Contagion, Isolation, and Biopolitics in Victorian London by Matthew L. Newsom Kerr (review)

For those skeptical of Foucauldian constructions of disciplinary modernity or notions of governmentality, Contagion, Isolation, and Biopolitics in Victorian London will make for an uncomfortable read. As Matthew L. Newsom Kerr explains at the start of his densely argued and richly contextualized book, the growth of an extensive archipelago of hospital isolation in London needs to be regarded as the epitome of the bureaucratic state and its regulation of life. Aligned with significant new scholarship that has reframed public health as more than a campaign against filth and the development of sanitary infrastructures, the book rejects standard narratives of measures to counter epidemics in Britain and explores instead the importance of isolation hospitals for a range of infectious diseases—among them smallpox, scarlet fever, typhoid, diphtheria, measles, and pertussis or whooping cough—to reveal how they structured some of the ways in which people in Victorian London were governed and were rendered governable.

In charting what he sees as a “great confinement” of infectious patients through the work and institutions of the Metropolitan Asylum Board (MAB), Newsom Kerr historicizes and spatializes isolation (3). Isolation becomes a strategy for managing population health that mobilized fears about contagion, drew on multiple technologies and tactics to manage urban bodies, and redefined ideas of risk, citizenship, parenthood, and individual responsibility. Fever and isolation hospitals become sites of biopower and complex negotiations between the state and infectious individuals; such sites were part of what Newsom Kerr terms a “liberal biopolitics” of the population, which was ultimately a product of new forms of “urban governmentality” (6).

To set the scene for the politics and practices of mid-Victorian biosecurity, chapter 2 offers an overview of the political birth of isolation and how the British successfully integrated strategies of isolation into public health. Metropolitan reforms, medical charities, and metropolitan bodies were crucial to the emergence of fever and isolation hospitals as agents of societal sanitation and hygiene. Chapter 3 charts the difficult relationship between pauperism and contagion. Here Newsom Kerr investigates the mid-century scandals regarding the care and confinement of the pauperized sick that led to the birth of the MAB. Having established how early MAB hospitals were connected to the ethos of the New Poor Law, Newsom Kerr in chapter 4 turns to how hospital isolation made constant concessions to consent and citizenship. While coercion was present in multiple forms, efforts to de-pauperize London’s infectious disease hospitals intersected with a vision of workingmen’s household sovereignty, parental authority, and social duty that came to structure the private government of the family and a gendered version of consent. The remaining three chapters explore the more technical aspects of isolation as material instruments of the biopolitics of government. Chapter 5 investigates the shift to centralization and the management, expansion, and design of MAB hospitals between the 1870s and 1890s, with chapter 6 detailing the cartographic and surveillance practices that underpinned smallpox facilities and generated new knowledge of infectious disease, the city, and its inhabitants. Although MAB hospitals came to rely on a large degree of public cooperation, as Newsom Kerr repeatedly reminds us in these chapters, the rise of hospital isolation and the scale of metropolitan governance involved was at times controversial, disruptive, and contestable. Constantly at play was a tension between liberty and security as debates around isolation shaped contentious new relationships between health, social regulation, and the liberal state.

In the final chapter of the book, Newson Kerr takes up Tom Crook’s idea of the “individuating power” (“Power, Privacy and Pleasure: Liberalism and the Modern Cubicle,” Cultural Studies 21, [2007], 561) of the cubical in modern life to argue how, by 1900, the fever hospital had emerged as the “premier institution” (340) for problematizing and compartmentalizing the body to “produce new opportunities for governing the self” (341). Yet, although Newson Kerr is conscious of how hospital isolation transformed the experience of sickness, Contagion, Isolation, and Biopolitics in Victorian...