The Gospel of Germs: Men, Women, and the Microbe in American Life.

The Gospel of Germs: Men, Women, and the Microbe in American Life. By Nancy Tomes (Cambridge, Massachusetts: Harvard University Press, 1998. xv plus 35lpp.).

In The Gospel of Germs Nancy Tomes has produced a discerning study of how average Americans came to believe that microscopic organisms were the specific causes of disease and that there was something each person could do to prevent their spread. Tomes convincingly demonstrates that the cultural understanding of germs depended on a number of factors including scientific theory, middle-class culture, and the persuasiveness of medical reformers, entrepreneurs, and advertisers. Though the work holds few surprises for historians of medicine or hygiene, it is an impressive and lucid blending of current scholarship in the histories of medicine, housing reform, public health, technology, and women's domestic work.

In the introduction Tomes proposes to counter four ideas that have become basic tenets of disease and medical history: 1. that popular understanding of disease should be judged in terms of how well it integrates current scientific theory, 2. that middle-class hygiene rituals are psychological responses to industrialization rather than reactions to the everyday reality of disease, 3. that changes in personal hygiene had little to do with the decline in mortality due to infectious disease, 4. that prejudicial attitudes and behaviors toward blacks and immigrants are inherent in the germ theory itself.

Tomes successfully demonstrates that it was not necessary for the general public to fully understand scientific ideas about germs for the theory to have an effect on individual behavior. Indeed, she notes that in the earlier period: "As a simple rule of thumb, the further removed the author was from the medical establishment, the more likely he or she was to accept the germ theory as a credible and important scientific discovery." (56) This is not to say that public understanding of the mechanism of microbial infection was ever fully rational or complete. Rather, even faulty faith in germs was sufficient to create sweeping changes in personal and public hygiene.

Particularly intriguing is Tomes' discussion of the ways in which people altered their everyday practices in an attempt to redeem themselves and their families from germs. Tomes suggests that not only were daily bathing and taboos against spitting an outgrowth of the gospel of germs, but so too was use of topsheets in hotels and homes, the fashionableness of clean-shaven men, restraint in kissing babies on the lips, and American desire for increased personal space. Though her evidence for the relationship between the germ theory and this conduct is nor completely persuasive, her reasoning that these changes must have affected the transmission of germs and therefore the demographic transition is convincing. Her assertion that people came to see the human body as the source of disease and that this understanding, as much as the psychological reaction against industrialization, was significant in the acceptance of hygiene rituals is equally plausible.

Tomes' work on cultural prejudice in reform movements arising from the germ theory is more problematic. She does a fine job of demonstrating that anti-black and anti-immigrant bias is not inherent in the theory. Her analysis of two reform organizations, the Joint Board of Sanitary Control in New York and the Negro Anti-Tuberculosis Association of Atlanta, that used the germ theory to resist both class and ethnic bias in order to improve the lives of blacks and working class people sheds important new light on the way in which political values influence use of scientific findings. Yet in attempting to prove that the germ theory could be used in liberating ways, she skims over the predominant political use of the theory: assertion of social control over powerless people. It seems odd that in discussing the link between acceptance of the theory and the modernist outlook she completely ignores the mid-twentieth century social hygiene movement which linked cleanliness behaviors to human social value. Social Hygie nists used efforts to rid society of the germs as weapons against genetic contamination. The link between germ theory and social hygiene also calls into question one of Tomes' earlier assertions that what made the U.S. situation unique was the way in which germs were politicized. The social hygiene movement was international in scope as were the forced sterilization laws that accompanied it.

Despite this flaw the work is generally insightful and the narrative engaging. Particularly noteworthy is Tomes' use of the experiences of the rich and famous at the beginning of each chapter to lend a note of humanity to a type of study that is frequently abstract and impersonal. Indeed Tomes' analysis is rooted in an empathy for ordinary people who were struggling to make sense of the all too real illnesses that threatened them. Those of us who work in this area would do well to emulate Tomes' humanizing approach.