Behind the glamourous facade, life as a Yoshiwara courtesan was far from paradise; it had its mundane, trying, and often cruel aspects (see next panel). The daily grind of keeping up appearances, energy, and spirit while delivering entertainment and sexual services was particularly grueling. A soothing bath was likely a welcomed respite as well as an important hygienic requirement. The Portuguese, via China, had brought syphilis and gonorrhea to Japan in the early 16th century and venereal diseases later earned the nickname "flower and willow diseases," a reference to the pleasure quarters throughout Japan. Records seem to indicate, however, that the Yoshiwara was particularly effective at controlling them although it is not entirely clear how. Most references to the venereal diseases in popular literature belong to illegal brothels, which in general did not maintain high standards of hygiene, sexual or otherwise. Still, allusions to the risks of visiting the Yoshiwara do occasionally crop up in literature.