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Intrusive Interventions

Intrusive Interventions: Public Health, Domestic Space, and Infectious Disease Surveillance in England, 1840-1914

Graham Mooney
Copyright Date: 2015
Edition: NED - New edition
Pages: 292
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  • Book Info
    Intrusive Interventions
    Book Description:

    The politics of public health in modern democracies concerns the balance between rights and responsibilities. This equilibrium of citizenship is under perpetual negotiation, but it was particularly intense in mid-nineteenth-century Britain when public health became deeply embedded as a state practice. Using extensive archival research, Intrusive Interventions examines the contested realm of Victorian liberal subjectivity through an interconnected group of policies: infectious disease reporting, domestic quarantine, mandatory removal to isolation hospital, contact tracing, and the disinfection of homes and belongings. These techniques of infectious disease surveillance eventually became one of the most powerful and controversial set of tools in modern public health. One of the crucial questions for liberal democracies has been how the state relates to the private family in shaping duties, responsibilities, rights, and needs. Intrusive Interventions argues that the gaze of public health was retrained onto everyday behaviors and demonstrates that infectious disease surveillance attempted to govern through the agency of family and through the concept of domesticity. This fresh interpretation of public health practice during the Victorian and Edwardian periods complements studies that have examined domestic visiting, the infant welfare movement, child protection, and school welfare. Graham Mooney is an assistant professor at the Institute of the History of Medicine at Johns Hopkins University.

    eISBN: 978-1-58046-889-3
    Subjects: Health Sciences
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Table of Contents

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  1. Front Matter (pp. i-vi)
  2. Table of Contents (pp. vii-viii)
  3. Acknowledgments (pp. ix-xii)
  4. Abbreviations (pp. xiii-xiv)
  5. Introduction (pp. 1-16)

    In an 1876 address that was reported in both the medical and popular press, the newly inaugurated president of the Society of Medical Officers of Health, Dr. George Buchanan, spoke to his colleagues about “Citizenship in Sanitary Work.”¹ As one of the first medical officers of health in London—appointed in 1856 at the parish of St. Giles in the Fields—and at the time an assistant medical officer to the Local Government Board, Buchanan had been steeped in the public health problems of English urban life for two decades.² Despite this wealth of experience—or more likely because of...

  6. Part One: Making Infectious Disease Surveillance
    • Chapter One Finding Disease in the Victorian City (pp. 19-39)

      The English System of infectious disease surveillance crystalized in the latter part of the nineteenth century, when preventive interventions such as hospitalization and disinfection blended with scientific discoveries in aseptic surgery and bacteriology. Legislatively speaking, the fulcrum for this was the Infectious Disease (Notification) Acts of 1889 and 1899. These acts forced general practitioners to report cases of infectious disease to the local sanitary authority, which then pursued existing public health laws to isolate patients in hospital, disinfect property and belongings, suspend schooling, and temporarily close businesses.¹

      Most accounts of public health ideology and practice in the late nineteenth century...

    • Chapter Two “These Bastard Laws”: Infectious Disease, Liberty, and Localism (pp. 40-66)

      In February 1882, Nottingham’s MOH Edward Seaton outlined the benefits of infectious disease notification:

      I have urged the adoption of a system of notification because by this means we should undoubtedly be in a better position to control the spread of disease. I have urged it in the case of smallpox, because we may thus get patients thoroughly well isolated and by getting the persons who are likely to be exposed to the infection vaccinated, we may stop the course of this highly infectious and terrible disease; I have urged it in the case of scarlet fever because we should...

  7. Part Two: Spaces of Risk and Opportunity
    • Chapter Three Sequestration and Permeability: Isolation Hospitals (pp. 69-92)

      On the cover page of his 1872 report to the influential Manchester and Salford Sanitary Association, entitled “A Paper on the Duty of Municipal Authorities to Provide Hospital Accommodation for Cases of Infectious Diseases,” James Hardie, MD, quoted from John Stuart Mill’sOn Liberty: “The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty and action of any of their number, is self-protection.”¹ Isolation hospitals for infectious disease were required, argued Hardie, because unlike diseases of the hip or inflammation of the lungs, ailments such as scarlet fever and typhus were unresponsive to medical...

    • Chapter Four “Combustible Material”: Classrooms, Contact Tracing, and Following-Up (pp. 93-120)

      It has long been argued that the introduction of elementary schooling in 1870 shaped the identity of the English working classes by reinforcing their station in the social hierarchy.¹ Strict discipline, obedience, and the maintenance of order were the foundations of moral reformation and spiritual salvation that drove the mid-nineteenth-century creed of social obligation.² The curriculum in elementary schools came to be heavily influenced by ideas about national identity and imperialism, particularly against the background of national decline in the 1890s and 1900s.³ The economic threat posed by Germany and the worrisome physical condition of Anglo-Boer War recruits prompted a...

    • Chapter Five Disinfection, Domestic Space, and the Laboratory (pp. 121-153)

      A peculiarly Victorian disquiet centered on the materiality of domestic life.¹ The disease-harboring threat of furnishings and decorations had been long acknowledged by medical authorities on the sickroom.² Writing in the 1840s, elite physician Anthony Todd Thomson argued not only that infection settled in clothes and bedding made from wool, cotton, and fur, but that it also clung to floors, furniture, and ornaments, especially if these objects had rough and unpolished surfaces.³ Advice from physicians like Thomson remained a feature of home nursing manuals throughout the Victorian period.⁴ Removing superfluous furniture and ornamentation formed part of the ritual that signified...

    • Chapter Six Rules for Home Living: Tuberculosis and the Consumption of Self-Help (pp. 154-178)

      By the early twentieth century, the aspirations for disinfection that had been expressed by John Simon and others in the 1860s had, to some extent, been realized. A “modern” and scientifically up-to-date program of municipal disinfection in the early 1900s combined formalin spray for houses and steam disinfection for articles and clothes. When using these processes in conjunction with technology that reduced operator error and increased capacity, sanitary authorities—certainly in the big industrial cities, but also in some rural areas that owned mobile apparatus—were as confident as they ever had been that some measure of command could be...

  8. Conclusion (pp. 179-182)

    Intrusive Interventionsopened with a focus on citizenship. It closes with the same. The year is 1908. The place is the inaugural issue of theSociological Review, edited by Leonard Trelawney Hobhouse, a leading proponent of social liberalism. We have already met the writer, Dr. (later Sir) W. Leslie Mackenzie, from the Scottish Local Government Board. Mackenzie was the innovator who attached a bicycle inner tube and a T-shaped crosspiece to a disinfecting spray pump, thus making it “liberal.”

    The theme for Mackenzie’s paper was “The Family and the City: Their Functional Relations.”¹ Explicating the tenets of a new liberalism,...

  9. Notes (pp. 183-232)
  10. Bibliography (pp. 233-264)
  11. Index (pp. 265-278)
  12. Back Matter (pp. 279-279)