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Elliott Bowen examines a venereal disease clinic in Hot Springs, Arkansas, offering insights into class-based, racial, and gendered aspects of the federal government's early twentieth-century public health work. Public Health in the US and Global South is a collection of interdisciplinary, multimedia publications examining the relationship between public health and specific geographies—both real and imagined—in and across the US and Global South.
These essays raise questions about the origin, replication, and entrenchment of health disparities; the ways that race and gender shape and are shaped by health policy; and the inseparable connection between health justice and health advocacy. Selected from a competitive group of submissions, these pieces offer new perspectives on the multiple meanings of health, space, and the public in the US and Global South.
Her experience was less than satisfactory. Because the clinic officially admitted only acute, infectious VD cases, Ishcomer was initially denied entrance—on the grounds that she was "not a danger to the public health. Without money, she made her way to a bus station where a police officer found Girls looking for sex Hot springs NC "in a very serious condition. Soon after her release, a PHS official angrily wired the health officer in Ishcomer's home county that "such cases will not be treated in the future.
Cumming, Surgeon General, to Charles M. Hereafter VD Division Records. The treatment Minnie Lee Ishcomer received likely did little to improve her health.
Her husband appears to have been a mill hand but no occupation is listed for her. Exactly which of her conditions triggered resentment by clinic doctors is not clear. Nevertheless, her story sheds light on a relatively unexplored site of public health work in the Girls looking for sex Hot springs NC twentieth-century US South. The opening of the Hot Springs VD clinic in followed upon extensive anti-venereal initiatives carried out by the U.
Closing in the s, the clinic marked a transition in the federal government's campaign against syphilis and gonorrhea —including the Tuskegee Syphilis Study —72 and the Chicago Syphilis Control Project — Throughout the interwar period, Hot Springs sat on the front lines of the PHS's war against VD, and although its efforts were largely unsuccessful, the clinic's history points toward a more complex understanding of this moment of "venereal peril.
The history of the Hot Springs clinic offers insights into racial, gendered, and class-based aspects of the federal government's campaign against syphilis and gonorrhea. The clinic treated all manner of patients—black as well as white, male as well as female. Some patients were chronically poor, and others—particularly with the onset of the Great Depression —had only recently fallen on hard times.
How similar were the experiences of these different groups, and to what extent did their treatment reflect prejudices against the various "others" such as prostitutes and African Americans popularly associated with VD?
While many historical VD studies examine population subsets, this article about Hot Springs offers a more comprehensive analysis, comparing the experiences of stigmatized groups along with those of Hot Springs's prototypical health-seekers: syphilitic white males.
Although they ed for the vast majority of the clinic's caseload, white men have not received ificant attention in VD historiography. Including their experiences adds new depth to our understanding of the "venereal peril" while illustrating how forcefully eugenics pervaded the PHS's campaigns against syphilis and gonorrhea. Eugenics, of course, figures prominently in scholarship on the infamous Tuskegee Study. This experiment, in which the PHS deliberately withheld treatment from four hundred syphilitic Alabama black men in order to study the disease's "natural" progression, was deed to provide evidence for the theory that as the Johns Hopkins syphilologist Joseph Moore put it "syphilis in the negro is in many respects almost a different disease from syphilis in the white.
From to white PHS doctors attempted to prove that black syphilitics almost never progressed to the late, advanced stage of the disease characterized by disorders of the nervous system—including tabes syphilis of the spinal cord and paresis syphilis of the brain. Blacks were seen as belonging to an uncivilized race with smaller, less developed brains that equipped them with a "racial resistance" to neurosyphilis; as a result, they were more likely to suffer from the disease's cardiovascular symptoms—including syphilis of the heart.
Doctors believed that this partial immunity to neurosyphilis was a hereditary trait. As the authors of a recent article on Girls looking for sex Hot springs NC observe, the experiment's goal was to "prove the biological basis of racial difference by documenting race-linked pathology, consistent with prevailing eugenic theory. Lombardo and Gregory M.
In providing an assessment of intellectual undercurrents circulating through the PHS in the s and s, this new literature successfully rebuts the claim that Tuskegee had little to do with scientific racism or eugenics. Unanswered, however, is how eugenic theories informed aspects of the agency's anti-venereal work involving non-blacks. At Hot Springs, these theories found expression in a campaign deed to prevent the clinic's mostly white male patients from succumbing to the "racial poison" that was VD.
Comprising traditional medical services and a variety of extra-medical measures including financial assistance for food, shelter, and basic carethis campaign cost hundreds of thousands of dollars, with its budget increasing dramatically during the early years of the Great Depression—just as the PHS dismantled a of pilot projects deed to provide mass treatment to syphilitic blacks. Although many of the initiatives undertaken in Hot Springs benefited patients regardless of race or sex, the clinic's white male health-seekers experienced a level of preferential treatment denied to both women and African Americans.
Further, for the latter group, discrimination and hostility were part and parcel of the Hot Springs experience—both inside and outside the clinic. All of this represented the eugenic impulses coursing through the PHS facility, whose director— Oliver C. Wenger —declared syphilis and gonorrhea important "from the standpoint of race conservation.
Hot Springs reveals a ificant instance of the federal government's racist approach to public health policy. When dealing with white patients, Washington extended a taxpayer-supported hand. Because such a sizable gap existed between the experiences of Hot Springs's black and white health-seekers, the story of the city's VD clinic provides a further context for understanding the Tuskegee Study.
Hot Springs's selection as the site of the federal government's "model" VD clinic would not Girls looking for sex Hot springs NC surprised early twentieth-century Americans.
InCongress declared that the boiling waters of the Ouachita Mountains were to be forever set aside for the "benefit and enjoyment" of the general public. Initially consisting of 2, acres, the HSR was public land managed by a federally-appointed commission, whose task was to maintain and control access to thegallons of water that daily coursed through the site. Word of the area's therapeutic prowess spread across the country, and as the city began welcoming hundreds of health-seekers every year, its waters acquired a reputation for curing syphilis.
During the late nineteenth-century, a growing belief in the springs' ability to "drive out syphilis completely" spurred a "Hot Springs craze" among venereal sufferers. Contemporaries began referring to the city as the " Mecca for syphilitics in America.
While some of Hot Springs's health-seekers received treatment at the Free Government Bathhouse created by the HSR inincreasing s did so at private enterprises. Hot Springs was "fast becoming a fashionable resort. Louis Medical and Surgical Journal 38 : Leasing land and water from the HSR, local developers began replacing the city's "miserable board shanties" with "palatial hotels. The resort's clientele shifted: earlier the preserve of "poor, miserable paupers," it was increasingly visited by "very wealthy people from the Northern states.
See also H. To ensure that its visitors remained a "people of leisure, with an abundance of money to spend," local officials forcibly uprooted the city's poorer health-seekers—those living in "shanties or tents" or found "encamped under the trees with no other shelter.
One turn-of-the-century visitor reported on how "it was the policy of the municipality of Hot Springs to discourage the coming of the poor people to that place," which it did "by withholding all of the usual eleemosynary institutions from their use. Medical authorities in other locales came to believe that "only the rich" could afford the "costly excursion" to Hot Springs.
As a Chicago physician said of his city's syphilitic patients: "our rich people go to the great Mecca of medical wisdom, to Hot Springs," while "our poor people may go to—where they please. The invention of Salvarsana more effective drug, also prompted a decline in the city's voluminous traffic in syphilitic health-seekers.
Nevertheless, neither new drugs nor the discrimination against impoverished health-seekers succeeded in severing the city's association with VD. Albert J. Whitworth and John M. Hot Springs's status as federal land and as a "mecca" for syphilitics made the city an ideal site for the PHS's "model" VD clinic. But why would the government create such a clinic? The early twentieth-century was a time of profound anxiety over syphilis and gonorrhea, diseases said to be "undoubtedly on the increase.
It is unknown whether the general prevalence of VD increased during the late nineteenth and early twentieth centuries. What changed was likely not the percentage of the population infected by syphilis or gonorrhea, but instead, the medical profession's awareness of how many illnesses originated in one of these two diseases.
Medical authorities proclaimed that 80 percent of adult males living in large cities contracted syphilis or gonorrhea before the age of thirty, and that 80 percent of all operations performed on women for diseases of the womb and ovaries were the result of one of these conditions. Such figures, though highly suspect, engendered fears of a looming VD epidemic across the country. A colleague named John Cunningham declared that "it is a fact worthy of consideration that every year in this countrymales reach the age of maturity. It may be affirmed that under existing conditions at least 60 percent, or overof these young men will sometime during life become infected with venereal disease, if the experience of the past is to be accepted as a criterion of the future.
The sense that venereal diseases constituted "a menace to the national welfare" stemmed less from epidemiology than from social and cultural concerns—of "race suicide" attendant upon the declining fertility of native, white-born women and the influx of "new immigrants," of urbanization and its impact on sexual mores, of a " family crisis " prompted by the emergence of the "new woman," and of eugenic concerns tied to the rhetoric of social Darwinism and racial degeneration. Reformers clamored for an attack on prostitution, artists luridly illustrated the consequences of untreated syphilitic and gonorrheal infections, and anxious legislators passed laws that ranged from the reporting of all professionally-handled VD cases to the bacteriological examination of immigrants and prospective spouses.
The climax of these fears came during World War I. With scientific diagnoses, doctors found that a surprisingly high of prospective US military recruits suffered from VD. Hoping to head off a manpower shortage, in Congress created the Committee on Training Camp Activities —an organization that sought to curb the venereal scourge through the forced incarceration of prostitutes, the provision of medical services Girls looking for sex Hot springs NC infected soldiers, and the establishment of "wholesome" alternatives to the vice-ridden recreational opportunities commonly found in cantonment zones.
See also Alexandra M. As the war came to a close, Washington followed up on these efforts by conducting a nationwide VD survey. Each of these actions drew attention to Hot Springs. Throughout the war, military authorities fretted over Little Rock's Camp Pikea training facility whose VD rates were reportedly "the [highest] by far of any camp or cantonment in the United States. According to Vaughan, the venereal disease rate at Camp Pike was According to local commanders, Camp Pike's reputation as a hotbed of sexual sickness owed to its proximity to Hot Springs, where prostitution had been legal since the late nineteenth-century and where brothels enjoyed a reputation as home to the profession's "aristocrats.
Cowles, a syphilitic health-seeker who traveled to Hot Springs in In a letter dated December 10,Cowles wrote that "many of the women here seem to be on the courtesan order. Of course, it would not do to call them prostitutes," Cowles remarked, "for they are aristocrats in their profession. In AugustCamp Pike's commanders ordered the closure of Hot Springs's numerous "houses of immorality. Local businessmen and religious leaders rejected the association the military made between Camp Pike's high venereal disease rate and the "terrible conditions" in Girls looking for sex Hot springs NC Springs.
Municipal authorities reluctantly complied, but the federal government's interest in Hot Springs did not end. While conducting their post-war VD survey, government officials Girls looking for sex Hot springs NC increasingly anxious about the city's "serious medical and social problems," observing that Hot Springs was home to an increasing population of venereally afflicted "indigents" and an entirely "inadequate" public health infrastructure.
From the federal perspective, syphilitic health-seekers represented an "interstate menace.Girls looking for sex Hot springs NC
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Before Tuskegee: Public Health and Venereal Disease in Hot Springs, Arkansas