Hektoen International

A Journal of Medical Humanities

Casanova: Patient Zero and other insights into sexual health in the 1700s

Beth Jarosz
Washington, DC, United States

Portrait of Giacomo Casanova, 18th century

Moscow State Historical Museum, Russia

Giacomo Casanova, the infamous rake, is responsible for providing historians and anthropologists with a veritable treasure trove of historical health information. His life spanned from 1725 to 1798, and his memoir, Histoire de Ma Vie, recounts nearly every day of his life with meticulous detail, from the most basic breakfast (usually chocolate) to the most convoluted course of treatment for venereal disease (usually mercury). Far from being merely a smut-filled account of Casanova’s sexual conquests, the memoir provides modern readers with extraordinary insight into the world of public health, family planning, and the transmission and treatment of sexually transmitted disease in Europe in the eighteenth century.

Cultural historians are not entirely in the dark about sexual health among Europeans prior to the memoir. Ample evidence suggests that contraception is older than the Bible. Both the Bible and Koran refer to coitus interruptus, and ancient Egyptians used a form of spermicide. By the late 15th century, prophylaxis was also a growing concern. It is well documented that syphilis began its rampage through Europe in the late 1400s, and archaeological evidence from England’s Dudley Castle shows that condoms were used in Europe by the mid 1600s.1 In addition to the hard evidence, the 1655 bawdy book L’Escole des Filles describes “un petit linge” (a condom) as a birth control device, and a 1666 report from a British commission on birth trends identifies condoms as a causal factor in declining birth rates.2,3

Yet it is unknown whether contraceptive and prophylactic devices were a rare commodity or a common household item before the 1700s. It is also unknown whether, for example, condoms were used primarily for contraception or for prophylaxis. Nor is much known about public attitudes and practices regarding venereal disease. Aside from a few references, like those noted above, little evidence remains of public beliefs and practices surrounding sexual health before the Industrial Revolution.

Inasmuch as we can presume that Casanova and his partners reflect the state of public knowledge among their contemporaries, Casanova’s memoir, Histoire de Ma Vie, first published posthumously in the 1820s, provides answers to these questions. The memoir is one of the first surviving documents that provides vivid historical detail regarding common sexual health beliefs and practices of the eighteenth century including contraceptive techniques, knowledge and treatment of sexually transmitted disease, and a brief glimpse into epidemiology.

One hundred years after an inhabitant of Dudley Castle left behind a very unique piece of “armor,” Casanova’s memoir provides evidence that he (and many of his partners) were well aware of the existence of condoms, which he refers to as “packets,” “sheaths,” and “English articles,” among other euphemisms. The profligate protagonist regularly uses the sheaths, often made from linen or animal intestine, as a contraceptive device. For example, in 1754, during an affair with a cloistered nun referred to by the initials M.M., Casanova describes finding a box of “certain preservative sheaths against the fatal and dreaded plumpness” in the desk of his “beloved nun.” He hides the box. M.M. pleads for Casanova to return them “avec securite” (for security) against “a certain fatal plumpness …” Casanova “gave her back those objects so precious to a nun who wants to sacrifice on the altar of Venus.” This interaction implies widespread public access to condoms as well as use of condoms for contraception.

Condom use aside, Casanova remains quite uninformed about the biological process of procreation. During one encounter between Casanova and his beloved nun, M.M. reports that she swallowed a few drops of Casanova’s semen, and Casanova laments: “I should be in despair if I happened to place you in a position to become a mother.” To which M.M. replies “I shall know before long …” and describes how she might be “cured” by a physician should the potential pregnancy become a reality. While she does not describe the method of the potential “cure,” M.M.’s comment makes clear that abortion services were readily available. Of course M.M. does not become pregnant, but the panic both she and Casanova experience implies, at best, an incomplete public knowledge of the mechanics of conception.

Likewise, despite his extensive sexual experience, Casanova displays shockingly little knowledge about disease prevention. Instead of using a condom as prophylaxis in all sexual encounters, Casanova relies on a partner’s physical symptoms, such as the clear or chancred appearance of a woman’s skin, to determine whether or not she is ill. While Casanova is correct that this diagnostic tool has the potential to identify stage 1 and stage 2 syphilis, it fails to identify syphilitic infection during the latent stage. Moreover, because lesions may be hidden in the folds of the skin, external physical examination may even fail to diagnose stage 1 syphilis. In 1760 Casanova discovers the limits of his diagnostic powers after contracting a severe case of syphilis from his beloved Renaud, who “gave me a disease, which devoured her interior parts and left no marks outwardly, and was thus all the more dangerous, as the freshness of her complexion seemed to indicate the most perfect health.”

Unsurprisingly, the infection passed on by Renaud is but one instance among many in which Casanova contracts a venereal disease – most likely cases of both gonorrhea and syphilis, though he does not describe the symptoms in sufficient detail to be certain. Indeed, it is likely that he may have contracted several sexually transmitted diseases, alone or in combination, over the years.4 Casanova often treats his infections with some combination of mercury and diet (either fasting or consuming certain prescribed foods), and the memoir includes great detail about the course of treatment he follows. For example, after the infamous infection from Renaud, Casanova engages a doctor named Cephalides for treatment:

He examined me and declared he could cure me by sudorifics without having recourse to the knife. He began his treatment by putting me on a severe regimen, ordering baths, and applying mercury locally. I endured this treatment for six weeks, at the end of which time I found myself worse than at the beginning. I had become terribly thin, and I had two enormous inguinal tumors. I had to make up my mind to have them lanced, but though the operation nearly killed me it did not make me any better. He was so clumsy as to cut the artery, causing great loss of blood which was arrested with difficulty, and would have proved fatal if it had not been for the care of M. Algardi, a Bolognese doctor … Dr. Algardi prepared in my presence eighty-six pills containing eighteen grains of manna. I took one of these pills every morning, drinking a large glass of curds after it, and in the evening I had another pill with barley water, and this was the only sustenance I had. This heroic treatment gave me back my health in two months and a half, in which I suffered a great deal of pain; but I did not begin to put on flesh and get back my strength till the end of the year.

As the modern reader may guess, the “heroic treatment” likely did more harm than good, and the “cure” Casanova attributes to “grains of manna” may simply have been the result of the secondary syphilis symptoms running their course. In later chapters Casanova himself acknowledges the danger of some “cures,” including mercury, which kills at least one of his friends (Count Lamerg). Unfortunately for Casanova and his contemporaries penicillin’s curative properties would not be discovered for another two centuries.

Perhaps most astounding, given the limited knowledge of public health and hygiene at the time, we find clear evidence of early epidemological analysis in Histoire de Ma Vie. On returning to the town of Orsera a year after his first visit, Casanova is greeted warmly by a local doctor. The doctor credits Casanova with drumming up an impressive and lucrative medical business by starting an outbreak of the clap:

It is to you, captain, to you (may God bless you!) that I am indebted for my present comforts … You had a connection with Don Jerome’s housekeeper, and you left her, when you went away, a certain souvenir which she communicated to a friend of hers, who, in perfect faith, made a present of it to his wife. This lady did not wish, I suppose, to be selfish, and she gave the souvenir to a libertine who, in his turn, was so generous with it that, in less than a month, I had about fifty clients.

While there may have been no widespread public health record-keeping in Croatia two hundred and fifty years ago, local gossip filled in the gaps in the doctor’s epidemiological investigation as he traced the disease back to Casanova as Patient Zero.


  1. Jennings, Jan. “Ancient condoms leave Dudley for Dutch exhibition.” Dudley Metropolitan Bureau Council. http://online.dudley.gov.uk/news/fullrelease.asp?recid=556.
  2. Collier, Anne. The Humble Little Condom: A History. New York: Prometheus Books, 2007.
  3. Styles, Ruth. “Happy condom week! From linen cloths, to sausage skins and rubber dipped in sulphur… the curious history of the condom revealed” The Daily Mail. http://www.dailymail.co.uk/femail/article-2275040/Happy-condom-week-From-linen-cloths-sausage-skins-rubber-dipped-sulphur–curious-history-condom-revealed.html.
  4. Baughn, Robert E., and Musher, Daniel M.. “Secondary Syphilitic Lesions.” Clinical Microbiology Reviews. 18 (2005): 205-216.

BETH JAROSZ, MA, has more than a decade of experience in demographic estimation, forecasting, and analysis. Her analytical work spans a wide range of issues including public health, transportation planning, and economic development. She recently taught sociology at Pensacola State College and currently works at the Population Reference Bureau. Her work on mortality trends has been published in Social History of Medicine, and her work on population estimation techniques has been published Population Research and Policy Review.

Highlighted in Frontispiece Summer 2014 – Volume 6, Issue 3

Summer 2014 



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