Allan M. Brandt

The human response to venereal disease has always had a strongly social component. Not only is there biology involved; other factors also include prostitution, gender dynamics, sexuality, fear, and moralisms. In this work, Brandt identifies all of these impacts and constructs a narrative of how Americans have reacted to this disease since the underlying biology had begun to be unearthed in the late 19th century. He does so meticulously and comprehensively so that no important stone is left show more unturned and so that the reader has a 360-degree view of this often “hush-hush” matter.

This book begins in the progressive era when hope for triumph over social ills abounded. Already in this era, the disjunction of the causes of disease and morality can be seen. Individuals and groups emphasized an understanding of STDs either as a moral failing or as part-and-parcel of nature and life. While these differences in perspective underlay the social nature of this disease, they also impacted how the disease was portrayed among the public. The fundamental conflict of these approaches (morality vs. disease), well-illustrated by Brandt, seems to continue with us to this day.

This book provides an interesting take on human sexuality. As a history, the book’s contents are not meant to convey any inherently socially disruptive message. Nonetheless, it illustrates the shortcomings of many approaches towards sexuality from earlier times that are still with us. For instance, the need for personal responsibility is still an answer many give to sexual problems. Campaigns based on fear are still with us as are stigmatizations. The reader acquires an in-depth and intriguing view of the social dynamics of sexuality without being argued with. This side effect highlights the book’s strengths – that it treats a complex issue with fairness and objectivity.

Several themes should be noted. The military campaigns of the world wars are detailed because of their transformative impact. Not all trends continue with us; some trends change. For example, male use of prostitutes was viewed as a central issue in the late Victorian era and early 20th century; however, after World War II, premarital sex became a defining issue in its place. Effective medications also provided a means of social transformation towards sexual liberty while the resurgence of viruses (herpes and HIV) curtailed that same sexual liberty.

I wish more people would treat sexual diseases like Brandt does, with the seriousness they deserve. Sexuality is an important facet of human life, and despite the widely enforced cultural silence, its central social role is becoming increasingly identified. Likewise, disease is another facet with significant social import. The combination of these two – viewed through the prism of history – makes for a supremely interesting read. Despite being 35 years old, this book hits a high mark with erudition and excellence. show less

Brandt set out to write a book about cigarettes that he thought would be quick because so little was known about the industry’s internal workings. Then as part of one of the settlements millions of documents were released, and his plan changed. Brandt tracks the deliberate creation of demand via newly developed marketing techniques that are now standard and then the deliberate creation of controversy as evidence mounted about the dangers of cigarettes. The companies knew that their only show more hope was to generate uncertainty among the public, so they pursued a “teach the controversy” strategy while simultaneously maintaining that the choice to smoke was an individual, informed one, since the risks of cigarettes were well-known. Eventually these strategies conflicted, but fortunately the individual choice narrative succeeded in dominating, plus the industry was able to exercise so much political influence that regulation ended up protecting tobacco more than discouraging its consumption. The ending chapters are truly distressing, especially the parts about the US pressuring other countries to allow more tobacco imports, which leads to US marketing strategies and massive increases in smoking. It also turns out that tobacco has a relationship to that other source of evil, securitization—in the “global” settlement with the states, the states got promised big payouts and then securitized their interests, so now they lose money if people stop smoking. show less

Allan M Brandt’s “No Magic Bullet: a social history of venereal disease in the United States since 1880” was first published in 1985. A new edition came just two years later, I have to assume that is because its topic was changing so quickly with AIDS becoming common knowledge. I imagine Brandt wanted a do over on what he had written about AIDS in the first edition’s introduction.

Very early in the first chapter Brandt explains that doctors at first thought that women were not show more affected by gonorrhea. I was bothered by this not because I doubted it was true but because just a few pages earlier, in the introduction, Brandt wrote that AIDS was a disease of gay men without questioning what was considered true at the time. At the very least he should have mentioned that at one time gonorrhea had been considered the problem of only one gender. Why study history if we don’t use it to form questions about the present? Even in the introduction to the 1987 edition, when it was well known that there were multiple modes of transmission, he failed to mention the failure in physician's reasoning in assuming venereal disease, any disease, is limited by gender by anything other than ease of infection. Did Brandt miss the similarity of the failed assumptions about gonorrhea and AIDS? Did he simply choose not to mention it? I have to believe that if he had noticed it he would have mentioned it even if only to dismiss it as meaningless.

Brandt looked at only two parts of society in this “social history”. One made up of military and public health officials and the other made up of that large and vocal subset of the leisure class that makes everyone else's behaviour their business, moralists. The military and public health professionals followed the science but often were forced to bow to pressure from the moralists.

The moralists clamor for abstinence before during and after World War I. They continued to clamor for abstinence before during and after WWII. They are still at it. Then, as now, they are only concerned with their version of morality and about other people's behaviour, not their own. Brandt manages to overlook the opinions of working people, business men and women, minorities in regard to venereal disease. I was surprised that the book was from the 1980s and not the 1950s. People besides the powerful had their agency recognized in the 1960s, why not here?
Sometimes I feel I should make allowances for works of history that are as old as this, twenty eight years since the new edition, but I can’t bring myself to do it. Histories on on narrow topics like this are few and far between. Unlike books about Lincoln or major wars there is not a new volume on the history of VD being published every few months. A search of World Cat for the subject “Sexually Transmitted Diseases United States History” turns up only a few dissertations, several government publications that look like primary sources and Alexandrea Lord’s 2009 book “Condom Nation” which looks at government sponsored sex education from World War II to the present. Unfortunately this could be the go to book on social attitudes about VD for many more years. I hope a student interested in the subject gets creative in their readings and are able to find more than the two viewpoints Brandt offers on the subject. show less

Lies, deceit, unethical PR campaigns, and cover-ups are nothing new, and we know that these disdainful actions are happening right under our noses. And yet, when it all comes out and companies are revealed for their misdeeds, it never ceases to surprise just how low they will go. Probably the most exposed corporate industry, Big Tobacco proves to be one of the most malicious and underhanded. Maybe because they were forced to divulge so much publicly or maybe because of the innate harms and show more properties of tobacco, this industry stands out as one of the worst when it comes to lying, cheating, and bullying.

One hundred years and fifty years ago, cigarette smoking hardly occurred. In 1900, cigarettes made up 27% of tobacco consumption, and by 1952 they made up 81%. As Brandt repeatedly shows throughout the book, cigarette smoking is more than a fad. The rise in the use of cigarettes and in their social acceptability was manipulatively created by the tobacco industry to lure people to smoke cigarettes. The introduction of cigarettes, their ingratiation into American culture, and the symbolism they evoked spurred cigarette sales and made the tobacco companies extremely wealthy.

At the time of their inception, cigarettes were regarded as unhealthy, odorous, and immoral - a dirty habit. As early as the late 19th century, anti-tobacco advocates crusaded for abstinence and even banning of sales. The tobacco industry, however, slyly fought back mainly in the form of advertisements designed to mislead health debates and glamorize the product. Through these ads, the Hollywood-style glamour and the glitz of smoking cigarettes and doctors' approval were broadcast to the nation. Slowly but surely, the image of smoking cigarettes made a 180 degree turn.

By the 1930s, a debate emerged over smoking and disease. Viewed for years as unhealthy, doctors began to notice specific diseases and their co-occurrence with smokers. Science and medicine at this time was much different than today's. It was not until researchers began to perform both epidemiological and statistical studies that the link between the two began to solidly spring forth in the 1950s. By this time, Big Tobacco had created their own PR department disguised as a "research" organization to study the effects of tobacco in an attempt to combat any theories that smoking caused disease. Their research focused on finding other causes of disease, and they made every attempt to suppress any notion that it was tobacco's fault.

By 1964, the Surgeon General issued a report on smoking and health, definitively stating that tobacco caused disease, and that portion of the scientific/medical controversy was over. What had yet to begin was the uncovering of methodical concealments that the industry performed. Big Tobacco knew that what they were selling was deadly, and they tried as hard as they could to not only keep that information from the public through incited controversy but also to pretend they did not know its deadly nature in the first place, bold-facedly lying to the American people and the government.

So began the public health role in tobacco's history. As individuals began to sue the tobacco companies, legislators were trying to decide how to deal with their knowledge of the harms of tobacco, the role the tobacco industry maintains in commerce and taxes, the addictive nature of nicotine, and the deliberate enshrouding the harms of smoking by the industry. While Big Tobacco has had to shell out billions of dollars to the states and to individuals, most legislation and public health initiatives to curb tobacco has fallen considerably short.

Brandt details the history of tobacco and cigarettes by discussing the social elements essential to smoking, the practices, changes, and ultimate congruities in the medical and scientific professions that managed to tease out truths amid constructed controversy, and the laws - and in many cases the attempted yet failed legislation - that ultimately changed public perceptions about smoking. As a history of medicine and history of science professor, Brandt is specially situated to tell the story of cigarettes in America. This book is not a journalistic treatment, but a tome of information that brings together the myriad parts of history to explain and give perspective on how we view cigarettes and why we view them this way as well as how these views have changed in the last century. It was fascinating reading, accessible, and remarkably thorough. show less