In Search of Sexual Health : Diagnosing and Treating Syphilis in Hot Springs, Arkansas, 1890–1940

How did beliefs about syphilis shape the kinds of treatment people with this disease received? The story of how a town in the Ozark hinterlands played a key role in determining standards of medical care around syphilis. 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.