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Bulletin of the History of Medicine 75.4 (2001) 821-823



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Book Review

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


Roger Davidson. Dangerous Liaisons: A Social History of Venereal Disease in Twentieth-Century Scotland. Vol. 57 of Clio Medica. Wellcome Institute Series in the History of Medicine. Amsterdam: Editions Rodopi, 2000. vii + 383 pp. Ill. $85.00 (cloth), $28.00 (paperbound); Hfl. 200.00 (cloth), 65.00 (paperbound); £60.00 (cloth, 90-420-0628-5), £19.50 (paperbound, 90-420-0618-8).

The development of British policy and administration on the venereal diseases (VD), later termed the sexually transmitted diseases (STDs) in the nineteenth and twentieth centuries, has been the subject of a huge amount of recent historical attention. Much of this has derived from research initially stimulated by feminist concerns, or by interest in the construction of deviance. The historical examples of opposition to the Contagious Diseases Acts of the nineteenth century and the Royal Commission on Venereal Diseases' establishment of a state-funded system of confidential open-access clinics were also valuable precursors for those arguing for a similar liberal response to HIV/AIDS. All this work is set on the national stage: English experience stands as surrogate for the rest of the United Kingdom. Roger Davidson's Dangerous Liaisons corrects this balance and reminds us that there have been few local studies. The response to VD in [End Page 821] Scotland is, however, more than a local divergence: Scotland has its own distinctive traditions of medicine, derived from long association with continental Europe, and even today its own systems of health organization. On occasion, Scottish initiatives have fed through into English health policymaking. The history of health education for smoking, and of harm-reduction policy for HIV/AIDS and drug use, are two recent examples.

VD policy also had its own trajectory in Scotland. By contrast with the "liberal" English response, Davidson uncovers a tradition of "civic authoritarianism" in Scotland in the interwar years that manifested itself in proposals for more stringent control of VD, including compulsory notification. The Edinburgh Corporation (Venereal Disease) Bill of 1928 was the most far-reaching with its provisions for compulsory treatment, extending both to children and to defaulters. Such moves were unsuccessful, and Davidson argues that the opposition to them underlined continuing public opposition, demonstrated earlier in antivaccinationism, to the growing alliance between expertise and the potentially authoritarian state.

Despite the existence of substantial later pressure--mainly from Medical Officers of Health--for the continuance of World War II controls of notification and compulsion as long-term policy, these were not extended in the late 1940s. The English Ministry of Health was anxious not to make the National Health Service negotiations more difficult by implying that controlling physicians might be an outcome, and the advent of penicillin made scientific advisors feel that physical control would be unnecessary. Scotland in the postwar period was in some senses less restrictive than England: it did not follow the provisions of the 1968 National Health Service regulations that allowed more extensive contact tracing--in part because of sharp postwar declines in the incidence of gonorrhoea and syphilis, which were rising elsewhere in the United Kingdom. Edinburgh and Glasgow were, however, introducing local contact-tracing policies that shifted from the traditional preoccupation with defaulters to tracing the hidden pool of infection within the community.

The book covers much more than the trajectory of policymaking. Davidson studies the role and nature of treatment (irrigation for gonorrhea seems to have been particularly damaging before the advent of M and B therapy), and discusses clinic architecture (based on the pawnshop). He is sensitive to the gender dimension of treatment and of health discourse, where it was the woman--either as mother or as "good time girl"--who was variously the innocent victim, the guardian of the future of the race, or the potential polluter and vector of infection. The low status of venereology as a medical specialty did not help matters.

Scottish VD policy did not influence...

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