Circulating Now welcomes guest blogger John Parascandola, PhD from the University of Maryland to explore the use of film in public health campaigns against venereal disease. His essay explores two films from the U.S. Public Health Service held in the National Library of Medicine’s historical audiovisual collection and now highlighted in our Medicine on Screen: Films and Essays from NLM project.
The United States Public Health Service released several venereal-disease education films in the 1930s and 1940s as part of a broader campaign against venereal disease (VD). Two of the best of these, produced in cooperation with the Hollywood filmmaking industry, were Know for Sure (1941) and To the People of the United States (1944).
The Public Health Service (PHS) had been operating a venereal-disease program since World War I, when concern over the number of Army recruits infected with syphilis or gonorrhea led Congress to enact a law that created a Venereal Disease Division in the PHS. With the end of the war, Congress lost interest in the venereal-disease problem, and funding for this purpose declined dramatically.
When Thomas Parran was appointed Surgeon General of the PHS in 1936, however, he wasted no time in launching a new national campaign against venereal disease. Parran had served as chief of the PHS Venereal Disease Division earlier in his career and had never lost interest in the subject. In the early 1930s, he was detailed by the PHS to New York to serve as State Health Commissioner, and he made venereal disease a priority of his administration. In one well-known incident, Parran made headlines in 1934 when he canceled a radio address at the last minute because he was told that he could not mention syphilis or gonorrhea by name on the air.
Parran’s articles in magazines and his 1937 best-selling book, Shadow on the Land, were instrumental in breaking down the taboo in the popular press against the frank discussion of venereal disease. He sought to focus the battle against venereal disease on scientific and medical grounds, rather than placing an emphasis on moral or ethical views concerning sex. Parran did not completely ignore moral issues related to sex, but in the words of historian Allan Brandt,
“Though he sought to avoid offending the social hygienists [who emphasized behavioral reform], Parran downplayed the moral argument.”
Parran also played a key role in the passage of the National Venereal Disease Control Act in 1938, which provided Federal funding through the PHS to the states for venereal-disease control programs, as well as supporting research into the treatment and prevention of venereal disease. As a part of its efforts to combat venereal disease, the PHS launched an educational campaign that involved issuing posters, brochures, and other publications on the subject, an effort that was stepped up when the United States entered the war in December of 1941.
Included among the weapons in the campaign’s arsenal developed by the PHS in this period were motion-picture films. In 1942, PHS physician James A. Dolce wrote to a colleague:
“We feel very strongly that motion picture films are a most important medium for health education. Well-written and produced films not only command large audiences, but, as you know, actually instill more information into observers than does any other teaching aid.”
PHS began producing films about venereal disease (VD) even before the United States entered the war. Just a year after he assumed the office of Surgeon General, Parran arranged for the PHS to collaborate with the American Medical Association (AMA) in the production of Syphilis – A Motion Picture Clinic (1937). This 80-minute sound film, however, was not aimed at the general public but at clinicians. It consisted of several segments featuring leading syphilologists lecturing on various aspects of the disease, essentially a group of “talking heads,” with occasional visual presentations or demonstrations. PHS also released two silent VD films that year, Syphilis of the Central Nervous System – A Preventable Disease (aimed at health professionals) and Syphilis: Its Nature, Prevention and Treatment (aimed at lay audiences). The annual report of the PHS for fiscal year 1938 indicated that this latter film was in great demand.
These early films were not very sophisticated from a cinematic point of view. In the case of the film designed for lay audiences, Syphilis: Its Nature, Prevention, and Treatment, a later reference to it by a PHS staff member termed it “amateur” in nature. He also noted that although it was useful in its time, it had become outdated and outmoded by 1940. It was silent and has been described as more of a slide lecture than a film. The fact that this film was “in great demand” in 1938 may be more a reflection of the paucity of good VD education films for lay audiences than of the quality of the product.
Also in 1938, PHS produced a motion picture that made much better use of the film medium, Three Counties Against Syphilis. The film tells the story of a PHS syphilis control program developed in 1937 in three counties in southeastern Georgia. The program was aimed at African Americans in a rural environment. PHS sponsored a mobile trailer clinic that traveled through these three rural counties and provided blood tests and treatment for syphilis. The film documented the program but presumably could also be used as a VD-education film, spreading the message that syphilis can be diagnosed and cured. It is painfully ironic that at the same time that PHS was promoting this program for African Americans, it also was conducting the infamous Tuskegee syphilis experiment.
Recognizing that it was not in a position to develop professional-quality films on its own, the PHS contracted with the Department of Agriculture (USDA) to produce Three Counties Against Syphilis. A PHS staff member explained in 1937 that USDA had “a very complete motion picture unit upon which it spends several hundred thousand dollars a year” and that its staff included people with experience working for commercial film studios. He believed that PHS could retain more control over the film and get the work done more cheaply by using USDA than by contracting with an industrial film company.
As the conflict in Europe intensified, and the prospect of American involvement became more likely, efforts to prepare for war increased, as did concerns about venereal disease as it might affect the military and essential defense industries. The PHS intensified its campaign against venereal disease, which included the production of further films. Among these were Know for Sure (1941) and To the People of the United States (1944). These films were intended to warn the public about the dangers of venereal disease and of the need to seek diagnosis and treatment….
John Parascandola received his PhD in the history of science from the University of Wisconsin-Madison. After spending a postdoctoral year at Harvard University, he returned to Madison to join the faculty of the School of Pharmacy and the Department of the History of Science at the University of Wisconsin. In 1983, he moved to Bethesda to serve as Chief of the History of Medicine Division at the National Library of Medicine. He held that position until 1992, when he became the Public Health Service Historian. Since retiring from the federal government in 2004, Dr. Parascandola has been an adjunct faculty member in the Department of History at the University of Maryland, College Park. He has published several books and numerous articles, including Sex, Sin, and Science: A History of Syphilis in America (Westport, CT and London: Praeger, 2008).