Sex, Sin, and Science: A History of Syphilis in America (review)

John Parascandola suggests that Sex, Sin, and Science can provide the general reader with an introduction to the history of syphilis and public health policy in America. Although he believes the book will offer materials of interest to specialists in the history of medicine and public health, his main goal is to write a popular book–an overview that will provide information on the disease and its treatment so that the broader public can understand the ways that social and cultural beliefs affect illness, medicine, and social policy.

To support this program, Parascandola offers two background chapters. The first outlines the emergence and treatment of syphilis in Europe. The second provides an overview of venereal disease in America before the twentieth century. Both chapters explain the historiography, detail changing medical treatments, and show how policies and beliefs shifted over the course of long sweeps of time. The next three chapters examine the ways that the state began to educate broad groups of people and treat syphilis as part of an expansive military policy. During the Great War, the establishment of large training centers meant that men needed to be organized and entertained lest they would find their own pleasures. As a result, coercive policies against prostitutes and charity girls went hand-in-hand with education about venereal disease. The War Department created the Commission on Training Camp Activities to oversee recreation and placed VD control under the auspices of the re-worked Public Health Service, a process that Parascandola documents carefully and clearly. At the end of the war, coercive measures were largely dismantled but agencies tried to continue the sex-education campaigns despite opposition from religious organizations. The outbreak of World War II meant that the problem of training, treatment, and education for masses of men again came to the fore. The final chapter examines syphilis in America after the development of antibiotics.

Across these chapters, Parascandola finds that there are three patterns or themes worth exploring. The first is the tendency to focus blame for contagious diseases on particularly vulnerable groups like women and African-Americans. The second is the tension between state needs and individual rights in cases of medical necessity like quarantining and testing. The third is the reluctance and oftentimes refusal in America to discuss venereal diseases. Though these points might seem simplistic or unnecessary to the professional historians, given religious resistance to science in twenty-first century America and given the refusal by certain segments of the conservative movement to move beyond the language of abstinence to discuss sexuality, such projects are not only necessary but central to what historians should be doing. This type of story should be told and re-told so that the state’s power over the individual, the blaming of the vulnerable, and the impact of silencing discussions about sexuality can be the basis for thoughtful discussions about the role of public health in treating sexual disease.

This book contains enough information– both charming and thought-provoking–to aerate any lecture. The Columbian exchange debate over the New World origins of syphilis, the derivation of the word syphilis from a sixteenth century Latin poem, and famous European syphilitics can all be useful to get a good “ick” response that so enlivens the undergraduate lecture. Well worth the price of admission is Parascandola’s discussion of the Tuskegee experiment. Parascandola demonstrates that the experiment came as part of a broad public health movement intended to rid the African-American community of syphilis. Scientists and public health officers, upon finding that funding cuts caused by the Depression would not allow for the expensive therapies necessary for treatment, decided to continue to monitor the population and study the effects of non-treatment. Once funding disappeared the choice was not between treatment and non-treatment as is often understood; instead, it was between non-treatment and monitored nontreatment. That section provides one of the most powerful discussions I’ve read on exploring the context...