A recent forum in French Historical Studies addressed French natality and the relation between the state and population during the end of the nineteenth century and through the post-1945 era. The collected essays explored how science, medicine, and legislators perceived the role and responsibilities of French women to the state. As mothers, women held the responsibility for repopulating the nation. This position, Jean Elisabeth Pedersen noted, was studied and emphasized by scientists who wielded what she referred to as significant "cultural authority" in discussions about natality. Furthermore, legislators helped focus attention on women's presumed duties by using science to support programs such as financial incentives to promote higher birthrates.[1] Finally, Rachel Fuchs, as she summarized the key points of the essays, wrote that men and women were assigned different roles in the French debate: "Women," she noted, "had relevance solely in their capacity as 'mandatory mothers,' and it was women's reproduction, not men's, that politicians wished to affect."[2]

This is clearly true, but what of the men? While I cannot address natality in all eras of French history, I would like to suggest that from 1914-1918, doctors and advisors associated with the French army helped to redefine the responsibility for procreation in France. On the home front, a clear duty existed for women to produce children; they would provide the future of the nation. Within the confines of the French army, however, women were seen differently. Considered the carriers of endemic disease, increasingly seen as a threat to France, women could not also hold the duty of repopulating the nation.[3] Aware of climbing rates of venereal infection from 1914-1918, military officers and doctors increasingly placed the burden of procreation upon the soldiers of the French army. Pronatalism, as masculine pronatalism, emphasized soldiers' masculine honor and duty to the nation to produce children. This paper will explore the expectations of masculinity and masculine honor, the spread of venereal disease, and the increased focus among military doctors and officials on men's reproductive duties to France.

Admittedly, before 1914, substantial interest in men's sexual health, masculinity, and degeneration existed within the European medical community. Extensive discussions of the "dangers" of the unmanly homosexual and of masculinity appeared in Great Britain and British colonies while in France, intellectuals, scientists, and politicians focused on studying root causes for the degeneration of the race[4] and threats to men's health.[5] Medicine advised healthy men to avoid "alcohol, tobacco, venereal disease, or unhygienic living and working conditions."[6] In general, European medicine at the turn of the century encouraged men to protect their sexual health and to provide healthy seed for reproduction, while simultaneously emphasizing that it was women's duty to produce children.

Intricately intertwined with the question of men's sexual health during the nineteenth century was masculine honor. Middle class men's sense of honor, Robert Nye argued, was saturated with meaning and importance reflecting "the bourgeois preoccupation with moral discipline, inner values, and with the control of reproduction and sex."[7] Producing competent heirs was critical both for family status and the stability of family businesses. As a result, medical and professional attention focused on marital fertility and a regulated sexuality that would reinforce class goals.[8]

Rather than focus on men as those responsible for producing children in general, doctors perceived the health of children to be a reflection of the health and vigor of the father. Therefore, professional disciplines such as medicine promoted middle-class goals, working to "find ways to enhance marital fertility, and to valorize genital, reproductive, and marital sexual behavior over 'pathological' sterile kinds."[9] The middle class doctors who worked during the war would carry this medical tradition with them, as they worked to control the spread of venereal diseases.

In 1914, when the Great War began, the French army's attention to the reproductive powers of its soldiers was nearly non-existent, limited to the potential threat of venereal disease. With no extensive program of education, treatment, or prevention for soldiers, the dangers of venereal infection and the importance of reproduction were mentioned only briefly in a small handbook for soldiers. In Advice to the Soldier for his Health, the army warned the poilus against the dangers of frostbite, alcohol, cold, and wet climates and stressed the general importance of good personal hygiene to prevent illness. In the midst of discussions of contagious diseases, the small booklet also reminded men that maintaining one's sexual health was important. Syphilis and gonorrhea, the pamphlet advised, were highly contagious and readily transmitted to men's families.[10] "Think of your wife, your fiancée and the beautiful children who will create the joy of your home and the power of the nation." "They," the booklet advised, "will be the replacements of your glorious comrades who fall on the Field of Honor."[11]

Though there was little interest at the start of the war, a combination of the rapid spread of venereal disease throughout 1915 and military losses during 1916 provoked new interest in soldiers' sexual health and reproductive duties. The military's casual attitude toward policies on venereal disease quickly changed and military doctors began to refer to syphilis as a dangerous plague, a "peril not only for the health of individuals, but for the future of the country."[12] Concerned, in January 1916 the leadership of the French army made its first serious efforts to control venereal disease during the war, reasoning that "everyone must be conscious of the dangers that, as a result of this scourge, threaten the stability of homes, families' futures, the vigor of future generations and that have attacked the Nation even at the source of its vital powers, its ability to grow and all its energies."[13] The French General Headquarters therefore issued secret orders commanding generals to initiate bi-monthly health exams for soldiers, ensure immediate treatment for those infected, and provide educational lectures for all battalions. Further, they required that any poilu going on leave receive a medical screening upon his return, and suggested that men who showed signs of disease be punished in some way. Finally, the orders required soldiers to supply police with the name of the woman who infected them.[14] The official attempt made, few generals recognized the problem or occupied themselves with the application of the order.

In contrast, members of the Chamber of Deputies became increasingly concerned with the spread of disease and threat to the race. From "every corner of France," deputies complained they had received "worrisome" reports on the sanitary condition of the army and health of soldiers.[15] Politicians argued that in the face of what appeared to be a growing epidemic of disease, the military health service had made little progress. The gravity of the problem, the deputies charged, "frightened even the most level-headed people."[16] They placed blame for the spread of disease with the medical profession, charged with protecting public health and the health of soldiers: "Like grammarians, even more perhaps, doctors discuss, argue, quibble, and their decisions are still indefinitely unwise. We can no longer, faced with this dangerous plague, maintain our academic serenity nor lose ourselves in a sea of eloquence. We must act, we must do something."[17]

With pressures to control the spread of syphilis mounting, in September 1916 the Director of the Military Health Service, Justin Godart, issued new orders on prophylaxis and treatment of venereal disease for men in the army and civilians. It was a final effort to take decisive action, but as an aggressive step against disease, Order 251 was also a turning point: it prompted a new focus on men's health and their masculine, procreative duties. For the French army, Order 251 became the standard for controlling venereal disease during the war and into the 1920s. It was, as one report noted, the "French charter for anti-venereal prophylaxis."[18]

Briefly, among other things, this order emphasized that all soldiers in the army would attend lectures and be educated about the dangers of venereal disease. Regular foot soldiers already in the army were required to attend lectures when possible, while each class of new recruits attended obligatory lectures on the dangers of venereal disease and prostitution. This portion of the order is significant since it was through these initiatives that middle class doctors instructed the poilus about masculine honor and their procreative duties to France.

In booklets and educational tracts distributed to soldiers, doctors in the Military Health Service consistently reminded French soldiers about the destructive potential of syphilis and the duties of masculine honor and emphasized their reproductive responsibilities for the future of the nation. For example, during 1916 and 1917, Médecin-Major second class Alfred Anzoulay wrote extensively on the anti-venereal battle, danger to future generations, and prostitution. Stationed near Paris, Anzoulay took particular interest in men's honor and duties, publishing titles in a series called To Save the French. His first work, What Everyone Should Know: The Venereal Peril, appeared in November 1916.[19]

In his work, Dr. Anzoulay began by discussing the progress of venereal diseases, ending with the dangers they posed. He explained that venereal disease was a socially delicate question both for doctors and the public, generating fear and scorn because of stigma and misunderstanding. Anzoulay argued that the public often thought of gonorrhea as a misère or bagatelle. However, it was only a "misery" or "trifling" if treated immediately. Left to grow, Anzoulay wrote, the infection in a man's urinary tract would develop into the "soldier's drip," eventually descending into the testicles where painful swelling would occur. Once there, it would render the infected male sterile.[20]

Syphilis was no better, and Anzoulay explained that it attacked the skin (with chancres), destroyed cartilage (particularly in the nose), and weakened bones (the tibia was known as "syphilis' beloved bone"). The nervous system suffered, too; syphilis could induce paralysis or dementia.[21] There was no way to deny the danger or horrors of the disease and Anzoulay appealed to French men's honor, insisting on their duty to have and maintain healthy families and children:

Other than fear, like people jokingly say, syphilis motivates good conduct, one can also gain this good conduct by other emotions than fear, one can learn it through moral principals, by respect for women, respect for one's self, by the respect due in advance by he who is not married for she who will be his companion, to the children that will be born of him, to the domestic foyer that he will want to create.[22]
Anzoulay also tried to convince soldiers to avoid disease by avoiding sex altogether:
People say that before marriage, a young man has the need to sow his wild oats and learn, by frequenting prostitutes, to understand the honest woman who will become his spouse. These are absurd and dangerous preconceived notions. Debauchery is always harmful and it will always leave something with those who give themselves up to it. Chastity before marriage is a very useful and wise precaution that has never harmed anyone.[23]
Dr. Anzoulay cited various authors who agreed that chastity was neither bad nor dangerous for a young man's health and that it should not be considered a "ridiculous" condition. Chastity had benefits that would guard a man's health, protecting him from "being prematurely used up with excessive nervous expenditures."[24]

Inexpensive, one-page tracts became a popular method for spreading information about the dangers of venereal disease, and they increasingly emphasized the duties of masculine honor. Médecin-Major second class Gougerot, the director of the Venereal and Dermatological Center in the ninth military region and professor in the medical faculty in Paris, was one of the most influential and productive doctors in or out of the army during the war. His efforts to educate soldiers, doctors, and civilians about venereal disease and its prevention were wide-ranging. He composed and circulated tracts and pamphlets by the thousands on the dangers of venereal disease and prostitution in France, and many were reprinted in professional medical journals during the war.[25]

The tracts themselves contained a variety of information, but most addressed venereal disease and prostitution. The responsibilities of masculinity and procreation were stressed throughout. One advised, "Venereal diseases are serious: the person who is afflicted risks, by ignorance or lack of strong will, contaminating his entourage, procreating degenerate children due to illness and himself falling into decrepitude." This particular tract added, "The duty of a young man is to be chaste, to conserve his moral and physical vigor for the collective, race, and country. The duty of a married man is to remain faithful to his wife and to chase away passing temptations thinking of his home and the future of his children [original emphasis]."[26]

During lectures, especially in the required lectures soldiers attended, doctors often used slides to identify syphilitic chancres and illustrate graphically the progression of disease. In this medium, the importance of procreation and duty was emphasized. Lecturing to a group of poilus in 1917, Major Betherand followed slides of the microbe that causes syphilis with images of the physical damage to the genitals. He then displayed graphic slides of children born with lesions from congenital syphilis. Later, he reported he did this precisely to emphasize "the dangers of the venereal peril for the future of Frenchmen" and the attending duty of the poilus to avoid infection.[27]

While doctors undertook the instruction of poilus, commanders wondered if the educational aspects of Order 251 were useful since no one could guarantee that soldiers actually listened to the information or understood the dangers. In 1918, a closed meeting of the Consultative Commission of the Military Health Service considered the venereal threat to the French and the success or failure of educational prophylaxis in the army. Some committee members felt that providing soldiers with information was an important step in reducing their chances of contracting a disease and infecting the women who would bear their children. Even if educational attempts only turned "10 men out of 100 away from danger," they would be a partial success at least. One committee member reminded the others there still might be some either among the medical corps or the soldiers who did not understand the serious nature of venereal disease or did not understand that the poilus were carrying it home. Once again, the importance of reproduction appeared as one member of the committee argued that soldiers

contaminate their wives who are then dirtied for perpetuity and in a fashion so grave that if they ignore it, this extinguishes the family, the race, this is a menace which does not only weigh heavily [on France] for the duration of the war, but above all on regeneration, many wives will no longer be able to have children because they are contaminated.[28]
This discussion, like many others about disease and men's health, mentioned the women who would be contaminated by men or who would ultimately have the children of the poilus. Nonetheless, the speaker emphasized not only that men should simply remain healthy, but that they had a distinct masculine duty to produce children to repopulate France.

I do not intend to suggest that the medical community outside of the French military was uninterested in men's health. On the contrary, interest in sexuality and the war's ability to destroy men's health (other than by the most obvious of means) were readily discussed. The well-known sexologist Havelock Ellis warned that war posed a danger to the race because of the effects that it had on men and the disease it spread. According to Ellis, war was a disruptive act in the midst of the natural order. It tended to eliminate the strongest men of a country, leaving the weakest to produce children. Even trying to avoid war by marrying could produce problems. Early marriage by "unformed" men, he said, could produce weak offspring, resulting in damage to the strength of a country. Ellis added that "nearly all the ways in which war and armies disturb the normal course of affairs seem likely to interfere with eugenical breeding, and none to favour it."[29]

In addition, Ellis, like others, recognized contagions as particularly threatening. "Armies," he wrote, "are highly favourable to the spread of racial poisons, especially of syphilis, the most dangerous of all." The spread of disease and syphilis in particular, Ellis warned, could only be "dysgenic rather than eugenic."[30] Professionals in the public realm were also aware of the dangers of syphilis. Lectures given by the National Society for Public Lectures (Société Nationale de Conférences Populaires) stressed the threat venereal disease posed. Dr. André Bernheim argued during a lecture that "curing" syphilis in the first stages was very important so that men could marry and "all of your wife's pregnancies will develop to term; your children will be solid and well-formed, with an inquisitive mind; and they in turn will be able to assure the continuity of the race."[31]

Within the confines of the French army, there was not only an increased awareness of the spread of syphilis and its public health dangers, but a new emphasis on the procreative responsibilities of French soldiers. That responsibility was linked to their health, yes, and mirrors some discussions about men's health and sexuality before and during the war. However, while the primary responsibility for procreation was seen as that of French women, within the French army, doctors increasingly emphasized soldiers' honor and duty to the nation, not only to remain healthy and to fight, but also to produce children for the nation.

    1. Jean Elisabeth Pedersen, "Regulating Abortion and Birth Control: Gender, Medicine, and Republican Politics in France, 1870-1920," French Historical Studies 19:3 (spring 1996): 673-98; Rachel Fuchs, "Population and the State in the Third Republic: Introduction" French Historical Studies, 19:3 (spring 1996): 635. There is a considerable literature on women and natality during the nineteenth century. For a selected discussion see Andrés Horacio Reggiani, "Procreating France: The Politics of Demography, 1919-1945," French Historical Studies 19:3 (spring 1996): 725-54; Joshua H. Cole, "'There Are Only Good Mothers': The Ideological Work of Women's Fertility in France before World War I," French Historical Studies 19:3 (spring 1996): 639-72; Angus Mclaren, Sexuality and Social Order: The Debate over the Fertility of Women and Workers in France, 1770-1920 (New York: Holmes & Meier, 1983); and Karen Offen, "Depopulation, Nationalism, and Feminism in Fin-de-Siècle France," American Historical Review 89 (1984): 648-76.return to text

    2. Fuchs, 635.return to text

    3. For a brief discussion of what I have called "the dangerous woman" and perceptions of prostitution, please see Michelle K. Rhoades, "'There are no Safe Women': Prostitution in France during the Great War," Proceedings of the Annual Meeting of the Western Society for French History 27 (2001): 43-50.return to text

    4. A note on translation: currently, race may be translated directly from French into English. However, the meaning of race changed during the twentieth century. In the late twentieth century, "race" carried with it references to "racism" and discrimination in both French and English. In 1914, however, the first sense of race as translated into English was "a) series of descendents from one stock; b) extraction, c) offspring, progeny, issue; d) generation." Please see A New French-English Dictionary (Paris: Garnier Frères Publishers, 1914), 1069. I have made every effort to maintain the 1914 sense of the word in my translations.return to text

    5. See, for example, Angus McLaren, The Trials of Masculinity: Policing Sexual Boundaries 1870-1930 (Chicago: University of Chicago Press, 1997); Mrinalini Sinha, Colonial Masculinity (Manchester: Manchester University Press, 1995); and George L. Mosse, Nationalism and Sexuality: Middle-Class Morality and Sexual Norms in Modern Europe (Madison: University of Wisconsin Press, 1985). See in particular Mosse's chapter 2, "Manliness and Homosexuality," for a discussion of different theorists' opinions of masculinity and homosexuality in Europe at the turn of the century.return to text

    6. Robert Nye, Masculinity and Male Codes of Honor in Modern France (New York: Oxford University Press, 1993), 75. See also Nye, "Honor, Impotence and Male Sexuality in Nineteenth Century French Medicine," French Historical Studies 16:1 (spring 1989): 48-71.return to text

    7. Nye, Masculinity, 32.return to text

    8. Ibid., 44-5.return to text

    9. Ibid., 84.return to text

    10. Bibliothèque historique de la ville de Paris [hereafter BHVP] 908928, Conseils au soldat, 19.return to text

    11. Ibid., 24.return to text

    12. Service historique de l'Armée de Terre [hereafter SHAT] 9N 968 suppl. "Les Origines et la Marche," 2.return to text

    13. SHAT 16N 2515. Letter which accompanied orders from the General Headquarters to control disease.return to text

    14. SHAT 16N 2515. Secret note from Directeur Général du Service de Santé Chevasse, 15 Jan. 1916.return to text

    15. SHAT 9N 938 suppl. Letter from the Chamber of Deputies to Minister Simonin, 19 Sept. 1916.return to text

    16. Ibid.return to text

    17. Ibid.return to text

    18. SHAT 9N 968 suppl. "Les Origines et la Marche," 6. The original designation of "Order 251" was actually Circular 251 Ci/7. It was a constant source of reference for the doctors and commanders in the Army and remained a solid basis for prophylaxis in the French army well into the 1920s.return to text

    19. SHAT 9N 978 suppl. Médecin-Major Anzoulay, Pour Sauver la Race, 6.return to text

    20. Ibid., 3.return to text

    21. Ibid., 4.return to text

    22. Ibid., 8.return to text

    23. Ibid., 9.return to text

    24. Ibid.return to text

    25. Dr. Gougerot, "Prophylaxie des Maladies Vénériennes," Annales d'Hygiène Publique et de Médecine Légale 29:2 (1918): 95-114.return to text

    26. SHAT 9N 978 suppl. Pour Eviter les Maladies Vénériennes, (1917).return to text

    27. SHAT 9N 978 suppl. Médecin-Aide Major Bertherand. Report from the 12th military region, May 1917.return to text

    28. SHAT 9N 989 suppl. Report from the Commission Supérieur Consultative du Service de Santé. M. Siredey speaking. 29 July 1918.return to text

    29. Havelock Ellis, Essays in Wartime: Further Studies in the Task of Social Hygiene, (New York: Houghton Mifflin Company, 1917), 33.return to text

    30. Ibid.return to text

    31. SHAT 9N 978 suppl. Program notes for lectures given in 1916 by Doctor Bernheim for the Société Nationale de Conférences Populaires.return to text