Synthesis Issue 3

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Synthesis

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A N U N D E RG R A D UAT E J O U R N A L OF THE H I S T O RY O F S C I E N C E I S S U E 3 , M AY 2 0 1 1

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Editor-in-Chief Whitney Adair ‘11 Associate Editors Julie Barzilay ’13 To the readers of Synthesis,

Emma Benitende ’11 Jana Christian ’12

I am happy to announce the third issue of Synthesis, an undergraduate journal in the history of science. We endeavor to provide a venue to further the collaboration between undergraduate history of science institutions, and each year expand our readership a bit more to students and faculty in programs involving the history of philosophy of science, technology, and medicine. This year we received submissions from all across the country, including Dartmouth, Berkeley, Yale, and the University of Pennsylvania, in addition to Harvard. With over sixty submissions, I am pleased to present an issue dedicated to research on the history of medicine and pharmaceuticals, as well as new content, featuring an interview with one of the history of science’s most reknown pioneers, Dr. Everett Mendelsohn, and a review of the new book featuring an artistic display of photographs and stories of historical science artifacts, Lost in Learning.

Catherine Flynn ’13

The editing board of Synthesis would like to dedicate this issue to our friend and colleague, Ilya Chalik, who passed away before seeing the completion of this issue and the publication of his submission, How Histamine and Antihistamine Transformed the Popular Conception of Allergy in Postwar America, which is illustrated on the cover. As a dear friend of mine, and fellow history of science enthusiast, Ilya is well-remembered for his good nature and delightful demeanor by all who knew him. His contributions to the study of the history of science and his community will not be soon forgotten.

Alyssa Blaize ’11

,Q WKHVH SDJHV GHDU UHDGHU \RX ÀQG HQOLJKWHQLQJ IDUH IXVLQJ KLVWRULFDO YLHZV ZLWK VFLHQWLÀF DQDO\VLV ,I \RX DUH LQWHUHVWLQJ LQ EHFRPLQJ D SDUW RI WKLV HQGHDYRU WR foster collaboration between undergraduates in the history of science, as a sponsor, contributor, erditor, or collaborator, please contact us as synthesisjournal@hcs. harvard.edu.

Jenay Powell ’13 Brandon Seah ’13 Allen Shih ’13 Helen Yang ’11 Staff Editors Edwin Acosta ’12 Katie Banks ’11 Stephanie Bucklin ’11 Michael Dunn ’11 Cory Johnson ’11 Rebecca Martinez ’11 Asa Schachar ’11 Design Whitney Adair ’11 Melissa Wong ’12

Sincerely, Advisors Whitney Adair

Prof. Steven Shapin

Editor-in-Chief

Allie Belser

original cover art by Whitney Adair, photo of Everett Mendelsohn courtesy Jonathon Ruel

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SYNTHESIS

ISSUE 3

Contents Letter from the Editor

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The Visual Culture of Venereal Disease and HIV/AIDS Brandon Levin, Yale University ‘13

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‘Lost in Learning’ Under the Magnifying Lens Catherine Flynn, Staff Writer

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How Histamine and Antihistamine Transformed the Popular Conception of Allergy in Postwar America Ilya Chalik, Harvard University ‘11

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The Scientist: From Biologist to Bioweapon Kimberly Goh, Harvard University ‘13

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A Study on the Politicization and Moralization of Medicine:

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Anti-Vaccination Movements in 19th Century Britain and Colonial India Stephanie Woo, Harvard University ‘12 A Journey Through the Past, Present, and Future of the Department

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of the History of Science with Professor Everett Mendelsohn Julie Barzilay, Staff Writer Pathologizing Suburbia: How Tranquilizers Made Their Own Market Chelsea Link, Harvard University ‘12

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1 The Visual Culture of Venereal Disease and HIV/AIDS: An Analysis of the Portrayal of Sexually Transmitted Infections in Public Health Posters in World War II and the 1990s Brandon Levin, Yale University ‘13

S

exually transmitted infections (STI’s) have been an enduring source of stigma, confusion and pain for infected individuals throughout United States history. Moreover, such infections have been the subject of numerous efforts, public and private, to increase awareness for the use of contraceptives – many of these efforts revolving around the public health poster. This essay ZLOO H[DPLQH WZR VXFK SRVWHUV WKH Ă€UVW ZDV SURGXFHG E\ the Venereal Disease Education Institute, a joint creation of the United States government and military during the Second World War (Figure A), while the second was created in 1997 by a private organization, Project Action (Figure B). On initial glance, these posters, despite a common focus on STD prevention, have little in common. Some would even claim the relative foolish absurdity of the 1997 “Anti Horny Patchâ€? poster in comparison to the solemn “VD can wreck a lot of plansâ€? wartime pronouncement. However, upon further investigation, these posters, shaped by the unique social and moral arena in which they originated, both make strong, effective warnings regarding the infection of STDs. When taken seriously, these posters function as their own acts of “warâ€? against the dangerous health behaviors that led to the transmission of deadly diseases during both WWII and the 1980s – 90s. Under this lens, the “Anti-Horny

“VD can wreck a lot of plans,� Venereal Disease Education Institute, Helfand Collection poster0049.dc, Yale University Medical Library.

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3DWFK¾ SRVWHU EHFRPHV OHVV à DJUDQWO\ ULGLFXORXV DQG PRUH LQGLFDWLYH RI VRFLDO QRUPV HYHQ PRUH VLJQLÀFDQWO\ LW UHà HFWV the impact of the war in the perception of venereal disease. During World War II, solemn appeals to patriotism DQG IDPLO\ YDOXHV UHà HFWHG PLOLWDU\ DQG JRYHUQPHQWDO LQà XHQFHV LQ SURPRWLQJ SXEOLF KHDOWK HIIRUWV JURXQGHG in both moral and practical concerns. Conversely during the 1990s, this same appeal to families, stability, and morality would have failed as a convincing deterrent due to the changing target populations of the respective public health posters. Although this latter poster of the 1990s in comparison to the WWII poster does not initially appear to be forceful and effective, it was in fact at the center of its own war – waged by populations – namely homosexuals DQG VLQJOH LQGLYLGXDOV³WKDW GHÀQHG WKHLU FRPPXQLWLHV E\ sexuality and for whom sexuality was at the core of their cultural identities. As a result, the more creative campaign in the late 1990s was in response to an evolving conception of sexually transmitted infections. While the military was the driving force in efforts against venereal disease, a grassroots war spearheaded by private organizations and individuals in the late 20th century combated AIDS with more nuanced advertising techniques and a less conventional campaign of public health education. In order to effectively determine the importance of each poster in evoking themes central WR LWV FUHDWLRQ LW LV ÀUVW HVVHQWLDO WR DQDO\]H WKH SLHFHV

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SYNTHESIS

Figure 1

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themselves. The title of the earlier poster is indicative of its overarching message and intended impact: entitled VD can wreck a lot of plans, it is at once a striking and grave pronouncement.1 Portraying a dejected soldier looking down upon the family from which he is separated, the image is evocative of a sense of duty, responsibility and guilt that the diseased soldier undoubtedly feels. The color palate itself—consisting simply of dark green, black, white and red—suggests the solemn mood.2 The soldier is depicted in a state of utter despondency: with his head resting on one arm, he looks despairingly at his presumed wife and two children. Particularly noteworthy is the fact that the poster is aimed at the married, or soon to be married, man; during wartime, soldiers were put in positions where they were inevitably tempted to ‘fool around,’ thus making them more susceptible to sexually transmitted infections. Here the soldier reaches out with his right arm, yearning to tenderly touch his family. The soldier is unsuccessful, though, as the blood-red text “can wreck a lot of plansâ€? serves as a barrier that the soldier is unable to cross; quite literally, the text prevents the soldier from touching his family. Furthermore, a question mark ensnares the man’s family. The prevailing theme is one of uncertainty; the fact that the mark appears to originate from the same spot on the poster as the soldier’s WRUVR PDNHV LW VHHP OLNH WKH TXHVWLRQ PDUN LV D UHĂ HFWLRQ RI the soldier in the eyes of his family—his return is unknown. The implication of this uncertainty, and the intent behind the advertisement, suggests that soldiers were meant to react to this pointed message with guilt and fear. By evoking images of the family while simultaneously stressing the undercurrent of patriotism and military duty, the poster undoubtedly imbued soldiers who saw it with a sense of responsibility—both to their nation and their family. The FRQĂ DWLRQ RI WKH FRQWUDFWLRQ RI YHQHUHDO GLVHDVH ZLWK VXFK weighty and substantial topics lends both credence and emotional power to the poster. An even more telling analysis of this poster is derived from a consideration of its origin. The Historical Library database lists that the piece was published by the Venereal Disease Education Institute between the years of 1935 and 1941. Created by the Venereal Disease Control Division of the United States Public Health Service, the Venereal Disease Education Institute was a joint effort of the government and the U.S. Armed Services.3 This collaboration is clear in the way the Institute operated: it “followed the recent trend in health education and procured a staff of experienced

laymen to man the assembly lines of its ‘factory,’ including artists, writers, and specialists in venereal disease and sex education.â€?4 By likening the Education Institute to a factory, the author—himself an editorial assistant at the Institute— highlights the way in which the production of posters was as integral a part of the war effort as any other item produced in a factory during wartime. Moreover, the assertion that “since the start of production every piece of material [was] submitted to authoritative medical criticism, as well as to the VFUXWLQ\ RI OHDGLQJ HGXFDWRUV LQ WKH YHQHUHDO GLVHDVH Ă€HOGÂľ suggests just how vital these posters were to the public health campaign against venereal disease.5 It should come as no surprise, then, that the subject matter of these posters was presented in a serious light; as will be discussed later, at stake were not only the lives of individuals, but also, and more importantly, the success of the war effort. A cursory evaluation of the more contemporary poster presented in this analysis yields markedly different results; not surprisingly, this second poster was selected for juxtaposition primarily because of its blatant and RVWHQVLEOH GLVVRQDQFH ZLWK WKH Ă€UVW &UHDWHG LQ DQG entitled “Introducing the Anti-Horny Patch,â€? the poster uses humor to encourage the use of contraceptives. There is irony inherent in the comic presentation of a poster whose subject matter targets AIDS, a destructive and deadly pandemic. While some may contend that the poster is purely a humorous farce, further examination results in a more compelling interpretation: while the poster may not be as serious as the venereal disease poster in its presentation style, it is equally staid in motivation and intention. AIDS emerged as a virus in the early 1980s, and by the late 1980s it could be suppressed at best.6 In this sense, and similar to the case of venereal disease, a campaign of prevention was plainly the most effective option.7 8QOLNH WKH Ă€UVW SRVWHU WKLV RQH ZDV YHU\ FOHDUO\ QRW aimed at married or family men. Instead, the posters of the 1990s were designed to target singles for whom sexual freedom was accepted and embraced as a way of life. A far cry from the dark, melancholy-inducing colors employed in the World War II era advertisement, the bright, sparkly and eye-catching poster exudes vibrancy and vitality.8 The manifest absurdity of an “Anti-Horny Patchâ€? pulls the viewer in immediately. Instead of appealing to a sense of 4

Doak, 13.

5

Doak, 13-14.

World Health Organization, The World Health Report 2003: Shaping the Future (France: World Health Organization, 2003), 44.

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The poster itself is 20 x 15 inches.

Douglas E. Doak, “The Venereal Disease Education Institute,� Journal Of Social Hygiene 30 (1944): 12. 3

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World Health Organization, 47.

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The poster is an impressive and imposing 30 x 25 inches.

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SYNTHESIS

Figure 2

ISSUE 3

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5 SPRING 2011 LEVIN/AIDS morality, patriotism or familial responsibility, the poster Allan Brandt’s A Social History of Venereal Disease in the United unashamedly pokes fun at the newfound public acceptability States Since 1880 provides an extraordinarily comprehensive of topics related to sex. It very effectively calls attention to narrative that illustrates the contextual underpinning of the the potential health-related dangers of acting on horniness venereal disease poster examined here. Brandt frames the by claiming “Horn-Away Anti-HORNY Patches are a snap battle against sexually transmitted infections as one waged to use and instantly relieve all of the classic symptoms of simultaneously by the government and the military: “long oncoming horniness.â€?9 This psychological maneuver is EHIRUH WKH Ă€UVW $PHULFDQV HPEDUNHG RQ WKHLU PLVVLRQ WR HIIHFWLYH DV WKH Ă DJUDQW OXGLFURXVQHVV RI WKH SURQRXQFHPHQW ‘make the world safe for democracy,’ the U.S. War Department does indeed underscore the importance of contraception. undertook a major campaign to make military camps in Moreover, when considering the poster as a medium, the United States safe for the soldiers—safe from the twin and particularly the product of private rather than military threats of immorality and venereal disease.â€?12 Although this efforts, it becomes clear why posters which were generally TXRWH UHIHUHQFHV SURJUHVVLYH VRFLDO UHIRUPHUV¡ LQĂ XHQFH RI inappropriate for general presentation—such as this one— government efforts during World War I, the deep-seated and still played a central role in AIDS efforts. As opposed to lasting impact that such a program of reform had on efforts a medium such as television, activist groups could use the during World War II should not be discounted. As a result, poster to target a focused audience. By controlling where the the fact that the health campaign during World War I, which posters were placed, producers of the artwork could limit was aimed at ridding much of the country of immorality, WKH VSHFLĂ€F JURXSV H[SRVHG WR WKH SRVWHU 3ODFHPHQW DW D “constituted one of the most fully articulated ventures in nightclub, for example, would allow for the promotion of social engineering in American historyâ€? serves to underscore messages and campaigns that were more provocative than the moral element to a number of posters created during those waged over the airwaves or on television. World War II.13 Although the central theme of the latter Furthermore, an inscription on the poster indicates effort did not consist of “a comprehensive program to rid that it is a 1997 product of Hugh Johnson Laboratories. the nation of vice, immorality, and disease,â€?14 the majority Although not immediately apparent to many observers, of public health posters produced during the Second World the sexual connotation implicit in the name—read: Huge :DU ZHUH LQGHOLEO\ LQĂ XHQFHG E\ FRQFHSWLRQV RI PRUDOLW\ Johnson (where Johnson is slang for the male reproductive Such an appeal to ethical norms—more a remnant organ)—provides an even more nuanced, witty and of the World War I campaign against venereal disease than intellectually humorous element to the piece. A white a focal point of the World War II effort— was only part notice on the bottom of the poster, however, reveals the of the story; equally, if not more, important, were the true origin of the piece. The poster is in fact a product of practical considerations that motivated such a hard-fought “Project Action,â€? which was launched in Portland, Oregon campaign against sexually transmitted infections. Wary of LQ DV ´WKH Ă€UVW WHHQ IRFXVHG PDUNHWLQJ SURMHFW LQ WKH the inevitable temptations that soldiers would encounter U.S.â€?10 The project, which was later replicated in Seattle while on duty, efforts on behalf of the military were also and San Jose because of its resounding success, “consisted governed by the pragmatic realization that “in the charged of four integrated components: community mobilization, atmosphere of world war, venereal disease threatened military a motivational media campaign, a condom accessibility HIĂ€FLHQF\ DQG KHDOWK Âľ15 In this sense, the poster reveals program, and active involvement of youth at risk in peer why advertising methods during World War II focused so education and outreach activities.â€?11 As opposed to the intently on prevention as opposed to treatment. Such efforts government-initiated campaign against venereal disease ZHUH Ă€UVW DQG IRUHPRVW ´DQ DWWHPSW WR VDYH WKH KHDOWK during World War II, Project Action is emblematic of the DQG HIĂ€FLHQF\ RI WKH $PHULFDQ Ă€JKWLQJ PDQ Âľ SUHYHQWLRQ more creative, innovative, and grassroots efforts employed of disease altogether was a more pragmatic alternative to WR Ă€JKW $,'6 DQG RWKHU VH[XDOO\ WUDQVPLWWHG LQIHFWLRQV LQ medical intervention after the fact.16 Most importantly, such the late 20th century. “Introducing the Anti-Horny Patch,â€? Hugh Johnson Laboratories (Project Action), Helfand Collection poster0150.dc, Yale University Medical Library.

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Behavior Works: Changing Behavior for Public Health, “HIV Prevention, Project Action,� http://www.bwpdx.org/programs/hiv-prevention/ (accessed November 22, 2010).

12 Allan M. Brandt, No Magic Bullet: a Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1985), 52. 13

Brandt, 52.

14

Brandt, 52.

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Brandt, 52.

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Brandt, 52.

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Behavior Works: Changing Behavior for Public Health.

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SYNTHESIS ISSUE 3 treatment would necessitate the soldier’s temporary removal Years later, in the 1990s, a similar appeal to health concerns from duty. Each soldier that contracted venereal disease was grounded in military functionality was no longer a viable one less active member of the American armed forces. strategy to combat AIDS. The most compelling reason An examination of the available treatments for for this distinction is undoubtedly that the nation was no YHQHUHDO GLVHDVH DW WKH WLPH DIĂ€UPV WKLV FODLP ,Q WKH HDUO\ longer embroiled in a world war. As subsequent analysis will 1900s, Salvarsan was the primary treatment for syphilis. reveal, though, private organizations and individuals would However, although it “gave physicians a treatment that themselves waging a different type of war against AIDS. RIIHUHG YLFWLPV RI V\SKLOLV D GHĂ€QLWH EHQHĂ€WÂŤ SK\VLFLDQV Fundamentally, an underlying link between both posters still debate whether it offered a complete cure.â€?17 In much and their corresponding public health campaigns does the same vein, penicillin, “discovered to be effective in indeed exist— both efforts were aimed at prevention. Many treating syphilis and gonorrhea in 1943,â€? entered the game similarities between the two efforts become apparent: just IDU WRR ODWH WR VHULRXVO\ LQĂ XHQFH WKH PHGLD VWUDWHJ\ DQG as penicillin was not readily available for mass production public health campaign surrounding venereal disease, at XQWLO WKH HQG RI :RUOG :DU ,, ZKHQ ´+,9 ZDV LGHQWLĂ€HG least in the context of the posters produced by the Venereal as a human retrovirus, [and] the usual paradigms in human Disease Education Institute between 1939 and 1945. This is virology were not entirely applicable.â€?20 7KH VLJQLĂ€FDQFH RI GXH ODUJHO\ WR WKH IDFW WKDW WKH HIĂ€FDF\ RI SHQLFLOOLQ GLG QRW this realization played out in subsequent medical trials and lead to “substantial reductions in appropriations for venereal research efforts, but, ultimately, the fact that “in the absence disease control [until] the 1950s.â€?18 As such, public health RI D VDIH DQG HIIHFWLYH YDFFLQH PRGLĂ€FDWLRQ RI EHKDYLRU LV efforts were governed principally by the fact that a program the only means of curtailing the spread of HIV infection of prevention was the only viable strategy from a military ZRUOGZLGHÂľ VHUYHG WR LQĂ XHQFH DFFRPSDQ\LQJ SXEOLF KHDOWK perspective. efforts.21 Quite simply, prevention was the only logical Consequently, the government and military alternative to a panacea. HPEUDFHG D GXDO SURQJHG DSSURDFK WR Ă€JKW YHQHUHDO GLVHDVH Although public health campaigns against venereal during World War II. The central focus was undoubtedly disease and AIDS both targeted prevention, the radically the result of a purely practical consideration—health and different cultural norms and values surrounding their PLOLWDU\ RIĂ€FLDOV DOLNH QHHGHG WR HQVXUH WKDW $PHULFDQ SURPXOJDWLRQ DUH UHĂ HFWHG LQ WKH YDU\LQJ DUWLVWLF DQG KHDOWK IRUFHV GXULQJ :RUOG :DU ,, ZHUH KHDOWK\ DQG DEOH WR Ă€JKW related connotations imbued in each poster. To begin, the $ VHFRQG DQG OHVV VLJQLĂ€FDQW HPSKDVLV ZDV GHULYHG IURP absence of explicit sexual content, images or innuendos in the progressive health campaigns of World War I. Although the venereal disease poster is indicative of a time in which Thomas Parran, who as Surgeon General of the United Parran was censored by CBS and unable to “mention States at the time, spearheaded efforts against venereal syphilis or gonorrhea by nameâ€? on a radio address in 1934.22 disease in the late 1930s, “downplayed the moral argumentâ€? Conversely, artists in the 1990s felt “the need to counter and the “traditional moral call to arms,â€? it was not altogether stigma and hysteria, which, particularly in the epidemic’s absent from the World War II public health campaign.19 As early years, threatened people with AIDS.â€?23 There was D UHVXOW ERWK RI WKHVH HOHPHQWV DUH UHĂ HFWHG LQ WKH SRVWHU no overarching program of censorship. Instead, America’s published by the Venereal Disease Education Institute that is ´HQWLUH VHQVH RI VH[XDOLW\ÂŤFKDQJHG LQ QR VPDOO SDUW EHFDXVH H[DPLQHG KHUH Ă€UVW DQG IRUHPRVW WKH GLVHDVHG VROGLHU ZKR of AIDS,â€? and this was manifest in the visual culture and LV GHSLFWHG LV XQDEOH WR IXOĂ€OO KLV GXW\ ERWK WR KLV FRXQWU\ artistic renderings of the disease: “what poetry and song and his family. As such, Parran’s emphasis on practicality lyrics attempted during the sixties became in the age of and the importance of a healthy militant force is evident. Nonetheless, there is also an underlying moral element, as 20 $QWKRQ\ 6 )DXFL ´$,'6 5HĂ HFWLRQV RQ WKH 3DVW &RQVLGHUDWLRQV IRU WKH the soldier appears to be ridden with guilt. It thus becomes Future,â€? in Aids and the Public Debate: Historical and Contemporary Perclear that the poster “VD Can Wreck a Lot of Plansâ€? spectives, ed. Carolina Hannaway, Victoria Harden and John Parascandola TXLWH DFFXUDWHO\ DQG PHDQLQJIXOO\ UHĂ HFWV WKH SXEOLF KHDOWK (Amsterdam: IOS, 1995), 67. campaigns that took center stage during World War II. 21 Fauci, 70. 22 17

Brandt, 130.

18

Brandt, 176.

19

Brandt, 140.

Brandt, 122.

Richard Goldstein, “The Impact of AIDS on American Culture,� in Aids and the Public Debate: Historical and Contemporary Perspectives, ed. Carolina Hannaway, Victoria Harden and John Parascandola (Amsterdam: IOS, 1995), 133. 23

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7 SPRING 2011 LEVIN/AIDS AIDS the task of theater, video, performance, and the visual of a changing advertising landscape. Less obviously, it was also the product of a very real war—one waged by private arts.â€?24 Intriguingly, though, because in the 1980s coverage groups for whom sexual identity was paramount; in this of the HIV epidemic became so widespread and mainstream, way, a second, and subtler, parallel emerges between the two “routine coverageâ€? of the virus in the early 1990s and public health campaigns. These two posters, after careful “saturation of the airwavesâ€? made it clear that other examination and historical contextulization, display the way preventive methods were “necessary to keep individuals LQ ZKLFK SXEOLF KHDOWK DGYHUWLVLQJ ZDV LQĂ XHQFHG DUWLVWLFDOO\ vigilant about proper prevention, such as safer sex.â€?25 It is by social norms and public temperament. in this “saturatedâ€? environment that Project Action emerged. In light of this contextual information, it becomes clear how FXOWXUDO DWWLWXGHV WRZDUGV $,'6 LQ WKH ODWH V LQĂ XHQFHG the creation of posters like “Introducing the Anti-Horny 3DWFK Âľ DQG KRZ LQ WXUQ VXFK SRVWHUV UHĂ HFWHG WKH QHFHVVLW\ of new forms of more exciting and eye-catching advertising. As a result, the ostensible absurdity of a poster making in light of such an acute and debilitating disease was not an insensitive blunder, but rather a calculated and strategic advertising gambit. The humorous themes presented in VXFK D SRVWHU LPSOLFLWO\ DFNQRZOHGJHG DQG UHĂ HFWHG WKH QHHG for advertising that marked a departure from public health announcements that were altogether routine and traditional. In conclusion, a rather intriguing analysis results from the juxtaposition of two ostensibly unrelated posters in the Helfand Collection of the Medical Historical Library DW <DOH 8QLYHUVLW\ :KDW EHJLQV DV DQ DUWLĂ€FLDO DVVRFLDWLRQ becomes a more meaningful relationship in light of research WKDW UHYHDOV D QXPEHU RI VLJQLĂ€FDQW FRQWH[WXDO SDUDOOHOV between the two pieces. Advertisements during World :DU ,, ZHUH VLPXOWDQHRXVO\ D UHĂ HFWLRQ RI WKH SURJUHVVLYH inculcation of morality whose latent seeds remained from World War I, Parran’s efforts to “bring [the] infection to the center of public consciousness,â€? and military preoccupation ZLWK WKH SUDFWLFDO FRQFHUQV RI Ă€HOGLQJ D KHDOWK\ DUP\ 26 On the contrary, the saturation of media markets with traditional and repeated warnings about AIDS and unprotected sex during the 1980s incited the formation of groups like Project Action, which operated under the idea that effectively “serving young adults require[d] creativity.â€?27 As a result, “Introducing the Anti-Horny Patchâ€?—which is dazzling, attention-grabbing, and laden with humor—was the product

24

Goldstein, 132-3.

Timothy E. Cook and David C. Colby, “The Mass-Mediated Epidemic: The Politics of AIDS on the Nightly Network News,� in AIDS the Making of a Chronic Disease, ed. Elizabeth Fee and Daniel M. Fox (Berkeley: University of California, 1992), 114. 25

26

Brandt, 123.

“Serving Young Adults Requires Creativity,� FHI: The Science of Improving Lives, http://www.fhi.org/en/RH/Pubs/Network/v17_2/nt1725. htm (accessed November 22, 2010). 27

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SYNTHESIS

ISSUE 3

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SPRING 2011

FLYNN / LOST LEVIN/AIDS

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2 ‘Lost in Learning’ Under the Magnifying Lens: Seeing Creativity in Science

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Catherine Flynn, Staff Writer

he juxtaposition of elegant black and white photographs of historical artifacts with thought-provoking musings on the creative nature of discovery and exploration, Eva Koleva Timothy unites science and art in her book, Lost in Learning: The Art of Discovery. This illuminating photo HVVD\ Ă€QGV FUHDWLYLW\ LQ WKH PRVW XQH[SHFWHG RI SODFHV E\ VKHGGLQJ OLJKW RQ ROG SDLQWLQJV WH[WV DQG VFLHQWLĂ€F LQVWUXPHQWV 7LPRWK\¡V breathtaking pictures of noteworthy historical artifacts—including the Mona Lisa, the front page of Newton’s Opticks, and Galileo’s compass—make the past come alive in a new, inventive way. Her focus on details of individual artifacts exposes the history bustling behind these inanimate objects, allowing modern readers to realize the past and current importance of these old relics. Depicting the achievements of Isabella D’Este, the famous First Lady of the Italian Renaissance, Timothy chooses to combine photographs of two separate paintings – Leonardo da Vinci’s Isabella D’Este and Raphael’s Pope Leo X – to illustrate the relationship between these power patrons of the arts and sciences. 5HDGHUV VHH ,VDEHOOD Ă€OWHUHG WKURXJK D VXSHULPSRVHG PDJQLI\LQJ lens, gaze at her patron, Pope Leo X. He stares right back at her, as an equal, in a time when females faced male domination. Timothy uses these layers of historical gazes to mirror the interpretation of historical discoveries: how we understand learning and discovery depends upon the varying perspectives of the historical actors.

With her striking camera skill, Timothy reminds readers to interpret art, science, and discovery through multiple lenses. Timothy consciously carries the theme of looking through lenses throughout Lost in Learning. One particularly provocative image is titled “Lightâ€? in which she imposes a prism on the front page of Newton’s landmark publication, Opticks. With this choice, Timothy adds new dimensions to a physically simple object: a text. The addition of the prism disrupts the RULJLQDO FRPSRVLWLRQ RI WKH SDJH DQG GLYHUWV WKH FDPHUD¡V Ă DVK LQ DQ XQQDWXUDO DUWLĂ€FLDO GLUHFWLRQ 0RGHOLQJ WKH YHU\ PHFKDQLVP RI WKH UHĂ HFWLRQ RI OLJKW 1HZWRQ HQGHDYRUV WR H[SODLQ LQ 2SWLFNV Timothy elegantly invites readers how to see the artistry involved LQ VFLHQWLĂ€F GLVFRYHU\ These two examples are just the tip of the iceberg in Timothy’s vibrant exploration of creation, discovery, and dreams. Patching the layers of images in Timothy’s photographs together, the reader successfully completes the path to understanding the creativity behind discovery laid out by the author. The minimal but illuminating text accompaniment helps transform the images into worlds themselves worth considering. Eva Koleva Timothy’s radiant photography and Adam Timothy’s enlightening writing, FXOPLQDWHV LQ D Ă€QDO SURGXFW WKDW LV ERWK YLVXDOO\ DSSHDOLQJ DQG intellectually stimulating. For more information on the Lost in Learning project, visit www.lostinlearning.com

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SYNTHESIS

ISSUE 3

3

SPRING 2011

LEVIN/AIDS CHALIK / ALLERGY

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3 How Histamine and Antihistamine Transformed the Popular Conception of Allergy in Postwar America Ilya Chalik, Harvard University ‘11

“Reports on allergy appear almost weekly in the media and the vast majority of the population either suffer, or know somebody who suffers, from an allergic condition.� – Science and Technology Committee of the House of Lords, 6th Report Session of 2006-07.1

T

he unprecedented boom in medical research experienced throughout the twentieth century has produced considerable progress in unraveling some of the biggest medical challenges of mankind, from the battle with infectious diseases to the treatment of the most tenacious cardiac disorders. Yet as medicine claimed victory over a number of serious human ailments that were previously incurable, physicians conceived of novel medical paradigms that opened up entirely new FRQFHUQV IRU VFLHQWLĂ€F UHVHDUFKHUV WR JUDSSOH ZLWK 2IWHQ no matter how many resources scientists would commit to addressing these concerns, new discoveries would lead to more tantalizing questions than actual answers. Especially tantalizing has been the case of allergy, a phenomenon that scientists have attempted to surmount throughout that twentieth century. Over these past one hundred years, researchers have produced no shortage

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of medical literature on the subject of allergy, but in the meantime the number of allergy sufferers in the developed world has only dramatically increased. According to Mark Jackson, the leading modern authority on the history of allergy, although “pharmaceutical companies have developed a substantial arsenal of therapeutic substances and treatment SURWRFROV GHVLJQHG VSHFLĂ€FDOO\ WR FRPEDWÂľ DOOHUJLHV WKHVH have been limited to treatments of symptoms rather than etiology.2 Even though scientists know more now about the pathophysiology of allergic response than they ever have before, because of their ever-increasing prevalence, the vast range of allergens that trigger them, and the lack of a substantial cure, allergic disorders very much remain an unresolved enigma for medical science. In order to try to decipher how the understanding of allergy has evolved over time and recognize how it is that allergies still persist as an open question for mankind, SHUXVLQJ WKH KLVWRU\ RI VFLHQWLĂ€F UHVHDUFK GRQH RQ DOOHUJLHV

1

Mark Jackson, “Allergy: the making of a modern plague,� Clinical & Experimental Allergy 31, no. 11 (2001): 1665.

2

12

SYNTHESIS ISSUE 3 would simply not be adequate. The understanding and and socio-economic forces, they devote very little attention treatment of allergy did not exist for long as a purely to how the popular understanding of allergies changed over VFLHQWLĂ€F HQGHDYRU RU PHUHO\ ZLWKLQ WKH UHDOP RI SULYDWH the past century. interactions between patients and physicians. From early on It is remarkable that for such a weighty public in the twentieth century, allergy emerged as a public concern, concern, hardly any analysis has been performed on how the so much that because allergies affected broad segments of SXEOLF KDV SHUFHLYHG DOOHUJLHV <HW LW LV QRWRULRXVO\ GLIĂ€FXOW the population, the public perception of allergies became to comprehensively gauge public attitudes, especially when an important agent in the struggle against allergies. After looking back across history. One way to overcome this all, people are the primary victims of allergy, and at least GLIĂ€FXOW\ LV WR DSSURDFK LW WDQJHQWLDOO\ E\ H[DPLQLQJ YDULRXV in theory, medical research on allergy above all stands to media sources and other kinds of literature pertaining to EHQHĂ€W WKH JHQHUDO SXEOLF 7KH SXEOLF SHUFHSWLRQ RI DOOHUJLHV allergies aimed toward the general public. A close sampling not only has high relevance to the way the public has been RI WKHVH VRXUFHV UDQJLQJ DFURVV WKH Ă€UVW KDOI RI WKH WZHQWLHWK DIIHFWHG E\ VFLHQWLĂ€F LQQRYDWLRQ EXW SXEOLF SHUFHSWLRQ KDV century reveals a distinct upsurge in the 1940s of print KDG DQ LPSRUWDQW LQĂ XHQFH EDFN RQ VFLHQWLĂ€F UHVHDUFK media dedicated to allergies, with a particular highlight on a However, an examination of allergies within the public realm set of newly-discovered compounds called anti-histamines. ventures into relatively uncharted territory, as few historians $OWKRXJK LW WRRN GHFDGHV WR FRQĂ€UP WKH SK\VLRORJLFDO have retrospectively looked back to assess the impact of action of the immune agent histamine in allergic responses, VFLHQWLĂ€F LQQRYDWLRQV FRQFHUQLQJ DOOHUJLHV RQ WKH SXEOLF RU antihistamines took off almost instantly after their discovery. how the public perception of allergies changed over time. Almost suddenly these antihistamine drugs became While a copious quantity of medical literature SURPLQHQWO\ IHDWXUHG DV WKH Ă€UVW UHDO KRSH IRU WKH PDVV about the nature of allergies and the immunological role relief of allergies. Amid the initial success of antihistamines of histamine has long existed, it is only in the last decade in mitigating allergy symptoms, the media championed that historians have seriously begun to examine the events them through advertisements and articles. However, it that shaped the history of the allergy phenomenon. Among soon became clear that antihistamines were not a panacea the few pertinent historiographies of allergy that have been IRU DOOHUJLHV EHFDXVH RI WKHLU PL[HG HIĂ€FDF\ DQG WHPSRUDU\ recently published, the most prominent are the books of action. Nevertheless, the record-level consumption of historians of science Mark Jackson and Gregg Mitman. antihistamines among the public was here to stay – by Jackson and Mitman’s in-depth historical investigations WRGD\ WKH\ DUH D Ă€YH ELOOLRQ GROODU LQGXVWU\ 4 In fact the vastly improve upon the prior cursory and celebratory only author that digs more deeply into any socio-economic histories of allergy published by scientists to commemorate UDPLĂ€FDWLRQV UHODWHG WR KLVWDPLQH LV *UHJJ 0LWPDQ ZKHQ WKH NH\ SOD\HUV DQG VXFFHVVIXO GLVFRYHULHV LQ WKHLU RZQ Ă€HOG he forays into how the release of antihistamine medications Jackson and Mitman delve into the dynamic context in which set off a major power struggle between physicians, the allergy research developed by constructing broad analyses pharmaceutical industry and government agencies.5 Even of the 20th century allergy timeline in British and American as Mitman considers the effect of histamine’s emergence social history, respectively.3 Within their coverage of the on American society, he does not stop to explore how the major players and events in allergy history, both authors DOOHUJLHV ZHUH UHGHĂ€QHG LQ WKH SXEOLF LPDJLQDWLRQ LQ OLJKW RI touch upon Henry Hallett Dale’s seminal research on the histamine and the therapies that ensued to target its pathways chemical compound histamine and the subsequent hot in the body. Indeed, despite a surge in allergy advertisement market that emerged with the introduction of antihistamine and educational literature in the 1940s, any investigation medications. However, the topics related to histamine are of popular views of allergy is missing from the secondary of secondary concern to Jackson and Mitman in the grand source literature currently available. scheme of allergy history and the broad claims that they Even though medical research yielded a number of PDNH DERXW DOOHUJ\¡V LQĂ XHQFH RQ VRFLHW\ DQG LWV LQVWLWXWLRQV GLIIHUHQW VFLHQWLĂ€F GLVFRYHULHV DERXW DOOHUJ\ LQ WKH VHFRQG KDOI in the past hundred years. Moreover, although the two of the twentieth century, the introduction of antihistamine authors contextualize science within political developments medications immediately after World War II established a

Steve Sturdy. Review of Allergy: the History of a Modern Malady, by Mark Jackson and Breathing Space: How Allergies Shape our Live and Landscapes, by Gregg Mitman. The British Journal for the History of Science 42, no. 02 (2009): 282-284.

3

Gregg Mitman, Breathing space: how allergies shape our lives and landscapes (Yale University Press, 2007), 5.

4

5

Mitman, Breathing space:, 216-7.

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13 SPRING 2011 LEVIN/AIDS CHALIK / ALLERGY VLJQLĂ€FDQW WXUQLQJ SRLQW LQ WKH SXEOLF SHUFHSWLRQ RI DOOHUJLHV certain individuals exhibited various kinds of abnormal negative A historical investigation scrutinizing the trends in how the reactions when injected with horse serum, from skin rashes and media portrayed allergies throughout the middle of the fever to symptoms that were more deadly.7 Generalizing from twentieth century will reveal how the advent of histamine this experience, Pirquet proposed the term “allergyâ€? in 1906 to and antihistamines catalyzed a transformation in the popular describe a pattern of altered “reactivityâ€? of the human body conception of allergies. toward various substances with which it came into contact.8 Von Pirquet’s new term was met with initial skepticism, as well as a debate over allergy in contrast to Charles Richet’s PART 1: THE PREWAR, PRE-HISTAMINE CONCEPTION OF ALcontemporarily coined concept of anaphylaxis.9 By the middle LERGIES of the century, allergy would be adopted by the medical $FWXDOO\ IRU PDQ\ LW ZRXOG EH D VXUSULVH WR Ă€QG RXW establishment as a catch-all term for “a spectrum of related that allergy did not exist prior to the twentieth century. Of immunologically-mediated diseasesâ€? that included hay fever, course individuals suffered from allergies, but they did not hives, and asthma, while acute allergic reactions were redubbed know them as such. Even so, as early as Hippocrates (460-375 as anaphylaxis.10 'HVSLWH WKH YLJRURXV VFLHQWLĂ€F GHEDWHV WKDW BCE), physicians have noted that some individuals’ bodies RFFXUUHG LQ WKH Ă€UVW GHFDGHV RI WKH WZHQWLHWK FHQWXU\ RQO\ LQ would badly tolerate common foods like cheese.6 Patients the late 1920s and 1930s did information about allergies start would consult doctors, as well as sources of folk remedies, trickling down to the public. about individual symptoms like skin rashes, hives, sneezing In the early twentieth century United States, public DQG EUHDWKLQJ GLIĂ€FXOWLHV EXW WKH\ FRXOG RQO\ FRQMHFWXUH DZDUHQHVV RI DOOHUJLHV ODJJHG EHKLQG VFLHQWLĂ€F GHYHORSPHQWV about their causes. As medicine expanded and specialized Through the press Americans were made more and more aware in the nineteenth century, physicians documented a variety of the ravages of hay fever, a seasonal ailment that troubled of unexplained and unconnected conditions like hay fever people with a particular sensitivity to various kinds of pollen.11 DQG HF]HPD WKDW DIĂ LFWHG KXPDQV DQG HYHQ RWKHU DQLPDOV By 1923, specialized clinics had begun to offer “diagnosis to Few of these physicians could offer the public reliable sufferers from hay fever, asthma, and kindred ailments,â€? with explanations or treatments for these conditions. The limited the number of sufferers of these diseases being estimated at “5 medical observations about the patients generally pointed to per cent of the population of the United States.â€?12 Although normally harmless stimuli like pollen, dust, various foods, the term allergy had yet to make a public appearance in the and a number of other substances; the ensuing medical 1920s, the public was already familiar with some of its major advice to relieve symptoms was to stay away from the manifestations, which were already being grouped together offending substance. Yet no one in the medical community as a set of “kindred ailmentsâ€? that could be diagnosed and FRXOG GHĂ€QLWLYHO\ HVWDEOLVK WKH UHDVRQ ZK\ D QXPEHU RI potentially treated. A detailed 1932 article about hay fever in unlucky individuals suffered from these conditions, while the Saturday Evening Post mentions that allergy “meaning an many others in the population would remain unaffected and altered reaction, has become the popular word among doctorsâ€? otherwise healthy. The idea to group the seemingly disparate as an overarching concept for classifying hay fever and other symptoms and conditions would only gain serious traction at conditions like asthma, eczema and urticaria (hives).13 While the beginning of the twentieth century. subsequently the word allergy would accompany hay fever $V WKH SOD\HUV LQ WKH EXGGLQJ Ă€HOG RI LPPXQRORJ\ scored a number of early victories from germ theory to a growing number of vaccines, many scientists began to believe 7 WKH\ FRXOG H[WUDSRODWH WKH VXFFHVV RI Ă€JKWLQJ LQIHFWLRXV Mitman, Breathing space:, 52-3. disease to other types of human ailments. Ironically it was 8 Jackson, Allergy, 38. the development of vaccines for infectious diseases that 9 Mark Jackson. “Allergy and history.â€? Studies in History and Philosophy of directly lead to the birth of allergy as a concept. Vaccines Biological and Biomedical Sciences 34, no. 3 (September 2003): 386-387. for diseases like diphtheria were derived from horse serum, 10 Ibid. EXW QRW HYHU\RQH VWRRG WR EHQHĂ€W IURP WKHP ² H[SHULPHQWV 11 “Hay Fever Sneeze Foils Science Still,â€? New York Times (1857-Current E\ 'UV &OHPHQV YRQ 3LUTXHW DQG %HOD 6FKLN FRQĂ€UPHG WKDW Ă€OH $XJXVW Hay Fever Clinic Opens in Brooklyn,â€? New York Times &XUUHQW Ă€OH August 17, 1923.

12

Mark Jackson. Allergy: the History of a Modern Malady (London: Reaktion, 2006), 28.

6

Morris Fishbein, “Hay Fever and Sensitivity,� Saturday Evening Post 204, no. 47 (May 21, 1932): 76.

13

14

SYNTHESIS ISSUE 3 in newspaper and magazine articles, by association the treatment for allergies, leaving the population of distressed allergy epidemic of hay fever paved the way for allergy to become sufferers susceptible to published claims of success, no matter the accepted term used among the public. As the people how false. However, without a known biological mechanism for who were affected by allergies became better able to identify allergies that legitimate medicines could target, consumers were DQG ODEHO WKHLU SHFXOLDU DIĂ LFWLRQ WKHLU DWWHQWLRQ QDWXUDOO\ subject to solely ineffective or unpleasant therapies if they sought turned to possible explanations and treatments for allergy. to relieve their allergies. However, prior to the development and mass production Physicians specializing in allergy did have something of anti-histamines in the 1940s and 50s, no widely approved to offer the public– the one moderately successful therapy for medical drugs were available that could offer legitimate relief to allergies that was actually discovered early on in twentieth century the broad range of allergy sufferers. A number of remedies of was therapeutic inoculation. Also called allergen immunotherapy, GXELRXV HIĂ€FDF\ ZHUH DYDLODEOH IRU VHDVRQDO KD\ IHYHU )RU H[DPSOH or desensitization, it was developed beginning in 1910 by British in 1922 the New York Times published a suggestion from a physicians Noon and Freeman as a series of injections to protect meeting of the United States Hay Fever Association – this was against hay fever, based on earlier work of American William for hay fever sufferers to “spend the day in an ice box.â€?14 The Dunbar.19 :KLOH DOOHUJ\ VSHFLDOLVWV FRQWLQXHG WR UHĂ€QH DQG suffering public was desperate, as science had yet to come up administer this treatment for allergies throughout the twentieth with a viable solution to the allergy problem, so the void was century, it does not appear to have been a popular option—the Ă€OOHG E\ WKH PDUNHW 2QH RUDO UHPHG\ DGYHUWLVHG LQ IRU KD\ procedure requires repeated doses, has a limited success rate, as fever was called Ercolin, and it distinguished itself as a successful well numerous potentially dangerous side effects, and an unknown “treatmentâ€? that brought “instant relief â€? to allergy sufferers.15 The biological mechanism. While popular articles in the 1930s advertisement, which appeared in the Rochester Times-Union, promoted the success of desensitization therapy, for those patients tellingly reveals that a number of “salves, capsules, and other which this therapy disappointed the suggested options were to Hay Fever palliatives of no therapeutic valueâ€? were available on “evade the source of the symptomsâ€? or if they were suffering the market and scorned by physicians.16 Ironically, Ercolin must from hay fever to “go for a long and pleasant vacation.â€?20 Since the have been no different as it now appears in the Product Name only viable treatment option for treating has been far from optimal, Index of the AMA’s Historic Health Fraud Collection. A 1929 ad symptomatic remedies have enjoyed a far greater appeal among the that also promised “instant relief â€? for respiratory conditions from public. colds to hay fever proclaims that a new treatment using chlorine is Although the word “allergyâ€? only made its way into the “pleasant, safe, and tremendously helpful in preventing as well as public vocabulary from medical use in the 1930s, it merely became healing.â€?17 Chlorine is indeed a time-tested antiseptic, especially a collective term for an existing concept that included the familiar for pool water; however for a number of people chlorine in pool conditions of hay fever, asthma, and other disorders of sensitivity water acts a common allergen and no evidence exists for it being to common substances. Medicine had yet to offer any sensible a “treatmentâ€? for any kind of allergy. One may also wonder how explanation or practical remedy for allergies, which allowed the “safeâ€? administering chlorine was, since chlorine can also be lethally befuddled public to turn to many untested claims advertised poisonous in increasing quantities. Another intriguing invention to in the press about allergies. The early remedies, ranging from protect against hay fever appears in advertisements on the pages of obvious advice and familiar “curesâ€? to outlandish suggestions and The New York Times and the Chicago Tribune in the late 1930s—a absurd contraptions, played upon the desperation of the public. VSHFLDO Ă€OWHU PDVN IRU KD\ IHYHU YLFWLPV WR ZHDU RYHU WKHLU IDFH ZKHQ Even though early therapies for allergy were not successful since faced with intolerable environmental doses of pollen.18 There is they were medically unproven, their promise of “instant relief â€? little evidence that this highly publicized contraption, resembling for symptoms of allergy set the bar for future treatments that the gas masks worn by soldiers in World War I, ever gained popular science could offer to the public. With science responsible use. All of these advertised remedies fueled public demand for a for a growing number of effective new treatments for other diseases, the public awaited the same success to be replicated with the problem of allergies. 14 Special to The New York Times, “Ice Box As Hay Fever Cure,â€? New York Times &XUUHQW Ă€OH 6HSWHPEHU 15 “Hay Fever.â€? Duke Digital Collections Item, 1927. http://library.duke. edu/digitalcollections/mma.MM0059/pg.1/. 16

Ibid.

“Colds Nasal Catarrh Whooping Cough Hay Fever etc, etc. New Chlorine Discovery Brings Instant Relief.� Duke Digital Collections Item, 1929. http://library.duke.edu/digitalcollections/mma.MM0061/pg.1/. 17

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18 “Display Ad 32 — No Title.â€? New York Times &XUUHQW Ă€OH $XJXVW 1, 1937.

M. Jackson. “John Freeman, hay fever and the origins of clinical allergy in Britain, 1900-1950.� Studies in History and Philosophy of Science Part C: Biological and Biomedical Sciences 34 (September 2003): 477-479. 19

20

Fishbein, “Hay Fever and Sensitivity,� 78.

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15 LEVIN/AIDS CHALIK / ALLERGY Anne-Marie Staub at the Pasteur Institute in France, gradually PART 2: THE SNEMY AND THE SAVIOR – A NEW FOCUS ON narrowed down the search, early antihistamine candidate drugs HISTAMINE AND ANTIHISTAMINES ZHUH KDG OLPLWHG HIÀFDF\ DQG KLJK WR[LFLW\ 26 On the eve of World Success in demystifying the workings of allergy in the War II, a number of groups both in Europe and in the United body took a long time to achieve, but the efforts made by a number States were working to produce antihistamines that would yield of scientists along the way would ultimately yield not only a new JRRG UHVXOWV LQ KXPDQ XVH 7KH ÀUVW DYDLODEOH DQWLKLVWDPLQH IRU source of legitimate relief for patients affected by allergies, but a new human use was Antergan, released in France in 1942.27 This race way for the public to think about allergies. Since similar patterns of for laboratories to patent an effective drug to inhibit histamine allergic reactions would be observed in different patients reacting drew attention from pharmaceutical companies. These companies to various sorts of antigens (allergens), from the beginning of the ZHUH HDJHU WR UHDS WKH EHQHÀWV RI SURGXFLQJ WKH ÀUVW OHJLWLPDWH VFLHQWLÀF IRUPXODWLRQ RI DOOHUJ\ LQ WKH ÀUVW GHFDGH RI WKH WZHQWLHWK drugs to counter the whole gamut of allergic conditions from century, there was a hypothesis that a single common substance hay fever and eczema to asthma and hives. In the Unites States, a in the body was liable for producing allergic reactions.21 In 1910, drug developed during the war that showed promising results in Henry Dale, who several years earlier helped isolate histamine from relieving the symptoms of hay fever, went on sale in 1946—this ergot mold, working with Patrick Laidlaw showed that the injection was Benadryl, originally patented by Parke, Davis & Company.28 In of histamine into small mammals like guinea pigs produced a the following three years over 20 other antihistamine compounds potentially deadly anaphylactic response.22 This would be one of would become available for public consumption.29 Although WKH ÀUVW RI D VHULHV RI H[SHULPHQWV WKDW LPSOLFDWHG KLVWDPLQH DV pharmaceutical companies and researchers were enthusiastic about a potential biological intermediary in allergic reactions. By 1927, the new antihistamines, some doctors were cautious. In a 1946 Dale with Dr. Charles Best, one of the discoverers of insulin, review of histamine and antihistamine research for the Journal demonstrated that histamine was constitutively present in various of the American Medical Association, Dr. Samuel Feinberg tissues of the human body, adding credence to the theory that FRPSUHKHQVLYHO\ FRPSDUHG WKH HIÀFDF\ RI WKH HDUO\ DQWLKLVWDPLQH histamine is released upon bodily contact with an antigen, thereby drugs with respect to different manifestations of allergy: his unleashing the symptoms associated with anaphylaxis or allergy.23 conclusions reveal common concerns about antihistamines that However, many doctors were confused about the biological role continue to this day, such as the temporary symptomatic relief of histamine—one physician writing a book about allergies for and limited potency (especially with asthma) they provided, which the general public in 1941 unequivocally stated that “histamine is would also come with notable side effects like sedation.30 One of a poison.”24 Since the essential physiological and immunological Feinberg’s remarks about antihistamines is especially farsighted, functions of histamine had yet to be discovered, many people as he cryptically suggests that “it must be admitted that since it is mistook histamine as a “poison” activated in allergic individuals QRW GHÀQLWHO\ NQRZQ WKDW KLVWDPLQH UHOHDVH LV WKH RQO\ LQMXULRXV by usually harmless substances that would cause the symptoms of effect of the allergic reactions, even the most potent antagonists of allergy. Although throughout the 1930s debate about the relationship histamine may fail to be completely effective in the relief of allergic of histamine, anaphylaxis and allergies would continue, especially manifestations.”31 In other words, histamine became the prime since a mechanism for histamine release had yet to be established, enemy in a war against allergies, and while scientists were busy the search for a compound to block the action of histamine in the developing antihistamines to bombard it, the possible accomplices body was on.25 Now, whoever would discover an effective antidote of histamine were getting off empty-handed. Sensing a sensation in the making, the press seized on to histamine would then be responsible for delivering relief much the emergent antihistamine boom. Already in 1946 articles started desired by the millions of people then suffering with allergies. Yet the search for substances to counteract histamine appearing in popular periodicals hailing antihistamines as “a new would not be as conclusive as scientists had hoped. Although hope for the allergic.”32 One article by Steven Spencer published by throughout the 1930s pioneering scientists, like Daniel Bovet and the Saturday Evening Post, a magazine that was riding on its wartime

21 S.M. Feinberg. “Histamine and Antihistaminic Agents: Their Experimental and Therapeutic Status.” JAMA 132 (1946): 703.

M.B. Emanuel. “Histamine and the antiallergic antihistamines: a history of their discoveries.” Clinical & Experimental Allergy 29, sup. 3 (1999): 5. 22

23

Ibid.

Warren Taylor Vaughn. Strange malady: the story of allergy (New York: Doubleday, Doran & company, Inc., 1941), 248. 24

26

Feinberg, “Histamine and Antihistaminic Agents,” 707.

27

Emanuel, “Histamine and the antiallergic antihistamines: a history,” 8.

28

Mitman, Breathing Space, 216.

29

Ibid.

30

Feinberg, “Histamine and Antihistaminic Agents,” 713.

31

Ibid.

16

SYNTHESIS ISSUE 3 popularity, affords an insight into the common conception of with only temporary relief, pharmaceutical companies were into the new age of allergy treatment in early postwar America. content for the public to believe that regular consumption of Spencer writes that histamine “appears to act as a chemical fuse antihistamines for allergies would become the equivalent to a in the allergy explosion,â€? while antihistamines like Benadryl cure. are “a defense mechanism prefabricated outside the body and The cause of improving the lifestyle of allergy EURXJKW LQ WR Ă€JKW RII WKH LQYDVLRQ GLUHFWO\ Âľ33 Borrowing suffers also allowed sectors of business outside the realm of terminology from coverage of the war, Spencer portrays science SKDUPDFHXWLFDOV WR JHQHUDWH PRQHWDU\ SURĂ€W 5HPLQLVFHQW RI as becoming mobilized to defend the suffering public from the the claims of the allergy masks of the 1930s, the air conditioner “invasionâ€? of allergies, with antihistamines exploited as the novel DQG DLU Ă€OWHU GHYLFH PDQXIDFWXUHUV SURPLVHG WR Ă€OWHU DOOHUJHQV weapons to defeat the menace of histamine in the body. No out of indoor air in a convenient fashion. A 1959 Ad for longer was allergy the “strange diseaseâ€? for which was “oftimes 0LFURQDLUH VHH )LJXUH DQ DLU Ă€OWHU DSSOLDQFH VHOOLQJ IRU PRVW EDIĂ LQJ WR WKH PHGLFDO SXEOLF Âľ34 Now allergy could be $79.95, guarantees “99.2% positive protection against hay XQGHUVWRRG LQ WHUPV RI D VSHFLĂ€F FKHPLFDO SURFHVV GULYHQ E\ IHYHU VLQXV DVWKPD DQG RWKHU DLUERUQH DOOHUJLHVÂŤ DQG DOO \RX histamine, which went rogue in allergy sufferers, producing the GR LV Ă LFN WKH VZLWFK Âľ37 The use of air conditioners took off symptoms of hay fever, hives and the like. The public could thus in the United States after WWII, and beyond cooling the air, look to science to produce new compounds, antihistamines, to DLU FRQGLWLRQLQJ DSSDUDWXVHV IHDWXUHG Ă€OWHULQJ V\VWHPV WKDW Ă€JKW RII WKHLU DOOHUJLHV FRXOG Ă€OWHU DOOHUJHQV OLNH SROOHQ IURP FRPLQJ LQWR WKH KRPH However, although medical researchers continued One article advises parents of allergic children that “avoiding WKHLU ZRUN RQ UHĂ€QLQJ WKH PHGLFDO XQGHUVWDQGLQJ RI DOOHUJLHV pollens and molds is almost impossible except by living in and producing more effective treatments, pharmaceutical an air-conditioned environment or moving to a different companies had no patience to wait for them. Relying on the climate.â€?38 Although it may have been more possible to make well-established methods of advertising relief for allergy the home an allergy-free zone, such innovations could only sufferers, these companies hoped that antihistamines could provide temporary comfort for certain allergies rather than JHQHUDWH ODUJH SURĂ€WV 6LQFH WKHUH ZDV D JURZLQJ QXPEHU RI any actual permanent cure. In the end, since isolating oneself compounds that could act as antagonists to histamine to block in an air-conditioned home was just as impractical as wearing its action, competing pharmaceutical companies launched an DQ DOOHUJ\ PDVN DLU Ă€OWHULQJ GHYLFHV ZHUH MXVW DQRWKHU ZD\ advertising war to convince the public that their own brand of IRU HQWHUSULVLQJ JURXSV WR PDNH SURĂ€WV RII RI WKH GHVSHUDWH antihistamine was superior. A 1954 ad for Anahist proclaims public. that “doctors’ new 2-way treatment counteracts allergy, without Thus in some ways the cultural status of allergies did injectionsâ€? — this consisted of Super Anahist nasal spray with not really change after World War II. Just as they were before Anahist tablets so that “long-lasting hay-fever victims can achieve the war, allergies remained a major problem for society, and wonderful results.â€?35 This ad deceptively uses the authority of providing novel solutions to the allergy problem through doctors, without citing any data, to promise a treatment for mass marketing continued as a way of making money. The allergies as effective as the troublesome desensitization therapy difference was that pharmaceutical companies could now that required multiple planned injections. Another popular exploit the public awareness of histamine as a principal actor way to advertise antihistamines was to promise allergy suffers in the physiology of allergy, and advertise new antihistamine freedom to work and play without being hampered by their drugs as the most practical means for the public to relieve symptoms; this message resonated with the American public, their allergies. By legitimately reducing their allergy symptoms, generating enough demand for “to make antihistamines the Americans were now able to live a more comfortable lifestyle third most commonly prescribed class of drugs in America thanks to the efforts of scientists. Allergies went from being during the 1950s.â€?36 Although the effects of antihistamines a mysterious disease to a controlled condition, with evermore worked only on the symptoms rather than the causes of allergy, effective and promising medicines promised on the horizon. Steven M. Spencer. “New Hope for the Allergic.â€? Saturday Evening Post 218.42 (April 1946): 21. 32

33

Spencer. “New Hope,� 21, 121.

34

Vaughn, Strange malady, 249, 254.

35 Display Ad 207 – No Title.� Chicago Tribune (1849-1986), August 12, 1956, F40.

36

Mitman, Breathing Space, 214, 223

“Display Ad 42 -- No Title.â€? New York Times &XUUHQW Ă€OH $XJXVW 30, 1959, 42. 37

38 T.R. Van Dellen. “How to keep your child well,â€? Chicago Tribune &XUUHQW Ă€OH $SULO

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Figure 1

17 LEVIN/AIDS CHALIK / ALLERGY marketed to American civilians as the ideal travel accessory for SUHYHQWLQJ VHD DLU DQG FDUVLFNQHVV HDUQLQJ 6HDUOH UHFRUG SURĂ€ WV 40 At the same time, spurred by the observations of naval medical captain John Brewster, antihistamines became approved for the use against the common cold, which possessed the same initial symptoms as certain forms of allergy. For the pharmaceutical companies, capturing the cold market was a very lucrative prospect, especially if antihistamines became approved for over-the-counter (OTC) use by the Food and Drug Administration (FDA), which indeed occurred in 1949.41 In the span of a few short years, antihistamines transformed from a series of miracle drugs for allergy relief to practically a full blown panacea for the most common sinus problem. Moreover, the public now possessed access to antihistamines without having to consult physicians, and encouraged by promotional advertising, started consuming antihistamines at extraordinary levels. Almost immediately after these developments, a number of medical professionals started to question this widespread and unchecked use of antihistamines. Several months after antihistamines were approved for use against colds, the American Medical Association began to protest their use due to lack of VXIĂ€ FLHQW HYLGHQFH DQG OLWWOH NQRZOHGJH DERXW ORQJ WHUP HIIHFWV of “indiscriminateâ€? antihistamine use.42 Sobering messages started emerging in the popular press about the marketing of antihistamines as cures for the common cold, despite their approval by the FDA. Time magazine published a series of articles in 1950 voicing the warnings of medical and government agencies about the misleading advertising used by antihistamine drug manufacturers; the magazine reported that the Federal Trade Commission ruled that antihistamines “are neither a cure nor ‘an adequate or competent treatment’ for the common cold or its manifestations, nor will any of them prevent colds.â€?43 However these warnings proved ineffectual. Throughout the 1950s and 60s advertisements for antihistamines like Super Anahist promised to “defeat fever, sneezing, aching effects of virus colds.â€?44 Drug manufacturers continued to give the public the impression that antihistamines had the ability to cure disease, rather than modestly alleviate symptoms. Up to the present day the very same antihistamines that remained the market as OTC drugs for the relief of allergies would be advertised for use against colds as well. The economic success of early antihistamines further encouraged scientists to continue their quest for a more

PART 3: ALLERGIES CONQUERED; WHAT NEXT? While the public initially accepted antihistamine medications as an allergy remedy with gusto, pharmaceutical companies actively pushed to expand the applications of antihistamines. In 1949, the manufacturer G.D. Searle introduced Dramamine, a compound containing an antihistamine and a bronchodilator, to relieve motion sickness.39 Initially developed for military use, this drug was soon

39

Mitman, Breathing Space, 219.

40

Ibid.

41

Ibid, 227.

Waldemar Kaempffert. “Attack on the Common Cold by Antihistamine Medication Leads to Further Questions,â€? New York Times (1857-Current Ă€ OH 'HFHPEHU ( 42

“Medicine: No More Sneezing . . ..� Time, April 3, 1950. http://www. time.com/time/magazine/article/0,9171,934924,00.html. 43

18

SYNTHESIS ISSUE 3 comprehensive understanding of allergies, with the potential postwar America. The history of allergies through the twentieth century for developing even more effective anti-allergy medications. A VLJQLĂ€FDQW EUHDNWKURXJK ZDV ORJJHG LQ ZKHQ WKH DQWLERG\ makes it clear that the science of allergies has not developed in a Immunoglobulin E that recognized allergens within the body was vacuum. Scientists were responding to a public need by conducting discovered on the surface of mast cells.45 Through the second half research on how allergies functioned in the human body and how they of the twentieth century “the synthesis of, and pharmacological FRXOG EH PHGLFDOO\ WUHDWHG +RZHYHU WKH VFLHQWLĂ€F XQGHUVWDQGLQJ RI studies on, selective agonists and antagonists has established the allergies and the public conception of allergies developed as distinct existence of four types of histamine receptor and histamine receptor phenomena. The public conception of allergies, mediated by the antagonists have found very important therapeutic applications.â€?46 media, pharmaceutical companies, and the medical establishment, However, although the pathophysiology of allergies was described in ODJV EHKLQG WKH FRPSOH[ VFLHQWLĂ€F SLFWXUH WR ODUJHO\ UHO\ XSRQ D detail in the second half of the twentieth century, very little progress mechanism of histamine popularized in the 1940s. The availability has been made in the prevention or treatment of allergies. of antihistamine medications has given the public an easy solution However, even though the antihistamine boom failed to relieve their symptoms without facing the reality that allergy is still to produce a cure for allergies like many people had hoped, the ODUJHO\ XQWUHDWDEOH GLIĂ€FXOW WR FRQWURO IURP D PHGLFDO VWDQGSRLQW public perception of allergies had been changed. Histamine was The allergy epidemic currently stands at a kind of stalemate. Ă€UPO\ HVWDEOLVKHG DV D PHGLDWRU LQ DOO DOOHUJ\ UHDFWLRQV DQG D ODUJH Although allergies continue to appear regularly in newspapers, selection of antihistamines was available to block its action. Even magazines and on television, they have taken a backseat to seemingly with symptomatic relief, a large proportion of allergy sufferers could more pressing public health problems of the modern world like go back to their daily routines unhampered by hay fever and the like, EDWWOHV DJDLQVW $,'6 FDQFHU WKH Ă X DQG WKH H[SDQVLRQ RI KHDOWKFDUH and their desire for a complete cure made less urgent. Instead with coverage. Correspondingly, these efforts earn the largest outlays of the push by pharmaceutical companies in marketing antihistamines government funding, as well as attention from numerous private to relieve the common cold, new, seemingly larger public health foundations. With antihistamines holding their ground of allergy concerns were made to occupy American minds. Allergy had symptom relief, perhaps it will take a new impetus for allergy research become a familiar annoyance that could be forgotten with the pop to regain its imperative. Such an impetus may lie in the realm of drug of an antihistamine tablet. allergies, which limit people’s access to effective therapies for other medical conditions. Another area that could potentially revolutionize CONCLUSION the public conception of allergies is the relatively untapped domain of preventive medicine. Yet although it is too early to tell how our The establishment of histamine as a key factor within understanding of allergies will change in the future, looking back at the physiological mechanism of allergies provided the public a WKH SDVW UHYHDOV FOXHV RI KRZ D SXEOLF QHHG KHOSHG VWLPXODWH VFLHQWLĂ€F UHDVRQDEO\ YLVLEOH WDUJHW UHVSRQVLEOH IRU WKHLU DIĂ LFWLRQ ,Q D VLPLODU research that helped address the problem. However it is evident that vein, the advent of antihistamine drugs brought forth a palpable the interaction between science and the public in the case of allergies remedy that people could use to relieve the symptoms of their has been largely mediated by the popular press, as well as private DOOHUJLHV 8QIRUWXQDWHO\ EHJLQQLQJ ´LQ WKH Ă€UVW \HDU WKDW DQWLKLVWDPLQH industry, namely pharmaceutical companies. availability to the public, their magical qualities were broadcasted far At the same time, historians should continue analyzing the and wideâ€? and “thousands of allergics were misled into believing interactions of science and popular trends, especially when it comes that these drugs were cures.â€?47 Ultimately, by offering a mechanism to medicine. The temporal constraints on this particular study and a treatment for an enigmatic but increasingly prevalent group precluded any in-depth investigation into the political-economic of ailments, histamine and antihistamines together may have served factors that may have also shaped the popular conception of allergies. as one of the catalysts for the mass marketing of medications in Future studies have the potential to analyze both public and internal documents of pharmaceutical companies, such as annual reports, as well as government papers dealing with the allergy epidemic. Even LI WKH SXEOLF ORRNV WR VFLHQWLĂ€F UHVHDUFK WR VROYH LWV PRVW FULWLFDO 44 “Display Ad 18 – No Title.â€? Chicago Daily Tribune (1872-1963), February medical concerns, it may yet emerge that political and economic 3, 1956, A5. entities play a more decisive role in the management of public health 45 Robert J. Davies and Susan Ollier. Allergy: the facts. (Oxford: Oxford phenomena like allergy. However, even without sweeping historical University Press, 1989), 14. inquiries, it is hoped that more focused historical investigations like 46 Mike E. Parsons and C Robin Ganellin. “Histamine and its receptors.â€? this one will enrich awareness into how less familiar events like the British Journal of Pharmacology 147, no. S1 (1, 2006): S127. discovery of histamine have shaped public perception of seemingly 47 Harry Felix Swartz. The Allergic Child, (New York: Coward-McCann, familiar phenomena like allergy. 1954), 59.

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y a g y t e , D y n l

4 The Scientist: From Biologist to Bioweapon

. , y e H

e y h g r e n r t F t s e

e s y c . l s n O c h l e e y

19

Kimberly Goh, Harvard University ‘13

T

he microbial world of bacteria, germs, and viruses—although periodically asserting itself in the form of plagues and epidemics—coexists peacefully alongside the macroscopic human experience of day-to-day life, unseen and unnoticed. Biowarfare threatens to dissolve this peaceful paradigm, erecting in its place a new understanding of the microscopic as the most dangerous form of weapon—lethal, volatile, and invisible. Yet, the advent of the biowarfare threat has not weaponized life in a strictly microscopic sense; it has also created a weapon out of the living, breathing scientists whose knowledge has fueled the project. Because they differ from other technologies in their regulation, deployment, and their ability to evade surveillance and regulatory mechanisms, bioweapons pose D GLVWLQFW WKUHDW LQ ERWK D VFLHQWLÀF DQG D SROLWLFDO VHQVH 6FLHQWLÀFDOO\ ELRZHDSRQV DUH PRUH UHDGLO\ WUDQVPLVVLEOH and reproducible, making them ideal for mass destruction scenarios. Politically, they can easily be incorporated as part of a covert weapons program under the disguise of nonthreatening forms of biotechnology research. Because of this, the bioweapons threat represents an unprecedented type of security risk that cannot be forced within the frameworks used to approach other military technologies. Although they are often approximated to nuclear weapons because of their similarities in the scope and severity of damage,

the types of programs and institutions required to mount and respond to a bioweapons attack raise new challenges that the nuclear analogy cannot accommodate. In light of this weapons revolution, bioweapons scientists have become a new kind of weapon and a military commodity, for it is their knowledge that is crucial to establishing and defending against such a program. This new role of the scientist has created an unsettling irony in the interplay between war and peace: the scientist is both the greatest threat to and greatest hope for the prevention of biological warfare. He or she assumes a dual role as part of both the effort to enhance their destructive power and defuse that very same threat. During the height of its implementation from 1970 to 1980, the Soviet weapons program, the Biopreparat, H[HPSOLÀHG WKLV FKDQJLQJ SDUDGLJP RI WKH VFLHQWLVW DW WKH dawn of biowarfare. Drawing from the most talented minds LQ WKHLU ÀHOGV WKH 6RYLHW VWDWH HPSOR\HG FKHPLFDO SK\VLFDO and biological scientists in bioweapons facilities across Russia in projects that were, to those outside the Soviet Union, VHHPLQJO\ DLPHG WRZDUG WKH H[SDQVLRQ RI EHQLJQ VFLHQWLÀF GLVFRYHU\ 7KH ÀUVW KLQWV RI D ELRZHDSRQV SURJUDP VXUIDFHG through sporadic pathogenic outbreaks in areas surrounding Biopreparat labs, most notably an anthrax outbreak in 1973 in Sverdlovsk. Despite the results of examination of the outbreak by US scientists, the USSR vehemently denied that the accident was the result of bioweapons development. In

20

SYNTHESIS

ISSUE 3

the Current Digest of the Soviet Press 6RYLHW RIĂ€FLDOV FODLPHG procedures and political dealings, Alibek’s memoir captures that the evolution of the scientist in response to the Soviet bioweapons initiative. Through the Biopreparat, scientists ÂŤ REMHFWLYH LQIRUPDWLRQ GRHV QRW VXLW WKH were integrated into a clandestine culture of research and extremists and anti-Sovieteers in the top echelon intelligence in which they developed new and unprecedented of the US government. Clearly, at their orders, the technology. In response to these creations, they evolved into CIA and the Pentagon are concocting a series of D GLVWLQFW NLQG RI SROLWLFDO VFLHQWLĂ€F DFWRU E\ ZKLFK WKH\ WRR reports with ‘bloodcurdling details’ and ‘frightening became bioweapons. reports’ by intelligence services, which are presented This evolution of the scientist begins with the to President Carter and others for their perusal.1 weaponry revolution embodied in bioweapons, which This impassioned rhetoric casts the US government PDGH ZDUIDUH PRUH GHVWUXFWLYH DQG VHFXULW\ PRUH GLIĂ€FXOW in a paranoid and hostile light, capitalizing on the already WR DFKLHYH %LRZHDSRQV DUH PRUH GLIĂ€FXOW WR FRQWDLQ DQG high tensions of the Cold War to convince the public that counteract than their nuclear counterparts, although both US investigations were the result of distrust rather than in are mass-destruction technologies. Bioweapons demonstrate response to any warranted threat. The Biopreparat, then, an extended period of destruction that is prolonged beyond remained a secret within the Soviet government, its details the event of initial attack, much like nuclear fallout, but concealed from both the outside world and many within the bioweapon threat is compounded by the fact that they Russia. It was not until the defection of Vladimir Pasechnik harness the natural processes of disease transmission and in 1989 that Soviet scientists began to reveal to the rest infection to facilitate the pathogen’s spread from person to of the world the true extent of the USSR’s Biopreparat person. Not only does this allow for the rapid diffusion of bioweapons work. Pasechnik informed British intelligence the agent, but it also exacerbates the problem of combating that his research labs in Leningrad were developing a a biological attack because symptoms often will not manifest strain of plague “developed to be resistant to most drugs themselves until after some latent period, during which the available in the West while being vulnerable to antibiotics victim has no knowledge that he or she carries a dangerous known only to the Soviet Union,â€? and that it “would have and contagious pathogen.3 been able to kill half the population of a town of 100,000 The 1979 Sverdlovsk accident demonstrated how 2 people in a short time.â€? The successful synthesis of such a this latency effect confounds and complicates a response virulent pathogen and the USSR’s intention of its selective to a bioweapon outbreak. In the US investigation of the deployment against the West ran contrary to the USSR’s deadly anthrax outbreak from a Biopreparat facility in participation in international non-proliferatin agreements, Sverdlovsk, empirical evidence showed a latency period and also discredited previous cover-ups like the one in of up to forty three days during which ninety-six people Sverdlovsk. The scope and success of the Biopreparat was contracted cases of anthrax poisoning, sixty-four of which a shock to the international community, particularly the US. proved fatal.4 During this period, “trees were washed by )ROORZLQJ WKLV Ă€UVW UHYHODWLRQ RI WKH %LRSUHSDUDW¡V DFWLYLWLHV ORFDO Ă€UH EULJDGHV VWUD\ GRJV ZHUH VKRW E\ SROLFH DQG VHYHUDO the First Deputy Director of the Biopreparat, Colonel previously unpaved streets were asphaltedâ€? in an attempt to Kanatzhan Alibekov, defected to the United States in 1992. contain the spread of the toxin, and it was not until several Under the new name “Ken Alibek,â€? he provided accounts ZHHNV DIWHU WKH Ă€UVW FDVHV WKDW DQ LPPXQL]DWLRQ SURJUDP to US intelligence that became the most concrete and was mounted.5 These roundabout methods for controlling thorough source of evidence of the full scale of the USSR the outbreak and their inability to prevent substantial loss ELRZHDSRQV SURJUDP 9HUVHG LQ WKH %LRSUHSDUDW¡V VFLHQWLĂ€F of life illustrate the alarming potency of bioweapons and WKHLU UHVLOLHQFH WR FRQWDLQPHQW PHDVXUHV 7KH LQHIĂ€FLHQW Ye. Nikolayev, “Who Is Inspiring Slander Against the Soviet Union?,â€? Current Digest of the Post-Soviet Press 32, no. 32 (1980): 5.

1

Note: formerly titled the Current Digest of the Soviet Press, this newspaper was originally established under Stalin to disseminate information regarding Cold War politics and policies. It is currently issued under the new name “Current Digest of the Russian Press.� “Former Soviet Says He Developed Super-Plague,� Reuters, January 21, 1993.

2

National Research Council (US) Committee on Confronting Terrorism, LQ 5XVVLD DQG 5RVVL VNDL D DNDGHPLL D QDXN High-Impact Terrorism: Proceedings of a Russian-American Workshop (Washington, D.C.: National Academy Press, 2002), 251.

3

Matthew Meselson et al., “The Sverdlovsk Anthrax Outbreak of 1979,� Science 266 (1994): 1202, 1206.

4

5

Meselson et al, “The Sverdlovsk Anthrax Outbreak of 1979,� 1206.

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21 LEVIN/AIDS GOH / BIOWEAPONS and arcane methods of containment through washing trees programs and were assigned key roles in the military objective. and paving streets revealed a lack of protocol to target and Yet, they were also then considered a new security liability destroy the pathogen effectively. Additionally, the delayed because their knowledge was the vital material required for public health response (via immunizations) showed not only the creation of a bioweapon. Much like the pathogens that WKH GLIĂ€FXOWLHV RI PRELOL]LQJ DGPLQLVWUDWLYH VHUYLFHV EXW he designs, the scientist is a bioweapon—a living, changing, DOVR KRZ GLIĂ€FXOW LW LV WR KDYH WKH QHFHVVDU\ WHFKQRORJ\ÂłLQ and travelling threat. This is not only because his exposure this instance the vaccine—ready for public consumption at to pathogens in the laboratory makes the scientist the most the time of the unforeseen outbreak. likely candidate for the accidental spread of a dangerous Preparing for and anticipating a bioweapon agent, but also because he—like the pathogen—has the DWWDFN LV HVSHFLDOO\ GLIĂ€FXOW EHFDXVH ELRZHDSRQV DUH PRUH ability to spread destruction through the dissemination of GLIĂ€FXOW WR GHWHFW WKDQ RWKHU ZHDSRQV LQFOXGLQJ QXFOHDU his knowledge. The exceptionalism of the bioweaponeer technologies. The pre-existing biodiversity among bacteria, should also be noted: his knowledge was a rare commodity. YLUXVHV DQG WR[LQV LQ QDWXUH PDNHV LW H[WUHPHO\ GLIĂ€FXOW Even competent scientists with a general knowledge of to differentiate a dangerous form of microorganism from biology, like the Biopreparat director Sandakchiev, did not D EHQLJQ RQH %\ FRQWUDVW FKHPLFDO ZHDSRQV H[LVW LQ Ă€[HG QHFHVVDULO\ KDYH VXIĂ€FLHQW H[SHUWLVH WR ODXQFK D VXFFHVVIXO and limited forms whose presence can be detected as part program. Thus, the bioweapons program privileged those of a formal security protocol.6 Additionally, the natural scientists who had a particularly specialized skill set and process of mutation is already known to occur at alarming NQRZOHGJH EDVH HYHQ ZLWKLQ WKH VFLHQWLĂ€F FRPPXQLW\ 7KH rates among microorganisms, further complicating the Biopreparat explicitly recognized this danger in its handling process of identifying and segregating dangerous pathogens of its scientists. As Alibek recounts, as they arise by mutation. This added complexity is not a The KGB operated a counterintelligence factor in the case of non-living technologies like nuclear XQLW LQ HYHU\ ELRORJLFDO ZHDSRQV UHVHDUFK ODEÂŤ weapons. Therefore, the fact that these weapons derive from Every director had to accept this alternative chain already dynamic natural processes of infection and mutation of command without complaint. The KGB devoted complicates the means by which effective security systems as much energy to watching Biopreparat’s senior can be designed to combat them. managers as it did to lower-ranking employees. Through this lens of damage potential, the scientist Avoiding intelligence scrutiny was impossible: within the military infrastructure is uniquely dangerous. The DOWKRXJK IHZHU WKDQ WHQ RU Ă€IWHHQ .*% HPSOR\HHV scientist-soldier’s weaponized knowledge becomes both a were assigned to each facility, the units relied on crucial component of the bioweapons initiative as well as a informers to keep us in line.8 security threat that requires careful management and control. This dual condition of dependence on and distrust of the scientist is captured in Alibek’s memoir. First, he makes clear It is evident that, even within their own country, that it was the scientists who provided the fuel and expertise bioweapons scientists were treated with as much wariness required to mount the Biopreparat’s programs: as the pathogens that they were to create. Managed closely by the KGB, the USSR’s internal security agency, scientists Despite his laboratory expertise, Sandakchiev had to be closely monitored and kept “in line,â€? lest their [the director] knew little about the technological dangerous knowledge be diverted away from the strict Soviet process required to mass-produce smallpox. We weapons directive. The scientists, as the enabling factor in needed someone who was not only a smallpox deciding the success of a bioweapons program, could not be expert but who could make our new equipment and allowed to freely employ and share their knowledge. Rather, SURGXFWLRQ OLQHV ZRUN HIĂ€FLHQWO\ÂŤ:LWKRXW VXFK D they had to be guarded with as much, if not more, scrutiny production manager, the project was sure to falter.7 than would be given to any powerful and volatile weapon. Scientists were thus the cornerstone of bioweapons In addition to raising the scale of destruction, the second military revolution embodied in the bioweapons threat lies in the weapons’ ability to avoid detection by even 6 National Research Council (US) Committee on Confronting Terrorism, LQ 5XVVLD DQG 5RVVL VNDL D DNDGHPLL D QDXN High-Impact Terrorism: Proceedings of a Russian-American Workshop, 251. Clay Farris Naff, Biological Weapons, Contemporary Issues Companion (Detroit, MI: Greenhaven Press/Thomson Gale, 2006), 86.

7

Ken Alibek and Stephen Handelman. Biohazard : The Chilling True Story of the Largest Covert Biological Weapons Program in the World, Told from the Inside by the Man Who Ran it, 1st ed. (New York: Random House, 1999), 92.

8

22 SYNTHESIS ISSUE 3 highly advanced surveillance systems. This fact is politically nuclear weapons. However it is easier to evaluate whether or relevant because bioweapons thereby lend themselves well not a nuclear program is threatening because the production to the formation of powerful covert weapons programs. of nuclear weapons—due to their size and the fact that Facilities such as laboratories and test sites have a “dual they do not derive from a naturally occurring structure (e.g. XVHÂľ FDSDFLW\ PHDQLQJ WKDW WKHLU SUHVHQFH LV QRW VXIĂ€FLHQW organisms like bacteria)—is easier to detect. Conversely, evidence to prove the existence of a bioweapons threat as WKH Ă€UVW LQGLFDWRUV RI D ELRZHDSRQV SURJUDP DUH RIWHQ opposed to merely a civilian biological research program. the development of disease management and containment In other words, there is an innate uncertainty attached to infrastructures, which could easily be interpreted as the the presence of biological research facilities. Ironically, this buildup of public health service facilities to combat natural characteristic was best articulated in response to the USSR’s epidemic risks rather than efforts to protect local populations attempt to cover up the Sverdlovsk incident by turning from the pathogens being developed.10 Furthermore, these indicators are civilian in nature, meaning that efforts to scrutiny upon US labs: evaluate a country’s bioweapon capabilities require defense The US military department hastened to hush programs to constantly and vigilantly monitor not only a up the case of the disease contracted by E. Magee, nation’s military capacity but also the quality of its entire D JXDUG DW WKH VHFUHW 86 QDYDO ODERUDWRU\ÂŤZKLFKÂł public health and research development apparatus.11 Thus, yet another example of the American authorities’ bioweapons programs can easily be concealed from other K\SRFULV\ÂłLV FDPRXĂ DJHG DV D PHGLFDO UHVHDUFK nations’ surveillance systems or placed under the guise of institution. In that laboratory extensive work is being legitimate, even morally compelling, research. done on bacteriological weapons, particularly ‘Valley By harnessing the natural process of disease Fever’—the virus that infected E. Magee.9 epidemics, the bioweapon threat poses a unique danger because a country may not even realize it has been Averting Russian attention from the possibility of the victim of a biological attack. As Robert Kadlec12 clandestine activities in Sverdlovsk, the “dual useâ€? problem UHFRJQL]HV ´%LRORJLFDO ZHDSRQV FDQ EH HPSOR\HGÂŤXQGHU has two important implications. First, the opacity of labs to WKH JXLVH RI QDWXUDO HYHQWVÂŤ'HOLEHUDWH GLVVHPLQDWLRQ RI international surveillance makes discerning the true intent of BW [bioweapons] agents may be afforded possible denial ELRORJLFDO UHVHDUFK IDFLOLWLHV D GLIĂ€FXOW DQG SDLQVWDNLQJ WDVN by naturally occurring diseases.â€?13 Depending on the type ELRZHDSRQV ZRUN FDQ LQ IDFW EH ´FDPRXĂ DJHGÂľ DV OHJLWLPDWH of agent employed, a nation may attribute an outbreak to VFLHQWLĂ€F HQGHDYRUV 7KLV LV GHPRQVWUDWHG KHUH E\ WKH a natural event, thereby remaining ignorant of the political USSR’s reliance on inference and assumption to insinuate the and biological threat that recognition of a bioweapons attack existence of a US bioweapons program based on E. Magee’s would reveal. Bioweapons, then, can evade detection but contraction of supposed “Valley Fever.â€? Second, because of VWLOO LQĂ LFW LQFUHGLEOH GDPDJH ZKLOH NHHSLQJ WKH DJJUHVVRU this ambiguity, the accusation of bioweapons activity could safe from blame, accusation, and—most importantly— be used as a political tool to manipulate domestic attitudes retaliation. From creation to use, these weapons can remain and divert public attention away from questioning the Soviet completely concealed, making them the ideal basis for a government’s activities. Regardless of the veracity of these secret weapons initiative. Because bioweapons are so hard to detect, the claims by the Soviets, the uncertainty imposed by the “dual useâ€? quandary complicated international relations and made scientist becomes essential to the process of intelligence the detection of a true bioweapons threat exponentially and counter-intelligence gathering. Not only is the scientist’s technological knowledge of biology being militarized, but PRUH GLIĂ€FXOW Under the uncertainty of “dual use,â€? merely the accusation and public perception of the threat can be enough 10 Christopher F. Chyba and Alex L. Greninger, “Biotechnology and BioterWR LQĂ XHQFH WKH SROLWLFDO FOLPDWH DQG FKDQJH WKH ODQGVFDSH rorism: An Unprecedented World,â€? Survival 46, no. 2 (2004): 146. of domestic and foreign relations. A similar problem exists 11 National Research Council (US) Committee on Confronting Terrorism, in the case of nuclear technology: Nuclear research facilities LQ 5XVVLD DQG 5RVVL VNDL D DNDGHPLL D QDXN High-Impact Terrorism: could be directed toward benign endeavors like nuclear Proceedings of a Russian-American Workshop, 252. energy projects or toward more sinister directives like 12 Lieutenant colonel in US Air Force, part of United Nations inspection team for biological weapons in Iraq, member of US delegation to Biological Weapons Convention from 1993 to 1996 9

Nikolayev, “Who Is Inspiring Slander Against the Soviet Union?,� 5.

13

Naff, Biological Weapons,124.

3

GOH / BIOWEAPONS 23 SPRING 2011 LEVIN/AIDS Alibek: What was amazing to me, when I his political knowledge of a country’s bioweapons program came to the United States, I realized I knew practically is weaponized as well. This re-imagined role of the scientist everything about the United States program. as an intelligence weapon is best demonstrated in the Patrick: Right. And we knew absolutely administrative buildup and breakdown of the Biopreparat. nothing about yours. I never will forget when you Despite signing the non-proliferation tenets of the Biological VWDUWHG JLYLQJ PH WKH SRWHQWLDO SURGXFWLRQ Ă€JXUHV Weapons Convention (BWC) in 1972, the USSR continued for your various weaponized agents. If you recall, I to expand its bioweapons programs. The Convention was just put my head down on the table where we were designed to commit its signatories to the non-proliferation talking and said, ‘Oh, my God. Oh, my, God.’ It was of bioweapons and limit their research endeavors to solely a revelation that was just unbelievable to me.17 defensive biotechnology.14 However, as Alibek recounts, the USSR nevertheless embarked on the development of a monopolizing this new intelligence weapon as demonstrated in this interaction between Alibek and US bioweaponeer Bill secret bioweapons program: Patrick: ‘You are aware that this isn’t normal work,’ WKH RIĂ€FHU WROG PHÂŤ Âś<HV ¡ , UHSOLHG It was through this kind of exchange with defecting ‘I have to inform you that there exists an Soviet Union scientists that the US was alerted to its ignorance international treaty on biological warfare, which the of the scope and structure of the USSR bioweapons program. Soviet Union has signed,’ he went on. ‘According Adhering to standards of transparency and civilian oversight to that treaty no one is allowed to make biological outlined in the BWC in 1972, the United States had begun weapons. But the United States signed it too, and we the disassembly of its bioweapons programs. Meanwhile, believe that the Americans are lying.’ the Soviet Union had continued, if not strengthened, the I told him, earnestly, that I believed it too.15 Biopreparat.18 What is perhaps most alarming about this was the USSR’s ability to violate the BWC without notice from In this instance, Alibek became one of the few the international community. Patrick’s shock at learning the SULYLOHJHG PHPEHUV RI WKH VFLHQWLĂ€F FRPPXQLW\ÂłDQG 5XVVLD extent of the Biopreparat activities is only a single instance as a whole—who had knowledge of the USSR’s clandestine of this terrifying realization of the USSR’s bioweapon bioweapons program. As a scientist, he was required not capabilities; his disbelief demonstrates the unsettling only to make a technological contribution to the nation’s success of the USSR in integrating bioweapons scientists biological program but also to become a determining player LQWR WKH QDWLRQ¡V LOOLFLW RSHUDWLRQV DQG LQ FRQWDLQLQJ WKH Ă RZ in the Soviet intelligence infrastructure. By being privy to of information regarding the program. Without knowledge FODVVLĂ€HG ELRZHDSRQV LQIRUPDWLRQ WKH VFLHQWLVWV RI WKH of the Biopreparat’s violations of the BWC, the United Biopreparat became part of the intelligence elite, and their States could not reasonably invest the substantial funds cooperation was necessary for maintaining the clandestine required to fuel counter-defense technologies or public health programs needed to cope with a bioweapons attack. nature of the program. As a result of their knowledge, these biologists also Yet, this interaction simultaneously reveals the power of the presented the most effective means by which an outside VFLHQWLVW WR LQĂ XHQFH WKH WUDMHFWRU\ RI LQWHUQDWLRQDO UHODWLRQV country could detect an enemy’s covert bioweapons program. E\ HLWKHU SURWHFWLQJ RU GLVVHPLQDWLQJ FODVVLĂ€HG LQIRUPDWLRQ 'XH WR WKH GLIĂ€FXOW\ RI GHWHFWLQJ ELRZHDSRQ GHYHORSPHQW As shown by defectors like Alibek and Pasechnik, scientists and deployment, “reliable human intelligence with direct could the deciding factor in whether a bioweapons program DFFHVV WR DQ DGYHUVDU\¡V %: SURJUDPÂľ ZDV WKH PRVW HIĂ€FLHQW could successfully maintain the ambiguity of purpose that and dependable means of bioweapons detection.16 The gives it an advantageous “dual useâ€? quality. So long as scientist, then, became an intelligence operative, and his knowledge became an asset in the military game of national 17 “Bioterror: Interviews with Biowarriors,â€? NOVA online, accessed security. The Biopreparat was masterful at controlling and October 20, 2010, http://www.pbs.org/wgbh/nova/bioterror/biowarriors.html/. ). 15 “Hay Fever.â€? Duke Digital Collections Item, 1927. http:// library.duke.edu/digitalcollections/mma.MM0059/pg.1/. 15

Naff, Biological Weapons, 83.

16

Naff, Biological Weapons, 118.

Jeanne Guillemin, Biological Weapons: From the Invention of State-Sponsored Programs to Contemporary Bioterrorism, (New York: Columbia University Press, 2005), 130.

18

24

SYNTHESIS ISSUE 3 scientists do not reveal the nature of their activities within effort. Gerald Epstein, the director of the Center for Science, the lab, bioweapons facilities cannot be determined as Technology, and Security Policy at the American Association necessarily harmful or benign. Yet, the testimony of these for the Advancement of Science (AAAS) same scientists provides the most concrete evidence of a Epstein asserted that the prevention of research bioweapons program, removing any doubt or uncertainty as a way to stop bioweapons proliferation would not have regarding the potentially malicious intentions of research the desired effect of deterring nor protecting against the directives. The scientist then, takes on a political value as bioweapons threat. Counter-intuitively, it is the promotion both the target and tool of intelligence gathering programs of such research within a framework of global partnership looking to identify bioweapon threats. that will not only catalyze the process of discovery of useful $V ERWK D VFLHQWLĂ€F DQG PLOLWDU\ DVVHW WKHQ WKH health technology but also prevent the type of secrecy and scientist’s role in the techno-political system allots him an competition that fueled the Cold War arms race and weapons H[SDQGHG LQĂ XHQFH RYHU WKH DELOLW\ WR SUHYHQW RU SUROLIHUDWH proliferation. Recognizing that the threat of bioweapons FRQĂ LFW EHWZHHQ QDWLRQV :KLOH WKH SUHFHGLQJ DQDO\VLV cannot be completely eliminated or “reduced to zeroâ€?—in has focused on the scientist as a new kind of weapon— part because the natural process of disease and epidemics will portraying his knowledge of how to create bioweapons and inevitably continue—the best course of action is instead to his participation in a covert weapons program as the means temper that threat by dissuading governments and scientists by which the scientist himself becomes the most dangerous from aggravating it through the sinister deployment of bioweapon. However, the scientist also possesses, in this new ELRZHDSRQV 7KXV LW LV WKURXJK WKH ZRUN RI WKH VFLHQWLĂ€F role, the power to encourage international transparency and community that the threat of bioweapons is most aptly cooperation. Bioweapons scientists are crucial to efforts to mitigated and directed toward non-hostile endeavors. design adequate surveillance systems and counter-measures. The dawn of the era of biological warfare has Their technical expertise and their ability to anticipate brought about a unique set of circumstances that require a potential new threats allow bioweaponeers to know what new imaginative framework to encompass both the idea of kinds of threats security systems should be looking for and weapons’ destructive capacity and the role of the scientist in how such threats will manifest for detection. Furthermore, realizing and controlling that potential. In a strictly practical by monopolizing the existing collaborative culture of the sense, bioweapons differ even from other forms of high-tech VFLHQWLĂ€F FRPPXQLW\ VFLHQWLVWV KDYH WKH DELOLW\ WR SURPRWH weaponry in their expanded potential for mass, uncontrolled, transparency across national boundaries and disperse and proliferative destruction as well as in the pathogens’ ability invaluable knowledge of how to combat bioweapons and, to evade detection by containment and treatment technologies. more generally, natural epidemics. In a 2009 conference As a consequence, bioweapons lend themselves to important panel at the Center for Biosecurity of UPMC, discussion political ends—in particular, the formation of clandestine between several biosecurity policy centers and agency weapons programs. In doing so, bioweapons dramatically alter directors emphasized the importance of this collaborative the way that intelligence and surveillance systems interact and LQĂ XHQFH SROLWLFDO DQG PLOLWDU\ GHFLVLRQ PDNLQJ RQ WKH JOREDO promoted the idea of monitoring and scale. This unprecedented form of weapon creates a new kind transparency, suggesting that security should be the of scientist intricately involved in both the science of creating product of international engagement, collaboration, such weapons and in the political structure designed to manage, and enhanced epidemiologic capabilities. [Carol] GHSOR\ DQG GLVJXLVH WKHP $UPHG ZLWK SRZHUIXO VFLHQWLĂ€F DQG Linden [of the US government’s Department of political knowledge then, the idea of what can be considered a Health and Human Services]19 concurred, noting ´ELRZHDSRQÂľ LQĂ DWHV WR HQFRPSDVV WKH VFLHQWLVW DV ZHOO ,Q WKH that, since the insider threat cannot be reduced to same way that a virus spreads a deadly disease, scientists have zero, efforts to enhance security should focus on the ability to spread their deadly knowledge. However, it is also creating an open and transparent global bioscience in the hands of the scientist to do just the opposite—to use community.23 that knowledge to prevent the use of bioweapons and counter their effects. The ability of scientists to foster communities 19 Carol Linden, Principal Deputy Director, Biomedical Advanced Research of transparency and collaboration toward the goals of nonDQG 'HYHORSPHQW $XWKRULW\ %$5'$ 2IĂ€FH RI WKH $VVLVWDQW 6HFUHproliferation and public health initiatives represents the most tary for Preparedness and Response, Department of Health and Human potent avenue toward protection from biowarfare. Thus, the Services 20 Gronvall et al., “Prevention of Biothreats: A Look Ahead,â€? Biosecurity and age of bioweapons has expelled the scientist from the world of the laboratory and armed him and his knowledge with a Bioterrorism: Biodefense Strategy, Practice, and Science 7, no. 4 (2009): 435.

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5 A Study on the Politicization and Moralization of Medicine: Anti-Vaccination Movements in 19th Century Britain and Colonial India Stephanie Woo, Harvard University ’12

F y

s a

n l h , y . t e r d O d g , G a H e o e r s t e d a

T

hroughout the late 19th century and during the early years of the 20th century, smallpox was a major source of contention in both Britain and colonial India, not only because of its debilitating effects as a disease, but also for the controversy that was stirred in response to the anti-vaccination movements in both countries. In both cases, the state played a major role in the push for vaccination, thus raising questions concerning the authority of the state and autonomy of the individual. Ultimately, the anti-vaccination movement represents a moment in history in which dialogue surrounding a major health issue has a largely political, not medical, basis. Despite similar strands running through the story of the anti-vaccination movements in Britain and India, each country’s unique political and socio-cultural nuances have revealed the complexity of the two movements and led to a better understanding of the causes of the politicization and moralization of medicine. The development of the anti-vaccination movement in Britain was particularly timely, considering the political activity of what was seen as an “increasingly interventionist state” that threatened the autonomy of the individual.1 Much of the impetus behind the anti-vaccination movement Nadja Durbach, “ ‘They Might As Well Brand Us’: Working-Class Resistance to Compulsory Vaccination in Victorian England,” Social History of Medicine 13, no. 1 (2000): 45.

was drawn from the British working class; the Compulsory Vaccination Act of 1853 seemed like an extension of the state’s authority over its marginalized citizens. In the eyes of the working-class, the Compulsory Vaccination Act appeared closely linked to the “dreaded” New Poor Law, which was enacted in 1834 and was considered to have stripped the working-class of their independence by “forcing all recipients of government relief into the workhouse.”2 Since compulsory vaccination only mandated that babies be vaccinated, children played a crucial role in the antiYDFFLQDWLRQ PRYHPHQW 7KH VLJQLÀFDQFH RI FKLOGUHQ ZDV WKHLU status as an extension of their parents; therefore the state’s attempt to vaccinate babies was also seen as a “usurp[ation of] the parental role.”3 Historian George Behlmer posited that the state’s increasing efforts to control the lives of citizens had been brewing long before the anti-vaccination movement, with an augmented focus on child welfare, seen in the establishment of agencies like the National Society for the Protection of Cruelty to Children.4 Thus, it is clear that for decades, British politics had been building an environment in which the state assumed extensive authority, and the anti-vaccination movement must be seen as a 2

Ibid., 51.

3

Ibid., 50.

4

Ibid.

1

26

SYNTHESIS ISSUE 3 response to these many years of unwanted social reform due to the focus the state placed on whites in India and orchestrated from the top-down. subsequent neglect of the local population. Therefore, in Similarly, Indian oppositionists viewed vaccines as a purely medical terms, variolation proved to be a superior ´VLJQLĂ€FDQW H[WHQVLRQ RI VWDWH SRZHU RYHU WKH LQGLYLGXDO DQG means of smallpox prevention, and the implementation community.â€?5 In both Britain and India, the state attempted of vaccination represents the British desire to extend the to affect people who were marginalized in each respective status quo of Britain and the Compulsory Vaccination Act country’s societies—the poor in one, and the Indians in the into India. Despite differences in governance, the antiother. The political situation in India was complicated by the vaccination movements in Britain and India were both presence of an ethnically and culturally foreign authority— generated by principles of individual autonomy. Thus, it is the British colonists. The power dynamic that existed due clear that not only did the political activity within Britain to the colonial relationship between the two countries and India establish a system of mandated vaccination from resulted in adoption of a ‘crusader mentality’ by the British, which an anti-vaccination movement arose, but also that the and vaccination was seen as “emblematic of [Britain’s] self- movement itself was highly political. Vaccination was no declared humanity and benevolence toward the people longer valued for its medical virtues; rather, it was viewed of India.â€?6 This attitude of condescension inherent in as a political tool to be used by the state against certain colonialism tainted vaccination with similar negative marginalized members of society. connotations, thus Indians shied away from the practice. The anti-vaccination movement in Britain, which However, the political savvy of the British colonists was grew out of political tensions, was propelled by the GHPRQVWUDWHG ZKHQ WKH\ LQĂ€OWUDWHG ,QGLDQ VRFLHW\ UHFUXLWLQJ nation’s socio-cultural situation. The working-class antiregional chiefs and royalty to vouch for vaccination in vaccinationists not only argued for political autonomy, but order to mobilize social change. The British state however also for the physical wellbeing of their children, and here did not engage in such grassroots efforts, and this is likely emerged the issue of the immorality of vaccination. For because the racial implications of colonialism did not apply one, the vaccination procedure was highly painful, and it was in Britain itself. In the case of India, it is evident that policy also dangerous, as vaccinators did not screen for diseases. and medicine mutually impacted each other – vaccination Secondly, parents did not want their children to be infected was brought to India due to the fact it was a British colony, ZLWK WKH ERGLO\ Ă XLGV RI WKH LQIHULRU PHPEHUV RI WKH ORZHU and the implementation of vaccination was affected by the class, from which the working class worked to separate. country’s colonial status. 7KLV LQWHUQDO VWUDWLĂ€FDWLRQ WKDW WKH ZRUNLQJ FODVV FUHDWHG While the political history of the colonial India illustrates the lack of a common viewpoint—though all proved to differ greatly from that of Britain, both governing members of the working-class were made vulnerable to the powers demonstrated a desire to preside over disaffected Compulsory Vaccination Act, they diminished the egalitarian subsets of society through vaccination. Furthermore, stance they had once fought for by trying to assert the same the British colonists neglected the medical advantages of rights as members of the upper classes. Furthermore, public variolation, a method of smallpox inoculation popular vaccination, as mandated by the Compulsory Vaccination in India prior to vaccination. Prior to the push for Act, was stigmatized since only those who could not afford vaccination, some British medical authorities noted the private doctors were forced to comply. This “pauperizationâ€? merits of variolation. J.Z. Holwell, a British authority in of vaccination thus shows that the anti-vaccination Bengal noted that variolation “adds no malignity to the movement was more concerned with the political and moral GLVHDVH >ÂŤ@ QRU VSUHDGV WKH LQIHFWLRQ DV LV FRPPRQO\ consequences of the procedure than its medical value.8 believed in Europe.â€?7 Variolation was highly ritualistic and Conversely, the socio-cultural motivation held by systematic, requiring careful transmission of low-strength anti-vaccinationists in India was largely religious. Through doses of the disease, followed by a close monitoring of implementing vaccination by mandate, the British were not disease recovery. Conversely, the British implementation of only attempting to gain political authority but cultural power YDFFLQDWLRQ LQ ,QGLD SURYHG WR EH LQHIĂ€FLHQW DQG LQHIIHFWLYH over the Indians. Smallpox and its transmission were seen as the manifestation of the goddess Sitala, and the recovery process was highly ritualistic. Variolation, the traditional 5 David Arnold, “Smallpox: The Body of the Goddess,â€? in Colonizing the Indian method of inoculation against smallpox “celebrated, Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Los Angeles: Univ. of California Press, 1993), 116-158, 120.

6

Ibid., 120.

7

Ibid., 129.

8

Durbach, “They Might As Well Brand Us,� 53.

3

27 SPRING 2011 LEVIN/AIDS WOO / VACCINES rather than violated, Sitala’s rights over the body.â€?9 By the individual. British colonialism in India, however, created contrast, vaccination was considered “secular in character an environment in which an anti-vaccination movement and alien in originâ€?.10 Because variolation and recovery was almost inevitable. Similarly, in Britain, the government’s from smallpox carried religious value, the imposition of trend of legislating welfare throughout the middle of the vaccination was seen as immoral and disrespectful to Sitala. 19th century created an atmosphere of social discontent Therefore, smallpox vaccination, fundamentally a medical amongst the working-class, and the Compulsory Vaccination issue, became moralized. The attempt to replace the sacred Act seemed merely the catalyst that sparked the impending variolation ritual was highly offensive, but furthermore, revolt against the state. The religious environment in vaccination was inherently insulting to a wide majority of the India provided a different social context from which the Indian population, as it utilized lymph from cows, which are anti-vaccination movement emerged, as variolation was sacred in Hindu culture. The consequences of these cultural inherently linked with the goddess Sitala, and erasure of the differences between Indian locals and British colonists medical procedure meant the loss of a cultural ritual. These provide a stark contrast to the homogeneity of religion in various layers that together represent the causes of the Britain. Moreover, in the same way that the British working- anti-vaccination movements reveal the complexity behind class anti-vaccinationists attempted to elevate themselves the movements, and illustrate a diverse range of mindsets above the “undeservingâ€? poor, Indian anti-vaccinationists held by participants. Just as science often does not have a were loath to be vaccinated using lymph that had also been single united voice to represent a homogenous monolith, used on lower class children.11 Many Hindus found the PHGLFLQH LV QRW IRXQGHG PHUHO\ DURXQG D FRUH RI VFLHQWLĂ€F PL[LQJ RI ERGLO\ Ă XLGV EHWZHHQ ORZ FDVWH DQG KLJK FDVWH principles. The anti-vaccination movements in Britain and children “offensively polluting,â€? revealing social reasons, India demonstrate the way in which a medical procedure beyond the religious, that also drove the anti-vaccination FDQ EH TXHVWLRQHG VWULSSHG RI LWV LQKHUHQW VFLHQWLĂ€F YLUWXHV movement in India.12 and valued instead for its political and socio-cultural To the British, vaccination was a symbol of Western implications, as a result of politicization and moralization superiority in the face of age-old Indian traditions, thus the WKURXJK FRQWH[WXDO LQĂ XHQFHV implementation of a medical technique became an attempt to eradicate an entire portion of Indian culture. However, it was ultimately the introduction of mandated compulsory vaccination law in 1879 by Sir Sayyid Ahmad Khan, a OHDGLQJ 0XVOLP Ă€JXUH LQ ,QGLD ZKLFK OHG WR WKH WULXPSK RI vaccination over variolation, exposing disunity between the Indian citizens, as some were actually in favor of vaccination. Similarly, not all members of the British working-class harbored anti-vaccination sentiment. Even though the leading force behind legislated compulsory vaccination was not a colonist one, the successful eradication of variolation and “cultural pluralism,â€? and the implementation of vaccination represented a leap in the British “medical monopoly.â€?13 Through asserting medical and cultural dominance, the British colonists further tightened their power on their colony. In both countries, the anti-vaccination movement was less a revolt against the medical virtue of vaccination, and more a reaction to the state’s encroaching authority over 9

Arnold, Colonizing the Body, 133.

10

Ibid., 120.

11

Durbach, “They Might As Well Brand Us,� 45.

12

Arnold, Colonizing the Body, 141-142.

13

Arnold, Colonizing the Body, 133.

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SYNTHESIS

ISSUE 3

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SPRING 2011

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6 A Journey Through the Past, Present, and Future of the Department of the History of Science with Professor Everett Mendelsohn Julie Barzilay, Staff Writer

W

hen Everett Mendelsohn made his professorial debut in Harvard’s Committee on Higher Degrees in the History of Science and Learning LQ KH FRXOG Ă€W WKH FRPPLWWHH¡V HQWLUH population of undergraduates into the living room of his small Cambridge apartment. )URP WKH HDUO\ WK FHQWXU\ÂłZKHQ WKH Ă€UVW KLVWRU\ of science courses began percolating in Harvard’s hallowed halls—to 2011, when around 120 undergraduate concentrators per year advance new theses, explore subtle niches, and study WKH Ă€HOG¡V IDLUO\ UHFHQW IRXQGHUV PXFK KDV FKDQJHG DQG JURZQ in the study of the History of Science. Though little-known to many Harvard undergraduate students, the academic discipline of the history of science itself partially germinated on Harvard’s campus, due to the convergence of social factors—a VRFLHW\ UHFRLOLQJ IURP PDMRU VFLHQWLĂ€F VKRFNV OLNH WKH DWRP bomb—and the collaboration of a few key thinkers. *HRUJH 6DUWRQ RQH RI WKH Ă€HOG¡V PDLQ SURSRQHQWV at Harvard, retired in 1951. Sarton was a Belgian chemist who created the history of science journal Isis in 1912 and, along with biochemist Lawrence Joseph Henderson, founded the History of Science Society in 1924. Before Sarton, a few professors, such as Henderson and chemist Theodore Richards, had taught courses related to the history of science, but the

discipline was in no way formalized. When Sarton started teaching graduate students, the SRWHQWLDO IRU WKH Ă€HOG WR EHFRPH D WUXH FRQFHQWUDWLRQ ZDV UHDOL]HG WKH Ă€UVW VWXGHQWV UHFHLYLQJ WKHLU GHJUHHV LQ Classes focusing on history of science material bubbled up increasingly over time – particularly after the switch to the old General Education program, which promoted the use of KLVWRULFDO SHUVSHFWLYH WR DQDO\]H PDQ\ GLYHUVH Ă€HOGV %HUQDUG Cohen, Gerald Holten, Leonard Nash, and Thomas Kuhn were all hired to teach General Education courses that related WR WKH KLVWRU\ RI SK\VLFV FKHPLVWU\ RU RWKHU Ă€HOGV EXW WKH question remained into what department would they be placed? Furthermore, why had this sudden fascination with the myriad RI IRUFHV VXUURXQGLQJ VFLHQWLĂ€F GLVFRYHU\ DQG GHYHORSPHQW arisen? “Depending on who you talk to, the answer would be different,â€? Mendelsohn says. “I think at the time science was looming large—even pre-atom bomb, this was where a lot of philosophers had turned to work.â€? Though historian Crane Brinton helped chair the newly formulated Committee on Higher Degrees in the History of Science and Learning in 1938, it was not until Harvard President James Conant really got behind the study of the history of science that the idea of a concentration

30

SYNTHESIS ISSUE 3 was entertained. Students still needed to petition to get an well as law schools,â€? Mendelsohn said, noting that pre-medical undergraduate degree for a time, but Conant and Henderson and pre-law students have consistently comprised the bulk of were able to launch a concentration in History and Science FRQFHQWUDWRUV 5HFHQWO\ Ă€QDQFH KDV EHFRPH D SRSXODU FKRLFH on July 1, 1966, modeled after the university’s History and as well. Literature concentration. ´$ QXPEHU RI SHRSOH ZKR ZHQW LQWR VWRFN Ă€UPV DQG With just four full-time professors—Cohen, came back said they, among their peers, were unafraid to look Mendelsohn, John Murdoch, and Erwin Hebert—the History at the things coming up in the sciences,â€? Mendelsohn said. RI 6FLHQFH 'HSDUWPHQW ZDV Ă€QDOO\ ERUQ :KDW SUHFLSLWDWHG +H DGGV WKDW WKH FRQFHQWUDWRUV¡ VFLHQWLĂ€F OLWHUDF\ KLVWRULFDO the blossoming of a full department after all those years? aptitude, and familiarity with the social sciences all contributed “The whole notion that everyone ought to study WR WKHLU VXFFHVV LQ PDQ\ GLYHUVH Ă€HOGV science had become more and more prominent around the Drawing a diverse body of students to the department, country and around the world,â€? Mendelsohn says. “With that, the ranks of graduate students swelled from 5 to near 30. SHRSOH EHJDQ DVNLQJ ZKHUH GRHV LW Ă€W ZKDW LV LW ZKDW GRHV LW Mendelsohn says after the rise in students in the program The come from? What should people know about it? Shouldn’t National Science Foundation began granting fellowships to you know how science works as a thought system, and as a historians of science, and the department became truly selfpractice?â€? SURSDJDWLQJ 7KH Ă€HOG VRRQ JUHZ WDNLQJ KROG DW D IHZ RWKHU However, recognition of the importance of analyzing schools like the University of Wisconsin, Johns Hopkins, VRFLDO FRQVHTXHQFHV RI VFLHQWLĂ€F GHYHORSPHQWV OLNH QXFOHDU Princeton, Yale and Cornell. Despite the presence of the weapons was not the reason the department garnered an +LVWRU\ RI 6FLHQFH DV LWV RZQ VRYHUHLJQ Ă€HOG RI VWXG\ LQ WKH undergraduate following. 8QLWHG 6WDWHV IRU D FHQWXU\ WKH Ă€HOG LWVHOI FRQWLQXHV WR HYROYH “History of Science classes were also a way of with its subject matter. “It used to be that most of the people IXOĂ€OOLQJ FHUWDLQ UHTXLUHPHQWV Âľ 0HQGHOVRKQ DFNQRZOHGJHG ZRUNLQJ LQ WKH Ă€HOG ZHUH WUDLQHG VFLHQWLVWV ZKR WKHQ DGGHG recalling that hundreds of students used science and society history,â€? Mendelsohn says. But when trained historians started FRXUVHV WR IXOĂ€OO VFLHQFH *HQ (GV ´%XW IURP WKHUH LW EHFDPH to comprise a greater portion of the department team, “this fairly rapidly something that students enjoyed.â€? Mendelsohn changed in part what people could and couldn’t do, the nature carved out his niche in the department focusing on the history of the courses they would teach, the way they were thinking RI ELRORJ\ D VFLHQWLĂ€F Ă€HOG WKDW ZDV QRW DV ZHOO VWXGLHG DV DERXW WKH Ă€HOG Âľ either physics or chemistry at the time. For his dissertation, Mendelsohn is hopeful that the concentration remains KH H[SORUHG ´ZK\ WKHUH ZDV D Ă€UH ZLWKRXW Ă DPHV LQ OLYLQJ at its current size because of the value of having accessible thingsâ€?—otherwise known as the development of the theory SURIHVVRUV EOD]LQJ WUDLOV LQ WKHLU Ă€HOG WKRXJK KH DGGV D of animal heat. change in size could take the concentration in interesting new 'HSDUWPHQWDO FRXUVHV TXLFNO\ GLYHUVLĂ€HG WR LQFOXGH directions, as well. topics like medieval science in addition to the history of On the growing popularity of the history of science as science from the Greeks to the atom bomb. Mendelsohn D Ă€HOG RI VWXG\ 0HQGHOVKRKQ VD\V ´,¡G VD\ WKDW LWV LPSRUWDQW says he taught courses on the Darwinian Revolution, the to have enough people in any given society who are not afraid social context of science, the history of modern biology, as to be critical of science—to raise important questions, not out well as a General Education course entitled “From Aristotle of an ideological preference or religious commitment, but out to Einsten.â€? In the 1960s the concentration began to truly of an understanding of what science is.â€? He adds, “What outgrow the living-room intimacy of its earlier days. In 1949, LV WUXO\ LQYDOXDEOH LV WKH DELOLW\ QRW EH FRZHG E\ VFLHQWLĂ€F the number of History of Science students broke the double- authoritarianism.â€? digit barrier, but it was not until the 1970s that the number Mendelshohn believes “A thoughtful person in today’s grew from under 20 to about 40, temporarily surpassing the world ought to be able to turn to a scientist or authority and number of undergraduate History Department concentrators. say, ‘how do you know?’ ‘Where did that come from?’ â€? He Some of these students were drawn in from a popular course adds, “Our society as a whole needs more people who are on science and society, others from Mendelsohn’s “The LQWHUHVWHG LQ KRZ VFLHQFH Ă€WV ZLWKLQ WKH ZRUOG WKDW WKH\¡UH Darwinian Revolutionâ€? class. living in.â€? The growing number of departments specializing In addition to the interesting class material, the LQ WKH KLVWRU\ DQG SKLORVRSK\ RI VFLHQFH VLJQLĂ€HV WKDW KH LV LQWHUGLVFLSOLQDU\ QDWXUH RI WKH Ă€HOG SURYLGHG RSSRUWXQLWLHV IRU not alone in his assessment; the question of how science is students beyond the classroom—“It turned out that history FRQQHFWHG WR RWKHU Ă€HOGV RI VWXG\ DQG FRQWLQXHV WR HYROYH and science is a very good way to get into medical schools as remains a salient one.

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7 Pathologizing Suburbia: How Minor Tranquilizers Created Their Own Market Chelsea Link, Harvard University ’12

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Janie’s a pretty typical teenager. Angry, insecure, confused. I wish I could tell her that’s all going to SDVV«EXW , GRQ·W ZDQW WR OLH WR KHU µ 6R VD\V /HVWHU Burnham as he explains the status of his family life in the year leading up to his own death in the Academy AwardZLQQLQJ ÀOP American Beauty 7KH ÀOP RSHQV ZLWK D ORQJ shot of a very standard-looking upper-middle-class suburban street, voiced over by Lester blandly detailing the stereotypical À[WXUHV RI KLV OLIH KLV QHLJKERUV ZKR DUJXH RYHU SHWW\ GHWDLOV of dog care, his wife whose shoes match the handles of her pruning shears, his angsty teenage daughter who thinks a new pair of breasts will make her into a new person. Somehow Lester’s privileged life doesn’t make him feel privileged at all; instead, everything about it conspires to make him feel like he’s “dead already.”1 &ULWLFV KDYH KDLOHG WKH ÀOP IRU LWV startlingly spot-on portrayal of American suburban life. Apparently many of us also feel that there is something “dead” about our lives, or at least something very sick. But where did this sickness come from? How did suburbia turn from somewhere to live into something to survive? The return to peaceful American suburban life after World War II was celebrated in 1940s and 1950s, and the allAmerican consumerist family was held up as the antidote to American Beauty. DVD. Directed by Sam Mendes. 1999; Universal City, VA: DreamWorks SKG, 2000.

the evils of communism during the Cold War. Yet by the 1960s, the counterculture movement had turned Cold War values upside down and the family, the hero of American life was reduce to nothing more than a profane idol. Undoubtedly, many factors contributed to the transformation of societal perceptions of the suburban family—political factors, social factors, and others—but this shift could be attributed in part to psychiatric medicine. Minor tranquilizers, popularized as coping mechanisms for the pressures of everyday life, may have been partially responsible for leading people to SHUFHLYH WKRVH SUHVVXUHV LQ WKH ÀUVW SODFH $OWKRXJK WKHLU role in gender politics is often emphasized, this approach is perhaps too narrow to capture the essence of the role of minor tranquilizers in American society. They did not merely teach women to be contented with their domestic cages; they helped shatter the American Cold War cult of domesticity and replace it with suburban ennui and disillusionment. The minor tranquilizers—a class of drugs that began with Miltown and Equanil (two different trade names for meprobamate) and later grew to include Librium, Valium, and others—are commonly known by the derogatory moniker “Mother’s Little Helpers” (after a popular rock song decrying the trend of prescription drug abuse among housewives).2 Many modern historians see the minor tranquilizers as

1

2

The Rolling Stones, Aftermath, London Records (vinyl), 1966.

32 SYNTHESIS ISSUE 3 feminized drugs, used to oppress women by keeping them brand’s advertising claim that their milk comes from contented chemically contented and unlikely to notice or object to cows.7 Milk production is not only a solely female activity, their domestic imprisonment.3 After World War II, many but is also explicitly associated with reproduction, one of women were loath to give up their factory jobs and return the good postwar woman’s foremost civic duties. Therefore, to the kitchen. However, the men returning home from war both explicitly and implicitly, bluntly and subtly, advertising needed those jobs, and women had plenty of traditional and media coverage linked tranquilizers with femininity. responsibilities to occupy their time, such as keeping the This interpretation of tranquilizers’ role in acclimating house, making themselves sexually available in order to women to Cold War America, while compelling, is not SURFUHDWH HIĂ€FLHQWO\ DQG GXWLIXOO\ UDLVLQJ WKHLU FKLOGUHQ LQWR entirely satisfactory. It is valid, but incomplete. It ignores the strong patriots and soldiers. If this was a bitter pill for story of men and their relationships with minor tranquilizers. women to swallow, the story goes, there was soon another One of the earliest sources of support for Pacatal—the pill they could swallow to ease their psychological digestion. drug promoted in the advertisement starring Doris and her The typical targets of tranquilizers were supposedly “frigid QHJOHFWHG FKLOGUHQÂłZDV D VWXG\ WKDW GHPRQVWUDWHG LWV EHQHĂ€WV women, wanton women, unmarried women and other in treating patients in a hospital for war veterans (who were women who threatened to keep their wartime jobs, neglect predominantly male).8 One article which mentions the use of their duties in nuclear households or reject their husbands’ tranquilizers to shepherd a nervous bride through the terrors amorous advances.â€?4 of her honeymoon also mentions the use of the same drugs The evidence for this view of the role of tranquilizers to assist a busy and successful male psychiatrist in coping in the 1950s comes in part from the advertising campaigns with his stressful commute.9 Other successful male users and that appeared in medical journals to sell these new drugs to DGYRFDWHV RI PLQRU WUDQTXLOL]HUV LQFOXGH +ROO\ZRRG Ă€OP doctors and psychiatrists. “Early in the promotional history SURGXFHU 5REHUW *ROGVWHLQ ZKR VD\V RI RQH GLIĂ€FXOW Ă€OP of the minor tranquilizers,â€? historian Mickey Smith argues, production that he “couldn’t have done it if the doctor hadn’t “the married housewife began to make her appearance.â€?5 put [him] on Miltown’s [sic].â€?10 As with the feminization Smith offers, as an example, an advertisement for a tranquilizer UKHWRULF WKH UHSUHVHQWDWLRQ RI WUDQTXLOL]HUV¡ VLJQLĂ€FDQFH WR called Pacatal depicting a woman named Doris who “never the American man also took more subtle forms. For example, had time for the kidsâ€? until she took Pacatal, which “released one psychiatrist, explaining how minor neurosis could affect this housewife from the grip of her neurosis.â€? Thus, one up to a third of the country’s residents, describes the majority of the most troubling symptoms of Doris’s ailment is of those affected as people who are “not operating on all eight her neglect of motherly duties. Accordingly, her return to cylinders because of psychological sludge.â€?11 This mechanical proper maternal behavior is an important goal of the drug metaphor conveys masculine connotations comparable to DQG D SRZHUIXO GHPRQVWUDWLRQ RI LWV HIĂ€FDF\ 7KLV SRLQWHG the feminine ones conveyed by the dairy rhetoric used in advertising was not the only instance of the “marriage of “Miltown in Cowtown.â€? The masculine side of tranquilizers’ mothers and medications.â€?6 The feminization of tranquilizers public image cannot be ignored. also appeared in more subtle forms. For example, a 1957 Time Another factor complicating the standard view magazine article entitled “Miltown in Cowtownâ€? explains how of feminized tranquilizers is the existence of ads featuring a pharmaceutical company developed a method of mixing ZRPHQ LQ FRQWH[WV WKDW GR QRW QHFHVVDULO\ Ă€W WKHLU &ROG :DU minor tranquilizers into livestock’s food to make them both roles. For example, one advertisement promoting Miltown happier and fatter. Although the technique itself seems to be aimed at meat production rather than dairy production— EDVHG RQ WKH VWDWLVWLFV FLWHG IRU WKH WHFKQLTXH¡V HIĂ€FDF\ÂłWKH 7 “Miltown in Cowtown,â€? Time, June 10, 1957, accessed May 6, 2010, article uses rhetoric relating to dairy, playing on Carnation http://www.time.com/time/magazine/article/0,9171,937484,00.html. “Pills for the Mind,â€? Time, June 11, 1956, accessed May 6, 2010, http:// www.time.com/time/magazine/article/0,9171,862165-1,00.html.

8

See, e.g., Jonathan Metzl, “‘Mother’s Little Helper’: The Crisis of Psychoanalysis and the Miltown Resolution,� Gender & History 15, no. 2 (2003): 228; and Mickey Smith, Small Comfort: A History of the Minor Tranquilizers (Santa Barbara: Praeger, 1985). 3

4

Metzl, 231.

5

Smith, 101.

6

Metzl, 229.

“Happiness by Prescription,� Time, March 11, 1957, accessed May 6, 2010, http://www.time.com/time/magazine/article/0,9171,824739,00.html.

9

10 Thomas Pryor, “Hollywood Canvas: Dramatization of Argentine Revolt Is Set at Metro – Producer at Ease,� New York Times, May 13, 1956, 123, accessed May 6, 2010.

Andrea Tone, Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers (New York: Basic Books, 2008), 81. 11

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Figure 1 Image courtesy of Deco Dog’s Ephemera, accessed April 7, 2011, http://www.decodog.com/inven/MD/md31047.jpg.

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SYNTHESIS ISSUE 3 to doctors announces that the drug “improves the capacity makes people feel better, those people tend to legitimize and WR ZRUN HIĂ€FLHQWO\> @Âľ WKLV VHQWLPHQW LV LOOXVWUDWHG ZLWK D codify their use of the substance by assuming that they had photograph of a woman working at a typewriter and smiling a pre-existing condition. This is how people justify drugs (Figure 1).12 This positive depiction of a working woman DQG RWKHU WHFKQRORJLHV WKDW GRQ¡W VWULFWO\ UHPHG\ D GHĂ€FLW GRHVQ¡W Ă€W LQ WKH SLFWXUH SDLQWHG HDUOLHU RI WUDQTXLOL]HUV but instead render users “better than well.â€? In the book as chains binding the woman to her stove. Far from popularized this term for enhancing biotechnologies, Carl forcing this woman into her proper homemaking role, this Elliott describes the process by which treatments implant advertisement promotes the drug as a tool allowing her to disease constructs in the public consciousness. He uses the further her own career and enhance her productivity in non- example of Paxil, a medication developed by SmithKline to biological arenas. Similarly, an advertisement for another treat social phobia. He explains that: tranquilizer, Trepidone, shows a woman happily employed as SmithKline does not need to sell Paxil. What they a schoolteacher (admittedly a stereotypically feminine career, need to sell is social phobia. If an article, a journal but a paying, non-domestic job nonetheless) declaring, “this supplement, a conference session—or even better, could be your ‘anxiety patient’â€? (Figure 2).13 Advertisements a best-selling book—gets the word out about social like these complicate the idea that drug marketing boxed phobia, then social phobia is going to be much more women into roles as homemakers. widely diagnosed, and the drug that treats it is going In fact, the overarching theme expressed in to be more widely prescribed.15 advertisements for Miltown and other minor tranquilizers wasn’t a systematic targeting of any particular population; on This same process could explain how Miltown created a the contrary, marketing campaigns emphasized the universality market for itself: Americans did not know they were living of the drug’s applicability. Tranquilizers had something in the Age of Anxiety until an appropriate response to this to offer to everyone. One advertisement that appeared in situation presented itself in the form of a convenient white a medical journal in 1964 states in large, bold letters that pill. Miltown “belongs in every practice of psychiatryâ€? (Figure 3). But the disease implied by Miltown was a bit more Six photographs with captions provide examples of the types VSHFLĂ€F WKDQ LW Ă€UVW VHHPV 7KH DGYHUWLVHPHQWV DQG PHGLD of patients who can be helped by Miltown; they are diverse portrayals which seem to feminize the drug do not refer to all not only psychiatrically (labeled with 6 different diagnoses), women, or even all American women; they refer particularly but also demographically, including three males and three to middle-class suburban housewives like Doris. The more females, or alternatively two elderly people, three adults, and masculine associations, too, revolve around the bourgeoisie one child. Miltown is depicted as a miracle drug that enhances (mentioning doctors, business executives, and other white all other types of psychiatric treatment – it should be used FROODU Ă€[WXUHV RI VXEXUELD $V (OOLRWW JRHV RQ WR H[SODLQ LQ “as an adjunct to psychotherapy or any other therapyâ€? the KLV EULHI VXUYH\ RI WKH PLQRU WUDQTXLOL]HUV¡ VLJQLĂ€FDQFH LQ WKH doctor might think of, and is “helpful in almost every aspect story of biotechnological enhancement, of psychiatric practice.â€?14 It was supposedly a true panacea, WKH KLVWRU\ RI DQ[LRO\WLF GUXJV OLNH 0LOWRZQ LVÂŤ WUHDWLQJ RU FXULQJ HYHU\ FRQFHLYDEOH DLOPHQW 7KH Ă LSVLGH RI bound up with the history of American suburbia. this glowing portrayal was that, because anything could be Both had their heyday in the 1950s, and both have cured by Miltown, anything could be pathologized by its existence. A come to represent the peculiar brand of alienation drug that treats anything turns anything into a disease. WKDW KDV DFFRPSDQLHG $PHULFDQ SURVSHULW\ÂŤ )RU This transformative ability explains how Miltown better or worse, suburbia has come to stand for (along with the other minor tranquilizers) soared in sales something that can be survived only with minor GHVSLWH WKH YDJXHQHVV RI LWV PHGLFDO SXUSRVH 7KH LGHQWLĂ€FDWLRQ tranquilizers.16 of diseases does not create treatments; on the contrary, the development of treatments implies the existence of diseases ,W ZDVQ¡W DOZD\V WKLV ZD\ 0LOWRZQ¡V Ă€UVW DGRULQJ DXGLHQFH to be alleviated by them. When a substance is discovered that consisted of glamorous Hollywood stars—such as Robert

13 Lederle Laboratories, “This Could Be Your ‘Anxiety Patient’ on Trepidone,� advertisement, quoted in Smith, 111.

Wallace Laboratories, “The One Tranquilizer That Belongs in Every Practice of Psychiatry,� advertisement, Psychosomatic Medicine 26, no. 2 (1964).

14

Carl Elliott, Better Than Well: American Medicine Meets the American Dream (New York: W. W. Norton & Company, 2003), 125. 15

16

Ibid., 131-132.

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37 LEVIN/AIDS LINK / SUBURBIA Goldstein (the producer mentioned above) and Milton Berle more than tools for female oppression. Rather than simply (a popular comedian who joked about changing his name to strengthening the family values so cherished in the 1950s, “Miltown Berleâ€?)—who talked openly about their recreational the minor tranquilizers precipitated their downfall: these use of the drug. However, it soon had a trickle-down effect, drugs encouraged the construction of suburban ennui as an and the demographic make-up of the drug’s users shifted as American epidemic, which the counterculture of the 1960s Average Joe decided he needed some glamour in his life, too. sought to cure. Inasmuch as they hastened this rebellion By 1957, just two years after the drug’s release, “the manager against tradition, the pills apparently meant to lock women of Hollywood’s famed Schwab’s Drug Store conceded that more securely in domestic cages may have inadvertently his tranquilizer business was still booming but his clientele helped set them free. had changed,â€? as he gradually “sold less to celebrities and more to ‘just plain people.’ â€?18 The minor tranquilizers, after a brief heyday as the celebrity recreational drug of choice, thus became everyman’s remedy for suburban ennui – a disease construct formed in part by the existence of the remedy itself. Miltown and suburbia eventually became almost inextricably intertwined in the media. Housewives and businessmen, the stars of suburbia, also starred in discussions of minor tranquilizers, but the association went in the other direction as well. Miltown itself was drawn into commonplace conversations about suburbia. One New York Times DUWLFOH DERXW ODZQ FDUH VLJQLĂ€FDQWO\ referred to as a “suburban neurosisâ€?) mentions Miltown as D SRWHQWLDO UHIXJH IURP D GLIĂ€FXOW ZHHG SUREOHP 19 while an advice column offering packing tips for travel warns that “the road to Miltown is paved with excess baggage.â€?20 Thus the minor tranquilizer became the panacea for all suburban woes, from lawn care to travel stress. Similarly, just as suburban motifs frequent advertisements for the tranquilizers, Miltown DOVR EHFDPH D PRWLI LQ DGYHUWLVHPHQWV IRU RWKHU Ă€[WXUHV RI suburbia. A Baskin-Robbins advertisement offers one of WKH Ă DYRUV DV D SRWHQWLDO VXEVWLWXWH IRU WKH 0LOWRZQ LFH FUHDP GHPDQGHG E\ D Ă€FWLRQDO FXVWRPHU D /RV $QJHOHV FDU company offers its vehicles as substitutes for “happy pillsâ€? and “tickets to Miltownâ€?; a Valentine’s Day card even features a man asking the reader to “be [his] little Miltown.â€?21 The minor tranquilizers thus did much more then solidify postwar gender roles. Certainly, the literature on that side of the story is compelling, and the role of masculinity in the pills’ usage and marketing complicates the picture and merits further study. But Miltown and its relations were much 18

Tone, 24.

Marybeth Weston, “Suburban Neurosis: Crabgrass,� New York Times, July 24, 1960, SM21, accessed May 6, 2010, http://select.nytimes.com/gst/abstract.html?res=F00A17FB3B5A1A7A93C6AB178CD85F448685F9. 19

20 “Eliminating ‘Extras’ a Key to Packing,� New York Times, May 6, 1961, 34, accessed May 6, 2010, http://select.nytimes.com/gst/abstract.html?res =F40D10FF3B5912738DDDAF0894DD405B818AF1D3. 21

Tone, 60.

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