Contagion: Disease, Government, and the "Social Question" in Nineteenth-Century France (review)

Contagion: Disease, Government, and the "Social Question" in Nineteenth-Century France. By Andrew R. Aisenberg (Stanford, Stanford University Press, 1999) 238 pp. $45.00

Aisenberg offers another perspective on the well-established field of reassessing Third Republic reform policies. He joins other Foucauldian interpreters, arguing that during the late nineteenth century, new discursive repertoires emerged with new understandings of social phenomena. ¹ This epistemological break permitted a reconfiguration of the relations between republican principles of individual liberties and the interests of social order. The regulation of contagious diseases provided a site where the relations among individuals, the social order, and government could be re-articulated.

Aisenberg analyzes scientific knowledge as a discursive field, which reshaped perceptions of social order. This study focuses on nineteenth-century hygienists who defined contagion in such a way as to legitimate state intervention into individuals' intimate lives. This elaboration of contagion identified the home and the family as the locus of danger and the object of regulation. Aisenberg examines the tensions among and within new scientific paradigms, the construction of hygienists' professional identity, and the transformation of republicanism during the first half of the Third Republic. His ambitious agenda, although not completed, does suggest new insights.

Aisenberg spends considerable time examining the discursive operations of hygienists beginning in the 1820s and through the complex debates of the 1870s and 1880s on Louis Pasteur's germ theory. Reviewing these hygienists' public health proposals, Aisenberg stresses the tensions between principles of liberty and the discourse of science. Although persistent cholera epidemics of the nineteenth century are identified as the primary cause for efforts to improve public health, they remain largely off stage. The Second Empire demolition of "insalubrious" working-class dwellings in central Paris is briefly reviewed. The last two chapters focus on the hygienists of the Third Republic, the limitations of the 1902 Public Health Law, and the ultimate reliance on police regulation rather than legislation to control contagion.

Beginning in the 1880s, hygienists, strong supporters of the Republic, engaged in a national debate about the need for a public health administration with the power to regulate sources of contagion. The Public Health Law was ten years in the making; most responsibility was delegated to the communes, and no national regulatory authority was established. Aisenberg does not linger over this "failure." He does conclude that the positive regulation of social problems could not be implemented through Third Republican legality. The principles of individual liberty and the inviolability of private property and the home would always limit legislative solutions. This route being blocked, Aisenberg argues that hygienists shifted to elaborating police regulations. An 1851 decree had authorized Commissions d'hygiène d'arrondissement in Paris. These neighborhood committees, with their médecins délégués, guarded against contagion until 1914. They assumed a socialized individual, aimed to reduce the outbreak of disease--rather than treat the ill--and relied on police power to enforce their prescriptions for disinfection. These actions attest to the predominance of a new discourse that identified social order as the task of government and in which science was applied by policing.

Contagion certainly reinforces the argument that a discursive shift concerning the relation of government and society occurred in the late nineteenth century. Aisenberg has clearly demonstrated that scientific discourses, particularly those of hygienists struggling with the problem of contagion, were major contributors to it. He further argues that this shift transformed republicanism. That may well be, but how it occurred is not clear in Contagion. The central difficulty is that Aisenberg has only analyzed one set of voices in this complex transformation: What of the politicians, those republicans who supported the hygienist vision of government intervention and those who opposed it? What of the politics of the 1902 Public Health Law? What of those physicians who lobbied strongly against the law? While policing against contagion operated in Paris, how was public health...