The Contagious City: The Politics of Public Health in Early America by Simon Finger (review)

Abstract

The Contagious City: The Politics of Public Health in Early America. By Simon Finger. (Ithaca, NY: Cornell University Press, 2012. Pp. 226. Hardcover, $39. 95.)Simon Finger's The Contagions City is the engaging historiography of a city wracked by the twin dangers of disease and political rivalry. With each new crisis Philadelphians found themselves stuck in the interstices of prosperity [and] annihilation, which inspired political ingenuity to resolve (146). Comprehensive yet streamlined, The Conta-gions City thoughtfully surveys the history of public health, which Finger localizes in Philadelphia and situates at the intersection of medical, envi-ronmental, and political history.Finger argues that the constitutions of Philadelphia and its residents were mutually constitutive from the colonial period into the nineteenth century, the era of reform that has attracted the most scholarly attention. In planning Philadelphia, William Penn envisioned a space that would nurture the minds, spirits, and bodies of the populace-to facilitate sound constitutions for all its residents. According to seventeenth-and eighteenth-century Galenic principles of human physiology, a body's physical constitution, or humoral balance/imbalance, was influenced by interaction with the built or natural environment. Urban dwellers were threatened by moral and physical degeneration, which caused an imbal-ance in the bodily (i.e., blood, phlegm, yellow bile, and black bile), thus weakening their constitutions and making them vulnerable to disease (10).For Finger, the politics of public was shaped by efforts to achieve a balance within the city's humors or influences. Through policies and institutions, administrators of public sought a balance between individual and community needs, between guarding and grow-ing the population, between humanitarian and economic interests. As Finger argues, Equilibrium was essential to their sanitary calculus (155); however, like achieving balance or equilibrium in a body's consti-tution, keeping Philadelphia's interests and objects balanced required maintenance and negotiation when new hazards to the equilibrium were introduced.In observing the pattern of public in Philadelphia from its ori-gin as a would-be Quaker capital to a commercial, cultural, and even national capital, Finger observes the use of as a flexible political tool, helpful in establishing a communal identity and implementing poli-cies (6). By the early eighteenth century, Philadelphia had dramatically changed in population and appearance. Due to increased population, poor sanitation methods, crowding, and the constant arrival of ships ferrying new disease-causing microbes, a healthy constitution was in-creasingly harder to obtain (57). Emerging risks gave rise to efforts and institutions that comprise a general of the term pub-lic health that Finger understands as always already political. For instance, the flux in immigration and trans-Atlantic trade made it nec-essary to implement quarantine laws, establish lazarettos (quarantine hospitals specifically for maritime travel), and engage medical/political officials to oversee it all. Philadelphias feared and resented newcomers who brought diseases ashore from their ships; to these inhabitants, the lazaretto represented danger (35). To popular and proprietary politi-cians, however, new arrivals meant potential voters who could be useful in their disputes over control of the colony.Not all of Philadelphia's public conflicts concerned the con-frontation of difference as immigration and import did. The clearest example, by Finger's own estimation, for understanding the clashing ideologies of and public action is the establishment of the Penn-sylvania Hospital in 1751 (60). …