Fevered Lives: Tuberculosis in American Culture Since 1870 (review)

In the past five years, there have appeared a number of good histories of tuberculosis in the United States, including Barbara Bates’s Bargaining for Life (1992), Sheila Rothman’s Living in the Shadow of Death (1994), and Georgina Feldberg’s Disease and Class (1995). Now added to the list is Katherine Ott’s Fevered Lives, which represents the most ambitious effort yet to write a sweeping cultural history of TB in America. In a mere 168 pages, Ott takes on the Herculean task of surveying the transformation of the nineteenth-century disease of consumption into the twentieth-century entity we know as tuberculosis. She summarizes not only changes in scientific theory and medical treatment, but also the social experience and cultural significance of the disease. In the spirit of Susan Sontag, Fevered Lives looks at the way TB shaped and was shaped by the larger culture.

The results of this ambitious undertaking are flawed yet well worth reading. The strength of Ott’s work lies in her attention to the spatial, technological, and material dimensions of the disease experience. Drawing on her training in museum studies (she is a historian with the Smithsonian Institution), she provides highly imaginative and interesting readings of the “distinctive sites of tuberculosis—spaces inhabited by living beings and shaped by material objects,” as she states in the introduction (p. 5). “Being ill,” she reminds us, “took place within a geographic space constituted by objects, tools, instruments, and people” (p. 5). Thus Ott’s narrative of how consumption became TB focuses on

the figurative and literal locations significant in their history: the sickbed and sickroom, the healing wilderness into which invalids retreated and its attempted reconstruction within the walls of the chest, the microscopic world of the bacillus, the consumer marketplace of invalid goods, the stereotyped black body, the Lung Block, and the sanitorium. (p. 5)

To this end, Fevered Lives is filled with interesting excursions into the history of medical instruments such as the spirometer, which was used to measure patients’ lung capacity, and now-forgotten procedures such as the plombage, which involved packing the lungs with inert materials such as Ping-Pong balls. Ott also provides imaginative readings of the sickroom and the sleeping porch, spaces that reflected shifting conceptions of the “white plague.” Her discussion of the “invalid trade” generated by the consumptives’ desperate efforts to recover is especially interesting and original.

Where this book is less successful is in its grand synthesis of medical and social history. Specialists in medical history are likely to be dissatisfied with Ott’s summaries of medical theory and practice. Those who become apoplectic at the least sign of postmodernism will never make it past the introduction. Yet for all the attention to material and visual culture, the larger arguments Ott makes about the changing significance of the white plague are familiar ones. She concludes that the new scientific understanding of disease associated with the germ theory and bacteriology fostered trends toward greater specialization, dependence on precision instruments, and state surveillance of the sick. She emphasizes, as do many recent scholars, that the shift from consumption to TB fostered new ways of “race-ing” the illness, and deepened prejudices toward poor, foreign-born, and nonwhite Americans. What is more surprising is her reluctance to grapple with the recent work of scholars such as Sheila Rothman and Georgina Feldberg on similar themes. For example, Ott’s section on chasing the cure makes no mention of the gender differences in treatment that Rothman so clearly demonstrated in Living in the Shadow. Nor does Ott’s account sufficiently contend with Feldberg’s arguments about the peculiar character of the American public health movement.

Still, this is a remarkable first book—lively, bold, and imaginative. Ott’s commitment to and talent for writing about the material aspects of disease history make Fevered Lives well worth reading and assigning to students.