The Gospel of Germs by Nancy Tomes, Harvard University Press,
拢19.95/$29.95, ISBN 0674357078
FOR me, the word 鈥渄iphtheria鈥� sounds just as menacing now as when I first
heard it one morning over half a century ago at junior school鈥攖he name of
an ugly disease that killed a school friend鈥檚 younger brother. And everything I
learnt later as a microbiology student about Corynebacterium
diphtheriae failed to dispel these disquieting memories.
One of the many merits of The Gospel of Germs is its vivid portrayal
of the fear, sometimes terror, that infections once exercised over human life
and imagination. Nancy Tomes begins with her early recollections of adult
conversations about the victims of unseen killers鈥攁 cousin who succumbed
to typhoid fever, an aunt who cut her lip one day and died of 鈥渂lood poisoning鈥�
the next. Grave stones in the churchyard down the road made these tales all the
more poignant.
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Tomes鈥檚 main purpose is to chronicle the impact of the germ theory during its
early decades, particularly between 1870 and 1930, on social and domestic life
in the US. It is an aim admirably fulfilled, with lucidity, colour and scholarly
comprehensiveness鈥攓ualities rarely found together in the same book.
Much of the illumination comes from the countless vignettes with which Tomes,
a medical historian, peppers her text. We hear, for example, about the physician
Edward Trudeau nursing a consumptive elder brother through his final illness in
the 1860s. For many weeks he slept close to his brother in a hot bedroom, with
the windows tightly closed鈥攐n medical orders. Not surprisingly, Trudeau
also developed tuberculosis. It wasn鈥檛 until twenty years later, when he became
one of the first American converts to the ideas promulgated in Europe by Louis
Pasteur and Robert Koch, that he realised the almost certain source of his
infection.
Major themes of this fine book are the measures adopted to avoid malevolent
microbes, and the links between those precautions and wider issues such as
social justice and working conditions in the US. 鈥淭he triumph of the white china
toilet鈥� forms one delicate episode, as does what became a national obsession
with excellence in plumbing.
True to the entrepreneurial spirit of the still-young nation, there were also
innumerable initiatives to manufacture and sell products for keeping
microorganisms at bay. These included water fountains, which replaced communal
cups in public places, ingenious safeguards against 鈥渟ewer gas鈥�, individual bars
of soap for hotel guests and the largely unnecessary antiseptic mouthwashes
which are still big business today.
A rich variety of shifts in personal habits further demonstrated the
far-reaching impact of the newly perceived threat. 鈥淢en shaved their beards and
women shortened their skirts to eliminate germ-catching appendages. They
stripped their homes of allegedly microbe-laden furnishings and embraced as
necessities for a germ-free life such household institutions as the vacuum
cleaner and refrigerator.鈥�
Popular and women鈥檚 magazines were in the vanguard of exhortation. And, for
the most part, the advice was directed at women. As Ellen Richards and Marion
Talbot, two founders of the domestic science movement, said in 1887: 鈥淎
knowledge of sanitary principles should be regarded as an essential part of
every woman鈥檚 education, and obedience to sanitary laws should be ranked, as it
was in the Mosaic Code, as a religious duty.鈥�
Making women responsible for household hygiene had another consequence, as
Tomes shows. If women did not take diligent precautions against infections, or
were seen not to be doing so, they were blamed when things went wrong. If they
could not even afford the antiseptics or other means of dealing with
disease-causing microbes, then their sense of failure and shame in the face of
an outbreak of disease could be even greater.
The battle against infections sometimes brought together capitalists and
workers in common cause. On other occasions it widened the gap and opened up new
disputes, like that which arose around the sweatshops of the clothing trade. At
a time when garments were still considered to be major vehicles for spreading
germs, particularly the turbercle bacillus, middle-class women were warned to
avoid stores selling dresses that were made up in tenement workshops that
doubled as homes for the workers.
One criticism of this enthralling account of American society鈥檚 battles with
the microbe is that Tomes does not always explain sufficiently clearly which of
the strategies adopted during the rise of the germ theory were sensible and
which were (in retrospect) silly. The national preoccupation with plumbing,
despite its amusing facets, had sound foundations. But was there any validity
whatever in the parallel obsession with dust?
The final chapter suggests that the firm belief that fomites (inanimate
objects such as towels and bedding) spread infection was swept away by the
realisation that people were the real sources of infection. Yet modern textbooks
continue to include fomites, which remain a significant hazard.
There is, inevitably, something restrictive about a book which explains 鈥渉ow
Americans [my italics] came to believe in the existence of germs, and that
understanding changed their lives鈥�. The oddity is enhanced when Tomes mentions
researchers in the US who, together with those in Europe, apparently 鈥渢urned the
germ theory from a debatable hypothesis into an accepted scientific fact鈥�. But
she says virtually no more about these American researchers.
Nevertheless, alongside a superbly written account of social changes which
were paralleled in many other countries, Tomes highlights several distinctively
American features. Above all, advertising and mass communications were harnessed
more vigorously to the cause than anywhere else in the world, for example, the
big 鈥渃rusades鈥� against TB, during the early part of this century.
Will such campaigns be required ever again? In the face of new and resurgent
infections, and the burgeoning dangers of antibiotic-resistant bacteria, will
the lessons explained so meticulously in this historical account have to be
relearnt?
The Gospel of Germs comes in four principal sections鈥攖he
emergence of the gospel, its triumph, the gospel in practice and the gospel in
retreat. It sounds like a tidily orchestrated symphony. But the book ends with a
disquieting coda, examining the renewed threats posed by communicable diseases
today.