Abstract

While visiting relatives in northern England in October 1865 the London chemist William Crookes witnessed firsthand the economic devastation of farming communities blighted by the cattle plague that had been sweeping Britain since June. Crookes delayed his return to London for several months and obtained official permission to begin experimenting on eradicating the disease with a new disinfectant, carbolic acid. In his report to the British government in 1866, Crookes was explicit that his experiments had been based on a germ or contagion theory of the disease. Germs were considered to be airborne particles that might either be “living” material that “germinated” in the soil of animal flesh and blood or chemical poisons that decomposed flesh and blood.In the opening chapter of this fine study of the construction of British germ theories between the 1860s and 1900, Michael Worboys makes it clear that the cattle plague was a keystone in the long process of germ theory construction. Rinderpest was readily accepted by veterinary surgeons as a contagious disease to be controlled by wholesale culling with the poleax. On the other hand, they ignored or actively opposed the practical implications of a germ theory—disinfection , vaccination, and laboratory research—because these procedures posed a threat to the power and control of the veterinary profession. Plus ça change? In Britain, we are currently witnessing a similar example of party interest as a powerful Farmers' Union culls millions of cattle and sheep but prevents the use of vaccination in fighting a foot and mouth epidemic.Although a number of studies have celebrated the germ theory as the key development in producing scientific medicine in the late nineteenth century, this is the first critical book‐length study of its diffusion. The separate professional communities of veterinary practitioners, surgeons, and sanitarians are disarmingly shown to have developed different germ theories and differed over the practical consequences of their commitments. The closed subcultures inhabited by these groups meant that it took several decades before the germs of sanitarians were linked with those of surgeons and with the bacteria of microbiologists. Anyone who made a connection, such as the physicist John Tyndall, was dismissed as an inexpert interloper. Clearly, the singular specific disease germ theory was evolutionary in construction, not revolutionary.Worboys's ambitious monograph offers many fresh insights, including a finely tuned account of Joseph Lister's vacillating ideas and practices concerning wound management, and a splendid analysis of the problematic identification of specific germs causing cholera, smallpox, tuberculosis, diphtheria, typhoid fever, and scarlet fever. His meticulous survey of the contemporary literature unravels the deep uncertainty over whether “germs” were living organisms or chemicals, spontaneously generated or ancestral, causes or concomitants of disease. The fact that unpleasant wounds and the sick sometimes recovered spontaneously made sense only if patients constitutionally differed as an appropriate or inappropriate “soil” for “germ seeds” to blossom or perish. In this way ontological germ theories complemented the traditional medical concepts of constitutional strength and weakness and the healing power of nature. This insight underlines one of the strengths of the book, namely, its recognition of continuities in the construction of disease concepts and practices.Worboys successfully challenges the view that the British medical communities acted largely as onlookers while French and German practitioners honed a laboratory‐based medicine for the twentieth century. Overall, Worboys's monograph is a challenging and extremely readable medical history of germs. It will be essential reading for students taking history of medicine programs