HIV/AIDS at 30: Spreading the Word

To mark World AIDS Day (1 December) this year, BHIVA (the British HIV Association) held a World AIDS Day Event in collaboration with the Wellcome Trust on the theme HIV/AIDS at 30: Back to the Future. 2011 is the thirtieth anniversary of the first description of AIDS -- a milestone in the continuing epidemic that has claimed the lives of millions of people worldwide. While reflecting on the experiences and work of the past 30 years, eminent speakers reviewed today's challenges, and looked ahead to consider how the knowledge of the past will inform future strategies.

One aspect of the epidemic that was considered was the way in which health authorities, activists and charities around the world have tried to prevent its spread by publicity, including posters. The Wellcome Library now has over 3,200 AIDS posters from many countries. The exhibition Spreading the Word: AIDS Posters from Around the World is a selection of 24 posters chosen and interpreted by Dr Sarah Graham of Leicester University, and shown earlier this year at the New Walk Museum in Leicester.


The posters emphasize the range of graphic techniques adopted and the variety of ethnic and social groups at which they were directed. Spreading the Word was also on display today at the BHIVA/Wellcome Trust meeting (left) and was much appreciated by those attending.

Below: Wellcome Library no. 778362i

The latest AIDS poster to enter the Wellcome Library catalogue (right) must be one of the most allusive and discreet in the entire collection. It was published on World AIDS Day in 1994 by UNESCO in Paris, for Hispanic populations in which drug use was a source of transmission of the virus. Unlike the crashingly explicit posters (mostly from Germanic and Anglo-Saxon countries), it refers to open discussion within the family and use of counselling to help drug users, with no obvious indication to the casual passer-by that its end-purpose is to save them from contracting HIV through needle re-use.

Among the work publicised at the conference was a recent volume in the series Wellcome Witnesses to Twentieth Century Medicine, which was published in November 2011. It concerns the controversial National Survey of Sexual Attitudes and Lifestyles (NATSAL) which was launched in 1990. "A proposal that the UK Department of Health would fund it, after scientific scrutiny by the Economic and Social Research Council, was vetoed at government level – some say by Mrs Thatcher herself – on the grounds that this would be an unacceptable intrusion into private lives. This decision hit the headlines (first in The Sunday Times), as did the decision, some four weeks after the story broke, by the Wellcome Trust to step in and fund it instead. There is a similar story to be told of obstruction from the Bush White House,which forbade funding from the National Institutes for Health (NIH) for the American survey" (pp. xxi-xxii).

The phrase "some say by Mrs Thatcher herself" is backed up on p. 67 by a separate statement in the book (Appendix 3, pp. 66-68) by Dr Peter Williams, Director of the Wellcome Trust at the time, who received that account of events in a phone call from the Chief Medical Officer, Sir Donald Acheson. A note by Professor Virginia Berridge (p. 61) suggests that the reality behind the scenes may have been more complicated, but that at any rate Downing Street was happy to go along with the veto. More of the raw materials for this episode are set out in the volume, in the usual Witness Seminar manner: the spoken memories of people who were involved in the events at the time, provided with scholarly commentary and often with competing points of view. It makes compulsive reading. It is available in hard-copy from booksellers and Amazon, and available free of charge on the web as a PDF. [2]

[1] Overy C, Reynolds L A, Tansey E M. (eds) (2011) History of the National Survey of Sexual Attitudes and Lifestyles. Wellcome Witnesses to Twentieth Century Medicine, vol. 41. London: Queen Mary, University of London. ISBN 978 090223 874 9

[2] http://www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/index.html

Music of the blind

Blind musicians in Paris. Detail of lithograph by Martin Sylvestre Baptiste, 1828. Wellcome Library no. 16519i

An article by Ingrid Sykes in the latest issue of Medical History considers the blind in Paris from an unusual angle: their sound. One might think that the blind would sound the same as the sighted, but no, not in Paris in the years before and after the French Revolution. [1]

There was in Paris a mediaeval institution called the Hospice des Quinze-Vingts, founded by King Louis IX in the thirteenth century. The Hospice was a self-governing community of 300 (quinze-vingts, or 15 x 20) blind and partially sighted men and women, their spouses and their children. The hospice's autonomy and antiquity, its often truculent and anarchic spirit, the fact that it was founded by a king and protected by a cardinal (the Grand Almoner, Cardinal de Rohan), all brought it into conflict with the new spirit of improvement and control in the French Enlightenment.

The character of the Hospice was expressed in its sound. The musicians of the Quinze-Vingts could be heard in Paris on the streets, at fairs, and at an all-night café. Fiddlers, woodwind performers and vocalists produced a raucous popular sound in which successive members would perform as soloists followed by a chorus in which all performers would join. The results were variously described as "depraved", "threatening", and even as "une scène si déshonorante pour l'espèce humaine" (a scene dishonourable to the human race). The politer sort would give them some small change in order to make them go away. The print above shows one of the Quinze-Vingts bands in their outlandish costume about to have a brawl on the street with a rival amputee musician.

Left, Valentin Haüy,with, far left, his brother, the crystallographer René-Just Haüy. Engraving by the brothers Boilly, Jules and Alphonse; Wellcome Library no. 545537i

A performance by a Quinze-Vingts band made a deep, though not favourable, impression on the reformer Valentin Haüy (1745-1822). It was after hearing a performance of the Quinze-Vingts, described by him as "cette atrocité", that Valentin Haüy decided to found a new institution for the blind, organized along more up-to-date lines. [2] This was the Institut des Jeunes Aveugles (Institute for Blind Youth), a typical Enlightenment institution. Secular, educational, managed by the sighted, run by the state and not by the church, the new organization's nature was signalled by its name: not a mediaeval Hospice but a structured Institut.

Aquatint with etching by Marlé, 1805. Wellcome Library no. 545557i

The character of the Institut was also signalled by its musical performances. Instead of the popular music of the Quinze-Vingts, the blind would be trained in the harmonic system of the composer Rameau: the new system was based on Cartesian mathematics and was published in a book ominously entitled Code de musique pratique (1761).

The Hospice had always existed and was there by Royal fiat. The Institut was an innovation and was there for a purpose. In the 1790s attempts were made by the revolutionaries to suppress the Hospice, invoking the inmates' licentious life-style and spirit of independence. Suppression was avoided, but, despite their disparate characters, the Hospice and the Institut were amalgamated in 1805, largely for financial reasons. The print above recording Pope Pius VII's visit in that year shows the more decorous appearance of the blind, their more harmonious means of music-making, and their more regimented organization under the Institut.





















Sébastien Guillié (1780-1865). Left, as a young man: lithograph by C. Motte. Wellcome Library no. 3852i. His initial is given as J by mistake. Right, in later life: photograph by Giraudon, 1865. Wellcome Library no. 12835i

The merger did not last. In 1816 a new director, the despotic doctor Sébastien Guillié (above), determined to rid the Institut of its association with the Quinze-Vingts: he moved it away to a new site where, in the name of progress, he could carry out ophthalmological experiments on the blind children selected as his victims. [3] The Quinze-Vingts musicians continued their performances on the street for some years more, but could not defy change indefinitely: their building is now the site of a modern ophthalmological centre, the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts à Paris.

There is more to it than that, and more is provided in the article, which is available free online. One last point: the whole story would provide marvellous material for an opera. Richard Strauss and Clemens Krauss wrote Capriccio about different genres of drama and the relation between words and music. Bertolt Brecht and Kurt Weill included in The Threepenny Opera street songs and conflict with the police. Perhaps the authors of Les Misérables would like to produce a successor to those works, based on the struggles of the Quinze-Vingts? There would be a dramatic conflict between the two types of music, the protagonists on each side would provide plenty of character, and there would be scope for a variety of indoor and outdoor sets. And Victor Hugo himself could have a cameo role: according to the article, he was one of the champions of the Quinze-Vingts in their struggle against bureaucracy.

[1] Ingrid Sykes, 'Sounding the "Citizen–Patient": the politics of voice at the Hospice des Quinze-Vingts in post-Revolutionary Paris', Medical history, 2011 October; 55(4): 479–502. Available free online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199644/

[2] Pierre Henri, La vie et l'œuvre de Valentin Haüy, Paris: Presses universitaires de France, 1984, pp 37-43 (find in the Wellcome Library here)

[3] Zina Weygand, The blind in French society from the Middle Ages to the century of Louis Braille, Stanford, Calif.: Stanford University Press, 2009, pp. 261-267 (find in the Wellcome Library here)