Dangerous liaisons: a social history of venereal disease in twentieth-century Scotland

Scotland has a reputation for not being wholly at ease with its sexuality. Hence the delight with which, some years ago, a panellist on the BBC's News Quiz read out a cutting from the Inverness Courier: "Perhaps the most worrying feature of the AIDS virus is that it can be transmitted during normal sexual intercourse between a man and a woman. Fortunately this is still very rare in Scotland". In fact, Scottish VD rates have traditionally been relatively high, particularly in economically deprived areas. AIDS, alas, now displays a similar social geography. We are fortunate that the challenge of shedding light on Scottish attitudes and responses to the darker consequences of sexual behaviour has been taken up by an author who shows himself to be an exponent of meticulous research and dispassionate commentary. Dangerous liaisons is a careful and sensitive exploration of both the social and the medical history of venereal disease in the twentieth century. Roger Davidson's conclusions are also very pertinent to public health policy issues in the twenty-first. While providing a useful survey of the secondary literature on venereal diseases, the introduction, with its allusions to Foucault and social constructionism, might be said to raise expectations that the later test does not wholly fulfil. It is odd, moreover, that Davidson identifies the affliction known in the Highlands as "Sibbens" with venereal syphilis in the face of both contemporary and modem opinion that it was a different, albeit related, disease, with a non-venereal aetiology. But these are trivial matters. Once into the twentieth century, Davidson's touch is sure and his agenda is firmly that of the social historian rather than the social theorist. In Chapter 2, he skilfully outlines the admixture of moral censure and medical neglect that characterized attitudes to VD in the early decades of the twentieth century. Morality neatly reinforced civic economy, both town councillors and the governors of voluntary hospitals being unwilling to finance treatment for diseases that were generally regarded as the consequences of individual misconduct. Scotland participated, moreover, in the British patriotic anxiety about the health and fitness of the armed forces, especially during the First World War, and in national concerns with racial degeneration, within which fears of congenital syphilis played a significant part. Much painstaking work in many archives has gone into Davidson's authoritative account of the setting-up and development of the Scottish VD service in the inter-war period. All the major Scottish centres are covered and a genuinely comparative perspective emerges. I enjoyed the story that Colonel Harrison's panopticon design for VD clinics, in which individual consultations were conducted in private but where the senior consultant could survey the whole clinic, was based upon his experience, as an impecunious student, of the layout of the pawn shop. Davidson expertly dissects the intimate interweaving of medical and moral concerns. Treatment had a punitive as well as a curative function; thus the unpleasant irrigation treatment of gonorrhoea was persisted with despite the availability of new chemotherapy and growing evidence of its damaging effects on the urethra. Transmission was routinely blamed on particular stigmatized groups. Feminist