Review by Choice Review
A well-written and well-documented narrative of an interesting historical question: did the decline in tuberculosis mortality in the British Isles between 1850 and 1950 have anything to do with advances of scientific medicine? Smith concludes that if credit be assigned anywhere, it ought to go to streptomycin. When the "great sanitary awakening," the germ theory of disease, and the Sanitoria Movement are examined, their role in the steady abatement of tuberculosis becomes questionable. This work is important historically, for popular books about the eradication of infectious disease, such as Paul De Kruif's influential Microbe Hunters (1926), imply that discoveries were immediately accepted and their consequences were immediately realized. Smith points out, for example, that as late as 20 years after Koch's demonstration of the tubercule bacillus, several physicians still doubted its causative role in the disease. Smith did not forget to examine the social aspects of tuberculosis, and one of the strengths of his book is his ability to weave the individual into larger history. Although Smith does not mention it, the book is also pertinent to another debate in the history of medicine: epidemiology provides data contrary to some cherished historical ideas. The death rate from most infectious diseases--not just tuberculosis--began to decline after 1850. Why this happened and how the decline is related to the inauguration of the germ theory of disease are current issues in the history of medicine. The book's layout, copious notes, and bibliography are also noteworthy. Highly recommended for a variety of audiences, professional and lay. -T. P. Gariepy, Stonehill College
Copyright American Library Association, used with permission.
Review by Choice Review
