The late 19th century was an exciting time to be a tattooist in Europe and America. Foreign influences such as the beautiful and accomplished Japanese irezumi, combined with technological invention in the form of Samuel O’Reilly’s 1891 electric tattoo machine, and the patronage of royalty – traditionally the preserve of the fine arts – all coincided to inspire a generation of tattooists, who took advantage of a surge in the popularity of tattooing. Keen to elevate the status of the profession, Sutherland MacDonald, who had trained as an artist before coming to tattooing in 1890, coined the term ‘tattooist’, which he preferred over the more commonly used ‘tattooer’. According to Macdonald, ‘tattooist’ carried with it all the connotations of the title ‘artist’ that he wished to emulate, rather than the simple suggestion of a manual trade evoked by ‘tattooer’. The term stuck, and Macdonald is now considered to be one of the greatest tattooists of his era, as well as an early professional pioneer.
Not all 19th century observers took such a positive view of the practice, however. Some doctors in particular, warned of the potential health risks involved in tattooing. In medical journals, there was much discussion of the transmission of infectious diseases, such as tuberculosis and syphilis, via the unregulated and largely unhygienic practice of tattooing. In the early days of the professionalisation of tattooing, amateurs and semi-professionals in ports and barracks still outnumbered the ‘artists’ such as Macdonald, who were seeking to redefine the profession. The health risks were very real: it was not uncommon during this period for the amateur practitioner to use saliva to whet and mix their inks, or ‘clean’ the finished wound.
In 1889, a report appeared in the British Medical Journal of an outbreak of syphilis inoculated by tattooing at a naval barracks in Portsea.  Naval surgeon F. R. Barker reported 12 cases of syphilis infection amongst the recruits, all of whom had been tattooed by the same man, known only as ‘S’. This man was a discharged solider of the regiment, who traded as a tattooist in the barracks. Unfortunately, he also suffered from syphilis; he succeeded in infecting his unwitting clients by using his saliva in the tattooing process, often whetting the needles in his mouth or mixing his inks with saliva. Barker’s report was not isolated, with 8 other documented cases of syphilis following tattooing reported in the medical literature from 1853-1895. Unsurprisingly, the new class of professional tattooists soon became aware of the need to operate with some degree of antisepsis, and concerned for their livelihoods in the wake of such health scares, began advertising their ‘hygienic methods’. Writing in 1912, American tattooist Louis Morgan details his method of maintaining sanitary working practices as follows:
Keep the needles thoroughly clean by washing in strong antiseptic, such as bichloride of mercury or carbolic acid. Wash the acid off well in clear water and dry with a clean cloth. Then dip in vaseline. When a tattoo is finished wash it with witch-hazel and alcohol in equal parts, and apply some kind of antiseptic healing salve. 
It is interesting to note that whilst there was concern amongst tattooists and medical professionals alike about the health risks associated with tattooing, some tattooists – and their clients – actually considered the practice to be beneficial to health. Morgan himself stated that: “It is well known that a good-sized tattoo is as good an innoculation [sic] as any vaccination, and people who have considerable tattoo work on their bodies are generally more healthy than those who have none.”  Perhaps more surprising than this belief however, is the idea that tattooing could in fact cure the very same diseases it was implicated in spreading. It would seem that some of the imported folklore surrounding the healing properties of tattooing were confused – by some American tattooists, at least – with contemporary medical reports about the health risks associated with the practice, as this quote from Samuel Steward’s memoires of working as a tattooist in the 1950s reveals:
Old Randy in the arcade shop insisted that a tattoo cured syphilis. Possibly in his dim way he had heard of an article in the Journal of the American Medical Association stating that a syphilitic ulcer on a man’s arm, originating on his wrist and travelling upwards, was stopped dead when it reached the red pigment of a tattoo. No wonder: the red pigment was a spirocheticide – mercuric sulphide, one of the old specifics against syphilis before the days of penicillin. The presence of mercury in the skin was enough to arrest the progress of a shallow skin ulcer; after that, the bugs went undercover.
Somewhat ironically, the influence of folk belief and medical discourse conspire to produce an unfortunate amalgam, resulting in the assertion that a tattoo can, in fact, cure syphilis – apparently encouraged by the unexpected therapeutic side effects of the cinnabar-based red tattoo pigments used early on in tattooing. There are a number of articles in the British and American medical journals spanning from 1878 to around 1957, which deal with both the adverse and therapeutic effects of mercury-based tattoo pigments. However, the article most likely referred to in Steward’s book is George H. Belote’s Tattoo and Syphilis, which appeared in the Archives of Dermatology and Syphilology in 1928. In his report, which investigates cases of tattooed patients suffering with secondary syphilitic eruptions, Belote makes the following observation:
On both forearms there were tattoo designs done in dark blue, green and vermilion (mercuric sulphide). In all the designs papules were present in the green and blue, but apparently not in the red. This was made more apparent by the fact that here and there papules occurred in the blue outlining the red, but appeared to stop sharply when the red portion was reached. Since this eruption was extremely profuse, it is assumed to have been more than a mere coincidence that all the red was spared. 
Another commentator in the medical periodicals, Lieutenant Commander Novy of the U.S.N.R, took a particularly dim view of the “so-called artists” who practiced tattooing with “no concept of antisepsis” and thought less of their premises and methods, which he generally regarded as “filthy”. However, he concedes that, “a theoretic explanation of low incidence of infection may be found in the fact that one of the red dyes contains cinnabar, which is mercuric sulphide. This chemical may act as an antiseptic as the needles are constantly dipped into the dye.” 
Though syphilis was much more commonly contracted through sexual activity in the 19th century, tattooing nevertheless played its part in the spread of the disease. The short video below, produced by the Mutter Museum in Philadelphia, shows a colourful example from their collections, of an 1877 case of syphilis contracted via tattooing:
Unfortunately, syphilis is once again becoming a serious health concern in Europe and the USA, with a sharp rise in the number of reported cases. Most recently in the UK, an increase in the number of syphilis cases amongst teenagers was reported in 2011, making the observation of sterilisation and hygiene practices in contemporary tattoo studios all the more relevant.
© Life & 6 Months, 2013
Part of this post is an extract from Gemma Angel’s article, Atavistic Marks and Risky Practices: The Tattoo in Medico-Legal Debate, 1850-1950. Published in the forthcoming edited collection, A Medical History of Skin: Scratching the Surface. Available from Pickering Chatto, March 2013.
 F. R. Barker: ‘Notes Of Cases On An Outbreak Of Syphilis Following On Tattooing’, in British Medical Journal, 1:1479 (1889), pp. 985-989.
 Louis Morgan: The Modern Tattooist, Berkley: The Courier Publishing Company, (1912), pp. 59–60.
 Ibid, p.34.
 Samuel Steward: Bad Boys and Tough Tattoos: A Social History of the Tattoo, with Gangs, Sailors and Street Corner Punks, 1950-1965, New York: Harrington Park Press, (1990), p.82.
 G. H. Belote: ‘Tattoo and Syphilis’, in Archives of Dermatology and Syphilology, Vol.18, No.2 (1928), p.203.
 Novy, Frederick G. JR., (Lieutenant Commander, U.S.N.R), ‘A Generalized Mercurial (Cinnabar) Reaction Following Tattooing’, in Archives of Dermatology and Syphilology, Vol.49, No.3 (Mar. 1944), pp.172-173.