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Before Tuskegee: Public Health and Venereal Disease in Hot Springs, Arkansas

...Diseases, ed. William Josephus Robinson (New York: The Altrurians, 1909). For historical studies on this, see Theodor Rosebury, Microbes and Morals: The Strange Story of Venereal Disease (New York: Viking...

References
1.	H.S. Cumming, Surgeon General, to Charles M. Pearce, State Health Commissioner, Oklahoma, January 29, 1936, General Records of the Venereal Disease Division, 1918–1936, 203.4, in RG 90, Records of the Public Health Service, 1912–1968, National Archives, College Park, Maryland. Hereafter VD Division Records.
2.	Available federal census information indicates that in 1930, Ishcomer was married and had a least one son. Her husband appears to have been a mill hand but no occupation is listed for her. Exactly which of her conditions triggered resentment by clinic doctors is not clear.
3.	For a brief overview of the Hot Springs VD clinic, see Edwina Walls, "Hot Springs Waters and the Treatment of Venereal Diseases: The U.S. Public Health Service Clinic and Camp Garraday," Journal of the Arkansas Medical Society 91, no. 9 (1995): 430–7.
4.	The term "venereal peril" was a staple of turn-of-the-century discourse around syphilis and gonorrhea. For a particularly good example of this, see William Leland Holt,The Venereal Peril: A Popular Treatise on the Venereal Diseases, ed. William Josephus Robinson (New York: The Altrurians, 1909). For historical studies on this, see Theodor Rosebury, Microbes and Morals: The Strange Story of Venereal Disease (New York: Viking Press, 1971); Allan Brandt, No Magic Bullet: Venereal Disease and American Society since 1880 (New York: Oxford University Press, 1987); Suzanne Poirier, Chicago's War on Syphilis, 1937–40: The Times, the Trib, and the Clap Doctor (Urbana: University of Illinois Press, 1995); Nancy K. Bristow, Making Men Moral: Social Engineering during the Great War (New York: New York University Press, 1996); Andrea Tone, Devices and Desires: A History of Contraceptives in America (New York: Hill and Wang, 2001); Marilyn Hegarty, Victory Girls, Khaki-Wackies, and Patriotutes: The Regulation of Female Sexuality during World War Two (New York: New York University Press, 2008); John Parascandola, Sex, Sin, and Science: A History of Syphilis in America (Westport, CT: Praeger, 2008).
5.	Susan Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina Press, 2009), 136.
6.	Christopher Crenner, "The Tuskegee Syphilis Study and the Scientific Concept of Racial Nervous Resistance," Journal of the History of Medicine and Allied Sciences 67, no. 2 (2012): 244–80.
7.	Paul A. Lombardo and Gregory M. Dorr, "Eugenics, Medical Education, and the Public Health Service: Another Perspective on the Tuskegee Syphilis Experiment," Bulletin of the History of Medicine 80, no. 2 (2006): 313.
8.	For a recent article in the revisionist vein, see Thomas G. Benedek and Jonathon Erlen, "The Scientific Environment of the Tuskegee Study of Syphilis, 1920–1960," Perspectives in Biology and Medicine 43, no. 1 (1999): 1–30.
9.	O.C. Wenger, "The Need for Social Hygiene," Oliver C. Wenger Papers, Box 1, University of Arkansas for Medical Sciences Archives.
10.	C.N. Myers, "Hot Springs and the Model Federal Venereal Disease Clinic," Medical Review of Reviews 28 (1922): 86.
11.	For more on the city's early history and the role of the Hot Springs Reservation, see Janis Kent Percefull, Ouachita Springs Region: A Curiosity of Nature (Hot Springs, AR: Ouachita Springs Region Historical Research Center, 2007).
12.	J.K. Haywood, Analyses of the Waters of the Hot Springs of Arkansas (Washington, D.C.: Government Printing Office, 1912), 5.
13.	For evidence of this, see A.J. Wright, "Some Account of the Hot Springs of Arkansas," The New Orleans Medical and Surgical Journal (1860): 798–9, 801; R.M. Lackey, "The Hot Springs of Arkansas," Chicago Medical Journal 23 (1866): 9; J.L. White, "The Hot Springs of Arkansas," Chicago Medical Recorder 36 (1878): 311.
14.	S.B. Houts, "Cases in Practice," The Medical World 5 (1887): 248–52; Edward L. Keyes, The Venereal Diseases, Including Stricture of the Male Urethra (New York: William Wood & Company, 1880), 107–8; E.R. Lewis, "The Hot Springs of Arkansas," The Kansas City Medical Index-Lancet 10, no. 7 (1889): 249. For references to Hot Springs as a "Mecca" for syphilitics during the late-nineteenth and early-twentieth centuries, see "Editorial: Syphilis of the Nervous System," The Hot Springs Medical Journal 3, no. 2 (1894): 51; A. Ravogli, "The Thermomineral Cure in the Treatment of Syphilis," The Medical Era 6, no. 8 (1897): 276; Bukk G. Carleton, A Treatise on Urological and Venereal Diseases (New York: Bukk G. Carleton, 1905), 741; Loyd Thompson, Syphilis (Philadelphia, PA: Lea and Febiger, 1920), 212.
15.	Haywood, Analyses of the Waters, 5.
16.	J.L. Gebhart, "On the Therapy of the Waters of Hot Springs, Arkansas, and Their Relation to the Medical Profession at Large," St. Louis Medical and Surgical Journal 38 (1880): 634.
17.	Robert Heriot, "Letter to the Editor," Locomotive Engineers Journal 25 (1891): 919.
18.	E.B. Stevens, "Hot Springs, Arkansas," Transactions of the Ohio Medical Society 31 (1875): 197; Heriot, "Letter to the Editor," 919. See also H.M. Rector, "Then and Now," Hot Springs Medical Journal 4 (1895): 225; Henry Durand, "Uncle Sam, M.D., and His Great Sanitarium," The American Monthly Review of Reviews 16 (1897): 75–9.
19.	"Hot Springs, Arkansas," The Medical Visitor 20 (1904): 140; "Hot Springs, Arkansas, as a Health Resort," Hot Springs Medical Journal 3, no. 6 (1894): 173; William H. Deaderick, "The Development of the Hot Springs of Arkansas as a Health Resort," The Medical Pickwick 2 (1916): 265–6. One turn-of-the-century visitor reported on how "it was the policy of the municipality of Hot Springs to discourage the coming of the poor people to that place," which it did "by withholding all of the usual eleemosynary institutions from their use." Hal C. Wyman, "A Surgical Pilgrimage to Arkansas," Physician and Surgeon 28 (1906): 207.
20.	"Syphilitic Paresis," The Eclectic Medical Journal 50 (1890): 562.
21.	Joseph Zeisler, "The Social Evil," Year Book (Chicago: The Sunset Club, 1894), 218.
22.	"Since the arsphenamines have justly become popular," the director of the Hot Springs VD clinic observed in 1921, "the number of syphilitics coming to Hot Springs has been decreased year by year." O.C. Wenger, "The Early Days of Hot Springs, Arkansas (1850–1900)," Oliver C. Wenger Papers, Box 1, University of Arkansas for Medical Sciences Archives.
23.	"We see every day, here in Hot Springs," one local physician noted in a 1913 treatise, "from ten to a hundred persons" suffering from the "terrible disease" that was syphilis. Albert J. Whitworth and John M. Byrd, The Hot Springs Specialist (Memphis, TN: B.C. Toof & Company, 1913), 164. For more about Salvarsan, see Patricia Spain Ward, "The American Reception of Salvarsan," Journal of the History of Medicine & Allied Sciences 36, no. 1 (1981): 44–62.
24.	Oliver C. Wenger, "The Early Days in Hot Springs, Arkansas (1850–1900)." Oliver C. Wenger Papers, Box 1, University of Arkansas for Medical Sciences Archives.
25.	Oliver C. Wenger, "Results of a Study and Investigation of Venereal Disease at the United States Public Health Service Clinic at Hot Springs, Arkansas," Oliver C. Wenger Papers, Box 1, University of Arkansas for Medical Sciences Archives.
26.	George P. Dale, "Moral Prophylaxis," The American Journal of Nursing 11, no. 9 (1911): 689. It is unknown whether the general prevalence of VD increased during the late nineteenth and early twentieth centuries. What changed was likely not the percentage of the population infected by syphilis or gonorrhea, but instead, the medical profession's awareness of how many illnesses originated in one of these two diseases.
27.	For these estimates, see G. Shearman Peterkin, "A System of Venereal Prophylaxis That is Producing Results," American Medicine 10 (1906): 328. A colleague named John Cunningham declared that "it is a fact worthy of consideration that every year in this country 770,000 males reach the age of maturity. It may be affirmed that under existing conditions at least 60 percent, or over 450,000 of these young men will sometime during life become infected with venereal disease, if the experience of the past is to be accepted as a criterion of the future." John C. Cunningham, "The Importance of Venereal Disease," The New England Journal of Medicine 168, no. 3 (1913): 77–8.
28.	Abraham L. Wolbarst, "The Venereal Diseases: A Menace to the National Welfare," Medical Review 62 (1913): 327–80.
29.	For more on this, see Brandt, No Magic Bullet.
30.	See Bristow, Making Men Moral. See also Alexandra M. Lord, "Models of Masculinity: Sex Education, the United States Public Health Service, and the YMCA, 1919–24," Journal of the History of Medicine and Allied Sciences 58, no. 2 (2003): 123–52.
31.	For the Chamberlain-Kahn Act, see Alexandra M. Lord, "'Naturally Clean and Wholesome': Women, Sex Education, and the United States Public Health Service, 1918–1928," Social History of Medicine 17, no. 3 (2004): 423–41.
32.	Victor C. Vaughan, "Protection of American Army Against Social Diseases by More Rigid Health Laws," The Pennsylvania Medical Journal 22 (1918): 26. According to Vaughan, the venereal disease rate at Camp Pike was 568.7 per 1,000 soldiers. See also, "Disease Conditions among Troops in the United States: Extracts from Telegraphic Reports Received in the Office of the Surgeon-General for the Week Ending October 19, 1917," Journal of the American Medical Association 69 (1917): 1535–6; "Venereal Disease and Birth Control," Journal of the Switchmen's Union 20 (1918): 756.
33.	For evidence of this, see the letters of Archie C. Cowles, a syphilitic health-seeker who traveled to Hot Springs in 1905. In a letter dated December 10, 1905, Cowles wrote that "many of the women here seem to be on the courtesan order. Of course, it would not do to call them prostitutes," Cowles remarked, "for they are aristocrats in their profession." For Cowles' correspondence, see the Archie C. Cowles Papers, Garland County Historical Society Archives, Hot Springs, Arkansas.
34.	"Commissioners Issue Order to the City Manager to Close the Houses of Immorality, Which Goes into Effect at Once," Hot Springs Sentinel-Record, August 2, 1918. Local businessmen and religious leaders rejected the association the military made between Camp Pike's high venereal disease rate and the "terrible conditions" in Hot Springs. See "Ministerial Men to Discuss Morals: Report from Washington of Bad Conditions Here Stirs some Enthusiasts," Hot Springs Sentinel-Record, August 9, 1918; "The Moral Condition," Hot Springs Sentinel-Record, August 10, 1918.
35.	Audrey Wenger McCully, "The United States Public Health Service Venereal Disease Clinic and Government Free Bathhouse, 1919–1936," Oliver C. Wenger Papers, Box 1, University of Arkansas for Medical Sciences Archives.
36.	"Proceedings of the Minnesota Academy of Medicine," Minnesota Medicine 5 (1922): 61.
37.	First Deficiency Appropriation Bill, 1921; Hearings before Subcommittee of House Committee on Appropriations, 66th Congress, 3rd Session (Washington, D.C.: Government Printing Office, 1921), 588.
38.	This last point holds for all of the public health campaigns undertaken in the early twentieth-century US South. In the case of Hot Springs, the city was seen as a center of quackery, and in particular, of the country's VD patent medicine industry. See Excluding Advertisements of Cures for Venereal Diseases from the Mails; Hearings before the Committee on the Post Office and Post Roads of the House of Representatives, 66th Congress, 1st Session (Washington, D.C.: Government Printing Office, 1921).
39.	During the war, Wenger—a native of St. Louis—served in the Medical Corps of the Missouri National Guard, and later focused his efforts on "venereal disease prophylaxis" as a member of Sanitary Squad #18, stationed in Camp Mills, a military camp in Long Island, New York. Afterwards, Wenger sought and obtained appointment as a "regional consultant" in the PHS, whereupon he assisted in the nationwide venereal disease survey (1919–20). See McCully, "The United States Public Health Service."
40.	For more on Wenger's biography, see McCully, "The United States Public Health Service."

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