How the controversial practice of quarantine saved nineteenth-century Philadelphia after a series of deadly epidemics. In the 1790s, four devastating yellow fever epidemics threatened the survival of Philadelphia, the nation's capital and largest city. In response, the city built a new quarantine station called the Lazaretto downriver from its port. From 1801 to 1895, a strict quarantine was enforced there to protect the city against yellow fever, cholera, typhus, and other diseases. At the time, the science behind quarantine was hotly contested, and the Board of Health in Philadelphia was plagued by internal conflicts and political resistance. In Lazaretto, David Barnes tells the story of how a blend of pragmatism, improvisation, and humane care succeeded in treating seemingly incurable diseases and preventing further outbreaks. Barnes shares the lessons of the Lazaretto through a series of tragic and inspiring true stories of people caught up in the painful ordeal of quarantine. They include a nine-year-old girl enslaved in West Africa and freed upon arrival in Philadelphia, an eleven-year-old orphan boy who survived yellow fever only to be scapegoated for starting an epidemic, and a grieving widow who saved the Lazaretto in the midst of catastrophe. Spanning a turbulent century of immigration, urban growth, and social transformation, Lazaretto takes readers inside the life-and-death debates and ordinary heroism that saved Philadelphia when its survival as a city was at stake. Amid the controversy and tragedy of the COVID-19 pandemic, this surprising reappraisal of America's historic struggle against deadly epidemics reminds us not to neglect old knowledge and skills in our rush to embrace the new.

Explores the scientific and social factors that continue to influence the public's lingering uncertainty over how disease can-and cannot-be spread. Late in the summer of 1880, a wave of odors enveloped large portions of Paris. As the stench lingered, outraged residents feared that the foul air would breed an epidemic. Fifteen years later-when the City of Light was in the grips of another Great Stink-the public conversation about health and disease had changed dramatically. Parisians held their noses and protested, but this time few feared that the odors would spread disease. Historian David S. Barnes examines the birth of a new microbe-centered science of public health during the 1880s and 1890s, when the germ theory of disease burst into public consciousness. Tracing a series of developments in French science, medicine, politics, and culture, Barnes reveals how the science and practice of public health changed during the heyday of the Bacteriological Revolution. Despite its many innovations, however, the new science of germs did not entirely sweep away the older "sanitarian" view of public health. The longstanding conviction that disease could be traced to filthy people, places, and substances remained strong, even as it was translated into the language of bacteriology. Ultimately, the attitudes of physicians and the French public were shaped by political struggles between republicans and the clergy, by aggressive efforts to educate and "civilize" the peasantry, and by long-term shifts in the public's ability to tolerate the odor of bodily substances.

In this first English-language study of popular and scientific responses to tuberculosis in nineteenth-century France, David Barnes provides a much-needed historical perspective on a disease that is making an alarming comeback in the United States and Europe. Barnes argues that French perceptions of the disease--ranging from the early romantic image of a consumptive woman to the later view of a scourge spread by the poor--owed more to the power structures of nineteenth-century society than to medical science. By 1900, the war against tuberculosis had become a war against the dirty habits of the working class.
Lucid and original, Barnes's study broadens our understanding of how and why societies assign moral meanings to deadly diseases.