"Typhoid Mary" strikes back. Bacteriological theory and practice in early twentieth-century public health.

Abstract

THE SCIENCE OF BACTERIOLOGY, with its emphasis on role of microorganisms in causing disease, undoubtedly influenced practice of public health in early twentieth-century America. But how much did this new laboratory-based science narrow scope of public health activities? Or, to put it another way, how reductionist was this new science in practice? These questions are important because many historians and some late twentieth-century social critics have assumed, implicitly or explicitly, that germ theory, in contracting conceptions of etiology of disease primarily to microorganisms, brought an end to more holistic understandings of illness that preceded it. According to these scholars, laboratory became most important instrument for measuring degrees of sickness, substituting microbe hunting with test tubes and microscopes for wide-ranging sanitation and social welfare programs that characterized nineteenth-century public health practices. Paul Starr, for example, has written that the new outlook brought with it a radically reduced view of requirements of public health.... The limitations on public health in twentieth century were . . . profound. The early public health reformers of nineteenth century, for all their moralism, were concerned with social welfare in a broad sense. Their twentieth-century successors adopted a more narrow and technical view of their calling.' In examining early experiences with healthy