The Gospel of Germs: Men, Women, and the Microbe in American Life

What is cleanliness? Such a simple question (but then, go ask Pilate about truth and all that). Nancy Tomes has written a masterful study about the process through which cleanliness came to be newly conceptualized in America during the four decades with 1900 at their center. This is a book about the transformation of a cultural ideal—purity—from a concern for visible tidiness to a preoccupation with unseen but deadly microbes. Tomes chronicles the process of “antisepticonsciousness”-raising, by which home economists and salesmen of the novel porcelain toilet alike urged American housewives to protect their families from the microscopic menace. Tuberculosis, with its apparent tendency to lurk in dark corners or unaired carpets, was the preeminent source of fear, followed closely by typhoid fever. The latter spurred plumbing reformations that first targeted the dreaded sewer gas, and then led to a preoccupation with keeping the bathroom disinfected and shiny, and with separating the household food supply from germ-carrying flies.

Tomes tells this story with great sensitivity to the gendered nuances involved. Women were urged to keep the house spotless, to protect their children’s very lives, but it was men who had to make plumbing choices or buy screens. Reformers told women their skirts were too long, so that they inadvertently dragged street filth into their houses, and this point was driven home by cartoons—such as the wonderful one gracing the book’s cover, in which a servant dusting the hem of madame’s cape spreads a cloud of typhoid, consumption, and influenza into the faces of sweet children. The depiction of the home as a “whited sepulcher” that appeared pure but harbored death played effectively on maternal guilt and anxiety, in an era when infant mortality, even among the affluent, was still commonplace.

In the book’s final section Tomes documents the decline of the “gospel of germs,” admitting that, in part, the dangers were overblown and some reaction was inevitable. But she is unapologetically proud of her turn-of-the-century reformers as well, for they “serve to educate and inspire rather than simply anger or amuse us” (p. 267). She would have us remember that “the private side of public health is not just an important social phenomenon; it also protected people from disease” (p. 265). Public health reform really did make a difference, and contributed largely to America’s quality of life in the twentieth century.

However positive my overall feelings about this work, there is one snafu that cannot go unmarked (especially since I am cited as the source for it). On p. 238, after discussing Walter Reed’s role in disproving the fomite theory of yellow fever’s transmission, Tomes says: “He concluded that the mosquito alone bore the malaria plasmodium to its victims.” The latter discovery could be claimed by Ronald Ross (birds, 1897), or G. B. Grassi (humans, 1898), but of course Reed (in 1900) did nothing but learn from it.

The Gospel of Germs bears the common parochialism of works concentrating on the northeastern United States, with the assumption that the important diseases are typhoid and tuberculosis rather than, say, yellow fever or plague. It is curious in particular that Tomes avoids the great southern hookworm crusade, with all its blatant affinities to sin and its purification. There is a description of tuberculosis campaigns among African Americans in Atlanta, however, that partially redeems this omission.

It is always easy to criticize a book for what it has not done, but equally easy to turn the criticism on its head and proclaim that the work opens new avenues for exploration. This book is essential reading for historians of American medicine and public health, and will prove equally interesting for the general reading public, who may have long puzzled over their grandmothers’ obsessive preoccupation with germs.