Diseases of Men: Sexual Health and Medical Expertise in Advertising Medical Institutes, 1900-1930 A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF MINNESOTA BY Suzanne Michelle Fischer IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY Sally Gregory Kohlstedt August, 2009 © Suzanne Fischer 2009 This work is licensed under the Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/us/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA. i Acknowledgements Many thanks to my advisor, Sally Gregory Kohlstedt and the members of my committee for their assistance. Thanks also to Susan Jones, Mike Sappol and others who provided guidance. Many archivists and librarians assisted my research, including Christopher Hoolihan at the Miner Medical Library, Elaine Challacombe and Jim Curley at the Wangensteen Historical Library, Elizabeth Ihrig at the Bakken, and the staff of the Archives of the American Medical Association. Many thanks to my father and to my late mother. Members of DAWGs, the Dissertation and Writers Group, including Susan Rensing, Margot Iverson, Juliet Burba, Don Opitz, Hyung Wook Park, Gina Rumore, Rachel Mason Dentinger, Erika Dirkse, Amy Fisher and Mike Ziemko provided helpful commentary. Many friends, including Katherine Blauvelt, Micah Ludeke, Mary Tasillo, Megan Kocher, Meghan Lafferty, Cari Anderson, Christine Manganaro and Josh Guttmacher provided support and dinner. And endless gratitude to my greatest Friend. ii Dedication This dissertation is dedicated to the memory of my mother, Barbara Fischer. iii Abstract This dissertation uses a once-ubiquitous medical institution, the men’s specialist or advertising medical institute, to show how many different groups staked out ground around medical expertise in the early twentieth century Midwest. Regular doctors, the advertising doctors themselves, newspaper editors, reformers, legislators, patients and others saw the arguments over the legitimacy of medical institutes as places to take a stand on how medical expertise was constructed. In particular, this dissertation investigates how the practice of advertising defined practitioners as quacks, and how advertising for the new discoveries in scientific medicine implicated men’s doctors in questions of authority, authenticity, and medical views on sexuality. The process by which irregular practitioners were othered also highlights the disparities in access to health care for “men’s diseases,” such as sexually transmitted infections, in the early twentieth century. The Reinhardt brothers of St. Paul, proprietors of a chain of Midwest medical institutes in the early twentieth-century, provide a lens onto men’s specialist practice. iv Table of Contents Introduction. “Secrets of Life and Lost Manhood” 1 1. “Manliness, Vigor, Health:” Patients, Diseases and Spaces in the Advertising Medical Institute 27 2. “War against the Advertising M.D.s:” Advertisers Under Fire in Milwaukee 73 3. “We Never Cure Anybody Here”: The Chicago Tribune’s Crusade against Quackery 115 4. “606 Will Save You”: Selling Scientific Medicine 175 Conclusion: Health and Wealth 226 Bibliography 235 1 Introduction: Practitioners and Patients on the Fringes of Medicine “When the veil of mystery is torn from the medical faker, the naked sordidness and inherent worthlessness that remains suffices to make quackery its own greatest condemnation.” 1 Arthur Cramp, M.D., 1921 In his 1921 book Nostrums and Quackery , Arthur Cramp, director of the American Medical Association’s Bureau of Investigation, denounced medical quacks. The book, lively and packaged for a popular audience, was an anthology of investigations into quackery and patent medicine claims from the pages of the Journal of the American Medical Association ( JAMA ) and newspapers from around the country. It featured detailed stories on the inner workings of questionable medical businesses, with a tone verging on mockery at the audacity and blatant frauds of some practitioners. 1 Arthur Cramp, Nostrums and Quackery Vol. 1, 2nd ed. (Chicago: American Medical Association, 1921), 6. 2 Removing “the veil of mystery” from underground medical businesses, as Cramp suggested, might sell books to the public at large, but proving that the businesses were unethical, immoral, or quacks to the satisfaction of the law took more than a book. Nor did JAMA or newspaper exposés necessarily lead to arrests, convictions or the shuttering of the targeted medical businesses. The line between a ‘faker’ and a ‘real doctor’ might have been self-evident to Cramp and other anti-quackery crusaders. Throughout the nineteenth and early twentieth century, however, the meanings of quackery, and on the converse, legitimate medical practice remained contested. This dissertation uses a once-ubiquitous medical institution, the men’s specialist or advertising medical institute, to show how many different groups staked out ground around medical expertise in the early twentieth century Midwest. Regular doctors, the advertising doctors themselves, newspaper editors, reformers, legislators, patients and others saw the arguments over the legitimacy of medical institutes as places to take a stand on how medical expertise was constructed. In particular, this dissertation investigates how the practice of advertising defined practitioners as quacks, and how advertising for the new discoveries in scientific medicine implicated men’s doctors in questions of authority, authenticity, and medical views on sexuality. Though a regular practitioner like Dr. Cramp could thunder about the distinct line between regular and irregular medical practice, in the early twentieth century these lines were continually 3 being drawn and redrawn and blurred. The process by which irregular practitioners were othered also highlights the disparities in access to health care for “men’s diseases,” such as sexually transmitted infections, in the early twentieth century. In this introduction, I will consider themes, sources, antecedents and key literature in the story of men’s doctors. Building Medical Expertise In early twentieth century America, medical practitioners of all kinds, patients, legislators, and reformers debated definitions of “physician” and of “legitimate medical practice.” The familiar twenty-first century model of medical organization was partly formed through these negotiations. In the nascent twentieth century vital professional questions needed new and certain answers. Who was a doctor? Who was a good doctor, and who was a quack? How could you tell? If a practitioner advertised his services, was he a quack? If a practitioner specialized in venereal diseases, was he a quack? If a practitioner used the latest scientific equipment, could he be a quack? If advertising was a characteristic of a quack doctor, what were the characteristics of “real doctors”? What was the role of government in regulating quackery? Though a regular doctor might affirm the premises of most of these questions, in practice they were hard to answer positively. 4 At the heart of these contestations was a progressive consideration of medical expertise. At stake was the larger American cultural question of who counted as an expert and who could produce and use expert knowledge. A growing number of proponents of expertise in the progressive era assigned value to specialized knowledge, training, and certification in all areas of society, including medicine. 2 In medicine, however, with a proliferation of practitioners and schools, it was unclear what constituted legitimate knowledge, and who was qualified to decide. Mainstream “regular” doctors increasingly set themselves up as both the keepers of expert medical knowledge and the gatekeepers into the profession. In the context of the increasing professionalization of American society, it became increasingly important for professionals to distance themselves from more questionable workers, and to set clear boundaries between experts and quacks. Indeed, in the early twentieth century, medical expertise was constructed oppositionally: real doctors were those who were not quacks. This othering process begged the question of who the quacks were. Men’s specialists here serve as exemplars of irregular practice. These specialists and their clinics, called “advertising medical institutes” by both supporters and opponents, were often identified as quacks and became fulcrums in this contestation of medical 2See, for instance, Rebecca Edwards, New Spirits: Americans in the Gilded Age, 1865-1905 (New York: Oxford University Press, 2005); Michael McGerr, A Fierce Discontent: The Rise and Fall of the Progressive Movement In America, 1870-1920 (New York: Simon and Schuster, 2003); Paul Starr, The Social Transformation of American Medicine (New York: Basic, 1982). 5 expertise. Both their business model and their specialty, “diseases of men,” invited accusations of quackery. Successful men’s specialists Willis, Wallace and Frank Reinhardt of St. Paul, for instance, owned a chain of over thirty Midwest institutes stretching from Davenport to Peoria. From storefront offices including a wax museum and operating rooms, the Reinhardts and other proprietors advertised and widely disseminated their claims to be specialists in curing “diseases of men,” which included venereal diseases, “lost manhood,” and the effects of