The first substantive chapter uses a drinking song to tell the story of a man who travels to London from the countryside to attend an annual fair. As he cavorts with a prostitute behind a tent, she picks his pockets and he must leave the city with nothing to show for his time at the fair except a raging case of the pox. The chapter follows the fictional prostitute and the man through the streets, using actual medical cases and advertisements to piece together what each would have felt as their symptoms developed, as well as their desperate attempts to find affordable treatment. The main aim of the chapter is to establish much-needed context for the remainder of the book, both about the disease and about London’s ever-growing market in remedies for it. The chapter shows that those selling pox cures and those selling sex embodied the very same urban threats in writing of the era: in ballads and in medical writing, both prostitutes and purveyors of pox remedies were presumed to be deceptive, self-serving, and sexually aggressive. Their very existence personified the unbridled consumption and unchecked vice of the big city.

Chapter 2 shifts from representation to reality by looking at how patients navigated the city in search of cures. We follow a student as he searches for a healing powder in the back room of a coffee shop and imagine patients navigating the city in search of cures, often armed with little more than a healer’s inexact address. Using promotional material and advertisements, the chapter charts 230 different shops, taverns, bathhouses, and homes where antivenereal remedies were sold between 1650 and 1750. Mapping an urban geography of pox cures exposes the sheer number of medicines for sale for a single disease and how purchasing them brought patients far from the neighborhoods and homes of specific healers. Venereal treatments could be had just about anywhere in early modern London, from upscale thoroughfares to cheese shops and bookstalls lining the Royal Exchange. What is more, patients could find the very same remedy at a range of retail establishments, a uniform shopping experience that historians tend to associate with department stores of the Victorian era.

The book opens with Samuel Pepys, a naval administrator living in London in the 1660s. His candid diary relates the fatal illness of his brother, Tom, who allegedly died of the pox - or did he? The Introduction uses Pepys’ complex reaction to his brother’s ailment, including attempts to get a doctor to make a new diagnosis to clear the family name, as a way into the book’s central themes of deception, shame, unlawful sex, and the essential unknowability of venereal disease. The Introduction provides an overview of the history of disease that lays the groundwork for why the stories in this book matter and how they present evidence of seemingly modern ways of viewing and responding to diseased bodies nearly a hundred years earlier than historians presumed. It then situates the book in the history of medical retailing, sexuality, and the print trade, and ends with a discussion about the history of everyday urban life amidst epidemic disease.