City of Plagues: Disease, Poverty, and Deviance in San Francisco (review)

Susan Craddock. City of Plagues: Disease, Poverty, and Deviance in San Francisco. Minneapolis: University of Minnesota Press, 2000. x + 300 pp. Ill. $34.95 (cloth, 0-8166-3047-X).

Susan Craddock's provocative work offers an invaluable perspective on public health and the construction of race that speaks not only to the past but also to the present. She begins with the important and refreshing recognition of both the ethnic and the spatial distribution of disease, which makes this a historical study that speaks to contemporary concerns in a way that many do not: "a discussion of the body," she writes, "is inadequate without an accompanying discussion of place" (p. 7), for "space is not simply a passive container but a dynamic actor in the production of social relations" (p. 8). City of Plagues, which focuses on the experience of Chinese immigrants in San Francisco, offers a significant broadening of traditional historical analyses of public health and its impact on particular groups or communities.

Throughout the book, Craddock shows when and why public health imperatives intersected with social and economic imperatives and worked not simply to stigmatize the Chinese, but to define and create a pathological containment space for them within the city of San Francisco, creating the boundaries of Chinatown. In her analysis of the public health response to TB, plague, smallpox, and syphilis in San Francisco, she underscores the importance of considering the power of science not only to employ and define race, but also to control, through the use of space, participation in American cultural and civic life. It is this use of the police powers of public health, then, that distinguishes the experience of the Chinese in America from that of many other immigrant groups. As Craddock notes, "The ascription of disease to particular bodies and places can only work as a containment measure . . . if bodies remain within their specified geographic locations and if they can be easily coded as to their sexual orientation, social practices, ethnic origin, or nationality" (p. 9).

Craddock's book implies the need to connect, though not equate, the exclusionary aspects of public health policy with the segregation of African Americans—the more domestic side of the construction of difference and exclusion. Public health practice in San Francisco did not merely stigmatize or scapegoat the Chinese; it told them that they were a people apart. The Chinese were not only contained within the bounds of Chinatown and denied integration into the larger culture, they were also denied admittance to citizenship. When we contrast the case of the Chinese with other immigrant groups that have been the more typical subjects of historians interested in public health and deviance—southern and eastern European immigrants—we can see a larger pattern of how physical, geographic, and legal/political color lines in America were being drawn, not through Europe, but around immigrants from Africa and the Caribbean, African Americans, Asians, and, beginning in the 1920s, Mexicans. This effort to contain and exclude the Chinese, therefore, was part and parcel of a much broader effort to shape a national Anglo-American identity. In this fashion, Craddock's study can speak to the emerging debate regarding the growing and important literature on whiteness and its definition.¹

But, while Craddock sees the tools of public health—incarceration, exclusion, deportation, the imposition of fines for violations of public health law—as disciplinary tactics, as means to contain or control deviant groups or behaviors, the use of such tools really signaled a breakdown of the discipline imposed by public health and, indeed, by industrial society. Punitive or exclusionary measures were leveled at the Chinese precisely because this particular group was not perceived as responding to efforts aimed at achieving immigrant acceptance of industrial norms and values. In contrast, immigrants in the industrial northeast were viewed as suitable "industrial citizens"—necessary (though expendable) cogs in the modern industrial...