Robson on Reber, ‘Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires’

by H-Net Reviews

Vera Blinn Reber. Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires. New York: Routledge, 2018. 348 pp. $149.95 (cloth), ISBN 978-1-138-35950-5.

Reviewed by Charmaine Robson (University of New South Wales) Published on H-Disability (October, 2019) Commissioned by Iain C. Hutchison (University of Glasgow)

Printable Version:

This is a study of two cities—Buenos Aires in South America and Philadelphia in North America—and their experiences of tuberculosis in the period 1870-1945. In the nineteenth century, this disease emerged as a major cause of infirmity and mortality internationally, linked to the rise of urbanization and industrialization, but for most of this period it was poorly understood. Tuberculosis in the Americas 1870 to 1945 by historian of medicine, Vera Blinn Reber, opens at a time when advances in European biomedicine occurred, leading to international consensus on the etiology and treatment of tuberculosis. Crucial to this development was the emergence of germ theory and, in particular, identification of the causative bacillus by Robert Koch (1843-1910), Mycobacterium tuberculosis, in Berlin in 1882. But a cure did not follow until 1945, when streptomycin, a newly discovered antibiotic, was found to be effective. In the intervening years, with 8-15 percent of all deaths worldwide attributed to tuberculosis, the disease became both a global public health issue, with measures to prevent the spread of the disease, and the subject of medical research in the battle to find a cure. This forms the medical context for the social and public health histories presented in this book.

Tuberculosis in the Americas has seven chapters plus an epilogue. The first chapter focuses on medical and scientific discourse in relation to tuberculosis from the 1890s to 1920s. In this period, the theory of heredity was gradually replaced by that of contagion, as reflected in public health policies of isolating the tuberculosis sufferer from society. Chapter 2 describes Philadelphia and Buenos Aires during the period under discussion. It shows that in many ways these cities were like others of their time and, interestingly, resembled one other. As of the 1920s, they had become leading cities of their respective nations and modern centers of commerce, education, and manufacturing, with a rising middle class and growing migrant populations. By 1907, deaths from tuberculosis in both Buenos Aires and Philadelphia exceeded deaths from all other infectious disease epidemics. Both cities established internationally recognized research and treatment facilities for tuberculosis, but local variables, such as climate and culture, to some extent differently shaped the sites and nature of medical institutions that found acceptance for tuberculosis treatment in the two cities. 

In chapter 3, Reber analyzes the incidence of tuberculosis and its consequences for the cities’ migrants, both from within and outside the Americas. To the extent that these groups occupied the lowest socioeconomic positions, this chapter offers both a class and race critique of public health policies. Its conclusions echo what historians have found elsewhere: the correlation of tuberculosis deaths with substandard living and working conditions led to anxiety about the spread of the disease from the migrant poor and was accompanied by targeted, morally judgmental interventions from charities and government.[1] However, Reber also points to positive responses by authorities in their initiatives to improve housing and green spaces, which ultimately resulted in ameliorating the poor health of their citizens and lessening the risk of contracting tuberculosis.

Chapter 4 examines the medical treatment of tuberculosis patients. It does an excellent job of explaining the available tests, treatment regimens, and education campaigns during this period, as well as the different sites of treatment—home, outpatient clinics, and hospitals. With a subtitle of “Patient and Physician Experiences,” we might expect this chapter to consist mainly of diverse first-person perspectives, but this is not the case. The only substantial accounts were between Dr. Lawrence Flick (1856-1938) and his wealthy patient, George Macklin, as conveyed in Bargaining for Life: A Social History of Tuberculosis, 1887-1938 (1992) by physician Barbara Bates (1928-2002). There is little to substantiate the chapter’s early claim that “gender, class and age” affected diagnosis and treatment, despite some allusions to these different categories (p. 123). Read on to the next two chapters, and class and age are subject to some analysis. Chapter 5 expands on tuberculosis treatment by looking at life in the sanatoria, with an interesting section on patient protest and how it differed between the two cities. Chapter 6 is an excellent study of tuberculosis measures for children, especially the poor of Buenos Aires and Philadelphia. As Reber reminds us, governments were willing to foster expensive public health measures for the young in the interests of producing “vigorous, patriotic adults who could serve in the military and contribute to the national economy” (p. 216).

Chapter 7 considers the two cities against the background of international tuberculosis policies and practices, providing glimpses of, for example, Spain, whose changing relationship with Argentina was reflected in the latter’s shifting medical discourses. The epilogue does three things: it provides the aftermath to successful antibiotic therapy in the 1940s, it sums up the book’s content, and it provides an analysis of the late twentieth-century tuberculosis global outbreak.

Tuberculosis in the Americas relies on a rich selection of sources for its evidence, including the secondary literature and government archival records. The book is replete with tables setting out a myriad of statistics, connecting tuberculosis deaths to occupation, age, place, et cetera. Reber’s main point is that, while modern medical advances were crucial to combating tuberculosis in Philadelphia and Buenos Aires, improved living and working standards and access to health services were also essential to the decline of tuberculosis in the two cities. 

The importance of this book does not lie in any significant break with current historiographical themes and insights of tuberculosis history. Indeed, Reber makes the point that Philadelphia and Buenos Aires were not exceptional in the approaches taken to manage tuberculosis in this period. Her work, to quote the editors of one volume on tuberculosis history, is an example of the several “studies that show the contingent character of anti-TB policies across time and space.”[2] Nonetheless, Tuberculosis in the Americas contributes to tuberculosis and public health history through its painstaking documentation and broad-ranging study of institutions, treatments, medical discourse, and social conditions in these two cities of North and South America.


[1]. See, for example, Emily K. Abel, Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles (New Brunswick, NJ: Rutgers University Press, 2007); and Matthew Gandy and Alimuddin Zumla, eds., The Return of the White Plague (London and New York: Verso, 2003).

[2]. Linda Bryder, Flurin Condrau and Michael Worboys, “Tuberculosis and its Histories: Then and Now,” in Tuberculosis Then and Now: Perspectives on the History of an Infectious Disease, edFlurinCondrau and Michael Worboys (Montreal: McGill-Queen’s University Press, 2010), 8.

Citation: Charmaine Robson. Review of Reber, Vera Blinn, Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires. H-Disability, H-Net Reviews. October, 2019. URL:

Podcast Episode 16 – Perkins School for the Blind

Disability History Association Podcast – Episode 16 (October 2019): Perkins School for the Blind

Jen Hale, archivist at the Perkins School for the Blind, discusses the school’s history and collections.

Download mp3 file here.
Download pdf transcript here.

Jen Hale is the Archivist for the Perkins School for the Blind. She has presented on the need for accessible photographs in digital collections and on legal and ethical considerations for digitization selection. Jen is a coauthor of Read by Touch: Stewarding the Reading and Writing Collection at the Perkins School for the Blind (Preservation, Digital Technology & Culture, April 2016). More information about the Perkins archives is available at .

REVIEw of martin atherton’s deafness, community and culture

Martin Atherton. Deafness, Community and Culture in Britain: Leisure and Cohesion, 1945-1995. Disability History Series. Manchester: Manchester University Press, 2016.

Reviewed by Holly Caldwell (Chestnut Hill College)
Published on H-Disability (August, 2019)

Commissioned by Iain C. Hutchison (University of Glasgow)

Prior to the introduction of sign language and schools
designed for the deaf in the early nineteenth century,
deaf individuals were often isolated not only from the
“normal world” but also from each other. Consequently,
such entities as educational, charitable, and religiousbased societies were among the first to establish institutions to address the needs of this population during
that period, and their efforts would engender the development of deaf clubs and societies in the mid-twentieth
century. In Deafness, Community and Culture in Britain,
Martin Atherton examines the history of deaf clubs in
postwar Britain and the social, cultural, and psychological benefits that involvement in such clubs afforded its
members. He argues that it was in deaf clubs where deaf
people “first experienced what might be regarded as a
normal life,… one in which they did not form a misrepresented and misunderstood minority” (p. 50). Much like the use of sign language, which contributed to the formation of group identity and self-identity in the deaf community, in many ways deaf clubs allowed for and encouraged participation in leisure and sport and represented a central factor in the creation and vitality of Britain’s deaf community.
This book is primarily targeted at audiences specializing in deaf studies, but it will also appeal to scholars
interested in disabilities studies, as well as the social and
cultural histories of clubs and community life. Deafness,
Community and Culture in Britain is divided into nine
chapters, with the first and final chapters serving as the
introduction and conclusion, the latter considering the
future of deaf clubs in Britain. The remaining seven chapters are fairly chronological in scope and explore such
different themes as the social impact of poor laws, the influence of deaf-sponsored newspapers, and the ways deaf clubs served their members through leisure, cultural, and sport-related activities. Drawing on deaf clubs in northwest England as a case study, Atherton argues that due to the area’s varied urban and rural settings, such as factory towns, coalfields, and satellite towns, this particular region serves a “microcosm of all aspects of the wider deaf
experience in post-war Britain” (p. 2).
The first organized network of deaf societies, according to Atherton, appeared soon after the change in the
1601 Poor Laws, a set of laws that categorized the poor
into two distinct groups—the deserving and the undeserving. In short, the deserving poor were those whose poverty was through no fault of their own. The undeserving poor, on the other hand, were poor because of personal vices, such as laziness or other character flaws.
In his telling, deaf societies and clubs trace their origins
to the 1834 Poor Law Amendment Act, a set of laws that
essentially made it more difficult for “deserving” individuals to claim relief from religious or philanthropic agencies. Following the change in legislation, and in direct
response to the “suffering deaf people were experiencing as a result,” Atherton argues, deaf societies began to
form (p. 40). Though this shift in legislation coincided
with the creation of new societies pertaining to the deaf,
the author’s use of the term “society” in this historical
context is a bit confusing. For example, in describing
philanthropic organizations, such as the Edinburgh Deaf
Society, which were created to provide gender-specific
vocational training in such trades as printing, shoemaking, and needlework, as well as church-related missions that were established for the deaf to guarantee that they
received spiritual instruction, it is unclear how institutions and organizations fit the typical description of a
society or what would later become a club in the postwar era. More important, such organized societies do
not necessarily fall within the parameters of how the author has characterized “community” in this book, which
he borrows from linguist Carol Padden’s definition. For
Padden, there are three common features of a community: the sharing of common goals, a shared geographic location, and the freedom to organize the social life of its members.[1] While Padden’s definition itself is certainly not being called into question, the context in which it is used by Atherton and the ways such terms as “society,” “clubs,” and “community” are used interchangeably at times and over fairly broad historical time periods are rather confusing. Readers who are unfamiliar with these terms, especially with regard to how they applied to the deaf community and the ways their significance shifted over the course of the nineteenth and twentieth centuries, might wish for more analysis of how this process evolved over time.
While deaf individuals did not necessarily engage in
leisure activities that differed from their hearing counterparts, it was the broader social, cultural, and psychological benefits that made these relationships particularly impactful. Benedict Anderson’s notion of the “imagined community” (Imagined Communities: Reflections on the Origin and Spread of Nationalism [1991]) figures heavily into Atherton’s analysis of Britain’s deaf community and the clubs they eventually formed. Drawing on Anderson’s theory of the “imagined community,” Atherton suggests that the representation of such a community “could be found on a couch, in a holiday camp or even on board a cruise ship…. The location was less important in terms of understanding the reality of ’the deaf club’ than the people who engaged in a particular activity” (p. 9). The network of deaf clubs that was established allowed deaf people the opportunity to “develop notions of identity based on mutual deafness and a communal form of social, cultural, and linguistic expression” and thus to contribute to the formation of self-identity and group identity (p. 75). In addition to examining how societies and clubs were formed, Atherton explores the theoretical underpinnings of the emotional and psychological rewards that arose from participating in various clubs, sporting events, and cultural activities, such as attending the cinema. In this sense, “deaf clubs provided both a geographical centre for the deaf community and a social network through which existing notions of community and identity could be maintained” (p. 60).
Throughout the book, Atherton underscores the importance of British Deaf News (1955-95), as well as its predecessor British Deaf Times (1945-50), two publications
that not only helped disseminate news but also kept the
deaf community informed of local social events. When
members of a community read the same newspaper or
text, they built the same “cultural values and ideas,” and
the sharing of such values and ideas allowed for their
large-scale transmission, thus contributing to the development of what Anderson referred to as “nationhood” (p.76). Here Atherton argues that British Deaf News built a camaraderie with its deaf readers and, to some degree, served as a means of communication between deaf people for the first time in the era before such technology as email and textphones. This discussion, especially Atherton’s focus on community-based reporting, is interesting, but it suffers from what many historians of print culture would argue can be difficult to pin down: what does selfreporting actually reveal and to what degree can historians rely on these figures? Relatedly, while print runs provide data as to how many copies were printed, such figures do not necessarily inform us how many people actually read its contents or how far-reaching the influence of a particular message was. In addition to exploring the role of print culture, it would be interesting to see how the deaf community developed and shared its “cultural values and ideas” by incorporating oral testimonies from former club members.
Increasing urbanization throughout the nineteenth
and twentieth centuries contributed to dislocation of different social groups but also led to growth in leisure activities. These coinciding forces, Atherton asserts, gave
deaf individuals, who would have otherwise been geographically isolated, the opportunity to be gathered together in contact with those of similar background and
shared language in order to develop cultural attachments.
He describes deaf clubs as “a direct response to this social
dislocation, providing opportunities for socialising and
sharing leisure activities that had not been previously
available” (p. 70). The degree to which deaf people shared
similar backgrounds or experiences, other than the fact
that they were deaf, is unclear from Atherton’s analysis.
For example, in his discussion of deaf clubs and organizations, he mentions that there was a keen class distinction and that deaf clubs have traditionally been working class (and primarily white) with few members of the professional class. While he highlights that the perception that deaf people from minority ethnic backgrounds were reluctant to join remains “open for debate,” there is little mention as to whether or not there was equal membership among men and women (p. 55).
As the first scholar to examine the inner workings
of deaf clubs in Britain, Atherton certainly had his work
cut out for him as availability of sources, such as personal testimonies, is limited. However, it is rather surprising that the bibliography does not list any secondary
sources on deaf history or studies predating the book’s
2012 original publication date. In addition, the author’s
primary evidence is largely drawn from two sources: the
publications British Deaf Times and British Deaf News.
While this book is undoubtedly intended to provide insight on how deaf clubs operated, such institutions certainly did not exist in a vacuum. More historical context on how deaf clubs and their members interacted
with the broader community (and nation) would have
been beneficial. The reader is left with little to no understanding of how British policy or trends—social, cultural, or political—might have influenced or affected the
deaf community, which lends itself to a myopic recounting of how the clubs functioned in northwest England. In
particular, Atherton makes some very interesting points
about economic disparities and social class that existed
within the clubs and the ways these phenomena played
out within sporting teams as well as the relationship that
existed between deaf teams and their hearing counterparts. This work is certainly a conversation starter and is a welcome addition to the field of deaf history.
[1]. Carol Padden, “The Deaf Community and Deaf
Culture,” in Constructing Deafness, ed. Susan Gregory
and Gillian M. Hartley (London: Pinter Publishers, 1991),
If there is additional discussion of this review, you may access it through the network, at:
Citation: Holly Caldwell. Review of Atherton, Martin, Deafness, Community and Culture in Britain: Leisure and
Cohesion, 1945-1995. H-Disability, H-Net Reviews. August, 2019.

Review of robert wilson’s the eugenic mind project, by michael rembis

Robert A. Wilson. The Eugenic Mind Project. Cambridge: MIT Press, 2017. xiv. + 333 pp. $45.00 (cloth), ISBN 978-0-262-03720-4.

Reviewed by Michael Rembis (University at Buffalo (SUNY)) Published on H-Disability (September, 2019) Commissioned by Iain C. Hutchison (University of Glasgow)

Printable Version:

The Eugenic Mind Project emerged from the Living Archives on Eugenics in Western Canada project, which was funded by a Social Sciences and Humanities Research Council of Canada, Community-University Research Alliance grant. The book’s author, Robert A. Wilson, is now professor of philosophy at La Trobe University in Melbourne, Australia. When he was a professor at the University of Alberta, Wilson served as principal investigator on the Living Archives project and oversaw the creation of He also is the director and executive producer of the documentary, Surviving Eugenics. Given this context, I was eager to read The Eugenic Mind Project, a book that leading disability studies scholar Lennard Davis describes (on the back cover) as “one of the best studies of eugenics to date.”

The Eugenic Mind Project is Wilson’s attempt to think through, or, quite literally in some chapters, puzzle through key concepts and questions related to eugenics: What is a eugenic trait? What is human betterment?—a question that Wilson argues has been “glossed over” in previous accounts of eugenics (p. 6). What gave rise to eugenic thinking, or as Wilson calls it, “The Eugenic Mind” (p. 24)? Why does it persist? As Wilson states early in the book, The Eugenic Mind Project is part of a “recent turn in the study of eugenics, a turn that brings eugenics home, both from a perceived distant past to the ongoing present, and from ideas and practices that primarily affect others to those that remain continuing issues for many of us in our daily lives” (p. 10).

After providing a brief collage of late twentieth-century and early twenty-first-century manifestations of, and apologies for, eugenics, primarily in the United States and Canada, Wilson moves to the past. In the book’s second chapter, he explores the “short history” of eugenics, roughly the decades between 1865 and 1945 (p. 25). Wilson places the development of eugenics within the context of the creation of the “fragile sciences of human nature” during the second half of the nineteenth century (p. 26). Like other scholars of eugenics, Wilson sees the origins of the new science in a nascent acceptance of evolutionary theory, but perhaps more importantly in the development of psychology, anthropology, criminology, and sociology. He argues that eugenics spread across these disciplines, giving it a formidable “credibility” (p. 27). Although eugenics was never fully accepted, even among its most vocal proponents, Wilson does not acknowledge contestation among the numerous professionals, reformers, and others who expressed eugenic ideas.

Following previous scholars of eugenics, Wilson argues that it was both an emerging science and a social movement. According to Wilson, eugenics “carried with it an enthusiasm, both popular and scientific, for solving a wide-ranging series of social problems once and for all by controlling who reproduced, and who was reproduced, in future generations” (p. 27). Wilson argues that eugenics was “applied science” (p. 31). It was “not merely theoretical,” “not primarily mathematical,” and it was “not value-free science” (p. 31). Wilson offers a brief sketch of Francis Galton (1822-1911), the British founder of the field, and Galton’s definition of eugenics, and argues that what Wilson refers to as “The Eugenic Mind” can best be understood “in terms of this early Galtonian vision” (p. 30).

Taking a cue from both the Living Archives project and from nineteenth-century Marxists and twentieth-century feminists, Wilson describes his methodological approach as “standpoint eugenics,” which he describes as his aim to “explore eugenics from the standpoint of those who are survivors of its history” (p. 3). He states at the outset that the contributions of eugenics survivors to the Living Archives project were the “sin qua non” of his own thinking (p. xii). He dedicates the book to Leilani Muir (1944-2016), who successfully sued the Canadian province of Alberta in 1995-96, bringing legal redress and media attention to various eugenic abuses, including institutionalization and sterilization, that occurred over the course of the twentieth century.

Despite his dedication to survivors and his avowed use of standpoint theory, Wilson ultimately comes up short in his attempt at standpoint eugenics. Although at the end of his book he offers important insights into how we might think about the marginalization, both publicly and academically, of the voices and experiences of survivors of eugenics, Wilson does not make survivors and their stories and perspectives the focus of his study. Instead, he concerns himself with what he calls “The Eugenic Mind.” Wilson, who acknowledges his own past “ignorance” and the steep “learning curve” he encountered when he began work on The Eugenic Mind Project, seems either unwilling or unable fully to engage with standpoint theory (p. xi). As he states several times throughout the book, he deploys “at least a standpoint-ish eugenics” (p. 98). At various points in the book, Wilson brings in the voices of eugenic survivors and other disabled people. For example, Ken Nelson says that when he was institutionalized in the Provincial Training School for Mental Defectives in Red Deer, Alberta, it almost felt as if he had committed a crime. Yet, toward the end of a book dedicated to providing an analysis of eugenics from the standpoint of its survivors, Wilson feels compelled to offer a “precisifying discussion” of his use of standpoint theory, and states that he wants to move “beyond the playfulness invoked by [his] earlier deferring appeals to a standpoint-ish eugenics” (pp. 195-96). That Wilson would enter playfully into a “standpoint-ish” study of the experiences of survivors of the atrocities of twentieth-century eugenics and that he would feel the need only at the end of a book-length study to “precisify” his use of standpoint theory will, no doubt, give readers pause. If, however, one can set aside the idea that this book is built upon a survivor standpoint and accept it for what it is, a study of “The Eugenic Mind” from the standpoint of a Western/Global North (by training) philosopher of the mind, then one will see that it makes a novel, but not wholly unproblematic contribution to the growing body of literature on disability and eugenics.

As the title of the book implies, Wilson’s central aim is to understand what he calls “The Eugenic Mind.” That all three words are capitalized is important. Wilson is not necessarily concerned with the legacies of a past eugenics, or the historicization of a new eugenics from the standpoint of its survivors, but rather with explaining the “nature of eugenic thinking, past and present” (emphasis added, p. 24). As a philosopher of the mind and cognition, Wilson is most concerned with thinking or puzzling through the formation and persistence of eugenic thought. For Wilson, survivors of eugenics were not necessarily victims of social circumstance, a devalued and marginalized intersectional identity, capitalist class relations, medical hubris, or “bad science,” but rather the “targets” of The Eugenic Mind (pp. 48-49). The Eugenic Mind, is, in turn, a fundamental part of the human mind. Wilson’s main goal, his chief concern, is explaining how the human mind can conceive of something like eugenics. In the end, Wilson roots a notoriously persistent Eugenic Mind in the deep history of human evolution. For Wilson, it is not what humans think, but rather how they think that gives rise to eugenics and also explains its seemingly intractable persistence.

Wilson’s reasoning begins with the assumption that humans are not only social creatures but “prosocial” creatures. He argues that humans have a “specific social nature” that is part of our “primate heritage” (p. 122). This social nature shapes everything from our language(s) to the rules we create to regulate “how we should treat each other” to our sense of belonging, “often deeply,” to particular groups, including family, nation, “our people,” and “our species” (p. 7). Wilson argues that humans are not only “naturally sociable creatures” but also “prosocial creatures” in part because we help the most vulnerable among us (i.e., infants) to survive (p. 7). Ultimately, however, humans must make decisions about whom to include and whom to exclude. Humans ask: Who will most benefit the survival of the species? Wilson calls this “prosocial inclusion.” It is humans’ “prosocial” nature and more specifically “prosocial inclusion” that undergird ideas about human betterment or human improvement and ultimately eugenics.

Throughout the book, Wilson uses his “standpoint-ish” analysis of eugenics to further elaborate this idea of “prosociality” and its relationship with vulnerability and variation. Human variation, which Wilson argues is often read as cultural diversity, is critical to humanity and has become part of the “fragile sciences,” including anthropology and human geography (he does not cite any other disciplines.) Yet “cultural variation or diversity has not always been met with the warm embrace of prosocial inclusion” (p. 102). Humans discriminate. They engage in a “differential evaluation” of people (but not necessarily groups of people). The processes of both differential evaluation and prosocial inclusion, which for Wilson are both formed by and enacted through our “engaged individuality,” are actually quite constrained (pp. 102-03). According to Wilson, they are limited by characteristics such as race, ethnicity, sex, gender, and disability. These boundaries affect whom we consider one of “us” and ultimately shape The Eugenic Mind (p. 33).

But which characteristics get included and which ones get excluded? And perhaps more important, why do certain characteristics get singled out for exclusion? In addressing these questions, Wilson is careful to make a distinction between ontology and epistemology. He states that “human variation is ubiquitous”; it is everywhere (ontology) (p. 105). But what we know (epistemology) is “negatively marked difference” or “marked variation” (p. 105). (Wilson makes no mention of positively marked difference.) In other words, variation is everywhere, yet what we see as variation is really negatively marked difference, or what Wilson calls “marked variation.” Having established the idea of marked variation, he then asks the question: “In the case of disablement and medicalized pathology, what makes it epistemically possible, in a world full of many distinctive forms of human variation, for us to mark some of that variation as subnormal?” (p. 105). In chapter 3, Wilson asks: What “really is” a eugenic trait (p. 59)? Or put another way: What becomes marked variation? Then, in chapters 4, 5, and 6, Wilson treats the development of “attitudes and reactions” to marked variation, especially those that are not “celebratory,” as a puzzle to be solved (p. 103).

Somewhere along the evolutionary path, humans began excluding other humans from their various processes of prosocial inclusion by creating notions of “subnormalcy” and engaging in the “subhumanization” of “others” (p. 109). Precisely why this occurred is a critical question for Wilson. As he states: “Where do the ideas of normalcy and subnormalcy that mark disablement and medical pathologization come from” (p. 109)? In considering this question, he contemplates the work of three prominent disability studies scholars. In chapter 5, Wilson takes up the arguments of Lennard Davis, Shelley Tremain, and Nicholas Rose, all of whom he characterizes as disability studies scholars who have been influenced by Michel Foucault (1926-84). Wilson spends the most time on the work of Lennard Davis. He is most interested in Davis’s assertion that disability is socially constructed and that it has a relatively short history that dates only to the mid-nineteenth century. Wilson asserts that despite the different foci of the three philosophers, which he characterizes as the body (Davis), medicalization (Tremain), and psychological normalization (Rose), “there is a common idea at play here. That idea is that normalcy itself is a kind of social construction rather than something to be found in the world. Its emergence is tied to specific regimes of power, or what Foucauldians typically call power/knowledge, that discipline bodies and minds in particular ways” (p. 111). After briefly summarizing Davis’s argument about the social construction of disability, Wilson declares, “while the appeal to biopolitics at the heart of the social constructivist answer tells us something important about eugenics, it is more limited as a response to [the question of the origins of The Eugenic Mind] and the puzzle of marked variation” (p. 113). Wilson is not satisfied with Davis. He devotes the remainder of the chapter to the assertion that the idea that “normalcy and even normativity itself originates in some kind of 19th-century biopolitical nexus” is not plausible (pp. 112-13).

Wilson offers a more careful critique of Davis’s claims but his most salient point is that what Wilson calls The Eugenic Mind both predates and persists after the specific moment in the second half of the nineteenth century when Davis asserts disability and eugenics became knowable. According to Wilson, “some kind of cluster of normative and normalizing notions” existed in Aristotle’s Greece and they still exist in the twenty-first century; therefore, Davis’s idea of the social construction of normality in the nineteenth century is not adequate. Wilson characterizes Davis’s appeal to biopolitics and social constructionism as “shallow” because it cannot account for the longevity and the resilience of The Eugenic Mind (pp. 115, 117).

Wilson wants to suggest that what we humans experience as marked variation, as subnormalcy, or as the subhumanization of disability and medical pathology is “something” that is “psychological in nature, something concerning how we function as psychological creatures in socially constructed worlds” (p. 117). The world can change, but the way we humans think does not change, or at least it changes very slowly in evolutionary time. Wilson argues that the type of “sociality” that humans exhibit requires “sophisticated internal cognitive processing” and that this processing has developed through “key evolutionary changes in our lineage that facilitate distinctive forms of socially coordinated behavior” (p. 124). When “we” experience marked variation, which Wilson defines as disability or medicalized pathology, it, according to Wilson, is “permanent, phenomenologically direct and unmediated.… It is much like the emotional experience of fear and disgust” (p. 106). We can learn to “dampen or control” our response to marked variation, but we can never be fully rid of it. As problematic as this may seem to disability historians and disability studies scholars, in Wilson’s mind, this seemingly permanent and visceral response to disability is both evidence of and an explanation for the development and persistence of humans’ Eugenic Mind.

Wilson takes an essentializing or reifying position. He argues that the sociality that he describes is “a ubiquitous feature of the biological world, especially the mobile biological world containing creatures with some self-governing capacity to move from location to location” (p. 128). According to Wilson, cognition “goes beyond” both perception and behavioral reflexes and involves “representation crunching” and computation (italics in original, p. 129). Humans have, through deep time, that is, through the evolution of Homo sapiens, developed “a kind of externally mediated, cognitively driven normativity” that “constitutes an important feature of human social life” (p. 130). Normativity for Wilson is defined as “a distinction between a correct, proper, or appropriate way for a process, event, or outcome to turn out, and an incorrect, improper, or inappropriate such way” (p. 130). He goes on to argue that “one thing that this cognitively mediated normativity does is allow us to distinguish not simply between individual people but between kinds or sorts of people” (italics in original, p. 130). This process of human sorting, which for Wilson seems to be driven by evolutionary demands, is both continuous and ubiquitous. It occurs internally in our minds, and externally, in the way we structure the world around us. Wilson argues that this process of sorting leads to the creation of “we knowledge,” or the creation of “us” and “them” (p. 131). He calls this social cognition, or the socio-cognitive approach to understanding The Eugenic Mind. In a final blow to Davis and the social constructivists, Wilson concludes that “while both frameworks [social constructivist and socio-cognitive] contribute to our understanding of the persistence of eugenics, I have argued that the socio-cognitive framework provides an explanatorily richer and deeper account of that persistence, and of the marked variation that underlies it” (p. 141).

According to Wilson, The Eugenic Mind has enabled eugenics to persist in the late twentieth and early twenty-first centuries. Proponents of more recent iterations of eugenics can be dismissive of the “epistemic basis and execution” of the old eugenics but still maintain the idea of “human improvement or betterment” through the elimination of “defective” humans, or what Wilson would call marked variation (p. 141). The critical difference between old and new is choice. Advocates for the new eugenics claim that it is not coercive or state-directed, and that it targets people at the individual level and not kinds of people. Yet, as Wilson points out, this is precisely what Galton stated about the old eugenics at the end of the nineteenth century.

In what might be the best chapter in the book, chapter 7, Wilson highlights critiques of the new eugenics from disability rights activists and disability studies scholars. In this chapter, he focuses on what he calls the expressivist objection to eugenics, which is the idea that eliminating disability through measures such as prenatal screening and selective abortion sends (or expresses) the message that “we” do not value people living with disabilities. This chapter, more than any other, relies on the work and testimony of (mostly elite, white) disabled people. In addition to issues more directly related to reproduction, Wilson briefly mentions opposition to Autism Speaks as an example of an alternative standpoint to the devaluing of disability. He notes the silencing of oppositional voices by organizations such as Autism Speaks and spends a good chunk of the chapter rehearsing Rosemarie Garland-Thomson’s celebratory understanding of disability and the generative potential of a disability standpoint. Not as theoretically or philosophically driven as other chapters, chapter 7 is instead rich with insights from disabled activists and scholars. It is the closest Wilson comes to a survivor standpoint.

On the whole, The Eugenic Mind Project is a measured success. Wilson uses his experience with the Living Archives project to ask important questions and make significant assertions concerning the persistence of eugenics over time and the importance of centering marginalized voices and experiences. Yet while he makes new theoretical and philosophical interventions into the vast and increasing body of literature on eugenics, his use of standpoint theory remains underdeveloped. In addition to his “playful” engagement with “standpoint-ish” eugenics, some readers may be off put by Wilson’s at times seemingly casual engagement with important disability studies literature and scholars. He refers to Sharon Snyder as Laura Snyder, for example. Other readers may find his lack of citations troubling. He offers only a few “summative and self-contained” notes for each chapter at the end of the book. While useful for providing suggestions for further reading, the notes are not helpful in referencing specific arguments and passages in the book. Readers looking for a more narrative-driven or linear approach to the study of eugenics might find the bullet-point organization of the chapters frustrating. Important concepts, terms, and analyses are given no more than a page or two and the focus can shift rather quickly and sometimes dramatically at any point in a chapter. Many of the main arguments are repeated throughout the book.

Finally, readers may find Wilson’s discussion of the “engaged individuality” of some of the survivors of eugenics disconcerting. While disability scholars must recognize the rich lives and complex identities of our disabled subjects, we must be careful not to overstate or overvalue their normativity. Claiming that disabled people’s lives and experiences and their voices have value because they are “just like us” only further marginalizes those disabled people who cannot live up to the unattainable standards of compulsory ablebodiedness. At the beginning of The Eugenic Mind Project, Wilson writes about meeting Leilani Muir and of how that changed him and his work (a common disability trope). He goes out of his way to state that Muir was “normal” and that she was not “different” (p. 13). Wilson insists that Leilani Muir and other eugenics survivors that he met through his studies were complex human beings with what he called a certain type of “engaged individuality” (p. 18). While this is true (of course they are) and it must be acknowledged, it is also incumbent upon disability studies scholars to recognize that the value of disabled people is not contingent upon their normality, nor is it dependent upon their “engaged individuality.” A reader may come away from these passages with the impression that the institutionalization and sterilization of eugenic survivors who expressed a certain level of “engaged individuality” was somehow more offensive or tragic than if those survivors were not as complex or “engaged”—if they were not so much like “us” (p. 18). I am sure Wilson would agree that all human life should be valued, regardless of its “marked variation.”

Review of Gerald O’Brien’s Contagion and the national Body, by shun wan.

Gerald V. O’Brien. Contagion and the National Body: The Organism Metaphor in American Thought. New York: Routledge, 2018. 148 pp. $145.00 (cloth), ISBN 978-1-138-30622-6.

Reviewed by Shu Wan (University of Iowa) Published on H-Disability (September, 2019) Commissioned by Iain C. Hutchison (University of Glasgow)

Printable Version:

During the past two decades, the proliferation of academic publishing on philosophical perspectives of disability studies has influenced our understanding of human beings and the world in which disability is not only a reality, but also represents patterns of comprehension and perception. Guided by queer theory developed by pioneering feminists in the 1980s, disability theorists created crip theory to dissect our constructed view of human-embedded ableism. Parallel to the proliferation of scholarly discussion on emerging crip theory, sociologist Gerald O’Brien dissects the intersection between multiple historical issues of disability, immigrants, and race in Contagion and the National Body: The Organism Metaphor in American Thought.

The first three of the book’s eight chapters primarily examine the philosophical background and historical development of the metaphor, which paves the way for the author’s further analysis of its embodiment in the ramification of ableism, nativism, and racism in American society. Chapter 1 reviews the use of multiple forms of policies, while in chapter 2 O’Brien discusses the philosophical meanings of the metaphor and its evolution; the organism metaphor has a long history in the West and can be traced to ancient philosphers such as Plato and Aristotle. The third chapter reviews the “alarm periods” in which multiple social subgroups, including European and Asian immigrants, disabled people, Jews, and communists were targeted as threats to the purity and integrity of American society in different periods between the late nineteenth and the early twentieth century. Originating in the enforcement of strict immigration policy in reaction to the inflow of new immigrants in the late nineteenth century, the policy of oppressing and expelling multiple subgroups, not limited to immigrants, has been implemented repeatedly in the US history. In O’Brien’s words, the policy “was energized by the Yellow Peril, the Red Scare, eugenic fears, and anti-Semitism, along with more rational concerns such as the rise in immigrant numbers” (p. 47). As seen in the American government’s stance on Mexican immigrants, this trend continues today.

Following introduction to the basic terms and theories employed in his analysis of the history of the organism metaphor, O’Brien employs the remainder of the volume by investigating the tensions between the subgroups—the metaphor of “disease-maker” to the metaphorized American national “social body.” In chapter 4, O’Brien investigates procedures in categorizing subgroups as others in American society, noting that “it is important that threatening individuals or sub-groups not only be viewed as foreign to the existing population, but this alien nature also needs to be seen as permanent” (p. 62). On the basis of identifying those subgroups as unassimilable others, chapter 5 contends that federal and local authorities took a further step to label them with the tag of disease-maker. The policy, according to O’Brien, “provided the major way of describing target groups and highlighting public fear” (p. 71). Chapter 6 switches to examining the metaphorization of American society as an organism suffering from social diseases.

In his final two chapters, O’Brien substantiates the tension between the two metaphors in the oppression of those subgroups and metaphorization of the American government’s policy of cleansing them. Chapter 7 mainly discusses how the existence of those subgroups was assumed to cause the decay of American society. For instance, for supporters of strict immigration restrictions in the late nineteenth century, intermarriage between disadvantaged social groups and white residents was blamed as the cause for decay of the social body because it was assumed these connections impaired purity and cleanliness. In chapter 8, O’Brien turns to the other side of the metaphor of the national body: metaphoric medicine. In tandem with the metaphor of immigrants and disabled people as a threat to the national body, various solutions, including registration, surveillance, segregation, ghettoization, and quarantine, were “often viewed as a form of community medicine” (p. 116).

Through analyzing the pairing of “disease-maker,” “social body,” and other prevalent metaphors in the anti-immigrant, racial, and eugenic discourses in the twentieth century, O’Brien expands our knowledge of the interaction between the concepts of disability and nativism, and makes a noteworthy combination of the two fields for further research. O’Brien’s book bridges several major social issues of late nineteenth- and early twentieth-century American society. Examining the use of various metaphors in oppression of subgroups, the author reveals the underlying discursive models in the reactions of US governments and the general public.

Citation: Shu Wan. Review of O’Brien, Gerald V., Contagion and the National Body: The Organism Metaphor in American Thought. H-Disability, H-Net Reviews. September, 2019. URL: