History
Focusing on rubber production, as the first stage of the commercial process, Chapter 1 demonstrates the tensions between old and new manufacturing methods among British manufacturers, the medical profession, social conservatives and consumers. Most contraceptive appliances made from the late nineteenth century to the 1960s were made from rubber, but it was the introduction of latex in the early 1930s and contraceptive testing by the National Birth Control Association in 1935 that not only resulted in increased output and factory employment but also drew increasing public attention to the trade’s reputation. Social conservatives protested against the increasing feminisation of the latex contraceptive workforce that made contraceptives visible to adolescent girls for the first time, while the Association sought to ensure that the trade conformed to its medical standards. Yet, what is clear is that such changes were not wholesale during this period. Not all firms adopted latex production and while it was in a firm’s interest to supply the Association, firms largely ignored protests about workforce feminisation. This chapter demonstrates that the introduction of latex in the interwar period did not result in a technological revolution as some historians have suggested, but that old sat uncomfortably alongside new.
The epilogue outlines the interwar legacies of the contraceptive industry and reveals how its structures provided the foundations for the contraceptive Pill and the mass-contraceptive industry of the late twentieth and twenty-first centuries. Companies and brands in this trade that we now consider to be largely reliable, authoritative and trustworthy, such as Durex, played no small part in establishing their own reputations during the period under study, although as the epilogue will demonstrate, many of the commercial practices of today’s contraceptive firms are no less questionable than those of the interwar period.
The introduction orientates the reader to the topic of the book. It highlights how the concomitant increasing adoption of birth control as a practice and commercialisation of contraceptives as commodities resulted in a mid-twentieth-century moral panic, the outcome of which was the Contraceptives (Regulation) Bills of 1934 and 1938. The Bills aimed to curb excess commercialisation, but the lack of consensus on what constituted excess and how curbing it could be achieved meant that the Bills were abandoned. Focusing on the tensions between the growing acceptance, reliability, visibility and respectability of birth control and increasing contraceptive commercialisation, much of which morality campaigners saw as ‘conscienceless’, not only demonstrates the hitherto neglected importance of business in shaping sexual knowledge and practice but also sheds greater light on the ambiguities and struggles of an interwar Britain attempting to break away from its Edwardian and Victorian past through its embrace of modernity, science, technology and medicine.
The focus of Chapter 5 shifts to urban retail distribution, a commercial process largely neglected in current historical scholarship on birth control, but one in which the tensions and ambiguities of the interwar years and birth control in this period were the most obvious. The chapter examines how Lord Bertrand Dawson, birth control authorities, social conservatives and consumers responded to the growing visible and unmediated promotion and sale of contraceptives from chemists’ shops and surgical stores. Retail outlets became increasingly important to contraceptive distribution as they adopted ‘scientific salesmanship’ and brightly coloured and branded window displays, as did mechanised contraceptive slot machines placed outside the shops of chemists and barbers and at new sites of leisure. The chapter then outlines how the failure to find consensus on how to accept the rights of married adults to access birth control appliances via retailers and slot machines while preventing access to adolescent consumers meant that legislation was largely abandoned by 1950. Ultimately, free trade and, with it, overt commercialisation triumphed and contraceptives were freely available from, if not freely advertised by, chemists’ shops as the contraceptive Pill was introduced.
Chapter 3 uncovers how firms attempted to demonstrate their authority in birth control through the promotion of their brands in a range of print. Increasingly prominent and explicit advertising featured in a variety of respectable and non-respectable newspapers and magazines, in mail-order catalogues, and formed part of a plethora of medical and non-medical books on sex and birth control throughout the interwar period. It was this increasing visibility in print that resulted in a backlash against this new and modern public discourse on sexual topics. Of particular concern to medical authorities, birth control advocates and social conservatives were firms’ own advertising publications that were often shaped into medical tracts, some of which were delivered unsolicited to the homes of consumers. But such tracts confused unknowing consumers who were unable to discern what they considered legitimate medical contraceptive knowledge and commercial knowledge. Such was the blurring of medical, sexual and commercial publications that even authorities like Marie Stopes could not distinguish between them.
Chapter 2 turns to the next battleground in the commodification process in this transitional period: packaging, branding and trademarking. While it was only from the late 1930s at the earliest that the LRC’s famous brand ‘Durex’ became synonymous with the condom, this chapter draws attention to the importance of packaging, branding and trademarks before ‘Durex’. It draws on two prominent examples of branded contraceptives – W. J. Rendell’s ‘Wife’s Friend’ Soluble Quinine Pessary, registered in 1894, and Lambert’s ‘Pro-Race’ rubber cervical cap, registered in 1922 – and outlines the numerous infringement battles over imitation of these brands in the interwar period. Tensions between manufacturers and surgical stores not only indicated the perceived commercial value of brands and trademarks, but were indicative of firms’ attempts to establish themselves as the legitimate authorities on birth control in a more open market for such goods. Branding and trademarks, both a mixture of traditional and modern designs, were a way to convince consumers of the quality and reliability of products, and evidence from the Rendell company archive suggests a degree of success. Rendell’s customers, in particular, viewed these contraceptives as reliable through the identification of the firm’s branding and trademarks.
This chapter begins by showing how the First World War improved the technology used in amplified telephony while simultaneously creating the conditions of mass deafening that made such technology necessary. It then argues that the telephone was used as an arbitrator of normal hearing and that the data used to create apparently normal hearing levels in the British interwar telephone system featured a ‘disability data gap’. This disability data gap was embedded in the British Post Office’s ‘artificial ear’, which represented ideal hearing (eight normal men with good hearing) as normal, to the detriment of those at the outer edges of a more representative average curve. Subsequently, those with less than perfect hearing agitated to demand the Post Office supply telephones that could be used by the majority of the population. The Post Office responded by creating its ‘telephone service for the deaf’, and the subsequent user appropriation and modification of this service vividly demonstrates the fluid categorisation of deafness that the telephone enabled. This history reveals how aspirational users employed a variety of strategies to ensure equitable access to telephony and how users with hearing loss created modified devices so that they could access telephony.
This chapter shows how the standardisation of sound was perfected and pursued in the interwar years as the ‘telephone as audiometer’ was embraced as an objective tool to define noise limits and the thresholds of normal hearing. In this way, the audiometer was elevated as a tool for testing hearing loss and prescribing hearing aids because it provided an objective numerical inscription, which could be used to guard against malingering and to negotiate compensation claims for hearing loss. Simultaneously, the ‘telephone as hearing aid’ exploded into the interwar medical market as hearing aid moderation and prescription were complicated by conflicts over categorisation, the status of hearing aids as medical devices and the question of which institutional bodies were responsible for the ‘problem of hearing loss’. Finally, this chapter ends with analysis of the ending of the Post Office’s amplified telephone service and argues that failure to consider user input or the reality of hearing aid usage from the perspective of the ‘deaf subscriber’ led to failure to provide an NHS adjunct for telephony.
Measuring difference, numbering normal provides a detailed study of the technological construction of disability by examining how the audiometer and spirometer were used to create numerical proxies for invisible and inarticulable experiences. Measurements, and their manipulation, have been underestimated as crucial historical forces motivating and guiding the way we think about disability. Using measurement technology as a lens, this book draws together several existing discussions on disability, healthcare, medical practice, embodiment and emerging medical and scientific technologies at the turn of the twentieth century. As such, this work connects several important and usually separate academic subject areas and historical specialisms. The standards embedded in instrumentation created strict but ultimately arbitrary thresholds of normalcy and abnormalcy. Considering these standards from a long historical perspective reveals how these dividing lines shifted when pushed. The central thesis of this book is that health measurements are given artificial authority if they are particularly amenable to calculability and easy measurement. These measurement processes were perpetuated and perfected in the interwar years in Britain as the previously invisible limits of the body were made visible and measurable. Determination to consider body processes as quantifiable was driven by the need to compensate for disability occasioned by warfare or industry. This focus thus draws attention to the biopower associated with systems, which has emerged as a central area of concern for modern healthcare in the second decade of the twenty-first century.
Chapter 2 first discusses the wider philosophical implications of the book’s historical research to argue that the naturalist position on disease and disability is undermined by consideration of how statistical normalcy is technologically constructed. Second, it argues that this presents a problem of ‘mechanical’ epistemic injustice and explores this concept in relation to the ways in which measurement tools have been prioritised as authoritative and trusted ahead of individual testimony about personal experiences of health. Sustained attention is given to the problem of using group averages and reference classes in relation to normalcy and the ways in which ‘correcting’ for attributes like sex, class and race (or not) impacts on the measurement of normalcy. Finally, research from disability studies and the field of hedonic psychology is explored to argue that the measurement of disability is far more complex than a medical model of disability suggests.