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Ida Blom, Medicine, Morality and Political Culture: Legislation on Venereal Disease in Five Northern European Countries, c. 1870–c. 1995 (Lund: Nordic Academic Press, 2012), pp. 192, £26.95, paperback, ISBN: 9789185509737.

Published online by Cambridge University Press:  21 March 2013

Lesley A. Hall*
Affiliation:
Wellcome Library, London, UK
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Abstract

Type
Book Review
Copyright
Copyright © The Author(s) 2013. Published by Cambridge University Press.

This volume usefully investigates the strategies employed in the Nordic countries to control venereal diseases and provides valuable nuance to assumptions that there was a common Scandinavian approach, by considering in more detail the cases of Norway and Denmark. Significant work has already been done on Sweden, which has been assumed to embody a typically Nordic approach: this is now demonstrated to be an over-generalisation on the basis of its specific public health regime.

Blom sets her findings in a broader comparative context defined by the different approaches of Great Britain and Germany. These countries have already been much studied, but provide an interesting basis for comparisons of different approaches as well as common concerns over time.

Blom indicates that, in spite of some differences of timing due to local political, social, cultural and economic factors, the three Nordic countries under discussion did have numerous basic similarities in their political regimes. By around 1900 she suggests that, although not full-blown social welfare systems, they were ‘social-assistance states’. However, there were also specific differences: not until 1947 did all three have in place the same central governmental statutes relating to free (though compulsory) treatment, mandatory notification of sources of infection, imprisonment for infecting others, and police assistance in contact tracing.

Forms of regulationism – that is, the licensing and mandatory inspection of prostitutes, and sometimes other ‘dangerous bodies’ such as soldiers, vagrants and iterants – were the basis of approaches throughout most of the nineteenth century, subject to an increasing challenge from the abolitionist movement during the later decades. However, in Sweden a ‘contain and control’ policy affecting the whole population was already embodied in royal ordinances requiring notification of cases (or suspected cases) and their contacts, with funds for treatment provided through a special tax on citizens, even though only certain stigmatised elements within the population were seen as responsible for actually circulating the diseases. Denmark had even earlier instituted free treatment (with measures of compulsion) for ‘the common people’, subsequently made mandatory for all social groups, but a royal edict also initiated regulation of prostitution in Copenhagen, and this strategy continued to be extended during the nineteenth century.

Norway, previously under Danish rule, was ceded to the Swedish king in 1814 and did not become fully independent until 1905, although domestic policy was dealt with by the Norwegian parliament. There was no universal national legislation on venereal disease (VD), which instead continued to be dealt with under local municipal by-laws, which varied from place to place but usually involved regulation of prostitution. Carl Wilhelm Boeck’s introduction of Auzias-Turenne’s ‘syphilisation’ techniques to Norway is not discussed and it is not clear whether this had any impact on existing policies rather than in the clinical sphere of understanding of syphilis.

There is a particularly valuable analysis of transnational influences in the discussion of the relationships between German ideas and policies and those of Scandinavia. Social welfare measures and the discourse of social hygiene crossed boundaries. However, it has been demonstrated that there were significant differences between German ‘state corporatism’ and continuing conservative forces in the field of public morality, and the social-democratic welfare states emerging in Scandinavia. While Blom indicates a certain British exceptionalism in both policies relating to sexually transmitted disease (STD) control and in the ways the welfare state developed, she also points out that, even after the fall of the Contagious Diseases (CD) Acts, times of crisis such as wars could produce anxieties about women and their control in this context. Although late nineteenth-century abolitionist arguments originating in the British anti-CD acts campaigns played a part in the Scandinavian debates, they do not appear to have made a major impact on policies.

The extent to which the notion of women outside the bounds of the family continued to be perceived as the problem is demonstrated by Norwegian policies in the aftermath of the Second World War and the Occupation, which heavily stigmatised and penalised women. Similarly, in Denmark during the same period ‘young flighty girls’ were seen as dangerous vectors of disease.

The significant changes that took place in the post-Second World War era, and in particular the impact of the advent of HIV/AIDS in the 1980s, are not addressed in the same detail as earlier developments, though some suggestive conclusions are drawn as to the relative weight accorded by different political cultures with particular histories to appeals to individual responsibility versus state compulsion in the response to this new threat.

The detailed accounts of the evolution of policies relating to STDs within similar, but by no means identical, political systems and developing welfare states in Sweden, Norway and Denmark to the mid-twentieth century are a significant contribution to the historiography of STDs in the European context. It is a pity, however, that Nordic Academic Press has not provided an index, and that the standard of copy-editing is somewhat shoddy.