Sex,Surgery & Syphilis: The Contagious Diseases Act and Bram Stoker’s ‘Dracula’


‘This comely maiden, once buoyant in life,
by the dread hand of disease expires,
is now subject to the dissectors knife,
to carve and mutilate as he desires.’ [1]

Late 19th century fiction displays an emergence of scientific and medicinal essence. These practises are closely entwined with the Gothic genre due to the fear and horror that they generated in Victorian women, and this is due to the fact that ‘women were being used as subjects for medical research’.[2] Bram Stoker’s careful interest in science and medicine influenced the majority of Dracula (1897). In this novel, several scientists and doctors whom insist upon medical experimentation on the character of Lucy.  The above poem by Victorian anatomist and writer, John Wilkes Brodnax, tragically portrays how scientists and doctors were of a controversial professional career in the Victorian era.  In Dracula, female ‘gender intensifies the private mode of medicine’.[3] When the female body appears in scientific discourses, the stereotype of the passive and submissive woman is emphasised.

The Contagious Diseases Act, originally, issued in 1864, enforced strict regulations that any woman suspected of infection would undergo a violating and painful medical examination, which was a horrific invasion of the female body. The government’s attempt to control the spread of venereal disease resulted in widespread genital inspection. In Dracula, medical examination dangerously hovers on the moral boundary of women being ‘undressed scientifically’ versus that of an erotic and perverted manner.[4] Ludmilla Jordanova explores how women’s privacy of the body is invaded under a so-called justified act of science. Stoker’s erotic doctor-and-patient relationship portrays ‘the medical lust of handling and dominating women’ in the 19th century.[5] Stoker’s language surrounding the blood transfusions from man to woman awakens the horror of venereal disease, such as syphilis. On the other hand, the penetration of phallic medical objects, followed by the mixing of bodily fluids, is symbolic of Lucy’s consummative, sexual intercourse with multiple men. Furthermore, Stoker alludes to the unspeakable Victorian topic of menstruation, which was also deemed as a female disease. Like the ‘dissector’ in Brodnax’s poem, Stoker reinvents the male, scientific figure as someone to be carrying around deadly instruments of violence and torture, ready ‘to carve and mutilate as he desires’.

Jordanova states that ‘medicine in general is allied with privacy’.[6] In Dracula, medical invasion of privacy of the female body is alluded to through Dr. Seward’s attitude towards intimate examination. In the investigation of Lucy’s symptoms, Seward is governed by his romantic feelings for her, and therefore he feels an obligation to maintain a moral position in being her doctor. Seward writes in his diary, ‘I reminded her that a doctor’s confidence was sacred’, suggesting a high level of trust and confidentiality between doctor and patient.[7] The form of diary entries in the novel emphasise the sense of the private sphere, whilst letters of correspondence open up this barrier where inner thoughts can be shared. The Oxford English Dictionary defines ‘confidence’ as ‘the confiding of private or secret matters to another; the relation of intimacy or trust between persons so confiding; confidential intimacy’.[8] The latter part of this definition is an oxymoron when applied to medical practise. A doctor’s examination should not cross the boundaries into the sexually intimate. Seward’s awareness of this danger is conveyed: writing to Lucy’s fiancé, Arthur Holmwood, Seward admits, ‘I did not have full opportunity of examination such as I should wish, our very friendship makes a little difficulty which not even medical science or custom can bridge over’.[9] Seward is referring to how he couldn’t make such an intimate examination of Lucy’s body, arguably her genitalia, because this would be a violation of privacy. Furthermore, the fact that ‘gynaecology was one of the most controversial fields in medicine in the late nineteenth century’, it is easier to understand why doctors might be reluctant to pursue this specialised area of medicine.[10]

As Jordanova writes, ‘the secrecy associated with female bodies is sexual and linked to the multiple associations between women and privacy’.[11] Jordanova specifies that this ‘privacy’ is a vital necessity for the female body, for ‘women’s bodies […] cannot be treated as fully public, something dangerous might happen, secrets be let out, if they were open to view’.[12] These ‘secrets’ refer to a woman’s sexual activities, details about menstruation, and of course, it reveals any ‘dangerous’ disease that she may be carrying. A woman’s body, therefore, protects a lot of personal information that rises to the surface through ‘sexual assault by materialist medical men’.[13] This arises the common Victorian question: ‘was it decent for a male doctor to introduce an instrument into the body of an unmarried woman?’[14]

During the decades of The Contagious Diseases Act (1864-1886), women were forced to undergo painful examination to test for venereal disease. Like 19th century medical professionals, Stoker’s doctors ‘usually have all the latest gadgets and inventions’.[15]  Van Helsing refers to his instruments as ‘ghastly paraphernalia’, which suggests how medical equipment embodies violent and cruel shapes, and in particular, phallic instruments.[16]  Walkowitz lends a vivid image of ‘male medical evil, imagining the doctor as a trader in lunacy and as a sexually dangerous man’.[17] One woman gave her account of the violent and horrific examination that she suffered, published in an 1870 pamphlet, doctor’s used:

monstrous instruments,- often they use several. They seem to tear the passage open with their hands, and examine us, and then they thrust in instruments, and they pull them out and push them in, and they turn and twist them about [18]

This examination of the female body is explained in violent and ‘vivid sexual terms’, which creates a powerful sense of sexual assault. [19] The author of this account, published as ‘The Violated Woman’ highlights the sensitive similarity between sexual intercourse and the violent intrusion of a phallic, medical, instrument penetrating the vagina. This supports Elston’s statement that ‘the metaphor of medical science, and medical practise on women, as rape, became a dominant theme’ in late Victorian literature. [20]  Christopher Craft’s assertion that ‘the medical profession licenses the power to penetrate’ highlights the immorality and corrupt nature of health professionals.[21] This notion is prevalent in Dracula, where the repetitive operation of blood transfusions illustrate Lucy’s ‘infinitely penetrable body’. [22] First, before the blood transfusion takes place, Lucy is given a ‘hypodermic injection of morphia’.[23] Craft draws significance upon the phallic symbolism of medical drugs, as he comments on the ‘morphine injection that immobilises the woman’.[24] Essentially, the morphine paralyses the female before she is further penetrated by phallic objects. We should bear in mind Seward’s reluctance to make drastic medical decisions, “why mutilate her poor body without need? […] Nothing to gain by it – no good to her, to us, to science, to human knowledge – why do it”? [25] Seward highlights the immorality of mutilation and recognises the lack of scientific gain. He is therefore portrayed as a fairer scientist, one who is not seduced by the unconscious female body nor sexually curious about her internal system.

Lucy’s secret fantasy for polygamy is symbolically fulfilled in the multiple blood transfusions. Writing to Mina she ponders ‘why can’t they let a girl marry three men, or as many as want her, and save all this trouble’? [26] Lucy’s character resembles the ideas surrounding the New Woman, who sought after sexual liberation and expression. However, her sexual freedom is restricted and controlled by the decisions of medical men. Van Helsing says he must “transfer from full veins of one to empty veins which pine for him”.[27] The use of the word ‘pines’ contains an obvious sexual suggestion, implying that Lucy’s body possesses an erotic desire to receive male fluid. Critics have stated that ‘in the unconscious mind, blood is commonly an equivalent for semen’.[28] Sperm has also been deemed as the ‘life blood’ of men, which further combines medical and erotic imagery together. [29] In essence, the amalgamation of blood and semen represents the tight relationship between sex and medicine in the novel. Since Arthur is “her fiancé”, greater significance is attached to the very first blood transfusion.[30] Believing that ‘the transfusion of his blood to her veins made him truly his bride’, the medical procedure is labelled as the consummation of their love.[31] However, the other men, Seward, Van Helsing, and Quincey have all engaged in blood transfusions with her and therefore have experienced the same physical and intimate transferal. Seward writes ‘none of us said a word of the other operations and none of us ever shall’.[32] This secrecy in the blood transfusions reflects Jordanova’s view that the female body harbours ‘secrets’ that could be ‘dangerous’. Theoretically, Lucy’s body hides evidence of polygamous intercourse. Her body is gradually filled with the blood of four men, to which Quincey remarks “man alive, her whole body couldn’t hold it”.[33] The language metaphorically suggests how men are dominating Lucy from the inside, as they pass through her veins and around her body. Inevitably, Lucy’s fluid-filled body comes to a literal and metaphorical climactic end, when Arthur Holmwood stabs Lucy’s heart and decapitates her head.

The thing in the coffin writhed; and a hideous, blood curdling screech came from the opened red lips. The body shook and quivered and twisted in wild contortions; the sharp white teeth champed together till the lips were cut […] his untrembling arm rose and fell, driving deeper and deeper the mercy-bearing stake, whilst the blood from the pierced heart welled and spurted up around it. [34]

Lucy’s physical reaction hints towards orgasm as she ‘shook and quivered in wild contortions’, whilst her fiancé, Art, is ‘driving deeper and deeper’ his stake. Alternatively, Lucy’s reaction connotes both symptoms of pleasure and pain. The graphic and grotesque imagery of her blood which ‘welled and spurted’ is symbolic of ejaculation. Craft comments on the ‘murderous phallicism’ of the decapitation.[35] The ‘mixture of morbid and erotic ideas’ has a powerful impact on the reader, which Stoker undoubtedly intended for the exit of Lucy’s character.[36] The men’s horrific treatment of one single female body portrays the extent of medical power and domination over women.

Throughout the centuries, ‘the treatment of venereal disease had been left entirely to the doctors, hospitals, chemists’.[37] Stoker’s blood transfusions illustrate the method of blood testing for venereal disease, an exercise which became more prominent in the 20th century. Van Helsing’s repeated metaphor in the novel, we “will have to pass through the bitter water before we reach the sweet”, conjures the image of blood and blood flow in the human body.[38] Whilst Helsing’s is primarily a metaphor for persevering the evil of Dracula until peace is achieved, we can also view this language as a metaphor for treating venereal disease. A similar water metaphor is used in an 1873 pamphlet, called ‘A new contagious diseases act, or, a few suggestions for controlling men as well as women’, which states that, for some prostitutes, their ‘blood is more or less poisoned by a secret hidden spring of foul pollution’.[39] Language such as ‘poisoned’ and ‘foul pollution’ would have invoked fear into Victorian readers about sexual intercourse and venereal disease. Stoker is effectively implying that doctor’s must ‘remedy this evil’ by detecting syphilis in the blood, which is dirty and diseased, and to expel it from the body until the veins run clean and healthy.[40] Mina repeatedly asserts that she is “unclean! Unclean”, after Dracula taints her forehead with a stain.[41] As Carol Senf comments, this assertion ‘may refer to the horrors of venereal disease’.[42] On the other hand, her exclamatory dialogue reflects a popular Victorian opinion of menstruation. John Eliotson published in 1840 that ‘to regard women during menstruation as unclean is certainly very useful’.[43] Seward ponders on Lucy’s blood loss, and concludes that ‘the whole bed would have been drenched to a scarlet with the blood’, which alludes to menstruation.[44] The symbol of blood in Dracula has several connotations that all contribute to the significance of the female body: intercourse, disease and menstruation. Mr. Renfield’s memorable chant, “the blood is the life! The blood is the life!” is certainly a current, a linguistic vein that pulses throughout the novel.[45] This biblical quote is taken from Leviticus 17:11 , ‘for the life of the flesh is in the blood’.[46] And in Acts 15:20, The Bible advises to ‘abstain from things polluted by idols, and from sexual immorality […] and from blood’.[47] The fact that the terms ‘polluted’, ‘sexual immorality’ and ‘blood’ are used in the same sentence suggests how sex, disease and immorality were inseparable themes and social struggles in the Victorian era.

The frightening unity of the erotic and the medicinal is a stimulating mixture of pleasure and pain which contributes to both novel’s intensely Gothic flavour. The female body was clearly a subject of fascination for Victorian scientists in terms of how women’s bodies possessed information about sexual intercourse, venereal disease and the unspeakable topic of menstruation. The notion of medical professionals abusing their role and using female patients to satisfy their sexual urges is a nightmare to torture every reader. Finally, it seems that a doctor’s confidence was arguably non-existent throughout the mid-late Victorian era; as the 1870 pamphlet worryingly advises, ‘you must ask the women about this if you want the truth, you must not ask the doctors’.[48]


Featured Image: Thomas Eakins, ‘The Agnew Clinic’, 1889.


[1] John Wilkes Brodnax, ‘The Anatomist’, in X-ray Vol 13 (Virginia: Medical College of Virginia, 1926), p. 144.

[2] Coral Lansbury, ‘Horrible and Indecent Exposure’, in The Old Brown Dog Women Workers and Vivisection in Edwardian England (Wisconsin: The University of Wisconsin Press, 1985), pp. 83-96 (p.90).

[3] Ludmilla J. Jordanova, ‘Medical Images of The Female Body’, in Sexual Visions: Images of Gender in Science and Medicine Between the Eighteenth and Nineteenth Centuries (Wisconsin: The University of Wisconsin Press, 1993), pp.134-159 (p.140).

[4] Jordanova, Sexual Visions, p.99.

[5] J.J. Garth Wilkinson. ‘The forcible introspection of the woman for the army and navy by the oligarchy considered physically’, (London, F. Pitman 1870), p.15.

[6] Jordanova, Sexual Visions, p.136 .

[7] Stoker, Dracula, p. 130.

[8] confidence n6, in OED Online, <>  [accessed 20 April 2015]

[9] Stoker, Dracula, p.129.

[10] Elston,’Women and Anti-vivisection’, p.278.

[11] Jordanova, Sexual Visions, p.93.

[12] Jordanova, Sexual Visions, p.92.

[13] Elston, ‘Women and Anti-vivisection’, p.279.

[14] Ibid., p. 138.

[15] Glennis Byron, ‘Bram Stoker’s Gothic and The Resources of Science’, Critical Survey, 19 (2007), 48-62 (p.48).

[16] Stoker, Dracula, p.140.

[17] Walkowitz, City of Dreadful Delight, p.172.

[18] Wilkinson, ‘The Forcible Introspection’, p. 23.

[19] Marjorie Howes ‘The Mediation of The Feminine: Bisexuality, Homoerotic Desire, and Self-Expression in Bram Stoker’s Dracula’, Texas Studies in Literature and Language, 30 (1988), 104-119 (p.109.)

[20] Elston, ‘Women and Anti-vivisection’, p.279.

[21] Christopher Craft, “Kiss me with those Red Lips”: Gender and Inversion in Bram Stoker’s Dracula’, Representations, 8 (1984), 107-133 (p.126).

[22] Ibid., p.121.

[23] Stoker, Dracula, p.149.

[24] Craft, “Kiss Me”, p.126.

[25] Stoker, Dracula, pp.189-190.

[26] Ibid., p.73.

[27] Stoker, Dracula, p.142.

[28] Ernest Jones, On the nightmare (London, Hogarth Press, 1931), p.119.

[29] G.J. Barker Benfield, The Horrors of The Half Known Life (London: Routledge, 2000), p. 188.

[30] Stoker, Dracula, p.149.

[31] Ibid., p.201.

[32] Ibid. p.199.

[33] Ibid. p.175.

[34] Stoker, Dracula, p.245.

[35] Craft, “Kiss Me”, p.122.

[36] Jordanova, Sexual Visions, p.98.

[37] E.M. Sigsworth and T.J. Wyke, ‘A Study of Prostitution and Venereal Disease’, in Suffer and Be Still: Women in the Victorian Age, pp. 77-100 (p.91).

[38] Stoker, Dracula, p.196.

[39] ‘A New Contagious Diseases Act, or, a few Suggestions for Controlling Men as well as Woman’ (London: John Moore, 1873), p.4.

[40] Ibid., p.8.

[41] Stoker, Dracula, p. 321.

[42] Carol A. Senf, “Dracula’: Stoker’s response to the New Woman’, Victorian Studies, 26 (1982), 33-49 (p.45).

[43] John Eliotson, Human Physiology (London, 1840), quoted in Elaine Showalter, ‘Victorian Women and Menstruation’, in Suffer and Be Still: Women in the Victorian Age, pp. 38-44, (p.39).

[44] Stoker, Dracula, p. 144.

[45] Ibid., p.163.

[46] Leviticus 17:11, The Holy Bible (English Standard Version), pub. by Peter and Bernard Zondervan, BibleGateway Online <>

[47] Acts 15:20, BibleGateway Online

[48] Wilkinson, ‘The Forcible Introspection’, p.6.

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