Book Review: Contagion: historical and cultural studies.

Contagion: historical and cultural studies is a thought-provoking edited collection that permeates the boundaries between history, sociology, geography and the health sciences. According to the editors, the volume seeks to provide a “critical elaboration on the history and present” of what one of the contributors, Margrit Shildrick, terms “the dream of hygienic containment”. The elusiveness of control, claim the editors, “sustains the fascination of contagion in the cultural imagination of the west” (pp. 1–2). It is difficult to argue with this, given international concern over, and research resources pouring into, the prevention of (re)emerging infectious disease and bioterrorist threats. The book is subdivided into two time periods. The first deals with the nineteenth century and the first half of the twentieth, while the second takes up matters of contagion in more recent history. From a host of competing ideas and formulations, I have chosen to identify three key issues to bridge this modern/post-modern divide. One is “foreignness”. The fear of the transmissibility of foreign biological entities can express itself in public health policies that focus on “foreign” peoples. Warwick Anderson's study of the public health and laboratory practices of American colonialism in the Philippines; Alison Bashford's connection of smallpox inoculation and vaccination to oriental and colonial history; and the examination of the management of leprosy and race in inter-war Australia by Bashford and Maria Nugent, address this aspect of foreignness to a greater or lesser extent. Here we have challenging histories that consider public health policies as “civilizing”, racializing, differentiating, spatializing, and as mechanisms for empire- and state-building. Such approaches might be regarded as indicative of the influence of cultural interpretations on the history of health, while Marsha Rosengarten's chapter on organ transplantation, be that human to human or animal to human, stresses the significance of the immunological “self” defending against “foreign” invasion, in a more contemporary context. Another theme connected to foreignness is that of dangerousness. The dangers of this volume are Claire Hooker's elusive typhoid carriers and milk supply in Moorabbin, Victoria, Australia, in the early 1940s; and in the disabled body as discussed by Shildrick, which “may carry no infectious agents, and yet is treated as though it is contaminatory” (p. 158). Closely allied to such notions of dangerousness are those of risk. This is most explicitly dealt with by Lisa Adkins' essay on how HIV testing is constructive of heterosexual self-identity as “low-risk”, rather than simply as a technology for identifying homosexual as “high-risk”. Adkins' argument is also interesting for students of public health and risk in that it suggests a complexity of hierarchies, and diverse categorizations, of risk. A third bridge across the chronology, in addition to dangerousness and foreignness, is how morbid agents are conceptualized as seeds that require a fertile soil—in other words, a contaminated environment or a susceptible human being—in order to take hold and prosper. This botanical metaphor had a multiplicity of applications. As Christopher E Forth observes in his chapter on masculinity, writers in late-nineteenth-century France argued that moral contagion most threatened those members of the community whose defence mechanism was compromised by some form of hereditary defect, nervous disorder or previously acquired affliction. Margaret Pelling refers to the nineteenth-century biological uses of the metaphor in a wide-ranging survey on the shifting historical meanings of contagion, a reprint of her contribution to Bynum and Porter's Companion encyclopedia of the history of medicine (1993). Scholarly study of this botanical metaphor has enjoyed a renaissance in recent public health history, most notably in Michael Worboys' Spreading germs (2000). While Pelling's original 1993 essay is sufficiently recent and authoritative to be relevant for the volume in hand, the newly bolted-on introduction and conclusion are far too brief to do little more than list recent medical histories that take a renewed interest in contagion, of which Worboys' book is but one. I found the contribution by Jane Mahree on the placenta as pregnancy's site of the “performance of contagion” (p. 201) rather more difficult to place than other chapters, though other scholars more familiar than I with the literature in women's studies and embodiment may well disagree. The artist Melina Rackham's chapter drew me to her website (http://www.subtle.net.carrier) to consider contagion in a more positive sense: our viral lovers, she argues, “are encouraging us, their human and machine carriers, to become re-acquainted with the left-handed path, with the messy, ugly, multi-textured swarming cellular self” (p. 225). This, then, is a diverse collection. The three bridging themes chosen to frame this review are not mutually exclusive and cannot do justice to the many provocative and subtle interpretations of contagion that the book contains.