Allied against sin: American and British responses to venereal disease in World War I.

UNrIL THE twentieth century, venereal diseases presented almost unmanageable problems to Western man. In times of war they took an especially heavy toll, producing as late as the nineteenth century a rate of infection sometimes double that of peacetime. Given the vast movement and dislocation of people and the relaxation in morals associated with war, military leaders had no choice but to resign themselves to the inevitability of rampant infection.1 The First World War, however, promised to be different. By 1914, thanks to August Wasserman's development of a test for syphilis and Paul Ehrlich's discovery of arsphenamine, military and civilian medicine finally had available the means for both identifying and curing syphilis, at least in its early stage. Consequently, as that conflict began, there was optimism that one of the major venereal diseases was at last going to be mastered. Disease prevention, however, involved more than merely knowing how to kill a certain virulent bacterium. In any public health problem, non-medical factors such as organization, education, and methods of enforcement also assumed vital roles. In the case of venereal disease, one had to deal as well with a whole set of cultural and psychological factors. For most of the combatants in World War I, those nonmedical problems thwarted the realization of hopes for disease control. The British, in particular, were not able to organize effectively against venereal diseases until the last stages of the war. That they began to do so then was largely attributable to aid and advice from the Americans, who alone among the warring powers succeeded in making effective application of the new medical knowledge. The reasons for the American success, not all praiseworthy, were nonetheless instructive, for they revealed much about the relative strength of public health forces in Britain and America. They also reflected considerable variation in the value systems of the two countries, which explained better than anything the uneven results attained against wartime venereal diseases.