In the summer of 1746 London hospital provision for the poor with venereal disease entered a new phase. Surgeon William Bromfeild placed advertisements in the London Evening Post and the Daily Advertiser inviting donations for a new charitable hospital for impoverished patients suffering under the disease. Within six months his new charity had solicited enough support to launch the venture officially. The new London Lock Hospital opened its doors in January 1747. Unlike the royal hospitals supported by rents, or the workhouses supported by the public poor rates, the Lock was a private endeavor. That hospital would stand at the center of London, indeed of British hospital venereology for three centuries.

Why did Bromfeild open the Lock if there were already so many institutions treating the pox? If hospitals were not shunning venereal patients, as standard historical accounts have held for so long, then why did Bromfeild and his supporters embark on this endeavor? It was clearly not launched on a whim. The administration struggled mightily, but successfully, just to keep the hospital afloat during the difficult early decades. The hospital survived the turbulent eighteenth century and eventually found the stability to last all the way to 1952. This is an impressive record. We must ask what drove the founders? Why was this hospital, which seemed to offer services already offered by many other London institutions, considered necessary by the late 1740s? London charities were many and the competition for benefactions was stiff. How did the Lock Hospital convince English benefactors to support its mission? It is worth considering what was unique about the Lock Hospital and what niche it filled.

If it was not to provide care that was otherwise lacking, perhaps its mission was linked to a wider reforming agenda. Along with the idea that the Lock represented new tolerance, the idea that a reform program drove the charity has been one of the central assumptions of the scholarly work done on the Lock.