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In Search of Sexual Health

Diagnosing and Treating Syphilis in Hot Springs, Arkansas, 1890–1940

During the late 1800s and early 1900s, the central Arkansas city of Hot Springs enjoyed a reputation as one of the United States' premier health resorts. Throughout this period, the vast majority of Americans who traveled there did so because they had (or thought they had) syphilis—a disease whose incidence was said to be dramatically on the rise all across the country. Boasting an impressive medical infrastructure that included private clinics, a military hospital, and a venereal disease clinic operated by the United States Public Health Service, Hot Springs extended a variety of treatment options. Until the antibiotic revolution of the 1940s, Hot Springs occupied a central position in the country's struggle with sexually transmitted disease.

Drawing upon health-seekers' firsthand accounts, clinical case files, and the writings of the city's privately practicing specialists, In Search of Sexual Health examines the era's "venereal peril" from the standpoint of medical practice. How, Elliott Bowen asks, did people with VD understand their illnesses, and what therapeutic strategies did they employ? Highlighting the unique role that resident doctors, visiting patients, and local residents played in shaping Hot Springs' response to syphilis, Bowen argues that syphilis's status as a stigmatized disease of "others" (namely prostitutes, immigrants, and African Americans) had a direct impact on the kinds of treatment patients received, and translated into very different outcomes for the city's diverse clientele—which included men as well as women, blacks as well as whites, and the poor as well as the rich.

Whereas much of the existing scholarship on the history of sexually transmitted diseases privileges the actions of medical elites and federal authorities, this study reveals Hot Springs, a remote and fairly obscure town, as a local node with a significant national impact on American medicine and public health. Providing a richer, more complex understanding of a critical chapter in the history of sexually transmitted diseases, In Search of Sexual Health will prove valuable to historians of medicine, public health, and the environment, in addition to scholars of race, gender, sexuality.

About the Author

Elliott Bowen is an assistant professor in the history of medicine and public health at Nazarbayev University.

Endorsements

"Elliott Bowen elegantly and concisely uses the history of Hot Springs, Arkansas, to reveal tensions over federal institutions and authority, the continued role of patient histories even in an era of laboratory testing, and the sharp racism that shaped white practitioners' responses to their patients and to African American doctors. This readable and well-organized book will be of great use to historians of medicine, environmental historians, and all those interested in how place and race have shaped the experience of sickness in America."

- Conevery Bolton Valencius, Boston College, author of The Health of the Country: How American Settlers Understood Themselves and Their Land

"Bowen has chosen a fresh context in which to examine doctors, patients, and disease identity. By looking at these variables configured in the Hot Springs story, he has chosen to also examine notions of race and gender, as well as aspects of health policy. This solidly researched book illuminates the lived experience of a segment of patients in (mostly) early twentieth-century America."

- Charles E. Rosenberg, Harvard University, author of Our Present Complaint: American Medicine, Then and Now

"In Search of Sexual Health is a vital addition to the history of sexual health in the United States. It pushes beyond traditional narratives of sin and stigma, offering a nuanced study of the experiences of VD sufferers, their determined search for effective treatments, and the personal relationships that shaped their care."

- Anne Hanley, Birkbeck, University of London, author of Medicine, Knowledge and Venereal Diseases in England, 1886-1916

"Bowen decenters our understanding of the cultural/medical response to syphilis by exploring the importance of local patients, doctors, and communities in seeking health cures. A well-written, sophisticated, and important historical contribution that redeploys our attention outward from the local to tell a critical national story. I would teach this book in a heartbeat."

- Susan M. Reverby, Professor Emerita, Wellesley College, author of Examining Tuskegee: The Infamous Syphilis Study and its Legacy

"Skillfully blending attentive scholarship with compassionate prose, Bowen guides readers on an unforgettable journey. This wonderful book foregrounds considerations of race, place, class, and gender to uncover the wide-ranging experiences of everyday men and women—and their doctors, healers, and care attendants—grappling with sexually transmitted infections in the pre-penicillin era."

- Richard A. McKay, University of Cambridge, author of Patient Zero and the Making of the AIDS Epidemic
Johns Hopkins University Press
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September 29, 2020
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