‘Peculiar Resistance’: Tuberculosis, Identity and Conflict among Jewish Physicians in Early- Twentieth-Century America

Throughout the nineteenth century, tuberculosis (TB) killed more Americans than any other infectious disease.¹ For much of this period, people regarded TB as an age-old, private malady caused largely by hereditary factors. Only after German physician Robert Koch’s discovery of the TB bacillus in the 1880s did its image begin shifting into that of a modern, public scourge requiring medical intervention.² This reconceptualization also reflected Americans’ reactions to the modern forces transforming their physical and cultural landscape. Prominent citizens questioned whether unchecked immigration, industrialization, and urban development had compromised their nation’s ability to compete for resources, defend its borders, or even reproduce effectively, triggering widespread fears of “race suicide.”³ Tuberculosis, an infectious disease that saps the inner strength and vitality of its victims, embodied these fears perfectly.

Social anxiety, together with the fluid etiology of TB, created ideal conditions for associating tuberculosis with “new” immigrants—particularly Eastern European Jews, whose urban backgrounds, indoor occupations, and popular caricatures suggested strong ties between modernity and physical weakness.⁴ Immigration Restriction League officer Prescott Hall spoke for many antisemitic Americans when he portrayed Jews as potential societal burdens who were likely to contract tuberculosis shortly after their arrival.⁵ These depictions of the foreign-born as deadly vectors of disease comprised a central component of the growing debate over immigration, which became increasingly racialized and reinforced by scientific or pseudoscientific arguments.⁶

While historians have shed considerable light on the role of immigrant physicians as cultural mediators, much work remains in examining the difficult terrain they negotiated as aspiring professionals and as representatives for their minority groups.⁷ The writings of Maurice Fishberg, Theodore B. Sachs, and Charles David Spivak demonstrate that Jewish immigrant physicians did not speak with one voice as they worked to safeguard their fellows’ health and advancement opportunities. Fishberg, who was also a physical anthropologist, promoted Jews as hardy, tuberculosis-resistant survivors whose cultural values resonated with America’s white middle class. This argument placed him into conflict with Sachs and Spivak, who founded sanitariums to address a growing tuberculosis crisis among the Jewish poor. These approaches in turn faced criticism from Solomon Solis-Cohen, a nativeborn physician whose assessment of Jewish tuberculosis called for a drastic restructuring of American society altogether. Placing these physicians into conversation through their professional publications yields valuable insights into the challenges of American identity-building for immigrant Jews and their communities—most notably the intra-ethnic and individual conflicts accompanying that process.⁸

Fishberg, Sachs, Spivak: Common Background Factors

A glimpse into these immigrant physicians’ formative years suggests that they, along with a generation of aspiring Russian Jews, encountered discrimination and the challenges of bridging their cultural and national identities long before arriving in the United States. Born between 1860 and 1875 in different regions of present-day Ukraine, Maurice Fishberg, Theodore Sachs, and Charles Spivak grew up amid the social and intellectual ferment of the Haskala, or Jewish Enlightenment movement.⁹ As the tsarist government began easing restrictions in the 1860s regarding where educated Jewish professionals could live and work, increasing numbers of Jews abandoned traditional religious training to pursue a secular education in state-sponsored gymnasiums and universities.¹⁰ There, they hoped to find new paths upward where “a person would be judged not by his wealth, fame or race, but by his knowledge and character.”¹¹ These opportunities introduced Fishberg, Sachs, and Spivak to a broad range of Western languages and ideas, situating them within an emerging “Russified,” Jewish intelligentsia.¹² Many Jewish students at the university level, Sachs and Spivak among them, achieved a measure of solidarity with their Russian classmates through common causes, most notably radical political activism.¹³ Fishberg, who attended university in the United States, listed his Russian secondary-school education among his professional credentials throughout his thirty-seven-year career, suggesting that he valued it highly as a mark of distinction.¹⁴ As they sought social mobility through state-sponsored channels, these men experienced the pressures of representing their ethnic group in non...