For decades, tuberculosis in Buenos Aires was more than a dangerous bacillus. It was also an anxious state of mind shaped not only by fears of contagion and death but also by broader social and cultural concerns. These worries included changing work routines, rapid urban growth and its consequences for housing and living conditions, efforts to build a healthy “national race,” and shifting notions of normality and pathology. In The Ailing City, the historian Diego Armus explores the metaphors, state policies, and experiences associated with tuberculosis in Buenos Aires between 1870 and 1950. During those years, the disease was conspicuous and frightening, and biomedicine was unable to offer an effective cure. Against the background of the global history of tuberculosis, Armus focuses on the making and consolidation of medicalized urban life in the Argentine capital. He discusses the state’s intrusion into private lives and the ways that those suffering from the disease accommodated and resisted official attempts to care for them and to reform and control their morality, sociability, sexuality, and daily habits. The Ailing City is based on an impressive array of sources, including literature, journalism, labor press, medical journals, tango lyrics, films, advertising, imagery, statistics, official reports, and oral history. It offers a unique perspective on the emergence of modernity in a cosmopolitan city on the periphery of world capitalism.
In Zambia, due to the rise of tuberculosis and the closely connected HIV epidemic, a large number of children have experienced the illness or death of at least one parent. Children as Caregivers examines how well intentioned practitioners fail to realize that children take on active caregiving roles when their guardians become seriously ill and demonstrates why understanding children’s care is crucial for global health policy.
Using ethnographic methods, and listening to the voices of the young as well as adults, Jean Hunleth makes the caregiving work of children visible. She shows how children actively seek to “get closer” to ill guardians by providing good care. Both children and ill adults define good care as attentiveness of the young to adults’ physical needs, the ability to carry out treatment and medication programs in the home, and above all, the need to maintain physical closeness and proximity. Children understand that losing their guardians will not only be emotionally devastating, but that such loss is likely to set them adrift in Zambian society, where education and advancement depend on maintaining familial, reciprocal relationships.
As a public health field worker assigned to control tuberculosis in New York and Chicago in the 1990s, Paul Draus encountered the horrible effects of tuberculosis resurgence in urban areas, and the intersections of disease, blight, and poverty. Consumed in the City grows out of his experiences and offers a persuasive case for thinking about—and treating—tuberculosis as an inseparable component of the scourges of poverty, homelessness, AIDS, and drug abuse. It is impossible, Draus argues, to treat and eliminate tuberculosis without also treating the social ills that underlie the new epidemic. Paul Draus begins by describing his own on-the-job training as a field worker, then places the resurgence of tuberculosis into historical and sociological perspective. He vividly describes his experiences in hospital rooms, clinics, jails, housing projects, urban streets, and other social settings where tuberculosis is often encountered and treated. Using case studies, he demonstrates how social problems affect the success or failure of actual treatment. Finally, Draus suggests how a reformed public health agenda could help institute the changes required to defeat a deadly new epidemic. At once a personal account and a concrete plan for rethinking the role of public health, Consumed in the City marks a significant intervention in the way we think about the entangled crises of urban dislocation, poverty, and disease.
Until a decade ago, the conquest of tuberculosis seemed one of the great triumphs of modern medicine. The resurgence of TB in the wake of AIDS has to be understood, Georgina Feldberg argues, in the context of decisions the U.S. Public Health Service made, beginning in the 1930s, to prevent TB through improved hygiene and long-term treatment with medications, rather than program of BCG vaccination that Canada and many other countries adopted. Feldberg's aim is not to judge which was the right choice, but to explain why the U.S. rejected the vaccine and the consequences of that choice. To American physicians, TB, the conditions that fostered it, and the kind of people who got it were a direct threat to their own middle-class values, institutions, and prosperity. They prescribed vigorous social reform, and by the 1960s, they were convinced the strategy had worked. But, as the country's commitment to strong social welfare programs waned, the bacteriological reality of TB reasserted itself. Feldberg challenges us to recognize that the interplay of disease, class, and the practice of medicine can have unexpected consequences for the health of nations. The book is essential reading for students and professionals in public health, medicine, and the history and sociology of medicine. Georgina D. Feldberg is director of the York University Centre for Health Studies in North York, Ontario. She is coauthor of Take Care: Warning Signals for Canada's Health System.
Part biography, part medical history, and part study of Jewish life in turn-of-the-century America, Jeanne Abrams's book tells the story of Dr. Charles David Spivak - a Jewish immigrant from Russia who became one of the leaders of the American Tuberculosis Movement.
Born in Russia in 1861, Spivak immigrated to the United States in 1882 and received his medical degree from Philadelphia's Jefferson Medical College by 1890. In 1896, his wife's poor health brought them to Colorado. Determined to find a cure, Spivak became one of the most charismatic and well-known leaders in the American Tuberculosis Movement. His role as director of Denver's Jewish Consumptives' Relief Society sanatorium allowed his personal philosophies to strongly influence policies. His unique blend of Yiddishkeit, socialism, and secularism - along with his belief in treating the "whole" patient - became a model for integrating medical, social, and rehabilitation services that was copied across the country.
Not only a national leader in the crusade against tuberculosis but also a luminary in the American Jewish community, Dr. Charles Spivak was a physician, humanitarian, writer, linguist, journalist, administrator, social worker, ethnic broker, and medical, public health, and social crusader. Abrams's biography will be a welcome addition to anyone interested in the history of medicine, Jewish life in America, or Colorado history.
Known as "The Great Killer" and "The White Plague," few diseases influenced American life as much as tuberculosis. Sufferers migrated to mountain or desert climates believed to ameliorate symptoms. Architects designed homes with sleeping porches and verandas so sufferers could spend time in the open air. The disease even developed its own consumer culture complete with invalid beds, spittoons, sputum collection devices, and disinfectants. The "preventorium," an institution designed to protect children from the ravages of the disease, emerged in this era of Progressive ideals in public health.
In this book, Cynthia A. Connolly provides a provocative analysis of public health and family welfare through the lens of the tuberculosis preventorium. This unique facility was intended to prevent TB in indigent children from families labeled irresponsible or at risk for developing the disease. Yet, it also held deeply rooted assumptions about class, race, and ethnicity. Connolly goes further to explain how the child-saving themes embedded in the preventorium movement continue to shape children's health care delivery and family policy in the United States.
The history of medicine is much more than the story of doctors, nurses, and hospitals. Seeking to understand the patient’s perspective, historians scour the archives, searching for rare personal accounts. Bringing together a trove of more than 400 family letters by Charles Dwight Willard, Suffering in the Land of Sunshine provides a unique window into the experience of sickness.
A Los Angeles civic leader at the turn of the twentieth century, Willard is well known to historians of the West, but exclusively for his public life as a booster and reformer. Willard’s evocative story offers fresh insights into several critical issues, including how concepts of gender, class, and race shape patients’ representations of their illness, how expectations of cure affect the illness experience, how different cultures constrain the coping strategies of the sick, and why robust health is such an exalted value in certain societies.
Though notorious for its polluted air today, the city of Los Angeles once touted itself as a health resort. After the arrival of the transcontinental railroad in 1876, publicists launched a campaign to portray the city as the promised land, circulating countless stories of miraculous cures for the sick and debilitated. As more and more migrants poured in, however, a gap emerged between the city’s glittering image and its dark reality.
Emily K. Abel shows how the association of the disease with “tramps” during the 1880s and 1890s and Dust Bowl refugees during the 1930s provoked exclusionary measures against both groups. In addition, public health officials sought not only to restrict the entry of Mexicans (the majority of immigrants) during the 1920s but also to expel them during the 1930s.
Abel’s revealing account provides a critical lens through which to view both the contemporary debate about immigration and the U.S. response to the emergent global tuberculosis epidemic.
In The White Plague, René and Jean Dubos argue that the great increase of tuberculosis was intimately connected with the rise of an industrial, urbanized society and—a much more controversial idea when this book first appeared forty years ago—that the progress of medical science had very little to do with the marked decline in tuberculosis in the twentieth century.
The White Plague has long been regarded as a classic in the social and environmental history of disease. This reprint of the 1952 edition features new introductory writings by two distinguished practitioners of the sociology and history of medicine. David Mechanic's foreword describes the personal and intellectual experience that shaped René Dubos's view of tuberculosis. Barbara Gutmann Rosenkrantz's historical introduction reexamines The White Plague in light of recent work on the social history of tuberculosis. Her thought-provoking essay pays particular attention to the broader cultural and medical assumptions about sickness and sick people that inform a society’s approach to the conquest of disease.