Chasing Dirt.

Did you ever wonder about the history of our profession--and where the name "sanitarian" came from? Have you ever wondered who the heroes of environmental health were, and how their work, in the greater context of public health, influenced the growth of our nation? After all, we have always heard that it's hard to know where we're going if we don't know where we've been. Until now the books that gave us a glimpse of our niche in the context of public health included A History of Public Health, by George Rosen, and The Sanitarians: A History of American Public Health, by John Duffy. Although filled with a ton of facts, they are a bit ponderous. Even the old chestnuts that we used as textbooks--and still dip into for pearls of wisdom--provide little insight into the sanitary movement that shaped our beginnings. Only Dr. Ben Freedman's Sanitarian's Handbook provides a chronology of events that led us to where we are today but no mere list will tell us why things happened as they did.

While browsing through the paperback section of an airport bookstore, we came upon an interesting title--Chasing Dirt: The American Pursuit of Cleanliness, by Suellen Hoy. The bright pink spine and unusual title caught our eye. Because we found the book in the science section, we knew that the title did not refer to the makings of the supermarket tabloid. The cover had a quote from the Boston Sunday Globe that read, "A lively and reassuring history of American attitudes toward cleanliness--it is thorough, accurate, and very readable." This was right up our alley--at $12.95, we simply could not resist this 258-page tome published by Oxford Paperbacks.

What makes the book unique is the author's treatment of the subject matter: Suellen Hoy teaches American history at the University of Notre Dame. She came upon the subject by wondering about the contrast between our American customs of cleanliness and those of the rest of the world. In her introduction she writes that this book is about us as a people, a people who over a century and a half developed and nurtured a love affair with cleanliness. In a light and pleasant style, she then takes us on a well-researched historical journey of our attitudes and practices with respect to cleanliness, beginning with the early nineteenth century and continuing through modern times. She points out that the most compelling episodes of chasing dirt "meant ending life-threatening epidemics of cholera and dysentery, sewering a fast-growing country, eradicating hookworm, teaching immigrants and African-Americans along with the rural white majority about the dangers of dirt, and turning indoor plumbing into a national necessit y." In short, the book documents the triumph of middle-class ideals and habits and the critical role of women as "agents of cleanliness."

The book is filled with tales of our major cities and how they won battles against filth and disease. It also identifies the pioneers of the sanitary movement who actually shaped the history of disease prevention. The heroes in this book are quite surprising. While some of the early sanitarians were indeed notable physicians and engineers, the people who actually made things happen for the betterment of the public health included society women, philanthropists, insurance companies, the automobile industry, writers, teachers, and humanitarians. All were involved in shaping our ideas of environmental health and our profession. But I leave that for you to discover. Chasing Dirt is a must-read for each and every one of us.