Cholera in Post-Revolutionary Paris: A Cultural History.

The central problem of this ambitious, original, and densely argued book is the contrast between responses to the first two cholera epidemics in Paris, in 1832 and 1849. The former, which figures far more prominently in the historical literature, provoked an outpouring of sometimes hysterical commentary and a heightening of class tensions. As all the accounts tell us, the epidemic did not spare the elites; indeed, it carried off the prime minister, Casimir Perier. It struck first and hardest, though, among the teeming masses of the capital's poor. To the wealthy, the lower classes seemed a source of infection that threatened their health just as the revolutionary tradition, recently revived in 1830, imperilled their economic and social well-being. Among the poor, rumors spread that the disease, whose symptoms resembled those produced by corrosive toxins, was the result of a poisoning plot on the part of the government and the rich. One public health measure, on garbage collection, which jeopardized the livelihood of Paris's ragpickers, ignited a major riot. Although suspected poisoners were sometimes attacked in other parts of Europe, the frightening new disease became associated with social and political conflict far more in France than anywhere else. The second epidemic, however, produced a much more muted response - what Kudlick calls the "silence of 1849" (p. 1 and passim) - and nothing like the political and social antagonisms of 1832. In part for this reason, she suggests, it has received far less scholarly attention. Since the disease still had a fearsome impact - the morbidity rate was two-thirds that of 1832, and the total number of deaths was slightly higher - and since Parisians had lived through a period of worsening class conflict and a revolutionary episode in 1848 much bloodier than that of 1830, Kudlick finds this silence paradoxical. The analytical thrust of her study is an attempt to explain it in cultural, social, and political terms.

Kudlick's answer, like much else in this book, is too complex to summarize adequately. The key element is a more confident and more consolidated bourgeoisie, no longer driven to define itself against the poor, as it had in 1832. A second element is the spread of socialist ideology between 1830 and 1848, which, by holding out a greater threat than either cholera or the unruly masses, paradoxically encouraged the bourgeoisie to adopt a more conciliatory stance toward the working class. The revival of Catholicism, and the improved relationship of the Church with the government under the Second Republic, also promoted a more acommodating attitude toward the poor, and the outbreak of disease appeared less a divine punishment for France's revolutionary sins than an opportunity to engage in acts of Christian charity.

But Kudlick is perhaps less interested in finding the key to this particular puzzle than in making broader points about disease, culture, and society, and still broader claims about how we should go about studying the connections among them. She offers her book as an exercise in the new cultural history, inspired by poststructuralism and especially concerned with discourse and its relation to the exercise of power. Disease is socially and culturally constructed, the epidemic of 1832 illustrating how cholera defined in class terms could aid in the construction both of bourgeois class identity and of the revolutionary threat from below. Indeed, following Foucault, Kudlick suggests that medical discourse on cholera was not only linked to certain political and social ideas (as, for example, when liberals embraced the notion that cholera was not contagious in part because quarantines interfered with freedom of commerce) but was itself a form of political discourse, which helped shape the French revolutionary tradition. At the same time, she recognizes cholera as a biological phenomenon, as defined and analyzed by modern bacteriology and epidemiology, and wishes to accord it a status as an independent historical agency; she at least implies that French social history would have been recognizably different if the cholera vibrio had not arrived on French soil. If we add to this notion of disease as historical actor Kudlick's further contention that "unwitting agency" (p. 11) as much as conscious action motivated by ideology or policy governed the response to cholera, we arrive at a view of history in which the role of individuals or groups purposefully seeking to advance their ends is considerably reduced.

As should by now be clear, this is no conventional academic monograph, and it is difficult to judge it in conventional terms. Readers will find here a wealth of interpretations of many points large and small, many of them convincing, some arresting, a few brilliantly insightful. Kudlick is very perceptive, for example, on the way in which the new discourse of public health increasingly exposed the poor to public scrutiny (in reports on cholera victims, for example), while respecting the privacy of the bourgeoisie - a reversal of the tradition that put the elites on brilliant display and left the poor in the shadows as an anonymous mass. She is also very good on the sometimes competing and sometimes collaborative efforts of state and Church, and on the rival discourses of scientific public health and Christian charity.

At the same time, many readers will find the explanation of the silence of 1849 less than wholly persuasive and may conclude that in trying to knit together so many things, the book perhaps inevitably falls short as an exercise in the study of class formation, medical history, or even discourse analysis. Despite observations on the diversity of social groups and the real sophistication of some of the theoretical reflections on the meaning of class, the analysis frequently reverts to what is in effect a much cruder Marxist account of a bourgeoisie that rose to power following the Revolution of 1789 and consolidated its position under the July Monarchy; this bourgeoisie (at least in some parts of the account) shares a single and univocal set of values derived from Enlightenment rationalism and universalism. The treatment of the medical debates, particularly in its discussion of competing etiologies for cholera, does not do justice to either the influence of epidemiological traditions or the significance that physicians attributed to contemporary observations (on the irrelevance of climatic conditions, for example); to say that "from ancient times and up until the 1820s, the dominant medical wisdom held that epidemic diseases from plague to cholera were highly contagious" (p. 76) is to slight the role of environmental conditions in ancient medical thought and the revival of a neo-Hippocratic theory of epidemic constitutions in the seventeenth and eighteenth centuries. On these questions, Francois Delaporte's Disease and Civilization: The Cholera in Paris, 1832 (1986) is a better-informed and more penetrating guide. And in the analysis of the rhetoric on cholera, although some of the discussions of specific linguistic usages are at least suggestive (on the medical and religious senses of the word "quarantine," for example), others are at best a stretch. It is misleading to call fleau (scourge) a "religious word," on the grounds that it was "long associated with a kind of religious transgression." (p. 150) The word fleau, like the English word "flail," derives ultimately from the Latin flagellum, meaning whip (or scourge) and referred to an affliction, including - though not restricted to - one visited from on high. More dubious is the proposal that a document "with frequent references to cures being 'administered' rather than 'provided' or 'given' by doctors . . . suggested that the administration had placed its stamp upon medical ideas." (p. 106) This sense of administer is very old, going back to the Latin root, and the word in a medical context carries much clearer connotations of ministering to, or caring for, a patient than of imposing governmental authority.

As for the silence of 1849, the formula bundles together several things, including fewer published contemporary accounts, a lower level of affect expressed in those accounts, and a reduced tendency to associate cholera with the insurrectionary masses as a fearful enemy. It is of course difficult to document a silence, though one might have wished for some attention to contemporary observations on the phenomenon, since Kudlick assures us that the word was "used by most contemporaries who contrasted the two epidemics."(p. 5) In any case the contrast is a plausible one; what of the suggested explanation? More weight should probably be attached to a factor that Kudlick wishes to minimize: the cholera was new and exotic in 1832, and the potential extent of its spread, unclear. The epidemic of 1849 was the first of several recurrences in the nineteenth century. As for radical politics and popular insurrection, the outbreak of 1832 followed the major insurrection of workers in Lyons the previous November; it was, as Kudlick notes, at its height at the time of the riots associated with the funeral in June of General Lamarque, himself a victim of the disease. In contrast, the epidemic of 1849 followed the decisive crushing of popular insurrection in the June Days of 1848, the consolidation of a conservative French republic increasingly dominated by politicians with monarchist sympathies, and the failure of revolution throughout Europe. The revolt of 13 June 1849, at the height of the epidemic, had only limited popular support and was easily contained. All of this, it could be argued, did far more to reassure the capital's elites than the putative rise of the bourgeoisie to social preeminence and cultural hegemony in the 1830s and 1840s. One wonders how the propertied classes of Paris, far more fearful of working-class radicalism than in 1830, might have viewed the cholera had it arrived a year earlier.

Perhaps the fairest conclusion is that this book exemplifies both the strengths and the weaknesses of the new cultural history. But it should be added that to take it to task for the latter is to some extent to fail to meet the argument and the method on their own terms. Kudlick did not undertake to write the definitive history of anything - a labor of Sisyphus by any standard, and a particularly self-defeating enterprise when seen from a postmodernist perspective. She seems rather to have embarked on, and invited the reader to join her in, a series of experiments in reading, which by their very nature test the limits of more conservative forms of historical discourse. This is not a book to read nodding in passive assent while jotting down the occasional note, and then forget; it is a book to read actively, with both alert skepticism and an open mind - and then remember.

Matthew Ramsey Vanderbilt University