Conclusion

Abstract

In this study of syphilis in the white and African populations of South Africa during the past 150 years I have tried to mesh the strengths of two approaches: political economy and social constructionism. A political economy approach situates patterns of disease and the function of health services within wider patterns of socioeconomic change and class interests. However the perceptions that are held of disease carriers are as important in shaping medical and social explanations of the causes of disease. Thus I have drawn on a social constructionist approach to explore how fears about disease may reflect anxieties about the consequences of wider social change, rather than simply reflecting epidemiological patterns. I have examined how medical discourse is shaped by its political and intellectual context and also helps to shape perceptions about racial, gendered or class identities.