1How did demographic culture spread across France in the interwar period, and how did it survive its perverse exploitation by the Vichy regime while becoming taboo in Germany and Italy after 1945? In this article, Virginie De Luca Barrusse sheds new light on a topic that has attracted renewed interest among historians in recent years. By focusing on the fight against venereal disease, she describes both the sophistication of the "propaganda" deployed and the emergence of a new line of argument: to combat one of the major “social scourges” of that time, social medicine based its prevention policies on demographic reasoning. By representing the crusade against syphilis as a “policy for improving the productivity of marriage”, it durably united the notions of “quantity and quality”, of demographic interventionism and of sanitary progress.

2From the late nineteenth century, demographic trends in France diverged from those of its European neighbours, thanks to falling birth rates and – an often forgotten fact – an ageing population that kept death rates at persistently high levels. Reproduction became a crucial issue in French demography, for the “population” is not a static object but a collection of individuals who renew themselves by a combination of births and deaths, more so than by migration. Campaigners concerned about the future of the population highlighted the need for three children per family: “two are needed to replace the parents, followed by a third, since the law of probabilities shows that one out of the three, on average, will die before reproducing”. [1] In the first half of the twentieth century, the number of children per family and their chances of survival were central to demographic debate, as testified by the distinction made in censuses between births and surviving children to determine “household productivity” (De Luca Barrusse, 2008a, pp. 193-211). The networks of actors (institutions, associations) nonetheless tended to campaign separately, focusing either on birth rates or on mortality (Rollet, 2001), via distinct modes of action.

3The purpose of this article is to pinpoint the relationship between criteria of quantity and of quality in population policies with a view to restoring overall consistency to demographic thought. We agree with Paul-André Rosental who laments the tendency to classify and segment demographic ideas rather than demonstrate their permeability (Rosental, 2007). [2] Regarding the questions of quantity and quality in particular, the two issues were treated separately by virtue of a supposed incompatibility between pro-natalism and eugenism. These two movements may indeed have been in competition, but they should certainly not be considered a priori as mutually exclusive (De Luca Barrusse, 2008c). While this competition must be questioned and historicized, and not stated as a postulate, the same is true for the links between these two criteria. This is also the case in France, where the demographic thought that underpins population policies incorporates the dual requirement of quality and quantity.
For our purposes, we propose to define population policies as all initiatives and measures (laws, decrees), both implicit and explicit, designed to influence the size, growth, renewal or composition of the population. The initiatives are instigated by individuals acting alone or through networks (notably associations) and the most well-prepared measures are overseen or even financed by the state or by public bodies. The arguments put forward detail the primary and secondary factors conferring legitimacy on the initiatives or measures set in place. While French pro-natalism, with its very particular resonance, has been widely studied, very little research has focused on the way in which its broad dissemination led to an attenuation of its most “sensational” effects. Although pro-natalism fed upon the successive accumulation of lines of reasoning and strategies of reappropriation – notably via the issues of familialism – it also became diluted in other arguments (De Luca Barrusse, 2008a) that provide the best measure of its dissemination outside openly pro-natalist circles. Although quantity remains the common reference in a country whose very existence is felt to be under threat, the quality criterion is primordial, notably in the medical world, where the term “sanitary pro-natalism” could be used to describe the prevailing attitude. This term is doubtless preferable to that of “eugenic pro-natalism”, the overlap with eugenics being no more than partial. The term “family eugenics” used by Anne Carol – eugenics in a more discreet form – seems to be no more appropriate (Carol, 1995, p. 285). Here, it is indeed a question of ideas on reproduction in quantitative terms and of considerations relating to population quality.

4The fight against “social scourges” is an especially interesting case in point, as it highlights the complexity of the arguments deployed to promote population policies developed for the ostensible purpose of social protection. [3] As remarked by Patrice Pinell in relation to cancer, what characterizes a social scourge is “the belief that it threatens the equilibrium (demographic social and/or moral) of society and that [its] incidence can be reduced by appropriate modes of intervention” (Pinell, 1987, p. 74). Among such scourges, the fight against venereal diseases led by the medical profession and supported by state bodies represents an extreme case linked to the representations of sexually transmitted infections, as attested by the chronology given in the Box above (Castejón-Bolea, 2001; Davidson and Hall, 2001). Shameful and therefore unmentionable, these diseases were rarely exposed to public attention. Yet their quantified effects assumed a special significance when depopulation threatened, and the questions of population quality and quantity became crystallized around the productivity of marriage. A network of physicians thus took it upon themselves to educate the population about venereal diseases and their adverse effects on the population and the family. After the First World War, these initially isolated initiatives were co-ordinated by public bodies to form a system of both technical and social anti-venereal propaganda designed to organize and control social relations. The recommendations on sexual conduct clearly target individuals as members of society, for it is as such that they contribute to population renewal. The content of this propaganda, notably the anti-venereal films, leaves no doubt as to the role of pro-natalism in health education.
This article draws upon a wide range of sources including books, brochures, plays, pamphlets and association journals. The archives of the French army historical department and of the Institut Paster were also examined, along with the French film archives of the Centre national du cinéma (CNC). Providing new insight into the way population policy was constructed, these sources are of interest to historians and demographers alike.

I – Overlapping criteria of population quality and population quantity

5Given the range of demographic variables involved, the fight against venereal diseases offers an interesting field of observation. Among the various venereal infections, syphilis was particularly detrimental to population renewal since it increased mortality and miscarriages and thus reduced the number of live births. In its review of syphilis in 1922, the commission for the prophylaxis of venereal diseases estimated that 140,000 annual deaths could be attributed to the disease: “20,000 children killed in their mother’s womb (stillbirths), 40,000 pathological abortions, 80,000 deaths of children or adults. We believe that one-tenth of the population is infected with syphilis”. [4] Gonorrhoea, for its part, led to sterility and reduced female fertility.

6The frequency of the disease and its demographic impact in terms of mortality and reduced birth rates were a constantly recurring theme, up until the Vichy regime at least. The issue of venereal diseases thus extended far beyond the purely medical sphere: not only was the population’s health at stake, but also its reproduction through the negative impact on birth rates.

7The fact that syphilis in particular led to reduced birth rates and higher mortality was attributed to the belief that it had a hereditary component, known at the time as heredosyphilis (Corbin, 1981; Quétel, 1986). “Syphilis is a hereditary disease: it afflicts the first, the second and even the third generation of a syphilitic”. [5] The damage caused was substantial in a society possessed by the idea that each generation reaches a more advanced stage of degeneracy than the previous one (Carol, 1995, p. 91; Nye, 1984; Pinell, 2001). Owing to syphilis,

8

“certain families are struck down by multiple miscarriages and deaths; a benediction of sorts, since the race will be protected from corruption and miserable wretches will not survive to live a sterile existence; but a malediction also, for those families who witness the steady stream of small coffins across their threshold. If they do survive, what will become of them? Runts, weaklings, invalids, valetudinarians, perhaps lunatics, idiots or simpletons. In all cases, they will be flawed.” [6]

9Excess mortality and abnormality: such were the consequences of hereditary syphilis. For observers, the criteria of physical and moral infirmity were intimately linked:

10

“Thirty percent of children in France are tainted with hereditary syphilis and this heredity takes the form of stunted development, deformities (such as harelip), nervous disorders (convulsions, epilepsy, tics, meningitis), ocular lesions, malformed teeth, as well as disorders and abnormalities of the mind: most demented or criminal children are heredos (monomaniacs, arsonists, murderers).” [7]

11Through depopulation, degeneracy and moral depravity, syphilis throws a curse upon the population and jeopardizes the quality of its reproduction. In 1902, the chairman of the Council, Pierre Waldeck-Rousseau, simultaneously convened two extra-parliamentary commissions, one on depopulation, the other on venereal diseases, thus confirming the imminence and convergence of these two perils (Corbin, 1978, p. 269). Venereal diseases were thus a problem of both public health and of demography.

12More generally, sanitary and demographic problems were intimately linked in the fight against “social scourges”. In 1918, Dr Leredde defined social diseases, among which he included tuberculosis, alcoholism and syphilis, as “those which threaten social unity in terms of both quantity and of quality, and which may thus compromise the future of societies”. [8] This dual perspective extended beyond purely medical circles, and was overtly expressed by a government minister. In 1936, Henri Sellier, minister of public health declared:

13

“It is urgent to protect the race against the certainty of degeneracy and destruction foretold by the deplorable statistics on birth rates, disease and death [...]. We want vigorous children, born to healthy parents.” [9]

14Social diseases thus combine specific effects which threaten the economy of the population. The economy has two meanings in this statement. First, the economy can be seen as a combination of production factors, births and deaths, which are interrelated and which determine the level of population required for its reproduction. At the conference of the Alliance d’hygiène sociale (Social hygiene alliance) in Mulhouse in 1931, Dr Spilmann explained that syphilis and gonorrhoea are “equally detrimental to natality. Gonorrhoea prevents births. Syphilis kills children or renders them infirm”. [10] Second, the economy refers to the fact that the population must be administered, that it is a capital to be managed. For Professor Pinard in 1924,

15

“All human beings receive, or should receive, at the moment of procreation and should possess at the moment of birth the biological capital, the ancestral capital that is most precious and most sacred of all, namely good health [...]. This capital must be neither damaged nor destroyed, but conserved intact and transmitted, at least unspoiled if not enhanced.” [11]

16Two years later, in 1929, Dr Cavaillon and Dr Sicard de Plauzoles, key figures in the anti-venereal movement, summed up the situation as follows:

17

“Syphilis has the gravest consequences: for the individual, it signifies a temporary inability to work or, at the very least, a reduction in productive capacity and an inevitable drop in wages. And lucky the victim who, once the storm has passed, is not afflicted by a permanent infirmity that reduces him to indigence. For the family, it is disunion between spouses, disappointed motherhood or, worse still, offspring blighted by a hereditary flaw. For society, it is a waste of social capital, an increase in non-productive spending since all these invalids, all these wastrels, all this human detritus must be supported by the community. For the nation, it signifies the end of its moral and economic expansion, the bastardization of the race, fewer military forces available for service, a reduction in births and depopulation.” [12]

18These references to the individual, the family, the community, the nation, illustrate the collective dimension of the pathology, now classified as a social scourge thanks to the weight of the demographic argument. To achieve the status of social scourge, it is not enough for a disease to jeopardize the economy of the population; it must also mobilize actors eager to bring it to public attention. Identifying the phases in the “career and destiny” of social problems, among which the scourges of the early twentieth century can be included, Herbert Blumer defines a series of stages [13] (Blumer, 1971). After the emergence of the problem and its legitimation, the third stage of his model is that of mobilization. The debate on depopulation, degeneracy and moral depravity, with venereal diseases as a catalyst, provided grounds for the creation in 1901 of the Société de prophylaxie sanitaire et morale (Society for sanitary and moral prophylaxis). Its founder was Alfred Fournier, holder of the Chair in cutaneous and syphilitic diseases at the Saint-Louis hospital since 1879. This first network, comprised of specialist physicians and reformers, expanded with the creation of other groups such as La ligue contre le péril vénérien (League against the venereal peril) in 1923, headed by Dr Queyrat, Dr Gougerot and Dr Sicard de Plauzoles, and the Comité d’éducation féminine (Women’s education committee) set up in 1925 by a female physician, Dr Montreuil-Straus (Rollet, 2008a).

19This initial mobilization in the early years of the twentieth century stems from the need to take the fight against venereal disease beyond the mere question of its sexual transmissibility, which branded the disease as one of debauchery and corruption, a self-inflicted disease whose victims deserved to suffer as a just punishment for their turpitude. These diseases are all the more difficult to address for being invisible, shameful and unspoken (Baldwin, 1999, p. 355). The Société de prophylaxie sanitaire et morale thus set itself the goal of promoting individual prophylaxis against venereal diseases and bringing them out of the “brothels” to which they were supposedly confined, an assumption that limited health measures to the control of prostitution (Corbin, 1978 and 1982). It was by creating the concept of “syphilis of the innocent” that the syphilologist Alfred Fournier helped to extirpate the disease from the narrow context of extramarital and illicit sexual relations. [14] In his book Syphilis et mariage (Syphilis and marriage) published in 1880, he developed the idea of undeserved syphilis, citing patients who were “innocent” wives contaminated by their husbands (Harsin, 1989). Backed by figures, he deplored the spread of the disease among the middle classes, and the threat to their fertility. The syphilis of the innocent became the catchword of the anti-venereal campaign, challenging the idea of a self-inflicted disease, both in France and in Scotland, where the concept gained ground during the interwar years (Davidson, 1994, p. 273): “there are too many innocent victims to reasonably assert that their illness is a necessary retribution”. [15] One person’s illness is liable to become that of another, and the social territory of the disease expands.

“Some believe that no mention should be made of these diseases, which are no more, in their eyes, than the rightful punishment for debauchery. He who is commonly designated as a debauchee is not some special being who lives quite alone, without intercourse with the rest of humanity; this man has a family and friends, he goes to the café and drinks from a glass that will be served to you or me after a token rinse under the tap! He will go to the barber, and the same razor that was used upon his beard will then be brought into intimate contact with your own skin; and one day, this man will decide to ‘settle down’, and he will marry in the hope of having children.” [16]

II – Propaganda: A complex instrument to support population policy

20The process of disease transmission was to be controlled by educating the population, and this mission was embraced by the Société de prophylaxie. The education of young people, both men and women, was based on a series of recommendations established by the medical profession and, after the First World War, supported and even financed by government bodies. One campaign even exploited the techniques of advertising, for propaganda – this was the exact term used – “serves to fight the disease in the same way as advertising serves commerce and industry” said Dr Spilmann. [18] The aim was to “command attention by virtue of this effort of unconscious cerebration that is so familiar to shopkeepers and that they exploit so adeptly”. [19] Among other groups likewise, notably the Alliance nationale pour l’accroissement de la population française (National alliance for the growth of the French population), which used propaganda to promote large families, the communication strategy was also based on the example of advertising (De Luca Barrusse, 2008a, p. 62). Information and education campaigns were based on commercial practices and used a variety of media to obtain unconditional support for the ideas they defended. The aim was to develop a synergy between modes of action: all means were made available for the education of young people, and it was by combining these means that the message would be brought home. Throughout the first half of the twentieth century, brochures, pamphlets, lectures and posters, along with novels and plays, formed the backbone of health education. After the First World War, propaganda efforts became more organized, drawing together a number of hitherto disparate initiatives. With the mobilization of two new information media – radio and motion pictures – propaganda gained substance and coherence as an instrument to serve population policy.

21It was through brochures written by physicians that the education campaign was initiated, making it possible to evoke the venereal peril discreetly via a private “chat” with the doctor. In the first half of the twentieth century, many such information brochures were published, with separate versions for men and women (De Luca Barrusse, forthcoming, 2010). This “personalized” form of communication could be targeted towards specific groups (Ellul, 1990, p. 19), such as medical students or athletes, [20] and the content was tailored to their particular concerns.

22From 1915, new media were brought in to reinforce the crusade, with an intensification and diversification of information campaigns in response to the spread of venereal diseases in the army (Le Naour, 2002; Darmon, 2000). Like several other countries engaged in the war, the politicians and army medical services who had hitherto closed their eyes to these shameful afflicitions were forced into action by the threat of a syphilis epidemic among the troops (Towers, 1980; Parascandola, 2008). In France, the Interior Ministry’s Commission permanente d’hygiène et de prophylaxie (Permanent commission for hygiene and prophylaxis) provided the War Ministry with an array of measures to stamp out the epidemic in the armed forces. [21] Pamphlets were issued to accompany the lectures on sexual hygiene delivered to new recruits from 1902. [22] With the arrival of motion pictures, the lectures were also illustrated by short films.

23In 1918, On doit le dire (It must be said), a 7-minute animated film was shown in cinemas to audiences of soldiers. [23] It portrays two soldiers, the Frenchman Matthieu and the Italian Matteo infected by the same prostitute. Matteo prefers to consult the Dr Charlatanos, whose miracle cures are advertised on a poster, while Matthieu chooses to visit the dispensary doctor. In front of the doctor, Matthieu drops his trousers, and – to satisfy the film censor – a speech bubble appears in place of his groin: “my poor chap, you’ve got syphilis” (Kuhn, 1986 and 1994). “I’m rotting, I’m going to kill myself” cries the soldier. “You’re contagious; follow my instructions and nothing serious will happen to you. In four years time you’ll be able to marry.” Matteo, for his part, though covered in roseola, gets married, “a truly criminal act”. His wife miscarries seven times in five years. At last a child is born, weak-minded, followed by a second, hydrocephalic. Ten years on, Matteo’s nose collapses, and twenty years later he is paralysed and demented. A bubble gives the moral of this tale: “syphilis is a social peril, it often afflicts not only the sufferer, but also his or her children. The children of syphilitics who remain untreated will be stillborn or physically and intellectually degenerate”. The contrast with Matthieu, cured of the disease, is striking. The last scene shows him surrounded by his five children, with his wife breast-feeding her new baby next to a cradle. Here we find all the ingredients of the subsequent propaganda films: the drama of unfulfilled marriage, compromised fertility, stillbirths and damaged children, but also the chance of cure, [24] and a large, healthy family as the image of personal happiness and social order.
After the war, the propaganda campaign gained new momentum, stimulated by the experience of the Rockefeller Foundation which provided the framework for action. [25] In its fight against tuberculosis, various forms of communication – lectures, press articles, posters, brochures, films, plays and puppet shows – were adopted simultaneously. It was Lucien Viborel, hired by the foundation in 1917 to work on the Comité national de défense contre la tuberculose [26] (National committee for tuberculosis prevention, CNDT) who, in 1922, became its director of propaganda, which he described as “the art of disseminating, spreading, popularizing, broadcasting” (Viborel, 1930). During the interwar period, he took charge of social hygiene propaganda (tuberculosis, infant mortality), and this explains certain similarities in the various campaigns waged against these different social scourges. In 1924, as a senior functionary of the Public Health Ministry, he took charge of anti-venereal propaganda and the following year was appointed general secretary of propaganda at the Office national d’hygiène sociale. [27] He wrote a manual for social hygiene propagandists in which he assessed all available means of persuasion. Propaganda, as viewed and implemented by Viborel, was an instrument aiming to create a consensus and to reshape social practices (and in this case sexual practices) by means of diverse tools designed both to shock (posters, lectures, pamphlets) and to make a gradual but powerful impression via radio and film.
In France, Spain, Scotland and even in Canada, two new propaganda media were brought into service to educate the population (Perdiguero et al., 2007; Boon, 1990; Cassel, 1987, pp. 206-216; Davidson, 2000, pp. 139-141). Instead of targeting specific groups or shocking the public with eye-opening posters and pamphlets, the aim was now to educate the masses through film and radio (Ellul, 1990, p. 21). Radio reached a much larger audience than pamphlets, brochures or posters. Following the example of anti-tuberculosis campaigns, national anti-syphilis weeks were organized from 1926. They featured special radio programmes in which well-known medical specialists talked about venereal diseases over the airwaves. They received advice from Viborel, who recommended short, clear, incisive phrases. He wanted “appeal! restraint! concision! variety!” (Viborel, 1930). In April 1928, during the national anti-syphilis week for the protection of mothers and children, Dr Cavaillon spoke of “syphilis, the disease of the innocent” while Dr Queyrat warned that it was the “main cause of infant mortality” and Dr Milan explained that “combating syphilis means reducing stillbirths”. On 1 December 1937, Sicard de Plauzoles made a radio talk that was broadcast from the Eiffel tower: “Syphilis kills children or considerably weakens their resistance, while gonorrhoea prevents them from being born and brings illness and sometimes infirmity to once healthy young women”. [28] Radio provided a means to alert public opinion to population issues relating to mortality and birth rates, while simultaneous poster campaigns served to “drive the point home” (Document 1).

Document 1

Syphilis increases child mortality

Syphilis increases child mortality

24From 1925, through fiction and documentaries, the cinema became a linchpin of the propaganda campaigns orchestrated by government bodies. Lucien Viborel played a central role in developing such propaganda, whose “power of suggestiveness” is reinforced by the fact that “the number of visual messages is considerably larger than the number of auditory ones: around 80% are visual, I hear”. He affirmed that “the cinema as a creator of pleasurable impressions is above all a prodigious agent of education [...]. It is now very seriously considered as a powerful and highly effective instrument of intellectual, moral, technical and sanitary education”.

25It was via the Rockefeller Foundation and his visits to the United States that Viborel discovered the potential of motion pictures as an instrument of education. [29] Educational films on tuberculosis, commissioned by various institutions, became widespread after the war, while the Rockefeller Foundation set up travelling film shows to convey the prophylactic message across the country. Anti-syphilis propaganda was ready to follow the same path [30] (Lefebvre, 2002; Zarch, 2002), and the necessary impetus came in 1925, thanks to a private initiative. Dr Leredde, a well-known syphilologist, signed the first documentary, entitled Une maladie sociale : la syphilis. Comment elle peut disparaître (A social disease: syphilis. How it can be eradicated). [31] The timing of this film could not have been more opportune. At its statutory meeting in June 1926, Lucien Viborel, secretary of the propaganda commission at the Office national d’hygiène sociale, declared that the commission would need to invest in educational cinema and to promote this little-developed medium “by creating or supporting the creation of these documents of high educational value”. [32] Lucien Viborel, who was also a member of the CNDT, contributed to the incorporation of his film library into the propaganda commission. [33] It was henceforth managed jointly, although the film reels available for lending were stored in the premises of the CNDT. In 1926, the commission bought Leredde’s film, along with two other American titles: Female Sexual Hygiene which provided information on female physiology and venereal diseases for an audience of women, while Causes and Effects of Syphilis targeted men. [34]

26From 1927, new titles overseen and funded by the Office national d’hygiène sociale, such as Il était une fois trois amis (There were once three friends) directed by Jean Benoit-Levy, [35] were added to its cinema library catalogue. It was at the request of the Office’s propaganda commission that the paediatric specialist Dr Devraigne wrote the screenplay for this fictional drama. No fewer than four versions were produced before the film was finally shot (with the commission’s support). It was officially presented to the Sorbonne on 16 November 1927 and released on 15 February 1929 (Vignaux, 2007). The propaganda commission supervised and verified the credibility of screenplays. In March 1931, a certain Dr Malichowski underwent such scrutiny when he presented his screenplay entitled Le roi pâle (The pale king). It tells the story of a family “struck down by a terrible evil”. The children are all lame, blind or mentally unbalanced, as a result of which one of them runs away. The last part of the film shows the recovery of the youngest heredosyphilitic child after receiving treatment. Dr Sicard de Plauzoles approved the script but noted that limping due to congenital hip dislocation is a rare condition, while Dr Cavaillon wondered whether it is plausible for a young man with no history of mental disturbance in childhood to abandon his family. The psychiatrist Levy Valensi then quotes the case of a man who went out to buy cigarettes and was found... in Tongking. Given the infrequent nature of the cases observed, the commission chairman, Georges Risler, asked Malichowski to find other examples of hereditary defects “liable to have a more profound effect on the public consciousness”. [36]

27Les maladies vénériennes et l’armement antisyphilitique (Venereal diseases and anti-syphilitic armament) in 1928 and Conte de la mille et deuxième nuit (Tale of the one thousand and second night) in 1929 were also commissioned and funded by the Office. The first is a documentary and the second an animated film intended for the colonies. These films were presented in public places, in full daylight, thanks to a new “film loop” technique which projected short sequences over and over again. From June 1928, they were shown across the country thanks to travelling film shows much like those used by the Rockefeller Foundation and found elsewhere in Europe, notably in Scotland (Davidson, 2000, p. 141). In 1931, eleven propaganda trucks travelled from town to town to show anti-syphilis films and give lectures, following an itinerary prepared in collaboration with the government authorities (prefects). The départements concerned received pamphlets, brochures and posters to prepare the truck’s arrival.

28It is difficult to know how widely this films were shown or to assess their impact. The department for the prophylaxis of venereal diseases counted 1,207 film showings in 1929, 806 in 1930, and a striking 4,335 in 1931. [37] Yet these are certainly minimum figures. The cinema library of the Office national d’hygiène sociale was not the only body to centralize and disseminate propaganda films: The Musée pédagogique (pedagogical museum) and the cinema libraries of the Ministry of Agriculture and of the city of Paris did likewise (Vignaux, 2002; Murray Levine, 2004). Their efforts were backed up by the regional bodies, notably the educational cinema offices which broadcast anti-syphilis films (Borde and Perrin, 1992, pp. 52-53). Certain cinemas also contributed to the propaganda effort by occasionally showing news reports on the fight against syphilis and on the inauguration of dispensaries (Lefebvre, 1993). Within the army, films were produced by army physicians and presented to the soldiers. From the mid-1930s, La blennorragie danger social (Gonorrhoea, a social threat) and La syphilis ennemi public n 1 (Syphilis, public enemy number one) were shown to all new army recruits, but the impact of these films is difficult to measure. Historical research suggests that they were well received, although there is no way of knowing whether it was the interest of the subject matter, the appeal of novelty or the rare opportunity to see a motion picture show, in rural areas especially, that attracted cinema audiences (de Pastre, 2004; Murray Levine, 2004).
More generally, the overall influence of policy measures was difficult to assess, although regular accounts were kept and published in the association journals that reported on propaganda activities. In 1927, 60,000 copies of a poster bearing the slogan “Protect yourself against syphilis” were printed, along with 10,000 copies of a leaflet on “Services for prophylaxis of venereal diseases” and 25,000 copies of a brochure on “Venereal diseases”; 69,480 people attended 120 representations of a theatre show on venereal diseases; 200 lectures reached an audience of 160,000; and 102 film shows were organized.
Alongside these initiatives intended for a broad audience, targeted campaigns also played an important role. During the syphilis week in 1930, Parisian journalists, supplied with documents by the propaganda commission, were invited to publish articles on the question. The “Protect yourself against syphilis” poster was placarded in numerous public places, including railway and underground stations. Leaflets entitled “Don’t run the risk” and “Advice to students” were distributed in large numbers. Lectures were organized every day for students of the grandes écoles, for post office employees, railway workers etc. [38] Every day, Radio Paris broadcast chat shows with titles such as “What is syphilis?”, “Diagnosis and treatment of syphilis”, “Heredosyphilis”, “Syphilis and marriage”. “They raised not a murmur of protest on the part of radio audiences, quite the contrary”, affirmed Sicard de Plauzoles:

“The many letters I have received prove that the radio is a marvellous propaganda tool, capable of reaching the remotest villages. My listeners, surprised by our revelations, have written moving letters in which they promise to follow my advice.”

III – Propaganda objectives: population quality and quantity

29This propaganda was based on moral presuppositions which shaped its content. Its purpose was to control behaviour, as stated by Lucien Viborel:

30

“In the fight against syphilis and other venereal diseases, the critical factor, critical in order of importance and of logic, is education, which lies within the domain of morals. Education is necessary to develop willpower, to discipline and control the instincts.” [40]

31The control of behaviour as targeted by education campaigns involves a process of devolving to social players the concern for personal health and for the health of others. Indeed, the propaganda system aimed to regulate not only sexual practices but also social conduct. From personal interest to the general interest, from individual responsibility to the collective dimension of private behaviour, a series of norms and rules were decreed in which the individual “I” is linked to the collective “we”. Beyond the fight against venereal contagion, the purpose of this education was to maintain social order and to renew the population through the reproduction of healthy generations. Its underlying mechanisms reveal a little-known and underrated aspect of population policies, most often studied in terms of their coercive or incentive effects, but rarely in terms of their educational role.

32Propaganda provided information on venereal diseases that was more hard-hitting than is sometimes believed. This is particularly true for gonorrhoea. “Among the public it is fashionable to consider the clap as a trifling ailment, as a minor complaint [...]. Yet this mere trifle is one of the main causes of the depopulation which so severely afflicts our country”, [41] points out Dr Bizard. In 1925, before the students of the University of Nancy, Dr Spilmann denounced “the tendency among certain families to consider a son’s first attack of gonorrhoea as a certificate of virility”. [42] The message is driven home by means of two dramatic effects. The first is a demonstration of the insidious nature of the scourge. In 1911, Dr Bessede warns his son:

33

“One of the peculiarities of the disease is its capacity to develop in young people who give every impression of flourishing good health. Those enticing lips on that lovely fresh face could well inoculate you with the most toxic of venoms through a kiss that will poison your entire life, and that of your wife and children too.” [43]

34Here we see an approach similar to that observed by Patrice Pinell in the fight against cancer (Pinell, 1992). The second dramatic effect is the detailed description of bodily symptoms. Dr Gougerot warns his audience of soldiers:

35

“Did you know that untreated gonorrhoea can make you sterile and impotent by “spreading down to the scrotum”; it can cripple you by attacking your joints; it causes constrictions, diseases of the bladder and the kidneys; it can make your wife infirm, sterile and demented, and kill her from peritonitis; that it can make your children blind?” [44]

36The long list of adverse consequences was a admonition in itself. In 1920, Dr Azoulay explained that syphilis

37

“affects the skin, the bones such as the tibia, called “the syphilis bone”, the nose, that punctures and collapses into a saddle-nose, the tongue, notably among smokers, the hard and soft palate that it perforates, the testicles, the penis, the muscles of the eye. But it is above all the nervous system that suffers the greatest damage.” [45]

38While there was general consensus on the purpose of propaganda, the deliberate violence of the message was a subject of debate. Most authors in the 1920s and 1930s rejected the prewar mode of discourse. While in 1902, for Dr Burlureaux “it is not a bad thing to raise terror among one’s fellow citizens to attain a worthy goal”, [46] for professor Spilmann in 1930,

39

“on such questions, the main thing is to avoid shocking public opinion. One must act with infinite tact. It is senseless to adorn the walls with posters whose brutal horror has an effect quite contrary to the goal pursued. Anti-venereal propaganda can do without the images of snakes, flames or skulls. It is a strategy that can only be qualified as ridiculous. Frightening the public will not teach them to protect themselves against the venereal peril: what they need is information.” [47]

40While the aim of the prewar propagandists was to confront the public with the shock of realization, those of the 1920s tended to favour the idea of prevention, and thus advocated a change of tone, although it remained barely perceptible in the content of leaflets and lectures.

41Through their brochures, physicians provided the means for non-specialists to detect and diagnose the disease. Men and women started to worry about suspicious bodily symptoms, as is the case in the fight against cancer (Pinell, 1992). In 1930, Dr Fouqué explained to young athletes:

42

“Women with a history of miscarriages are likely to have syphilis, as are those who complain of frequent headaches, those whose voice is husky, as if hoarse, those with bald patches in their hair, those whose neck is encircled by a brown ring, known poetically as the necklace of Venus. Beware of women with swollen glands in their neck [...]. Before allowing your love story to unfold, take the young lady on your knees, gently stroke her neck, slide your hand towards her more intimate parts and feel the folds of her groin. Should you discover any hard glands that roll under your finger, from the size of a pea to that of a hazelnut, go no further.” [48]

43Propaganda taught the public how to interpret the signs of potential risk. [49]

44When Dr Bizard listed the consequences of syphilis: deformed fingers and toes, deaf-mutism, heart defects, stuttering, harelip, mental retardation, imbecility, hysteria, madness, he pointed out that:

45

“After listening to me, you will logically think that I can come to only one conclusion; that gonorrhoea and syphilis sufferers should remain single and, above all, that syphilitics should avoid having children. But you would be wrong. Indeed, if all those who had been tainted in their youth condemned themselves to a life of singlehood and childlessness, we would need to worry about population collapse rather than population decline.” [50]

Protecting future generations

52The brochures, leaflets and lectures were backed up by fictional and factual accounts that generally dwelt on the themes of thwarted marriage and heredosyphilis, recalling the importance of healthy but abundant reproduction. The play by Brieux, Les Avariés (The degenerates), banned by the censors in 1901, was a pioneering work on this theme. [64] Other play writers and novelists took up the cause. [65] In 1931, Maurice Lemoine gave a reading before the propaganda commission of the Office national d’hygiène of his “propaganda play” [66] Presque tous (Almost everyone) showing that two correctly treated heredosyphylitics can marry and have healthy children. It was performed at the Comédie des Champs-Élysées in 1933 with the support of the commission which, like in the case of films, passed judgement on the utility and efficacy of the work. [67] For these often prolix authors, the support of propaganda bodies provided opportunities to publish, perform and gain recognition. We can only speculate upon their commitment to the cause they defended. This is not the case for the documentary or fictional film makers who were more active in producing propaganda material, either because, like the doctors Leredde and Devraigne, they were the authors of the scripts or because, like Jean Benoit-Levy, they were educational cinema specialists (Vignaux, 2007).

53The content of the films – the same demonstration could be made for novels and plays – reveals the pro-natalist and sanitary obsessions of anti-syphilitic propaganda. Produced in 1925 Une maladie sociale: la syphilis [68] (Syphilis: a social disease) presented the effects of syphilis via a combination of words and images. A speech bubble uses simple language to explain the consequences of the disease, although it is tinged with technical jargon, as in the fight against cancer (Pinell, 1992).

54

“The parasite is passed from mother to child in the uterus. Miscarriages not due to criminal abortion are generally due to syphilis, which is the leading cause of stillbirth. Heredosyphylitic children have no visible skin lesions.”

Photos of skinny, deformed children accompany the text. “Syphilis causes bone disease. Many of the monsters you see here are heredosyphilitics.” Photos showing Siamese twins in formol, Siamese skeletons, hydrocephalic babies, harelip deformities, children with rickets, appear in slow succession to prolong the dramatic effect. “Syphilis affects physical development”: here viewers see a 36-year-old dwarf, and three microcephalic girls. “But also moral development”: the front and side profiles of a man are shown, with the words “this man killed a child”. The film confronts viewers with the visible and shocking evidence of the scourge. These ghastly images are similar to those shown in a German documentary film shot between 1934 and 1936 on hereditary diseases (Lowy and Bonah, 2006, p. 90). Exhibiting the consequences of irresponsible reproduction is a way to open people’s eyes. Another documentary, Les maladies vénériennes et l’armement antivénérien de la France [69] (Venereal diseases and the anti-venereal armament of France) was also designed to develop collective awareness of the problem as a means to awaken irresponsible individuals to the dual risk of losing all their children or producing only half-wits. The first images show the ravages of syphilis from 1887 to 1927 (Document 2).

Document 2

The ravages of syphilis on film

The ravages of syphilis on film

55A rapidly growing pile of skulls illustrates the “ravages due to an accidental calamity”. For those “due to a permanent calamity”, the skulls mount up more slowly, adding to the impression of an unending process. The strategy of provoking shock and anguish begins on an accusatory note, before moving to a more emotional register. In the next image, a couple looks into a cradle. It is empty, and a superimposed image turns it into a coffin. Sterility and stillbirth are much the same thing, with little to distinguish them in accounting terms. “Newborn mortality caused by syphilis: 40,000 annual miscarriages, 20,000 stillbirths.” “Syphilis does not only attack adults. These children are ill simply because their parents infected them with syphilis before they were born.” There follows a series of images of half-wit children, with twisted limbs and rotting teeth, while the consequences of gonorrhoea are illustrated by a woman shown knitting and who sighs: “this is a woman who can no longer be a mother: she has seen the surgeon’s knife”. The film concludes: “Young people! To avoid contracting venereal diseases, live chastely, marry young!” Sterility, stillbirth, thwarted marriage and heredosyphilis were the shocking ingredients of these documentary films.

56The works of fiction deploy other narrative strategies to develop the same themes. In 1929, Il était une fois trois amis (There were once three friends) tells the story of a bank employee, a garage owner and a farmer whose lives are followed from their engagement up to their silver wedding (Lefebvre, 1999). The bank employee and the farmer catch syphilis during their military service. The employee is treated and his doctor allows him to marry. The farmer, confident of his robust health, does not bother to seek a cure. Their engagement celebrations are joyful and promising: glasses are raised to wish them “happiness and lots of children”. What better way to press home the exhortation to fatherhood and motherhood? Some time later, the employee’s first son is christened, while the farmer bemoans his wife’s repeated miscarriages. At the same moment, the garage owner accompanies his wife to the maternity hospital where she gives birth to a “child who will not survive”. The doctor questions him in detail about his family history: the garage owner explains “my father is very nervy, he recently had a delirious attack... I had a brother and sister who both died young.” “Just what I thought: second-generation heredosyphilis!” exclaims the doctor. He invites the man for a consultation to convince him that the disease is curable. This is an opportunity for viewers to look at the anti-venereal propaganda posters placarded on the walls, with their statistics of mortality and stillbirth. The garage owner decides to opt for treatment and five years later he has a bouncing baby son, whose plump cheeks show off his good health. We see the three men again, waiting anxiously for the birth of the farmer’s first child. Despite the prospective father’s cocky self-assurance, the child is stillborn. The doctor explains that “this death is stamped with the word SYPHILIS”, and the farmer resolves at last to seek treatment. Twenty-five years later, the three households celebrate their silver wedding. The scene opens with a field of wheat, a symbol of fertility. The setting is the same as for the engagement party, although the table is extended to seat their fifteen children: the bank employee has six, the garage owner five, and the farmer four. The decreasing number of children per man is due to the “period of exposure to the risk” of healthy fertility (the earlier you are treated, the more children you will have) and not to birth control. Anti-venereal propaganda sought to promote large families: quality is not incompatible with quantity, far from it (De Luca Barrusse, 2008a). The film aims to convince a wide audience:

57

“This film will console the poor souls who have been contaminated and cured, and those who have neglected their treatment or remain untreated through bravado but who will quickly see the error of their ways. It will also reassure the countless people who live in constant fear of contamination while doing nothing to avoid the treponema bacterium.” [70]

Other screen dramas depict the ravages of untreated venereal disease. In 1929, Le baiser qui tue (The fatal kiss) directed by Jean Choux and Dr Malakowski received “official support from the Ministry of Labour and Hygiene” in exchange for some adjustments requested by the propaganda commission. In Paris and the provinces, the film “shows to full houses, and is everywhere accepted and well received by the public”; it attracted an audience of 32,000. [71] It tells the story of Yves, a young Breton who leaves his fiancée to begin his military service. His life in the navy is punctuated by stopovers in foreign ports, and the temptations that ensue. Yves discovers that he has syphilis, but is due to marry within the next few days. The doctor who examines him advises him to sign up for further duty and to come back home once he is cured. Yves hesitates. He is tricked by the promises of a mail-order remedy and decides to marry. Soon his life enters a downward spiral. His wife is infected, his child is half-witted, he takes refuge in alcohol and madness. But Yves wakes up: it was just a nightmare. Now he knows what is the right thing to do. He goes back into the navy, is cured and marries two years later.
These plays, novels, documentaries and works of fiction do not use authoritarian means to impose rules of sexual and social conduct. They are designed to convince their audience to change their ways and to assume responsibility for their actions, via messages on several levels, the most resonant being the threat of a doomed marriage. Syphilitics who refuse treatment are portrayed as egoists who compromise the number and health of their children and hence the destiny of the population as a whole.

Conclusion

58Educational anti-venereal propaganda emerged as a coherent overall approach to serve the needs of population policy. It was designed to obtain unconditional approval for the prescriptions of population quality and quantity, with a view to ensuring successful reproduction. It sought to convince absolutely, and to ensure that the model it defended was adopted unequivocally. The content of this propaganda shows that sexual practices and broader social practices (marriage) were judged upon what they produce or are capable of producing. It aimed to subjectivate rules of good conduct by inculcating standards of “reproductive savoir-faire”. Moreover, propaganda was a system of social control that focused on awareness of the collective dimension of the venereal question. It shifted the boundaries of intimacy, allowing the medical profession into the private domain, with the complicity of the state (Memmi, 2003). At the same time, and in parallel with this educational endeavour, the physicians of the Société de prophylaxie and of the Ligue contre le péril vénérien sought to introduce an array of legislative measures whereby to control, as it were, the consciousness-raising of social actors and hence one of the effects of the propaganda. These measures included the penalization of venereal contamination – of which echoes still exist today in relation to AIDS [72] – the prenuptial certificate which did not become obligatory until 1942, or again the health diary, whose diffusion remained limited up to 1939 (Carol, 1995, pp. 312-339; Rollet, 2008b, pp. 131-188).

59The finality of population policy as implemented through educational anti-venereal propaganda is clearly the productivity of marriage, in terms of both quantity and quality. It is within the family that the demographic future of the country is played out. Regarding the strategy of the pro-natalists and familialists, the social order they promote can be termed as “family order”, an order founded on the family as a unit of biological and social reproduction organized according to criteria of population growth and structure (De Luca Barrusse, 2008a, p. 33). The pro-natalist and familialist objective is not restricted to this one sphere. It also appears in the population policy supported by the anti-venereal medical community in the first half of the twentieth century, although criteria of quality and quantity are presented differently, in line with the priorities of the protagonists concerned. The place occupied by pro-natalism in the domain of public health reveals the structurally familial focus of French population policy.