
In hollow bones of man; strike their sharp shins,
And mar men’s spurring*. Crack the lawyer’s voice**,
That he may never more false title plead,
Nor sound his quillets shrilly. Hoar the flamen***,
That scolds against the quality of flesh
And not believes himself. Down with the nose****,
Down with it flat, take the bridge quite away
Of him that, his particular to foresee,
Smells from the general weal****. Make curl’d-pate ruffians bald,
And let the unscarr’d braggarts of the war
Derive some pain from you. Plague all,
That your activity may defeat and quell
The source of all erection. There’s more gold.
Do you damn others, and let this damn you,
And ditches grave you all!

 

* Tertiary syphilis gave rise to chronic granulomata (consumption) in the bones. This could cause bowed tibiae known as sabre shins. It also affected the talus (heel) which would surely “mar men’s spurring”.
** Laryngeal ulceration would “crack the lawyer’s voice”. (quillets are lawyers’ quibbles.)
*** "Hoar the flamen” refers to the dermatological manifestations of the Great Pox. A flamen is a priest and hoar means to cover in white blotches (cf. hoar frost): hence it means, “cover the priest with white blotches”. Psoriatic syphilide looks just as though the skin has been covered by frost and would fit the bill nicely.
****Down with the nose” alludes to destruction of the bridge of the nose by a collapsed gummatous septum (saddle nose). Then foul-smelling crusts and creamy coloured pus which fill the nasal cavity cause atrophy of the membrane (syphilitic ozaena), hence… “smells from the general weal”.

 

In secondary syphilis, tubercles typically occurred on the forehead, temple and behind the ears. When these small buboes subsided, they would leave a bald patch on the area of scalp (syphilitic alopecia). To the fanciful, this could be seen to be in the distribution of a crown. (They were sometimes known as ‘le chapelet’ from the French word for coronet). In other plays Shakespeare refers to these ‘French crowns’ no less than eleven times [1].

Bony pain is a very common and the “Neapolitan bone-ache” is mentioned in his other works.

Quelling… erection” refers to syphilitic orchitis and subsequent impotence.

 

Congenital Syphilitic Saddle Nose deformity (Liverpool Medical Society).

 

This wonderfully graphic clinical word picture of syphilis is remarkable in its thoroughness. It is a great tribute not only to Shakespeare’s excellent powers of observation, but also to his medical knowledge. Bucknill writing in 1860 [2] records that this passage from Timon brings together the signs and symptoms of syphilis better than any contemporary English medical texts, in which some of the features mentioned in the passage were scarcely recorded.

Clearly Shakespeare’s public knew that syphilis was a contagious venereal disease and that a primary syphilitic chancre could be caught by kissing. Timon says to Phrynia:

 

I will not kiss thee; then the rot returns
To thine own lips again.

 

 

References

1. Young JR. Poetry, Physick, Pestilence and Pox; Medical Ideas in English Poetry to the End of the 17th Century. Saarbrucken, Germany; VDM Verlag; 2009. For a full account of syphilis in poetry see Young JR. Syphilis and Poetry in: Pirsig W. et al (Eds.). Ear, Nose and Throat Mirrored in Medicine and Arts. Ostend, Belgium; Schmidt; 2005:Ch 4.
2. Bucknill JC. The Medical Knowledge of Shakespeare. London, UK. Longmans; 1860.

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John Riddington Young

TD and bar, MPhil, FRCS, DLO, North Devon DGH. Barnstaple, UK.

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