[JH] Some One Sole Unique Advertisement: Public Health Posters

While there have been broadsides on public health issues posted by local and state governments for several centuries, there were but few illustrated posters for such events in the nineteenth century. These were largely notices for fund-raising events, sponsored either by the Red Cross or by hospitals, beginning in the 1890s. A good example of the earliest public health posters was the “Croix Rouge du Congo” by Allard L’Olivier. Published as a supplement in a Belgian newspaper in 1891, it presented a realistic scene of physicians and nurses at work in a field hospital tent. A more striking image was an 1895 advertisement by Ramón Casas for a Barcelona sanitarium specializing in the treatment of venereal disease. Its design, similar in layout to L’Olivier’s in that it separated words from image and included an asp on the back of the woman’s dress as the only indication that she might indeed have an illness that would require treatment in the sanitarium. Somewhat later came two posters for hygiene exhibitions. One was an iconic poster by Franz Van Stock for an exhibition in Dresden in 1911 with a haunting monster eye to greet the viewer. The second, by Adolph Hohenstein, a German artist long active in Italy, was commissioned for a 1900 exhibition in Milan. Hohenstein’s poster uses the image of an idealized family drinking from a pure mountain stream — identified as the fons vitae, the fountain of life — which offers the four requisites of good hygiene: light, air, water and exercise.

[better transition from preceding paragraph needed] Other public health posters prior to the First World War were scarce. Beginning in 1917, however. with battles raging across Europe, serious issues concerning the alarming increase in tuberculosis cases as well as the chronic history of alcoholism in France, and the growth in venereal disease rates among service men, created a need for educational campaigns to warn about these dangers, and posters were not surprisingly included as part of the tactics that were employed. [I think this is a good beginning but it’s not an introduction per se in that it doesn’t really tell the reader where it’s going or what s/he can expect to read. Could you address this in your next revision using this space as an introduction to the whole essay? In other words, what themes/topics do you want the reader to know up front that you’ll pursue in the essay? Are you making a purely historical argument — WWI inaugurated a new type of public health poster — or is it more subtle/complex than that? Are there other scholars who have written on this issue whose work you’d like to build upon or take issue with? Make these theme(s) as explicit as possible here so as to develop your argument from the start.]

In July 1917, even before governments began to do something more serious about these problems [which problems? This thought is not carried over from the introduction], the Rockefeller Commission for the Prevention of Tuberculosis in France arrived to provide education [to whom?] and medical and nursing services. Among its varied programs, the organization commissioned more than a dozen posters, almost twenty postcards [why ‘almost’? Do you mean eighteen or nineteen?], and a series of large broadsides announcing meetings, programs and health-care services to be provided in several locations in Paris as well as in smaller cities around France. The Commission’s posters were the first such sustained campaign anywhere to attack a severe public health problem, and several of the posters created as part of the campaign are vivid models of what an effective poster can be.      

Of course, defining what makes an effective poster is not a simple matter. Like any piece of propaganda, a poster is designed to persuade the viewer to react, either by buying the product advertised or by modifying or eliminating destructive habits. The public health poster admonishes us to stop smoking, lose weight, use condoms, not share needles, breast feed our babies, and send money; if it can do these things, it is deemed worthwhile. At the minimum, however, it must make the passer-by stop, if only for a few seconds, to absorb its message. In general, it does this by presenting a forceful image accompanied by hard-hitting words. These qualities were best summarized by James Joyce in his Ulysses, when he described Leopold Bloom’s quest for “…some one sole unique advertisement to cause passers to stop in wonder, a poster novelty, with all extraneous accretions excluded, reduced to its simplest and most efficient terms not exceeding the span of casual vision and congruous with the velocity of modern life.” In the earliest public health campaigns, the Rockefeller Commission chose artists that could create large images that could be mounted in appropriate places where they were likely to be noticed. In the main, the resulting posters, with strong imagery and a short text reduced in importance, were the type that would have stopped Bloom in his tracks.

The posters created by the French artist Georges Dorival, who was asked to develop four posters for the Rockefeller Commission, had forceful images which met these criteria. One shows an eagle impaled on a sword, linking tuberculosis with the German enemy as two plagues, both of which will be destroyed. The sword has the word “tuberculosis” on it, perhaps the first instance the word itself was used in an image placed before the public, for at the time the word “tuberculosis” was rarely used in public statements. Another of Dorival’s images, published by the Commission when after World War I, pointed out that the French could not rest on their laurels as tuberculosis remained a prevalent public health issue. In a third poster, a snake serves as a metaphor for tuberculosis similar to the way the poster for the Barcelona sanitarium used an asp for syphilis. This concept was again repeated in a later image by Leonetto Cappiello, one of the more prolific and popular poster artists, in which a mother, holding her child high above her head, stamps on a frightening reptile. If the Commission’s first objective was to capture the public’s attention, its second objective was to provide information on both the causes and the methods to prevent the spread of tuberculosis. Un Grand Fléau (A Great Plague), by F. [do we know his whole first name?] Galais, shows some of the many conditions that promoted the spread of tuberculosis among the urban poor as a result of crowded and unhealthy environments. The Angel of Death holding his scythe hovers over the scene as refuse is thrown from windows, food taken from piles of trash, men are spitting and drinking, and a basket of food is left unprotected. In addition, an American artist, A. M. Upjohn, was commissioned to create a series of four posters pointing out proper habits to keep children from being affected by the cause of tuberculosis. These small posters were reproduced on postcards as well; they showed the importance of playing games, sleeping with windows open, holding classes in the open air and the value of the visiting nurse in treating patients. 

In the overall campaign, the Rockefeller Commission stressed the provision of health care, especially as supplied by visiting nurses. The title of Auguste Leroux’s arresting image of a visiting nurse sums up the message they wished to convey: “The visiting nurse is the aide of the physician and of social activities in the crusade against tuberculosis and infant mortality.” [reprint figure here?] In the poster, the nurse holds a young patient as she resolutely stands high above a crowded city. Leroux’s poster set the tone for what has been a recurring necessity throughout the twentieth century, especially in wartime, and which still continues today: the need to continually recruit nurses to join the profession. Following the Rockefeller’s lead, the Red Cross and local and federal agencies assigned well-known artists — including important commercial illustrators such as Haskell Coffin, Jon Whitcomb, John Falter, Thomas Tryon, and Harrison Fisher — to create public health posters, and their attractive and uplifting images have become a staple in the poster world.

By contrast, the Rockefeller Commission often turned to better-known artists to produce their posters [because…? It could pay more? It had greater influence?].Louis Raemakers, for example, was a Belgian artist who published many battlefield views and political caricatures that were ultimately collected into commemorative volumes when the war was over. Raemakers’s nursing poster asks the tuberculosis patients to have confidence, but its impression is rather routine, not at all typical of the power of other images which he was capable of creating. One of these, which was not commissioned by the Rockefellers, was Hecatomb, Syphilis, one of the most compelling examples in the group of posters calling attention to the dangers of sexually transmitted diseases, one of the central public health concerns during both world wars. The smiling woman with spider-like hair, holding the skull of one of her victims in a position which appears to equate death with sex, stands above a cemetery containing many other victims. The image is sufficient to make its point with only two words [if you’re not going to print it in the essay, shouldn’t you say WHICH two words?]. A second dramatic statement on the same subject was made in the 1918 poster by Theophile-Alexandre Steinlin (1859-1923) [shouldn’t you give dates to the other artist, like Raemakers, who you name? There should be a uniform style for each person you include in your essay.] in which the artist issues a dramatic appeal to those fighting on the battlefield to maintain strength for their country and to resist those “seductions of the street” that carry with them the risk of exposure to an illness that is as “dangerous as war” and may lead to a “useless death without honor.” The contrast between life, represented by a healthy soldier surrounded by laurel leaves and his country’s flags, and death, symbolized by skull and crossbones among withered branches and thorns, is reinforced by a gravestone-like tablet on which the impassioned warning is written. Reflecting the sensibility of the times, as was also the case with tuberculosis, neither the word syphilis nor gonorrhea nor even venereal disease appears in the text. [is this because of a shared common knowledge? Or a shared understanding of it as a health problem too “vulgar” to name out loud but only through iconic euphemism?]

[better transition from preceding paragraph here?] Another significant public health issue during the early part of the twentieth century was alcoholism. Excessive drinking had long been a chronic problem in France, even before the period of World War I, and a series of both public and private groups were created to do something about it. For example, the Union des Françaises Contre l’Alcool (French Temperance Union) sponsored three posters by B. [whole name?] Chavannez [birth/death dates?], each with a frightening domestic scene in which drunkenness is the ruination of a family. In Oh, When are They Going to Outlaw Alcohol, a crying mother and cowering daughter attempt to wrestle the tightly-held bottle from an alcoholic husband. In another poster with a similar title, a soldier observes a drunkard hanging on a lamppost. Eugene Burnand published a poster for another organization, the National League Against Alcoholism, with a similar scene and the brief statement, “L‘Alcool Tue” (Alcohol Kills).

During the 1920s, public health posters echoed earlier ideas and images, with continued emphasis on tuberculosis, sexually transmitted disease and alcoholism as well as on employing visual metaphors. B. [full name?] Cascella, an Italian artist, published two fund-raising posters [in year?] for the Italian Red Cross with identical titles, showing tuberculosis as a huge spider in the first and as a serpent encircling the earth in the second. The Next to Go, a poster Cascella designed for the American Red Cross,, depicted tuberculosis as an evil ghost-like figure being pushed out the door, while an Italian image by T. [name? dates?] Corbella echoed the sentiments of these images, suggesting that such means as rest, good hygiene and temperance, among others, would be sufficient to eradicate the disease. The skeletal figure of Death lends itself to representation for any disease for which there is no known cure. Not surprisingly, it is an image that has come back with some frequency in the contemporary visual imagery of AIDS. But in the 1920s, it was employed as a symbol for venereal disease. Two posters dating from the late 1920s show this theme. In the first, by Theodoro, Death sneers behind the kissing couple in a poster; in the second, by the prolific Achille Mauzan (1883-1952), an artist whose long career produced posters in Italy, France and Argentina, two figures representing Death stand with an unsuspecting bridal party. A similar concept, substituting Satan for the figure of Death, appears in a poster by an unknown artist, showing a blindfolded couple walking under the advice-giving headline, N’allez pas en aveugles vers l’amour, (Don’t fall in love blindly). The versatile symbol of Death also appeared in an anonymous Italian poster in which the figure appears piloting a plane that is releasing huge insect dropping bombs of microbes on a frightened population. The title of the poster, Guerra alla Mosche, called for a war against this frightening evil. By the 1930s, the basic structure and purpose of earlier public health posters began to change in both Europe and the United States, although it was still maintained under the Communist government in Russia. There, bold posters with powerful graphics continued, and examples of public health posters that addressed smallpox, breast-feeding and blood donations, among other topics, demonstrate iconography and design that was not too far from the hard-hitting posters done in the West during World War I [this, of course, begs the question: were there any public health posters produced in the pre-Revolutionary period, or do these only emerge after the Revolution?]. In the 1930s, posters generally became smaller in size and less confrontational in their presentation, relying on simple graphics to carry their message. Economic conditions forced a reduction in advertising expenditures and thereby curtailed the production of posters in most countries. In the United States, however, the development of the Federal Art Project (FAP), one of the many divisions of the Works Progress Administration during the New Deal, managed to develop a considerable body of impressive work in the service of public health. Posters produced for not-for-profit agencies became a major component of the large-scale effort to provide jobs for unemployed artists, and before its functions were transferred to the Defense Department in 1941, when the country entered World War II, more than thirty-five thousand designs had been developed. The majority of these used the newly-developed silkscreen process, a printmaking technique pioneered by the FAP in 1932 [FDR didn’t come into office until 1933. Please check dates] and ideal for Depression years because it used inexpensive materials and portable equipment. Silkscreened posters were generally twenty-two by fourteen inches, smaller in size than the majority of earlier posters. According to Christopher DeNoon, FAP posters generally used flat screen-printed colors and lots of diagonals, and reflected “the ‘synthetic cubism’ of the School of Paris, the geometric abstraction of Kandinsky and the de Stijl, and the efforts of Stuart Davis and American abstract artists – particularly those in New York – to make aesthetically revolutionary design principles the basis of a socially revolutionary art.” They also reflected the contemporary Art Deco style, and as a result are often considerably milder in impact than their predecessors. Two venereal disease notices, Shame May be Fatal and Don’t Wait, 70% are Doomed, are typical of those produced during the second half of the 1930s. Others, prepared by federal, state and local health groups, provided similar messages warning against quackery, emphasizing early medical attention for cancer, and endorsing blood tests before marriage.

European posters in the 1930s displayed some of the same characteristics, less immediate impact and less compelling graphics, and in addition, were generally wordier than their silk-screened contemporaries from the United States. One of the few dated specimens from this period is a French anti-alcohol poster, L’Intemperance provoque…., which depicts the dramatic as well as ubiquitous episode in which a young child attempts to extract his father from a saloon. An Art Deco poster by Leo Fontan [dates?] , La Syphilis est Curable, uses blocks of lettering to contribute to the overall design [not sure the “contribution” is clear—could you be more specific?]. European artists, in contrast to their American counterparts, were still as concerned with strong images as they were in earlier years. In one, a French fund-raiser for cancer research, a wraith-like figure rises from cancerous cells under a microscope, while another poster, by the Dutch artist Dirksen [name? dates?], depicts a skeletal arm held in a vise-like grip by the disease.

[transition from preceding paragraph needed] One would normally expect propaganda efforts in wartime to be commanding [unclear—what do you mean?], and this was indeed the case for many of the graphics issued by the major players in World War II. Posters for wartime needs such as enlistment, victory gardens, and encouraging secrecy among civilians and industrial workers demanded strong messages, and resulted in many memorable examples. For public health advocates, however, the key effort was to prevent sexually transmitted diseases among those in the armed forces. Late in the war, when adequate supplies of penicillin were available, the message changed to show that gonorrhea and syphilis could be cured. For the most part, posters warning against venereal disease echoed those published by the Federal Art Project. Service men were continually warned about the dangers of unorthodox treatments, and especially the hazards of loose women, or even of the girl next door who, as one widely distributed American poster suggested in its title, She May Look Clean, But…. In 1942, the American pharmaceutical firm John Wyeth & Brother solicited the services of a popular illustrator, Arthur Szyk, whose remarkable images were also used to publicize the dangers of venereal disease. Harkening back to the early tuberculosis poster of Georges Dorival, which coupled the German enemy with tuberculosis as two evils to be eradicated, Szyk created three posters designed to make the same connection between venereal disease and the Axis powers. In addition, comic books, one of the most favored reading material of American service men, were also employed for the first time for the same purpose. [do you want to say more about this? It seems important, and only mentioning it briefly seems like you’re giving it short shrift.]

Public health posters produced for the British public were mainly developed by Abram Games (1914-1996), a respected poster artist who in 1940 was appointed Official Poster Designer for the War Office. His lithographs warning against the dangers of mosquitoes and flies and for the need for blood donations adroitly mixed words and images to convey important messages. Another British graphic designer, Reginald Mount (1906-1979), developed two posters warning against venereal disease, one of which repeated the skeletal death image. In their designs, the poster images of both Games and Mount echo the sensibility of the American silkscreen posters first seen in the Federal Art Project of the 1930s.

With the war’s end, public health posters began to stress concerns other than sexually transmitted disease and insect carriers, but they still reflected many of the design conventions that were prevalent before the war. Regarding the advances in polio research as described in two public health posters of 1949 and 1950, one author commented that they “reflect the quintessential look of the Fifties, with their angled type, bands of color, integration of graphics with photography and greater use of white space.” The Austrian typographer Herbert Bayer [dates?] was one of a number of European poster artists who immigrated to the United States and became an influential graphic designer. His 1949 poster to raise funds for polio research built upon the type of imagery that Bayer had developed at the Bauhaus before the war [have you discussed this before? If not, then you might want to talk about the Bauhaus earlier so that this reference is more clear.]. Two French posters of the same period for the fight against cancer use similar symbols: in one by the French graphic designer Guy Georget, a sword cuts the heads of a hydra-like monster, while in a poster by Villemot a club is used to beat a huge crab into submission. Other public health posters of the period immediately following World War II were rather weak, offering a pale reflection of their former force and appeal. But this mild approach to public health fears has changed radically in more recent years as major campaigns have been mounted throughout the world to combat addiction to tobacco and narcotics, the continuing world-wide problem of alcoholism and, since the mid-1980s, the scourge of still-incurable HIV infection.

[transition needed from preceding paragraph] In the United States, the evils of cigarette smoking were clearly stated in the 1964 report issued by a committee under the chairmanship of the Surgeon General, Luther L. Terry. As the first widely publicized official recognition that smoking was a leading cause of cancer and other serious illnesses, the report spawned a host of measures to sensitize the public to the habit’s high cost. Similar drives to curtail substance abuse, despite some forceful posters as part of propaganda programs, have been less successful. Such campaigns have only been in existence since the 1970s, despite the fact that narcotic addiction is hardly a new problem. There had always been reticence to use popular media to discuss addiction, either because posters were not thought to be effective or that the subject was too coarse to permit public airing. Today, this has changed, considerably aided by the need for dramatic warnings about the use of shared needles [I’m also thinking of the poster campaigns against crystal meth seen in large cities with gay male populations].

Almost all of the posters for both smoking and narcotic use have been commissioned from graphic designers; their images are rarely signed and rarely dated. The same can be said of the thousands of AIDS posters that have been issued by countries all over the world over the last twenty years, but which were more prevalent during the years between 1985 and 1995. Their creation has slowed considerably since then as the development of different classes of pharmaceuticals have arrived, at least in the developed world, to enable many patients to survive for longer periods. But AIDS, as we know, has in no way been eliminated, and public health programs will be necessary as long as it remains incurable. The vast majority of the thousands of posters promoting AIDS and HIV education and prevention are not in the tradition of earlier, more powerful images. Because individual AIDS and HIV posters are normally created to address the perceived needs of specific groups such as young people, women, racial and ethnic groups, and men who have sex with other men, each category bases its appeals in specific ways. Frequently, these make use of rather shocking imagery because, as an executive with the New York City Department of Health noted, “Adolescents, in particular, demand and accept candor and choose not to accept abstractions.” The admonition could probably be applied to all viewers as well.

The graphics used in many AIDS posters provoke the viewer to pay attention to their messages, such as encouraging drug users to avoid sharing needles and practice safe sex through the mandatory use of condoms. Activist groups such as ACT UP, which began its use of graphic design as a form of political propaganda in New York City in 1987, played a prominent role in stimulating strong response. AIDS posters by the design collective Gran Fury used cartoons, humor, and even tabloid-style photographs of prominent political and religious figures, but rarely the work of famous artists and illustrators. Occasionally contemporary posters will appropriate iconic images by well-known artists such as Norman Rockwell and Pablo Picasso and, by adapting them for an AIDS poster, may well succeed in getting passers-by to look at them. Aids Prevention, for example, a poster that shows the image of a snake curled around an apple by the well-known California artist David Lance Goines, aroused used some controversy among those who felt that it implied an association between the disease and the concept of sin.

Recognizing that it is extremely difficult to generalize about the huge body of European and American public health posters of the last century, at a minimum their design has had to be attention-getting in order to be effective, for unless the poster is noticed, it cannot communicate at all. Dramatic posters were more the rule than the exception in the early years of the twentieth century, but in many ways contemporary designs have gotten away from the more forceful images that greeted passers-by when public health campaigns first began. Partly because of the development of less costly offset production methods in place of earlier lithographs, quantity has replaced quality. Posters being just one medium in a mix of many propaganda efforts, and rarely the sole means, it is always hard to tell if they alone have been an effective method of sensitizing men and women to the dangers posed by epidemics, endemic diseases, and other chronic public health problems. Clearly, they are a helpful means, but can never hope to singly modify habits and behavior patterns that need to be changed. And finally, in addition to their effectiveness at the time of publication, in many ways their designs and cautions provide a lasting body of images for us to better understand public health concerns in earlier years.