The gospel of germs: men, women, and the microbe in American life

such sensitivity. Popper has already been mentioned. See also the definition of clinical physiology on page 173. This is not a book that will satisfy all of the many constituencies with an interest in Laennec. But To see with a better eye will be required reading for the serious scholar of nineteenth-century French medicine and of the history of clinical diagnosis for the foreseeable future. As I read Nancy Tomes's sparkling account of popular assimilation of the germ theory, I could not help thinking of Howard Hughes. So afraid of contamination with unseen germs that he locked himself away for years and only handled objects wrapped in Kleenex, Hughes is an extreme example of the "antisepticonscious America" that Tomes so engagingly analyses. Though few Americans were as obsessed as Hughes, Tomes shows that belief in the existence of disease-causing germs was instrumental in the transformation of an "extraordinary range" of products and practices. Extra-long hotel sheets, prohibitions on spitting, public fountains, porcelain toilets and a mind-boggling array of other developments date from this period. In thus shifting historical attention away from municipal engineering and towards the "reformation of individual and household hygiene", Tomes delivers an impressive study of public health and its relation to the public's daily life. Tomes begins by demonstrating that, regardless of physicians' ambivalence towards germs as causes of disease, lay commentators rapidly assimilated germ theory largely because its early versions harmonized so well with the prescriptions of contemporary domestic sanitary science. The heart of the book, covering the period from 1890-1930, is an analysis of the transformation of germ theory into a code applicable to domains of existence far removed from sewers and water supplies. Tomes illustrates the transformation with extended discussions of the anti-TB crusade and the domestic science movement. These movements are fine examples of Tomes's contention that scientific findings have to be exported outside the lab by interested parties. She nicely outlines the historical context that structured the form that these particular extensions of the theory assumed. The primitive development of state and local public health bureaucracies ensured, for example, that the anti-TB campaign was largely voluntary in orientation. Likewise, the domestic science movement was founded and led by the expanding network of college-educated women who were otherwise excluded from full participation in public life. A second theme highlighted by these episodes is the central role played by advertising and commercial calculation in …