The Science of Pleasure: Medicine and Sex Therapy in Mid-twentieth-century Australia

The Science of Pleasure: Medicine and Sex Therapy in Mid-twentieth-century Australia Abstract In the city of Melbourne throughout the 1940s and 1950s, a radical general practitioner provided a nascent form of sexual therapy. It was an unusual treatment programme in a period when counselling of any kind was rare in Australia. Yet Dr Victor Wallace attracted a steady clientele, who were seemingly eager to fix their sexual dysfunctions and establish and maintain a healthy and happy sexuality. His patients, though diverse, were united in their belief that a harmonious sexual life was essential to marriage, the family and the wider social order. Both doctor and patient faced somewhat of a paradox: a broader culture that stressed the importance of an active heterosexuality within marriage, but which had not yet accepted counselling or psychotherapy. So what could be done when sexual pleasure or passion was elusive? This article explores Wallace’s very early form of medical sex therapy, over 20 years before such therapies became commonplace. sex therapy, contraception, birth control, nymphomania, homosexuality, violence, Victor Wallace, heterosexuality, Australia, Melbourne, history of sexuality There has been surprisingly little written on the history of early private sexual therapy in either Australia or in other western nations.1 The treatment of sexual problems has been historicised, if at all, in the asylum, rather than in private practice. This article will begin to provide a genealogy for early sexual counselling in Australia, based on the clinical archives of a radical general practitioner, Dr Victor Wallace. Dr Victor Wallace’s medical records, including patient file cards, are held in his papers at the University of Melbourne archives. Amongst his vast archives focused on general practice and the provision of birth control, there is a small collection of files under the heading ‘Sex Problems’.2 Each case in this file delineates a short sexual history of the patient, defines a ‘problem’ form of sexuality, and then generally outlines a treatment programme developed by Wallace. The Wallace cases have been briefly considered by a small number of other historians, including Joy Damousi and Kerreen Reiger.3 They are, nonetheless, an especially rich and detailed source, and offer singular insights into the intersections of medicine and culture. As such, they are a valuable archive for a more sustained analysis of sex therapy as medical care. This article will trace the micro-history of one medical treatment for sexual dysfunction in one clinic by one doctor. Just as crucially, the case files allow for a broader comment on the multiple ways heterosexuality was constructed and absorbed in both medicine, and by everyday men and women. The case notes reveal the broader classificatory modes of the post-war period: what was rendered ‘normal,’ what was desired, and what was coded as pathological or deviant, particularly within the confines of the heterosexual marriage. They show, very clearly, the ways an ideal sexuality was constructed as penetrative and mutually orgasmic, with the male partner the active agent in the sexual experience. The medical files show, too, that this ideal was not merely constructed by an authority figure, and imposed upon patients. Instead, Wallace’s patients actively expected this ideal of sexuality, and demanded treatment to experience it. Defining and articulating heterosexuality, then, was a negotiation between the medical expert and the patient. Through the doctor’s notes, the historian can read the ways patients manipulated broader information about sex, revealing what they absorbed, what they rearticulated, and what they rejected. This paper therefore considers the spread and interpretation of information and knowledge of sexuality and illustrates this process of negotiation between doctor and patient. It is thus a reading of the broader concepts of medicalised sexuality, politics and identity, and their application in the lives of individuals. The article begins with an introduction to Wallace and an overview of the files, to build a picture of the patients and their doctor. This is contextualised by a brief explanation of the place of medicine, marriage counselling, psychiatry and psychotherapy in Australia in this period, to more fully situate the Wallace archive. The article then moves onto an examination of the broad trends presented in the Wallace files: the ‘problems’ brought to Wallace, the ways these were defined and articulated, and the treatment programmes promised, including drug therapies. This finally progresses to a more detailed study of a number of the cases, teasing out the key concerns of the doctor and patient, and their dual, inter-related receptions of the contemporary socio-sexual definitions, ideals and anxieties. Throughout, all patient names have been changed, to maintain anonymity. Dr Wallace and his Files Dr Victor Wallace (1893–1977) was trained at the University of Melbourne, and was resident at the Melbourne Hospital and the Queen’s Memorial Infectious Diseases Hospital. Starting his medical career, he worked in various hospitals in Britain, including a Fellowship at the Royal College of Surgeons, Edinburgh. He established his general practice in Melbourne in 1928, and also consulted as a gynaecologist in Collins Street, Melbourne.4 In the 1940s and 1950s, Wallace was best known for providing birth control to the women of Melbourne.5 He had established one of Australia’s earliest birth control clinics in the city in 1934. His clinic, opened with two other doctors in Collingwood, was one of the rare places in Australia in this period where working-class women could be fitted for contraceptive devices, including cervical caps.6 He went on to have a thriving private practice supplying contraceptives. Wallace was also prominent in the local eugenics movement and a founding member of the Eugenics Society of Victoria. The two aspects—birth control and eugenics—were tightly linked. Wallace’s provision of contraception was based firmly upon ideals of eugenics and building the quality of the race.7 Beginning with the occasional case in the late 1930s, Wallace built a small but steady clientele to be treated for sexual disorders as part of his general practice. His file on ‘Sexual Problems’ contains medical records from 89 adults and one child, beginning in 1939, and ending in the late 1950s.8 Most patients sought assistance in the immediate post-war period, and into the early 1950s. The case notes appear on small cards, in Wallace’s handwriting, and seem to be designed simply as notes for the busy practitioner, without any longer term goal in mind. There was a tendency to write more on his female patients: their problems were often more complex and contained interwoven social and medical problems that Wallace attempted to delineate. Men, on the other hand, tended to consult Wallace for either impotence or premature ejaculation and, in the majority of cases, Wallace treated them simply with drugs. The case notes vary in length and quality. When he was particularly interested in a patient, Wallace attempted to take down quite extensive notes, and he regularly quoted the patient directly. Nonetheless, most of the case files are fairly brief and sometimes desultory: these are not the long and winding case notes of psychotherapy.9 There are, however, significant problems in reading case notes as historical evidence. If, in the clinic, there was some sense of a ‘conversation’ between patient and client, the historical record allows only glimpses of this. To some extent, the case histories reflect the ways the patient represented themselves to their doctor, and thus the cards show only the snippets of information they could or would tell. There were elements of the patient’s voice, particularly but not only in the direct quotations. Nonetheless, it was the doctor—not the patient—who took the story and made clinical sense of it, recording what he viewed as important, and abandoning the rest. All evidence was mediated through the doctor’s hand. Each and every thought written on the case card was merely a representation of how the doctor viewed the patient, rather than how the patient constructed himself or herself. The cards were thus imbued with the personality, practice and medical training of the doctor, and each file was construed through his own social and clinical understandings. The case histories must be read as evidence, not merely of the patient, but of Wallace himself, and the particular social and medical discourses and paradigms of mid-twentieth-century science. Medicine’s Place Wallace’s status as a sexual counsellor was highly unusual in mid-century Australia. Prior to the Second World War, public discussions about sexuality had been muted, and contained largely within a framework of disease prevention. Sex education was restricted, and in the media, close censorship ensured that discussions about sex and reproduction were in the main implicit rather than explicit. Doctors were one group who were socially sanctioned to talk about sex, but discussions by medical practitioners largely stressed the dangers of venereal disease and the need for abstinence.10 The Second World War, however, opened up discussions about bodies, as the home-front saw an influx of American soldiers. War-time fears over venereal disease, extramarital affairs and divorce led to complex debates over morality and sexuality, in ways not seen before in Australia.11 Doctors, social purity workers, feminists and increasingly the Churches were at the forefront of discussions over sex. The post-war breakdown of marriages—though low by current standards—ensured such discussions continued through the 1950s.12 Within these debates, a healthy, ‘natural’ sexuality was encouraged by sex educators and other experts, but only within the confines of monogamous marriage. Sex was constructed as a central way of maintaining a happy marital life and hence familial stability in a period of rapid social and economic change.13 Nonetheless, it remained difficult to find advice on intimate areas of relationships. Censorship remained a significant problem. Many sought help through the wealth of marriage manuals and sex education texts that proliferated in this period.14 These texts actively promoted a certain form of heterosexuality, and on the occasions when homosexual desires were mentioned, they were condemned as immoral, selfish and dangerous.15 Others turned to magazines, and by the 1940s and 1950s some respectable periodicals had a doctor’s advice column, which would often consider problems of a sexual nature.16 Tensions over censorship shifted slightly during and after the war, as fears over ‘fornication’, venereal disease, marital strife and escalating divorce rates grew. Yet the public interest in sexual matters did not necessarily correspond to a rise in counselling or psychotherapy for individuals. In the main, Australians had not adopted a sustained interest in the interior life. Like the British, they were slower to accept the psychological frameworks of European and American therapy.17 In the early twentieth-century there had been a small number of private physicians and psychiatrists who treated middle-class patients for psychological issues such as ‘nerves’, alcoholism, neurosis and neurasthenia.18 Nonetheless, the turn to psychiatry took on specifically Antipodean forms. In early and mid-century Australia, psychiatrists relied heavily on medication and other bodily regimes, rather than on psychoanalytic models as they did in Europe and later the United States. As Stephen Garton has suggested, Australian psychiatrists emerged out of a medical framework, and the majority continued to practise somatically, including the use of treatments (hypnosis, suggestion) that had been unfashionable in Europe for some time. Psychoanalysis was rarely the first choice and it was, as Garton notes, used as merely one part of an ‘armoury of therapeutic techniques’.19 In the main, at mid-century, Australia did not see a common turn to private therapy, and publicly funded marriage counselling was not established.20 Although doctors were involved in public discussions about sexual problems, sex therapy remained uncommon.21 Wallace’s practice, then, was remarkable, rather than the norm. Nonetheless, the case files remain a crucial source for understanding how sexual problems might be understood in 1940s and 1950s Australia. The Patients In consulting a medical man for sexual counselling, Wallace’s patients were rather unusual, and it cannot be assumed that their problems, issues and desires were entirely representative of the broader sexual lives of Australians in this period.22 Nonetheless, they do hint towards new and developing ideas of marital sexuality. Wallace’s patients were at the cutting edge of a new generation of men and women, many of whom believed sex was important to marriage. From the 1920s, when the English birth controller Marie Stopes argued for female pleasure within a companionate marriage, a range of sex educators suggested that sex and pleasure were integral to married life.23 By the 1940s and 1950s, sex education texts advised that an emotionally and physically satisfying sex life was key to individual happiness and marital success. As the doctor and sex educator Norman Haire told readers of Woman magazine, ‘Sex is certainly the basis of, and the central factor in, marriage.’24 Or conversely, as a fellow sex educator suggested, ‘A negative approach to sex union is the source of much unhappiness.’25 It was thought that a good sex life within marriage would ensure marital content, decrease the divorce rate, and reduce infections from venereal disease.26 Discursively, marriage and sex were therefore constructed as central to the maintenance of the family and hence the wider social order. It is difficult to trace just how fully these ideas infiltrated the public imagination, and it is certain that not all Australians felt an active sex life was essential to marital life. Yet certainly for Wallace and his clients, marital sexuality was important to their sense of self, family and place in society. Thus in seeking sex therapy, Wallace’s patients were exploring new avenues, and thinking about sex and its place in their lives in new, and very modern, ways. Very few of Wallace’s clients had the time, money or inclination for the extended talking cure of psychoanalysis: instead they appear attracted to his faster, cheaper, more immediate combination of listening and medication. His early form of sexual therapy was probably driven by demand. Some clients, for example, were existing patients who sought further, more specific, assistance. Wallace could not publicly advertise his medical services, though he may have attracted clients through a number of lecture series on sexuality that he ran in Melbourne for the Adult Education Council in the early 1950s.27 He probably relied on word of mouth, although a small number of patients were also referred to Wallace through other doctors and psychotherapists across Melbourne. The women and men who consulted Dr Wallace for sex therapy were from all walks of life, all ages and, for the period, even a variety of ethnicities.28 It is difficult to uncover the class dimensions of Wallace’s patients, as the evidence is patchy. Wallace did often record a male occupation, and from this, it seems that all classes were represented in the clientele, though poorer couples may not have been able to afford to consult a private doctor for sexual dysfunction. Amongst his patient cohort, there were slightly more men than women. Given Wallace’s reputation as an advocate of birth control for women, this might seem surprising, yet it mirrors Lesley Hall’s work on male sexual anxieties in interwar England. Men, as well as women, sought sexual advice from Marie Stopes.29 The men who sought out Wallace’s care were mainly concerned with mechanical problems of sex, and they frequently and explicitly articulated that curing their sexual problem would help their marriage. It was a particularly mechanistic explanation for marital trouble, yet it was one that was pushed more broadly in Australian marital education, which stressed the link between sexual satisfaction, emotional well-being and a stable marriage. The ages of Wallace’s patients varied, ranging from one 16-year-old brought in by his parents for excessive masturbation, through to a 78-year-old woman who could not sleep due to her intense sexual desires. Most, however, were aged between 25 and 29 years, with a significant portion in their early twenties. These figures reflect the age of first marriage, a moment which highlighted any sexual confusions or anxieties. The vast majority of the patients were married, and almost all unmarried patients were men, seeking premarital advice. It is clear that women too were sexually active before marriage, but they were constrained from seeking counselling, probably because of the remaining taboo over women’s premarital sexuality. The new war-time and post-war discourses of ‘romance’ (involving flirtation, sexualisation and consumption) still expected such romance to proceed to marriage.30 Even if many (probably the majority) of young women did engage in ‘petting’ or sex before marriage, they did not always imagine complete sexual fulfilment until after the wedding. When this did not occur, however, a modern young woman might seek help.31 Almost all of the patients presented as heterosexual. Homosexuality was illegal in all Australian states, and camp men feared ridicule and humiliation at best, prosecution and incarceration at worst.32 It seems unlikely that many men would have looked to doctors for support. By the late 1940s, in elite medical journals at least, doctors had begun to suggest a programme of homosexual decriminalisation, but they nonetheless continued to view same-sex desire as degenerate and disordered.33 Homosexual men read sexological literature, yet most avoided the medical profession itself, understanding that their desires would be pathologised.34 Further, Wallace’s prominent profile as a eugenicist may have deterred camp men and women from seeking advice or treatment for sexual ‘problems’ that would be labelled dysgenic and a danger to the race. Thus in the case files, there are only two men who did not conform to heterosexual normativity. The first was a homosexual man who was passed on immediately to another practitioner, and no record survives of his consultation. The second was a man who did not identify as camp, but who described his desires in forms that might now be described as homosexual, asexual or perhaps pansexual. He complained of an ‘absence of desire for women’, without revealing a specific desire for men. Wallace was optimistic that he could be treated socially, rather than clinically, and he recommended the man find himself a tolerant fiancée, who would carefully nurse/seduce him back to heterosexual desire. No records survive of how this treatment was received. Defining and Treating Heterosexuality If the men and women who consulted Wallace were seemingly disparate, they were united by a very modern belief that a happy sexuality was integral to life itself. They were also informed by a very particular idea of the forms this sexuality should take. Interwar and post-war sex education texts (which were eagerly consumed by many of Wallace’s patients) set up very strict parameters about the forms of sex that were both desirable and acceptable. Sex was tightly defined, as penetrative and mutually orgasmic.35 This might place very particular pressures on both husband and wife, if they chose to perform their sexual lives in this very specific and regimented fashion. Post-war heterosex rendered a husband responsible for bringing home an income, but also for providing his wife with sexual fulfilment. Managing her sexuality was a key part of his task as a successful husband. Not all husbands took on this role, of course, but for those who did believe in the nexus between sexual fulfilment and marital happiness, the stakes were high. If he failed, he had ‘only himself to blame’, as marriage manuals rather caustically noted.36 Not only would he be unable to have a happy sexual life himself, he would risk his wife’s physical and mental health, and finally the marriage itself.37 For men intent on pleasing their wives, the pressure could be intense and all-consuming, as a number of Wallace’s male patients indicate. In one instance in the patient records, a woman sought treatment because she could not orgasm. Her lack of orgasm made her unhappy and Wallace described her as ‘very nervy’. Further, her husband was ‘upset because she is upset about not achieving the orgasm’. As this case showed, the fear over a lack of orgasm could infect a marriage, both physically and psychologically. While men were constructed as the active agents of the sexual experience, women too were expected to respond to their husband’s advances in certain and specific ways. Ideas of female sexuality were infused with the popularised Freudian concepts of orgasm. The vaginal orgasm was viewed as the desired endpoint of sexual maturity, while the clitoral orgasm was seen as infantile or auto-erotic, even when experienced with a partner.38 Women’s sexuality, then, was potentially problematic in three fundamental ways. First, in the worst of cases, a woman might experience no sexual desire or pleasure at all, or anxiety might lead to physical conditions such as vaginismus (muscular spasms making penetration difficult and painful). In these cases, a woman might submit to sex only as part of her marital obligations.39 Second, a woman might feel some passion or desire, but be unable to reach orgasm. This was considered by the Australian doctor and psychotherapist Reginald Ellery as the more ‘common’ form of frigidity, and was an unexceptional reason for Wallace’s patients to seek treatment.40 Third, a woman might feel intense sexual pleasure and clitoral orgasm, but be unable to experience vaginal orgasm through penetrative sex. Such women, claimed Ellery, found marriage only a ‘clumsy compromise’, and indeed Ellery framed the clitoral orgasm as almost pathological, a form of masturbation that rendered marriage: a lop-sided affair while husband and wife are forced to seek individual gratification by diverse means—the one in a sterile and distasteful cohabitation, the other by resorting to the solitary titillation of a homologue.41 The potential for disastrous female sexuality was clear, whereby the form of her orgasm could render a wife little more than a deviant. The increased psychological and medical surveillance over marital sexuality was directly correlated to the demand for sexual therapy. The men and women who sought help from Wallace were well versed in the normative ideas of sex in this period: many had read sex education texts or marriage manuals, and some had even attended Wallace’s lectures on sex, which extolled the same views on heterosexuality as his sexual therapy. Most clients were not altogether ignorant of the mechanics of sex, as they might have been a generation earlier. Nor were they unaware of the cultural meanings of sexuality, and indeed most patients of Wallace seemed acutely conscious of the contemporary view that a healthy sex life was essential to a solid marriage. Many consulted Wallace for exactly this reason: they were concerned that their sexual life was inadequate in some way, and believed, sometimes quite explicitly, that it would lead to marital collapse. They were remarkably receptive to the dominant ideals of heterosexuality, pleasure and marital duty. For the men and women who consulted Dr Wallace, their failure to achieve penetrative, mutually orgasmic sex was a source of significant anxiety. Men who could not perform penetrative sex for extended periods of time were concerned that they were not able to ‘satisfy’ their wives. Women who could not achieve vaginal orgasm from intercourse (every time) were concerned that they were frigid and not a proper companion to their husband. As one woman cried desperately to Wallace, ‘The whole fault is mine. I’m too frigid.’ Some of the men and women who consulted Wallace suffered severe social and psychological problems, including phobias, crippling anxiety, domestic violence and post-birth gynaecological complications. A small number suffered from war-time traumas or injuries. Yet the majority consulted Wallace simply because of the tensions of achieving the ideal sexual goal of the mutual climax. All other forms of sex were deemed as substandard, even failures, and the slow road to sexual dissatisfaction, personal unhappiness and divorce. Dr Wallace replicated and remade these ideals, and he too shaped sex in particular ways through his discussion and treatments of his patients and their ‘problems’. Given the focus on penetrative sex, patients largely sought out help for one of two perceived flaws. Thirty-four women sought assistance for their failure to achieve orgasm, while twenty-five men consulted Wallace for their impotence. These two sexual problems formed the bulk of his clientele (39 per cent and 28 per cent respectively). In addition, 10 men (11 per cent) sought help for premature ejaculation. A complete aversion to sex was a problem for only one patient, while a further four felt no desire at all. Six (7 per cent) sought advice on behalf of their partners, whom they claimed were experiencing sexual difficulties. Other problems included gynaecological issues (6 per cent); orgasm at the ‘wrong’ time (2 per cent); fear of pregnancy and birth control issues (4 per cent); a diminutive penis (2 per cent); domestic violence (2 per cent); excessive masturbation (3 per cent;) and sterility (2 per cent). Three men sought help for broad sexual anxieties (in women, these cases were probably subsumed under the label ‘lack of orgasm’). One or perhaps two men sought help for their homosexuality. A sole patient consulted Wallace for each of the following problems: nymphomania; vaginismus; sexual failure due to tiredness; marital maladjustment; and problematic night-time erections.42 These were not, therefore, men and women with marginalised sexual practices or identities such as BDSM or fetishism. Instead, they were problems of the mainstream. Most patients sought assistance with maintaining heterosexual, penetrative sex with mutual orgasm: the emphasis from both Wallace and his clients was on developing a satisfying, harmonious marital sex life. In response, Wallace’s therapeutic framework was clinical and medicinal. He did not use, strictly speaking, psychoanalysis or a talking cure (though on odd occasions, he did refer patients for psychoanalysis, or saw patients who had been undergoing Freudian analysis). There were elements of the talking cure in his treatment, as Damousi has suggested.43 He listened, and for some that was significant in itself. He did not, however, allow patients to be guided to their own conclusions. Instead, he gave advice. In sixteen of the case files, he noted having discussed sexual technique, and it may have been that he did so in many other cases too. His advice was often pragmatic: he would promote birth control, tell his patients to read a particular marriage manual, or suggest the use of KY jelly as a lubricant. Not all of the problems were of course immediately sexual but were intertwined with other domestic issues, and he also gave practical advice to cases of familial violence and broader marital conflicts.44 In rare cases, he was more interventionist, such as one case of persistent childhood masturbation, when he performed a circumcision on a young boy. More generally, however, he treated patients by listening, and then by prescribing drugs. Of the 90 patients who sought treatment, 60 were given some form of drug therapy, most regularly syrup neurophosphates. Syrup neurophosphates was a tonic and supposedly a stimulant: it contained vitamins and a small dose of strychnine, which is poisonous in larger doses, but stimulating in smaller amounts. The therapeutic value or impact of syrup neurophosphates is rather doubtful. By the 1930s it was regarded as more of a quack medication than a serious drug therapy, and indeed some doctor’s used it as a placebo.45 Other drugs prescribed by Wallace have a therapeutic value, including bromide (a sedative and anaphrodisiac), phenobarbitol (a barbiturate sedative) and thyroid medications. In thirteen cases, Wallace provided women and particularly men with hormones, generally testosterone, which was often used in conjunction with other drug therapies. The dangers of testosterone, which can have serious side effects for both men and women, were unrecognised. Though patients sought help from Wallace for myriad physical, emotional and social problems, the majority could be divided into two camps: those who felt either too much desire, and those who felt not enough. Given the strict parameters of acceptable heterosexual activities, either was deemed a problem, both quantitively and qualitatively. The rest of this article will explore examples of each. These cases reflect a contemporary construction of a problematic or deviant sexuality, and the doctor and patient’s reactions to this. Thus the case notes should be read as a flawed and problematic reflection of an individual’s pathology or perceived pathology, but also as a signifier of the broader sexual tensions of the age. Case Study: Too Much Desire In May of 1950, Eva, a widow in her late seventies, consulted Dr Wallace. She had one child, and had been through the menopause some 30 years prior to her appointment. Unusually for a female patient, Eva sought treatment because of her unwanted sexual desires. Wallace recorded a version of her narrative: The lustful feeling is almost unbearable at times. I cannot tell anybody about it. I’m sure it is causing my headaches. … It wouldn’t be so bad if I were young but at my age it is awful. This had not been a long-term problem, but it was so disturbing that she had sought almost immediate medical attention. She claimed that her unwanted desires were disrupting her entire existence. Wallace took a short case history of her early life and the more recent problem. He recorded that she had not been ‘troubled’ much with sexual feelings in her youth. But now, he noted she ‘would give anything not to have this feeling’ of need for sexual intercourse. Wallace noted the physicality of her desire, which was ‘worse when she sits down or lies down’. It was interfering with her sleep, too, and she demanded medication to stop her intense feelings. Eva was particularly alarmed by the social implications of her desire—it was noted in her case file that she did not want her daughter told of her problem. Instead, she strove for normativity: ‘I want to be like other women of my age. I want to be calm.’ So too she disclaimed that her case was of any social or medical importance, suggesting rather tartly that this ‘may be interesting to you but not to me’. There is a sense that Wallace himself was more engaged in this case than Eva: she simply wanted a medical solution to what had become an intolerable situation. Wallace prescribed a range of drugs, including phenobarbital and bromide, to control her seemingly excessive sexual thoughts. In the Victorian period, Eva would almost certainly have been diagnosed with nymphomania, a medical and clinical diagnosis of pathological, uncontrolled, excessive female desire.46 But by the mid-century, attitudes towards female sexuality were far more complex. Women were now expected to have sexual feelings and desires, yet these were to be experienced only within certain social conditions: heterosexual, monogamous marriage. In Eva’s case, had she been married her sexual desire would quite possibly be seen as normal or necessary, particularly if she were younger. Her physical desire was, under the right circumstances, not necessarily abnormal, but as a widow, her desires were all too quickly rendered deviant, by both her doctor and the woman herself. Eva was pleased with the results of the clinical treatment. When she returned for a follow-up visit three months later, she noted that she needed the drugs only when she was particularly anxious. As Wallace noted in his case notes, ‘If she gets worried she gets a strong desire for sexual intercourse.’ Nonetheless, Eva deemed the medication a great success. Her own autonomy is notable even when read through the case notes. Her fears about her own sexual desire were not imposed upon Eva: rather she actively sought out medical care when her sexuality did not meet the culturally imposed norms. As such, she was an enthusiastic consumer of both medical advice and a range of drugs. Her own views of normative sexuality matched those of Dr Wallace: the cultural and the clinical coincided, indicating the monolithic and restrictive nature of sexual narratives in this period. Of course, those men and women who experienced their sexuality as ‘different’ but not ‘abnormal’ would not seek out medical treatment. Nonetheless, in Eva, and throughout these case files, there is a certainty, a definitiveness, a lack of ambiguity or questioning, about ideas of normative sexual feeling and practice. Case Study: Not Enough Desire If a number of men and women sought treatment for what they thought of as ‘too much desire’, many more sought assistance because they did not feel enough. In 1948, Edna Collins went to see Dr Wallace. She was 33 years old, and had been married for 10 years to a clerical worker, during which time she had borne four children. She sought help from Wallace, because she had never had an orgasm with her husband. She had a negative attitude towards men: her parents had (unconventionally) separated when she was 15, and she felt all men were ‘the same’. Edna and her husband had sex twice a week, which lasted five to ten minutes, and as Wallace noted, ‘preparation is inadequate’. She was able to orgasm on her own, but never with her husband, even though she was not frightened of pregnancy. Wallace’s case notes show that he simply gave her the tonic ‘syrup neurophosphates’ and sent her on her way. Unusually, Edna followed up with a second appointment in 1949, when she still had not experienced orgasm (the vast majority of patients saw Wallace only the once). Edna was, in Wallace’s words ‘depressed and disappointed’ that her sex life had not improved, and Wallace recommended psychoanalysis. It would, however, be long and expensive, and Edna continued to see Wallace three times while making up her mind. During this period he gave her advice on positions and technique. In the last consultation with Wallace, he finally did a physical examination, and found that while her uterus was ‘normal’ her clitoris was described as ‘minute’. For this, she was given further unnamed drugs. A year later, Edna sent a letter to Dr Wallace. She had not had psychoanalysis, because of the costs and because it did not have a guaranteed success rate, but she decided to work hard on having an orgasm with her husband. She clearly saw this as a central part to a good marriage and being a happy wife. And she did succeed—as she wrote to Wallace, ‘I could hardly believe it had happened—after ten years of marriage and having been trying for at least two of those years.’ Edna’s happiness shows that, for some, sex education, perseverance and a patient partner were central to developing a good sex life—or at least the contemporary definition of such. But for many of the others treated by Wallace, the results were less spectacular. Some were simply given drug treatments, and never returned for a second consultation, so there is no record of the final result. For instance, in early 1950, Evelyn Woods visited the rooms of Dr Wallace. She was unable to reach an orgasm. Wallace took a long case history, noting that she had not had a happy childhood, and had never learned anything about sex before her virginal first marriage. Her first marriage was also unhappy. She had no children, but ten months after marriage she had fallen pregnant, and she had an abortion, which she said she did not regret. Her first husband had a number of affairs, and they were eventually separated and then divorced. In those six years of marriage, she had never reached an orgasm. Evelyn did remarry, and her second husband was sterile: there was no fear of pregnancy in her new relationship. Nonetheless, she still could not reach the orgasm she so clearly wanted. She told Wallace that she did have ‘definite sexual desire’, and her ‘preparation’ was ‘adequate’. There was no pain, or obvious gynaecological problem. Instead she simply went ‘cold during intercourse’, and after two or three minutes of sex, she would push her husband away. Wallace’s case notes hint towards a psychological explanation for Evelyn’s lack of pleasure: perhaps a fear of pregnancy that led to a deep revulsion towards ending intercourse, or perhaps it was the trauma of a lack of sex education and knowledge as a child and adolescent. Nonetheless, the doctor’s case notes concluded this was a case of ‘failure to reach orgasm’ and she was treated medicinally with syrup neurophosphates. There was no second visit. Many of the women in the sample were ‘treated’ for a lack of sexual desires. In 1949, Jane Edwards took herself to Dr Wallace, complaining that ‘she is cold sexually’. She was 25 years old, and married to a salesman. Wallace wrote in the case notes, ‘She was concerned that “never” desires sexual intercourse.’ Her complaint was quite complex. She explained to the doctor that she ‘has to be made to feel that she wants to have intercourse’, which would take a long time. Once aroused, she did orgasm in 80–90 per cent of instances of sexual intercourse. The problem appeared to lie in her husband’s expectations. Her husband, wrote Wallace, complained she had an ‘absence of desire’, and could take up to an hour to orgasm. It was thought to be hereditary, with Wallace noting that Jane complained ‘her mother was cold. Thinks she might have got it from her.’ There may have been some physiological issues at work, for Jane noted that some sexual positions were painful to her, while others were comfortable. There were also fears around contraception: after she had her IUD removed, her husband had begun to use condoms, and this seemed to have escalated the problem. Finally, she was anxious about certain forms of foreplay, and in particular Wallace noted she thought ‘kissing of breasts is “rude”’. Despite a detailed case history, covering both physiological and psychological issues, the doctor’s summation was ‘Absence of sexual desire!’, and Jane was treated simply with syrup neurophosphates. There was no record of a follow-up appointment. Some cases clearly failed in terms of a treatment regime. Keith and Carolyn Birchgrove, for instance, were in their early forties, and they had been married for 18 years. Keith was the foreman in a factory, while Carolyn was a housewife. Despite their outward observance of normative gender and class ideals, the Birchgroves had a secret: what they described as their own inadequate sexual life. As Wallace noted in his case history, the Birchgroves’ problem was dual, made up of the ‘Frigidity of wife’ and the ‘Absence of complete satisfaction in husband.’ The loss of pleasure and desire within the Birchgroves’ marriage was probably unsurprising, given their awkward lack of knowledge of sex, and their manifest problems with contraception. Over the course of their marriage, the Birchgroves had used a range of methods of birth control. They had, like many others in early twentieth-century Australia, relied on coitus interruptus (withdrawal). They had abstained for long periods of time, and had also used karezza, a sexual technique where intercourse took place, often for extended periods, but male ejaculation did not occur.47 They had tried suppositories of quinine powder, douching and a sponge soaked in olive oil. None of these options were at all satisfactory, and some were described by the couple as ‘distasteful’. Fatigued by the rigours of preventing pregnancy, and the arrival of her four children, Carolyn ‘gradually became less and less inclined’ to engage in sex. The couple told Wallace that this sexual disharmony led to quarrels and semi-abstinence, with sex limited to perhaps once a month. When it took place it was largely pleasurable for both, although they continued to experience a range of problems including mild incontinence in Carolyn, and occasional impotence from Keith. Dr Wallace listened carefully to their unsettling narrative, took detailed notes, and the couple were given syrup neurophosphates. Later the same month, Keith returned to Wallace, and brought further ‘evidence’ of the problems the couple were suffering. Keith showed Wallace ‘elaborate notes’ and ‘graphs’ of their sexual life. The case notes suggest that Wallace found this rather peculiar, but he did later correspond with Keith, who repeatedly complained that his wife had been frigid for many years. In early 1943, Wallace was again consulted about the sexual problems of the Birchgroves, although no case notes of this visit survive. Shortly after, Wallace received a long letter from Keith, who complained of impotence, and on occasion, premature ejaculation. His problems were however rather more than physical. Keith felt that he was failing as a husband. After years of cajoling his wife, she had finally become more open to sex, at which point he began to have his own sexual problems. He wrote, ‘I am sure that the continued disappointments have a bad effect on her.’ He felt a strong and persistent anxiety over his sexual performance and its presumed impact on his wife. Carolyn herself seemed less concerned with their sexual life. In late 1945, a jittery Carolyn once again visited Wallace. She was suffering from great anxiety, but it was not related to sex: her son was in a hospital in Europe after a war-time injury, and she was concerned for his survival. She claimed that she was often tired, and now felt ‘disinclined to satisfy her husband’s abnormal and even erratic sexual demands’. At this point, Wallace wrote a letter to Keith, asking for consideration towards his wife, moderation in his demands and mutual harmony’. There is no record of what happened to the Birchgroves and their unhappy, uneasy sexualities. Their case, of an individual marriage marred by a lack of birth control and disagreements over the place of sex within a relationship, is nonetheless illustrative of the wider social, cultural and sexual dilemmas of the age. They were a couple who believed that sexuality was important to married life. After four children, and reaching middle age, Keith but also to a lesser extent Carolyn did not conceptualise sex as merely for reproduction. Instead, they viewed sex as integral to the happiness and success of their marriage. Even as difficulties of birth control rendered Carolyn a reluctant participant, both seemed to speak fairly frankly to Dr Wallace: their sexual life was a problem that they would like to solve. It was not until the additional trauma of war-time that Carolyn withdrew altogether from her husband, and what had become an almost obsessive interest in sex. Conclusions There is a considerable lacuna in historical understandings of medical interventions into early sex therapy, and in particular private medicalised sex therapy. This article has explored a significant treatment regime developed by one doctor in a major Australian city. The patient files in the Wallace Papers allow for a rare and intimate glimpse into the sexual lives of men and women in post-war Australia, who sought treatment for a variety of perceived sexual problems. Victor Wallace drew upon a range of methodologies to treat his patients, including limited elements of the talking cure—listening, discussing, but then advising. As a clinician, he also utilised an arsenal of medicinal options, from stimulants to hormones, and including dubious medications such as syrup neurophosphates, supposedly to right the body to sexual equilibrium. Both patient and doctor had faith—or wanted to have faith—in the clinical cure promised by medication. Yet Wallace attempted to treat both the mind and body. It was not always successful, for his patients often suffered long-term anxieties and deep-seated unconscious problems surrounding sexuality. Nonetheless, most appeared grateful for Wallace’s treatment regime, for at least listening, and attempting to help cure them of their sexual problems. The patient files, and this analysis of them, also illustrate broader trends in thinking about sexuality in this period. If there is a wide historical literature on the ways sexuality was constructed by the dominant discourses, it is far more difficult to uncover how these ideas were received. This paper has traced the reception of wider post-war sexual theories—of pathology, of normativity—and how these were consumed by both Dr Wallace and his patients. Sexual histories of the 1950s have stressed a model of the ‘normal’, where homosexuality was particularly reviled, and heterosexuality was constructed in certain specific forms, with an emphasis on marital, penetrative intercourse, culminating in mutual orgasm. The Wallace medical case files indicate the extent to which this model was absorbed by at least a portion of the general public, and that in fact, the ideal of normative sexuality was a negotiation between the expert and the general public, where the latter could both define and demand sexual normativity. In the patient files, there is quite a clear enunciation of what a ‘normal’ sexual life was expected to look like and how it should be experienced. In line with contemporary sexual theory, Wallace’s ultimate goal was that each client should achieve the ideal married life: a simultaneous orgasm during penetrative heterosex. And it seems that most of the men and women who sought his counsel thought this too: the Wallace case notes provide a fine example of the cultural constructions of sexuality, where certain forms of pleasure were condemned, and others desired. Wallace’s patients, almost without exception, accepted the importance of an active sexual life to self, to marriage and to the broader social order. Sex was rendered key to the post-war reconstruction of the nuclear family. The Wallace papers, then, allow a new view into the intimate spaces of married sexuality and the family, and how these intersected with Australian culture and society. This allows for a reading of sexuality that simultaneously includes the patient and the doctor, the normal and the ‘abnormal’, and the ideals of correct and pathological forms of sexuality, suggesting that the constructions of pleasure impacted on both the clinic and the broader social and sexual culture. 1 There are a number of different types of history that touch on therapy more broadly, especially in histories of insanity and madness. In Australia, the most notable include Stephen Garton’s groundbreaking work, Medicine and Madness: A Social History of Insanity in New South Wales, 1880–1940 (Sydney: UNSW Press, 1988) and Milton Lewis, Managing Madness: Psychiatry and Society in Australia 1788–1980 (Canberra: Australian Government Publishing Service, 1988). Joy Damousi’s important history of Freud in Australia investigates psychotherapy, see Freud in the Antipodes: A Cultural History of Psychoanalysis in Australia (Sydney: UNSW Press, 2005). In addition, there have also been more specific studies on the asylum as a space, including the excellent collection edited by Catherine Coleborne and Dolly Mackinnon, ‘Madness’in Australia: Histories, Heritage and the Asylum (Brisbane: University of Queensland Press, 2003). There has however been very little historical comment, either in Australia or in the international literature, on those not necessarily ‘mad’ or ‘lunatic’, but seeking outpatient or private counselling for problems of a sexual nature. 2 See Wallace Papers, University of Melbourne Archives, Group 17 Patient History Cards, 17/5/2, Sexual Problems, Male and Female, 1938–1954, Random 1/2 box. I would like to thank the Wallace family for permission to use these files. 3 See Damousi, Freud in the Antipodes, 63–5; Kerreen Reiger, Disenchantment of the Home: Modernising the Australian Home, 1880–1940 (Melbourne: Oxford University Press: 1985), 202–5. 4 Grant McBurnie, ‘Wallace, Victor Hugo’, Australian Dictionary of Biography, http://adb.anu.edu.au/biography/wallace-victor-hugo-11943/text21405. 5 On Wallace’s provision of contraception, see Lisa Featherstone, ‘Sexy Mamas? Women, Sexuality and Reproduction in Australia in the 1940s’, Australian Historical Studies, 2005, 37, 234–52. 6 McBurnie, ‘Wallace, Victor Hugo’; Diana Wyndham, ‘Striving for National Fitness: Eugenics in Australia 1910s–1930s’, PhD thesis, University of Sydney, 1996, 109; Featherstone, ‘Sexy Mamas’, 234–52. 7 See Victor H. Wallace, Women and Children First: An Outline of a Population Policy for Australia (Melbourne: Oxford University Press, 1946). On the intersections between race and eugenics in Australia, see Jane Carey, ‘The Racial Imperatives of Sex: Birth Control and Eugenics in Britain, the United States and Australia in the Interwar Years,’ Women’s History Review, 2012, 21, 733–52. 8 At the back of the file, there are also numerous cases of vasectomy, which are filed under ‘sexual problems’, rather than with the other contraceptive cases. These cases of vasectomy (which are generally very brief case notes) have been excluded from this study, as they do not reflect sex therapy. 9 On psychotherapy, see Joy Damousi, ‘Viola Bernard and the Analysis of “Alice Conrad”: A Case Study in the History of Intimacy’, Journal of the History of Sexuality, 2013, 22, 474–500. 10 See Lisa Featherstone, Let’s Talk About Sex: Histories of Sexuality in Australia from Federation to the Pill (Cambridge: Cambridge Scholars Press, 2011), ch. 6. There is a wide international literature on sex education in the period before the Second World War, and much of this provides useful context for the Australian situation. In Australia, see Ann Curthoys, ‘The Case of Marion Piddington’, Hecate, 1989, 15, 73–89; Lisa Featherstone, ‘Sex Educating the Modern Girl: The Formation of New Knowledge in Interwar Australia’, Journal of Australian Studies, 2010, 34, 459–69; Ellen Warne, ‘Sex Education Debates and the Modest Mother in Australia, 1890s to the 1930s’, Women’s History Review, 1999, 8, 311–27; Ellen Warne, ‘“Tell Them!” Anglican Mothers and Sex Education 1890–1930’, in People of the Past? The Culture of Melbourne Anglicanism and Anglicanism in Melbourne’s Culture (Melbourne: University of Melbourne, 2000), 12–27. 11 On the discussions around female sexuality during the Second World War, see amongst others, Kay Saunders, War on the Homefront: State Intervention in Queensland1938–1948 (Brisbane: University of QLD Press, 1993), 27; Michael Sturma, ‘Public Health and Sexual Morality: Venereal Disease in World War II Australia’, Signs, 1988, 13, 725–40; Kay Saunders and Helen Taylor, “‘To Combat the Plague”: The Construction of Moral Alarm and State Intervention in Queensland During World War II’, Hecate, 1988, 14, 5–30; Marilyn Lake, ‘Female Desires: The Meaning of World War II’, Australian Historical Studies, 1990, 24, 267–84. 12 Lisa Featherstone, ‘“The one single primary cause”: Divorce, the Family and Heterosexual Pleasure in Postwar Australia’, Journal of Australian Studies, 2013, 37, 349–63. 13 On the centrality of the family to the social order, see for instance Australian National Secretariat of Catholic Action, The Family: Social Justice Statement (no publication details, 1944), 1. 14 On censorship, see Alison Bashford and Carolyn Strange, ‘Public Pedagogy: Sex Education and Mass Communication in the Mid-Twentieth Century’, Journal of the History of Sexuality, 2004, 13; Parliament of the Commonwealth of Australia, Ninth Report of the Parliament Standing Committee on Broadcasting, Relating to the Question of Broadcast Talks on Venereal Disease and Other Sexual Matters (Canberra, 1942), 2–15. 15 See for instance Mary Winefride, Youth Looks Ahead (Brisbane: Polding Press, nd), 42–3; Father and Son Welfare Movement of Australia, Guide to Virile Manhood (Sydney: Father and Son Welfare Movement, 1957), 25; Father and Son Welfare Movement of Australia, Children No Longer (Sydney: Father and Son Welfare Movement, 1957), 35; Father and Son Welfare Movement of Australia, Just Friends (Sydney: Father and Son Welfare Movement, nd), 20. 16 In Australia the most notable example is Norman Haire, who wrote a column for Woman magazine from 1941 to 1952. He often dealt with sexual difficulties for both the married and unmarried. See Diana Wyndham, Norman Haire and the Study of Sex (Sydney: Sydney University Press, 2012); Bashford and Strange, ‘Public Pedagogy’, 71–99. There is an extensive collection of these columns held in the Haire Collections, Rare Book Collection, University of Sydney Library. 17 Indeed, Ann Westmore has argued that, in their avoidance of the psychological model, the Melbourne Medical School was ‘more British’ than many of the British institutions. See Ann Westmore, ‘Reading Psychiatry’s Archive’, in Coleborne and Mackinnon, eds, ‘Madness’ in Australia, 209; Lewis, Managing Madness, 49. 18 Stephen Garton, ‘Freud and the Psychiatrists: The Australian Debate 1900 to 1940’, in Brian Head and James Walter, eds, Intellectual Movements and Australian Society (Melbourne: Oxford University Press), 174–6; Martin Stone, ‘Shellshock and the Psychologists’, in W. F. Bynum, Roy Porter and Michael Shepherd, eds, The Anatomy of Madness: Essays in the History of Psychiatry, vol. II (London: Tavistock Publications, 1985), 242–71; Garton, Medicine and Madness, 82–3. 19 Garton, ‘Freud and the Psychiatrists’, 178–83; Lewis, Managing Madness, 43–4, 50–1. 20 Publicly funded marital counselling was instigated in Australia in the 1960s, in what was seen as a quite radical move. By the mid 1970s, Government Health insurance would subsidise counselling, including sexual counselling, to 85% of the cost. N. R. Rose, ‘Sex Therapy in Australia’, The Journal of Sex Research, 1976, 12, 332; Melanie Oppenheimer, ‘Voluntary Action and Welfare in Post-1945 Australia: Preliminary Perspectives’, History Australia, 2005, 2, np. 21 In Melbourne, there were a small number of other doctors treating sexual problems, often with psychoanalysis, including Paul Dane and Reg Ellery. In Sydney, Roy Winn was the first privately practising analyst. 22 Reiger, Disenchantment of the Home, 205. On sexuality in the 1950s, see Frank Bongiorno, Sex Lives of Australians (Melbourne: Black Inc, 2012) and Featherstone, Let’s Talk. 23 For Stopes’ impact in Australia, see Featherstone, Let’s Talk About Sex, ch. 6. 24 Dr Wykeham Terriss, ‘Salvaging Marriages’, Woman, 27 March 1944, 9. See also M. A. Horn, The Digest of Hygiene: For ‘Father and Son’ (Sydney: Hallmark Productions, 1948, 28–31; Father and Son Movement, Just Friends, 41; Hugh McLelland and J. W. C. Wand, Our Sexual Nature (Melbourne: Oxford University Press, 1944), 58–9. 25 Edward F Griffiths, Modern Marriage and Birth Control (Sydney: Dymocks Book Arcade, 1948), 112. 26 Reg Ellery, Typed MS, ‘Divorce. A Psycho-Sexual Problem’ (nd), 4 , in Reg S. Ellery Papers MS 7979 1910–1950 (SL VIC) Box 522/4 Sex and Its Related Problems; Dr Wykeham Terriss, ‘Promiscuity Always a Danger’, Woman, 8 March 1943, 8. 27 For the lectures, see Wallace Papers Group 4 Lectures, ‘Sex, Marriage and Family—First Series’ 4/2. 28 Until the post-war period, Australia had been a nation with an almost completely British heritage, and White Australia was a key part of the nation’s identity. There were few non-white migrants, and a small and highly marginalised indigenous population. After the Seccond World War, Australia had seen a large influx of refugees from Europe. 29 See Lesley Hall, Hidden Anxieties: Male Sexuality 1900–1950 (Cambridge: Polity Press, 1991). 30 On romance in this period, see Marilyn Lake, ‘Female Desires: The Meaning of World War II’, Australian Historical Studies, 1990, 24, 267–84; Marilyn Lake, ‘The Desire for a Yank: Sexual Relations between Australian Women and American Servicemen during World War II’, Journal of the History of Sexuality, 1992, 2, 621–33; Lyn Finch, ‘Consuming Passions: Romance and Consumerism During World War II’, in Joy Damousi and Marilyn Lake, eds, Gender and War: Australians at War in the Twentieth Century (Melbourne: Cambridge University, 1995), 105–16; Hsu-Ming Teo, ‘The Americanisation of Romantic Love in Australia’, in Ann Curthoys and Marilyn Lake, ed., Connected Worlds: History in Transnational Perspective (Canberra: ANU E-Press, 2006), 171–92. 31 Contemporary sources suggested that premarital petting and sex was common. See W. G. Coughlan, ‘Marriage Breakdown’, in A. P. Elkin, ed., Marriage and the Family (Sydney: Angus and Robertson, 1957), 133; Edward Griffith, Modern Marriage and Birth Control (Sydney: Dymocks, 1948), 51; H. M. North, ‘Sexual Problems of Childhood and Adolescence’, Medical Journal of Australia (MJA), 14 September 1946, 378. 32 Graham Willett, ‘The Darkest Decade: Homophobia in 1950s Australia’, Australian Historical Studies, 1997, 109, 120–32; Garry Wotherspoon, ‘“The Greatest Menace Facing Australia”: Homosexuality and the State in New South Wales During the Cold War’, Labour History, 1989, 56, 15–28. 33 See for example, Editorial, ‘Homosexuality’, MJA, 7 February 1948, 175; ‘Sexual Psychopathy’, MJA, 9 September 1950, 420; Crimes Amendment Bill Second Reading, NSWParliamentary Debates, 1955, 3289, 3291. 34 Men with sexual desires they knew would be considered deviant might avoid the medical model. See for example, Lisa Featherstone, ‘“Fitful Rambles of an Unruly Pencil”: George Southern’s Challenge to Sexual Normativity in 1920s Australia’, Journal of the History of Sexuality, 2010, 19, 389–408. 35 See, for instance, sex education manuals including Horn, Digest of Hygiene, 29; Griffith, Modern Marriage, 21. 36 Griffith, Modern Marriage, 174. 37 Ibid., 626. 38 R. .S Ellery, ‘Frigidity and Dyspareunia’, MJA, 16 October 1954, 627; A. T. Edwards, ‘Psychological Implications of Dysmenorrhoea and the Menopause’, MJA, 11 February 1950, 179. 39 Ellery, ‘Frigidity’, 627. 40 Ellery, ‘Divorce’, 6. 41 Ibid., 6–7. 42 These figures do not add up to 100%, as many patients sought help for more than one sexual problem, for instance a man might seek assistance for his impotence, but would also discuss problems with his wife’s sexuality or their shared need for birth control. 43 Damousi, Freud in the Antipodes, 64–5. 44 In ten of the cases, no treatment was recorded, and in one case further treatment was denied, as the problem was seen to be untreatable. 45 Neurophosphates were generally viewed as a proprietary tonic, containing calcium, phosphorus and strychnine, in the form of glycerol-phosphates. It is generally believed that while strychnine might be useful as aphrodisiac the dose in the syrup was too low to be therapeutically effective, and it was listed as a non-accepted preparation by the American Medical Association by the mid-1930s. Many doctors apparently thought of it as a ‘proprietary nostrum’ or a placebo. See ‘List of Non-accepted Preparations’, Journal of the AMA, 18 July 1936, 229; ‘Esky’s Neurophosphates’, Journal of the AMA, 29 September 1917, 1102; ‘Post Influenza Cases’, Journal of the National Medical Association (USA), 1929, 21, 63; Howard Spiro, ‘Clinical Reflections on the Placebo Phenomenon’, in Anne Harrington, ed., The Placebo Effect: An Interdisciplinary Exploration (Harvard: Harvard University Press, 1999), 39; Jeremy A. Greene and David Herzberg, ‘Hidden in Plain Sight: Marketing Prescription Drugs to Consumers in the Twentieth Century’, American Journal of Public Health, 2010, 100, 793–803. 46 See Carol Groneman, Nymphomania: A History (New York: W. W. Norton & Company, 2000); Clair Scrine, ‘Conceptions of Nymphomania in British Medicine 1790–1900’, PhD thesis, Macquarie University, 2003. 47 See Alice Stockham, Karezza: The Ethics of Marriage (New York: RF Fenno and Co, 1896). Hera Cook suggests that in England, karezza was used into the 1940s and 1950s, but it seems less common in Australia, despite Dr Rosamund Benham’s advocations. See Alison Mackinnon and Carol Bacchi, ‘Sex, Resistance and Power: Sex Reform in South Australia, c 1905’, Australian Historical Studies, 1988, 23, 60–71; Frank Bongiorno, ‘“Every Woman a Mother”: Radical Intellectuals, Sex Reform and the “Woman Question” in Australia, 1890–1918’, Hecate, 2001, 27, 48–51; Hera Cook, The Long Sexual Revolution: English Women, Sex, and Contraception, 1800–1975 (Oxford: Oxford University Press, 2004), 128. Acknowledgements I would like to thank the Wallace family for permission to use the Wallace papers. © The Author 2017. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Social History of Medicine Oxford University Press

The Science of Pleasure: Medicine and Sex Therapy in Mid-twentieth-century Australia

Loading next page...
 
/lp/ou_press/the-science-of-pleasure-medicine-and-sex-therapy-in-mid-twentieth-z0MuPgoYkz
Publisher
Oxford University Press
Copyright
© The Author 2017. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
ISSN
0951-631X
eISSN
1477-4666
D.O.I.
10.1093/shm/hkx005
Publisher site
See Article on Publisher Site

Abstract

Abstract In the city of Melbourne throughout the 1940s and 1950s, a radical general practitioner provided a nascent form of sexual therapy. It was an unusual treatment programme in a period when counselling of any kind was rare in Australia. Yet Dr Victor Wallace attracted a steady clientele, who were seemingly eager to fix their sexual dysfunctions and establish and maintain a healthy and happy sexuality. His patients, though diverse, were united in their belief that a harmonious sexual life was essential to marriage, the family and the wider social order. Both doctor and patient faced somewhat of a paradox: a broader culture that stressed the importance of an active heterosexuality within marriage, but which had not yet accepted counselling or psychotherapy. So what could be done when sexual pleasure or passion was elusive? This article explores Wallace’s very early form of medical sex therapy, over 20 years before such therapies became commonplace. sex therapy, contraception, birth control, nymphomania, homosexuality, violence, Victor Wallace, heterosexuality, Australia, Melbourne, history of sexuality There has been surprisingly little written on the history of early private sexual therapy in either Australia or in other western nations.1 The treatment of sexual problems has been historicised, if at all, in the asylum, rather than in private practice. This article will begin to provide a genealogy for early sexual counselling in Australia, based on the clinical archives of a radical general practitioner, Dr Victor Wallace. Dr Victor Wallace’s medical records, including patient file cards, are held in his papers at the University of Melbourne archives. Amongst his vast archives focused on general practice and the provision of birth control, there is a small collection of files under the heading ‘Sex Problems’.2 Each case in this file delineates a short sexual history of the patient, defines a ‘problem’ form of sexuality, and then generally outlines a treatment programme developed by Wallace. The Wallace cases have been briefly considered by a small number of other historians, including Joy Damousi and Kerreen Reiger.3 They are, nonetheless, an especially rich and detailed source, and offer singular insights into the intersections of medicine and culture. As such, they are a valuable archive for a more sustained analysis of sex therapy as medical care. This article will trace the micro-history of one medical treatment for sexual dysfunction in one clinic by one doctor. Just as crucially, the case files allow for a broader comment on the multiple ways heterosexuality was constructed and absorbed in both medicine, and by everyday men and women. The case notes reveal the broader classificatory modes of the post-war period: what was rendered ‘normal,’ what was desired, and what was coded as pathological or deviant, particularly within the confines of the heterosexual marriage. They show, very clearly, the ways an ideal sexuality was constructed as penetrative and mutually orgasmic, with the male partner the active agent in the sexual experience. The medical files show, too, that this ideal was not merely constructed by an authority figure, and imposed upon patients. Instead, Wallace’s patients actively expected this ideal of sexuality, and demanded treatment to experience it. Defining and articulating heterosexuality, then, was a negotiation between the medical expert and the patient. Through the doctor’s notes, the historian can read the ways patients manipulated broader information about sex, revealing what they absorbed, what they rearticulated, and what they rejected. This paper therefore considers the spread and interpretation of information and knowledge of sexuality and illustrates this process of negotiation between doctor and patient. It is thus a reading of the broader concepts of medicalised sexuality, politics and identity, and their application in the lives of individuals. The article begins with an introduction to Wallace and an overview of the files, to build a picture of the patients and their doctor. This is contextualised by a brief explanation of the place of medicine, marriage counselling, psychiatry and psychotherapy in Australia in this period, to more fully situate the Wallace archive. The article then moves onto an examination of the broad trends presented in the Wallace files: the ‘problems’ brought to Wallace, the ways these were defined and articulated, and the treatment programmes promised, including drug therapies. This finally progresses to a more detailed study of a number of the cases, teasing out the key concerns of the doctor and patient, and their dual, inter-related receptions of the contemporary socio-sexual definitions, ideals and anxieties. Throughout, all patient names have been changed, to maintain anonymity. Dr Wallace and his Files Dr Victor Wallace (1893–1977) was trained at the University of Melbourne, and was resident at the Melbourne Hospital and the Queen’s Memorial Infectious Diseases Hospital. Starting his medical career, he worked in various hospitals in Britain, including a Fellowship at the Royal College of Surgeons, Edinburgh. He established his general practice in Melbourne in 1928, and also consulted as a gynaecologist in Collins Street, Melbourne.4 In the 1940s and 1950s, Wallace was best known for providing birth control to the women of Melbourne.5 He had established one of Australia’s earliest birth control clinics in the city in 1934. His clinic, opened with two other doctors in Collingwood, was one of the rare places in Australia in this period where working-class women could be fitted for contraceptive devices, including cervical caps.6 He went on to have a thriving private practice supplying contraceptives. Wallace was also prominent in the local eugenics movement and a founding member of the Eugenics Society of Victoria. The two aspects—birth control and eugenics—were tightly linked. Wallace’s provision of contraception was based firmly upon ideals of eugenics and building the quality of the race.7 Beginning with the occasional case in the late 1930s, Wallace built a small but steady clientele to be treated for sexual disorders as part of his general practice. His file on ‘Sexual Problems’ contains medical records from 89 adults and one child, beginning in 1939, and ending in the late 1950s.8 Most patients sought assistance in the immediate post-war period, and into the early 1950s. The case notes appear on small cards, in Wallace’s handwriting, and seem to be designed simply as notes for the busy practitioner, without any longer term goal in mind. There was a tendency to write more on his female patients: their problems were often more complex and contained interwoven social and medical problems that Wallace attempted to delineate. Men, on the other hand, tended to consult Wallace for either impotence or premature ejaculation and, in the majority of cases, Wallace treated them simply with drugs. The case notes vary in length and quality. When he was particularly interested in a patient, Wallace attempted to take down quite extensive notes, and he regularly quoted the patient directly. Nonetheless, most of the case files are fairly brief and sometimes desultory: these are not the long and winding case notes of psychotherapy.9 There are, however, significant problems in reading case notes as historical evidence. If, in the clinic, there was some sense of a ‘conversation’ between patient and client, the historical record allows only glimpses of this. To some extent, the case histories reflect the ways the patient represented themselves to their doctor, and thus the cards show only the snippets of information they could or would tell. There were elements of the patient’s voice, particularly but not only in the direct quotations. Nonetheless, it was the doctor—not the patient—who took the story and made clinical sense of it, recording what he viewed as important, and abandoning the rest. All evidence was mediated through the doctor’s hand. Each and every thought written on the case card was merely a representation of how the doctor viewed the patient, rather than how the patient constructed himself or herself. The cards were thus imbued with the personality, practice and medical training of the doctor, and each file was construed through his own social and clinical understandings. The case histories must be read as evidence, not merely of the patient, but of Wallace himself, and the particular social and medical discourses and paradigms of mid-twentieth-century science. Medicine’s Place Wallace’s status as a sexual counsellor was highly unusual in mid-century Australia. Prior to the Second World War, public discussions about sexuality had been muted, and contained largely within a framework of disease prevention. Sex education was restricted, and in the media, close censorship ensured that discussions about sex and reproduction were in the main implicit rather than explicit. Doctors were one group who were socially sanctioned to talk about sex, but discussions by medical practitioners largely stressed the dangers of venereal disease and the need for abstinence.10 The Second World War, however, opened up discussions about bodies, as the home-front saw an influx of American soldiers. War-time fears over venereal disease, extramarital affairs and divorce led to complex debates over morality and sexuality, in ways not seen before in Australia.11 Doctors, social purity workers, feminists and increasingly the Churches were at the forefront of discussions over sex. The post-war breakdown of marriages—though low by current standards—ensured such discussions continued through the 1950s.12 Within these debates, a healthy, ‘natural’ sexuality was encouraged by sex educators and other experts, but only within the confines of monogamous marriage. Sex was constructed as a central way of maintaining a happy marital life and hence familial stability in a period of rapid social and economic change.13 Nonetheless, it remained difficult to find advice on intimate areas of relationships. Censorship remained a significant problem. Many sought help through the wealth of marriage manuals and sex education texts that proliferated in this period.14 These texts actively promoted a certain form of heterosexuality, and on the occasions when homosexual desires were mentioned, they were condemned as immoral, selfish and dangerous.15 Others turned to magazines, and by the 1940s and 1950s some respectable periodicals had a doctor’s advice column, which would often consider problems of a sexual nature.16 Tensions over censorship shifted slightly during and after the war, as fears over ‘fornication’, venereal disease, marital strife and escalating divorce rates grew. Yet the public interest in sexual matters did not necessarily correspond to a rise in counselling or psychotherapy for individuals. In the main, Australians had not adopted a sustained interest in the interior life. Like the British, they were slower to accept the psychological frameworks of European and American therapy.17 In the early twentieth-century there had been a small number of private physicians and psychiatrists who treated middle-class patients for psychological issues such as ‘nerves’, alcoholism, neurosis and neurasthenia.18 Nonetheless, the turn to psychiatry took on specifically Antipodean forms. In early and mid-century Australia, psychiatrists relied heavily on medication and other bodily regimes, rather than on psychoanalytic models as they did in Europe and later the United States. As Stephen Garton has suggested, Australian psychiatrists emerged out of a medical framework, and the majority continued to practise somatically, including the use of treatments (hypnosis, suggestion) that had been unfashionable in Europe for some time. Psychoanalysis was rarely the first choice and it was, as Garton notes, used as merely one part of an ‘armoury of therapeutic techniques’.19 In the main, at mid-century, Australia did not see a common turn to private therapy, and publicly funded marriage counselling was not established.20 Although doctors were involved in public discussions about sexual problems, sex therapy remained uncommon.21 Wallace’s practice, then, was remarkable, rather than the norm. Nonetheless, the case files remain a crucial source for understanding how sexual problems might be understood in 1940s and 1950s Australia. The Patients In consulting a medical man for sexual counselling, Wallace’s patients were rather unusual, and it cannot be assumed that their problems, issues and desires were entirely representative of the broader sexual lives of Australians in this period.22 Nonetheless, they do hint towards new and developing ideas of marital sexuality. Wallace’s patients were at the cutting edge of a new generation of men and women, many of whom believed sex was important to marriage. From the 1920s, when the English birth controller Marie Stopes argued for female pleasure within a companionate marriage, a range of sex educators suggested that sex and pleasure were integral to married life.23 By the 1940s and 1950s, sex education texts advised that an emotionally and physically satisfying sex life was key to individual happiness and marital success. As the doctor and sex educator Norman Haire told readers of Woman magazine, ‘Sex is certainly the basis of, and the central factor in, marriage.’24 Or conversely, as a fellow sex educator suggested, ‘A negative approach to sex union is the source of much unhappiness.’25 It was thought that a good sex life within marriage would ensure marital content, decrease the divorce rate, and reduce infections from venereal disease.26 Discursively, marriage and sex were therefore constructed as central to the maintenance of the family and hence the wider social order. It is difficult to trace just how fully these ideas infiltrated the public imagination, and it is certain that not all Australians felt an active sex life was essential to marital life. Yet certainly for Wallace and his clients, marital sexuality was important to their sense of self, family and place in society. Thus in seeking sex therapy, Wallace’s patients were exploring new avenues, and thinking about sex and its place in their lives in new, and very modern, ways. Very few of Wallace’s clients had the time, money or inclination for the extended talking cure of psychoanalysis: instead they appear attracted to his faster, cheaper, more immediate combination of listening and medication. His early form of sexual therapy was probably driven by demand. Some clients, for example, were existing patients who sought further, more specific, assistance. Wallace could not publicly advertise his medical services, though he may have attracted clients through a number of lecture series on sexuality that he ran in Melbourne for the Adult Education Council in the early 1950s.27 He probably relied on word of mouth, although a small number of patients were also referred to Wallace through other doctors and psychotherapists across Melbourne. The women and men who consulted Dr Wallace for sex therapy were from all walks of life, all ages and, for the period, even a variety of ethnicities.28 It is difficult to uncover the class dimensions of Wallace’s patients, as the evidence is patchy. Wallace did often record a male occupation, and from this, it seems that all classes were represented in the clientele, though poorer couples may not have been able to afford to consult a private doctor for sexual dysfunction. Amongst his patient cohort, there were slightly more men than women. Given Wallace’s reputation as an advocate of birth control for women, this might seem surprising, yet it mirrors Lesley Hall’s work on male sexual anxieties in interwar England. Men, as well as women, sought sexual advice from Marie Stopes.29 The men who sought out Wallace’s care were mainly concerned with mechanical problems of sex, and they frequently and explicitly articulated that curing their sexual problem would help their marriage. It was a particularly mechanistic explanation for marital trouble, yet it was one that was pushed more broadly in Australian marital education, which stressed the link between sexual satisfaction, emotional well-being and a stable marriage. The ages of Wallace’s patients varied, ranging from one 16-year-old brought in by his parents for excessive masturbation, through to a 78-year-old woman who could not sleep due to her intense sexual desires. Most, however, were aged between 25 and 29 years, with a significant portion in their early twenties. These figures reflect the age of first marriage, a moment which highlighted any sexual confusions or anxieties. The vast majority of the patients were married, and almost all unmarried patients were men, seeking premarital advice. It is clear that women too were sexually active before marriage, but they were constrained from seeking counselling, probably because of the remaining taboo over women’s premarital sexuality. The new war-time and post-war discourses of ‘romance’ (involving flirtation, sexualisation and consumption) still expected such romance to proceed to marriage.30 Even if many (probably the majority) of young women did engage in ‘petting’ or sex before marriage, they did not always imagine complete sexual fulfilment until after the wedding. When this did not occur, however, a modern young woman might seek help.31 Almost all of the patients presented as heterosexual. Homosexuality was illegal in all Australian states, and camp men feared ridicule and humiliation at best, prosecution and incarceration at worst.32 It seems unlikely that many men would have looked to doctors for support. By the late 1940s, in elite medical journals at least, doctors had begun to suggest a programme of homosexual decriminalisation, but they nonetheless continued to view same-sex desire as degenerate and disordered.33 Homosexual men read sexological literature, yet most avoided the medical profession itself, understanding that their desires would be pathologised.34 Further, Wallace’s prominent profile as a eugenicist may have deterred camp men and women from seeking advice or treatment for sexual ‘problems’ that would be labelled dysgenic and a danger to the race. Thus in the case files, there are only two men who did not conform to heterosexual normativity. The first was a homosexual man who was passed on immediately to another practitioner, and no record survives of his consultation. The second was a man who did not identify as camp, but who described his desires in forms that might now be described as homosexual, asexual or perhaps pansexual. He complained of an ‘absence of desire for women’, without revealing a specific desire for men. Wallace was optimistic that he could be treated socially, rather than clinically, and he recommended the man find himself a tolerant fiancée, who would carefully nurse/seduce him back to heterosexual desire. No records survive of how this treatment was received. Defining and Treating Heterosexuality If the men and women who consulted Wallace were seemingly disparate, they were united by a very modern belief that a happy sexuality was integral to life itself. They were also informed by a very particular idea of the forms this sexuality should take. Interwar and post-war sex education texts (which were eagerly consumed by many of Wallace’s patients) set up very strict parameters about the forms of sex that were both desirable and acceptable. Sex was tightly defined, as penetrative and mutually orgasmic.35 This might place very particular pressures on both husband and wife, if they chose to perform their sexual lives in this very specific and regimented fashion. Post-war heterosex rendered a husband responsible for bringing home an income, but also for providing his wife with sexual fulfilment. Managing her sexuality was a key part of his task as a successful husband. Not all husbands took on this role, of course, but for those who did believe in the nexus between sexual fulfilment and marital happiness, the stakes were high. If he failed, he had ‘only himself to blame’, as marriage manuals rather caustically noted.36 Not only would he be unable to have a happy sexual life himself, he would risk his wife’s physical and mental health, and finally the marriage itself.37 For men intent on pleasing their wives, the pressure could be intense and all-consuming, as a number of Wallace’s male patients indicate. In one instance in the patient records, a woman sought treatment because she could not orgasm. Her lack of orgasm made her unhappy and Wallace described her as ‘very nervy’. Further, her husband was ‘upset because she is upset about not achieving the orgasm’. As this case showed, the fear over a lack of orgasm could infect a marriage, both physically and psychologically. While men were constructed as the active agents of the sexual experience, women too were expected to respond to their husband’s advances in certain and specific ways. Ideas of female sexuality were infused with the popularised Freudian concepts of orgasm. The vaginal orgasm was viewed as the desired endpoint of sexual maturity, while the clitoral orgasm was seen as infantile or auto-erotic, even when experienced with a partner.38 Women’s sexuality, then, was potentially problematic in three fundamental ways. First, in the worst of cases, a woman might experience no sexual desire or pleasure at all, or anxiety might lead to physical conditions such as vaginismus (muscular spasms making penetration difficult and painful). In these cases, a woman might submit to sex only as part of her marital obligations.39 Second, a woman might feel some passion or desire, but be unable to reach orgasm. This was considered by the Australian doctor and psychotherapist Reginald Ellery as the more ‘common’ form of frigidity, and was an unexceptional reason for Wallace’s patients to seek treatment.40 Third, a woman might feel intense sexual pleasure and clitoral orgasm, but be unable to experience vaginal orgasm through penetrative sex. Such women, claimed Ellery, found marriage only a ‘clumsy compromise’, and indeed Ellery framed the clitoral orgasm as almost pathological, a form of masturbation that rendered marriage: a lop-sided affair while husband and wife are forced to seek individual gratification by diverse means—the one in a sterile and distasteful cohabitation, the other by resorting to the solitary titillation of a homologue.41 The potential for disastrous female sexuality was clear, whereby the form of her orgasm could render a wife little more than a deviant. The increased psychological and medical surveillance over marital sexuality was directly correlated to the demand for sexual therapy. The men and women who sought help from Wallace were well versed in the normative ideas of sex in this period: many had read sex education texts or marriage manuals, and some had even attended Wallace’s lectures on sex, which extolled the same views on heterosexuality as his sexual therapy. Most clients were not altogether ignorant of the mechanics of sex, as they might have been a generation earlier. Nor were they unaware of the cultural meanings of sexuality, and indeed most patients of Wallace seemed acutely conscious of the contemporary view that a healthy sex life was essential to a solid marriage. Many consulted Wallace for exactly this reason: they were concerned that their sexual life was inadequate in some way, and believed, sometimes quite explicitly, that it would lead to marital collapse. They were remarkably receptive to the dominant ideals of heterosexuality, pleasure and marital duty. For the men and women who consulted Dr Wallace, their failure to achieve penetrative, mutually orgasmic sex was a source of significant anxiety. Men who could not perform penetrative sex for extended periods of time were concerned that they were not able to ‘satisfy’ their wives. Women who could not achieve vaginal orgasm from intercourse (every time) were concerned that they were frigid and not a proper companion to their husband. As one woman cried desperately to Wallace, ‘The whole fault is mine. I’m too frigid.’ Some of the men and women who consulted Wallace suffered severe social and psychological problems, including phobias, crippling anxiety, domestic violence and post-birth gynaecological complications. A small number suffered from war-time traumas or injuries. Yet the majority consulted Wallace simply because of the tensions of achieving the ideal sexual goal of the mutual climax. All other forms of sex were deemed as substandard, even failures, and the slow road to sexual dissatisfaction, personal unhappiness and divorce. Dr Wallace replicated and remade these ideals, and he too shaped sex in particular ways through his discussion and treatments of his patients and their ‘problems’. Given the focus on penetrative sex, patients largely sought out help for one of two perceived flaws. Thirty-four women sought assistance for their failure to achieve orgasm, while twenty-five men consulted Wallace for their impotence. These two sexual problems formed the bulk of his clientele (39 per cent and 28 per cent respectively). In addition, 10 men (11 per cent) sought help for premature ejaculation. A complete aversion to sex was a problem for only one patient, while a further four felt no desire at all. Six (7 per cent) sought advice on behalf of their partners, whom they claimed were experiencing sexual difficulties. Other problems included gynaecological issues (6 per cent); orgasm at the ‘wrong’ time (2 per cent); fear of pregnancy and birth control issues (4 per cent); a diminutive penis (2 per cent); domestic violence (2 per cent); excessive masturbation (3 per cent;) and sterility (2 per cent). Three men sought help for broad sexual anxieties (in women, these cases were probably subsumed under the label ‘lack of orgasm’). One or perhaps two men sought help for their homosexuality. A sole patient consulted Wallace for each of the following problems: nymphomania; vaginismus; sexual failure due to tiredness; marital maladjustment; and problematic night-time erections.42 These were not, therefore, men and women with marginalised sexual practices or identities such as BDSM or fetishism. Instead, they were problems of the mainstream. Most patients sought assistance with maintaining heterosexual, penetrative sex with mutual orgasm: the emphasis from both Wallace and his clients was on developing a satisfying, harmonious marital sex life. In response, Wallace’s therapeutic framework was clinical and medicinal. He did not use, strictly speaking, psychoanalysis or a talking cure (though on odd occasions, he did refer patients for psychoanalysis, or saw patients who had been undergoing Freudian analysis). There were elements of the talking cure in his treatment, as Damousi has suggested.43 He listened, and for some that was significant in itself. He did not, however, allow patients to be guided to their own conclusions. Instead, he gave advice. In sixteen of the case files, he noted having discussed sexual technique, and it may have been that he did so in many other cases too. His advice was often pragmatic: he would promote birth control, tell his patients to read a particular marriage manual, or suggest the use of KY jelly as a lubricant. Not all of the problems were of course immediately sexual but were intertwined with other domestic issues, and he also gave practical advice to cases of familial violence and broader marital conflicts.44 In rare cases, he was more interventionist, such as one case of persistent childhood masturbation, when he performed a circumcision on a young boy. More generally, however, he treated patients by listening, and then by prescribing drugs. Of the 90 patients who sought treatment, 60 were given some form of drug therapy, most regularly syrup neurophosphates. Syrup neurophosphates was a tonic and supposedly a stimulant: it contained vitamins and a small dose of strychnine, which is poisonous in larger doses, but stimulating in smaller amounts. The therapeutic value or impact of syrup neurophosphates is rather doubtful. By the 1930s it was regarded as more of a quack medication than a serious drug therapy, and indeed some doctor’s used it as a placebo.45 Other drugs prescribed by Wallace have a therapeutic value, including bromide (a sedative and anaphrodisiac), phenobarbitol (a barbiturate sedative) and thyroid medications. In thirteen cases, Wallace provided women and particularly men with hormones, generally testosterone, which was often used in conjunction with other drug therapies. The dangers of testosterone, which can have serious side effects for both men and women, were unrecognised. Though patients sought help from Wallace for myriad physical, emotional and social problems, the majority could be divided into two camps: those who felt either too much desire, and those who felt not enough. Given the strict parameters of acceptable heterosexual activities, either was deemed a problem, both quantitively and qualitatively. The rest of this article will explore examples of each. These cases reflect a contemporary construction of a problematic or deviant sexuality, and the doctor and patient’s reactions to this. Thus the case notes should be read as a flawed and problematic reflection of an individual’s pathology or perceived pathology, but also as a signifier of the broader sexual tensions of the age. Case Study: Too Much Desire In May of 1950, Eva, a widow in her late seventies, consulted Dr Wallace. She had one child, and had been through the menopause some 30 years prior to her appointment. Unusually for a female patient, Eva sought treatment because of her unwanted sexual desires. Wallace recorded a version of her narrative: The lustful feeling is almost unbearable at times. I cannot tell anybody about it. I’m sure it is causing my headaches. … It wouldn’t be so bad if I were young but at my age it is awful. This had not been a long-term problem, but it was so disturbing that she had sought almost immediate medical attention. She claimed that her unwanted desires were disrupting her entire existence. Wallace took a short case history of her early life and the more recent problem. He recorded that she had not been ‘troubled’ much with sexual feelings in her youth. But now, he noted she ‘would give anything not to have this feeling’ of need for sexual intercourse. Wallace noted the physicality of her desire, which was ‘worse when she sits down or lies down’. It was interfering with her sleep, too, and she demanded medication to stop her intense feelings. Eva was particularly alarmed by the social implications of her desire—it was noted in her case file that she did not want her daughter told of her problem. Instead, she strove for normativity: ‘I want to be like other women of my age. I want to be calm.’ So too she disclaimed that her case was of any social or medical importance, suggesting rather tartly that this ‘may be interesting to you but not to me’. There is a sense that Wallace himself was more engaged in this case than Eva: she simply wanted a medical solution to what had become an intolerable situation. Wallace prescribed a range of drugs, including phenobarbital and bromide, to control her seemingly excessive sexual thoughts. In the Victorian period, Eva would almost certainly have been diagnosed with nymphomania, a medical and clinical diagnosis of pathological, uncontrolled, excessive female desire.46 But by the mid-century, attitudes towards female sexuality were far more complex. Women were now expected to have sexual feelings and desires, yet these were to be experienced only within certain social conditions: heterosexual, monogamous marriage. In Eva’s case, had she been married her sexual desire would quite possibly be seen as normal or necessary, particularly if she were younger. Her physical desire was, under the right circumstances, not necessarily abnormal, but as a widow, her desires were all too quickly rendered deviant, by both her doctor and the woman herself. Eva was pleased with the results of the clinical treatment. When she returned for a follow-up visit three months later, she noted that she needed the drugs only when she was particularly anxious. As Wallace noted in his case notes, ‘If she gets worried she gets a strong desire for sexual intercourse.’ Nonetheless, Eva deemed the medication a great success. Her own autonomy is notable even when read through the case notes. Her fears about her own sexual desire were not imposed upon Eva: rather she actively sought out medical care when her sexuality did not meet the culturally imposed norms. As such, she was an enthusiastic consumer of both medical advice and a range of drugs. Her own views of normative sexuality matched those of Dr Wallace: the cultural and the clinical coincided, indicating the monolithic and restrictive nature of sexual narratives in this period. Of course, those men and women who experienced their sexuality as ‘different’ but not ‘abnormal’ would not seek out medical treatment. Nonetheless, in Eva, and throughout these case files, there is a certainty, a definitiveness, a lack of ambiguity or questioning, about ideas of normative sexual feeling and practice. Case Study: Not Enough Desire If a number of men and women sought treatment for what they thought of as ‘too much desire’, many more sought assistance because they did not feel enough. In 1948, Edna Collins went to see Dr Wallace. She was 33 years old, and had been married for 10 years to a clerical worker, during which time she had borne four children. She sought help from Wallace, because she had never had an orgasm with her husband. She had a negative attitude towards men: her parents had (unconventionally) separated when she was 15, and she felt all men were ‘the same’. Edna and her husband had sex twice a week, which lasted five to ten minutes, and as Wallace noted, ‘preparation is inadequate’. She was able to orgasm on her own, but never with her husband, even though she was not frightened of pregnancy. Wallace’s case notes show that he simply gave her the tonic ‘syrup neurophosphates’ and sent her on her way. Unusually, Edna followed up with a second appointment in 1949, when she still had not experienced orgasm (the vast majority of patients saw Wallace only the once). Edna was, in Wallace’s words ‘depressed and disappointed’ that her sex life had not improved, and Wallace recommended psychoanalysis. It would, however, be long and expensive, and Edna continued to see Wallace three times while making up her mind. During this period he gave her advice on positions and technique. In the last consultation with Wallace, he finally did a physical examination, and found that while her uterus was ‘normal’ her clitoris was described as ‘minute’. For this, she was given further unnamed drugs. A year later, Edna sent a letter to Dr Wallace. She had not had psychoanalysis, because of the costs and because it did not have a guaranteed success rate, but she decided to work hard on having an orgasm with her husband. She clearly saw this as a central part to a good marriage and being a happy wife. And she did succeed—as she wrote to Wallace, ‘I could hardly believe it had happened—after ten years of marriage and having been trying for at least two of those years.’ Edna’s happiness shows that, for some, sex education, perseverance and a patient partner were central to developing a good sex life—or at least the contemporary definition of such. But for many of the others treated by Wallace, the results were less spectacular. Some were simply given drug treatments, and never returned for a second consultation, so there is no record of the final result. For instance, in early 1950, Evelyn Woods visited the rooms of Dr Wallace. She was unable to reach an orgasm. Wallace took a long case history, noting that she had not had a happy childhood, and had never learned anything about sex before her virginal first marriage. Her first marriage was also unhappy. She had no children, but ten months after marriage she had fallen pregnant, and she had an abortion, which she said she did not regret. Her first husband had a number of affairs, and they were eventually separated and then divorced. In those six years of marriage, she had never reached an orgasm. Evelyn did remarry, and her second husband was sterile: there was no fear of pregnancy in her new relationship. Nonetheless, she still could not reach the orgasm she so clearly wanted. She told Wallace that she did have ‘definite sexual desire’, and her ‘preparation’ was ‘adequate’. There was no pain, or obvious gynaecological problem. Instead she simply went ‘cold during intercourse’, and after two or three minutes of sex, she would push her husband away. Wallace’s case notes hint towards a psychological explanation for Evelyn’s lack of pleasure: perhaps a fear of pregnancy that led to a deep revulsion towards ending intercourse, or perhaps it was the trauma of a lack of sex education and knowledge as a child and adolescent. Nonetheless, the doctor’s case notes concluded this was a case of ‘failure to reach orgasm’ and she was treated medicinally with syrup neurophosphates. There was no second visit. Many of the women in the sample were ‘treated’ for a lack of sexual desires. In 1949, Jane Edwards took herself to Dr Wallace, complaining that ‘she is cold sexually’. She was 25 years old, and married to a salesman. Wallace wrote in the case notes, ‘She was concerned that “never” desires sexual intercourse.’ Her complaint was quite complex. She explained to the doctor that she ‘has to be made to feel that she wants to have intercourse’, which would take a long time. Once aroused, she did orgasm in 80–90 per cent of instances of sexual intercourse. The problem appeared to lie in her husband’s expectations. Her husband, wrote Wallace, complained she had an ‘absence of desire’, and could take up to an hour to orgasm. It was thought to be hereditary, with Wallace noting that Jane complained ‘her mother was cold. Thinks she might have got it from her.’ There may have been some physiological issues at work, for Jane noted that some sexual positions were painful to her, while others were comfortable. There were also fears around contraception: after she had her IUD removed, her husband had begun to use condoms, and this seemed to have escalated the problem. Finally, she was anxious about certain forms of foreplay, and in particular Wallace noted she thought ‘kissing of breasts is “rude”’. Despite a detailed case history, covering both physiological and psychological issues, the doctor’s summation was ‘Absence of sexual desire!’, and Jane was treated simply with syrup neurophosphates. There was no record of a follow-up appointment. Some cases clearly failed in terms of a treatment regime. Keith and Carolyn Birchgrove, for instance, were in their early forties, and they had been married for 18 years. Keith was the foreman in a factory, while Carolyn was a housewife. Despite their outward observance of normative gender and class ideals, the Birchgroves had a secret: what they described as their own inadequate sexual life. As Wallace noted in his case history, the Birchgroves’ problem was dual, made up of the ‘Frigidity of wife’ and the ‘Absence of complete satisfaction in husband.’ The loss of pleasure and desire within the Birchgroves’ marriage was probably unsurprising, given their awkward lack of knowledge of sex, and their manifest problems with contraception. Over the course of their marriage, the Birchgroves had used a range of methods of birth control. They had, like many others in early twentieth-century Australia, relied on coitus interruptus (withdrawal). They had abstained for long periods of time, and had also used karezza, a sexual technique where intercourse took place, often for extended periods, but male ejaculation did not occur.47 They had tried suppositories of quinine powder, douching and a sponge soaked in olive oil. None of these options were at all satisfactory, and some were described by the couple as ‘distasteful’. Fatigued by the rigours of preventing pregnancy, and the arrival of her four children, Carolyn ‘gradually became less and less inclined’ to engage in sex. The couple told Wallace that this sexual disharmony led to quarrels and semi-abstinence, with sex limited to perhaps once a month. When it took place it was largely pleasurable for both, although they continued to experience a range of problems including mild incontinence in Carolyn, and occasional impotence from Keith. Dr Wallace listened carefully to their unsettling narrative, took detailed notes, and the couple were given syrup neurophosphates. Later the same month, Keith returned to Wallace, and brought further ‘evidence’ of the problems the couple were suffering. Keith showed Wallace ‘elaborate notes’ and ‘graphs’ of their sexual life. The case notes suggest that Wallace found this rather peculiar, but he did later correspond with Keith, who repeatedly complained that his wife had been frigid for many years. In early 1943, Wallace was again consulted about the sexual problems of the Birchgroves, although no case notes of this visit survive. Shortly after, Wallace received a long letter from Keith, who complained of impotence, and on occasion, premature ejaculation. His problems were however rather more than physical. Keith felt that he was failing as a husband. After years of cajoling his wife, she had finally become more open to sex, at which point he began to have his own sexual problems. He wrote, ‘I am sure that the continued disappointments have a bad effect on her.’ He felt a strong and persistent anxiety over his sexual performance and its presumed impact on his wife. Carolyn herself seemed less concerned with their sexual life. In late 1945, a jittery Carolyn once again visited Wallace. She was suffering from great anxiety, but it was not related to sex: her son was in a hospital in Europe after a war-time injury, and she was concerned for his survival. She claimed that she was often tired, and now felt ‘disinclined to satisfy her husband’s abnormal and even erratic sexual demands’. At this point, Wallace wrote a letter to Keith, asking for consideration towards his wife, moderation in his demands and mutual harmony’. There is no record of what happened to the Birchgroves and their unhappy, uneasy sexualities. Their case, of an individual marriage marred by a lack of birth control and disagreements over the place of sex within a relationship, is nonetheless illustrative of the wider social, cultural and sexual dilemmas of the age. They were a couple who believed that sexuality was important to married life. After four children, and reaching middle age, Keith but also to a lesser extent Carolyn did not conceptualise sex as merely for reproduction. Instead, they viewed sex as integral to the happiness and success of their marriage. Even as difficulties of birth control rendered Carolyn a reluctant participant, both seemed to speak fairly frankly to Dr Wallace: their sexual life was a problem that they would like to solve. It was not until the additional trauma of war-time that Carolyn withdrew altogether from her husband, and what had become an almost obsessive interest in sex. Conclusions There is a considerable lacuna in historical understandings of medical interventions into early sex therapy, and in particular private medicalised sex therapy. This article has explored a significant treatment regime developed by one doctor in a major Australian city. The patient files in the Wallace Papers allow for a rare and intimate glimpse into the sexual lives of men and women in post-war Australia, who sought treatment for a variety of perceived sexual problems. Victor Wallace drew upon a range of methodologies to treat his patients, including limited elements of the talking cure—listening, discussing, but then advising. As a clinician, he also utilised an arsenal of medicinal options, from stimulants to hormones, and including dubious medications such as syrup neurophosphates, supposedly to right the body to sexual equilibrium. Both patient and doctor had faith—or wanted to have faith—in the clinical cure promised by medication. Yet Wallace attempted to treat both the mind and body. It was not always successful, for his patients often suffered long-term anxieties and deep-seated unconscious problems surrounding sexuality. Nonetheless, most appeared grateful for Wallace’s treatment regime, for at least listening, and attempting to help cure them of their sexual problems. The patient files, and this analysis of them, also illustrate broader trends in thinking about sexuality in this period. If there is a wide historical literature on the ways sexuality was constructed by the dominant discourses, it is far more difficult to uncover how these ideas were received. This paper has traced the reception of wider post-war sexual theories—of pathology, of normativity—and how these were consumed by both Dr Wallace and his patients. Sexual histories of the 1950s have stressed a model of the ‘normal’, where homosexuality was particularly reviled, and heterosexuality was constructed in certain specific forms, with an emphasis on marital, penetrative intercourse, culminating in mutual orgasm. The Wallace medical case files indicate the extent to which this model was absorbed by at least a portion of the general public, and that in fact, the ideal of normative sexuality was a negotiation between the expert and the general public, where the latter could both define and demand sexual normativity. In the patient files, there is quite a clear enunciation of what a ‘normal’ sexual life was expected to look like and how it should be experienced. In line with contemporary sexual theory, Wallace’s ultimate goal was that each client should achieve the ideal married life: a simultaneous orgasm during penetrative heterosex. And it seems that most of the men and women who sought his counsel thought this too: the Wallace case notes provide a fine example of the cultural constructions of sexuality, where certain forms of pleasure were condemned, and others desired. Wallace’s patients, almost without exception, accepted the importance of an active sexual life to self, to marriage and to the broader social order. Sex was rendered key to the post-war reconstruction of the nuclear family. The Wallace papers, then, allow a new view into the intimate spaces of married sexuality and the family, and how these intersected with Australian culture and society. This allows for a reading of sexuality that simultaneously includes the patient and the doctor, the normal and the ‘abnormal’, and the ideals of correct and pathological forms of sexuality, suggesting that the constructions of pleasure impacted on both the clinic and the broader social and sexual culture. 1 There are a number of different types of history that touch on therapy more broadly, especially in histories of insanity and madness. In Australia, the most notable include Stephen Garton’s groundbreaking work, Medicine and Madness: A Social History of Insanity in New South Wales, 1880–1940 (Sydney: UNSW Press, 1988) and Milton Lewis, Managing Madness: Psychiatry and Society in Australia 1788–1980 (Canberra: Australian Government Publishing Service, 1988). Joy Damousi’s important history of Freud in Australia investigates psychotherapy, see Freud in the Antipodes: A Cultural History of Psychoanalysis in Australia (Sydney: UNSW Press, 2005). In addition, there have also been more specific studies on the asylum as a space, including the excellent collection edited by Catherine Coleborne and Dolly Mackinnon, ‘Madness’in Australia: Histories, Heritage and the Asylum (Brisbane: University of Queensland Press, 2003). There has however been very little historical comment, either in Australia or in the international literature, on those not necessarily ‘mad’ or ‘lunatic’, but seeking outpatient or private counselling for problems of a sexual nature. 2 See Wallace Papers, University of Melbourne Archives, Group 17 Patient History Cards, 17/5/2, Sexual Problems, Male and Female, 1938–1954, Random 1/2 box. I would like to thank the Wallace family for permission to use these files. 3 See Damousi, Freud in the Antipodes, 63–5; Kerreen Reiger, Disenchantment of the Home: Modernising the Australian Home, 1880–1940 (Melbourne: Oxford University Press: 1985), 202–5. 4 Grant McBurnie, ‘Wallace, Victor Hugo’, Australian Dictionary of Biography, http://adb.anu.edu.au/biography/wallace-victor-hugo-11943/text21405. 5 On Wallace’s provision of contraception, see Lisa Featherstone, ‘Sexy Mamas? Women, Sexuality and Reproduction in Australia in the 1940s’, Australian Historical Studies, 2005, 37, 234–52. 6 McBurnie, ‘Wallace, Victor Hugo’; Diana Wyndham, ‘Striving for National Fitness: Eugenics in Australia 1910s–1930s’, PhD thesis, University of Sydney, 1996, 109; Featherstone, ‘Sexy Mamas’, 234–52. 7 See Victor H. Wallace, Women and Children First: An Outline of a Population Policy for Australia (Melbourne: Oxford University Press, 1946). On the intersections between race and eugenics in Australia, see Jane Carey, ‘The Racial Imperatives of Sex: Birth Control and Eugenics in Britain, the United States and Australia in the Interwar Years,’ Women’s History Review, 2012, 21, 733–52. 8 At the back of the file, there are also numerous cases of vasectomy, which are filed under ‘sexual problems’, rather than with the other contraceptive cases. These cases of vasectomy (which are generally very brief case notes) have been excluded from this study, as they do not reflect sex therapy. 9 On psychotherapy, see Joy Damousi, ‘Viola Bernard and the Analysis of “Alice Conrad”: A Case Study in the History of Intimacy’, Journal of the History of Sexuality, 2013, 22, 474–500. 10 See Lisa Featherstone, Let’s Talk About Sex: Histories of Sexuality in Australia from Federation to the Pill (Cambridge: Cambridge Scholars Press, 2011), ch. 6. There is a wide international literature on sex education in the period before the Second World War, and much of this provides useful context for the Australian situation. In Australia, see Ann Curthoys, ‘The Case of Marion Piddington’, Hecate, 1989, 15, 73–89; Lisa Featherstone, ‘Sex Educating the Modern Girl: The Formation of New Knowledge in Interwar Australia’, Journal of Australian Studies, 2010, 34, 459–69; Ellen Warne, ‘Sex Education Debates and the Modest Mother in Australia, 1890s to the 1930s’, Women’s History Review, 1999, 8, 311–27; Ellen Warne, ‘“Tell Them!” Anglican Mothers and Sex Education 1890–1930’, in People of the Past? The Culture of Melbourne Anglicanism and Anglicanism in Melbourne’s Culture (Melbourne: University of Melbourne, 2000), 12–27. 11 On the discussions around female sexuality during the Second World War, see amongst others, Kay Saunders, War on the Homefront: State Intervention in Queensland1938–1948 (Brisbane: University of QLD Press, 1993), 27; Michael Sturma, ‘Public Health and Sexual Morality: Venereal Disease in World War II Australia’, Signs, 1988, 13, 725–40; Kay Saunders and Helen Taylor, “‘To Combat the Plague”: The Construction of Moral Alarm and State Intervention in Queensland During World War II’, Hecate, 1988, 14, 5–30; Marilyn Lake, ‘Female Desires: The Meaning of World War II’, Australian Historical Studies, 1990, 24, 267–84. 12 Lisa Featherstone, ‘“The one single primary cause”: Divorce, the Family and Heterosexual Pleasure in Postwar Australia’, Journal of Australian Studies, 2013, 37, 349–63. 13 On the centrality of the family to the social order, see for instance Australian National Secretariat of Catholic Action, The Family: Social Justice Statement (no publication details, 1944), 1. 14 On censorship, see Alison Bashford and Carolyn Strange, ‘Public Pedagogy: Sex Education and Mass Communication in the Mid-Twentieth Century’, Journal of the History of Sexuality, 2004, 13; Parliament of the Commonwealth of Australia, Ninth Report of the Parliament Standing Committee on Broadcasting, Relating to the Question of Broadcast Talks on Venereal Disease and Other Sexual Matters (Canberra, 1942), 2–15. 15 See for instance Mary Winefride, Youth Looks Ahead (Brisbane: Polding Press, nd), 42–3; Father and Son Welfare Movement of Australia, Guide to Virile Manhood (Sydney: Father and Son Welfare Movement, 1957), 25; Father and Son Welfare Movement of Australia, Children No Longer (Sydney: Father and Son Welfare Movement, 1957), 35; Father and Son Welfare Movement of Australia, Just Friends (Sydney: Father and Son Welfare Movement, nd), 20. 16 In Australia the most notable example is Norman Haire, who wrote a column for Woman magazine from 1941 to 1952. He often dealt with sexual difficulties for both the married and unmarried. See Diana Wyndham, Norman Haire and the Study of Sex (Sydney: Sydney University Press, 2012); Bashford and Strange, ‘Public Pedagogy’, 71–99. There is an extensive collection of these columns held in the Haire Collections, Rare Book Collection, University of Sydney Library. 17 Indeed, Ann Westmore has argued that, in their avoidance of the psychological model, the Melbourne Medical School was ‘more British’ than many of the British institutions. See Ann Westmore, ‘Reading Psychiatry’s Archive’, in Coleborne and Mackinnon, eds, ‘Madness’ in Australia, 209; Lewis, Managing Madness, 49. 18 Stephen Garton, ‘Freud and the Psychiatrists: The Australian Debate 1900 to 1940’, in Brian Head and James Walter, eds, Intellectual Movements and Australian Society (Melbourne: Oxford University Press), 174–6; Martin Stone, ‘Shellshock and the Psychologists’, in W. F. Bynum, Roy Porter and Michael Shepherd, eds, The Anatomy of Madness: Essays in the History of Psychiatry, vol. II (London: Tavistock Publications, 1985), 242–71; Garton, Medicine and Madness, 82–3. 19 Garton, ‘Freud and the Psychiatrists’, 178–83; Lewis, Managing Madness, 43–4, 50–1. 20 Publicly funded marital counselling was instigated in Australia in the 1960s, in what was seen as a quite radical move. By the mid 1970s, Government Health insurance would subsidise counselling, including sexual counselling, to 85% of the cost. N. R. Rose, ‘Sex Therapy in Australia’, The Journal of Sex Research, 1976, 12, 332; Melanie Oppenheimer, ‘Voluntary Action and Welfare in Post-1945 Australia: Preliminary Perspectives’, History Australia, 2005, 2, np. 21 In Melbourne, there were a small number of other doctors treating sexual problems, often with psychoanalysis, including Paul Dane and Reg Ellery. In Sydney, Roy Winn was the first privately practising analyst. 22 Reiger, Disenchantment of the Home, 205. On sexuality in the 1950s, see Frank Bongiorno, Sex Lives of Australians (Melbourne: Black Inc, 2012) and Featherstone, Let’s Talk. 23 For Stopes’ impact in Australia, see Featherstone, Let’s Talk About Sex, ch. 6. 24 Dr Wykeham Terriss, ‘Salvaging Marriages’, Woman, 27 March 1944, 9. See also M. A. Horn, The Digest of Hygiene: For ‘Father and Son’ (Sydney: Hallmark Productions, 1948, 28–31; Father and Son Movement, Just Friends, 41; Hugh McLelland and J. W. C. Wand, Our Sexual Nature (Melbourne: Oxford University Press, 1944), 58–9. 25 Edward F Griffiths, Modern Marriage and Birth Control (Sydney: Dymocks Book Arcade, 1948), 112. 26 Reg Ellery, Typed MS, ‘Divorce. A Psycho-Sexual Problem’ (nd), 4 , in Reg S. Ellery Papers MS 7979 1910–1950 (SL VIC) Box 522/4 Sex and Its Related Problems; Dr Wykeham Terriss, ‘Promiscuity Always a Danger’, Woman, 8 March 1943, 8. 27 For the lectures, see Wallace Papers Group 4 Lectures, ‘Sex, Marriage and Family—First Series’ 4/2. 28 Until the post-war period, Australia had been a nation with an almost completely British heritage, and White Australia was a key part of the nation’s identity. There were few non-white migrants, and a small and highly marginalised indigenous population. After the Seccond World War, Australia had seen a large influx of refugees from Europe. 29 See Lesley Hall, Hidden Anxieties: Male Sexuality 1900–1950 (Cambridge: Polity Press, 1991). 30 On romance in this period, see Marilyn Lake, ‘Female Desires: The Meaning of World War II’, Australian Historical Studies, 1990, 24, 267–84; Marilyn Lake, ‘The Desire for a Yank: Sexual Relations between Australian Women and American Servicemen during World War II’, Journal of the History of Sexuality, 1992, 2, 621–33; Lyn Finch, ‘Consuming Passions: Romance and Consumerism During World War II’, in Joy Damousi and Marilyn Lake, eds, Gender and War: Australians at War in the Twentieth Century (Melbourne: Cambridge University, 1995), 105–16; Hsu-Ming Teo, ‘The Americanisation of Romantic Love in Australia’, in Ann Curthoys and Marilyn Lake, ed., Connected Worlds: History in Transnational Perspective (Canberra: ANU E-Press, 2006), 171–92. 31 Contemporary sources suggested that premarital petting and sex was common. See W. G. Coughlan, ‘Marriage Breakdown’, in A. P. Elkin, ed., Marriage and the Family (Sydney: Angus and Robertson, 1957), 133; Edward Griffith, Modern Marriage and Birth Control (Sydney: Dymocks, 1948), 51; H. M. North, ‘Sexual Problems of Childhood and Adolescence’, Medical Journal of Australia (MJA), 14 September 1946, 378. 32 Graham Willett, ‘The Darkest Decade: Homophobia in 1950s Australia’, Australian Historical Studies, 1997, 109, 120–32; Garry Wotherspoon, ‘“The Greatest Menace Facing Australia”: Homosexuality and the State in New South Wales During the Cold War’, Labour History, 1989, 56, 15–28. 33 See for example, Editorial, ‘Homosexuality’, MJA, 7 February 1948, 175; ‘Sexual Psychopathy’, MJA, 9 September 1950, 420; Crimes Amendment Bill Second Reading, NSWParliamentary Debates, 1955, 3289, 3291. 34 Men with sexual desires they knew would be considered deviant might avoid the medical model. See for example, Lisa Featherstone, ‘“Fitful Rambles of an Unruly Pencil”: George Southern’s Challenge to Sexual Normativity in 1920s Australia’, Journal of the History of Sexuality, 2010, 19, 389–408. 35 See, for instance, sex education manuals including Horn, Digest of Hygiene, 29; Griffith, Modern Marriage, 21. 36 Griffith, Modern Marriage, 174. 37 Ibid., 626. 38 R. .S Ellery, ‘Frigidity and Dyspareunia’, MJA, 16 October 1954, 627; A. T. Edwards, ‘Psychological Implications of Dysmenorrhoea and the Menopause’, MJA, 11 February 1950, 179. 39 Ellery, ‘Frigidity’, 627. 40 Ellery, ‘Divorce’, 6. 41 Ibid., 6–7. 42 These figures do not add up to 100%, as many patients sought help for more than one sexual problem, for instance a man might seek assistance for his impotence, but would also discuss problems with his wife’s sexuality or their shared need for birth control. 43 Damousi, Freud in the Antipodes, 64–5. 44 In ten of the cases, no treatment was recorded, and in one case further treatment was denied, as the problem was seen to be untreatable. 45 Neurophosphates were generally viewed as a proprietary tonic, containing calcium, phosphorus and strychnine, in the form of glycerol-phosphates. It is generally believed that while strychnine might be useful as aphrodisiac the dose in the syrup was too low to be therapeutically effective, and it was listed as a non-accepted preparation by the American Medical Association by the mid-1930s. Many doctors apparently thought of it as a ‘proprietary nostrum’ or a placebo. See ‘List of Non-accepted Preparations’, Journal of the AMA, 18 July 1936, 229; ‘Esky’s Neurophosphates’, Journal of the AMA, 29 September 1917, 1102; ‘Post Influenza Cases’, Journal of the National Medical Association (USA), 1929, 21, 63; Howard Spiro, ‘Clinical Reflections on the Placebo Phenomenon’, in Anne Harrington, ed., The Placebo Effect: An Interdisciplinary Exploration (Harvard: Harvard University Press, 1999), 39; Jeremy A. Greene and David Herzberg, ‘Hidden in Plain Sight: Marketing Prescription Drugs to Consumers in the Twentieth Century’, American Journal of Public Health, 2010, 100, 793–803. 46 See Carol Groneman, Nymphomania: A History (New York: W. W. Norton & Company, 2000); Clair Scrine, ‘Conceptions of Nymphomania in British Medicine 1790–1900’, PhD thesis, Macquarie University, 2003. 47 See Alice Stockham, Karezza: The Ethics of Marriage (New York: RF Fenno and Co, 1896). Hera Cook suggests that in England, karezza was used into the 1940s and 1950s, but it seems less common in Australia, despite Dr Rosamund Benham’s advocations. See Alison Mackinnon and Carol Bacchi, ‘Sex, Resistance and Power: Sex Reform in South Australia, c 1905’, Australian Historical Studies, 1988, 23, 60–71; Frank Bongiorno, ‘“Every Woman a Mother”: Radical Intellectuals, Sex Reform and the “Woman Question” in Australia, 1890–1918’, Hecate, 2001, 27, 48–51; Hera Cook, The Long Sexual Revolution: English Women, Sex, and Contraception, 1800–1975 (Oxford: Oxford University Press, 2004), 128. Acknowledgements I would like to thank the Wallace family for permission to use the Wallace papers. © The Author 2017. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.

Journal

Social History of MedicineOxford University Press

Published: May 4, 2017

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off