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The Wages of Sin. Sex and Disease, Past and Present.
  1. Michael Waugh
  1. General Infirmary at Leeds, LS1 3EX

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    By P L Allen. £17.50; pp 202. Chicago: University of Chicago Press, 2000. ISBN 0 226 01460 6.

    This is a profound work describing the impact of venereal diseases and conventional morality in the build up to AIDS. It is written by an American, who has been personally affected by the impact of AIDS. He has written a book on topics in history relating to sex, morality, and infectious diseases, which have had an impact on the public response to AIDS. Throughout, one senses the author's very real loss in what to him and many others have been tragic times.

    It is interesting to see how different the general public moral climate is in different societies in the developed world. Thankfully, some forms of evangelism do not have the same influence everywhere.

    Does the historical part of the book tell the medical historian anything new? The answer is yes. And that is the gap between what has been known on this subject to academics for a long time and what others are only finding out about now. The chapters containing information on the church's attitude to sexual morality; on leprosy, the early history of syphilis, bubonic plague, and masturbation illustrate the age old story of reactionary view against progress. It is difficult to judge the mores of the past through the views of the present.

    It is a pity that the author seems to have given such prominence to those whose views resisted progress. Nothing is mentioned of liberal pioneers in venereal diseases from Van Swieten in the 18th century, through Ricord, Fournier in the next, Abraham Flexner (for the Rockerfeller Foundation), Neisser, or indeed the enormous changes brought about by the Royal Commission on Venereal Diseases in Great Britain at the time of the first world war or such notable more recent Americans such as Kampmeier, Stokes, or Earl Moore.

    The chapters on America are particularly interesting from a European point of view. Learning about reactionary views always helps in developing any strategy for public knowledge and education. Well educated AIDS lobbyists have certainly had an impact in Europe as in the United States and are neatly described in this work. The bibliography, 14 pages, is particularly good.

    This is a book questioning responses and conventional morality in respect, sorrow, and anguish. It is worthy of merit. It enables the modern reader to learn about difficult aspects of morality in relation to venereal diseases and sexuality which have always had more impact on the public than the practising physician.