Contagion, Isolation, and Biopolitics in Victorian London by Matthew L. Newsom Kerr

Abstract

Reviewed by: Contagion, Isolation, and Biopolitics in Victorian London by Matthew L. Newsom Kerr Annmarie Adams (bio) Contagion, Isolation, and Biopolitics in Victorian London. By Matthew L. Newsom Kerr. New York: Palgrave Macmillan, 2018. Pp. 370. Paperback €93.59 Matthew L. Newsom Kerr’s Contagion, Isolation, and Biopolitics in Victorian London explores the history of London’s fever and smallpox hospitals, built by the Metropolitan Asylums Board (MAB) between 1870 and 1900. In seven chapters and seventeen illustrations, the United States-based historian investigates the debates surrounding infectious disease, locating London’s hospitals in a complex landscape of governance and social control. Newsom Kerr engages well-known and obscure printed sources, especially surrounding the series of health and social reform acts which punctuated nineteenth-century British politics. Examples are the Metropolitan Poor Act of 1867 and the Infectious Disease Act of 1889. Newsom Kerr’s project is novel, illuminating for readers in the style of a Victorian detective [End Page 347] the “subtle and almost invisible coercions lurking at the back of hospital isolation” (p. 159). A distinction of the book is this focus on isolation. Newsom Kerr argues that isolation in the Victorian period was fundamentally different than quarantine, which we know from the Black Death as a system of banishment and social stigma. To Victorians, Newsom Kerr says, quarantine had been “more a political tactic than a medical one” (p. 31). A central argument of the book is that hospital isolation was an everyday way for citizens to encounter state medicine (p. 3), thus rendering them governable. Technology and Culture readers may be particularly interested in Newsom Kerr’s insistence on isolation itself as a technology and his contention that that the isolation hospital typology is a British invention. If the act of isolating patients was technological, then it follows that the late nineteenth-century fever hospital network could work like machinery. This analogy is best illustrated in chapter five, entitled “Machines of Security.” By the epidemic of 1884, Newsom Kerr says, the MAB system was working really efficiently. Londoners with smallpox were identified and evacuated from home by ambulance and steamers to floating hospitals and purpose-built encampments. The MAB ambulance system, Newsom Kerr tells readers almost as aside, was one of the first public services in London to be done by telephone (p. 203). In terms of medical history, smallpox gets more attention in the book than other infectious diseases that threatened London during time period, such as scarlet fever, diphtheria, typhoid, and typhus. Perhaps the most dramatic section of Contagion, Isolation, and Biopolitics in Victorian London is chapter six, which explores the highly significant role of mapping in the epidemiology of smallpox. Especially gripping is Newsom Kerr’s attention to the role of physician William Henry Power, whose concentric maps showed that smallpox hospitals were complicit in spreading the disease through the atmosphere. Despite the emphasis on hospitals, this is not a book about hospital design. Still, the term architecture appears frequently in the book and even in a title chapter. Hospital buildings are described through the eyes of others and surprisingly, given the book’s focus on space, no hospital floor plans are included. Newsom Kerr makes no reference to the rich architectural history of British hospitals, including studies that have addressed contagion and isolation. “Still, there has been no sustained analysis of the place of hospitalization within the broader narratives of public health and urban history,” he says (p. 7). I think particularly of Jeremy Taylor’s excellent 1997 book on the incremental development of the pavilion plan, with its useful work on the ventilation debates. In Newsom Kerr’s book, architects play negligible roles in the design of the fever hospitals, as if they passively realized the intentions of the MAB. The change in design preference from open hospital wards to glass, cubicle-like spaces for infectious patients [End Page 348] post-1900 is a subject of the final chapter, with agency for the change granted to doctors such as A. G. R. Cameron and F. Foord Caiger. Contagion, Isolation, and Biopolitics in Victorian London will appeal to readers in a range of disciplines, including urban history, medical geography, history of medicine...