The Ailing City: Health, Tuberculosis, and Culture in Buenos Aires, 1870–1950 (review)

New approaches to the history of science and medicine in Latin America have broadened this discipline and grounded disease, public health, and scientific innovation into a broader framework of social relationships, state and society dynamics, and the contestation over the production and dissemination of medical knowledge. Diego Armus’s Ailing City is a thoughtful addition to this well-established yet dynamic field.

Structuring his analysis around the late 1800s through the 1950s, Armus examines the history of Buenos Aires through the lens of tuberculosis, illustrating the anxieties and tensions that Argentines were experiencing due to issues of immigration, urban growth, and redefinition of gender roles. The author does not follow a chronological trajectory but instead organizes his work around “a sort of inventory of the shifting spectacle of modern life in Buenos Aires” (11). He crafts an exceptional narrative around defining tuberculosis and the initiatives and policies that emerged to combat this deadly disease.

One complication of writing a medical history from a socio-cultural perspective is locating material to illuminate tensions and concerns that gripped various segments of the nation. Armus skillfully supersedes this issue by taking advantage of a diverse range of sources and a unique analytical approach. He draws on conventional works such as medical journals, medical school theses, and political treaties that concerned themselves with public health. For instance, the emerging hospital infrastructure created to combat tuberculosis is fully examined with a keen eye focused on death rates as well as doctor and patient descriptions (55–61).

The author also includes an analysis of folk remedies, popular sports, and fashion trends in order to tease out the practicality of defining, combating, and preventing tuberculosis. An example of this can be seen when Armus examines the relationship between hygiene and prevention, demonstrating that “[d]uring the last third of the nineteenth century the debate on the corset received increasing public attention, partly because tuberculosis could no longer be ignored, and anything that might spread it had to be avoided” (162). In utilizing such a vast array of distinct historical sources, Ailing City successfully offers the reader a glimpse not only into the state’s position but also into the daily lives of the people who were affected by the disease.

As pressure to eradicate threats to public health intensified, Argentine officials were forced to navigate a delicate balance between state intrusion and personal sovereignty. An important factor of this emerging debate was the sometimes complex relationship between politicians, doctors, and society. Armus’s broad analysis of tuberculosis illustrates the ambiguity of constructing medical knowledge from the top down as well as from the popular classes. In addition, he confidently moves from conversations within the political and upper classes, as well as lower class and anarchist demographics.

For audiences and readers interested in a comprehensive history of Buenos Aires and the history of tuberculosis, Ailing City is an essential resource to flesh out those lost in the historical record. While unnecessary internal or regional comparisons are avoided, many parallels can be drawn between other nations that sought an answer to their own public health issues while at the same time maintaining national integrity. One of Armus’s main contentions, the importance of gender in the shaping of medico-political discourse, can also be seen woven throughout Ann Zulwaski’s Unequal Cures: Public Health and Political Change in Bolivia, 1900–1950 (Durham, North Carolina, Duke University Press, 2007).

Armus has cleverly reoriented social medicine through a lens in which we can view larger processes at work. His scholarship contributes to the broader context of the debate in which public health becomes part of the political and cultural landscape. In addition, it contributes to the field of nation building and paints a more complete picture of Latin American history. It pushes the reader to develop a more nuanced understanding of the intersection of disease, nation, and society in the Argentine context and...