Combattre la tuberculose, 1900–1940

D. DESSERTINE and 0. FAURE, Combattre la tuberculose, 1900-1940, Lyons, Presses Universitaires de Lyon, 1988, 8vo, pp. 244, illus., Fr. 110.00, (paperback). Recent French contributions to the history of tuberculosis have been impressive, often iconoclastic, and this volume is a valuable addition to the corpus. As Pierre Guillaume set out to destroy the Western myth of tuberculosis as the gentle killer (in Du desespoir au salut, 1986), so Dessertine and Faure undermine the French myth of the early twentieth-century antituberculosis campaign as an "enormous, infallible machine" which eradicated the disease by "modern" methods and became a model for the control of specific diseases. The book is a local study of the anti-tuberculosis campaign in the Lyonnais, a region which, thanks to private enterprise, took a pioneering part in the struggle. Vigorously written and packed with illuminating observations, it effectively destroys any lingering belief in a coherent, nationally directed anti-tuberculosis campaign. While the administrative perspective continued to be dominated by the late nineteenth-century German policy of prevention and control through the isolation of sufferers, the dire consequences of the First World War left the daily implementation of the policy to local effort. Here the hand of private enterprise is clearly visible, whether in the personnel of the departmental committees, the financing of sanatoria, the sale of charity stamps (which illustrate the volume), or the failure to establish the disease as a worthwhile medical specialty. While sanatoria, dispensaries, and "preventoriums" emerged as the institutional bases of the campaign, no attempt was made to incorporate, coordinate or direct the efforts of the existing institutional structure: the communes, the departments, and the hospitals. Social themes dominate the argument of this book: tuberculosis was seen as a social disease, to be eradicated by social control and social improvement; yet the broader social history of the region is only glimpsed, tantalisingly suggested by the variety of local experience across the region. While such a short work (some 65,000 words) inevitably has its shortcomings, this lively and stimulating study is well worth careful reading, and constitutes an excellent example of the corrective and positive value of the local historical viewpoint.