This rather lengthy book is the latest work of Diego Armus, a professor of Latin American history at Swarthmore College and a leading scholar of public health and disease in Latin America. The Ailing City, an English-language version of his previously published La Ciudad Impura. Salud, Tuberculosis y Cultura en Buenos Aires, 1870–1950 (2007), is a cultural history of tuberculosis before the widespread use of antibiotics to treat the disease. The author’s stated goal is to examine how the disease affected the life and culture of Buenos Aires. Using a wide range of sources including oral histories, government reports, newspaper articles, literary texts, tango lyrics, and medical case histories, he seeks to understand both the reactions to and the influence of the disease. Included in this cultural history are the experience of the sick, the reaction of civil society, prevailing ideas about the disease, attempts at limiting contagion, the supposed link between race and TB, the interaction of immigration and gender on perceptions of the disease, attempts at social engineering, and the creation of programs to strengthen resistance to [End Page 477] the illness. This work thus centers on the relationship between tuberculosis and the porteño experience of the disease on a multiplicity of levels.
Armus chooses to organize this work along thematic lines, which is both the strength and the weakness of his work. For example, the use of themes allows him to examine in detail the commonly held idea that TB was linked to excess, to study the reaction of patients to their illness, to review attempted cures and crusades against TB, and to view the disease’s impact on everyday culture. He is especially interested in the use of tuberculosis as a metaphor linked to issues as diverse as racial stereotypes and prejudices and the creation of parks. But the same use of theme over chronology produces a work that tends toward repetition, as well as a choppy view of the relationship between the themes being discussed and overall change over time. Moreover, although Armus repeatedly refers to numerical information (e.g., “pulmonary tuberculosis was one of the largest killers in absolute numbers in Buenos Aires” [p. 9]), the book is sadly bereft of hard data on the disease. While pictures of posters, hospital rooms, and gymnastic classes, tango lyrics, and analysis of discourses on the nature of the city are interesting, some concrete information such as the number of reported TB cases over time or maps showing the concentration of cases within the city by decades would have provided additional grounding to this interesting work.
Armus finds that for more than eighty years, doctors, social workers, and concerned citizens viewed the disease as the inevitable result of living in crowded urban slums, thus ignoring contributory factors related to economic prosperity or the lack of it, such as diet and work patterns. Although a wide variety of treatments are mentioned throughout the book, Armus, in his brief epilogue, concludes that it is impossible to assess the efficacy of the multiple efforts at prevention and education. He also finds that both old and new ways of dealing with tuberculosis persisted until the 1950s, when treatment with streptomycin became the standard practice in Buenos Aires.
The Ailing City is an interesting and important work, but this reader wonders how different Armus’s findings would have been had he compared the Buenos Aires experience to that of any other large American immigrant city such as New York or São Paulo.