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

BOOK REVIEWS THE AILING CITY: HEALTH, TUBERCULOSIS AND CULTURE IN BUENOS AIRES, 1870–1950. By Diego Armus. Durham: Duke University Press, 2011, pp. 432, $27.95. The old medical history that centered on the rise, apex and fall of an epidemic gave biographies of doctors or lauded public health campaigns has dwindled. From its ashes three new approaches have arisen. First, the new medical history tracks the development of medical scientific knowledge and places it within political, social and technological contexts. A second new approach has developed the history of public health, focusing on the formalization of health institutions that implemented strategies to combat disease and guarantee the collective health of society. Lastly, the sociocultural approach uses disease and health as a lens though which to discuss an array of issues such as gender, immigration, modernization, urbanization and politics, topics that would otherwise and previously have likely fallen in the repertoire of social and cultural historians. In The Ailing City, Diego Armus utilizes all three approaches to study the history of tuberculosis in Buenos Aires at the turn of the century. He recreates the experience of tubercular porteños through advertisements, medical journals, tango lyrics, union newsletters, literature, photographs and private correspondence. In addition, Armus completed oral interviews with tuberculosis survivors and people who lived during the period under study, and who spoke to the fear and disquiet tuberculosis incited. For Armus the disease became a metaphor for the ills and trials of urban life as well as a proxy to measure the development and modernization of the city itself. The book is structured thematically, and Armus connects the multiple themes in the book by demonstrating that tuberculosis opened the way for the state to regulate all manner of private and public behaviors such as consumption, dress, immigration, family, housing, marriage, sexuality, leisure and education. The opening chapters (1–3) focus on tubercular patients and the development of treatments that phased out over-the-counter medicine, and as professional hospitals replaced patient home-care. Armus tracks a burgeoning middle class and the rise in consumer culture through consumption of medicines and accessibility to medical care. Related to this, Armus shows the rise of literacy through multiple magazines dedicated to advertising medicines and the agency of patients pushing the state to authorize the use of experimental treatments. Although mortality rates slowly dwindled, the inability to cure the afflicted created an anxiety and helplessness that pushes the remaining chapters forward. C  2013 Southeastern Council on Latin American Studies and Wiley Periodicals, Inc. 131 The Latin Americanist, June 2013 As the fear of tuberculosis became more prominent within society, the state, doctors, public health officials, the church, public assistance programs and political parties banded together to fight against the pulmonary affliction. In chapters 4–6, Armus argues that the agendas they enacted created a culture of hygiene that infiltrated the public and private space. Newspapers, magazines and posters were created to initiate anti-spitting and anti-kissing campaigns and present the medical side-effects of corsets. In the new medicalized Argentina of the early twentieth century, the antituberculosis movement was primarily directed towards women and children . For women it developed in literature and tango lyrics that were critical of women moving from the domestic space to the factory floors of the industrialization taking place in Argentina during the 1920s. Children were taught proper hygiene practices during their primary education or state-funded hospitals separated them from their tubercular parents. the Armus holds that it is difficult to measure the success of public health in quelling mortality rates as socioeconomic factors, such as accessibility to health care and better quality food, or improved nutrition, also assisted in their decline. Armus is most at home when analyzing the advertisements, lyrics and literature, the “imagined city” writers saw with the elimination of tuberculosis , and the role of disease and health in creating model citizens in the final chapters (7–10). The final chapter brings Armus’ urban study full circle in presenting the multiple “cities” porteños experienced through tuberculosis. Hygiene discourse was at the center of conceptions on the regeneration or degeneration of the city in representing its worst and best aspects. Turn of the century...