AIDS and Contemporary History Edited by Virginia Berridge and Philip Strong (review)

AIDS and Contemporary History. Edited by Virginia Berridge and Philip Strong. New York: Cambridge Univ. Press, 1993. Pp. 284. $54.95. Scholars of the medical sciences have long realized that diseases can exist only within a specific social, political, and economic context. Their studies of disease acquire added salience with the arrival of each new disease, such as AIDS. What is AIDS? How have we as physicians and scientists chosen to define this new disease? How should we as a society respond to this new disease? Answers to these questions have often come from people working within the framework of the humanities, such as history, and historians have paid attention to AIDS almost from its very beginnings. Yet, just as has been the case for scientific studies, in the years since we first started to define AIDS the nature of historical analysis has changed. As Virginia Berridge points out in her excellent introduction to this volume, historians initially turned to epidemics to provide "lessons from history." Perhaps learning about earlier plagues could help policy makers deal with this seemingly new and devastating disease. Berridge suggests that the model of AIDS as an epidemic disease guided initial British policy development, and that at the start policy makers were open to input from a number of different areas. However, from about 1987 onwards, policy has been normalized and the standard model has become one of chronic disease. This observation probably applies as well to the United States. Too often, history is seen as relevant only for understanding the distant past. Berridge points out three general ways in which historians' ways of thinking may enhance our understanding of contemporary events. First, historians tend to be firmly rooted to the importance of chronology. They ask questions about how things change over time. Second, historians tend to be skeptical about "routine proclamations of a new departure in policy" (p. 6). By locating antecedents to what is claimed to be new and different, they can help us understand policy-relevant decisions. Finally, historians tend to be not as concerned as people working on other social sciences with theoretical models, and to be sensitive to a wider range of empirical evidence. The value of contemporary history is well-demonstrated by the twelve essays in this volume, which are divided into two major sections: "The pre-history of AIDS" and "AIDS as history." An appendix discusses collection of historical material about AIDS. Most essays are informed by a sociological approach to historical practice, paying careful attention to the creation of interest groups and occupational coalitions. However, a few of the essays have within them strong strands of presentism—the tendency to try to apply standards of the present to analyze events of the past, to act as though there are certain acultural, transhistorical, immutable standards or ideas that can be used to judge past events. Because people in the past can only have acted in accordance with the beliefs and ideas of their own time, presentism does not lead to meaningful scholarship or useful insights. It is far better to examine and understand people 's actions within the specific framework in which they lived and worked. Many of the essays do just that, examining a wide range of historical topics that are relevant to understanding AIDS. For example, liana Löwy analyzes the Perspectives in Biology andMedicine, 37, 4 ¦ Summer 1994 | 617 construction of facts about syphilis, following on Ludwik Fleck's masterful 1935 study, The Genesis and Development ofA Scientific Fact (reprinted by the University of Chicago Press in 1979). Löwy examines changes in various serum tests for syphilis and discusses how physicians and scientists related false-positive reactions to disease definitions. These same subjects have been extremely important as people develop serum tests for HIV infection. This history provides an important warning: apparently uncontestable "facts" about AIDS, just as previous "facts" about syphilis, will change. Other essays examine the history of screening tests in general, and the ways that hepatitis B did (and did not) serve as an effective model in preparing society to deal with AIDS. International comparisons suffuse the book. These are primarily comparisons between the United States and Great Britain, although one...