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Journal of the History of Medicine and Allied Sciences 56.1 (2001) 95-96



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Book Review

The Sanitary City:
Urban Infrastructure in America from Colonial Times to the Present


Martin V. Melosi. The Sanitary City: Urban Infrastructure in America from Colonial Times to the Present. Baltimore, Johns Hopkins University Press, 2000. xii, 578 pp., illus. $59.95.

The Sanitary City is a comprehensive survey of urban systems of water supply, wastewater removal, and solid waste management in the United States from colonial times through the present. Melosi fruitfully utilizes the social science approaches of ecological theory (environmental context), systems theory (development of sanitary technologies), and path dependence (policy choices) to explore national trends in sanitary technology. He skillfully details how evolving technology, political and economic constraints, and prevailing notions of health and the environment shaped emerging and established sanitary systems. Although the implementation of a technological system could improve the health and welfare of those in the city, Melosi notes that the same technology could have a negative effect on the community’s other sanitary systems and on communities at the “end of the pipe.”

In the first section, the “Age of Miasms” (to 1880), Melosi shows how the technologies of cast iron piping and steam power combined with Chadwick’s sanitary idea, the belief that the physical environment influenced the health and well-being of the individual, to make possible the emergence of private and later public water supply systems in the United States. By 1880, major cities had the basic technology and financial arrangements for a water supply in place; wastewater management, though increasingly necessary because of the large influx of water, developed more slowly.

Rapid urban growth and Progressive reformers’ concern with the urban [End Page 95] environment pushed cities to design large-scale, permanent, capital-intensive sanitary technologies during the era of the “bacteriological revolution” (1880–1945). State governments granted cities the authority to incur debt, making such projects financially feasible. Bacteriology raised concerns about the effects of pollution on the whole city and, to a lesser extent, on the area beyond. Public water supply and wastewater treatment systems grew and multiplied as urban growth and citizen concern with water purity required expensive chlorination, distant supplies, extension of pipes, and sewage treatment. A dramatic increase in refuse led municipal housekeepers to support the public (or partial public) management of solid refuse and reject incineration and water dumping. Melosi shows how the federalgovernment became increasingly involved in funding water supply and wastewater projects between the wars; at the same time, federal policies fostered the suburban growth that undermined the urban core. The interwar period also witnessed the emergence of regional planning and the recognition of nonbiological industrial toxins in the water supply.

In the postwar era informed by the new ecology (1945–2000), American sanitary systems faced the dual problem of expanding services to meet suburban growth and repairing extant lines at the urban core. It was during this era that environmentalists and the federal government recognized the dangers of groundwater contamination, nonpoint pollution, and toxic wastes to the human population as well as the entire ecosystem. Melosi equates federal pollution control legislation and national standards with progress. While he carefully shows the interaction between local, state, and federal government in the first two sections of the book, the local and state authorities fall out of focus in the final section as Melosi concentrates his attention on federal legislation that expanded federal authority over waste management.

The text has a few minor problems. The author confuses yellow fever with typhoid fever (p. 85). He criticizes Progressive era engineers for designing technologies that were not flexible enough to anticipate recent developments like radioactive wastes that they could not have foreseen. In addition, language biases obscure the positive role that some industries played in promoting clean air and water; while he describes conservationists as “concerned with water as a national resource,” coastal oystermen were “covetous of their economic livelihood” (p. 225). The role of private industry...

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