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The following is an article from the Spring 1987 issue of "Women and Revolution" that may have some historical interest for old "new leftists", perhaps, and well as for younger militants interested in various cultural and social questions that intersect the class struggle. Or for those just interested in a Marxist position on a series of social questions that are thrust upon us by the vagaries of bourgeois society. I will be posting more such articles from the back issues of "Women and Revolution" during Women's History Month and periodically throughout the year.
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The Battles Against Syphilis and AIDS: Medicine vs. Anti-Sex Moralism
A Tribute to Paul Ehrlich
"I was led by the desire to direct my lifetime's work to an important and worthy objective— I chose diseases that affect man and which it had hitherto been impossible to combat with other medicines." —Paul Ehrlich, quoted in Ernst Baumler, Paul Ehrlich, Scientist for Life
Women and Revolution has chosen this International Women's Day as an occasion to commemorate Paul Ehrlich, one of the great pioneers of medical science. Among his many discoveries in bacteriology, immunology and hematology, any one of which would earn him a place in history, was Salvarsan, the first effective treatment for syphilis, one of humanity's most terrible scourges. Although Salvarsan has been superceded by the far more effective penicillin, its discovery established the use of chemical agents in the treatment of disease (chemotherapeutics) as a new branch of medicine. And by targeting a venereal disease for treatment, Ehrlich took head-on the superstitious moralist which viewed such an illness as a "just punishment" for "sin." To the scientist Paul Ehrlich, this terrible disease was a medical condition, caused by a microbe, that could be cured and eliminated; his concern was to find that cure. Today, when anti-sex bigotry and hysteria against AIDS victims impede the already difficult task of conquering this new and deadly disease, the lessons of Paul Ehrlich's work are all the more important.
Ehrlich was born in 1854 of a German Jewish family. He entered medical school in 1872, at the dawn of anew age in medicine: the discovery that microorganisms are the cause of many diseases. With the aid of the microscope and the new theory, Louis Pasteur had saved the silk industry of southern France from the ravages of silkworm diseases. Over the next decade, the German bacteriologist Robert Koch identified the agents of anthrax, tuberculosis and Asiatic cholera.
Previously medicine had been dominated by the ancient theory of "humors." Syphilis patients, for example, were treated with mercury to cause profuse salivation and perspiration, which were believed to remove the bad "humors." Doses of mercury, a poison, probably neared lethal levels; whether patients suffered and died more from the illness or the "cure" is impossible to say.
It is hard to comprehend today the scale of devastation caused by this dreaded disease. The 1940s movie made of Ehrlich's life, Dr. Ehrlich's Magic Bullet (starring Edward G. Robinson), paints a heart-rending picture of the suffering caused by syphilis: the desperate faces of the ill; a young man who commits suicide when informed that he has syphilis and cannot marry his sweetheart. The lives of millions of people were destroyed by syphilis, which often caused terrible complications such as heart ailments, blindness, insanity, sterility and paralysis. It has been estimated that 20 percent of the inmates of mental hospitals suffered from syphilis-induced dementia. In the latent phase of the disease, a woman could pass it on to her unborn child, without even being aware that she was infected. Congenital syphilis was a leading cause of stillbirths and infant mortality.
Bacterial research had been greatly aided by the discovery of dyes to stain tissue, which enhanced the microscopic details of cells. As a student Ehrlich became fascinated with staining and meticulously researched the affinities of various dyes with cellular structure. One of his first important discoveries was a stain which made a positive diagnosis of tuberculosis possible for the ordinary doctor.
In 1892 Ehrlich joined Robert Koch at the Institute for Infectious Diseases in Berlin, where they worked on tuberculosis immunology. Ehrlich was also part of the research team which realized the development of a diphtheria antitoxin and saved the lives of countless children. For this work Ehrlich won the Nobel Prize in medicine in 1908, along with llya Mechnikov, who introduced the theory of the role of the white blood cells in immunity.
Out of this work Ehrlich developed the concept of chemotherapy, highly controversial at the time. He expressed his insight in a vivid image: "Antibodies are to some extent magic bullets which seek out their own targets without damaging the organism" (Baumler, Paul Ehrlich, Scientist for Life). Would it not be possible to use chemicals which would bind with specific microorganisms and render them harmless in the body? As the later development of antibiotics was to show, Ehrlich was on the right track, in a broad and technical way. But his discovery of Salvarsan was fortuitous: his work was highly experimental and conducted primarily through trial and error, without benefit of the decades of research into bacteriology and biochemistry which medical science now has. Advances in molecular biology have enabled scientists to better understand many cellular functions and so to design more effective drugs.
In 1907, with the Japanese bacteriologist Kiyoshi Shiga, Ehrlich discovered the dye known as trypan red, which destroyed trypanosomes in infected animals. Encouraged by this success, Ehrlich decided to target the spirochete causing syphilis, which had already been identified. In 1906 his colleague August von Wassermann had even developed a diagnostic test for the disease, but there was no effective treatment.
Ehrlich began his search for the "magic bullet" with arsenic compounds, which had long been known to be effective against disease. With his own research facility and staff in Frankfurt, Ehrlich proceeded to subtly alter also found himself the target of scurrilous attacks by moralists and enemies of scientific progress: one Dr. Richard Drew, formerly in the police vice squad, accused him of endangering the public health. Scandal sheets distributed in Frankfurt charged that Salvarsan had been forced on prostitutes and was responsible for blindness and several deaths. Ehrlich characterized his opposition as anti-scientific, anti-progress and anti-Semitic "rabble." When the Nazis came to power they took up the cudgel for this rabble, the enemies of Paul Ehrlich, and tore down the street signs on Paul-Ehrlich-Strasse. Ehrlich's widow was forced into exile.
Ehrlich's magic bullet targeted more than the syphilis spirochete: the stigma of venereal disease had been as much of an obstacle for its victims as the disease itself. Henrik Ibsen's 1881 play Ghosts describes the ravages brought by secrecy, hypocrisy and syphilis on one family. An eminent critic of the time gave voice to typical destructive prudery: Ghosts was "an open drain, a loathsome sore unbandaged, a dirty act done publicly, a lazar [leper] house with all its doors and windows open" (quoted in Six Plays by Ibsen, Eva Le Gallienne). In 1916 Dr. Allan J. Mclaughlin, a Massachusetts public health authority, denounced the moralists who claimed that "to advertise the marvelous effects of Salvarsan, and to place it within the reach of the poor is to place a premium upon vice and to absolve the syphilitic from the just punishment of his sins. As health officers let us be practical and consider syphilis as a public health problem..." (Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States Since 1880). In 1881 Massachusetts General Hospital had changed its policy from charging syphilitic patients double rates to refusing them admission altogether!
To this day, although both syphilis and gonorrhea are generally easily cured, they are widespread in the United States. In 1979 gonorrhea accounted for two-thirds of all reported communicable diseases in the U.S.; it is the most prevalent human bacterial infection on the planet. Just when the wide availability of penicillin after World War II could have dramatically lowered rates of venereal disease, government funding allocated for public education was slashed to the bone. While disingenuously de-emphasizing that syphilis and gonorrhea can be treated and cured, educational programs still often withhold the simple truth that condoms can be effective against venereal disease. The current controversy over public advertising for condoms is merely another episode in a long, dreary story.
For Free, Quality Health Care for All!
The control of disease is as much a social question as a scientific one; in this sick capitalist society, the profits of the pharmaceutical giants and the insurance vultures come before public health. For decades the U.S. Public Health Service conducted an "experiment" only one step away from Nazi Germany: for 40 years, from 1932 to 1972, it "studied" 400 black sharecroppers with syphilis, who were never told they had it and never treated, so that "researchers" could watch the ravages of the untreated disease as it destroyed their bodies and minds. Over one-quarter of the victims died of the effects of syphilis!
Today a new plague is upon us: AIDS, caused by a virus which destroys the immune system. Because the victims of AIDS in the United States have so far been predominantly gay men or users of intravenous drugs, bigotry and ignorant fear have come down on them full force. Ostracism and discrimination compound the physical suffering of an invariably fatal disease that is if anything even more horrible than syphilis.
So far AIDS has no effective cure and there is no preventive vaccine. Although much has been learned about the virus, the obstacles are indeed formidable. The only good news is that it is rather hard to transmit; nevertheless, hysteria has focused on bogus "dangers" of casual transmission as reactionaries seek to eject AIDS children from the classroom and fire AIDS victims from their jobs. The recent federal proposal for massive testing of hospital patients and applicants for marriage licenses will do nothing to stop the spread of AIDS—but it will create a blacklist of victims of the anti-sex crusade.
Conservative columnist William F. Buckley thinks that people infected with the AIDS virus should be tattooed—perhaps he has in mind the pink triangle that marked gays in Hitler's Germany? In fact, the fascists have put themselves forward as the shock troops of anti-sex bigotry. J.B. Stoner, the man behind the racist Birmingham church murder bombings in 1964, rallied the Ku Klux Klan in Forsyth County, Georgia against black civil rights marchers with a pamphlet "Praise God for AIDS." Commentary editor Norman Podhoretz, frothing at the mouth as usual, railed against government expenditures on vaccination research: "Are they aware that in the name of compassion they are giving social sanction to what can only be described as brutish degradation?" (ibid.).
As the history of syphilis and gonorrhea reveal only too well, such bigotry can be as much of an obstacle to fighting a disease as the microbe itself. Although the need for massive funding for AIDS research has been evident now for years, Reagan has consistently cut allocations for this work, while his director of communications, Patrick Buchanan, declared AIDS to be "nature's retribution" on homosexuals. What's necessary is bi//ions for an internationally coordinated program of AIDS research,
Paul Ehrlich pointed the way forward when in the early years of this century he brought in the methods of science and threw out ideas of "retribution" as medieval rubbish. It will take a socialist revolution to put the tools that the heroes of medical science have given us fully to use in the service of all humanity."
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