From Library Journal
Copyright 1997 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.
From The New England Journal of Medicine
Markel tells a compelling story of two epidemics that became tragically linked to one particular immigrant group -- the Eastern European Jews. Fleeing from the starvation and violence of czarist Russia, they encountered a hostile new world in Gilded Age New York. The first part of Markel's book recounts an outbreak of typhus fever in February 1892, which was traced to Jewish immigrants arriving on the SS Massilia. The New York City Department of Public Health ordered a dragnet of the Lower East Side to round up all the ship's passengers, healthy as well as sick, and quarantined them under unsanitary conditions at the city lazaretto on North Brother Island. More than a decade before "Typhoid Mary" Mallon gained infamy as a disease carrier, the Massilia Jews became the symbol of the public health dangers of unregulated immigration. As an 1892 editorial in the Journal commented, "We open our doors to squalor and filth and misery -- which mean typhus fever."
The second part of the book examines the cholera epidemic that hit New York City only a few months later. It was also blamed on the Eastern European Jews. Although public health authorities professed their allegiance to bacteriologic principles, Markel argues that the measures adopted to control cholera amounted to little more than quarantine by ethnicity and class. For example, when steamships arrived in New York Harbor with cholera-stricken passengers aboard, those traveling first or second class were allowed to debark, while those in steerage, healthy as well as ill, were placed in quarantine.
In the last section of the book, Markel looks at how the 1892 epidemics contributed to passage of the National Quarantine Act of 1893, which set up a more rigorous system of medical inspection and isolation of immigrants. Markel finds that physicians were deeply divided over quarantine and immigration policy; their lines of debate followed not their differing allegiances to the germ theory of disease, but rather their views on the desirability of immigration itself.
As a practicing physician, Markel takes seriously the need for disease control based on sound scientific principles. Yet he warns against the dangers of a "quarantine mentality," in which "not only does the infectious disease become the `enemy' but, so, too, do the human beings (and their contacts) who have encountered the microbe in question." When a contagious disease becomes linked to a specific group of people, Markel argues, public health authorities must be doubly vigilant to guard those people's individual rights and to combat their stigmatization. As he concludes, "The burden of illness is wearing enough for those stricken with contagious disease without the added social layers of separation." This is a fine piece of history with a timely and thoughtful message; it deserves a wide readership among both health care professionals and professional historians.
Reviewed by Nancy Tomes, Ph.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.