Judith Walzer Leavitt

Public Resistance or Cooperation? A Tale of Smallpox in Two Cities

AS WE THINK ABOUT how to respond to current threats of bioterrorism and new emerging diseases, one major consideration must be the importance of gaining the trust and cooperation of the public. Public apprehension increases with each new disease since HIV/AIDS in the 1980s and SARS, Monkey Pox, Lyme Disease, and West Nile Virus more recently. The potential for bioterrorist use of Anthrax and other weaponizable biological threats makes the public much more edgy. In the face of decreasing trust in the ability of the public sector to be honest about any health problem that might emerge and to address it swiftly and effectively—distrust in government has been growing since the Vietnam War and Watergate—the potential for civic panic and social disorder in the face of a real public health emergency such as a reappearance of smallpox is significant. It behooves us to prepare ahead of time to try to avert such trauma to our cities and towns. Looking back historically to the eras when epidemics commonly attacked American cities can provide some insight into strategies that might be worth adapting to today’s situation and can also provide information about some things to avoid. While history cannot provide simple answers to our own debates, and actions cannot be merely transferred from the past to the present, there is a lot we can learn by looking back. In this article, I concentrate on smallpox to make the bigger point about the importance of public health preparedness. Historically, smallpox ravaged North American communities from the seventeenth century well into the twentieth century. Encounters with the new European disease often destroyed or decimated Native American communities, and the European settlers themselves periodically fell victim to this horrible disease.1 Even though vaccination provided a reliable preventive by the end of the eighteenth century, epidemics persisted throughout the nineteenth and first half of the twentieth century. The history of smallpox in America can be instructive in trying to understand why a disease with a clear preventive was not in fact prevented, and in casting light on what factors are most important to success in public health campaigns against infectious diseases. Two outbreaks of smallpox in two different American cities are particularly relevant to our situation at the beginning of the twenty-first century, and they are the focus here. One occurred in Milwaukee, Wisconsin, which experienced a major smallpox outbreak in 1894 that led to a complete breakdown in civic order. The health department mainstays of vaccination and isolation were resisted by the public in a context of political wrangling and medical dissension, and resulted in almost a month of rioting in the city streets, during which time smallpox spread widely and killed many who were exposed only because of the social disorder. The second smallpox outbreak is the one that threatened New York City in 1947, and it illustrates the opposite response, civic order and citizen cooperation. In New York in 1947, people stood in line for hours, full days, even came back the next day in some cases, waiting to get their vaccinations, and there was no sign of the kind of disturbances that characterized Milwaukee 53 years earlier. Smallpox did not gain a foothold in the city. How can we explain these diametrically different public responses and what can we learn from them?

Maternity in Dispute: New Zealand 1920-1939

In this new account of New Zealands history, Philippa Mein Smith considers the rugged and dynamic land from its break from Gondwana 80 million years ago to the beginning of the twenty-first century. Mein Smith highlights the effects of the countrys small size and isolation, from late settlement by Polynesian voyagers, very late colonization and settlement by Europeans, and the interactions that made these people Maori and Pakeha, to struggles over land, and efforts through time to manage global forces. Placing New Zealand in its global and regional context, the book reveals its links to Britain, despite being immersed in the Pacific, and part of Australasia. Distinctively, it reveals key moments contributing to the founding of the countrys national myths.

Political Economy of Public Health

Review of:Launching Global Health: The Caribbean Odyssey of the Rockefeller Foundation. Steven Palmer. Ann Arbor: University of Michigan Press, 2010. xi + 301 pp. (Cloth US

The Modern Period: Menstruation in Twentieth-Century America. By Lara Freidenfelds (Baltimore: The Johns Hopkins University Press, 2009. 242 pp.)

70.00)Partner to the Poor: A Paul Farmer Reader. Paul Farmer, edited by Haun Saussy. Berkeley: University of California Press, 2010. xii + 660 pp. (Paper US

Brought to Bed: Childbearing in America, 1750-1950

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A Once Charitable Enterprise: Hospitals and Health Care in Brooklyn and New York, 1885-1915

Hershfield’s keenest recognitions and contributions are contextual. That is, she is deeply aware of the roles to which women were assigned, how their relative lack of power enabled more powerful members of Mexico’s divided society to force them to work in largely unrecognized, unpaid fashions, even harder than Mexico’s exceedingly hardworking men. At the same time, combining both a sociological and a spatial expertise, Hershfield reminds us that during this historical period, Mexican women were told that the spaces where they lived revealed who they were. It was to follow, then, that by purchasing and using particular cleaning agents, by creating homes that “reveal(ed) a cleanliness according to the most up to date methods,” women themselves would be transformed. (180.) Perhaps most impressive here is the array of disparate images of women emerging simultaneously in this period. Outsiders used images to engage female consumers to modernize their appearances by wearing “blouses that drape over the skirt and carefully crafted skirts made of distinctive materials,” along with the “ribbons” which were the “obligatory companions for women who wished to dress elegantly and economically;” (52,) by installing electricity and running water, despite the fact that few Mexican homes possessed separate kitchens, (78,) and to transform their work lives by learning how to use the adding machine, and most especially, to type. (115.) In other words, Hershfield suggests that capitalists drew on mainly foreign imagery in efforts to create a particular series of connections with Mexican women. As thoughtful as Imagining La Chica Moderna is, it would have been even more compelling had the numerous ways Mexican women not only participated in the Mexican-post-revolutionary period but in important ways shaped that period been considered. Nonetheless, Imaging La Chica Moderna is as insightful as it is suggestive.

Women in Medicine: A Bibliography of the Literature on Women Physicians

Brought to Bed: Childbearing in America, 1750-1950, written by Judith Walzer Leavitt, is a detailed history of the journey undertaken by both parturient women and doctors struggling to find their place in the birthing rooms of America. Covering the periods between 1750 and 1950 chronologically and categorically, Leavitt attempts to recreate in as much detail as possible the stereotypes and medical difficulties encountered in childbirth. Drawing from the personal records, journals, and correspondences of both the women and doctors involved, the author is able to untangle complex meanings from the history of obstetrics.

Safeguarding the Public Health: Newark, 1895-1918

Preface Introduction 1. Health care and community change 2. Embattled benefactors: the crisis in hospital financing 3. Social class and hospital care 4. Conflict in the new hospital 5. Taking control: political reform and hospital governance 6. Consolidating control over the small dispensary: the doctors, the city and the state 7. The battle for Morningside Heights: power and politics in the boardroom of New York Hospital 8. Looking backward Notes on sources Notes Select bibliography Index.

Ordered to care : the dilemma of American nursing, 1850-1945

This annotated bibliography of more than 4,000 citations from the published literature about female physicians is an extraordinary volume. It comes at an important time because of recent interest in the subject of women in medicine and will serve as a useful guide to anyone— physician, historian, or general reader—who wishes to learn more about female physicians. It catalogues historical and current material about the lives of specific women, their career patterns, and institutions with which they have affiliated. Fourteen general subject categories organize the citations into topics such as the history of women in medicine, biographies, medical education, and psychosocial factors. In addition to the general topic organization of the book, entries are divided by geography and are indexed by personal name, author, and subject. Researchers are thus aided in finding entries through four modes of access. The annotations themselves vary in length from one sentence to more than

Typhoid Mary : Captive to the Public's Health

Stuart Galishoff examines the effects of germ theory on the work of the Board of Health of Newark, NJ, in the early years of the 20th century. Street cleaning and garbage collection gave way, under the impetus of bacteriology, to the use of specific remedies for contagious diseases. Although slow to respond to pressing health needs of the immigrant population in the second half of the 19th century, Newarks Board of Health surged ahead rapidly in the 20th, adopting new techniques in its search for a healthier city. The bacteriology laboratory established in 1895 led the revival. Quick success with the use of diphtheria antitoxin established the laboratorys reputation and paved the way for improvements in the quality of the citys water and milk, in sewage disposal, and mosquito control. Infant mortality greatly diminished, malaria and tuberculosis rates decreased, and the board turned its attention to new concerns such as