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Bulletin of the History of Medicine 76.2 (2002) 391-393



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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. Creating the North American Landscape. Baltimore: Johns Hopkins University Press, 2000. xii + 578 pp. Ill. $59.95 (0-8018-6152-7).

The Sanitary City represents the culmination of Martin Melosi's years of pioneering scholarship on urban infrastructure and the urban environment. This body of work fully justifies the characterization of Melosi as a "historical innovator." [End Page 391] The Sanitary City is a major work of scholarship—a comprehensive, perceptive, well-written, lavishly illustrated, and attractively published book. And, although it draws upon Melosi's past writings, it goes well beyond them in terms of its scope and depth, drawing from extensive research in the primary and secondary literature. Melosi's detailed narrative skillfully traces the history of sanitation services—water supply, sewerage, and solid waste collection—through American history from colonial times to the present. He carefully notes the importance of technology transfer from Europe, as well as the successes and failures of these imported technologies.

The author deals with each of his major themes in three time periods: "The Age of Miasmas: From Colonial Times to 1880," "The Bacteriological Revolution, 1880-1945," and "The New Ecology, 1945-2000." Melosi designates these themes as "environmental paradigms" that reflect technological choices "informed by and within the context of the prevailing environmental theory of the day" (p. 6). For Melosi, in this context, "environmental theory" appears to mean theories of disease etiology that involve interactions with aspects of the environment—air, water, and land. Thus, he explores how the technical choices of city decision-makers and engineers have been strongly influenced by prevailing theories of public health—for example, the miasmatic or filth theory of disease and bacteriological theory. His last period, on the other hand, the most recent, is shaped by "new" ecological theories that do not necessarily correspond to a public health domain alone. In addition, this last period includes a range of developments such as the infrastructure crisis, the environmental movement, and new pollution concerns that brought an extended set of influences to bear on sanitary decision-making. Melosi discusses these new forces in detail, although without the depth that characterizes his first two sections; as a scholar interested in the policy implications of history, he chose to continue his narrative to the present, even though the available scholarly literature was limited.

For the total period explored, Melosi advances what he had earlier called a "techno-environmental theory of urban growth"—one that reflected "the intimate connection among technical systems, urban growth, and environmental impact."1 Thus, a systems perspective, as pioneered by Thomas P. Hughes for large technical systems, infuses his analysis. Also structuring his text is economist W. Brian Arthur's concept of "path dependency," a hypothesis that helps explain sources of resistance to reforming in-place sanitary infrastructures. Like Hughes, however, Melosi does not fall into the trap of technological determinism, delineating the important roles played by individuals and by competing decision-making theories.

In a recent review of The Sanitary City, historical geographer Matthew Gandy, while praising Melosi's work as "invaluable," criticized it for failing to link sanitary developments more fully to urban processes, and for neglecting psychoanalytic [End Page 392] and metaphorical conceptions of urban space. Gandy noted, furthermore, that urban environmental history as a subfield had a "narrow theoretical base."2 Gandy's comments suggest the need for scholars to build upon the foundations laid by pioneering researchers such as Melosi and to explore other possible paradigms relating to sanitary infrastructure and the politically contested urban terrain. In addition, more research is required on the relationship between urban infrastructure and sickness and health in the city. David Rosner and Amy Fairchild are presently directing such a study in their "The Living City" project at Columbia University, but...

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