A History of Public Health in New York City, 1866–1966 by John Duffy (review)

358 THE CANADIAN HISTORICAL REVIEW theirroleasadvisers andtechnical experts, helped shape anewconsensus favouring moderate reformandpositive state action, thetrademark ofAmerican progressivism attheturn of thecentury. Professionalism meantthatachievement wasnowtobejudgedbyinternal scholarlystandards ; members ofadiscipline insisted thatonlytheywerequalified tojudge theirpeers.Thiswasnotmereself-serving butaboldattempttoliberateacademics from externalpressures at a time when universitytrustees believedthemselves empowered tooversee theactivity andopinions of academics. The passionless and cautious pursuitof knowledge did not,by andlarge,fostera rigidseparation of thought and action; it promoted academicfreedom. The claim to value-neutral expertise wasactually asubtle legitimation of thenewliberalism, garbedintherobes of science. Furnerbegins asaniconoclast andendswithanintricateandmany-sided picture of theramifications of professionalism. Historians of Europehavelongknownthat thetransformation ofhistory intoascience, innineteenth-century Germany, was the cuttingedgeof Germanliberalism. Liberalvaluesandthepursuitof science were brotherandsister. Professor Furner's excellent booksuggests thatthisalsowasthe case in the United States. JACQUES KORNBERG University ofToronto ,, AHistory ofPublic HealthinNewYork City,•866-•966. JOHN DUFFY. NewYork, Russell SageFoundation,x974. PP-xxii, 690, illus. With thepublication of thisstudy, JohnDuffy hascompleted themostdetailedand comprehensive historyof publichealtheffortsin anyAmericancommunity.(An earliervolumeof parallelscopehad coveredthe yearsfrom colonization to •865.) New York, moreover,wasno ordinarycommunity.Largestof Americancities,its problems wereequallyimmense. At theendof thenineteenth andbeginning of the twentiethcentury,moreover,New York'sdepartmentof publichealthplayedan exemplaryrole as leader in the applicationof the new bacteriological and immunological knowledge tothefightagainst communicable disease. Duffy has soughtto sketchin the general- and necessary - backgroundof intellectual anddemographic changeagainst whichtheinternalhistoryof thecity's publichealtheffortsmustbe seen.Similarly,he hasoutlinedthe relationship between the city'spublic health departmentand other city agencies as well as its relationship withprivatephilanthropy. It isa complexandchallenging storywhich mustbetoldonmanydimensions. In some ways, however, itisastory toobigevenfor thisgenerously-scaled study(almost seven hundredclosely-printed pages). Forthe appropriatecontextfor the historyof publichealth is asbroad associety itself. Despitethe author'sawareness of thesensitivity of publichealthto political, public policy, andintellectual issues, theverycomplexity of events hasforcedhimtofollow thehistoryof thedepartment's activities from theinside. Duffy followsthe historyof theinternalorganization andactivities of thedepart- REVIEWS 359 mentof publichealthalmost toofaithfully.Asaresult,thereisnoexplicitemphasis onwhatisinmanyways themostchallenging question of publicpolicy impliedbythe historyof the departmentin the centurycovered.How did an areaof high-status activityandrealachievement - bothintellectual andadministrative - changeintoa far moremarginalenterprise intheworldofmedicine. It isasignificant incidentin a more generalshiftof socialprioritiesfrom the publicto privatesector.Within medicine itselfitreflects aparallelshiftinintellectual andsocial priorities fromsocial and environmental to individualandlaboratory-oriented concerns. It isa development ,moreover, consistent withchanges in manyotherareasof social policy, both relatedtomedicine(ashospitals), andmoregeneralconcerns (asin theuseof public space). A moreconsistent effort toseeNewYork'spublichealthstoryincomparative terms- thatisin comparison withotherAmericancommunities andperhapsforeign citiesaswell- mighthavemadea longbookevenlonger,but wouldhaveaddeda significantdimensionto its usefulness for socialand institutionalhistorians. Moreover,it mighthaveshedadditionallight on thisshiftin social priorities.But despitethesereservations, letmeemphasize thatweareallin Professor Duffy'sdebt forhaving theenergy andorganizational skilltoundertake andcomplete sovaluable a project. CHARLES E. ROSENBERG University ofPennsylvania Progress andPragmatism:James Dewey, Beard, andthe American IdeaofProgress. D^vIDW. M^RCELL. Contributionsin American Studiesno 9. Westport, Conn., Greenwood Press,•974. PP.xiv,4o2.$•3.95. Much hasbeenwritten aboutWilliamJames,John Dewey,and CharlesBeard in relationto the antiformalistpragmatic movementeversince•949 whenMorton G. Whitefirstopenedup thesubject. DavidW. Marcellgoesbackoverthesameterritory againin linkingthethreethinkerstoameliorismthattriedtotranscend thepolarity of rationalismand empiricism.His claimsfor advancingthe argument,however, unfortunatelyevaporate under scrutiny, and he isleft witha lucidand knowledgeablebookthatrehearses whatisalreadyknownandrepeatscriticisms alreadymade. Marcellbelieves thatheiscorrectinga failureto talkof the'positiveandconstructiveconsequences ' of Beard's revoltagainst positivism andthat'thepragmatic wayin whichBeardqualifiedhisrelativismhasscarcely beennoted'(32o).Marcelliswrong onbothcounts. In •9581examinedBeardasa'pragmatic relativist' whoemphasized 'the centralrole of plansand hopesfor future bettermentasdeterminantsof the historian's actof historical synthesis.' I specifically concluded that'thisrevoltagainst pseudoscience, finality,andformalism wasfundamentally creative,' evenif'it did not fully accomplish itsaims.'In •955 I emphasized the unrecognized extentto which antiformalists like Beard, Dewey,and Veblen had their own rationalism,derived from amodernrevivalandrevision of theEnlightenment's ideaof progress. Marcell eventuallyalwaysconcedes with one hand what he hasdenied with the other. He says Beard'scriticsfail to seethathe waswellawareof modernscientists ...