Public Health

“Health officers, because of growing numbers of healthy carriers among them, developed guidelines that encompassed both particular and general factors. Health officials needed to control disease and found ways to do this without isolating all who tested positive in the laboratory. Toward this end they judged housing conditions, sanitary facilities, and the individual’s tractability as they determined the proper handling of typhoid bacilli-carrying healthy people” (Leavitt III, 625) . . . . According to Rosenau, “The sick [with typhoid] should be isolated in homes or hospitals; the healthy carriers could be allowed to walk about on the city streets. The laboratory thus did not define the full scope of the public health problem or its solution” (626). . . . Chapin, Rosenau, and other public health officials advocated and practiced differential treatment. Public health workers sought control of carriers in ways that acknowledged their health, their place in the community, and the near impossibility of constraining them all, considerations well beyond the laboratory findings (627). . . . Early twentieth-century proponents of bacteriology could no more isolate disease from its environmental and social context than could their predecessors who were driven by the filth theory of disease. . . . But the laboratory could not provide all the answers to health officers trying to protect the public from contagious diseases. The real world impinged on their deliberations, and of necessity the health officers in the field adopted a broad approach to disease control, one that in many respects resembled earlier practices. . . . Science, when applied on the streets and in the tenements of urban America, became tainted by the values, limitations, and commitments of that world” (629).