Hektoen International

A Journal of Medical Humanities

A Night with Venus, a lifetime with Mercury: syphilis among the British aristocracy in William Hogarth’s marriage à-la-mode

Sally Metzler
Chicago, Illinois, USA

Fig. 1: William Hogarth
The Inspection, from Marriage A-la-Mode
ca. 1743, National Gallery, London.

William Hogarth’s famous series Marriage à-la-mode parodies English society, particularly their arranged marriages and often dissolute lifestyle. He peppered his satire of upper-class matrimony with a moralizing tone and made clear visual references to syphilis and its treatment in the mid-eighteenth century. Regarded as one of the greatest British artists of his time, Hogarth chronicles the rise and fall of the newlywed couple the Viscount and Countess Squanderland—he the son of a pedigreed though bankrupt Count, she the daughter of a wealthy though common merchant.

An indiscretion on the part of the Viscount has given him and his exceedingly young mistress syphilis, evident in Hogarth’s fourth painting of the series titled “The Inspection” (fig. 1). A dark circular patch appears on the neck of Viscount Squanderland, likely a deliberate beauty mark of velvet concealing a syphilitic scar, or a tuberculous scrofula,1 also an indication of disease. His mistress, frail and wan, dabs her mouth, perhaps a sign of distress or of impending illness? The couple is visiting the doctor, who looks well-fed and pompous.

Hogarth spares no expense in his mockery of the doctor. His office is panoply of objects, akin to a cabinet of curiosities. On the right side of the room, an open book in French sits on a rather barbaric-looking contraption, which, according to the title page, is a machine to realign shoulders. The book also describes the second, smaller machine to the left, which is a bottle opener. The doctor polishes his pince-nez, perhaps readying himself to examine the patient or to proffer a bill. His office is a caricature of the medical profession: visible on the left, an array of apothecary jars full of potions; an uncannily lifelike skeleton lurks in the background; and a very prominent narwhal horn suggestively thrusts upward, alluding to the lustful behavior that originally caused all the trouble.

Fig. 2: William Hogarth
The Lady’s Death, from Marriage A-la-Mode
ca. 1743, National Gallery, London.

The buxom woman between the doctor and the Viscount, also ridden with dark beauty spots, could be the assistant to the doctor, or as suggested by the National Gallery in London, the mother of the child-mistress. But were she the mother of the young mistress, it seems more likely they would be standing next to one another and interacting. Could she not be a procuress or even another patient? Squanderland appears to be offering her his dose of mercury pills, and she looks down at him, highly agitated. Curiously, she brandishes a small clasp knife. What may have been overlooked in the past is a double-entendre of the clasp knife and that of clasp-knife syndrome, which would signify a manifestation of syphilis involving the nervous system.

More than a decade earlier, Hogarth painted the vicissitudes of relaxed sexual mores and concomitant danger of syphilis in his series The Harlot’s Progress, narrating the downfall of a country lass in London.2 At the time of Hogarth’s paintings, mercury was administered to patients suffering from syphilis, and Hogarth references this by the small open pill box Count Squanderland holds. First referred to as the French disease, or simply the pox, its exact origin even today is debated, and some historians attribute its virulence in Europe to Christopher Columbus—his expedition thought to have brought syphilis back from the New World.3 But what was known was the horrific suffering of the afflicted. The sores, often initially surfacing on the genitals, caused excruciating pain. But at this time in mid-eighteenth-century England the common treatment of an elixir of mercury could cause even more complications, and patients often died of the cure rather than of the disease. It was not until 1943 that syphilis was successfully treated with penicillin and the use of heavy metals abandoned.4

The final print of the series, The Lady’s Death, shows the nadir of the Squanderland family and the ensuing effects of syphilis on the Count’s progeny. They are bankrupt, and the creditors have come to collect what remains, such as the wedding ring of Mrs. Squanderland. Barely conscious, she swoons back in her chair, apparently from the effects of opium—indicated by the small bottle fallen on the floor labeled “laudanum.” Squanderland’s wife is on her deathbed, though their child remains, shown here reaching out to her mother (fig. 2). But a black cloud has already been cast upon the child, as evident by an unmistakable dark patch on her neck (similar to the father), and the deformed leg—a sign of syphilis. Hogarth’s original six paintings were immortalized in countless sets of prints for decades, heightening their popularity and moral impact at the time.


  1. See Fiona Haslam, From Hogarth to Rowlandson: Medicine in Art in Eighteenth Century Britain, p. 117 (Liverpool University Press, 1996).
  2. The paintings have been lost, but Hogarth’s series is known through engravings.
  3. For an engrossing history of syphilis and concomitant treatment, see: Frith, John, “Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins, in Journal of Military and Veterans’ Health,vol. 20, no. 4 (open access: http://jmvh.org/article/syphilis-its-early-history-and-treatment-until-penicillin-and-the-debate-on-its-origins/). According to Frith, “Mercury had terrible side effects causing neuropathies, kidney failure, and severe mouth ulcers and loss of teeth…”
  4. According to Frith, “…John Mahoney, Richard Arnold and AD Harris at the United Marine Hospital, Staten Island administered intramuscular injections of penicillin four-hourly for eight days for a total of 1,200,000 units, curing four patients.” See Mahoney JF, Arnold RC, Harris AD, “Penicillin treatment of Syphilis,” American Journal of Public Health, 1943 vol. 33, no. 12: 1387-1391.

SALLY METZLER, PHD, interned at the Alte Pinakotek in Munich, obtained her PhD in Art History from Princeton University, and worked at the National Gallery in Washington DC and the Cummer Museum in Jacksonville, Florida. She was director of the D’Arcy Museum of Loyola University in Chicago and in 2014 curated an exhibition on Bartholomeus Spranger at the Metropolitan Museum of Art in New York.

Highlighted in Frontispiece Spring 2017 – Volume 9, Issue 2

Winter 2016



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