Dangerous Liaisons: A Social History of Venereal Disease in Twentieth-Century Scotland (review)

Roger Davidson emphasizes the "Scottish dimension to the social history of VD" rather than simply placing it within a British framework dominated by Westminster and Whitehall (4). He certainly has a point that the history of the national British regulation of syphilis and gonorrhea (the two venereal diseases with which this book is concerned) is a relatively familiar one to most historians of modern Britain and modern medicine. What then does the "Scottish dimension" add to our understanding of policies that were primarily concerned with women's bodies and morality? Davidson claims that his examination of Scotland does more than provide further local histories of the working of regulations, hospitals, and clinics; rather, he suggests that Scotland contained its own medical, legal, civic, and sexual cultures that affected the understanding and treatment of venereal diseases.

Davidson takes us through the social history of twentieth-century Scottish attitudes toward VD in a thorough manner. After a brief discussion of pre-1900 antecedents, he provides a snapshot of 1900 in order to examine better the changes produced by the First World War. During this time initiatives by social welfare and purity organizations against such dens of iniquity as "ice cream parlours" gave way to central and local moral regulation. Most significantly, Scottish policy was influenced by reactions to stringent government provisions under the Defense of the Realm Act and to the report of the Royal Commission on Venereal Diseases issued in 1916. The report, which counseled against compulsory measures, was favorably received in the Scottish press. One concrete result of the commission's report and the legislation it inspired was the establishment in the interwar period of centers to test for VD and treat patients confidentially at no cost.

Davidson demonstrates that in practice local provision of such treatment, despite support from the Scottish Board of Health and the Treasury, met with mixed success. The care of those suffering from VD varied enormously at the local level. By 1927 forty-nine treatment centers had been established, although with some broad geographical gaps in coverage and with concentrations in the major cities such as Glasgow and Edinburgh. Drawing upon the records of local clinics and hospitals and the Scottish Board of Health, Davidson is able to offer details of who was treated and how, noting that the majority of those seeking treatment were male and over twenty-five; evidence for occupation, class, and region is more sketchy. Where information is available, for instance, in Edinburgh, Davidson asserts that it contradicts the perception of VD as a disease of the unskilled laborer; instead, sufferers "reflected the socio-economic structure of the city" (91).

The establishment of new treatment facilities led to the rise in the same period of "venereology" as a specialty within Scottish medicine, notably, in the Edinburgh Medical School. This is in sharp contrast to England, where general practitioners typically staffed clinics. Unsurprisingly, women formed about 22 percent of those who took up a specialty that remained marginal in the medical profession. Less surprising still were the attitudes of those involved in the treatment of patients with VD. Many adopted the views of the broader Social Hygiene Movement that saw improving morality as part of any public health strategy and differentiated between "innocent" and sexually indulgent patients. The interwar period saw a growing focus on "problem girls," a group that during the First World War and after was seen as being a main source of the spread of VD. In this regard, prevailing Scottish practices and attitudes were not unique.

Davidson's study also covers the role of educational propaganda and the potential effect of both education and treatment. He concludes that the establishment of clinics helped reduce deaths and disabilities associated with VD...