This article looks at cases of venereal disease from the early 1700s and how healers presented themselves as shrewd interpreters of patients’ bodies and souls. Because the disease was so stigmatizing, patients were said to be unreliable narrators of their own symptoms and health histories. Practitioners, in turn, exhibited diagnostic expertise by sagely navigating such constraints. They characterized themselves as medical detectives who gathered clues and made diagnoses in spite of patients’ alleged lies and omissions. Such work entailed moral integrity, astute observations, and the ability to persuade patients to divulge their most shameful sexual secrets. These findings illuminate how a particular disease shaped constructions of medical expertise, as well as the details of early modern medical practice that we rarely have the privilege of seeing.
This article examines links between mid-Victorian opposition to commerce in popular works on sexual health and the introduction of a legal test of obscenity, in the 1868 trial R. v. Hicklin, that opened the public distribution of any work that contained sexual information to prosecution. The article demonstrates how both campaigning medical journals’ crusades against "obscene quackery" and judicial and anti-vice groups who aimed to protect public morals responded to unruly trade in medical print by linking popular medical works with public corruption. When this link was codified, it became a double-edged sword for medical authorities. The Hicklin test provided these authorities with a blunt tool for disciplining professional medical behavior. However, it also radically narrowed the parameters through which even the most established practitioners could communicate medical information without risking censure.
In 1936, Fulgencio Batista, the head of the Cuban military (and the de facto ruler of Cuba), founded the National Tuberculosis Council (CNT) to lead a state-directed anti-tuberculosis campaign. While most national and colonial governments neglected tuberculosis until the postwar period, populist politics pushed Batista to prioritize a disease of poverty by the mid-1930s. However, national politics also undermined efforts to control the disease in Cuba. Authoritarianism facilitated Batista’s considerable influence over tuberculosis policy, and he and his advisors pursued political objectives rather than following the technical advice offered by professional groups. As a result, the administration of the campaign was inefficient, nowhere more notably than in the CNT’s premiere project, the Topes de Collantes National Sanatorium. Citizen and physician discontent with this project, the anti-tuberculosis campaign, and the state health sector fed into processes of political delegitimation and regime change in the 1950s.
In the 1920s and 1930s, doctors stationed in the Middle East and North Africa debated whether bejel, a form of endemic syphilis, was an Arab version of syphilis, or a separate disease altogether. Using their clinical experience and the region, they tried to weave this unfamiliar phenomenon into a civilizational narrative, which placed European civilization at the top of a hierarchy. The assumption was that there was something inherent to Islamic societies and their hygienic habits that accounted for this difference. After World War II, the eradication of bejel was declared to be one of the objectives of both the Iraqi government and the newly founded World Health Organization. Examining the postwar life of bejel, I question how colonial legacies affected postcolonial and international medical theories and practices, on both national and international levels.