- Thorns on the Rose: The History of Sexually Transmitted Diseases in Australia in International Perspective
The subtitle of this work promises much, and this ambitious effort in the study of public health policy delivers much. Milton Lewis begins with a look at the possible antiquity of the classical STDs (sexually transmitted diseases), before concentrating sharply on what in this case is an almost obligatory look at the origins of syphilis. Following this, he begins to exercise a method that serves throughout the volume to keep the work comparative: he looks at the state of STDs in Great Britain, Europe, and North America during a particular time period, along with the state of preventive and clinical medical knowledge available to be leveled against them, and then reduces the focus to an Australian context.
Because any historical study of STDs must also be a study of prostitution, the reader is also kept apprised of the pervasiveness of this ancient industry in the West, in the British Empire, and, of course, in Australia. The story of European [End Page 544] sexual encounters and European ills in the antipodes began with various explorers and whalers, but it unfolded with rapidity as the eighteenth century waned. One of the many consequences of the American Revolution was that it deprived Great Britain of a dumping ground for its convicts, and Australia became a substitute. Consequently, in January 1788 the First Fleet landed at Botany Bay carrying 568 male convicts and 191 female convicts—the first wave in a deluge that would wash ashore another 160,000 in the decades to follow. The female convicts aboard (perhaps a quarter of whom had been prostitutes at home) had promiscuous relations with the sailors and marines; venereal diseases were apparently rife, and these were carried ashore as the relations continued. The STDs spread in turn to the Aborigines, to help trigger their precipitous decline, and became a medical fact of life among the whites. In large part this was because prostitution was widespread, maintained by an excess of male convicts transported (males represented 75 percent of the population in 1800, and until the 1830s convicts constituted the majority of migrants to Australia). Even after transportation ended in the 1840s, females remained a distinct minority in the population—an imbalance of the sexes exacerbated by the gold rushes of the 1850s; and as late as 1881, males still constituted 54 percent of the white population.
Subsequent chapters carry the history forward, starting with a description of prostitution, syphilis, and treatments for it in the nineteenth century, a period when the stigma of STDs greatly stimulated quackery (although doubtless this fear of stigma was joined by an equally understandable fear of the mercury administered by orthodox medicine). In twentieth-century Australia—despite the end of convict transportation, the withdrawal of the British Army in 1870, and a nearly even sex ratio by the beginning of the twentieth century—data on soldiers serving during the First World War revealed sufficiently high rates of STDs to initiate a national program of free clinics for the treatment of venereal diseases, together with legislation to make such treatment compulsory. With penicillin in the wake of the Second World War came the hope that STDs would be wiped out, but there was also a fear of widespread promiscuity when disease was no longer a deterrent. This fear, of course, was not totally unfounded, as demonstrated by the resurgence of STDs that began in the late 1950s and early 1960s and is still accelerating.
Chapter 8 returns to the issue of the Australian Aborigines and STDs, beginning with a fascinating examination of the evidence for treponemal diseases in Australia prior to the Europeans, and ending with a look at the very high prevalence of the classical STDs among the Aborigines today, as well as the risk that AIDS poses for them. A global survey of HIV/AIDS and a detailed examination of the disease in Australia in chapter 9 is followed by...