SYPHILIS AND SEX: TRANSATLANTIC MEDICINE AND PUBLIC HEALTH IN ARGENTINA AND THE UNITED STATES, 1880-1940 by Julien Comte BA, Université François-Rabelais, 2005 MA, University of Pittsburgh, 2008 Submitted to the Graduate Faculty of the Dietrich School of Arts and Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Pittsburgh 2013 UNIVERSITY OF PITTSBURGH DIETRICH SCHOOL OF ARTS & SCIENCES This dissertation was presented by Julien Comte It was defended on March 29, 2013 and approved by George Reid Andrews, Distinguished Professor, Department of History Edward Muller, Professor, Department of History Todd Reeser, Professor, Department of French and Italian Dissertation Advisor: Lara Putnam, Associate Professor, Department of History ii Copyright © by Julien Comte 2013 iii SYPHILIS AND SEX: TRANSATLANTIC MEDICINE AND PUBLIC HEALTH IN ARGENTINA AND THE UNITED STATES, 1880-1940 Julien Comte, PhD University of Pittsburgh, 2013 This dissertation explores the international response to syphilis before the advent of penicillin in the 1940s. I focus on Argentina and the United States and within these two countries on New York and Buenos Aires. Since Paris, like New York and Buenos Aires, was an important node in a transatlantic system of scientific and policy exchange, I investigate first and foremost the connections between historical actors in France, Argentina, and the United States. My research pushes Atlantic history beyond the turn of the nineteenth century—the traditional ending point for most Atlantic historians—and explores the idea of a multi-centered Atlantic world, where knowledge circulated in all directions and between various nodes. By moving back and forth between different scales of analysis, this dissertation shows how subnational, national, and region-wide networks were imbricated into Atlantic and global circuits. Analyzing the relationship between Atlantic and national networks allows me to underscore the persistence of the national in the transnational. In a number of ways, rather than eliminate national boundaries, the transnational currents I examine reified national differences, as the people who shaped venereal disease control in France, Argentina, and the United States engaged in repeated cross- national comparisons. International scientific understandings and policy proposals were filtered through local and national concerns, resulting in different outcomes in different parts of the world. More than iv the demonstration effect, local political and cultural landscapes shaped the relationship between science and public policy. My discussion of sex education programs highlights the impact of transnational discourses on local conceptions of gender and sexuality. Furthermore, informed by shared eugenic concerns, all governments worried about the potential impact of syphilis on the collective welfare of the nation. However, in each case, the precise articulation between medical professionals, scientists, maternalist activists and other social reformers, on the one hand, and municipal, state, and national level politicians and bureaucrats, on the other, determined the ultimate evolution of public health laws and institutions. This dissertation blends transnational history and world history by using the transatlantic history of syphilis prevention as a window onto the formation of modern interventionist states. v TABLE OF CONTENTS ACKNOWLEDGMENTS .......................................................................................................... XI 1.0 INTRODUCTION ........................................................................................................ 1 1.1 ATLANTIC OR GLOBAL HISTORY? ............................................................ 2 1.2 DISEASE AS SCIENTIFIC REALITY AND DISEASE AS SOCIAL CONSTRUCTION ............................................................................................................... 7 1.3 SYPHILIS AND RACE ....................................................................................... 9 1.4 SYPHILIS, SEXUALITY, AND THE FAMILY ............................................ 12 1.5 SYPHILIS, SCIENCE, AND THE STATE ..................................................... 16 1.5.1 The persistence of the national ..................................................................... 19 1.6 SYPHILIS AND MEDICINE AND PUBLIC HEALTH ACROSS BORDERS ........................................................................................................................... 20 1.7 OUTLINE ........................................................................................................... 24 2.0 PROFESSION OR PATRIA? SYPHILIS AND THE PURSUIT OF SCIENTIFIC PRESTIGE ON A GLOBAL STAGE ....................................................................................... 27 2.1 SYPHILOLOGY AND THE TRANSATLANTIC CIRCULATION OF IDEAS ............................................................................................................................. 30 2.1.1 Cheap printing and cheap travelling ........................................................... 33 2.2 SEROLOGY AND THE DIAGNOSIS OF SYPHILIS .................................. 58 vi 2.3 CONCLUSION .................................................................................................. 73 3.0 BEYOND PROSTITUTION CONTROL: SYPHILIS PROPHYLAXIS REVISITED................................................................................................................................. 76 3.1 SYPHILIS AND PUBLIC HEALTH IN NEW YORK AND BUENOS AIRES ............................................................................................................................. 80 3.2 POST-EXPOSURE PROPHYLAXIS .............................................................. 90 3.3 CASUAL TRANSMISSION ........................................................................... 105 3.4 CONCLUSION ................................................................................................ 119 4.0 THINK OF THE CHILDREN: PREMARITAL AND PRENATAL TESTING FOR SYPHILIS ........................................................................................................................ 121 4.1 BEFORE WASSERMANN............................................................................. 123 4.2 AFTER WASSERMANN ............................................................................... 129 4.2.1 Prenatal testing emerges ............................................................................. 130 4.2.2 Is syphilis hereditary? ................................................................................. 134 4.2.3 Legislative campaigns.................................................................................. 137 4.2.4 Legislative victories ..................................................................................... 146 4.3 CONCLUSION ................................................................................................ 157 5.0 HEALTHY MASCULINITY: ABSTINENCE, SYPHILIS CONTROL, AND SEX EDUCATION ................................................................................................................... 159 5.1 SEX EDUCATION IN TRANSNATIONAL PERSPECTIVE.................... 161 5.1.1 Sexual sublimation in the United States .................................................... 171 5.2 SELF-CONTROL AND CIVILIZATION .................................................... 177 5.3 ARGENTINA ................................................................................................... 181 vii 5.3.1 Abstinence and the search for modernity.................................................. 188 5.4 CONCLUSION ................................................................................................ 191 6.0 CONCLUSION ......................................................................................................... 194 BIBLIOGRAPHY ..................................................................................................................... 198 viii LIST OF TABLES Table 1. Foreign corresponding members of the French Society of Dermatology and Syphilology (1933) ............................................................................................................................................ 56 ix LIST OF FIGURES Figure 1. Foreign corresponding members of the Argentine Dermatological Society (1922). .... 35 Figure 2. Place of residence of attendees at the First Congress of French-Speaking Dermatologists and Syphilologists (1922). ................................................................................... 45 Figure 3. Map of France................................................................................................................ 51 Figure 4. Map of Argentina. ......................................................................................................... 52 Figure 5. “¡Mire de frente el peligro!” (ca. 1939) ......................................................................... 88 Figure 6. “Estación profiláctica no. 1.”......................................................................................... 98 Figure 7. “Two intruders who, very often, are part of the wedding party: syphilis and gonorrhea” (ca. 1939). ................................................................................................................................... 143 Figure 8. Extract #1 from the Keeping Fit poster series (1918). ................................................ 175