Cholera and Crisis: State Health and the Geographies of Future Epidemics

by

Paul Stephen Brierley Jackson

A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Department of Geography University of Toronto

© Copyright by Paul Stephen Brierley Jackson 2011

Cholera and Crisis: State Health and the Geographies of Future Epidemics Paul Stephen Brierley Jackson

Doctor of Philosophy

Department of Geography University of Toronto

2011

Abstract

In the fall of 1892, fear of cholera was pervasive in North America. Ten years into the fifth international cholera epidemic—that lasted from 1881 to 1896—cholera had been raging in the Middle East, India, and Europe, but the disease had yet to cross the Atlantic Ocean. The maritime traffic of immigrants from Europe was continuous, and each migrant ship potentially carried the disease. Doctors, government officials, and politicians were not asking ‘will cholera come?’, but rather when. While no one got sick or died of cholera in the city of Toronto in 1892, the crisis and fear of imminent cholera was very real. Drawing on archival research, this dissertation maps how a cholera crisis was shaped by urgency, immediacy, and speculation on the future. My argument will show how the geography of an epidemic is not limited to the presence of a disease. If crises are times of profound activity, how does this event need to be substantiated in order to produce change? This dissertation follows how cholera was integral to producing an object called proliferating life that held together: migrating populations, growing cities, and degeneration; marshland as the source of disease; the medical theory of zymosis that explained how disease outbreaks got out of control; and Malthusian ‘laws’ of population. Health experts used correlation and synecdoche to visualize these relations. However, these experts needed a stable institutional base to articulate both their fears and their recommendations, which included: professionalized expanding health boards, as social infrastructures; reclaiming Toronto’s marshland of Ashbridge’s Bay; and a health ideology built upon the fear of future epidemics, immigration, and a growing economic rationale for health. By the early 20th century, state health became instrumental to a “national vitality”, a practice of government intervention that I frame as bureaucratic bio-economy.

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Acknowledgments

To begin I have to thank my supervisor Scott Prudham, who was patient with my random thinking and reading. He always asked the incisive and political questions that grounded my ‘guilty by association’ mindset. Scott fostered a generous and collective space that allowed me to get invested and emphasize the politics under which my work gets done, both inside and outside the university. Robert Lewis, Sue Ruddick, and Mark Hunter—who filled out my committee—all possessed a keen eye for theoretical wrangling, insightful political questions, and an attention and commitment to detail. I would also like to thank Debby Leslie, who was on my committee during my comprehensive exams, and Deb Cowen who read and commented on my other work that helped to direct my questions. Additionally, three classes by faculty outside of the Geography Department at University of Toronto—led by Erik Swyngedouw, Noel Castree, and Michelle Murphy—were highly influential and formative. My stumbling through the archives was greatly helped by the archivists at the City of Toronto Archives, Ontario Archives, and the Gerstein Library. Finally, I have to thank the external reviews Bruce Braun and Matt Farish for their extensive and generous comments that allowed me to complete this process.

Quite surprisingly, the Department of Geography at the University of Toronto was a fiery, flippant, and completely un-stuffy place to land. Looking back, I would be an alienated, exhausted, and angry academic if not for some amazing people. I have to thank a very loose cohort that bounced from Viva Hate to Spirit Animals to Team Precarity, including: Jen Ridgley (who told me I was a geographer), Emily Eaton, Lisa Freeman, Amy Sciliano, Vanessa Mathews, Patrick Vitale, Tom Young, Shiri Pasternak, Roger Picton, Kate Parizeau, and Robert Ramsay. I am grateful to them for creating an amazing, non-competitive, collective space through the Graduate Geography and Planning Student Society (GGAPSS) and a strong union that had my back, CUPE Local 3902. This space included a wide variety of reading groups, writing groups, and workshops that took on nature, capital, ‘matters of life and death’, critical geography, and even science fiction. In the process I shared my time with in the department with many more great folks who influenced me, including Laura Pitkanen, Katie Mazer, Martin Danyluk, Josh Akers, Charles Levkoe, James Nugent, Lindsay Stephens, Heather Dorries, Mark Kear, Martine August, Jim Delaney, Kate Geddie, David Wachsmuth, Mike Ekers, Tomas Frederiksen, and

iii many others. All these folks to allow me to feel at ease, just nodding at my obscure cultural references incomprehensively.

My time at the University of Toronto was financially supported the Social Sciences and Humanities Research Council (SSHRC), the Department of Geography and School of Graduate Studies at the University of Toronto, the Ontario Graduate Scholarship Program (OGS), and the Lupina Doctoral Fellowships. I also have to thank Gene Desfor, Gunter Gad, Michael Moir, Jen Bonnell, and Jenn Laidley and the entire SSHRC-funded Changing Toronto’s Waterfront project for the support, both financial and academic. Additionally, at the end of my masters Roger Keil and Harris Ali opened up a space for me in their SARS and the Global City project that allowed me to transition into researching disease. Finally, a thank you must go to Gerda Wekerle who supported my masters’ work and convinced me to do a PhD.

I also had the opportunity, funded by Canada-U.S. Fulbright Program, to be hosted at the Center for Place, Culture and Politics at the City University of New York. A debt of gratitude goes to David Harvey and Neil Smith who gave me space at the Center, along with a seat at the table for the seminar’s lively discussion. By sharing an office with Jenna Loyd, I was brought into the gravity of her vortex as she included me into her “militant” reading, eating, and wandering. Jenna was pivotal in making my time in New York City such a refreshing experience. I met many many inspiring people in New York, but I have to mention those graduate students at CUNY who directly influenced this work: Jesse Goldstein, Christian Anderson, David Spataro, Michael Polson, Chris Grove, Lilly Saint, Jen Gieseking, and the Capital Volume 3 reading group.

A huge thank you to all my friends who aren’t geographers, including Steve, Jill, Jen, Perlitz, Jessica, Maggie, Deb, Dani, Ronke, Ed, El, Zahra, Jacob, Marney, the many uproarious others, and not forgetting my former lovers. No idea is singular, I stole from all of you and you didn’t even know it. My four parents and my Uncle Michael were there for me in their different ways of support and acceptance. Finally, a huge debt of gratitude goes to Nicole Pasulka for straightening out my sentences, and much much more.

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One last thing: music. As a release and an inspiration, if I didn’t have a soundtrack I really would have gone crazy. “Give me, your eyes, I need sunshine / your blood, your bones, your voice, and your ghost.”

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Table of Contents Acknowledgements iii List of Figures viii Dissertation Schema ix

Introduction: Cholera and Crisis 1 0.1. The Problem of Cholera and Dissertation Outline 2 0.2. My Archive: Documents, Sources, and Framing 5 0.2.1. Method, genealogy, history 8 0.2.2. Urban political ecology 10 0.3. Past and Present Crises 12

Chapter 1 - The Cholera Crisis of 1892 19 1.1. Cholera Crosses the Atlantic Ocean 21 1.1.1. The cholera crisis in Hamburg 21 1.1.2. United States prepares for cholera 24 1.1.3. North America closes its borders 27 1.1.4. North America’s cholera wall 31 1.2. How to Theorize a Crisis Event 33 1.3. How Cities and Governments Dealt with a Cholera Crisis 41 1.4. Theorizing the State 43 1.5. Historical Context: Toronto and the International Economy 46 1.6. Conclusion: Where and When do Disease Crises End? 50

Chapter 2 – The Conditions of Crisis: Migrating Populations, Growing Cities, and the Atlantic Ocean 62 2.1. The Geography of the Cholera Pandemic: Atlantic Spaces and Migrating Pilgrims 64 2.2. The Sciences of Decline and Improvement 72 2.3. Positivism and the Progressive Movement 76 2.4. Conclusion: Crisis Expertise 80

Chapter 3 - Crisis Environments: Marshland as a Cholera Landscape 87 3.1. The Marsh Fixation: Polluted, Threatening, and Foreign 88 3.1.1. Marshland, pollution, and water 88 3.1.2. Marshland as foreign landscape 90 3.2. Cholera as a Force of Nature 92 3.3. The Science of Medical Topography 94 3.4. Conclusion: Filthy Environments 97

Chapter 4 - Crisis Science: Zymosis and the Definition of an Epidemic 103 4.1. History of Cholera Science: Theories, Disciplines, and Paradigms 105 4.2. Zymosis and Farr: The Flexibility of Synthetic Expertise 107 4.3. Bacteriology and Persistence of Zymosis 110 4.4. Conclusion: The Definition of an Epidemic 113

Chapter 5 – Crisis as Proliferating Life: Positive Evil and the Effects of Malthus’ Principle of Population 119 5.0.1. Positive evil 121 5.1. The Science of Proliferating Life: Malthus, Farr, Darwin 122 5.1.1. Farr’s take on Malthus’ principle of population 124 5.2. Proliferating Life in Practice: An Example from Canada 128 5.3. Conclusion: Critiquing Proliferating Life: the Naturalization of Population and Misery 131

Chapter 6: Imagining the Crisis: Synecdoche and the Visualization of Proliferating Life 138 6.0.1. Forms of visualization 140 6.1. Making Visible the Cholera Crisis 142 6.2. The Problems of Representation: Metaphor and Synecdoche 152 vi

6.2.1. Synecdoche and disease 154 6.3. Conclusion: Metaphors and Representation in Geography 156

Chapter 7 – Health Boards Against Cholera: The Emergence of Social Infrastructures 163 7.1. Medical Professionals and Social Infrastructures 164 7.2. Cholera Impels the Creation of Health Bureaucracy in Ontario 170 7.2.1. Scales of health governance 172 7.3. The Provincial Board of Health of Ontario 175 7.4. Conclusion: The State Becomes Bastion for Health Expertise 176

Chapter 8 – Health Boards' Recommendations: The Marsh Reclamation Solution 183 8.1. Problems and Proposals Accumulate 185 8.2. Health Experts Diagnose Toronto 188 8.3. Conflict on the Waterfront 190 8.4. Engineering Toronto: Institutions and Marsh Reclamation 200 8.5. Social Infrastructures and the State 205 8.6. Conclusion: Expertise Impotence 207

Chapter 9 – The Ideologies of a Health Board: From Cholera Crisis to National Vitality 217 9.1. “Work to be Done”: Health’s Common Interest 220 9.1.1. Pillar 1: The fear of future epidemics and the obsession with cholera 222 9.1.2. Pillar 2: Immigration as health threat 224 9.1.3. Pillar 3: The economic rationale for national vitality 229 9.1.4. Health and economy: The limits of synthesizing expertise 232 9.2. Nationalism and Health Ideology: The Success of Health Boards 234 9.3. The Ideology of Bureaucratic Bio-economy 240 9.4. Conclusion: Charge of the State 241

Chapter 10 – Reversing the Politics of Life and Death 252 10.1. Life and Value: Bio-economy and the Relations between the State, Capital, and Health 257 10.1.1. The limits of bio-economy 257 10.1.2. The protracted and particular enabling of medicine and capital 259 10.2. Theoretical Reversals and Transforming the Politics of Life and Death 265 10.2.1. Reversing proliferating life? 268 10.3. Conclusion: Towards an Anti-Crisis Politics and a Reflexive Life Sciences 272

Appendix 1 – Timeline: The Cholera Pandemics and Related Events 285 Appendix 2 – Glossary: People, Theories/Things, General Terms, Places, and Institutions 289 A2.1. People 289 A2.2. Disease and Health: Theories/Things 292 A2.3. General Terms 294 A2.4. Places 295 A2.5. Institutions 295 Bibliography – Cholera and Crisis 299

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List of Figures Figure 1.1. Dr. Peter Bryce 30 Figure 1.2. E.P. LaChapelle 30

Figure 2.1. Actual & Supposed Routes of Cholera from Hindoostan to Europe and to North & South America in 1832, 1848, 1854, 1867, 1873. 65 Figure 2.2. Course of Epidemic of 1832, 1848, 1866, 1873. 65 Figure 2.3. Routes of Cholera from India to Asia, Africa and Europe. 67 Figure 2.4. Map of the Course of Cholera in Russia, Poland & part of Hungary. 68

Figure 3.1. Ashbridge's Bay looking south-east. 99 Figure 3.2. Ashbridge's Bay looking northeast from north bank of cut. 99 Figure 3.3. Ashbridge's Bay looking east. 100

Figure 6.1. El Paso Health Board. Diagrammatic Travelling Report of the Household. 143 Figure 6.2. From Report of the Committee on scientific Inquires in Relation to the Cholera Epidemic of 1854. 144 Figure 6.3. A drop of Thames water, as depicted by Punch in 1850. 144 Figure 6.4. John Snow’s cholera map. 145 Figure 6.5. Peter Bryce, "Report of the Secretary: A Hundred Years of Sanitation in Ontario." 146 Figure 6.6. Father Thames introducing his offspring to the fair city of London, Punch Magazine, 1858. 147 Figure 6.7. “Right About Face, Mr. Angers,” Evening News, Friday June 23, 1893, p.1. 148 Figure 6.8. “An Undesirable Emigrant,” Evening News, Wednesday August 31, 1892, p.1. 149 Figure 6.9. “No Alien Need Apply,” Evening News, Wednesday September 5, 1892, p.1. 150 Figure 6.10. “Things Coming Our Way,” Evening News, Friday September 6, 1895, p.1. 151

Figure 7.1. Dr. Peter Bryce 171 Figure 7.2. Dr. Charles Coverton 171

Figure 8.1. Town of York, Lake Ontario, and Ashbridge’s Bay 184 Figure 8.2. Keating Plan to reclaim Ashbridge’s Bay, 1892 195 Figure 8.3. William Oldright 197 Figure 8.4. J.J. Cassidy 197 Figure 8.5. Charles Sheard 197 Figure 8.6. Toronto 1894. 198 Figure 8.7. Ashbridge's Bay looking north from north bank of cut. October 3, 1904 199 Figure 8.8. Ashbridge's Bay marsh. [1910?] 199 Figure 8.9. Toronto Harbour Commissioners, Waterfront development, 1937 202 Figure 8.10. Plan of the City of Toronto, 1902, Signed by Villiers Sankey, City Surveyor 203 Figure 8.11. Ashbridge's Bay from the Disposal Works. 204 Figure 8.12. Making ship channel, Ashbridge's Bay. 204

Figure 9.1. Charles Hastings 228 Figure 9.2. Charles Hodgetts 228 Figure 9.3. Conservation of Life Journal 234 Figure 9.4. Canadian Association of the Prevention of Tuberculosis 234 Figure 9.5. Hastings’s 1916 Diagram of Organization, Department of Public Health. Lower figure is a detail of the above figure. 239

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Dissertation Schema: Cholera and Crisis

Description

This schema consists of six interrelated sections. I have put the categories together in this manner in an attempt to show how parallel events, ideas, theories, fears, and institutions can held at the same time. From left to right, the schema illustrates: [1] a simple timeline between 1810 to 1950; [2] the periods of time that cholera pandemics effected the world (six out of seven are shown); [3] the cholera outbreaks that took place in Toronto; [4] theories of disease and medical explanations of what caused cholera; [5] the objects of disease crisis, that I have labeled proliferating life; [6] and finally, infrastructures or government agencies that were created at a variety of scales, that I have named bureaucratic bio-economy. For the Disease Theory category, contagion and infection gets stronger, and then verified, as they got darker. In the Object category I attempted to show how fears or obsessions increased or decreased. But also my schema hopefully illustrates how they became intertwined. The Infrastructure section also has general frameworks like degeneration, social Darwinism, and eugenics. These are rough backdrops during what institutions were being formed, or disbanded. The horizontal line that runs through the entire schema is for 1892, the year around which this dissertation pivots. Obviously, this is a crude simplification of the dissertation that follows. To be clear, this is a representation of ideas—a map that holds together events, institutions, and abstractions—rather than a naturalization of time and progress.

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Cholera and Crisis | 2010 | Paul Jackson | 1 Introduction – Cholera and Crisis: State Health and the Geographies of Future Epidemics

In the 19th-century, cholera was a crisis disease. A crisis was declared even before a community became sick with cholera. Cholera was the classic 19th-century epidemic, and it shaped the formation of the discipline of epidemiology.1 When cholera was brought into cities, blame for the illness spread from the disease to unwanted populations, poor neighbourhoods, migration patterns, India, and marshlands. Ultimately, cholera had an urban character.2 The disease highlighted the fear, pollution, and the accumulation of populations in cities. Cholera was not the greatest killer in the Victorian period, TB accounted for one-third of all deaths,3 but cholera was the exposé, the muckraker, and the drama queen. But cholera is just a microorganism. Cholera enters a human being, reproduces in the digestive tract, causes the bowels to acutely evacuate, which leads to massive dehydration. This may cause death. But what is more important is that cholera’s unique biological materiality created confusion: a mix of certainty and uncertainty. Because water was its vector of transmission, that is, a water-borne bacteria spread through human feces in the water supply, cholera had profound environmental associations. However, this dissertation is not a history of cholera epidemics4 or a history of the “great” men of science who made new discoveries.5 This dissertation is about the times and places between cholera crises and how cities prepared for distant or future threats.6 In particular, I follow how the City of Toronto envisioned and planned for an impending cholera pandemic that never materialized. How cholera became, and remained, a source of fear. Cholera was scary. An infected person could die in a day, sometimes in hours. Cholera was messy; it could produce an abundance of watery diarrhea and vomit while the body cramps painfully. This rapid loss of bodily fluids could lead to dehydration, shock, and finally death. In the 19th century, half of those infected died. Cholera was emblematic. As the historian Erin O’Connor summarizes: “Over the course of the [19th] century, Asiatic cholera became the master trope for urban existence.”7 While grandiose, this claim is not unfounded.8 Cholera, the disease of the 19th century, laid the groundwork for ways that reformers could deal with unwanted places, environments, and people. Urban reformers and medical experts were obsessed with what, where, or who caused cholera. If these questions could be answered, then cures to the crisis could be proposed, and this would enable the healthy transformation of cities. Cholera, feared as a disease that kills, has been previously confined within the politics of life

Cholera and Crisis | 2010 | Paul Jackson | 2 and death. This dissertation intends to break out of that debate and examine the ways that health and crisis can be reframed.

0.1. The Problem of Cholera and Dissertation Outline Let me describe the problem that health experts were tackling. By the late 19th century, cholera had illustrated the dangers of the free movement of goods and people under capitalism. The circulation of goods and people throughout the north Atlantic region had become potentially deadly. North America’s demand for workers also supplied unwanted diseases. By the 1890s, cities and nations had been dealing with cholera for close to sixty years. Epidemics had become an unpredictable, but constitutive part of the management of cities and nations, as well as the relationships between nations. If a port was shut down due to quarantine, this stoppage had serious economic consequences, especially during cyclic depressions in the economy. However, the need to stop the circulation of goods and labour was often dismissed because the causes of and ways to prepare for cholera epidemics were still highly debated. Beginning in the 1910s and beyond, governments slowly instituted disinfection technologies and health-based immigration restrictions such as the bill of health and the passport. Throughout my time period, roughly 1880 to 1920, even though health experts were still highly uncertain of how cholera became a crisis, they instituted massive changes to prepare for epidemics and pandemics. However, the cholera crisis that I am isolating was not just a biological life form that produced epidemics. The cholera crisis was also an idea. A contradiction existed within the circulation of capital and the circulation of disease. The reproduction of capital was believed to be irreconcilable with the reproduction of society. Health experts stepped up to appease this contradiction: in recognition of the need for workers and trade, they administered healthy workers and disinfected trade. But to institute their ideas, health experts did not turn to corporations or labour organizations. Rather, they turned to government and sought out bureaucratic positions. These health experts were not a class or a profession, but a practice, a sectional interest of social protectionists who implemented thought. As bureaucrats speaking beyond their expertise, their practices were not intended to work against the circulation of capital; instead, these health authorities spoke for the good of all. In the politics of life and death, health experts were against death. Cholera threatened lives, but it also threatened the movement of capital. But health expertise was not directly involved in managing the circulation of goods and bodies, these social relations were negotiated through the state. The vital role of the state in promoting health and stopping epidemics had implications on both the disease

Cholera and Crisis | 2010 | Paul Jackson | 3 preventions reforms and the science of disease. The historical questions that this dissertation will investigate are how, and in what ways, did health experts in state bureaucracies attempt to solve the problem that cholera posed. The questions in the first half of the dissertation (chapters 1–4) examine the cholera crisis. Why was a cholera outbreak such a feared crisis in 1892? How was this crisis reflected in the formulation of what is now called the progressive movement? In order to avert the cholera crisis, why did the marsh become an object to eliminate? How did medical science articulate the cholera crisis? Chapter 1 begins with a detailed account of the Toronto cholera crisis in the fall of 1892. While cholera did not infect Toronto in 1892, there were effects for Canada and Ontario. These effects structured the historical context, municipal politics, and international economy of the late 19th century. Chapter 2 is a look at how, during this time, cholera epidemics legitimized anxieties around the pilgrimage to Mecca, immigration to North America, and the growth of cities throughout the Atlantic world. It’s also a discussion of how urban and health experts in the progressive movement known as liberal positivists used the arguments of eugenics and nationhood to frame these crises as degeneration. Chapter 3 examines these reformers’ obsession with the marsh landscape and the environmental cause of disease, which was brought together by the tradition of medical topography. Cholera was rotting the body, marshes were rotting the city, and degeneration was rotting the civilization, and health experts believed that science could discover the facts behind these processes. Chapter 4 examines the science that tackled cholera, with a focus on William Farr’s theory called zymosis, which explained how disease outbreaks were crises. In chapters 5 and 6, the dissertation shifts it focus to proliferating life, which is the object of this dissertation, and examines how its science, bureaucratic bio-economy, created or understood this object. Subsequently, how was the crisis visualized? Chapter 5 gets to the heart of the experts’ fear of a crisis. The object of their fear was not just cholera or zymosis; instead, it was proliferating life, a term that combined disease with population and growth. I isolate proliferating life from Farr’s adaptation of Malthusian “laws” and the ways in which these were applied in Canada. Chapter 6 investigates how these health experts used correlation and synecdoche to visualize disease crises. However, to articulate both their fears and their recommendations, these experts needed a stable institutional base. This leads to the questions asked in the dissertation’s second half (chapters 7–10), which interrogates the state, ideology, and capital. Why were health experts listened to by the state and how did they become organized through health boards? Why push to reclaim the marsh of

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Toronto? What was the ideology of health and what did this ideology enable? Chapter 7 follows both the professionalization and growth of health boards, in particular the Ontario Provincial Board of Health, formed by the ongoing cholera epidemics of the 19th century. I use David Harvey’s social infrastructures to explain the establishment of these health boards. In chapter 8 I illustrate how, once this institutional base was established, the province pushed to reclaim Ashbridge’s Bay marsh in Toronto. I also discuss the authorities’ and experts’ feelings of impotence in the face of politics and the competition with engineering expertise. In chapter 9, the fear of future epidemics, immigration, and a growing economic rationale informed the ideology of these health boards. In the early 20th century, health became instrumental to “national vitality,” the condition of the state and the economy. In the conclusion, chapter 10, I summarize this history, but the contemporary literature on the bio-economy is contrasted with my own questions over life and the circulation of value through the state. The conclusion also seeks to refute the politics of life and death by rethinking concepts of heath and the economy through critical theory. Is there a way to think differently about the politics of life and death? While this dissertation is centred on the cholera pandemic of 1892, to focus on Hamburg Germany, the hot zone of the crisis, would only tell one small part of the story. My claim is that the periphery, and the non-event, along with fear and speculation are all equally important to our understanding of a crisis. This dissertation is an account of after-effects of politics, science, and legislation after Thomas Malthus, Robert Koch, Louis Pasteur, and Charles Darwin, Edwin Chadwick, and William Farr, and after the professionalization of the medical science and the institutionalization of boards of health. This is an account of implementation and interpretation. The discovery of new knowledge is important, but what are the political and cultural ramifications of implementing “revolutions” of thought? What can be gained by following the “experts” who quoted the great men and who relied on the work of others? While this dissertation deals with science, discourses, ideology, and representations, this history is rooted in three very material forms of life and nature: marshlands, humans, and vibrio cholerae. These material forms of life are marked by a radical unknowability. Authorities of medicine and health read fear and crisis into these murky depths, migrating degeneration, and invisible agency of death. This dissertation hinges on two failures: an epidemic crisis did not happen, and the sanitary reforms of swamp remediation did not happen. At least they did not happen according to plans or projections. Yet, while nothing was happening, much activity was taking place, and many processes were set in motion. I propose that because of these failures a different valence

Cholera and Crisis | 2010 | Paul Jackson | 5 was given to the progressive movement’s take on urban crises both in Toronto and North America. Health-minded liberal positivists felt mandated to manage future forms of proliferating life. During the 19th century, cholera became the model, a model whose foundation was the fear of future crises. Cholera undermined the structures of cities and science. It shook up Victorian culture. My argument is equally disruptive. I examine confusion, follow misinformation, and track speculation. I elevate “wrong” theories, but my purpose is not to outline truth, get to the core of a culture, or expose the heart of capitalism. Rather, my argument is that confusion, misinterpretation, fear, and speculation created activity. Confusion, a mix of certainty and uncertainty, was exceedingly productive. In times of confusion, those who claim to know the truth are able to silence political debate. These were the “experts” whom I followed.

0.2. My Archive: Documents, Sources, and Framing “There is no just way in which the past can be quarantined from the present.” —Edward Said9

“This simple four-letter word can conceal what may be described as a spasmodic view of popular history.” —E.P. Thompson10

“Does terror have an archive? Is panic indexed in the annals of history?” —Jackie Orr11

I have to admit something before proceeding to outline my archive. I am a not a good historian. For me, the documents seem to go on forever and the depths of the archives seem very deep. To make matters worse, I did not choose a clear and bounded topic, based on a set of documents. I chose to follow cholera as an idea. I found myself overwhelmed with material. Critical historian Jackie Orr’s quote summarizes the challenges I faced in the archives—the challenge to understand how disease and crises could be organized though documents. I would like to revise Orr’s question to ask, does cholera have an archive? Cities and governments have archives, a corporation has an archive, and even disciplines have archives. Cholera, specifically the cholera that travelled to Toronto in 1892, has no archive. The fear of future outbreaks has no archive. My dissertation has attempted to cobble an archive together. I would claim there is no better way to do so than to become obsessed. Each source I came across I scanned for references and connections to cholera, and in the process this lead me in interesting and unforeseen directions. To E.P. Thompson’s four-letter word “riot,” I would like to add a letter or two and expand on

Cholera and Crisis | 2010 | Paul Jackson | 6 his comment. My claim is that “crisis” and “cholera” were both popular and spasmodic, and both words concealed so very much. Finally, Said’s observation, a nice little reference to history and disease, also represents my struggle to limit this history. I honestly didn’t know when to stop. As I said, I am a not a good historian. All the same, below is a quick summary of the documents I used. Since this project examines how health experts instituted themselves into government, many of my primary documents were government sources. For Ontario, the Annual Reports released by the Ontario Provincial Board of Health of Toronto were highly valuable. I read in detail each year from 1882 to 1894 and then perused the rest until 1930.The Sanitary Survey of Ontario (Ontario Archives RG 49-92-0-1 to RG 49-92-0-8) along with the Select Committee re Public Health, Minute Book (Jan 22,1878–March, 1878) helped to set the scene in Ontario. Federally, the Commission of Conservation Annual Meeting Reports between 1910 and 1919 were fruitful. These documents were also useful because they included the minutes of the Dominion Public Health Conference in 1910. I also combed their official journal Conservation of Life: Public Health, Housing and Town Planning (1914–1921) and Quarterly Bulletin issues under the direction of the Commission of Conservation. In the City of Toronto archives I researched in detail the Toronto City Council proceedings of 1892–1893 (City of Toronto Archives, Fonds 200, Series 1078). I also perused records from five years before 1892 and followed leads into the following years with decreasing rigor until around 1930, looking for city comments on both health and Ashbridge’s Bay. I examined the Annual Reports of the Local Board of Health (Fonds 200 Series 365, File 2). Also, I found James Morrison Glen, The Public Health Manual containing The Public Health Acts of the Province of Ontario and Regulations of the Provincial Board of Health to be a great reference for historical framing. Dr. Norman Allen, the Medical Officer Of Health, created the Report on Sanitary Conditions of the City of Toronto (Fonds 200, Series 365, File 6), which included an account of the operations of the Board of Health and the vital statistics for the year 1891. This document also included a report on operations of the Board of Health. For comparison with the United States, I looked into the Marine Hospital Service’s publications. Leland E. Cofer’s Maritime Quarantine, released as part of the Public Health Bulletin series by that institution, was exteremely helpful as a benchmark. I also sought out public discussions and formulations of health institutions through the annual meetings for the American Public Health Association, Ontario Medical Associations, and the Canadian Medical Association, which were published in the journals covered below. I found international meetings such as the International Congress of Hygiene and Demography in

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London 1891 and the first Pan-American Medical Congress in Washington, D.C., in 1893 useful for context. While I look at the files and documents produced by bureaucrats, I am not doing a Weberian history of institutions. Instead, I look at how health bureaucrats extended influence into other spheres and brought in new concepts. The experiments and thoughts of bureaucrats were played out in medical journals. Nineteenth-century journals of “expert” knowledge are strange beasts. Reading old medical journals is a particular joy, both perplexing and surprising. A description of landscape gives way to a report from an international conference, which leads to a new technique to set a bone, and ends with a general editorial discussion about the moral laxity of today’s city dweller. For example, Scientific Canadian is about everything and nothing at the same time. The March 1881 issue covered the following: the benefits of lighting, tapestry, and piping; the discovery of a new people in the arctic; a list of new patents; and informative articles with titles such as “How opium is produced in India” and “Is alcohol food?” The journal is also littered with beautifully rendered full-page illustrations of gecko anatomy and the discovery of a new race called “human trees of India.” Reading through these journals was very distracting. While these journals were written as factual accounts of the material world from specific expertise, such as engineering and anatomy, in actuality they documented a general body of knowledge. Even when limited to disciplinary publications, the authors and editors brought in politics, fiction, and rhetoric. The health journal by the end of the 19th century was a very particular document steeped in interdisciplinary flourishes and future predictions. To institute the science of medicine, writers relied on and interweaved articles about biology, chemistry, hydrology, climatology, and even morality. These medical experts were also historians of a sort. Doctors quoted from the past, and from political, social, and economic theories. Scientists weaved poetry into their articles and policy documents. This form of exposition situated their individual thoughts and practices within a longer, historic schema of progress and knowledge. For my project, the importance of reading historical journals is not to only gather views and events of the time period but also to see how facts are used to institute a framework of social relations to deal with events in the world, in particular, health crises. The key Canadian journals used were Canadian Engineer; Canadian Journal of Medical and Surgery; Canadian Lancet; Canadian Municipal Journal; Canadian Practioner (especially useful because of the Canadian Medical Association minutes); Canadian Public Health Journal (the official organ of the Canadian Public Health Association); Contract Record; Journal of American Water Works

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Association; and Ontario Medical Journal. The international journals that were used were American Journal of Public Health (additionally helpful because this included the minutes and presentation from the annual meetings of the American Public Health Association); Bulletin of the Academy of Medicine; British Lancet; Harpers Weekly; Nature; Popular Science Monthly; Science; and The North American Review. In the course of my research I perused many journals and various articles to give context to events, theories, and disciplines. Both historical events and concepts of disease and health were triangulated roughly between the years 1880 and 1920 from the American Journal of Nursing; American Journal of Sociology; American Lancet; Annals of the American Academy of Political and Social Science; Atlantic Monthly (The Galaxy); Biometrika; British Lancet; Scientific American; Scientific Canadian; and Town Planning Review. These experts were part of newsworthy events, and relied on published big names and treatises. For newspapers as primary documents, I made the choice to focus on the Toronto Evening News, 1892–1893, for a complete coverage of the year around the cholera scare. I compared the coverage with The Globe and The New York Times. Reading treatises, books, and reports gave me in-depth knowledge of how problems and arguments were formulated, and also offered a sense of how knowledge in Canada and Toronto was shaped by work in Britain and the United States.12 Since the bulk of this dissertation is built upon historical analysis from periodicals, this has shaped the final product and influenced how and why I have written a dissertation focused on ideology and health concepts. To track down these documents and follow leads I relied on secondary literature that spoke to the construction of these institutions, infrastructures, and the political economy, and to the ideology of health and moral reform. The important contextualizing works for Toronto,

Ontario, and Canada were by Paul Bator, Heather MacDougall, Angus MacLaren, J.M.S. 13 Careless, Catherine Brace, and Mariana Valverde. This research, predominately dissertations, allowed me to focus both my arguments and contribution. I also relied on some exemplar cholera histories to get a sense of the time period and the debates in science and health in North America and Britain.14 This included two stellar histories directly related to the cholera outbreak in 1892 by Richard Evans for Hamburg and Howard Markel for New York City.15 While there was some overlap on documents, time periods, and topics, I found myself charting a distinct path, in part due to my methodology.

0.2.1. Method, Genealogy, History

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This history of cholera was structured by Foucauldian genealogy, specifically how the idea of cholera emerged and transitioned. To summarize, with genealogy the historian looks for errors, disturbs the immobile, fragments the unified, dissociates from tradition, and finally sacrifices taken-for-granted truths. The key: there are no origins. Rather, look to descent (as in lineage) and emergence. To problematize and diagnose the present, Foucauldian genealogy re-orders timelines, disciplines, and knowledge production. Genealogy uses history to explore how the present is as strange as the past and how certain practices today emerged from this past, not to be comfortable with them, but to disturb the taken-for-granted nature of them. Genealogy has been called an anti-science.16 My attempt was to search for those documents that speak back to what is happening or what has been defined. At the same time, history is contingent, just one possible result in a complex web of relations. The items and documents that Foucault asks us to pay attention to are not ordered, but entangled and confused, filled with errors and fear.17 In contrast, my research topic is not organized around a discourse or a discipline, like madness, or the clinic.18 My dissertation was focused on cholera, but the object that emerged from my archive was proliferating life. My genealogy of proliferating life outlines the emergence of this un-named idea; along with the methods and technologies that attempted to mange its various manifestations. Foucault’s history has been a guide and inspiration, but not a model. The genealogical perspective allowed me to focus on politics when experts declared that the origin of cholera was the swamp, the immigrant, a far-off geography, or the bacteriological practices of Koch.19 The speculation on the source of disease produced particular spaces and institutions. Even if there is debate, ambiguity, conflict, and confusion, these can reinforce one another. This dissertation will explore the murky period of the 1890s to see how practices and spaces emerged and became consolidated by the descent of zymotic theory and the emergence of germ theory (see chapter 4). Still, I have struggled with the ways in which this dissertation is a history of ideas and systems of knowledge production.20 Both Foucault and Bruno Latour focused on the “big names,” the benchmarks of science and knowledge, the discoverers, and those who put delimiters on knowledge. Foucault emphasized encyclopedias and essential treatise.21 Latour suggested that the laboratory was where systems of knowledge were revealed. Rather than examining science or scientific methods, in my dissertation I attempt to trace what might be called pseudoscience. To discuss Dr. Robert Koch isolating the vibrio cholera in 1883 or Dr. Pasteur establishing his Institut is to follow the emergence of bacteriology and microbiology in Europe. However, I find it equally important to show how, far from their labs, experiments, and

Cholera and Crisis | 2010 | Paul Jackson | 10 petri dishes, doctors and experts took up these scientific breakthroughs in unique and contingent ways. In other words, I’m just as interested in how doctors got the science wrong. How the misinterpretations of what made people sick could be used as an authority to be relied upon and even used to support the establishment of the health expert within government. I do not use pseudoscience in a dismissive way. This dissertation is about expert knowledge, but I followed those experts who were on the wrong side of the history of science and who, at the very least, added to the confusion. Through this process, it became difficult to parse out or discover the motivations for using a cholera outbreak to enact reforms. Scientists and doctors brought more and more ideas and opinions to bear on their ideologies. Some of these associated beliefs such as racism, eugenics, and stereotypes about India and Muslim pilgrims were extremely problematic. I could have ignored those acts as separate or excess data, merely noise, that were not directly related to my historical geography. But I think this would have been wrong and would have led me down a very different path.22 Finally, my dissertation concerns interdisciplinary work by health experts. For my purposes it was more fruitful to engage with the documents than engage with the consolidation of the disciplines. Latour was helpful methodologically when he stated: “Economics, politics, sociology, hard sciences, do not come into contact through the grandiose entrance of ‘interdisciplinarity’ but through the back door of the file.”23 In journals and disease research, “science status” was gained by relying on acts of synthesis from organic chemistry, gas chemistry, and phenomena like electricity. In the 1850s, using chemical theories that included fermentation and spontaneous generation to understand disease was the rage.24 After 1900, evolution, eugenics, health statistics, and economics were directly brought to bear on disease causation. Rather than interdisciplinary work, I call these practices synthetic expertise. My claim is that through these acts of synthesis transitions, crises were interpreted through correlations. But I let the files and documents lead my conclusions around disciplines, abstractions, and concepts.

0.2.2. Urban Political Ecology While this project examines the dangers of interdisciplinary work, I must acknowledge that I draw on a wide range of disciplines. I work in between disciplines because of my engagement with the historical material and the geographic perspective I draw inspiration from. My first interdisciplinary provision is political ecology,25 and urban political ecology has profoundly

Cholera and Crisis | 2010 | Paul Jackson | 11 influenced my engagement with the archive. For this dissertation, urban political ecology’s intervention insists that cities must be seen as a foundational geography from which to examine human–nature interactions and transformations.26 Fundamentally, the city opposed to nature is a problematic fallacy.27 The geographers Nik Heynen, Maria Kaika, and Erik Swyngedouw have defined the sub-discipline in their keystone book In the Nature of Cities to show how the environment and society should be seen through relational dialectics. While the non-human has an active role to play, the transformation of environments is deeply related to the politics and power of class, gender, race, and colonialism.28 The definition of urban cannot be left unpacked. The urban has been described as “dense networks of interwoven socio-spatial processes that are local and global, human and physical, cultural and organic, places where myriad transformations that support and maintain urban life.”29 Metabolism and circulation have become key metaphors in understanding how nature is integral to the function of cities.30 Socio-natural metabolism and circulation can be both enabling and disabling, and places embody these contradictions. Recently, Nik Heynen has emphasized the focus on socio-natural moments like hunger in the day-to-day life of cities. These moments act as springboards for political action, politically inform research, and lead to what he calls a politics of survival. This dovetails with Matthew Gandy’s intervention, which suggests extending the right to the city to become the right for urban life.31 But, if I can be so bold and broad, the purpose of this work is not to combine disciplines. The combination of the city, ecology, and social theory is not for the sake of combination only, or for theoretical innovations. The point is not to be interdisciplinary; the point is to get to the politics of the non-human, of the city, of capital. Those who I respect in this literature focus on the materialism and history in these politics. The questions asked arise from politics, rather than theory or disciplinary concerns. In my archive, the health of people, the politics of marshes, and the science of the non- human were not sharply demarcated into disciplines. Therefore, animated by political questions, I had to cobble together my own analysis of this interdisciplinary world. In my archive, I also witnessed and followed how the politics were drained out of events and debates in these interdisciplinary maneuvers. That being said, this dissertation has hoped to contribute, by way of cholera, to an understanding of how, even in their separation, urban form and natural entities are always transformed together. This historical geography of cholera focused on the politics of separating the categories of health, environment, and the city. The creation of a social–nature binary was predicated on the specialization of disciplines, such as engineering and medicine.

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The city had to be separated from all incarnations of its filthy nature, from everything unhealthy. However, this separation failed. For me, the politics that occurred during this attempted separation must be parsed and interrogated. But I also want to parse how practices, attitudes, and assumptions were retained during these shifts. Is the destruction of unwanted ecologies and biological threats a simple or even a “natural” progression? Marsh reclamation and sanitary reformers were not unique to Toronto. Indeed, concrete replacing nature—paved paradise/parking lot—is commonplace; it is a story of progress or a story of loss, depending on whom you ask. I refuse both narratives. My intervention is to show how, during this period, competing ideas of health (engineered/concrete/purity/productivity) and crisis (degenerating/marshland/rotting body-city/disease/waste) circulated. One of this dissertation’s conclusions is how both narratives failed the urban health reformers. I have attempted to ground this discussion by focusing on the history of 1892 and the materialism of cholera. Combing my archive with the interventions of urban political ecology, I propose a way for cholera to be seen as a metabolic vehicle that circulates and transforms the urban social relations. A cholera infection can be seen as a socio-natural moment. My expanded project is to show how human health is central to urban political ecology, and how illness as a socio-natural moment hinges on social reproduction, either in the form of class power and/or state intervention. Following Nik Heynen’s intervention of hunger, I have attempted to focus on the “gristly parts” of Foucault, how disease relates to the dis-enabling of life, both human and non-human. The politics that arose when unruly natures were brought into conflict, or even merely threatened to be brought into conflict, with managed urban space.32 What this dissertation has charted is how these practices erased nature, or perhaps the unknowable, uncontrollable non-human, in order to create a particular idea of the city. What Mathew Gandy has called antibiotic urbanism.33 In the writing of this dissertation, and in creating my argument, process thinkers have been extremely helpful. Relation dialectics or dialectical materialism utilized by process thinkers work with two fundamental ideas: the notion that processes can only be understood through their effects, and the notion that these effects arise not from some external or transcendent cause, but always from within the immanent material relationships among the elements of those processes.34 In geography, Harvey shifts conventional dialectics that privilege time over space and asks how time and space co-constitute each other? The method becomes a movement from abstract to the concrete and explores how phenomena are increasingly “hardened” into practices and social relations. Concepts are not just born, but develop over

Cholera and Crisis | 2010 | Paul Jackson | 13 time.35 In many ways, this history of cholera in 1892 is a “history of the present,” an attempt to understand the hardened spaces, times, and things of today’s current crises.

0.3. Past and Present Crises Accordingly, from the vantage point of the present, the relationship between health and capital has ossified through gene patenting, drug companies, health care, multimillion-dollar research institutes, biotech start-ups, and the biomedical model of health.36 However, this sense of what’s obvious has been produced over time, quite slowly, with many missteps, failed ventures, and insane forms. How this has played out is a historical question. But to show how these processes emerge and shift, I focus on active moments when funding is transformed and new institutions solidified. For the state, these active movements were shaped by times of crisis, crises that were simultaneously real and abstract. After 1892, the activity led to widespread institutionalized vaccination and the so-called “end of disease” by the mid-20th century. This was a presumptuous celebration. Epidemics have not disappeared.37 With twenty-nine newly emerging pathogens since 1973, some are calling the current period the “third epidemiologic transition.” Since the 1980s, the fallacy of the end of disease is clear from newly emerging diseases such as HIV/AIDS, Ebola, BSE, SARS, and newly mutated influenza such as H1N1.38 However, this talk of disease transitions throughout all of human history seems grandiose. For my purposes in this dissertation, the documents I use are old, yet the fears are quite current.39 Finally, the interrogation of my archives comes from contemporary issues and struggles. My political questions come from what I observe in the present. My questions are legion. How did environmentalism become, not co-opted by neoliberalism, but co-constitutive with neoliberalism? How does resistance to capitalism become a way to open up new regimes of accumulation? How does de-politicization work? How does science mystify? How do statements and practices become a way to marshal processes into the primary circuit of capital? How does “not-value” become a value? Can health become commoditized? To answer these questions, or isolate these processes, I wanted to isolate the “thing” least likely to have a value, a piece of nature that no one would ever defend, a piece of nature that everyone wants to eradicate: microscopic scary cholera, nature that can kill you. The provisional answer to “how do these processes happen?” is: never directly. In the process of writing this dissertation, what emerged was the problematic politics of crisis as a defining theme. When I started this research, the category of crisis didn’t dominate

Cholera and Crisis | 2010 | Paul Jackson | 14 my project. But I started writing this work in New York City, during the beginning of what has been called the “great recession.” Consequentially, I could not rip my writing out of my own context and geography. The way that present conditions echoed past crises was striking.40 The current resonances of this history can be read in discussions of ecological crises or global warming and the panics in the global financial markets. Scott Prudham frames my engagement nicely; in his case, the production of an ecological crisis “had everything to do with...capitalist nature…however, the actual political construction of new meanings arising in the midst of this crisis (i.e., the politics of interpreting and describing environmental change) and the influence of these meanings on changes in the regulatory arena has been a contingent project that has rarely challenged commodity production per se.”41 I seek to understand how seemingly progressive political movements used crises in their struggles to maintain positions of authority. I am depressingly fascinated when events, things, and practices are thought to have no politics or believed to be beyond political debate; how experts and those in power claim what should be done is obvious. In the process, decisions are declared self-evident, and consensus is never discussed or debated, but implied. For me the politics of statements like “a matter of life and death” is a politics of silence. This political ideology changes questions from “what” and “how” to “when.” In times of crisis, the answer is immediately. While I went through my archive, these tensions, fears, and politics spoke to me. Crisis was in the air.

[NOTE: This dissertation is filled with scientific and medical language and terms that are historically specific that the reader may not be familiar with, including disease names, disease concepts, people, and places. Please use the expansive glossary if you are unfamiliar with any of the terms. In the process of constructing this glossary, I included some extra definitions of words that may be helpful for their root meanings and etymology.]

Endnotes

1 The Greek root of the word epidemic is disease comes upon (epi) people (demos) and the study (logos) of that process. 2 This dissertation is written from and contributes to the literature of urban political ecology. Additionally, my interrogation of the archives has been deeply shaped by the umbrella term “third nature,” see Donna Jeanne Haraway, Simians, Cyborgs, and Women : The Reinvention of Nature (New York: Routledge, 1991); Bruce Braun and Noel Castree, Social Nature : Theory, Practice, and Politics (Malden, Mass.: Blackwell, 2001); Bruce Braun, "Environmental Issues: Writing a More-Than-Human Urban Geography," Progress in Human Geography 29, no. 5 (2005). 3 David McLean, Public Health and Politics in the Age of Reform : Cholera, the State and the Royal Navy in Victorian Britain (London: Tauris, 2006). 4 The cholera outbreaks during the 19th century have been heavily researched. For Canada, see Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo:

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University of Toronto Press, 1980); Charles M. Godfrey, The Cholera Epidemics in Upper Canada 1832-1866 (Toronto: Seccombe House, 1968). In the United States, see Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: Univ. of Chicago Press, 1962); Howard Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore, Md.: Johns Hopkins University Press, 1997). In Europe, see Pamela K. Gilbert, Cholera and Nation : Doctoring the Social Body in Victorian England, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2008); Pamela K. Gilbert, Mapping the Victorian Social Body, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2004); Margaret Pelling, Cholera, Fever and English Medicine, 1825-1865, Oxford Historical Monographs (New York: Oxford University Press, 1978); Richard J. Evans, Death in Hamburg : Society and Politics in the Cholera Years, 1830-1910 (New York: Clarendon Press, 1987); McLean, Public Health and Politics in the Age of Reform : Cholera, the State and the Royal Navy in Victorian Britain; R.J. Morris, Cholera, 1832 : The Social Response to an Epidemic, Croom Helm Social History Series. (New York: Holmes & Meier Publishers, 1976). For Victorian culture, see Asa Briggs, Cholera and Society in the Nineteenth Century (Oxford: Past and Present Society, 1961). Evans’ article notes the parallels in European history between cholera outbreaks and moments of political crisis, revolution, popular unrest, class conflict, along with resentment of both the authorities and the medical profession. For more, see Richard J. Evans, "Epidemics and Revolutions: Cholera in Nineteenth-Century Europe," Past & Present, no. 120 (1988). 5 The ‘microbe hunting’ classic work is Paul De Kruif, Microbe Hunters (New York: Harcourt, 1926). 6 Thanks to Christian Anderson who made the point that that this research looks to document the work of the ‘virtual’, particularly how and where urban forms are brought into being as a claim on the future. 7 Erin O'Connor, Raw Material : Producing Pathology in Victorian Culture, Body, Commodity, Text (Durham, N.C.: Duke University Press, 2000), 26. See also Gilbert, Mapping the Victorian Social Body. 8 O’Conner states that “Asiatic cholera was a corporeal form of culture shock, a paranoid physiology whose characteristic diarrhea flowed into widespread fears of personal dissolution, and whose final of dehydrated collapse fostered fantastical scenarios of a regressive reduction of the self to so much raw material.” In O'Connor, Raw Material : Producing Pathology in Victorian Culture, 35. By the beginning of the 1800s, cholera was both new and not new. The word itself is an amalgamation of time periods and conjecture. While dictionary definitions are generally flawe, the medical dictionary entry for cholera reveals much. From the Greek, cholera (χολέρά) is based on “gall, bile,” (χολη), and to flow (ρέІλ). To the Roman medical encyclopedist Aulus Cornelius Celsus, cholera was “a type of disease characterized by diarrhea, supposedly caused by choler”. It was a disease of the body humours (liquids) and said humours are violently discharged by vomiting and diarrhea. While historically the word cholera arose from general observations of ill bodies, the definition shifted from general observations of symptoms to the naming of specific microscopic bacteria. The other sense of khole (same word in Greek χολέρά) was “drainpipe, gutter” which water poured out. Accordingly, the word is associated with the combination of intestines and flow. There is debate whether the disease that Hippocrates and Celsus observed was the cholera of the nineteenth century, or diarrhea. In 1565, the word cholera was revived as a name for a severe digestive disorder that was rarely fatal to adults. And again in 1704 as cholera morbus, a highly lethal disease endemic in India (also termed Asiatic cholera) that periodically broke out in epidemics. The term became confused with choler and choleric, terms that refer to a queasy nature. These definitions illustrate how cholera, as an object, did not arrive untarnished of past associations. 9 Edward W. Said, Culture and Imperialism (New York: Knopf, 1994), 4. 10 E.P. Thompson, "The Moral Economy of the English Crowd in the 18th Century," Past & Present 50 (1971). 11 Jackie Orr, Panic Diaries : A Genealogy of Panic Disorder (Durham, N.C.: Duke University Press, 2006), 9. 12 The treatises, books, and reports included the following. An Account of the Rise and Progress of the Indian or Spasmodic Cholera: With a Particular Description of the Symptoms Attending the Disease: Illustrated by a Map, Showing the Route and Progress of the Disease, from Jessore, near the Ganges, in 1817, to Great Britain, in 1831, (New Haven: L.H. Young, 1832). William Farr, Vital Statistics, ed. Noel A. Humphreys (London: Royal Sanitary Institute, 1885). William Farr, Report on the Mortality of Cholera in England, 1848-49. (London: W. Clowes, 1852). Edwin Chadwick and Thomas Southwood Smith, "Report of the General Board of Health on the Epidemic Cholera of 1848 & 1849," (London: W. Clowes and Sons, 1850). Inquiry Great Britain. Sanitary and Edwin Chadwick, The Chadwick Inquiry on the Sanitary Condition of the Labouring Population: The Local Reports for Scotland; and, Supplementary Report on Interment in Towns, 1842-43 (Shannon: Irish University Press, 1971). T.R. Malthus, An Essay on the Principle of Population, as It Affects the Future Imporvement of Society, with Remarks on the Speculations of Mr. Godwin, M. Condorcet, and Other Writers (Clark, N.J.: Lawbook Exchange, Ltd., 2007 [1798]). John Snow, Snow on Cholera: Being a Reprint of Two Papers [from 1849 and 1853] (New York: The Commonwealth Fund, 1936). A Former Surgeon in the Service of the Honorable-East-India-Company, Epidemic Cholera : Its Mission and Mystery, Haunts and Havocs, Pathology and Treatment : With Remarks on the

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Question of Contagion, the Influence of Fear, and Hurried and Delayed Interments. (New York: Carleton, 1866). Nordau, Degeneration (New York: D. Appleton and Company, 1895). August Hirsch and Charles Creighton, Handbook of Geographical and Historical Pathology (London: New Sydenham Society, 1883). Friedrich Engels, The Condition of the Working-Class in Enland in 1844 (Gloucester: Dodo Press, 2007). 13 Paul Adolphus Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930" (University of Toronto, 1979). Heather Anne MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890" (University of Toronto, 1983). Angus MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945 (Toronto, Ont.: McClelland & Stewart, 1990). J.M.S. Careless, Toronto to 1918 : An Illustrated History (Toronto: James Lorimer & Co., 1984). Catherine Sylvia Brace, "Thesis: One Hundred and Twenty Years of Sewerage the Provision of Sewers in Toronto, 1793-1913" (University of Toronto, 1993). Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885- 1925 (Toronto: McClelland & Stewart, 1991). 14 Bilson, A Darkened House: Cholera in Nineteenth-Century Canada. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866. Pelling, Cholera, Fever and English Medicine, 1825-1865. 15 Evans, Death in Hamburg : Society and Politics in the Cholera Years, 1830-1910. Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892. 16 Michel Foucault, "Nietzsche, Genealogy, History," in Language, Counter-Memory, Practice, ed. D.F. Bouchard (Ithaca: Cornell University Press, 1977). Michel Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, ed. Mauro Bertani, et al. (New York: Picador, 2003), 9. 17 Furthermore, according to Foucault, history has no meaningful development or intention. What emerges then is the result of forces, and the domination of forces. What is produced always takes place within the interstices of these forces. Foucault’s other history, a history of technologies, is more general and a “more fuzzy history of the correlations and systems of the dominant feature which determine that, in a given society and for a given sector…a technology of security.” For more, see Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007), 8. 18 The archive that I organized centred around statements on cholera. My process of researching and writing this dissertation, Foucault succinctly describes as: “However, it is not possible to describe all the relations that may emerge in this way without some guidelines. A provisional division must be adopted as an initial approximation: an initial region that analysis will subsequently demolish and, if necessary, reorganize. But how is such a region to be circumscribed? On the one hand we must choose, empirically, a field in which the relations are likely to be numerous, dense, and relatively easy to describe…But on the other hand, what better way of grasping in a statement, not the moment of its formal structure and laws of construction, but that of its existence and the rules that govern its appearance, if not by dealing with relatively unformalized groups of discourses, in which the statements do not seem necessarily to be built on the rules of pure syntax?” In Michel Foucault, Archaeology of Knowledge (New York: Routledge, 2002), 32. 19 Foucault’s genealogical method allowed me to grasp, and follow, how a spatial and temporal imagination emerged in relation to the theory of disease transmission called zymosis. This theory was produced as a response to cholera epidemics. Additionally, this method highlighted how the metaphors of the seed and the soil became a vital engagement to understanding disease prevention in relation to a body, country, and city. Accordingly, many layers of fear, fiction, imagination, and theories of disease will be outlined. 20 With questions of knowledge and the construction of knowledge, I am invoking the French school of Episteme that includes Foucault and Canguilhem (who I deal with directly in this dissertation), but also Gaston Bachelard and Michel Serres (who have inspired my thinking but I haven’t incorporated their work). This episteme approach, as coined by Foucault, looks at a conceptual grid that delimits the possibility of knowledge and systems of thought. 21 As a random side note, that one of the key knowledge makers cited in Foucault’s Order of Things actually died of cholera in a Paris outbreak. 22 The archival paths I did follow lead me to the ‘dead theory’ of zymosis. In the history of knowledge of the pathology and biology of disease, the question became what is the point of spending so much time outlining a theory that currently is completely dismissed? Why not just forget these mistakes and misunderstandings? My simple retort is these mistakes had material effects on the world. Those experts who held these viewpoints—of how disease could make a city or a patient sick—implemented and pushed for reforms within this theoretical framework. Zymosis constituting their vision even if that framework was inconsistent. This persistence of zymosis pushed me to refocus my dissertation on my object and science (proliferating life and bureaucratic bio-economy). I wanted to expose this heavily laden scientific engagement with the world as a small part of Donna Haraway’s call to rebuild the life sciences. The process of exposing the science of ‘dead theories’ is to show the fictive character of all science. The process of shedding light on the ‘real facts’ that are just repetitions of unexamined contradictions, for

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example in such fields as evolution and genetics. 23 Bruno Latour, "Drawing Things Together’," in Representation in Scientific Practice, ed. Michael Lynch and Steve Woolgar (Cambridge, Mass.: MIT Press, 1990), 54. 24 John M. Eyler, "William Farr on the Cholera: The Sanitarian's Disease Theory and the Statistician's Method," Journal of the history of medicine and allied sciences 28, no. 2 (1973): 95. 25 The term political ecology is highly debated. Blaikie and Brookfield defined the framework in 1987 this way: “The phrase “political ecology” combines the concerns of ecology and a broadly defined political economy. Together this encompasses the constantly shifting dialectic between society and land-based resources, and also within classes and groups within society itself.” For an overview to contextualize this quote see P.A. Walker, "Political Ecology: Where Is the Ecology?," Progress in Human Geography 29, no. 1 (2005). For key influences on my take on political ecology, see W. Scott Prudham, Knock on Wood : Nature as Commodity in Douglas-Fir Country (New York: Routledge, 2005). Neil Smith, Uneven Development : Nature, Capital, and the Production of Space (New York, NY: Blackwell, 1984). Geoff Mann, "Should Political Ecology Be Marxist? A Case for Gramsci’s Historical Materialism," GeoForum 40 (2009). 26 This intervention comes from a predominately Marxist analysis, building on interventions of David Harvey (such as ‘there is nothing unnatural about New York City’), and Neil Smith’s work on the production of nature, see Smith, Uneven Development : Nature, Capital, and the Production of Space. But more importantly I would say this move has been animated by working out many of Lefebvre’s hypothesis that “society has been completely urbanized” in the first paragraph of Henri Lefebvre, The Urban Revolution (Minneapolis: University of Minnesota Press, 2003). I would also suggest that in this sub-discipline there has been a extensive engagement, and then rejection, of Bruno Latour, We Have Never Been Modern (Cambridge, Mass.: Harvard University Press, 1993). In this acid bath of theory, I hope is any retention of a binary between nature and society has been scoured away. Urban political ecology uses historical inquiry into how the material relations of the social and the natural became intermeshed and contested in cities. Two exemplars are Matthew Gandy, Concrete and Clay : Reworking Nature in New York City, Urban and Industrial Environments (Cambridge, Mass.: MIT Press, 2002); William Cronon, Nature's Metropolis : Chicago and the Great West (New York: W.W. Norton, 1991). 27 Maria Kaika’s claim is that in rendering cities as separate from nature actually “wove them together more closely into a socio-spatial continuum”, in Maria Kaika, City of Flows : Modernity, Nature, and the City (New York: Routledge, 2005), 5. 28 This dissertation has attempted to empirically flesh out some key points from this book: “environmental and social changes co-determine each other”; “nothing [is] un-natural about produced environments like cities, GMOs, damned rivers; rather these produced environments are the results of specific historical transformations”; “all socio- spatial processes are invariably also predicated upon the circulation and metabolism of physical, chemical, or biological components that the non-human play an active role in mobilizing”; “socio-environmental metabolism produces a series of both enabling and disabling social and environmental conditions. Many places embody these contradictory tendencies”; and “environmental transformation is not independent from class, gender, ethnic or other power struggles”. Nik Heynen, Maria Kaika, and Erik Swyngedouw, In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, Questioning Cities Series (London; New York: Routledge, 2006), 11-13. See also Braun, "Environmental Issues: Writing a More-Than-Human Urban Geography." 29 Heynen, Kaika, and Swyngedouw, In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, 2. 30 For more on metaphors of metabolism and circulation, see Erik Swyngedouw, "Metabolic Urbanization," in In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, ed. Nik Heynen, Maria Kaika, and Erik Swyngedouw (London; New York: Routledge, 2006); Matthew Gandy, "Rethinking Urban Metabolism: Water, Space and the Modern City," City 8, no. 3 (2004). I would also say the recent translation of Foucault has much to contributed to the notion of circulation, see Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78. Additionally, the cyborg has been an intervention in this literature as well, however I don’t have the space to get into my reservations about that metaphor, see Matthew Gandy, "Cyborg Urbanization: Complexity and Monstrosity in the Contemporary City," Sage Urban Studies Abstracts 34, no. 2 (2006); Erik Swyngedouw, "The City as a Hybrid: On Nature, Society and Cyborg Urbanization," Capitalism Nature Socialism 7, no. 2 (1996). 31 See Nik Heynen, "'but It's Alright, Ma, It's Life, and Life Only': Radicalism as Survival," Antipode 38, no. 5 (2006); Matthew Gandy, "Planning, Anti-Planning and the Infrastructure Crisis Facing Metropolitan Lagos," Urban Studies 43, no. 2 (2006). 32 I do find Lefebvre’s interventions quite useful. When talking about urban ideology and the urban illusion—as both reductive and as a solution—Lefebvre says: “This extrapolation becomes excess when it tends towards a kind of medical ideology. The urbanist images himself caring for and healing a sick society, a pathological space. He

Cholera and Crisis | 2010 | Paul Jackson | 18

perceives spatial disease, which are initially conceived abstractly as an available void, then fragmented into partial contents. Eventually space itself becomes a subject. It suffers, grows ill, must be taken care of so it can be returned to (moral) health. The urban illusion culminates in delirium. Space, and the thought of space, lead the thinker down a dangerous path. He becomes schizophrenic and images a mental illness—the schizophrenia of society—onto which he projects his own illness, space sickness, mental vertigo.” Lefebvre, The Urban Revolution, 157. 33 Gandy, "Rethinking Urban Metabolism: Water, Space and the Modern City." This dissertation looks at struggles over urban-natural spaces and attempt by urban reformers to expel all forms of nature, or life, from the city. This dissertation looks at how this worked, and how this failed, to reveal much about current social relations. 34 This clarification of my method came from Christian Anderson, but also when David Harvey talks about his methods in David Harvey, Spaces of Capital : Towards a Critical Geography (Edinburgh: Edinburgh University Press, 2001). David Harvey, Justice, Nature, and the Geography of Difference (Cambridge, Mass.: Blackwell Publishers, 1996). 35 Bob Jessop, "Spatial Fixes, Temporal Fixes and Saptio-Temporal Fixes," in David Harvey: A Critical Reader, ed. Noel Castree and Derek Gregory (Malden, MA: Blackwell, 2006), 143. 36 For the current period Sunder Rajan’s term biocapital, or the wider literature under the umbrella bio-economies, traces much of these present-day relations between the life sciences and capital. My purpose is to suggest that these have a longer historical trajectory. I will return to these questions throughout my dissertation, but directly in my conclusion. 37 The current literature includes: S. Harris Ali and Roger Keil, "Global Cities and the Spread of Infectious Disease: The Case of Severe Acute Respiratory Syndrome (Sars) in Toronto, Canada," Urban Studies 43, no. 3 (2006); S. Harris Ali and Roger Keil, Networked Disease : Emerging Infections in the Global City, Studies in Urban and Social Change (Malden, MA; Oxford: Wiley-Blackwell, 2008); Bruce Braun, "Biopolitics and the Molecularization of Life," Cultural Geographies 14, no. 1 (2007); Susan Craddock, "Market Incentives, Human Lives, and Aids Vaccines," Social science & medicine. 64, no. 5 (2007); Nicholas B. King, "Infectious Disease in a World of Goods" (2002); Mike Davis, The Monster at Our Door : The Global Threat of Avian Flu (New York: New Press, 2005); Nikolas Rose, Politics of Life Itself : Biomedicine, Power, and Subjectivity in the Twenty-First Century (Princeton: Princeton University Press, 2007); Roger Keil, "Urban Politics and Public Health: What's Urban, What's Politics?," Urban geography. 30, no. 1 (2009); Catherine Waldby, Aids and the Body Politic : Biomedicine and Sexual Difference (London; New York: Routledge, 1996); Keith Wailoo, Dying in the City of the Blues : Sickle Cell Anemia and the Politics of Race and Health, Studies in Social Medicine (Chapel Hill: University of North Carolina Press, 2001). 38 Ronald Barrett et al., "Emerging and Re-Emerging Infectious Diseases: The Third Epidemiologic Transition," Annual Review of Anthropology 27 (1998); Abdel R. Omran, "The Epidemiologic Transition: A Theory of the Epidemiology of Population Change," The Milbank Quarterly 83, no. 4 (1971). For similar arguments as my own, but in relation to the current period, see Matthew Sparke, "Unpacking Economism and Remapping the Terrain of Global Health.," in Global Health Governance: Transformations, Challenges and Opportunities Amidst Globalization, ed. Adrian Kay and Owain Williams (New York: Palgrave Macmillan, 2009). 39 Both the fears of the misuses and abuse of health are quite current. As Bashford and Strange make clear: “The point is that managing infectious disease holds a particular potential for misuse…not that this necessarily materializes.” In Alison Bashford and Carolyn Strange, "Thinking Historically About Public Health," Medical Humanities 33, no. 2 (2007). 40 For more see, Rebecca Solnit, A Paradise Built in Hell : The Extraordinary Communities That Arise in Disaster (New York: Viking, 2009); Naomi Klein, The Shock Doctrine : The Rise of Disaster Capitalism, 1st ed. (Toronto: A.A. Knopf Canada, 2007); Mike Davis, Ecology of Fear : Los Angeles and the Imagination of Disaster (New York: Metropolitan Books, 1998). I have read these accounts and agree with the political projects and interventions. But these books are a different document than the one I am producing here, and for a different audience. They are more like echoes to my argument, confirming that something was there on the other side of the valley. In contrast, I purposely did not read works like Guns, Germs and Steel and The Ghost Map whose arguments seemed reductive and cheap, and therefore they do not deserve a citation. 41 Prudham, Knock on Wood : Nature as Commodity in Douglas-Fir Country, 185.

The Cholera Crisis in 1892 | 2010 | Paul Jackson | 19

Chapter 1 – The Cholera Crisis of 1892

IS THIS DREAD CHOLERA? KOCH ON THE SCENE. CHOLERA MAY COME. NEW YORK IS READY. NO CAUSE FOR ALARM. CHOLERA TO COME NEXT YEAR. WATCH JEWISH IMMIGRANTS. NEW CURE FOR CHOLERA. CHOLERA IS IN ENGLAND. SHIPS BOYCOTT. THE PLAGUE’S PATH. WAKE UP, TORONTO. COMING VIA CANADA. GROSSE ISLAND CONDEMNED. BARRIER AT DETROIT. THOSE JEWS COMING TO CANADA. QUEBEC CLOSES ITS DOORS. KEEP AWAY FROM US. GUARDING THE FRONTIER. IS CHOLERA HERE? GOOD NEWS ABROAD. A VOYAGE OF HORROR. FEAR IT’S CHOLERA. A BAN IS PUT ON NEW YORK. TORONTO IS READY. GRAVE STUPIDITY AT OTTAWA. TO CLEAN THE CESSPOOL. – Toronto Evening News, Headlines, Fall 1892, Chronological Order

Each statement above is a newspaper headline from the fall of 1892, compiled in chronological order. Headlines tell a particular story, a fearful account of panic and speculation.1 Published in the Toronto Evening News, a popular, cheap, and sensational newspaper, these headlines followed the looming cholera epidemic of 1892.2 The editors threw around blame and made bold declarations. Fear sells newspapers. I have laid out the headlines in this manner to illustrate the urgency and immediacy of the impending cholera outbreak. This chapter will tell the story of “what happened” in the fall of 1892 and will discuss how this cholera outbreak was framed as an urgent and sudden crisis. This chapter documents how future threats became immediate and dire concerns. Orthodox histories of disease outbreaks generally focus on locations where sick and dying people are found. But the fear and conjecture of impending epidemics should be included in this history of disease. Predictions about both the present and the future were speculative statements, and these statements had effects on cities and nations. This project will The Cholera Crisis in 1892 | 2010 | Paul Jackson | 20 explore the political, cultural, and scientific context leading up to the fall of 1892 and the outcomes that followed. Because the cholera outbreak of 1892 is the pivotal moment for this dissertation, it requires a detailed explanation. In the fall of 1892, ten years into the fifth international cholera epidemic that lasted from 1881 to 1896, fear of cholera in North America, particularly in Toronto, was full blown. Cholera had been raging in the Middle East, India, and Europe, and in Russia alone there were an estimated 300,000 deaths, but the disease had yet to cross the Atlantic Ocean. In the case of previous Canadian outbreaks of cholera (at various times between 1832 and 1871), the bacteria had travelled from Europe on migrant ships. Maritime traffic of immigrants from Europe was continuous, and each migrant ship potentially carried the disease. Doctors, government officials, and politicians were not asking “would cholera come?” but rather when. In the city of Toronto, no one actually got sick or died of cholera in 1892. However, the crisis and fears of imminent cholera were real. The cholera outbreak of 1892 was marked by countervailing tendencies, particularly in Toronto. Cities were caught off guard. Urgency was pervasive. But at the same time, government officials postured as though they were completely prepared, especially if both human lives and their jobs were on the line. Local sanitary conditions had to be put in order, and national borders also needed securing since the disease would come from overseas. Health reformers were pulled to institute reforms both locally and internationally, yet the lack of scientific consensus over the causes and vectors of the disease confused what direct changes were necessary in sanitation and quarantine methods. Debate was thought to be inefficient; instead, experts recommended various reforms whose implementation had “obvious” benefits. Government officials quickly declared plans that had previously been delayed due to politics or budgetary constraints as necessary and pressing. My task here becomes how to write a history of an event that was shaped by urgency, immediacy, and speculation on the future. My argument will show how the geography of an epidemic is not limited to the presence of disease. Since the cholera bacteria never arrived in Toronto in 1892, how can we explain all the developments, debates, policies, and politics? Was this activity merely error and delusion? If crises are times of profound activity, how does a crisis need to be substantiated in order to produce change? The first half of this chapter will empirically assess how North American state institutions framed and managed future events, particularly epidemic crises. The second half of this chapter will engage with the theoretical implications of this question. To do this, I will use a Foucauldian framework to examine how state actors marshaled The Cholera Crisis in 1892 | 2010 | Paul Jackson | 21 statements of disease crisis for political ends. I’ll also look at the way David Harvey addresses the production of social infrastructures in order to explain how these processes were made permanent in state institutions. I combine Foucault’s understanding of the event with David Harvey’s analysis of the state within capitalism in order to explain how a crisis became articulated and understood and how actors in government used the crisis to solidify their positions in state institutions, such as health boards. Additionally, I want to emphasize how these events were profoundly contingent on and limited by the actors involved and the contexts in which they took place. After the cholera outbreak of 1892, substantial changes took place in state institutions, science, international coordination, waterfront transformation, and the ideology of health experts. North American health experts and political authorities seized the moment to align their health borders, to reclaim the marshlands of cities, and to debate and reform immigration. These changes were all declared necessary. Despite this widespread change, cholera as disease crisis was a proportionally small event for Toronto. If cholera in 1892 did not happen in Toronto, then why was there such fear and demand for reform? How do crises produce this degree of activity? To answer these questions, we must begin in the summer of 1892 in Hamburg, Germany.

1.1. Cholera Crosses the Atlantic Ocean 1.1.1. The cholera crisis in Hamburg, Germany By August of 1892, Toronto’s newspapers, as well as news outlets around the Atlantic, were regularly reporting cholera outbreaks occurring in far off and foreign locales. For over sixty years, North American audiences had read updates and notices on the spread of cholera throughout the world. These outbreak events appeared to be increasing in frequency and were encroaching on Western European cities. However, some reports dismissed these fears, suggesting the notices were false alarms—only diarrhea or “cholera infantum.” Then, at the end of August, international attention was focused on the city of Hamburg, Germany. Port authorities in neighbouring countries suspected for some time that Hamburg was in the middle of a serious cholera emergency. However, Hamburg’s city government publicly denied the outbreak. The city government tried to quell the fear and rationalized that, even if cholera was present, every precaution was being taken to keep the disease local. There were doubts the disease could be contained, since Hamburg was one of the largest and busiest ports in the world. North America was particularly worried. New York and Hamburg had the highest volume of shipping between any two ports of that period. Hamburg’s The Cholera Crisis in 1892 | 2010 | Paul Jackson | 22 direct shipping connections to Montreal worried Canadians. While Hamburg city officials denied cholera, the growing death count could not be ignored. The cholera outbreak was confirmed in Hamburg when the famed German bacteriological scientist Robert Koch, the scientist who “discovered” the cholera bacterium in 1882, rushed back from Persia where he was doing research and declared he had found cholera in the German city’s water supply. The Toronto Evening News reported, “The declaration of the renowned Professor Koch…is accepted without question by the physicians of Toronto.”3 By August 24th Hamburg finally admitted that there had already been 120 cases of cholera and 35 deaths. The city’s official telegraph notices were sent to every port to prepare for Hamburg ships. Toronto newspapers reported that people were dying in Hamburg within six hours, sometimes in as little as one hour after coming down with the disease.4 Toronto headlines exclaimed: “CHOLERA MAY COME. The Asiatic Type is at Hamburg and Havre! America Has Direct Communication! Washington Warned to Beware of the Scourge—A Steamship on the Way From Havre Which is to be Fumigated—This Continent in Genuine Danger.”5 Ships began to boycott Hamburg,6 and ships from Hamburg in other ports were no longer allowed to dock and were placed in quarantine. To deal with the crisis and clean their city, Hamburg’s city officials requested 38,000 gallons of disinfecting fluid from the London authorities.7 As one newspaper headline stated: “The Epidemic in Hamburg Worse than Any of the Nineteenth Previous.”8 But Hamburg rationalized that the city was not at fault; it was merely a victim of the scourge of dirty migrants travelling through. The Hamburg authorities denied culpability, saying that they were merely the gateway onto the Atlantic that unleashed the cholera crisis from its source in the Russian interior. Yet the cholera crises re-established and confirmed for shipping and port authorities that pandemic outbreaks were a common problem. The coverage from London, England, claimed British authorities of having suspected that cholera had infected Hamburg even before Hamburg’s senate admitted the outbreak of the disease. Concealing local problems had international ramifications. The orders were to inspect everyone from Russia and Hamburg and specific instructions were given: “Dirty clothing and all baggage suspected of being infected with cholera will be burnt.”9 Hamburg was the most recent port during that pandemic to have an outbreak; however, Hamburg was distinct in terms of scale and intensity of the outbreak and the city’s key position in international shipping routes. The tone of the newspaper articles suggested that, because Hamburg had such extensive international connections, it was only matter of time before another city would become a new nexus in the spreading pandemic. Many predicted that The Cholera Crisis in 1892 | 2010 | Paul Jackson | 23 the next city would be New York City, particularly because a ship with cholera passengers was already travelling toward the city and Hamburg would not allow the shipping company to return to its port. Hamburg was the site of the Atlantic outbreak, but it was not where cholera originated. As the newspapers repeatedly reminded their readers, the real cholera problem was, and continued to be, India. India was perceived and declared to be the origin of cholera, the source of previous pandemic crises by the international medical community. Doctors and scientists blamed cholera transmission throughout the Atlantic on Muslim pilgrimages travelling from India to the Middle East. Many of the previous cholera pandemics were said to have originated at the yearly Hajj pilgrimages to Mecca. The London Daily News reported that cholera had been discovered in “the East.” Constantinople reported that although the Mecca pilgrims had shown clean bills of health up to the present, several new cholera cases had been found.10 The Toronto Evening News gave a quick overview of “Meshad, the Sacred City of Persia, Home of the Scourge.” Medical journals and the Western media repeatedly labelled India as perpetual cause of cholera pandemics, even as this explanation did not adhere to the evidence in 1892. But the carriers of cholera from Hamburg were Russian Jews looking to cross the Atlantic, bound for North America in search of jobs and new lives. The European experience of Jewish migration was focused not just on shipping but also on rail transportation. By the 1890s, railway networks had spread across and connected western European nations with the Russian empire. These railways provided a swift new means of transportation for the disease. The 1892 cholera pandemic had travelled overland from Afghanistan to Russia. The disease was in Moscow by July of that year. Jewish migrants bound for the United States via Hamburg were driven to migrate by famine, the pogroms, and the expulsion of Jews from Moscow. In response to these reports and the higher volume of Jewish passengers, the German Imperial Health Office sealed the border. Migrants were allowed to travel through the country but they could not stay in Germany. Jewish migrants were transported in sealed trains and no passenger was allowed to leave. If any migrant left the train, heavy disinfection of the train station and surrounding areas was required.11 The migrants had paid for passage to cross the Atlantic on shipping vessels whose foremost destination was New York City. Therefore, they were “stored” in Hamburg and not allowed to leave the shipping companies’ facilities. Though Hamburg’s lack of clean water supply was responsible for the spread of the epidemic, cholera fed into the long-standing stereotypes and structural discrimination against the Jewish community in European cities. While in Paris, headlines blared the French authorities’ The Cholera Crisis in 1892 | 2010 | Paul Jackson | 24 warning to Canadians: “WATCH JEWISH IMMIGRANTS. Those on Their Way are in a Terrible Filthy State.” The news reports suggested that the combination of the condition of the Jewish emigrants and the city was a “fertile field for its spread.” News reports from Paris called the city a disaster waiting to happen. The Paris Jewish Committees said that in August, 1,000 Jewish refugees from Russia passed through Paris, and most were on their way to the United States. The recent arrivals “have been in a most filthy condition.”12 The association between dirt and cholera had yet to be debunked, so these migrants were feared based on their appearance. A couple days later, another report from Paris claimed that Russian Jews were planning to go through Canada to get into the U.S. and avoid any quarantine measure. Newspaper reports on cholera were sensational. Stories on the spread of the disease used a particular format. Newspapers constantly predicted which city would be the next site of infection. Toronto’s newspapers featured a sick city roll call: short reports from each major city and port stating the existing sanitary conditions or any cholera cases. As an example, Vienna was declared to be in a “[s]hocking state of filth and overcrowding” with tons of rotting meat sausages and fruit, and if cholera reached Vienna, “the number of victims will run in the tens of thousands.”13 In contrast, for St. Petersburg on September 2, 1892, the report was just a listing of official cholera “returns”: “5,273 new cases and 2,722 deaths as a total 15,900 have already died.”14 The daily newspapers’ reports on each city’s death toll and the event of a new city being added to the list of the infected must have had a tremendous effect on Toronto’s readers. Sometimes the reports would also declare false alarms and recant previous accounts; for example, the notices of cholera in Venezuela were false. These false reports would only lead to further confusion. There were also reports that doctors in Paris and London were misdiagnosing scarlet fever as cholera out of fear. Fear, confusion, and speculation were rampant.

1.1.2. United States prepares for cholera A few Canadian officials made the astute judgment that if cholera was to enter North America in the fall of 1892 it would be through the United States, probably New York City. The United States delegates in Germany had been caught by surprise. Since Hamburg officials did not want other nations to know there was a cholera outbreak brewing, they hid the disease from the American Consul Charles Johnson who was stationed in their city. When the European consuls received the correct information, they immediately reported to Washington, according to procedure. The official notification was too late. Ships with sick migrants were already on their way across the Atlantic. But according to procedure, the outbreak notice was relayed to the The Cholera Crisis in 1892 | 2010 | Paul Jackson | 25

Health Officer of the Port of New York, Dr. William Jenkins, along with directions for the customs officers to disinfect baggage from cholera-infected ports.15 Washington’s official position was clearly stated: “The greatest danger to which this country is exposed is from the hordes of emigrants. More than 50,000 come into this country every month, Germany heads the list, with natives of the British Isles second and Russians a good third.”16 Ships with migrants from Europe were placed under high scrutiny. However, New York City doctors and medical experts exuded confidence. Both city and port officials declared New York ready for the cholera patients that were to arrive any day. New York City’s Sanitary Superintendent Cyrus Edson declared, “There is positively no danger to New York...The European outpost of the disease is, to be sure, unpleasantly near us, particularly in view of the heavy tide of emigration from Northern Europe with flows from Hamburg.” But he correctly declared that the incubation of the disease guaranteed that cholera would be discovered during the Atlantic transit. Public health officials in New York City would be aware of who was sick before the ships docked in the city. Edson knew that cholera had to get into your internal digestive system to cause illness, and he assured the public that the mere presence of a person with cholera within a community was not a danger. He spoke of holding a child suffering from cholera in his arms and walking away without getting sick. He suggested that cities must purify their water, as cholera in polluted water lived on organic matter that allowed the germ to multiply.17 He worried that, if New York City’s Croton watershed became “impregnated with cholera germs,” a citywide epidemic could take place. The Toronto Evening News editors ended the story with Edson outlining how cholera followed in the wake of war, famine, or other misfortunes, and how the present outbreak was directly connected to the famine in Russia.18 The report concluded with a small history lesson on how New York City had had five outbreaks during the 19th century and how an estimated 15,000 people had died.19 When cholera did arrive in New York City, three shipping vessels were put into quarantine. In Toronto, a constant detailed reporting on what was happening in New York City took place. As each ship with sick passengers arrived in its ports, the health officials restated their confidence of the city’s position. There were reports of the horror and panic of passengers who were quarantined on the ships in the harbour along with the sick. Many of the rich passengers begged the health commission to break quarantine and let them disembark. New York City policemen began patrolling the ships and port to make sure no one jumped ship to swim to shore.20 Despite all these fears, the New York City and North American cholera crisis never materialized. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 26

New York City isolated the disease and was the only North American city to be affected by this cholera pandemic. Thirty-two people died in New York, but the majority of the deaths were among the Russian Jewish migrants quarantined on the ships, and this halted the spread of cholera. But these quarantine measures were politically unpopular. From some liberal circles, the act of keeping everyone at bay in quarantine reflected poorly on both the city and the nation. There had been long-standing criticism against New York City’s quarantine practices. Since 1888, New York City’s Committee of Physicians had warned that the quarantine facilities were inadequate to manage an outbreak and the lack of reform, despite their warnings, was probably due to financial constraints. New York City’s quarantine islands and stations lacked adequate water supplies and sanitary measures. Dr. William Jenkins, the health officer of the port, instituted the politically unpopular practice of keeping all migrants on ships floating in the bay during the outbreak. When ships tried to land against the quarantine, riots broke out. Though the disease was contained, Jenkins was publicly attacked for his mismanagement of the cholera outbreak.21 The condemnation was strange given that he had halted the spread of the disease. However, federal authorities and medical experts throughout the United States called for reforms of the national quarantine measures. An editor of the Nation, E.L. Godkin, who had been forced to stay on one of the ships in the New York harbour, wrote influential pieces about his experiences in the Nation and the North American Review in a series called “Letters from the Normannia,” the name of ship that he had travelled on. He attacked the quarantine measures as old fashioned, medieval, and even barbaric. Godkin supported his argument with expert opinions from The Boston Medical and Surgical Journal, which had declared the quarantine of New York a “national disgrace about which the less said the better.” Yet Godkin extolled his readers to take up a public outcry. He said the United States was still unprepared for the threat of cholera. He claimed that with the Columbian Fair in Chicago scheduled for the following year, thousands of migrants would be travelling into the interior of the continent, and a disease crisis was waiting to happen.22 Godkin asserted that people of his status, with either money or authority, who would be coming to the United States should not be kept for twenty days in quarantine before reaching the fair. Throughout the 1890s, in journals such as Harper’s Weekly, a regular discussion took place on immigration, quarantine, and the need for a national health agency. The 1892 cholera outbreak also became a national lightening rod in debates over immigration. President Benjamin Harrison was against immigration and had renewed the Chinese Exclusion Act in May 1892. Even he couldn’t stop the flow of migrants in the name of The Cholera Crisis in 1892 | 2010 | Paul Jackson | 27 health concerns because ports were not under federal jurisdiction. If cholera and typhoid were found on migrant ships, neither the president nor any federal agency could bar entry. Quarantine was under state and city jurisdictions. With a number of strikes and labour disputes throughout the country at this time, the intersection of immigration and disease became a nativist rallying point. In the spring and summer before the cholera outbreak, many politicians railed against these new immigrants taking jobs. Senator William Chandler pushed for immigration reform, a nativist crusade masked as a health concern. Under the auspices of stopping cholera in the upcoming year, he called for the suspension of all immigration. He gathered his experts into an Immigration Committee to discuss the “public health evils of immigration.”23 This furthered his “alarm and danger of immigration” line, which he’d used during the typhoid outbreak in the summer of 1892.24 Immigration decreased by 95 percent during the five months after the cholera emergency was declared. When President Grover Cleveland was elected on November 8, 1892, he continued President Harrison’s immigration policies. Twenty days of quarantine for all steerage was upheld, even while his opponents criticized him, saying that politics were being made into a public health issue.25 By December, Cleveland declared quarantine to be a national issue, and acknowledged that the port of New York was the most important gateway for disease to travel into the United States. Even though the cholera epidemic was contained, the city’s quarantine was called “utterly inadequate.” The federal government hoped to establish uniform regulations for the whole country.26 In January 1893, Harris-Rayner’s National Quarantine Act was passed. It specified national regulations for medical inspections and disinfection of ships and immigrants. The act put the Marine Hospital Service in charge of these services. The act also required more specific medical documentation from shipping lines before they departed for North America. These new powers made up for the fact that the president couldn’t intervene during a health crisis like the cholera outbreak of 1892.27 Now the Marine Hospital Service could intervene. For the United States, the 1892 outbreak had transformed quarantine laws and polices into a national concern within federal jurisdiction.28

1.1.3. North America closes its borders The fear of cholera produced profound jurisdictional tensions and political conflicts between different levels of government throughout North America. Paranoia and tension prevailed. Dr. Lachapalle, the chief of Quebec’s Provincial Board of Health, forbade any vessel from a suspected infected port to touch any piece of land in his province. In Canada, the federal The Cholera Crisis in 1892 | 2010 | Paul Jackson | 28 government had exclusive jurisdiction over quarantine, and Lachapalle condemned them for not taking the necessary precautions. He took matters into his own hands and shut Quebec’s doors to all ships.29 The Hamburg-American Packet Company in Montreal was so concerned that the manager told the Canadian authorities that they would take precautions on their own ships to help the effort.30 A vessel containing only rags31 from an infected European district was put in quarantine in the St. Lawrence (while rags cannot transmit the cholera bacteria, many authorities claimed that they could). Quebec had been warned that 4,000 Russian Jews were coming from Dieppe, France, to Canada in order to sneak across the border into the United States. In Detroit, reports stated the opposite, declaring that Jewish migrants had already bypassed the United States quarantine measures and were travelling to Canada to spread the disease. In response to these reports, the Ontario Provincial Board of Health held a special meeting on September 7th where it resolved that the province would establish a twenty-day quarantine. This new resolution was in conflict with Canadian procedures, but in accordance with the direct orders from the President of the United States. The Ontario doctors also put pressure on the federal government to establish the same quarantine and to appoint sanitary inspectors on all trains and vessels coming from New York to Canada.32 Public health officials from cities and the provinces put pressure on the federal governments to coordinate North American quarantine procedures.33 Simultaneously, doctors and health officials across Canada felt adequately justified by the 1892 cholera epidemic to demand a national role for epidemic controls. In Toronto, predictions of outbreaks in the city started to circulate days after Hamburg officials finally admitted to the disease. Even before cholera reached New York City, Toronto headlines stated: “CHOLERA TO COME NEXT YEAR” and “The Dread Scourge Altogether Likely to Visit Canada” and “May Come This Year, but Not to be Epidemic—History of Past Outbreaks Leads to the Belief That it Will Come to Stay Next Season.” 34 Local health experts fuelled and validated the reports. Again, while fear mongering was constant, there was a counter tendency, a national or new world pride that claimed Canadian quarantine facilities were strong and would hold. The doomsayers claimed that the “fair” City of Toronto would be “plague smitten unless a beneficent Providence interfere[d].” In Toronto, a schizophrenic tone can be found throughout the reports. On one hand, Toronto was filthy and ripe for a cholera outbreak; on the other, predictions of cholera’s impending arrival touted Toronto’s superior health and hygiene Amidst this fury in the press, Toronto health experts stepped onto both the national and international scenes. If cholera was going to come, then the “notoriously tardy” federal The Cholera Crisis in 1892 | 2010 | Paul Jackson | 29 government would be to blame. There were immediate demands by Toronto doctors to make the quarantine station on Grosse Island more efficient. Grosse Island, on the St. Lawrence Seaway, was Canada’s largest quarantine station and ships were inspected there throughout the 1800s.35 But in comparison Toronto was much better equipped in terms of quarantine. The city had an isolation hospital and Dr. Allen of the city’s Health Department had recently purchased a steam disinfector. The city was celebrated as quite well prepared, though Toronto experts still looked to institute health reforms locally. Dr Allen’s steam disinfector, which could disinfect clothing for smallpox and diphtheria patients, was no longer declared a waste of city funds. Since the Dominion Government’s Grosse Island quarantine station did not have a disinfector and there was no time to construct one, Toronto loaned the station its machine. Dr. Norman Allen, the Toronto Municipal Health Officer, then directed the Polsons Company in Toronto to make another one, which Ottawa then paid for. The papers declared: “It is pointed out by the Government that the stopping of cholera at the entrance to the Dominion is of even more importance than the stamping out of diphtheria in Toronto.”36 The crisis of cholera overshadowed chronic and endemic diseases like diphtheria, which predominately infected children. Predictions of the coming pandemic were accompanied by calls for sanitary reforms. Despite Toronto’s existing health preparations, there was focus on more citywide sanitary reforms, including “the dire matter of the sewage” being discharged into Toronto’s bay. The images in the newspapers described how underneath the waterfront and bay, the city’s pipes were ready to explode and spread cholera into the water supply. The papers warned that leaky pipes and sewage in the bay were the reason why cholera might spread throughout the city; the Evening News writing, “Unless remedied the city is in the greatest possible danger.”37 Practical recommendations that included all readers should boil their water were given.38 Medical experts also offered a seasonal explanation of the crisis. Their opinion, based on previous outbreaks, was that winter stopped “the ravages of the disease.” The newspapers and experts believed the activity of the undeveloped germs would be latent during the cold season. However, “recrudescence, as the wise men call it, is the process through which that activity will be revived, and the deadly comma bacilli will get to work again.”39 So, if Toronto avoided the cholera crisis in the fall, by spring, cholera could re-emerge. The health officials articulated an ambivalent attitude over the present urban sanitary conditions of Toronto. Even if no outbreak occurred, no matter what preparations were made, the potential for crisis would always be present; the disease was waiting to be unleashed. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 30

Dr. Norman Allen, the Medical Officer of Toronto at the time, was worried, but did not want to start a scare. Allen described how in the past cholera infected cities for two to four years, pointing out that “nothing short of a miracle will prevent its visiting America next summer and remaining here for a couple years.” 40 At the same time, Dr. Peter Bryce, the secretary of the Provincial Board of Health (see Figure 1.1), was even more concerned, stating that cholera was “getting too near to be comfortable…Hamburg is near in the sense that there is a great deal of traffic from there to America…All we can to do is to keep Canadian machinery as perfect as possible and I trust that the American sea board authorities will do the same…The question is what ‘we may expect in 1893.’ I can only say the discussion must be viewed with alarm.” Bryce told the Evening News readership he was worried that, in these summer months, the high temperature along with the humidity and moisture would be conducive to the spread of the disease.41 Bryce noted that when cholera arrived in New York in 1873, the disease did not spread to Canada. Full of hubris, Bryce suggested that the Canadian government health officers’ efficient quarantine regulations and the work of the city’s local health boards kept the disease from spreading to Canada.42 Discussing the present, Bryce predicted, “The scourge may not get as far westward as Toronto this fall, but it is almost certain to be upon us with the opening of the spring. In any case every possible precaution should be taken at once to prepare for the attack, which may be looked for sooner or later.”43 Accordingly, Bryce called on every household to do its part and that all “lurking places of disease be removed.” Temperance was advised in eating, drinking, and the pursuit of pleasure.

Figure 1.1. Dr. Peter Bryce Figure 1.2. E.P. Lachapelle The Cholera Crisis in 1892 | 2010 | Paul Jackson | 31

According to the provincial health authorities, Toronto’s greatest emergency in preparing for the coming cholera outbreak was Ashbridge’s Bay. On September 1st, soon after Hamburg’s outbreak, the Toronto Evening News stated that the City of Toronto’s principal duties were to clean up Ashbridge’s Bay and to build a modern sewer system. These improvements were deemed immediately necessary. The paper championed City Alderman Daniel Lamb who had already outlined a plan of improvement that will at once remove a sanitary evil and create valuable city property. Let immediate action be taken on the lines suggested. The Local Improvement Act and power conferred on the Board of Health will probably be found sufficient to allow of this improvement being carried out…There is no reason why considerable progress with the actual work should not be made before the beginning of winter.44

Dr. Bryce agreed and suggested that “the urgent necessity there is for placing our city in such a sanitary condition as will make cholera, should any appear amongst us, as little serious as the nature of the disease permits.”45 Bryce gave a more complete version of his sanitary reforms to transform Ashbridge’s Bay to be in the “best possible condition before 1893 when it is feared cholera may reach Canada.” Bryce called for the purification of the bay; the removal of causes of future pollution; the placing of the shores in a sanitary condition; and the gradual extinction of the swamp. However, as Bryce’s actions demonstrated, local sanitary clean up was just one way the health experts dealt with the cholera crisis.

1.1.4. North America’s cholera wall After chastising Toronto because of the local conditions, Dr. Bryce began to organize internationally against the impending pandemic. He was one of the primary founders of the International Conference of State Boards of Health. Bryce hosted Dr. Henry Baker of Michigan, J.N. McCormack of Kentucky, Dr. J.R. Laine of California, Dr. Joseph Holt of Louisiana, and Dr. Domingo Orvananos of Mexico. This Toronto meeting was merely the starting point. Before conducting a complete inspection of the Dominion and United States quarantine stations, the group stopped in Montreal. Their arrival galvanized Montreal city officials. The mayor of Montreal ordered the city to be cleaned and all citizens, whether tenants or owners, were ordered to clean their own yards and cellars. After Montreal, the delegates changed their name to the International Conference of Quarantine Inspection.46 When they arrived at Grosse Island, they found the sanitary conditions and disinfection equipment inadequate to protect Canada The Cholera Crisis in 1892 | 2010 | Paul Jackson | 32 against cholera or any other contagious disease. Chief problems included no wharf adequate for the safe and speedy landing of passengers and their effects; no process for how the vessels were to be disinfected; no suitable disinfecting apparatus for baggage, cargo, or vessels; no proper accommodation for detained diseased suspects; and no adequate and safe water supply for washing, bathing, or drinking.47 Because the station was in such poor condition, they recommended the complete exclusion of emigrants and their effects, in other words, basic and complete quarantine. The commissioners condemned the lack of federal funding for the quarantine station. But they expressed their appreciation of the efforts of Dr. Montizambert, the superintendent who had done so much with so little to keep smallpox and other diseases from entering Canada. The tone of the reports and much of the outrage from the state officials was due to the lack of funding and support from the federal government, both in Canada and the United States. During their time at the station, a steamship carrying sugar completely bypassed the quarantine station without stopping, particularly raising the group’s ire. After Grosse Island, the International Board of Health delegates moved on and travelled to New York City, Boston, Philadelphia, Washington, St. John, Halifax, and Portland, Maine, for similar assessments. During this same period, the United States was pressuring Canada to improve its quarantine procedures. New York City’s Chamber of Commerce’s Special Committee on Quarantine appointed on September 9, 1892, stated that “Canada is...ready to make concessions to draw travel and trade from us.”48 The worry was that the United States–Canada border was too easy to cross, making it impossible to maintain a nationwide quarantine. The United States, in looking outward to secure its borders, targeted Canada specifically. In Washington, Postmaster-General John Wanamaker issued an order that all mail must be disinfected. Surgeon H.W. Sawtelle of the United States Marine Hospital Service was ordered to secure the inspection stations on the Canadian frontier at Island Pond, Vermont, and Ogdensburg, New York. Washington declared that it must take action, in particular “guarding the frontier” against Canada.49 The acting Secretary of the Treasury Spaulding wired Detroit that disinfection must be under the control of the state health officers, even though the Canadian Pacific Railway Company had already provided disinfection facilities. The Evening News stated that, despite the constant communication between the officers of the U.S. Marine Hospital Service and the Canadian quarantine authorities, suspicion was rampant. Toronto newspapers also reported on the quarrelling between U.S. federal authorities, the state authorities, and the officials at Port of New York City.50 The fear was that the cholera threat would move to the Canadian border. National quarantine measures, rather than relying on The Cholera Crisis in 1892 | 2010 | Paul Jackson | 33 a city’s quarantine, were thought to be the best defence.51 On September 10, 1892, the New York Times published an article entitled “Canada Poorly Protected: The Grosse Isle Quarantine Declared to be almost Worthless.” The New York Times declared the quarantine a “farce”: disorganized, permissive, and unhygienic. The reporter then asked Dr. Emmanuel Lachapple (see Figure 1.2), the president of the Canadian Central Board of Health: “Do you expect cholera here?” The reply was: “I do. I expect it here this week…The quarantine appliances at Grosse Isle at the present moment are utterly inadequate to prevent its entrance.” The article goes on to assert that Canada was not dealing with cholera, and describes how European immigrants could enter the United States through Canada to avoid quarantine regulations.52 This critique overlapped with the movement of the State Boards of Health led by Dr. Bryce. However, the assessment wouldn’t last. By the beginning of March 1893, the international views on Canadian quarantine had changed; now the New York Times headline read “Canada’s Cholera Wall.” The Dominion government had erected strong barriers that included nine quarantine stations with “excellent” sanitary and disinfection technologies. By March, Grosse Island’s quarantine station had three steam disinfectors to sterilize the baggage of 600 immigrants a day, along with a sulpher oxide blaster to fumigate ships using a small steamboat.53 While both sides of the border were anxiously discussing this “dread disease” in 1893, the Canadian federal government reformed the quarantine system to be equal to any in the world, implementing full precautions “stretching along the three-thousand-mile frontier.” The New York Times reported on a Canadian National Sanitary conference convened the month before to standardize sea and rail connections and to coordinate actions with the United States. Also, if the U.S. mandated a twenty-day quarantine, Canada would follow.54 So this “cholera wall” was not merely a Canadian institution;55 rather, it coordinated efforts for standardization and notification across North America and was discussed and planned during the yearly meetings of the American Public Health Association. In very little time, a seemingly unprepared and uncoordinated set of local institutions of cities, ports, states, provinces, and nations, had been brought under one umbrella and had one mission: to make North America disease-crisis proof. That said, the wall had yet to be tested. Cholera would never threaten North America again as it did in 1892.

1.2. How to Theorize a Crisis Event How do you theorize a crisis in the absence of an actual disease outbreak? How do you theorize an event that didn’t happen? This section will define and articulate the terms crisis and event. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 34

Cholera did not materialize in Toronto, but the fear of cholera transformed social relations and mobilized practices in anticipation of the crisis. The cholera crisis in 1892 validated a particular ideology. This ideology built upon the history of previous epidemics to articulate a future framework on how to manage healthy cities and nations. However, the institutions and practices that were produced came from the idea of a cholera crisis, along with the historical conditions and contingent actions that shaped this particular crisis. To define crisis and theoretically frame the rest of this project, I have found it necessary to construct an argument that holds together Foucauldian analysis and David Harvey’s Marxist geography. Cholera was a crisis, but this crisis was constituted through both the idea and the material reality of the epidemic. My claim is that if held together, the idea and the material reality could productively speak back to the crude divide between Foucault’s discourses and Harvey’s circulation of capital. In times of crisis, these practices56 become codependent. My case uniquely sheds light on this because an actual outbreak never occurred. I want to ground how a crisis was articulated, or how the idea of a crisis circulates, within historical materialism. A crisis implicitly pushes for decisions to be made for the sake of the future. Therefore, I am exploring how the genealogy of a cholera crisis both structured and was transformed by the political economy of late-19th-century capitalism. This theoretical intervention was not an arbitrary decision; rather, it arose from my struggle to understand my archive around the cholera epidemic of 1892. I do this because the definition of the object of “crisis” is both imprecise and overdetermined. As I work towards my definition, I think I can eliminate terms such as emergency, a disaster, or a catastrophe as they don’t accurately reflect Toronto’s experience with cholera in 1892.57 Since no one lost his or her life or suffered cholera, to frame this event with words like catastrophe is careless and distorts what took place. What then is the difference between disaster and crisis? To be pedantic in formulating a general definition, I’d like to think though a range of disease events, from the perspective of a doctor or health expert. The first version of a disease event could simply be a situation where people die. A second version could be a situation where people get sick, and that includes instances when the cholera bacterium was found. In a more nuanced version, a medical expert looks back to past disease events and demarcates what was or was not an outbreak. This declaration of outbreak would be dependent on the fluctuations of death and sickness numbers during a bounded period, and that period would then be judged in comparison to other periods. This would distinguish the presence of cholera from the severity of cholera’s effects—cholera as an affliction versus cholera as an epidemic. However, Toronto in 1892 does not fit any of these typologies of a disease event. In Toronto, no one died of cholera, The Cholera Crisis in 1892 | 2010 | Paul Jackson | 35 no bacterium was found, and no upsurge of sickness took place; there was no emergency. Despite this, the cholera pandemic caused activity in Toronto—indeed, throughout the world. Nevertheless, to formulate my definition as a crude materialist would be a dead end. I need to directly face the power of the idea of a cholera epidemic. According to the philosopher Hasana Sharp, ideas are not right or wrong, instead we should engage ideas in terms of their “force, vitality, and power.” This “requires attention to the collective dimensions of thinking life, where ‘collective’ refers to a transpersonal accumulation of ideal power that includes human as well as nonhuman beings.” Ideas are strengthened and weakened by other ideas, but also by incidents that happen (or do not happen in the case of 1892 in Toronto). The imagination of the crisis affected the world in ways that went beyond a question of how these ideas were shaped, behaved, and interacted with other ideas.58 The geographer Vinay Gidwani, working with philosopher Louis Althusser’s tension between “imaginary” and “lived,” suggests that “ideology exists in the obviousness—empirical immediacy—of our world and the actions we take, imagining ourselves to be the center of initiatives.”59 The health experts of my archive provide an excellent example of this tension. In their words and ideas, they placed themselves at the centre of a large movement to produce a world without disease. But in the negotiation with their ideologies, these health authorities regularly failed, were frustrated, needed support, felt impotent, and derided the public they took up the responsibility to protect. My argument is they lived out the ideas and imagery they articulated (they were saving lives of those around them, but also saving their “Race,” whose demise they saw as imminent). However, their imagination was collective, as the cholera bacteria demanded a reshaping of their idea of the world. From a different perspective, the Italian philosopher Antonio Gramsci helps to explain this relationship: ideologies overtake events and shape histories; events overtake ideologies and “explode schema.”60 Gramsci speaks of the “living out” of thought, even in spite of what can be predicted. While Gramsci emphasizes how doctrines rely on “the normal course of events,” he makes clear that ideology does not follow the normal course of events, and neither do events.61 To paraphrase the geographer Geoff Mann’s take on Gramsci, what is of interest here is more than the discursive production of a cholera crisis. Actors involved in contests over the meaning and controls of “disease” often understand the movement of “health” not as more than a normative standard, but as an active, material force in the making of the world—what Gramsci called an “idea-force.”62 The idea of health and the crisis of cholera was a force to be reckoned with. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 36

The cholera crisis—as an idea, a history, and an event, and also as part of an ideological project—lends itself to Foucault’s toolkit whose method allows me to trace the relations of power around the event. (Though Foucault’s major contributions of biopolitics and governmentality—the calculated relations among government, population, and political economy —cast a long shadow over this project, I do not directly interrogate or utilize those terms.)63 Foucault frames the event in a very specific way when he states: “The event on which one tries to get a hold will be the reality of grain much more than the obsessive fear of scarcity.”64 This assessment of history accords with my archive. The microscopic biology of cholera (bacterium vibrio cholerae) was indeed isolated, “got hold of” in the petri dish, well before the regulation of the modulations and transmission within international relations of the Atlantic (the epidemiology of cholera). Koch’s practices that “discovered” the vibrio cholerae were validated before the disease was subject to international management and control. However, according to Foucault, we have to reject the idea of the irruption of a “real event” from a secret origin. Seeking origins drives the investigation back further and further into history, to search for a secret cause of events. In my case, following cholera back to its “birth in the Ganges” was a powerful myth that had political and cultural ramifications. Foucault disparagingly suggested history’s intelligibility comes from assigning a cause, which is more or less a source of events; instead, he recommends searching for cumulative effects. Both statements and practices gain strength through repetition. One method I want to utilize is Foucault’s method of searching for a sudden irruption of a statement and what enabled this statement “to be repeated, known, forgotten, transformed, utterly erased, and hidden.”65 Foucault’s method was to look at statements, or the accumulation of statements, in which causation is neither direct nor obvious, but instead is seen to build up over time and draw in disparate actors and logics. Accordingly to Deleuze, Foucault’s method specifies that only statements repeat, and how this repetition takes place is strictly limited by the conditions of the milieu.66 Milieus must have some similarity to give a statement the material force to be uttered and repeated. But not all statements or all places are equal. Foucault defined the milieu as “a multiplicity of individuals who are and fundamentally and essentially only exist biologically bound to the materiality within which they live.”67 Does this consequentially mean everything depends on context? Or do external forces limit the making of declarations? No. Statements possess a necessary materiality that includes their context and what has enabled the speaker. 68 With an emphasis on The Cholera Crisis in 1892 | 2010 | Paul Jackson | 37 the particularity of the geography of crisis I see within Foucault’s milieu, nothing that explicitly contradicts David Harvey’s geographic Marxism. To illustrate statements and the milieu, take the headlines from the Toronto Evening News quoted at the beginning of this chapter. Each in its own way expresses the same impending sense of doom. They are all different statements, but they required Toronto’s milieu to give them traction. At other times in Toronto’s history, very similar crisis statements were ignored. Another example of how statements require a milieu and practices would be the telegraph notification system69 between North American governments that spread and documented the existence of potential outbreaks. This communication infrastructure documented, stored, and circulated statements of impending crises. These relations of statements illustrate how power is not a property that can be possessed; power must be exercised. And so for Foucault, this power cannot only be found in the state; the state itself is an effect of interacting structures and located at a different level at the “microphysics of power.” As I deal with the microscopic realm, I have to clarify that the “micro” for Foucault does not refer to small or minute but to “mobile and non-localizable connections.”70 The statement “cholera is coming” was repeated and then it travelled to many different locations, attempting to become localized. Because of the way epidemics arrive from outside the local, the statement can never be entirely local, by an epidemic’s very definition. To summarize, cholera relations became a crisis in the variety of places where these statements were uttered: in Hamburg and New York where people died, but also in Toronto where the concrete materiality of cholera failed to become a biological object to eradicate locally. I must assert that power is not contained within those statements, or only in the microphysical relations. However, how these crisis processes became increasingly localized were through political and economic acts by local state governments and agencies, which shaped how the statements were uttered and heard. To return this discussion to ideas and ideology, I read ideology as also having been built on statements that are similar but not equivalent to Foucault’s statements. But ideology is slippery. I do not have the space in this chapter to follow all of the issues I’ve raised in this section, but the rest of this dissertation will substantiate these arguments. This work is not looking for a theory of ideology, but sees ideology as a problem. As Stuart Hall says, “The problem of ideology is to give an account, within a materialist theory, of how social ideas arise.”71 My question is how do social ideas—in this case, a genealogy of a cholera crisis—arise in relation to the material constraints and marshalling of productive forces between both the state and capital?72 These social ideas of crisis did not persist because they were true or reflected The Cholera Crisis in 1892 | 2010 | Paul Jackson | 38 the reality of the social conditions; instead, the idea of crisis required decisions to be made. While the “speculative and illusory core of bourgeois ideology” is the notion that “ideas provide the motor of history, or proceed independently of material relations to generate effects,”73 this is not what I am doing with cholera and crisis. Instead, I will show how each uttered and written statement depended on actors, institutions, and the historical context. Had these abstractions not been validated and made necessary, a variety of different state authorities would not haven taken up or consented to an idea or statement. The statement became true not because it was true, but because it was explanatory. How ideologies were lived can be found throughout my archive, in newspaper articles, medical journals, policy documents, and especially theories of science. Ideologies and statements have a materiality; they are built from practices, spoken from within institutions, and circulate between cities through communications systems. Ideologies and statements accumulate and have effects beyond their utterance. To hone in my definition of this crisis idea-force, I want to follow how ideas became necessary, in terms of what Gramsci called the living out of thought. The insights of Christopher Hamlin, a historian of public health, help to form a definition of crisis. For him, there was no particular reason why sanitation and toilets became mandatory in Britain. Granted, there were urban sanitary conditions that called for a response; however, Hamlin believes that, “conditions do not determine responses.” Just because urban sanitary conditions were appalling in Victorian England does not mean clean water and drains were just needed. Currently, sanitation and clean water is needed around the world, but whether or not infrastructures are built does not depend on need. The politics and rhetoric of crisis is rooted in implied need—an idea. However, declaring a crisis means nothing, since a crisis is always happening.74 Statements of need are insufficient by themselves for change, like indoor plumbing in England, to be implemented. My questions then become, How are need and necessity negotiated in times of crisis? How was a declared crisis transformed into a particular form or process that enabled activity? In other words, how does the abstraction of crisis produce material effects? To distinguish my definition of crisis from the more general category of the event, I will remain pedantic, but also do some violence to these concepts to clarify my intervention. In my crude division, an event invoked direct material responses. For Hamburg, the combination of deaths, outbreak, and cholera bacteria as an event overtook the ideology that the city was modern and clean. Further, cholera was a disaster and an emergency in Hamburg. However, for Toronto, a crisis formed in the intersection of fear, distant pandemic, and cholera predictions. The crisis also invoked direct material responses. The idea of cholera overtook local events. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 39

Toronto’s crisis was dependent on Hamburg’s event, but it never became the emergency that it was predicted to become. While I have parsed out the event and the crisis to work toward a definition, these concepts cannot be divided. Event and crisis intersect as a “concrete-in- thought.”75 Accordingly, the cholera pandemic of 1892 was, by definition, an international or trans-local phenomenon, in which Toronto had a part. Histories of this cholera pandemic crisis could be written about any one of the points where the crisis touched down. At each of these points, concrete practices and places (events) must deal with material relations and bodily sickness. Yet these acts of materially touching down are contingent on particular expressions and they intersected with abstractions and fears (crisis). For example, a newspaper article illustrates, but cannot contain, the excess of fear and speculation that was bound up in a crisis. Ideas such as “cholera may come” determine the responses, which are predicated on the existing conditions. For an epidemic the object that triggers the crisis becomes an obsession. In this case, the object was the biological life form of cholera bacteria. To further account for this distinction between the event and the crisis, I will turn to Foucault in his different relations between discipline and security. On the one hand, the apparatus of discipline was an attempt to prevent and constrain in order to avoid the event. Security, on the other hand, attempted to create an apparatus that was able to work within fluctuations to prevent the crisis in advance.76 Health and disease continuously illustrated Foucault’s ideas. The management of smallpox was Foucault’s example of a security apparatus. To understand smallpox and security, he distinguished between prevailing disease (epidemic) and the case (single death). This difference highlighted, for Foucault, the crucial notion of acceleration within a range of risks and dangers. Foucault defined acceleration, when death numbers and cases grew rapidly as “[t]he phenomenon of sudden bolting [as in ‘bolt out the door’ or unexpected action], which occurs regularly and is also regularly nullified, can be called, roughly—not exactly in medical terminology, since the word was already used to designate something else—the crisis. This crisis is this phenomenon of sudden circular bolting that can be checked either by a higher natural mechanism, or by an artificial mechanism.”77 (This definition actually accords with the American Public Health Association debate over the term “epidemic” written in 1900, which I will discuss in chapter 4.) For my purposes, in this chapter, the cholera epidemic in the fall of 1892 became an international event because of the sudden bolting of cases in Hamburg—the rapid multiplication of cases that created an epidemic. On the ships in New York City’s harbour, the relationship of space and state power can illustrate the distinction between case and prevalence. A cholera outbreak existed on the ships. The prevalence of The Cholera Crisis in 1892 | 2010 | Paul Jackson | 40 cholera depended on the context and the ability of the disease to circulate or bolt. Within the ship’s steerage, cholera was bolting; however, from the shores of New York City, the sick retained their status as “case” because of the artificial mechanisms of the state that enforced quarantine. For New York City, the disease emergency as an event was checked as cases which were due to the workings of artificial mechanisms like quarantine. While cholera was not prevented, the cholera fluctuations were prevented in advance. Because of this, the events of fall 1892 accord with Foucault’s definition of security. This explains the role, function, and emergence of an “artificial mechanism” that deals with crisis. In this case that mechanism was the health state apparatus. Before continuing, I should parse Foucault’s method of historical analysis and his description of the event, as distinct from his concept of power. The distinction between crisis and event is important to my work because Foucault gives my argument a sense of how the accumulation of statements (the crisis is coming, the crisis is coming, the crisis is coming) by health experts implied that a decision had to be made. Decisions are made in times of crisis, but these experts presupposed consensus rather than gaining consensus through political discussion. By implication, stopping cholera became an inherently good thing, and therefore anything to stop cholera deaths became an inherently good decision. This theoretical assertion may be bold, but I see my version of a crisis and its politics, informed by Foucault’s event, residing in the space between Antonio Gramsci’s notions of coercion and consent. But this leads to the question, Coercion of whom and consent to whom? I will leave these as an open question, because my claim is the idea of disease crises and the ideologies of health allowed authorities to evade the answers. Foucault helps to articulate the object of an epidemic crisis (I use his methods in chapters 4 and 5). However, my definition of crisis relates to a concept of power that is not flattened, ubiquitous, or dematerialized (though I acknowledge that this is a crude caricature of Foucault’s argument). Crisis, and the ways that ideology formed this crisis, must be actively constructed, but the crisis also fails, falls apart, and must be reformed. The crisis can be ignored. I will chart out this path for the cholera crisis, a path divided between implicit consent around consensus of health reforms and the failure of health experts’ attempts to use coercion. In my conclusion, I attempt to shatter the inherent positive associations around health in order to dislodge the hegemony of the politics of life and death. A hegemony where consent is gained through the healthy good life and the coercion is threatened with fears of death. In this way, a version of Foucault can be integrated with the historical materialism of Gramsci and Harvey. There is a geography to this that can be described and explained by Harvey’s The Cholera Crisis in 1892 | 2010 | Paul Jackson | 41 geographic Marxism, but with attention being given to Foucault’s milieu where statements could be uttered. To acknowledge the particularity of the milieu makes Foucault’s power dependent and partial, and requires active construction and mobilization. For my work, the geographic milieu where cholera touches down is the city.

1.3. How Cities and Governments Dealt with a Cholera Crisis As the above history has shown, both actual and feared cholera circulated through cities and ports. Foucault can also help to show how the acts of chance that have structured urban social relations can bring the state, the city, and the event together. Melinda Cooper, for whom the modern form of urbanism demands a political control that attempts to manage future events, uses Foucault to describe how “the town will not be conceived or planned according to a static perception that would ensure the perfection of the function there and then, but will open into a future that is not exactly controllable, not precisely measured or measurable.”78 This is an urbanism that relies on particular apparatus of security to manage events and crisis. Nevertheless, I assert that more emphasis should be placed on the particular and contingent forms that this apparatus of security takes within specific aspects of the city and urban social relations. What are the limits of these structures? Do these relations—finance capital, small businesses, and religious groups, among other things—encompass the entire city? If “the city” is a site where the future can be controlled in times of crisis, then all of those groups and institutions can’t be involved; therefore, I seek to be more precise in my reading of the archive. What specific and contingent groups and actors of this urbanism took it upon themselves to deal with crises? This question is particularly relevant to my work because preparation79 for the future for the sake of the whole city was predominately confined within the state, or within specific aspects of the state such as health institutions. These health institutions both made demands and pushed for reforms. These state structures both articulated problems (cholera) and proposed ways to solve them (health expertise). Foucault helps and warns against viewing the state as something that has been “born.” Instead, state apparatuses existed and were reconfigured over time. Foucault’s larger project is concerned with when the state became consciously viewed as a distinct object to be analyzed.80 Foucault suggests that “the state is not a cold monster in history that has continually grown and developed as a sort of threatening organism above civil society…,” but rather “…a governmentalized society organized something that is both fragile and obsessive that is called the state.”81 For Foucault, “the state effect [is] constituted on the basis of a thousand diverse processes.” 82 State health institutions and The Cholera Crisis in 1892 | 2010 | Paul Jackson | 42 expertise will be emphasized as one illustration of Foucault’s larger project. My project here is not to take the state as something to be described or reflected up as a whole, but rather to question how these state apparatuses hang together. My contribution is not to follow how the state or government apparatus emerged, but rather to see how these fragile and diverse processes cohered into particular health state structures. The important question for me is not what are the myriad processes of the state that exist, but why do some persist? To investigate persistence and permanencies, I rely on the work of David Harvey to show how statements of the cholera crisis created a sense of the need for health-related social infrastructures. The circulation of capital then validated these social infrastructures over time.83 The relationship between necessity and persistence feeds the central tension of this project, a productive tension, I hope, between the work of Foucault and Harvey. My claim is that ideological statements, in particular ideas about disease crises, have become ways for switching value—or perhaps ways to politically marshal the shifting of value—into different circuits of capital. For health, and for very particular historical reasons, this circuit is the tertiary circuit of capital. In terms of health, value in the form of state budgets and debt was invested to produce social infrastructures for future needs. While in the present period the relationship between health and capital is not strictly contained within this circuit, my claim is that historically the tertiary circuit became the way value transitioned into other circuits of capital. Some social infrastructures persisted through incorporation and validation, and this must take place over time and not in the act of making the statement. The validation of social infrastructures relied on appeals to the common interest enacted through the state. The reproduction of capital and an eventual return to the primary circuit of capital is beyond the scope of this dissertation; however, the conclusion will open up these questions. Initially, a health boards’ persistence is not a hard argument to make, as health directly contributes to the reproduction of labour power or, phrased in another way, of healthy workers. But the return to the primary circuit of capital health took a much more circuitous route. To examine these relations, Harvey’s interrogation of historical and geographic change under capitalism shows how permanencies come to be established over time. I will follow that process and the ideological statements that made it possible. I will explore how the genealogy of the cholera epidemic validated and complemented particular state institutions under extremely contingent conditions. I will follow how a cholera outbreak made state health institutions less “fragile,” to use Foucault’s word.

The Cholera Crisis in 1892 | 2010 | Paul Jackson | 43

1.4. Theorizing the State Before proceeding, Harvey’s theory of the state needs to be parsed. I use Harvey’s theory of the state to keep the geography of these processes central to my endeavour, but I also want to answer the questions he asks of the state. To understand how health, the state, and capital became intertwined, I propose to extend David Harvey’s methods and framework from Limits to Capital.84 Harvey’s geographical Marxism can show how state health boards were produced and maintained over time. I rely on Harvey to ground the history and geography of my argument, particularly how capital produces spatial forms. In Limits to Capital, Harvey did not have the time to fully explore the state,85 especially in terms of “the reproduction of the labourer and of labour power, the production and use of knowledge as both a material force in production and as a weapon for domination and ideological control.” Accordingly, the majority of this analysis will reside in the tertiary circuit of capital. Within the tertiary circuit of capital, the state produces and is institutionalized through social infrastructures. While Harvey divided the reproduction of capital and the reproduction of labour power in his own analysis, he declared that for theory of the state to be robust, labour and capital must be reunited. In this reunification, the reproduction of labour power becomes combined with practices of legitimacy, democracy, and ideology. According to Harvey, through these fora, class struggle became displaced from production and into politics. This is why the political control of the state apparatus has ascended in importance. Harvey adds more complications—class relations have become transformed into “multiple and conflicting configurations” along with new configurations of elites such as scientists, engineers, management, and bureaucrats.86 I add health experts to this list and will investigate the process of how the medical profession became incorporated into this elite. I use the term health experts instead of “medicine” to signal that this was an expansive movement to rid cities and nations of all disease as a holistic project, and it was not limited to particular sciences or professions. Unpacking the intersection of social infrastructures, the tertiary circuit of capital, and the mobilization of common interest helps me understand how value asserts itself and circulates through the state; but, in order to do so, I have to take a different starting point than Harvey.87 My claim is that the institutionalization of health within government can illustrate these processes. I rely on Harvey to emphasize the spatial aspects of his analysis, even though he is not known as a state theorist. By doing so, I hope to guard “against a general theory of the state,” to use Bob Jessop’s phrase. Jessop declares no one single theory of the state can understand the totality of social relations. Accordingly, Jessop explains the state’s contingent The Cholera Crisis in 1892 | 2010 | Paul Jackson | 44 necessity by saying that “we must engage in an analysis of the many determinations that are combined in a concrete conjuncture and show how they are interrelated as necessary and/or sufficient conditions in a contingent structure of causation.”88 For Jessop, state theory is not concerned with raw descriptions and genealogies of particular events except as a preliminary step in the movement from historical and empirical evidence toward a theory of the state.89 I agree, and I will attempt, with Harvey’s help, to show both the contingencies and the geographies of these relations. For Harvey, “The State should…be viewed, like capital, as a relation or as a process – in this case a process of exercising power via certain institutional arrangements.” The state should not be seen as quick and easy stand-in like “the man.” To see the state as an abstract category or independent moving force leads to mystification.90 The state is not a single thing and should never be studied independently from capitalism.91 The state must be seen as intricate, multiple, and relational. Moreover, the state did not appear as a mirror of capitalism; instead, for Harvey, “[s]tate institutions had to be painfully constructed and at each step along the way power could be and was exercised through them.” Harvey maintains that capitalism and the state came into being simultaneously and dialectally92 as “state capitalism” existed in the early years of capitalism. These intermeshing processes of capitalism and social relations never end; they are constantly refashioned.93 Therefore, only particular arrangements of state and capital relations, the processes that produced those relations, can be understood. For my purposes in this project, when engaging with the materiality of the state, I will look at specific institutional arrangements organized through the ideology of health. In Harvey’s engagement with a theory of the state, he ends with the three questions I’ve summarized below: 1. Do aspects of the state exist autonomously from capitalism, and can those who work in the state be neutral? 2. What variations of the state are possible? How different can things become within a capitalist society? (He talks about different nations, and I suggest you could analyze scales as well.) 3. Which structures and functions within the state are necessary (organic) to the capitalist mode of production and therefore basic to the survival of capitalist social formations, and which are purely accidental (conjunctural)?94

I encapsulate Harvey’s three questions of the state into autonomy, variation, and necessity.95 Harvey’s questions cannot be answered in the realm of theory, so for my purposes I want to phrase them as questions of historical processes. [1] How is state autonomy reduced and expanded? [2] How are state variations and similarities produced? [3] How do state structures become necessary over time? Of the above questions, I find the question of necessity the most The Cholera Crisis in 1892 | 2010 | Paul Jackson | 45 important for my thesis. Harvey elaborates on the line and the importance of a theory of the state to help me to distinguish what is necessary and what is accidental in “the particular form assumed by the State in a particular historical situation.”96 This leads to the question that frames much of this dissertation: Is a health board necessary (organic) or accidental (conjunctural) to the workings of capitalism? Or, to put it another way, how do unnecessary state functions become necessary? And how can newly necessary state processes provide avenues for future accumulation processes? Utilizing Harvey’s method in Limits to Capital can help to answer these questions by theorizing credit’s role in the production of spatial configurations (which I will do in chapter 8). His suggestion is to look for active constitutive moments in the dynamics of accumulation.97 In order to answer these questions through historical analysis, I suggest examining the active moments and coordinating devices that may or may not be contained within the institutional arrangements of the state. Since organic and conjunctural are Gramscian terms, I will also be engaging with ideology and the hegemony of health. I’ll examine two crises as active moments articulated from within health social infrastructures: [1] the fear of the cholera epidemic in 1892 and [2] the fear of the declining vitality and health of national workforces. This dissertation is split into a first half that will explore the cholera crisis, and into a second half that explores healthy nations. But before that, I need to elaborate on historical particularities around cholera in 1892 in terms of science and fear of the city. In particular, how Ontario health governance attempted to be autonomous, called for its own necessity, and used accidental events for opportune ends.

1.5. Historical Context: Toronto and the International Economy The cholera crisis was tempered and made contingent by local and historical conditions. “Accidents”—both the impending cholera epidemic and the fact that the outbreak didn’t materialize as predicted—helped to formulate the institutions of health in Toronto. Both the statements around the cholera outbreak and state infrastructures were shaped by the political and material conditions from which they arose. The economy of the period around 1892 was also an important circumstance that constricted the push for governmental health reforms. The politics and economy of Toronto and Canada, along with relationships with the United States and the British Empire, structured how the state responded to the cholera crisis. As cholera circulated throughout the Atlantic world, the international economy was affected by the regular downturns and economic depressions that were taking place during the second half of the 19th century. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 46

After the 1870s, Canada transitioned from a sparsely populated colonial state where farming and staples predominated into a growing urban and industrial force. Toronto’s level of industrialization was far greater compared to other places in Ontario. During the 1880s, Toronto saw an increased concentration of capital and became the hub of Ontario. This concentration also led to a growth of union organizations, such as the Knights of Labour. By the 1890s, Toronto had also become the financial centre of Ontario and the largest importer and wholesale centre. With major rail shipping that connected its port from the St. Lawrence Seaway to the interior of the province, along with increased density, the city’s built form had become markedly different from the rest of the province. Between 1867 and 1892, Toronto had tripled in population; industrial production quadrupled in value; and capital investments in industry had increased by 725 per cent.98 Toronto’s growing homogenous population, mostly British Protestants or Irish Catholics, was loyal to the British Empire. Yet, by the end of the 19th century, the social and political power was shifting away from the old families to new men, factory owners, and railway entrepreneurs who had achieved industrial and mercantile success. These middle classes were the “balance weight” of late Victorian Toronto.99 The cultural politics of Toronto during this period was wrought with intense social and moral anxieties, best summarized in Mariana Valverde’s book The Age of Light, Soap, and Water. 100 But in general, Toronto was a typical North American city, growing but still provincial. It had come into its own in many ways, and this may have been best symbolized by the introduction of modern streetcars in August 1892. At the same time that Toronto installed its modern trolley system, cholera threatened to attack. During the summer of 1892, the tension between the city’s dirty provincial past and modern future was stark. Cholera highlighted the danger of the city’s connections to international cities and ports around the Atlantic world now sharing epidemic crises. For Toronto’s urban reformers, who had a growing sense of Toronto’s place within Canada and North America, the potential cholera outbreak highlighted the transformations in both the government and urban landscape that were necessary to realize their dream of a health city and nation. The above history of the cholera outbreak of 1892 is not the only story that could be written. Toronto’s Municipal Council proceedings give a vastly different account of the events during 1892 and 1893. From the Toronto municipal archives and the city’s perspective, there is no explicit record of the fears of the cholera crisis. Cholera was never mentioned in these documents. The silence in this archive is a stark contrast to the screaming headlines of the newspapers. But the effects of the looming cholera outbreak in these documents can be found in The Cholera Crisis in 1892 | 2010 | Paul Jackson | 47 the election results, waterfront transformations and planning, health board personnel changes, and the general feeling of urgency. The disconnect at the urban scale makes sense; the city government was in charge of dealing with actual problems and the living conditions of its citizens. Controlling the future cholera outbreak was the task of the province, the federal government, the health experts, engineers, and urban reformers, and they positioned themselves as the necessary solution to this crisis. For the city aldermen and urban bureaucracy—those who had to enact and pay for the changes to the city, who were straddled with debt, and required to follow democratic processes—fear-mongering was not a useful tactic for marshalling the common interest. I follow those who used the fear to institute changes and explore how these experts increased their power by jumping scale both federally and internationally. A variety of actors and institutions could assert their influence in the tension between abstract international fears and the practices of local reforms. Provincial health experts learned from these cholera intervention experiments and would later apply them in different political and disciplinary arenas. Though the city council and municipal health experts had to deal with the particulars and the local politics of elections and economic pressures, Toronto was, and still is, a creature of the province. The politics of the crisis that were invoked by health reformers were at odds with the limitations on the municipal governments. The political officials of Toronto had different issues to tackle than just cholera. The year before the cholera outbreak, Mayor Robert John Fleming of Toronto declared in his inaugural address that citizens had voted him in on a mandate for reform. He was expected to eliminate or amalgamate committees; reduce departments and staff; and improve the city’s finances after a decade of mismanagement. The mayor announced there was too much debt, and the existing debt must be managed more efficiently. He even declared he would stop paving and lighting the streets. However, within this time of fiscal restraint, he wouldn’t halt all development. Fleming did echo the health experts’ call to reclaim or sell the land of the marshy Ashbridge’s Bay, in his words, a site of “vast importance to the material and sanitary interests of the city.” Manufacturing and industry could be encouraged to locate on this new land. If the new land remained under the control of the city, profits could be reaped.101 For the mayor, cleaning up the swamp for health purposes was of interest only if it coincided with investment and tax revenue. By the end of his leadership and after the cholera crisis of 1892, Fleming again complained about the city’s debt load and declared council must always try to reduce expenditures as the city was paying over $1,500,000 annually in interest and sinking fund charges on the general and local debt. “The rapid growth of the city necessitating the The Cholera Crisis in 1892 | 2010 | Paul Jackson | 48 construction of many important works, together with the abuse of the local improvement system [which he said he alluded to in his inaugural address in 1892] swelled the volume of the public debt during the decade prior to 1891 to an unexampled extent. No more effective service to the people of Toronto could have been done by the Councils of 1892 and 1893 than has been done in curtailing the issue of debentures.” Fleming said the city stopped the issuing of long date expenditures, even though some, like Ashbridge’s Bay reclamation, did take place.102 In times of fiscal restraint, health reformers’ recommendations were approved if there were economic rationales to further support the health benefit. The debt load of the city amidst a cholera crisis puts the politics of the time into relief: the sirens of disease drowned out the drone of accounting.103 Why did Toronto authorities call for fiscal austerity, both leading up to the 1892 crisis of cholera and afterwards? The cholera crisis of 1892 should be placed into the historical context of a corresponding international economic depression. To be clear, the “crisis” of capitalism is not the same crisis of the cholera epidemic, even though they historically overlap.104 In this overlap there may be a commonality with Antonio Gramsci’s notion of a crisis of authority, in terms of a general crisis of the state and hegemony. A general crisis references the dynamic where older ideological blocs and social formations have been called into question but newer ones have yet to be completely established.105 The period after the cholera crisis of 1892 could be framed in this manner to show how health experts and state bureaucrats came together. The historical period that this research covers takes place during severe periods of economic depression. My claim is that health, and in my case health-based social infrastructures, had a role in Harvey’s spatial fixing, as state health opened a space and a time to coordinate with capital and fix the conditions to prepare for future crises, be they financial or biological.106 In this dissertation, I have been dealing with crisis; however, a disease crisis is not the same as a crisis of capital accumulation. Massive economic changes and crises were a significant concern throughout the second half of the 19th century. Britain in the 1880s saw a severe cyclical depression (between 1884 and 1887) and the structural decline of old industries.107 These were also transitional years for the international economy, especially for North America. Since the late 1880s, the American South had been hit hard with social conflict, market disruptions, and soil exhaustion. This all led to plummeting commodity prices. In the Plains, the economic bubble burst in 1887 as three successive droughts, severe winters, low wheat and corn prices, and deflation led to bankruptcies and mortgages.108 By 1890, the major industrial nations of the world experienced a The Cholera Crisis in 1892 | 2010 | Paul Jackson | 49 downturn that eventually became a depression. It took three more years before the slowdown hit the United States, which was sparked by the failure of the National Cordage Company on May 4, 1893, bringing to a close a period of slow industrial prosperity that grew after the Panic of 1873. After Cordage failed, a stock-market panic ensued that had national significance, leading to more business failures, and then bank failures. New York City banks, as the central reserves, were unable to meet the demands of the banks of the West and the South.109 This led to a currency famine and money hoarding, which intensified the existing depression in agriculture and transportation, as well as in industry. The slowdown spread throughout the country. Goods stopped being shaped, because there was no money to buy them and this affected the freight industry. Factories shut down. Industry stopped. By September of 1893, the resumption of currency prices abated the crisis. But by that point there had been 15,242 business failures, making 1893 the worst year up to that time. In the United States, 158 banks had failed or been suspended by October 1893. Exports showed a decline of $300 million. The depression would last for five years.110 The long-term implications of this economic crisis are difficult to pin down, but many political and economic reforms coincided with the effects of the cholera outbreak. The historian Michael Bliss, in his 1883–1911 study of Canadian business, suggests that this period’s business generation varied from “black depression to boundless expansion.” Anxiety over the “supposed depression” of the 1880s and 1890s continued until the Laurier boom of industrialization that the ushered in the 20th century. Many business and political leaders thought they were in the middle of a depression until 1896.111 The number of unemployed is hard to gauge, even if the question is limited to the United States, although historians have estimated at the time the number was between two to three million. This massive unemployment led to protests and growing political movements and social conflict in cities. Political leaders frowned upon national relief, so support was confined to the local scale with municipal poor laws, the occasional public works project, and charitable work. Many charities were organized after the 1873 economic downturn and still remained by 1893 to provide support.112 Citizens experienced shock and denial that turned into anger.113 After 1893, the United States federal government began to intervene directly in the economy more often in response to public pressure to do so. The United States and countries around the Atlantic began to transition away from laissez-faire policies and move toward a general welfare state. Many of the industrial and financial elite of Canada were against the free trade policies of Britain and looked to recreate the protectionism of the United States, offering a wide variety of policies that encouraged U.S. foreign investment in The Cholera Crisis in 1892 | 2010 | Paul Jackson | 50

Canada.114 This is the point when the progressive movement began to gain traction within government (I will discuss this in greater detail in chapter 2). These details are important because both the growth of state health structures and the push for reforms after 1892 took place in times of fiscal crisis or economic downturn—Gramsci’s general crisis of authority. My question is, How did health bureaucracies marshal funding to expand their institutions during these periods? I argue that an economic rationale for health, which I will focus on during the second half of this dissertation, became dominant.

1.6. Conclusion: When and Where Do Disease Crises End? These questions open up a broader question of history and geography: How do you mark the end of disease crisis? Mike Davis asks as similar question to my own, “Where does the nightmare end?” For Mike Davis, imagined disasters and catastrophes, whose ecologies of fear simultaneously loom and threaten to loom, contain ideas of what might come. These ideas— from fiction, myth, or science—can shape landscapes. This project follows how the imagined cholera crisis fits into the larger landscape of the history of Toronto and the institutionalization of public health.115 In 1892, the United States successfully contained the cholera pandemic and the disease never infected Canada during this international outbreak. But this didn’t end the nightmare. Conventional histories of international disease outbreaks suggest that the fifth cholera pandemic ended in the year 1896. However, the sixth pandemic was well underway by 1899 and continued until 1923. From the perspective of North America’s medical experts, the fear and speculation from one pandemic bled into the next. During the sixth pandemic, the disease was confined to Asia and no one in Western Europe or the Americas got sick or died from cholera. However, speculation over cholera’s arrival continued for decades. The spectre of cholera haunted North American and European states well into the 1930s. My argument is that the presence of disease does not indicate the effect or the geography of an epidemic. When looking at the reforms of Toronto’s public health, the debates are never simply local; experts and government officials situate their responses in the larger context of Atlantic-wide shifts in policy and disease crises. My claim is that, while conventional histories of the progressive movement believe its emergence to be a response to economic crisis and the growth of urban poverty,116 the cholera crisis gave a particular tone to the manner in which health reformers took up the challenge to reform cities. Later, the ideology of health experts offered an economic rationale for the efficient management of healthy nations. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 51

This dissertation is organized in two halves. The first half investigates the threat I call proliferating life. Health experts produced the object of proliferating life as an excited form of life fostered by its environment and possessing the potential to multiply out of control. The second half investigates the response to this threat, which I call bureaucratic bio-economy. Bureaucratic bio-economy is state health expertise that becomes social infrastructure, a state-led push for biological efficiency of urban and national populations. Cholera is embedded in proliferating life, and health boards are essential to the bureaucratic bio-economy, yet both categories are exceeded by fears, abstractions, and scientific practices. Threat and response are deeply reliant on one another; perhaps they’re even symbiotic. Diseased practices, and consequently the health experts’ response to produce healthy cities and nations, became battlegrounds for ideology and state intervention. Many urban reformers used medical understanding to frame the city as a crisis itself. When public health institutions came into their own (see chapter 7), disciplines and professional allegiances cohered between health reformers, moralists, engineers, and planners. The cholera crisis was something all actors could mobilize around and speak together about. Cholera became a shared object to speak through in part because in this period conceptual traffic between different spheres of knowledge was constant. Officials and commentators utilized what I am calling synthetic expertise. Synthetic expertise is a form of expertise built on acts of conceptual synthesis: how the combination of ideas formed a system of knowledge where different disciplines and practices are held together by correlation, analogy, or, in my particular case, synecdoche (see chapter 6).117 In my archive, this synthesis placed a special emphasis on economics and economic rationales. Economism crept into public health. Economism became a key form of marshalling the common interest of the state (see chapter 9). This project can be viewed as an indirect muddling through Althusser’s ideological state apparatus, though in a different form and rooted in historical and geographic specificity. My claim is that the disease event-crisis illuminates these relations so well precisely because of the politics: an epidemic internalizes tacit consensus almost by definition. This default consensus arises because no one is “for” a cholera outbreak and therefore debate over how to be “against” one is absent. The common interest is not even open to debate. Timothy Mitchell warns against knowing an answer in advance, arguing that the task in critical inquiry is to render issues of power and agency as real questions; not necessarily what, but how, and who? Therefore, my question becomes, How did medical/health experts mobilize the politics of life and death in the process of consolidating power and agency? This The Cholera Crisis in 1892 | 2010 | Paul Jackson | 52 consolidation happened in very contingent ways and included the cholera outbreak of 1892. Mitchell suggests that human agency, like capital, is a technical body—something made. He suggests examining hybrid agencies, connections, interactions, and forms of violence, and attempting to understand how these entities are able to portray their actions as history.118 During the period that I cover, health institutions and practices were gradually intermeshed in urban governance. Today, we take institutions like health boards and state laboratories for granted. It’s significant to note that doctors, urban reformers, politicians, and scientists instituted themselves through political work. They did this by combining health and state practices, producing new departments of government, new laws, and new technologies; by making connections to science, international shipping companies, free trade, and the health of national workforces; and by interacting with other countries, attending international conferences, and meeting experts of chemistry and biology. Health officials constituted and validated themselves as experts through acts of synthesis and revelled in that position by situating their work within the forward march of history and progress. I outline how this particular cholera disease event-crisis shaped many of the medical responses and how these responses were shaped by economic constrains and zealotry of science- based reforms. These responses were articulated into statements. The statements that circulated in 1892 around cholera crossing the Atlantic structured the response to health threats for years to come. This frightening, amorphous threat that lurked over the horizon of the ocean shaped politics and practices in cities and ports and became an epidemic event. Crisis politics is obviously problematic. I hope to show how the politics of crisis limits and impoverishes the statements and the debates that take place. What the statements and practices of the health reformers show is that, though doctors were against corporate interests and the vagrancies of the free market, they still enabled an accumulation strategy that contributed to the biomedical model of health.119 I do this by kneading together Foucault and Harvey, which raises a vital question undergirding much of the dissertation: How, and in under what conditions, can disease produce value in the Marxist sense? However, in kneading these frameworks together, I hope to illustrate how economic arguments are not the sole basis for all statements made. Capital and the material practices that form from the abstractions and statements of ideology do allow social infrastructures to persist. Cholera was coming, but this abstract crisis didn’t happen in Toronto. Still, in the meantime, health experts would attempt to understand how conditions like migrating populations and growing cities produced these crises.

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Endnotes

1 How Toronto audiences read these news stories is both important and extremely hard to determine. In this chapter I will focus on how statements were made, rather than how they were understood. I’ll rely on Walter Benjamin to frame the act of reading “the newspaper. Its content is ‘material’ which refuses any form of organization other than that imposed by the reader’s impatience. This impatience is not only that of the politician who expects a piece of news, or of a speculator who awaits a tip: behind them hovers the impatience of whoever feels himself excluded, whoever thinks he has a right to express his own interests himself. For a long time, the fact that nothing binds the reader to his paper as much as this avid impatience for fresh nourishment every day, has been used by editors, who are always starting new columns open to his questions, opinions, protestations.” In Walter Benjamin, "The Author as Producer," New Left Review I, no. 62 (1970). 2 Toronto had five papers by the early 1880s. The number of newspapers went up to seven between 1892 and 1895. The Globe, The Mail, and The Empire were more expensive and conservative. The Telegram, The World, The Star and The News were shorter and cheaper. In many ways, class delineated the readership, as the penny papers were more about colour and excitement. However, all papers were city boosters, holding a bourgeois outlook that stressed progress, the nation, democracy, order, and social harmony. Most stories cited here gave no authorship, however this does not mean they were disinterested. For more, see Keith Walden, Becoming Modern in Toronto : The Industrial Exhibition and the Shaping of a Late Victorian Culture (Toronto; Buffalo: University of Toronto Press, 1997), 28. 3 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. For New York City’s experience with cholera in 1892, see Howard Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore, Md.: Johns Hopkins University Press, 1997). 4 Evening News, “Cholera May Come,” Evening News, August 24, 1892, 1. 5 Evening News, “Cholera May Come,” Evening News, August 24, 1892, 1. 6 Evening News, “Cholera is in England,” Evening News, August 26, 1892, 1. 7 This dissertation does not go into the details of what happened in Hamburg since this has been extensively researched in Richard J. Evans, Death in Hamburg : Society and Politics in the Cholera Years, 1830-1910 (New York: Clarendon Press, 1987). This chapter outlines how, from afar, Toronto constructed and discussed the Hamburg and New York City outbreaks. 8 Evening News, “Grosse Island Condemned,” Evening News, September 3, 1892, 1. 9 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 10 Evening News, “Cholera May Come,” Evening News, August 24, 1892, 1. 11 Evans, Death in Hamburg : Society and Politics in the Cholera Years, 1830-1910, 282. 12 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 13 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 14 Evening News, “Coming Via Canada,” Evening News, September 2, 1892, 1. 15 Evening News, “Cholera May Come,” Evening News, August 24, 1892, 1. 16 Evening News, “,” Evening News August 27, 1892, 1. 17 This theory of cholera is partially correct. For a detailed discussion of cholera’s transmission and the science of disease, see chapter 4. 18 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 19 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 20 Evening News, “Those Jews Coming To Canada,” Evening News, September 5, 1892, 1. At that time many detailed accounts of the experience in New York City harbor were written, summarized quite well in Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892. 21 For more on Jenkins’ role and the bureaucratic aftermath of these events, see Ibid. For a more condensed version, see Howard Markel, "'Knocking out the Cholera': Cholera, Class, and Quarantines in New York City, 1892," Bulletin of the history of medicine. 69, no. 3 (1995). 22 E. L. Godkin, "A Month of Quarantine," The North American Review 155, no. 433 (1892): 742-743. 23 Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892, 174. 24 Ibid., 85. 25 Ibid., 144. 26 New York Times, “A National Quarantine,” New York Times, December 9, 1892. 27 Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892, 139. 28 This Marine Hospital Service movement quashed the push to re-institute a National Board of Health in the United States. A National Board of Health had existed between the years of 1879-1883, for more see Fitzhugh Mullan, Plagues and Politics : The Story of the United States Public Health Service (New York: Basic Books, The Cholera Crisis in 1892 | 2010 | Paul Jackson | 54

1989); W.G. Smillie, "The National Board of Health 1879-1883," American Journal of Public Health 33, no. 8 (1943). 29 Evening News, “Guarding The Frontier,” Evening News, September 7, 1892, 1. 30 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 31 At that time rags were highly feared and always scrutinized by health authorities. A valid argument behind this fear existed, but the cause was not due to cholera, rather other diseases such as typhoid that had a lice vector. Why would only rags be shipped across the Atlantic? Rags were valuable because they were made into money and newspapers, see Martin O'Brien, A Crisis of Waste? : Understanding the Rubbish Society (New York: Routledge, 2008). 32 Evening News, “Guarding The Frontier,” Evening News, September 7, 1892, 1. 33 Where this common dialogue and discussion took place was through the professional medical associations throughout North America, particularly the American Public Health Association (APHA). These institutions and networks were strengthened in times of crisis, for more see chapter 7. 34 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 35 For more on Grosse Island see, Andre Charbonneau, Andre Sevigny, and Canada Parks, 1847, Grosse Isle: A Record of Daily Events (Ottawa: Parks Canada, 1997). Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980). Geoffrey Bilson, "The First Epidemic of Asiatic Cholera in Lower Canada, 1832 " Medical History, 1977, 21: 411433 21 (1977). Frederick Montizambert, "The Canadian Quarantine System," Public Health Papers and Reports 19 (1893). 36 The quarantine hospital of Toronto was given $1,500 to create of “superheated steam and disinfecting station” where all infected clothes may be disinfected. City of Toronto Archives, Fonds 200, Series 365, File 6, 5-6. 37 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 38 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. Looking back, this was probably the best recommendation that public heath authorities could have given. If everyone just boiled their water then all the bacteria would have been eliminated. However, for those living in poverty the cost of fuel to heat the water may have been prohibitive. But then those communities probably wouldn’t have been buying newspapers anyway. 39 Evening News, “Cholera To Come Next Year, Evening News, August 25, 1. This position was considered to be false at the time, and was later confirmed as false. This theory was based on the miasmic understandings of disease, which reflects the British Empire’s experts focus on local conditions against controlling international connections. This was also reported as Dr. Allen perspective in one article in The Globe, 1892, An Ounce of Prevention, The Globe, September 3, 6. This can be compared to Dr. Bryce’s perspective in another article, The Globe, “Ashbridge’s Needs”, The Globe, September 3, 1892, 6. 40 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 41 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 42 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. This contradicts his other talks of the efficiently of health boards (for more on health boards, see chapter 7) 43 Evening News, “Wake Up, Toronto,” Evening News, September 1, 1892, 1. 44 Evening News, “Wake Up, Toronto,” Evening News, September 1, 1892, 1; my emphasis. 45 Evening News, “Wake Up, Toronto,” Evening News, September 1, 1892, 1. 46 As this institution formed and travelled they kept on changing its name. How they had become connected was probably due to the American Public Health Association as they were all members. 47 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 48 New York Times, “National Quarantine Urged,” New York Times, December 14, 1892. 49 Evening News, “Guarding The Frontier,” Evening News, September 7, 1892, 1. 50 Evening News, “Guarding The Frontier,” Evening News, September 7, 1892, 1. 51 New York Times, “National Quarantine Urged,” New York Times, December 14, 1892. 52 New York Times, “Canada Poorly Protected,” New York Times, September 10, 1892, 2. 53 Disinfection is a vast topic and this technology had many implications in regards to the crossing of borders. But I do not have the space to get into that discussion. For context, the disinfection technologies was an established field, see George Frederick Barker and Health National Board of, Instructions for Disinfection : Prepared for the National Board of Health in 1879, by a Committee (New York: Trow & Co.], 1879). Samuel Rideal, Disinfection and Disinfectants (an Introduction to the Study of) Together with an Account of the Chemical Substances Used as Antiseptics and Preservatives (London; Philadelphia: Griffin; J.B. Lippincott Co., 1895). 54 New York Times, “Canada’s Cholera Wall,” The New York Times, March 3, 1893, 5. The Cholera Crisis in 1892 | 2010 | Paul Jackson | 55

55 In September of 1893, following this quarantine turn around, Dr. Montizambert was sent to Pan-American Sanitary Congress held in Washington. He was elected as a member of the International Executive Committee to represent Canada. After these experiences he continued to be fixated with cholera. Frederick Montizambert, "The Story of Fifty-Four Years' Quarantine Service from 1866 to 1920," Canadian Medical Association Journal 16, no. 3 (1926). Montizambert was a key figure in national health and quarantine, from his biography: “Over the course of three decades Montizambert brought Grosse Île to the front rank of North American quarantine stations…The installations were largely rebuilt and compartmentalized, the quarantine regulations were amended, and reception and service were brought into line with the steamship age. Much more important was the fact that, on Montizambert’s initiative, the station rapidly and radically altered its scientific approach. From the 1880s, on the heels of major discoveries in microbiology, disinfectants and vaccination put an end to lengthy confinement. In 1892 a bacteriological laboratory was built on the island, enabling bacteria of infectious diseases to be quickly identified. In this way, serious illnesses could be distinguished from ordinary infections that could be treated at Quebec. In 1894, while remaining at Grosse Île, Montizambert was appointed by Ottawa to be superintendent of Canadian quarantine stations…In 1899, when immigration was becoming heavier and more varied than ever, the federal government considered it urgent to set up, within the Department of Agriculture, a section devoted exclusively to public health. Having spent more than 30 years at Grosse Île, Montizambert was immediately chosen to head this section. In Ottawa, he retained control of the quarantine stations and continued to modernize them… As an adviser to the government on public health, he submitted many recommendations of all kinds, including a commitment by the federal government to the fight against tuberculosis, inspection of health conditions on passenger trains, and funding of bacteriological laboratories. But there was one project especially dear to his heart: the establishment of a real federal department of health. He shared this idea with the Canadian Medical Association, of which he was president in 1907-8. In 1919, soon after the end of World War I, the government finally granted his wish and created the long-desired department. On the heels of this victory, in 1920, Montizambert retired.” Sévigny, André, “Montizambert, Frederick”, Dictionary of Canadian Biography Online, www.biographi.ca. See also Geoffrey Bilson, "Dr. Frederick Montizambert (1843-1929): Canada's First Director General of Public Health," Medical History 29 (1985). 56 For me, “practices” is the preferred term since I do not want to re-inscribe the duality of knowledge/reality. Practices are the common grouping of techniques and discourses. Stuart Hall, "The Toad in the Garden: Thatcherism among the Theorists," in Marxism and the Interpretation of Culture, ed. Cary Nelson and Lawrence Grossberg (Urbana: U of Illinois 1988). 57 The politics of events such as these—the ‘who’ and the ‘what’ involved in producing these events—have been dealt with in many forms. Some recent and popular accounts of the social relations around these events are Rebecca Solnit, A Paradise Built in Hell : The Extraordinary Communities That Arise in Disaster (New York: Viking, 2009). Mike Davis, Ecology of Fear : Los Angeles and the Imagination of Disaster (New York: Metropolitan Books, 1998). Naomi Klein, The Shock Doctrine : The Rise of Disaster Capitalism, 1st ed. (Toronto: A.A. Knopf Canada, 2007). I appreciate these accounts as they give perspective to the politics involved in different situations and places. 58 Hasana Sharp, "The Force of Ideas in Spinoza," Political Theory 35, no. 6 (2007): 733. A big thanks goes to Sue Ruddick for giving me this reference. Sharp brings in Spinoza and Althusser, which I do not space to fully engage with in this dissertation, but here are some telling quotes shed more light on my thinking: “Rather, Spinoza’s singular contribution is an examination of the life force of ideas, how ideas qua ideas behave and interact, and how humans live among and as ideal powers.” (Sharp, "The Force of Ideas in Spinoza," 736.) “Since I have been steeped in Spinoza, I no longer find strange the notion that ideas generated by nonhuman and inorganic life affect and are affected by my power of thinking, even as I acknowledge that such a metaphysical assertion will appear ridiculous to many.” (Sharp, "The Force of Ideas in Spinoza," 739.) “Ideas, like bodies, are augmented by amenable encounters with similar ideas and weakened by destructive, contrary encounters.” (Sharp, "The Force of Ideas in Spinoza," 745.) 59 Vinay K. Gidwani, Capital, Interrupted : Agrarian Development and the Politics of Work in India (Minneapolis: University of Minnesota Press, 2008), 7. 60 Antonio Gramsci, "The Revolution against Capital," in Antonio Gramsci: Pre-Prison Writings, ed. Richard Bellamy and Virginia Cox (Cambridge: Cambridge University Press, 1994), 6. 61 Gramsci says, “When history is developing through a series of moments, each more complex than the last and richer in meaning and value, but nonetheless similar.” (Ibid., 39-41.) In Gramsci’s case, war was what galvanized the people’s will to not follow the normal course of events. I think a cholera crisis had a similar effect, but under very different conditions, in particular not “the people’s” will, rather health reformers’ will. 62 Geoff Mann, "Should Political Ecology Be Marxist? A Case for Gramsci’s Historical Materialism," GeoForum 40 (2009): 336. The actual quote that I modified is: “What is of interest is more than the discursive production of The Cholera Crisis in 1892 | 2010 | Paul Jackson | 56

nature; it is a nothing less than a moral ecology. Actors involved in contests over the meanings and control of “nature” often understand the movement of “Right” as more than a normative standard, but as an active, material force in the making of the world—what Gramsci called an “idea-force”.” 63 I do not directly engage with these aspects of Foucault’s work because many others have taken on these concepts and histories in a variety of cases and disciplines. Instead I find Foucault’s other interventions more useful for my project. For governmentality see his lecture on 1 February, 1978 in Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007). I think my work attempts to move the discussion away from the before and after of “modernity”, and keep Foucault’s interventions within their historical context. I also hope to trace how the concepts and practices he isolated were later modified, shaped, and articulated in different historical contexts and geographies. One great example of this extension is Ann Laura Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things. (Durham: Duke University Press, 1995). 64 Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, 36. 65 Michel Foucault, Archaeology of Knowledge (New York: Routledge, 2002), 27-28. 66 Gilles Deleuze, Foucault (Minneapolis: University of Minnesota Press, 1988). This might lead a reader to ask, what of Deleuze’s event? While I do not see my work at odds with Deleuze, I cannot incorporate everything. Luckily, Paul Patton has been written about Deleuze’s event and frames his approach as “eventualization.” When the thinking of history becomes something that needs not to be explained, but in fact breaks down and becomes singular and contingent. He suggests that “the event is ‘eternally that which has just happened or that which is about to happen.” Deleuze had “a stratigraphic conception of event time in which pure events co-exist in superimposed layers and ‘what History grasps of the event of the event is its effectuation in states of affairs or in lived experience, but the event in its becoming, in its specific consistency, in its self positing concept, escapes History.” See Paul Patton, "The World Seen from Within: Deleuze and the Philosophy of Events," Theory and Event 1, no. 1 (1997): 17. Further Patton says, “The nature of the event is conditioned by the meanings of these contents, along with the fears and hopes which these produce…These recurrent events are recognizable across variable circumstances and ways in which they occur in different societies at different times, but are not reducible to those circumstances, or to the bodies and material processes involved on each occasion. They provide further illustrations of the distinction between the pure event and its actual incarnations.” See Patton, "The World Seen from Within: Deleuze and the Philosophy of Events," 13-14. 67 Foucault definition of the milieu is more extensive than I gave in the main body of my text. I’ll give the full quote regarding milieu as part of his larger project: “To summarize all this, let’s say then that sovereignty capitalizes a territory, raising the major problem of the seat of government, whereas discipline structures a space and addresses the essential problem of a hierarchical and functional distribution of elements, and security will try to plan a milieu in terms of events or a series of events or possible elements, of series that will have to be regulated within a multivalent and transformable framework. The specific space of security refers then to a series of possible events; it refers to the temporal and the uncertain, which have to be inserted within a given space. The space in which a series of uncertain elements unfold is, I think, roughly what one can call the milieu. As you well know, the milieu is a notion that already existed in biology with Lamarck…What is the milieu? It is what is needed to account for action at a distance of one body on another. It is therefore the medium of an action and the element in which it circulates. It is therefore the problem of circulation and causality that is at stake in this notion of milieu…The milieu, then, will be that in which circulation is carried out. The milieu is a set of natural givens—rivers, marshes, hills—and a set of artificial givens—an agglomeration of individuals, houses, etcetera. The milieu is a certain number of combined, overall effects bearing on all who live in it…Finally, the milieu appears as a field of intervention in which, instead of affecting individuals as a set of legal subjects capable of voluntary actions--which would be the case of sovereignty--and instead of affecting them as a multiplicity of organisms, or bodies capable of performances, and of required performances—as in discipline—on tries to affect, precisely, a population. I mean a multiplicity of individuals who are and fundamentally and essentially only exist biologically bound to the materiality within which they live.” (Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, 20-21. My emphasis.) Interestingly, this description of the milieu has a strong resemblance to medical topography that I will cover in chapter 3, and how health experts documented Toronto and its polluted marshes in chapter 8. 68 Deleuze, Foucault, 10-11. Deleuze is reading Foucault through his own lens here, in particular Gilles Deleuze, Difference and Repetition (New York: Columbia University Press, 1994). He says a statement is a repetition where The Cholera Crisis in 1892 | 2010 | Paul Jackson | 57

a similarity is retained, even if differently stated. Statements do not exist in a free-floating ether form, rather require structures, technologies, and agency to both state them and to hear them. 69 Telegraphy technology was extremely important for this era and international disease, for more see Menahem Blondheim, News over the Wires : The Telegraph and the Flow of Public Information in America, 1844-1897, Harvard Studies in Business History, 42 (Cambridge, Mass.: Harvard University Press, 1994). Iwan Rhys Morus, "‘the Nervous System of Britain': Space, Time and the Electric Telegraph in the Victorian Age," The British Journal for the History of Science 33, no. 04 (2000). 70 Deleuze, Foucault, 25, 62. 71 Stuart Hall, "The Problem of Ideology: Marxism without Guarantees," Journal of Communication Inquiry 10, no. 2 (1986): 29. 72 How are these frameworks integrated? Or can they be? As I have attempted to argue, neither a pure materialist nor pure idealist position seems adequate for my interrogation of my archive. However, as Hall says, “[t]he problem with Foucault is a conception of difference without a conception of articulation, that is a conception of power without a conception of hegemony.” (See Hall, "The Toad in the Garden: Thatcherism among the Theorists," 53.) I will be engaging with hegemony later in this dissertation. But for Gramsci hegemony is constructed through complex processes of struggle. Hegemony is not just given, but structured by institutions and/or the mode of production. Hegemony is subject to continuing evolution and development. The hegemony of cholera crisis lacked a material incident, however there were still practices that needed to be maintained, constantly and ceaselessly to be renewed and reenacted. What Foucault gives this more Marxist influenced intersection of crisis and hegemony is to trace the statements of a crisis, or the idea of the crisis. But why did this particular event crisis emerge, in this very contingent manner? This gets to questions of power, and for my work the state is important to power relations around cholera (more than maybe Foucault would liked and that is fine by me). But I also want to emphasize how the state actors and agencies felt impotent in that power, or reached the limits of state power. 73 Hall, "The Problem of Ideology: Marxism without Guarantees." 74 Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854 (New York,: Cambridge University Press, 1998), 11. 75 How the concrete relations of disease and abstractions of crisis became ‘concrete-in-thought’. For this insight I want to thank Christian Anderson and others at the CUNY writing group. They helped me to focus on the overlap with ‘concrete abstractions’ of Henri Lefebvre, The Urban Revolution (Minneapolis: University of Minnesota Press, 2003); Henri Lefebvre and Donald Nicholson-Smith, The Production of Space (Malden, MA: Blackwell, 2007). Another way crisis and event intersected could be framed as a particular disease event-crisis assemblage. The term assemblage works to hold together the event and the crisis, in particularly related to cholera. With the term assemblage, this is a nod to more Deleuzian framework, which has shaped my thinking of this dissertation. However I use his formulations sparingly. Since I do not have the space to integrate Deleuze into the above narrative and argument, I will have to relegate his work to the formative process of this dissertation, see Gilles Deleuze and Felix Guattari, A Thousand Plateaus: Capitalism and Schizophrenia (Minneapolis: University of Minnesota Press, 1987). 76 Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, 37. 77 Ibid., 61. Foucault recoiled from using the term ‘crisis’ and there is a historical echo in the health experts also saying the term “epidemic” was too tainted to use. For my own work thinking through a cholera crisis, I acknowledge there is a long debate about “crisis theory” in terms of Marxist theories of capital. I deal with this below in endnote 104. However, rather than avoid or eliminate these tensions, I want to work through them. I also find Foucault’s flagging of artificial or natural mechanism, an echo of Thomas Malthus’s population “checks”. I flag this now but will return to the influence of Malthus in chapter 5. 78 Melinda Cooper, "Pre-Empting Emergence," Theory, Culture & Society 23, no. 4 (2006): 20. Melinda Cooper utilizes Foucault’s understanding of the city to suggest that the modern form of urbanism demands a political control that attempts to manage future events, whose “horizon is the contingent (l’aleatoire) and its repetition or seriality.” (Melinda Cooper “Infrastructure and Event: Urbanism and the Accidents of Finance”, Presentation at The Center for Place, Culture and Politics, CUNY, 2008, Unpublished, 1.) Melinda Cooper also gives credit to these insights to French historian Francois Ewald. As there is no English translation of Ewald that I can find, I quote him at length here from Cooper: “In his extensive genealogy of the 20th century welfare state, Francois Ewald suggests that risk first emerges with the growth in international trade and the problems posed by movable assets, maritime exploration and the dangers of sea travel. Ewald states, “Insurance is the child of capital. It is a form of security that makes no sense in a feudal economy, where property is tied to land and the individual is held to familial, religious and corporatist forms of solidarity. On the other hand, it becomes necessary when fortune becomes mobile, when capital begins to circulate and finds itself exposed to the dangers of circulation. It is no accident that the first form of insurance was maritime insurance’ (1986, 182). [sic]” (Melinda Cooper The Cholera Crisis in 1892 | 2010 | Paul Jackson | 58

“Infrastructure and Event: Urbanism and the Accidents of Finance”, Presentation at The Center for Place, Culture and Politics, CUNY, 2008, Unpublished.) 79 Preparedness and critical infrastructure protection has become a lively discussion in anthropology. This literature works within the biosecurity framework inspired by Foucault. While I have read this literature extensively and found inspiration, I found this framing inadequate to explain my evidence. Stephen Collier, "Enacting Catastrophe: Preparedness, Insurance, Budgetary Rationalization," Economy and Society 37, no. 2 (2008). S. J. Collier and A. Lakoff, "Distributed Preparedness: The Spatial Logic of Domestic Security in the United States," Environ. Plann. D Soc. Space Environment and Planning D: Society and Space 26, no. 1 (2008). Stephen J. Collier, Andrew Lakoff, and Paul Rabinow, "Biosecurity: Towards an Anthropology of the Contemporary," Anthropology Today 20, no. 5 (2004). Andrew Lakoff and Stephen J. Collier, Biosecurity Interventions : Global Health and Security in Question (New York; Chichester: Columbia University Press, 2008). 80 Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, 247. 81 Ibid., 248. 82 Ibid., 239. 83 Again I could have used a more biopolitical or biosecurity framework of understanding why and how states become prepared, for a survey see S. Hinchliffe and N. Bingham, "Securing Life: The Emerging Practices of Biosecurity," Environ. Plann. A Environment and Planning A 40, no. 7 (2008). Why I chose Harvey’s social infrastructures was to emphasize how these state institutes become necessary and permanent. Over time many public health groups and agencies emerged in many wild forms. For this project I wanted to emphasize how these infrastructures became necessary and durable. I am not looking to contradict the biosecurity literature, rather I hope to contribute to this discussion from a different direction. 84 While David Harvey is not a state theorist, he grants the important role of the state. In Limits to Capital David Harvey ends his book with his own limitations. Or, in another way, Harvey ends the book with a caveat. Harvey declares that he didn’t deal with the “controversial” state because to do so he would have first needed to carefully analyze the reproduction of the labourer and labour power. But at the same time Harvey grants that he did deal with the state, which is throughout the book and he concludes that: “The state, in short, plays a vital role in almost every aspect of the reproduction of capital” (David Harvey, The Limits to Capital (London; New York: Verso, 2006), 449.). Harvey goes further to suggest that: “There is scarcely any aspect of production and consumption which is not deeply affected, directly and indirectly, by State policies. But it would be incorrect to maintain that the state has only recently become a central pivot to the functioning of capitalist society. It has always been there – only the forms and modes of functioning have changed as capitalism has matured.” In David Harvey, "The Marxian Theory of the State," Antipode 8, no. 2 (1976): 81. Also see his chapter on the state in David Harvey, Spaces of Capital : Towards a Critical Geography (Edinburgh: Edinburgh University Press, 2001). 85 For Harvey the state is important because “[t]he notion that capitalism ever functioned without the close and strong involvement of the State is a myth that deserves to be corrected.” (Harvey, "The Marxian Theory of the State," 88.) For Harvey the state is neither mere fluff, nor noise, nor unworthy of theoretical or empirical engagement. The state is not an accessory to his arguments. Harvey dealt with the state in a particular way. To justify my use of Harvey a brief overview of how the state percolates through the Limits to Capital is necessary. In the “Afterward” (and repeated in the essay “The Marxian Theory of the State”) Harvey outlines the ways the state engages with capital as: [1] a legal force (guarantees private property, contracts and the freedom of individuals); [2] regulating under inter-capitalist competition and working conditions; [3] facilitating or balancing the centralization of capital; [4] in the production of commodities which capitalist are unwilling to take on (chiefly the built environment); [5] through planning, as a power shaping the space economy of capitalism and thereby regulating the tension between geographic concentration and dispersal; [6] providing the central bank and money supply; [7] in turn, the state’s fiscal and money functions can intervene in the spaces of accumulation within it’s territory; [8] as the central institution through which class alliances form; [9] as the central institution through which inter-regional conflicts are worked out; and finally, [10] the state seeks a spatial fix to the contradictions within its capitalist economies. However, Harvey claims that he couldn’t really deal with the state because he couldn’t theorize it, in Harvey’s words, “[the book] do[es] not form an adequate basis of a comprehensive theory of the state.” To get a theory of the state is why Harvey would need to start from a different position. The question then is whether there is a theory of the state within Harvey’s work that can be teased out? I have attempted to do this in the second half of the dissertation by using his method and focusing on what he calls “active moments” in the circuits of capital. 86 A single capital-labour relationship becomes harder and harder to isolate in these processes, as class relations become more diffused and contradictory. 87 However, I do not accept Harvey completely. But my concerns with Harvey are minor and hopefully not nitpicking—an internal critique rather than external critique. I raise them only because I think the critique opens up spaces that can be productive. In Harvey’s analysis, the state is implicit rather than explicit. To summarize his The Cholera Crisis in 1892 | 2010 | Paul Jackson | 59

caveat at the end of Limits, ‘I couldn’t deal with the state, the state is huge, yet the ghost of the state haunts all of the preceding pages.’ If Harvey falls into a trap, it may be that the state is constructed as a receptacle of capital. This is not pigeonholing him into the base-superstructure debates. Harvey repeatedly says that he (and Marx) does not position the state as mere superstructure (and according to Harvey if you think so, this is a figment of bourgeois scholarship, and I don’t want to be that). Self-declaring, Marx and himself are not economic determinists. (Harvey, "The Marxian Theory of the State," 80.) Harvey says, “Marx plainly did not regard the State as a passive element in history.” (Harvey, "The Marxian Theory of the State," 87.) But Harvey also admits that there is a strong lure of the image of economic basis and superstructure that reflects that basis, but one should work hard to get rid of the image. I agree with Harvey and his reading of Marx. My concern is rather that Harvey deals with the state always later, as an afterthought. If the state is a constant and vital pivot, as he declares above, how does the lack of the state temper his project? There are very good reasons for this lack, as Harvey’s project was not to directly deal with the state. Harvey project is to understand urban injustice through time and space. In order to do this tries to understand Marx through Capital. Harvey’s project is to show how capitalism works in cities through geographical historical materialism. I suggest these starting points—the city, capitalism, Marxist theory—structures his work. He looks at how geography and history of capitalism transforms cities and social relations therein. In doing so, he de-privileges how the processes can themselves be transformed. Understandably he wants to get to first principles and he does that by starting with Marx. But Marx is unfinished. Marx always intended to write a book about the state. I think we should also see Harvey’s work as unfinished. So how to continue the project? Perhaps not by following the logical progression that there was Marx’ Capital and then Limits to Capital followed. For me to write The Limits in the Limits of Capital is a dead end. For example, in Harvey’s one article on the Marxist state, after an apology for being abstract, he begins by looking at Marx and Engel’s take on Hegel and the state as forum for class struggle. To extend a take (Harvey) on a take (Engels) on a take (Marx) on a mis-take (Hegel) is fairly distant from the geographical historical materialism. (Harvey, "The Marxian Theory of the State," 81.) But then where to start? Starting with the state is like starting with capitalism—too large. The state and capital are not bounded, separate entities anyway. So where is the ‘commodity’ that can root the analysis and theories of the state? A possible material foundation in the conclusion of Limits that Harvey suggests is the birth of the worker, looking at life and productive life (labour power). Interestingly this emphasis on birth is also where Judith Butler grounds her notion of precarity, see Judith Butler, Frames of War: When Is Life Grievable (New York: Verso, 2009). I engaged with Butler in the conclusion. My project engages with how matters of life and death of working people become entangled in the circulation of capital. This can be understood through Harvey’s Marxist analysis. Harvey’s methods and insights can gives us some clues to how this gets entangled. My goal is to isolate the crucial dynamics of social infrastructures, the role in value circulation, and common interest, in order to have a working, Harvey- inspired, theory of the state in relation to capital. 88 Bob Jessop, The Capitalist State : Marxist Theories and Methods (New York: New York University Press, 1982), 213. 89 Jessop phrased this transition as “‘real-concrete’ to the ‘concrete-in-thought’”. Accordingly, I do not see Harvey’s work in conflict with Jessop or the Regulation School overall. However, Jessop does give some guidelines for the Marxist account of the state. [1] The state is a set of institutions that cannot, as an ensemble, exercise power. [2] Political forces do not exist independent of the state but are partly formed through its forms of representation, internal structures, and forms of interventions. [3] State power is a complex of social relation that reflects the changing balance of social forces. [4] State power is capitalist to the extent that it creates, maintains, and restores, the conditions required for capital accumulation and is not-capitalist to the extent that these conditions are not realized. Michel Aglietta calls the analysis of the state the Achilles heel of the social sciences. He critiques the disciplines in suggesting that those who do engage the state see it as functional purpose or instrumental role. He says “[n]o direct analysis is undertaken of the nature of the social relations that have to generate the specific form known as the state in order to ensure their reproduction.” He suggests to work towards a theory of the state do not look for unity rather how the relations of capitalism involve a separation between private and public. In Michel Aglietta, A Theory of Capitalist Regulation : The Us Experience (London,: NLB, 1979), 27. 90 Harvey’s full quote may be helpful: “The State as we usually speak of it is an abstract category, which may be appropriate for generalizing about the collectivity of processes whereby power is exercised and for considering that collectively within the totality of a social formation. But the State is not an appropriate category for describing the actual processes whereby power is exercised. To appeal to the category “the State” as a “moving force” in the course of concrete historical analysis is, in short, to engage is mystification.” (Harvey, "The Marxian Theory of the State," 87.) I assume Harvey here is wary over how other people wrongly analyze the state, akin to analyzing the “Man” or the “Machine”. He clearly declares, “[t]he danger lies in the tendency to posit the State as some mystical autonomous entity and to ignore the intricacies and subtleties of its involvement with other facets of society.” (Harvey, "The Marxian Theory of the State," 86.) The Cholera Crisis in 1892 | 2010 | Paul Jackson | 60

91 But this is a negative definition of the state. By saying what the state is not does little to help me understand what is going on. Harvey’s definition of “a process of exercising power via certain institutional arrangements” is also very vague. This leads me to questions like: where is power, how is it exercised, through which specific institutions? Granted, one method to treat the state like capital, dialectically. 92 This distinction comes from the section when Harvey wades into the base-superstructure debates saying that the state as a superstructure for capitalism is perfectly appropriate for theory, but completely inappropriate in historical analysis. I agree. Harvey declares that if the state has appeared to fade into the background, in Marx’ or his own analysis, this is because social relations have become one with capitalism, internalizing its dynamics. However that does not mean it should not be distinguished, for more see Harvey, "The Marxian Theory of the State," 88. 93 In Harvey’s words, “We have also to see that the institutions of the State and the relations which are expressed through these institutions as constantly in the process of being reshaped and re-fashioned.” Ibid. 94 Ibid.: 89. 95 My readings of these questions—perhaps a harsh reading—is that Harvey project leads him to answers that deal with the state and state institutions as things, not processes. My contention is he has framed these questions and this analysis in this way due to his project (a perfectly valid project) and therefore the state becomes a receptacle for capital. 96 Sue Ruddick reminds me that Foucault would not make this argument, or do this form of history. I am fine with that, and if that is a mistake, it is my own. (The quote is from Harvey, "The Marxian Theory of the State," 86.) It is at this point I think Harvey falls into the danger of thinking about the state in a thing-like manner. This could lead to a ‘who’s in and who’s out’ mode of historical materialism. In context of the above quote Harvey says bourgeois democracy is in. Liberal democracy and rights are organic to capitalism. Also the state and legal structures that support the reproduction of capitalism are in. But does this framework, albeit in cartoon form, not slide into a form of thing-like analysis? Does Harvey treat the state as an object or a process? The question is not what is the state, rather but what does the state do, and how? 97 Harvey, The Limits to Capital, 440. 98 Gregory S. Kealey, Toronto Workers Respond to Industrial Capitalism, 1867-1892 (Toronto, Ont.: University of Toronto Press, 1991), 291. See also Michael S. Cross and Gregory S. Kealey, Canada's Age of Industry, 1849- 1896, Readings in Canadian Social History, V. 3 (Toronto, Ont.: McClelland and Stewart, 1982). 99 J.M.S. Careless, Toronto to 1918 : An Illustrated History (Toronto: James Lorimer & Co., 1984); Walden, Becoming Modern in Toronto : The Industrial Exhibition and the Shaping of a Late Victorian Culture. 100 Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991). 101 City of Toronto Archives, Fonds 200, Series 1078, Toronto City Council proceedings, Appendix C, Mayor Fleming’s inaugural address, 1892, 5. 102 See chapter 4 for more. City of Toronto Archives, Fonds 200, Series 1078, Toronto City Council proceedings, Appendix C, Fleming’s valedictory address in January of 1893, 1893, 511. 103 The second half of the dissertation deals directly with this relationship will be dealt with directly, and in more detail. 104 How crises can coincide and support each other, yet remain distinct, I have taken inspiration from James O'Connor, "The Second Contradiction of Capitalism," in The Greening of Marxism, ed. T. Benton (New York: Guilford Press, 1996). O’Connor says “[i]n traditional Marxism, capitalism is not only crisis-ridden but also crisis- dependent. Capital accumulates though crisis, which functions as a economic disciplinary mechanism.” (O'Connor, "The Second Contradiction of Capitalism," 203.) Then later O’Connor states that: “Crisis forcibly causes capital and the state to exercise more control or planning over production conditions (as well as over the production and circulation of capital itself). We can be almost certain that the first major crisis of the new system of global capitalism will be the occasion for a host of new international planning instruments.” (O'Connor, "The Second Contradiction of Capitalism," 210.) O’Connor brings together state and capital, however I want to keep them separate in order to show that how particular social infrastructures exercise control, albeit limited by contingencies in history and geography. 105 Antonio Gramsci, Selections from the Prison Notebooks of Antonio Gramsci (New York: Lawrence and Wishart, 1971), 276. 106 Jessop summarizes nicely Harvey spatial fix as the spatial re-organization and geographical expansion that serve to manage the crisis tendencies inherent to accumulation. These fixes can only be temporary. There are two types of fixes: [1] a durable fixation of capital in a place; and [2] a more metaphorical fix in the sense of temporary solution based on spatial reorganization. Jessop continues to say that in Harvey’s temporal fix, time and temporality are key moments during this accumulation process, and put together these spatio-temporal fixes are transformations that create the forms and periods of capitalism imperialism and accumulation. Theses fixes buy time through fixed The Cholera Crisis in 1892 | 2010 | Paul Jackson | 61

investments. These investments absorb current surplus capital and increase the future productivity and profitability. Bob Jessop, "Spatial Fixes, Temporal Fixes and Saptio-Temporal Fixes," in David Harvey: A Critical Reader, ed. Noel Castree and Derek Gregory (Malden, MA: Blackwell, 2006), 146-150. My claim is the ‘fixes’ that emerged from the 1890s depression were co-constitutive and dialectally related to cholera, disease epidemics, and ideologies of health. 107 Gareth Stedman Jones, Outcast London: A Study in the Relationship between Classes in Victorian Society (Oxford: Clarendon Press, 1971), 285. 108 H. Roger Grant, Self-Help in the 1890s Depression (Ames: Iowa State University Press, 1983), 4. 109 Gerald T. White, The United States and the Problem of Recovery after 1893 (University, Ala.: University of Alabama Press, 1982). By July of 1893 a major wave of distrust also hit the banks of the west and the south. Cash reserves at the New York national banks had declined 25 percent lower than required by law. A suspension of cashing checks occurred in New York and spread to other cities. 110 Ibid., 5. 111 Michael Bliss, A Living Profit : Studies in the Social History of Canadian Business, 1883-1911 (Toronto: McClelland and Stewart,, 1974). 112 White, The United States and the Problem of Recovery after 1893, 22-25. 113 Grant, Self-Help in the 1890s Depression. Many experts and politicians, including the president, declared the problem to be psychological. In 1896 President McKinley had the confidence to declare that recovery was on its way, as a result of the grain shortages by the US competitors and favoring protection measures through tariffs. 114 Bliss, A Living Profit : Studies in the Social History of Canadian Business, 1883-1911, 109. 115 Davis, Ecology of Fear : Los Angeles and the Imagination of Disaster; Mike Davis, The Monster at Our Door : The Global Threat of Avian Flu (New York: New Press, 2005); Mike Davis, "Beyond Blade Runner: Urban Control: The Ecology of Fear," Open Magazine, no. 23 (1992); Mike Davis, "The Flames of New York," New Left Review 12 (2001). 116 Robert Lewis is correct to assert that I am stereotyping the vast literature on the progressive movement. I acknowledge that this literature is quite more nuanced than I make it out to be. 117 Synthetic also invokes associations with fake, false, and insincere that obliquely references my view on this practice. 118 Timothy Mitchell, Rule of Experts : Egypt, Techno-Politics, Modernity (Berkeley: University of California Press, 2002), 53. 119 The term “accumulation strategy” comes from Bob Jessop whose relations to biomedicine I will outline in the conclusion. The Conditions of Crisis | 2010 | Paul Jackson | 62 Chapter 2 – The Conditions of Crisis: Migrating Populations, Growing Cities, and the Atlantic Ocean

When cholera threatened North America in 1892, the crisis was not new. Medical experts and health reformers had been dealing with cholera crises for the previous sixty years. During the 19th century, cholera emerged as a common problem throughout the North Atlantic. The movement of people, trade, and ideas also circulated medical practices and expertise.1 At that time, medical experts felt that interventions were necessary, even lacking a consensus over the science of disease transmission. Medical experts, news organizations, and government officials placed current events into the longer history of the management of crises and the ways in which crises and the growth of cities were dealt with in general. Cholera’s routes of infection appeared to follow a historical template. History led to certainty. This made future fears understandable. This historical evidence on how previous outbreaks were dealt with bolstered arguments for state interventions. Fears of the future focused on the ways cholera was seen as integral to the corresponding problems of migrating populations and growing cities, both seen as threats to the nation. This chapter will explore how health authorities negotiated and understood the relationship between cities, nations, and populations in terms of the fear of degeneration and the will for improvement. The cholera outbreak of 1892 came at a very particular time in light of the growth and change of cities across the Atlantic, as well as in terms of the international economy and the shifting notions of state intervention and governance. This chapter will also explore how liberal positivists, a particular segment of the progressive movement, responded to these cholera concerns. How did liberal positivists read the cholera crisis through the frameworks of urban degeneration and the role of population improvement? And how did the cholera crisis push these reformers to see the state as a secure bastion for their expertise? This chapter will end with an interrogation of Max Weber’s notions of bureaucracy. In 1892, health authorities needed to deal with cholera as a current event. At the same time, cholera persisted as a future event to be feared. Accordingly, the history of cholera events shaped what political recommendations could be made. When cholera threatened in 1892, government officials immediately invoked Canada’s previous encounters with cholera. Cholera came fully laden with historical baggage that had accumulated from dealing with outbreaks in the past. Canadian cities and towns experienced cholera from 1832 to 1871. The total death toll has been estimated between 17,000 and 20,000. During the first pandemic of 1832, Canadian

The Conditions of Crisis | 2010 | Paul Jackson | 63 newspapers regularly reported on the disease’s movements through Russia, Germany, and Britain.2 Cholera first arrived in the Canadas from migrant shipping vessels that crossed the Atlantic, often called coffin ships. The ship Carrick set sail from Dublin in April 1832 with 167 emigrants. When the ship arrived in Lower Canada on June 3rd, forty-five people had died during the crossing. Five more passengers died on Grosse Island, then a makeshift quarantine stop over before reaching Quebec City. Afterward, the ship continued to Montreal. As the disease moved further inland, fatalities followed in Cornwall, Prescott, and Kingston. Mr. Filgiano, a merchant tailor, fled Montreal to escape the disease, and on June 21st he became listed as the first case of cholera in York (Toronto).3 The diary entry of soon-to-be alderman James Lessile on June 29, 1832, described the fearful situation throughout the town: …9 new Cases of Cholera & 6 deaths since yesterday!—the alarm excited by it very great so that but few persons are found coming in from the Country but many leaving & going to a distance—The most active measures adopted by the Magistracy to prevent its spreading—all drunkards found on the Streets taken up & put either in Jail or in the Stocks—Houses occupied by poor persons cleaned & washed in Lime…The burning of Tar, Pitch—Sulphur &c recommended & adopted by many &…an anti-Contagion Hand Bills circulated to persuade people not to use Brandy—opium &c as preventatives…4

This description speaks volumes of the cultural fears brought on by cholera: the flight to the countryside; the moral overtones of blaming “drunkards”; and useless attempts at cleansing the air of impurities by burning tar. Even so, compared to the rest of the Canadas, the 1832 epidemic in York was not as dire and panic was not as widespread.5 However, the next epidemic hit Toronto harder. In 1834, cholera seemed more virulent and caused more panic throughout Upper Canada, perhaps because cholera infected more cities and towns. There were two other major cholera outbreaks in 1849 and 1854, and two minor outbreaks in 1851 and 1852. Two very localized cholera outbreaks occurred in 1866 in Toronto, and in 1871 in Quebec City. Since 1871, cholera hadn’t infected Canada. Other major disease epidemics in North America did take place during the mid-to-late 1800s and influenced how governments and experts dealt with diseases, in particular, the major 1873 cholera epidemic in the United States and the 1885 smallpox outbreak in Montreal. However, my claim is that, once cholera had arrived in Toronto in 1832, the city could no longer see itself as a small isolated outpost of the British Empire. Rather, it was part of an interconnected network of ports and cities in which cholera circulated. The cholera outbreak of 1892, discussed in chapter 1, built upon the cholera reforms and science that had been instituted since 1832. But after 1892, these reforms were pushed even further. In the 1890s, cholera authorities had articulated a particular convergence of conditions that could

The Conditions of Crisis | 2010 | Paul Jackson | 64 enable a cholera crisis. Two key reports had been released that defined the international space and population source of the cholera crisis.

2.1. The Geography of the Cholera Pandemic: Atlantic Spaces and Migrating Pilgrims The geography of the cholera pandemic crisis of 1892 was understood through histories of past outbreaks. At the start of the pandemic on August 31st, the Toronto Evening News printed two maps of past cholera routes. The accompanying headlines were “The Plague’s Path” and “Courses of Cholera in Former Years” (see Figures 2.1 and 2.2).6 These maps were actually unaccredited reprints of the famous maps published by physician and writer Edmund Charles Wendt in his 1885 book A Treatise on Asiatic Cholera. This book, written in New York City, was intended for primary American audiences. Wendt collaborated with Dr. John C. Peters and utilized both Peters’ cartography and epidemiology skills. Peters’ maps delimitated cholera’s historical movements beginning with its origin in India and ending in America (see Figures 2.1, 2.2, 2.3, and 2.4). These maps reflected how cholera became known and was spread through the British colonial expansion of India.7 But the maps also illustrated a specific oceanic space of cholera—an imperial space linked by colonial shipping and transportation routes. With each epidemic, the geography was extended. From this history, the Toronto Evening News stated that the 1892 outbreak had followed the same route as it did in Europe in 1829 to 1833 and declared, “The ravages of cholera in those four years decimated the entire world, and America suffered almost as keenly as the foulest fever spots of the East. [T]he hand of man is feeble in such works…The present epidemic, like that of 1831, had its rise at one of the great religious pilgrimages in the north of India.”8 The maps illustrated how all cholera epidemics had their origin in India. The theory of disease causation that supported this approach and that claimed all diseases were imported through contagion. At the time, this contagion theory was highly debated, and it opposed sanitarians’ theories that the local environment had the greatest affect on one’s health (I will address these debates in the following chapters). My question in this chapter is why the religious pilgrimages of India and the Middle East were seen as the source of international epidemics in minds of North American health experts. While these conclusions came from years of speculation, a recently published report made a definitive statement of the cause of cholera.

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Figure 2.1. Actual & Supposed Routes of Cholera from Hindoostan to Europe and to North & South America in 1832, 1848, 1854, 1867, 1873. By John C. Peters, MD.

Figure 2.2. Course of the epidemics of 1832, 1848, 1866, 1873.

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In 1887, Dr. E.O. Shakespeare published the findings of his long-term research project in the book entitled Report on Cholera and India.9 His project took off in 1885 when Shakespeare was appointed by the U.S. federal government to go to Europe where cholera existed and make a report to congress for the next year. All of his expenses were paid for and he could travel wherever he needed to. However, once he arrived in Europe, Shakespeare declared that cholera was “vanishing” from that continent. After being hosted by the famous bacteriologist Dr. Koch in Berlin, he travelled to the Mediterranean were he met with other health officials. Then, after getting permission from the U.S. government, he headed to India: “the native home of cholera.” During his time in India he became severely sick, although it was never clear what disease he suffered from, and he also declared he could not stand the heat. Since Shakespeare was “much shattered in health” from his Indian “experience,” his report was delayed after his return.10 His finished report was a fascinating mix of history, demography, and geography of the cholera- afflicted countries that included the older practice of medical topography (see chapter 3). He began the book with the chapter entitled “Course of the Last Wide-spread Epidemic of Asiatic Cholera” [sic]. This section begins by stating that that, even though during the early 1880s “cholera appeared among the Mohammedan pilgrims on their way to Mecca by sea from Bombay to Hedjaz, the principal Red Sea port,” the problem has always been India. He makes clear: The history of invasions of Europe by epidemics of cholera has shown that these visitations have without expectation been traced back to India as their point of origin, and that they have followed the course of trade, of travelers or of armies moving by land or by sea. The last wide-spread epidemic of cholera furnished no exception to this apparently universal rule concerning its movements.11

What Shakespeare’s authoritative work justified was the belief that sick migrating populations, in particular religious pilgrim populations, were the problem and source of the crisis. It was these populations that turned cholera into an international epidemic. However, Shakespeare’s report merely gave an American stamp of approval to long-time and widespread views that had been widely circulating throughout the Atlantic health expert community. Shakespeare’s report led William G. Eggleston to comment in the July 1892 North American Review that “to make the pilgrims observe the commonest rules of hygiene and cleanliness would require two soldiers for each pilgrim. The most riotous imagination could scarcely exaggerate the filth of India and Egypt and of the Hindoo and Mohammedan pilgrims…So long as the pilgrimages continue Europe and [the United States] will be endangered and will be visited by cholera.”12 These

The Conditions of Crisis | 2010 | Paul Jackson | 67 migrating populations on the other side of the Atlantic were perceived as a direct threat to North America.

Figure 2.3. Routes of Cholera from India to Asia, Africa, and Europe. By Dr. John C. Peters. While widely influential, Shakespeare was not alone in his condemnations of pilgrim populations. The International Sanitary Conferences—eight were held between 1851 and 1894—were one of the initial attempts to tackle disease pandemics through international cooperation and the standardization of procedures. The International Sanitary Conferences were different than many of the scientific congresses held during that time because they included diplomats and had an explicit political agenda.13 The purpose was to defend Europe against an “evil” originating in Asia. The defence of Europe was not to create a wall between Europe and Asia, but rather to control and monitor the new types of transit such as rail and steamships and new water routes such as the Suez Canal. Eastern European countries like Russia were seen as buffer zones.14 Delegates attending the 1866 conference held in Constantinople were worried about how fast cholera had travelled from Mecca to Europe. The uncontrolled mobility between the countries in the “orient”15 was a source of fear. The regulation of this traffic to the Meccan pilgrimage led to heated arguments with the delegates from Muslim countries.16 After the 1873 epidemic, the Vienna International Sanitary Conference’s mandate became stopping the sick before they reached European and North American countries. From the conference proceedings:

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“We have to stop that cursed traveler who lives in India, everyone knows it, from taking his trips; at least we have to stop its progress as closely as possible to its departure point.”17 Public health expertise had isolated the cholera threat in particular bodies. Geographer Bruce Braun frames this discussion by saying that a body is “embedded in a chaotic and unpredictable molecular world, a body understood in terms of a general economy of exchange and circulation, haunted by the specter of newly emerging or still unspecifiable risks.” Braun makes clear that this has a long history; that “from its inception…public health has taken the body to be a geopolitical body.”18 This history of cholera reminds us that not all bodies are equal in terms of both health and surveillance.

Figure 2.4. Map of the Course of Cholera in Russia, Poland & part of Hungary. These international concerns and fears were repeated to local Canadian and American audiences. Accounts from these conferences and their recommendations were published in the local medical journals and reported in newspapers. Moreover, many North American doctors and scientists travelled to Europe to attend these meetings. The editor of the Ontario Medical Journal reported back from the “Cholera Conference”19 in Paris 1894. The editors predominately focused on how the international medical community must track

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cholera to its seats of origin—that is, Asia and India, dealing especially with the Meccan pilgrimage. The principal question laid before the conference is to find thus “the examination of the Asiatic origin of cholera, and the measures to be taken relating to the defence of Europe against this scourge.”…[O]ne of the most brilliant European Hygienists, Mr. Ernst Hart, has denounced Mecca as a main centre from which European cholera spreads…He has pointed out that Hagar’s well, where the Mussulman pilgrims wash and drink, is nothing better than sewer water; in one day (June 26th, 1893) there were 500 deaths at Mecca from drinking this water. Let the pilgrims die for the glory of Mohammed, that is their affair; but they spread the cholera to the rest of the world, and they must be prevented from making us that present…fumigations, railway and frontier quarantines, powderings and antiseptic fluids, are only vain ceremonies, simple sacrifices to popular ignorance, the idolatrous homage which dirt pays to cleanliness. The prime focus of cholera is India; its gates of invasion are the Indian fairs and the Meccan pilgrimage. Mecca is the reinforcing station of cholera between the Gulf of Bengal and Europe; it is there especially that the chief danger lies. [sic]20

Experts from Canada used these European experiences and recommendations to frame health problems and prepare for future threats in North America. But this was not just Orientalist fear- mongering. The 1893 pilgrimage became one of the worst cholera outbreaks that had ever taken place in Mecca.21 Fearful reports sped across the ocean during the Hajj of 1893 when over 30,000 pilgrims of approximately 200,000 pilgrims died in Jidda, Mecca, and Medina. (For perspective, this death count is greater than the total deaths from cholera in Canada’s entire history.) The causes include a lack of clean drinking water, exploitive shipping companies, and lack of public investment by the colonial administration. That being said, concern over Indian and Meccan pilgrimages persisted for quite some time. For example, in 1926, the U.S. Surgeon General in his history of the International Sanitary conferences still claimed that the pilgrim was the central threat.22 But why would these distant outbreaks so obsess American health experts? Shakespeare, in his report, compared the Indian and Meccan pilgrimages to the North American experiences with immigration thereby bringing the problem home to his audiences of experts and government officials. Shakespeare stated: “In their enormous numbers, their poverty, and their squalor, and in their frequent transportation of all sorts of infections and contagions, these immigrants can be likened only to those oriental pilgrims, in whose track pestilence has so frequently followed.”23 He declared it was rare that immigrants did not introduce cholera or smallpox to North America. For Shakespeare, the existing U.S. system of quarantine was insufficient to stop the importation of these diseases, and stopping disease was impossible by local means alone. He felt individual port quarantine was not enough, arguing that a “National

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System of maritime quarantine is necessary.” His recommendations to limit and monitor the health of immigrants were put into place only after the 1892 cholera outbreak. Shakespeare was one of many who blamed immigrants for cholera. This argument had a long history even by 1892. After the 1832 epidemic, the Montreal Gazette editorial declared: “[W]hen I see my country in mourning and my native land nothing but a vast cemetery, I ask what has been the cause of all these disasters?. . . the voice of thousands of my fellow citizens responds from their tombs. It is emigration.”24 As the numbers of immigrants increased so did the fears. By the end of the 19th century, immigration to North America had shifted into a new register. In the 19th century, 1892 was the peak year for immigration in the United States. In that year, the older settler society made up less than half of the population.25 The majority of these newcomers were making their homes in the major cities. In Canada, the Laurier Government started an aggressive campaign to increase immigration during the 1890s. Between 1896 and 1914, three million immigrants entered Canada. From 1901 to 1911, Canada’s population grew 43 percent, during which time it was the world’s fast growing country. For the health reformers, the major concern was not the number of immigrants, but that an increasing proportion came from the non–Anglo-Saxon world (this was declared good for the economy but bad for the “nation”).26 These immigrants were living in Canadian cities. The fear of the immigrant city was a worry that Old World problems were being reproduced in North America.27 The wrong type of person was settling in North American cities. While the immigrant threat circulated, there was an equal concern over the environment where these immigrants settled. The fear was that the urban environmental conditions could unleash a disease crisis. During the 19th century, the city appeared to be transformed into an entirely new entity28 in terms of size, density, and growth. Cities at that time represented “paradox of progress”; the processes that had created a society of affluence and leisure had also destroyed the quality of urban life. A city as a place to work could not also be a place to live.29 By 1892 Toronto had tripled in population over the last 25 years.30 It grew from 86,415 in 1881 to 521,893 in 1921. Much of this growth was concentrated in the first twenty years of the 20th century when Toronto grew by 313,853.31 In the United States after the 1880s, the urban population had increased from a quarter to a third. The number of workers in manufacturing doubled during the 1890s. While many cities had shifted into a new register, nowhere was urban growth more striking than in London. In the mid-1800s, London was the largest city in the world, twice the size of Paris. Leading up to 1892, Britain was marked by economic depressions and a lack of working-class housing that coincided with the emergence of socialism and

The Conditions of Crisis | 2010 | Paul Jackson | 71 collectivism as a challenge to liberalism. The past strategies for dealing with urban crisis that came out of London and Britain circulated around the Atlantic world. The British experience was particularly influential on Canada. Newcomers found homes in cities. More specifically, the majority settled in the “slum” sections of the city. Accordingly, the slum environment was where urban reformers attempted to negotiate between the city, growth, and overpopulation. By the 1870s, the poor districts of cities became terra incognita that were periodically mapped out by missionaries and social explorers who catered to middle-class demands for travellers’ tales. In Victorian England, the slum began to be framed as a threat from within.32 One particular account and corresponding call to reform that had a long-lasting influence was Friedrich Engels’ chapters on the “Great Towns” in The Conditions of the Working Class. In Engels’ words, slums “are generally unplanned wildernesses of one- or two-storied terrace houses built of brick…They are filthy and strewn with animal and vegetable refuse. Since they have neither gutters nor drains the refuse accumulates in stagnant, stinking puddles. Ventilation in the slums is inadequate owing to the hopelessly unplanned nature of these areas.”33 Later Engels says: “It is here that one can see how little space human beings need to move about in, how little air—and what air!—they need to breathe in order to exist, and how few of the decencies of civilization are really necessary in order to survive…Everything in this district that arouses our disgust and just indignation is of relatively recent origin and belongs to the industrial age.”34 Engels was merely one example in a long tradition of urban reform and moral outcry.35 However, Engels’ analysis of the problem differs from most reformers. For him, the causes were not due to those who lived in these urban conditions; instead, the problem was the structures of industrialization and capital. While Engels’ outrage and description of this new urban environment was typical of the period, his analytic was not. Many health experts began to focus on how this environment affected and shaped those who lived in those conditions. One argument that predominated was that people born in cities would sink into poverty and intermingle with the immigrant populations. Accordingly, the authorities feared that the resulting generations would descend inwards and downwards.36 The rest of this chapter will show how crises of immigration, growth, and urban environments became an interrelated site of intervention. While experts feared that urban people and places could degenerate, the hope was they could also be improved. How these relations came to be understood was an ongoing project for urban and health authorities. My project is to examine how cholera played into these more widespread and over-reaching concerns around social and biological change. In particular, how

The Conditions of Crisis | 2010 | Paul Jackson | 72 health expertise—expertise from disease, medicine, and the science of biology—was imported into urban reform. Foucault has stated, “The city with its principled spatial variables appears as a medicalizable object.”37 Foucault’s interventions targeted places that were believed to be breeding grounds for disease and threats in general, such as prisons, ships, harbours, hospitals, and the populations that moved through these spaces. What were those interventions in relation to cholera? How were they validated and how did the practices become necessity over time? The rest of this chapter will give a general overview of the shifting ideas of reform throughout the Atlantic expertise community. The historian Daniel Rodgers suggested that the Atlantic Ocean should not been seen as a geographic barrier or division, but as a connective lifeline. The Atlantic Seaway was the movement of peoples, goods, ideas, and aspirations. Rodgers says, “American social politics was of a part with movements of politics and ideas throughout the North Atlantic world that trade and capitalism had tied together.”38 This chapter shows how health expertise circulated to confront the conditions that produced urban health crises.

2.2. The Sciences of Decline and Improvement New immigrant populations living in impoverished conditions at the centre of growing cities was a rich mine where social reformers could extract outrage. Experts synthesized their concerns into a common argument over the problems of degeneration, and offered expert-led improvement of both cities and people as a solution. By 1892 outrage and lamentation over the urban conditions had become an institution in the United States. With the publication of Jacob Riis’ How the Other Half Lived two years earlier, the historian David Ward interrogated Riis calling his reforms “pauperized citizenship” that fused environmentalism and hereditarian ideas. For Riis, the slum “makes its own heredity. The conclusion was the bad environment of today became the heredity of tomorrow, and would become the citizenship of tomorrow. The lowered vitality, the poor workmanship, the inefficiency, the loss of hope—they all enter in and make an endless chain upon which the curse of the slums is handed down through generations.”39 These thoughts were similar to those of British reformers, but according to the North American reformer this degradation was happening in the U.S. and Canada much more rapidly than in England. The New World was seen as a blank slate. These views were building on decades of speculative theories that had been argued throughout the Atlantic world. Each country had its own perspective on the ongoing shifts in cities and health. This section will show how interlocking perspectives of degeneration and eugenics were brought into a North American

The Conditions of Crisis | 2010 | Paul Jackson | 73 view on how to improve urban health and living conditions, in particular how Canada and United States reformers fit into these debates. In England during the 1880s, as the historian Gareth Stedman Jones explains, many reformers no longer presented the poor as the objects of compassion, but instead as coarse, brutish, drunken, and immoral, the result of “individualism run wild.” Pressure from urban existence itself was believed to be the root cause of the problem of the poor. The pressures were vaguely defined, but drew support from various areas of expertise, including medicine. The general conclusion was that the city nurtured conditions that would cause urban dwellers to physically and morally degenerate. Previously, Darwin’s laws of nature were seen to “weed out the unfit” and preserve a balance. The economic depressions of the period were seen as a cruel, but almost natural force. Now that doctors, sanitarians, and more humanitarian legislators increasingly violated these laws through acts such as welfare, the unfit were multiplying. The poor were seen as a growing, degenerate stratum of city life and, as summarized by Stedman Jones, “the ultimate causes of their poverty and distress were neither economic nor moral but biological and ecological.”40 In the 1880s, social Darwinists used lofty arguments to lend “cosmic significance to the struggle between country and town.” This grandiose biologism provided a framework for a comprehensive theory of hereditary urban degeneration.41 These bio-sociological laws were backed up by extensive statistical data whose interpretations were never proven and that assumed causal links based on circumstantial evidence. The theories of degeneration were being woven from these various threads. While the term degeneration was widely used, there was little agreement on precisely what it meant.42 The historian Anne McClintock suggests that this severe depression of the 1880s created a subsequent feeling of impending catastrophe in England. As McClintock summarizes, “The poetics of degeneration was a poetics of social crisis.”43 These fears led to major changes in social theory. Degeneration was a set of knowledge and practices in which bad blood, contagion, and paranoia of boundary order were interrelated. The social power of degeneration declared and directed how social classes and groups were deemed “races” in need of separation. In this way, poverty and social distress that distinguished these groups was the result of biological flaws. These fears fostered a sense of legitimacy and urgency in the call for state intervention. McClintock quite aptly describes these interventions as baroque. McClintock’s contribution was to explain how women, colonized people, and the urban working class were all embodiments of the “primitive,” positioned to exist in an anterior time. In the city, certain spaces were deemed anachronistic and became sites of surveillance. Importantly, these

The Conditions of Crisis | 2010 | Paul Jackson | 74 differences were examined through the empirical standards of science. For the sake of science, it became necessary to “invent visible stigmata to represent—as a commodity spectacle—the historical anachronism of the degenerate classes.” Further, when a boundary was transgressed, the act implied a form of racial regression.44 Fear became institutionalized in the daily life of the Victorians. The groups called “races” were separated as contagious or as containing internal biological flaws.45 These social relations were founded, supported, and fought over by the science of the day. The social crisis, as an idea and a social relation, became materialized through science—necessarily a racial science. These fearful poetics were not merely about degeneration: the decline, fall, or tainting of population. While degeneration was a declinist ideology, it was also extremely flexible. My claim is that health-minded authorities equally feared the uncontrolled growth of certain populations, a population that could not be educated or turned into a productive workforce. The social crisis was not just the pure being infected by the impure, or the impure needing to be separated from the pure. Rather, the crisis was the increase of misery without either natural or artificial “checks.” Investments in health could improve the national vitality and production and would potentially have corresponding economic benefits. Degeneration was a slow biological weakening. Urban growth was a rapid increase—sudden bolting—of population and the sense of being overwhelmed by populations that could not be improved. To understand why these ideas were so powerful, I will follow and critique how this proliferation of population was articulated. The degeneration discussion reached its zenith between 1880 and 1914. Degeneration dealt with difference and the natural basis of urban segregation. During the same period, eugenics was also part of these debates and focused on how social statistics of urban fertility could lead to improvement. Improvement could be marshalled through eugenic reforms. 46 While degeneration and eugenics were distinct movements, they also supported each other. Bill Luckin suggests that degeneration didn’t pass the baton to eugenics, they co-existed. The release of Charles Darwin’s Origin of Species (1859) and his ideas of natural selection renewed a much longer debate, one that had occurred before the 1860s, about how environmental conditions shaped health. These scientific and medical studies were profoundly worried about the urban environment. The larger movement declared that the city possessed a “malign and deadly agency” and would turn on its inhabitants.47 During the 19th century, experts declared the urban poor as “a race apart” that needed to be biologically understood.48 As health policy and administration, eugenic social biology opposed social policies that let the unfit breed. According to the historian Dorothy Porter, the eugenic movement condemned the

The Conditions of Crisis | 2010 | Paul Jackson | 75 environmentalist Victorian public health advocates who assumed that better environment meant race progress. Instead, preventative medicine, as one expert suggested, actually led to “race- decay.”49 Porter argued that public health in Britain was affected very little by eugenics; rather, it gave ammunition to the right-wing response to social welfare and liberalism. Edwardian preventative medicine’s answer to poverty and disease was to expand the environmental influences to incorporate the “physical conditions of existence.” From the 1890s onward, a more holistic understanding of urban systems emerged. Reforms consisted of decentralizing the city, spreading industry, and returning workers to the countryside. Porter suggests that environmentalist ideologies co-opted the language of degeneration and Social Darwinism into arguments for comprehensive and holistic social planning.50 Scientists who pushed for the complete elimination of the sub-human underclass were an extremely small element, but their ideology permeated through science and government bureaucracies. Definitions are helpful to clarify differences between degeneration and eugenics. Francis Galton coined the term eugenics in 1883 and by 1904 he asked of eugenics, “What is meant by improvement? What by the syllable eu in ‘eugenics,’ whose English equivalent is ‘good’?”51 He answers himself through a parable of walking through a zoo, declaring: All creatures would agree that it was better to be healthy than sick, vigorous than weak, well-fitted than ill-fitted for their part in life; in short, that it was better to be good rather than bad specimens of their kind, whatever that kind might be. So with me.

According to the ideology of eugenics, disease exists to create activity. This deliberate activity benefits the health of the nation because it enables the full potential of the fit and the strong. Eugenics was obsessed with managing the future: “The aim of eugenics is to bring as many influences as can be reasonably employed, to cause the useful classes in the community to contribute more than their proportion to the next generation.” In many ways, eugenics was a form of biological and generational accumulation in the face of the fearful ideologies of degeneration. Relevant to my argument, the state and nation were sites where these experts articulated their position (see chapter 9). Galton, for one, called for [p]ersistence in setting forth the national importance of eugenics. There are three stages to be passed through: (1) It must be made familiar as an academic question, until its exact importance has been understood and accepted as a fact. (2) It must be recognized as a subject whose practical development deserves serious consideration. (3) It must be introduced into the national conscience, like a new religion. It has, indeed, strong claims to become an orthodox religious, tenet of the future, for eugenics co-operate with the workings of nature by securing that humanity shall be represented by the fittest races. 52

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The goal was a national project of improvement that would balance proportions and foster good. Eugenics was a new “religion” based on rationality and science. In my research I did not focus on eugenics because, in my assessment, eugenics has been framed as a historical aberration or special period: an exception. My work has shown that eugenics was merely one aspect of a larger, even if internally conflicted, set of ideologies that included degeneration and general urban health reforms. With the rise of the progressive movement in the “New World” these tendencies took on a particular form.53

2.3. Positivism and the Progressive Movement In many ways, within all these crises—cholera, the city, economic depression, degeneration— the beneficiaries were the bureaucrats. However, health bureaucrats took up different roles, different responsibilities, and acted in different ways. These health bureaucrats incorporated concerns from various factions of the social protectionism movement, including humanitarians, town planners, sanitary engineers, and moral reformers. While sometimes lumped together because they were all motivated by the sense of crisis, these groups were distinct.54 What emerged after these crises was a new type of civic mindedness, which was to be called progressivism. Robert Wiebe in his famous book A Search for Order gives a sweeping history of the national change that led to the progressive movement. After the rise and fall of the railroads and industrial competition, a new form of financial leadership gathered momentum in the 1880s. This finance capitalism accelerated in the 1890s to dominate the investment market. While the depression of the 1870s was the longest and the mildest in terms of human strife, the crash of 1893 made the problems of free market capitalism unavoidable. In response, a bureaucratic- minded middle class focused on rules of impersonal sanctions and sought to institute continuity and predictability in a world of endless change. This progressive movement had an active hostility toward the business community. Wiebe’s argument, while contested, is that the progressive movement gave power to government and the centralization of authority as a retort to laissez-faire beliefs.55 As the progressive era came into its own after 1900, the period of government expansion into new agencies slowed down. Instead, government services were to be extended and details or instances of shoddy work would be scrutinized. A major issue was the fact that a patchwork government could not deal with the wide range of urban problems. These urban progressives were systematizers while their opponents were governors, albeit

The Conditions of Crisis | 2010 | Paul Jackson | 77 democratically elected. These reformers looked to reorganize government itself. What came to the fore was budgeting, auditing, increasing the number of appointed posts for specialists, and expanding bureaus of research.56 Wiebe declared that by 1920 a new urban bureaucratic middle class had emerged. They were younger men with a zeal for the future. These progressives tackled the slums and the settlement houses, transforming public health campaigns that were previously focused on filth removal into citywide reforms (and, for many, the child was to be the heart of these reforms). As Wiebe states, “Scientific government, the urban reformers believed, would bring opportunity, progress, order, and community.” Health experts were part of this growth of the progressive movement, and this scientific government was unified through a particular form of positivism. My claim is that the majority of the experts who engaged with cholera can be placed within the positivist tradition, in terms of methods and truth claims. Positivism, according to historian of science Duncan Fuller, was a movement that declared politics to be inherently irrational. Because of this, science must replace politics. Positivism saw both scientific rationality and the increase of scientific knowledge as paths to progress, perhaps even human salvation. However, positivism should not be reduced to vulgar scientism. Positivism can be seen as specific knowledge claims within inherently anti-democratic politics.57 Positivism’s mission was to form a scientific vanguard that was capable of offering guidance to the unenlightened and creating a process for self-optimization as new evidence and reflection emerged. This renewal would avoid self-destructive scepticism that hindered the implementation of changes that were for “the good of all.” As Fuller states: [T]here is a fundamental ambiguity [read: elite knowledge for all the public] in positivism’s appeal to organized reason, or “science,” in the public sphere. Sometimes this ambiguity is finessed by saying that positivists regard science as the main source of political unity. At the very least, this implies that it is in the interest of all members of society to pursue their ends by scientific means, as that may enable them to economize on effort and have more time to enjoy the fruits of their labor.58

Positivists regarded science as the main source of political unity. From the philosopher Auguste Comte onward, this crusade argued that science could unify the polity by resolving, containing, or circumventing social conflict.59 By the 1880s, positivists’ primary method was to use correlations to articulate this unity, avoid conflict, and translate their ideology to the “unenlightened.” For my work, these correlations found traction—visualized and imagined— through the use of synecdoche, interrelating the part for the whole. In the face of the politics of

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“evil” and “random” disease, positivism provided unity, rationality, and scientific consensus. Furthermore, scientists and experts who believed in positivism increasingly found themselves supported by state institutions. In the late 19th century, a segment of the scientific community can be seen to combine liberal and positivist beliefs in opposition to the “irrational” laissez-faire individualism. This group was especially against laissez-faire individualism that sought to limit the role of the state, a state that was increasingly supportive of scientific research and publishing. In contrast, the experts pushed and supported the federal government to adopt new responsibilities and duties.60 This was a specific, but arguably foundational, strand of North American progressive thought built upon evolutionary theory, political economy, and German organicism. The historians Michael Lacey and Mary Furner call this strand liberal positivism.61 Liberal positivism was a way of engaging with the world rather than with a cohesive group or profession. Liberal positivists thought that “men who think alike will act together.” Science was believed to be a major ecumenical movement and became increasingly significant politically.62 Additionally, liberal positivists were against the nature-based, evolutionary Social Darwinist thought of “survival of the fittest,” simply because this argument also went against government intervention. They articulated an interventionalist version of evolution and the economy centred on those sciences that could foster improvement—arguably, later becoming a form of eugenics.63 Over the last half of the 19th century in the United States, science had seen a huge increase in the number of agencies within a much stronger federal government. Both natural and social scientists moved into public service. For the liberal positivists, the state was defined, in the words of American anthropologist and geographer John Wesley Powell, as “the grand unit of social organization” and the “most important step taken in the direction of controlling social forces.” The state was much more than the government. Indeed, it was analogous to the social order with legal and regulatory operations and connections between the public and private that formed a vast “plexus of organizations.” Government organization was seen to grow only in response to the complexity of the society.64 To justify their process of inventing a tradition of government, the liberal positivists made arguments and claims about the usefulness of methods and practices, such as statistics. Against the criticism that these movements were inherently political and filled with nepotism, Powell declared, “Scientific men spurn authority, but seek for coordination.”65 As the state’s response to cholera pandemics has shown, this coordination took place not only within countries but also between countries throughout the Atlantic world.

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Scientists and experts were able to spread their liberal positivist ideas in research and publications as government bureau chiefs favourable to their views became editors of journals and magazines. Publications flourished. During this period notary journals like National Geographic, Science, and American Anthropologist were established. Increasingly, specialized journals that had strong connections to universities also began to appear.66 Over time, the locus of academic life shifted from independent scientists and government work toward universities. Advocacy work came from professional associations such as the American Social Science Association, the American Association for the Advancement of Science, and the National Academy of Science. For the medical community, this period saw the creation of the American Public Health Association, as well as many regional health organizations in Canada. Journals such as The Canadian Practitioner and Canadian Public Health Journal that fostered a common language and base of knowledge proliferated. This dissertation used many of these documents as sources because they vocalized their ideology and stated their triumphs. The rise and institutionalization of these liberal positivists, including health experts, build on the earlier academic work of the progressive movement. However, my claim is that while the economic depressions did influence the health experts in my archive, their move into the state bureaucracy at local, provincial, and federal levels was spurred by disease crisis, rather than abstract concepts like efficiency. These liberal positivists—in particular health experts who sought government positions to enact reforms of social protectionism and to mitigate future crises—make up the group that I am calling bio-economic bureaucrats (which I will deal with in more detail in the second half of this dissertation). With the mention of bureaucrats I cannot ignore the work of sociologist Max Weber. Weber is a bit tricky because he discusses “pure” types in an attempt to bracket these models from the historical reality. According to Weber, bureaucratic officials have jurisdiction over an area; are ordered by rules; have duties; are paid to fulfill these duties; are given authority; live through hierarchy; are trained as specialists; and finally, managed with documents. These activities form a “bureaucratic agency” in the state. However, I will show how the bureaucrats that I follow are so impure that they contradict Weber’s categories. Weber raises, but does not answer, the question of how bureaucracy becomes indispensable (I phrased this in chapter 1 as necessary). Indispensable is not an economic issue for Weber.67 For Weber, “The power position of a fully developed bureaucracy is always great, under normal conditions overtowering [sic]. The political ‘master’ always finds himself, vis-à-vis the trained official, in the position of a dilettante facing the expert.” The expert holds the facts whether this “master”

The Conditions of Crisis | 2010 | Paul Jackson | 80 whom the bureaucracy serves is a “people,” a parliament, or a popularly elected leader.68 Professional knowledge makes the bureaucrat indispensable, and therefore secrecy and obscurity become integral to expert knowledge and facts. Similarly, Weber identifies pure types of legitimate authority that base their claims on rational, traditional, or charismatic grounds.69 Weber says, “Bureaucratic administration means fundamentally the exercise of control on the basis of knowledge. This is the feature of it which makes it specifically rational.”70 However, in the case of cholera, the relations of power were far from rational and repeatedly ignored. The “secrecy” was their confusion and their irrational claims, and I don’t think that was conscious. The legitimate authority of the health experts I follow came from fearful claims, confused science, and baseless predictions.

2.4 Conclusion: Crisis Expertise In general, during the second half of the 19th century, the fears of epidemics, immigration, and degeneration were not a narrow concern for a few experts. The city had become feared as the accumulation and receptacle of undesirable populations of the nation. The growth of the city had widespread cultural implications. Writers like Charles Dickens in Britain and Emile Zola in France narrated the lives of the urban poor, feeding a popular public debate. The poor slum dweller became a popular concern. Health expertise held a key role in discussions of these concerns. While health reformers such as Edwin Chadwick and Southwood Smith in England had been on the scene for decades, by the end of 19th century, the health concerns cohered on the aggregate level: populations, cities, nations. According to the liberal positivist movement, if these populations could be efficiently managed, as Wiebe writes, the “ragged violence of city life…would dissolve into a new urban unity.”71 Accordingly, there was an almost symbiotic relationship between the rise of the “problem” of the unhealthy city and the emergence of reformers who took up the challenge to solve these problems. This relationship was one of the defining features of the 19th century. The rise of the Atlantic progressive movement allowed experts to create methods and tactics to maintain their position within the state. To do so meant claiming unique proficiency to manage the state and the economy based on positivist principles. At the same time, new professions and social movements were entering into the fray and new specialized commissions and departments were added to government. In direct response to the new forms of urbanism that emerged and to the pattern of uncontrolled growth, progressivism began to shape the emergence of city planning. City planning was considered a new, idealistic redefinition of the public and the urban environment. It took shape in concert

The Conditions of Crisis | 2010 | Paul Jackson | 81 with developments in architecture and engineering, notably the City Beautiful movement.72 Around the cholera outbreak of 1892, planning was coming into its own, and much of the profession was showcased in America through the 1893 Chicago World’s Fair (the site feared as the source of the future cholera outbreak of 1893). Later, these debates over the city would continue at the Chicago School.73 Furthermore, public health and sanitary reforms had a vital role in the development of urban planning. The experts that I follow in the rest of this dissertation are placed within the progressive movement, but as health experts they relied on or gestured to positivist science. In Canada, the social and political transformations that can be placed under the umbrella of the progressive movement continued from 1890 to 1930. These shifts had powerful cultural reverberations. Mariana Valverde has traced the social purity movement that constituted a powerful coalition toward moral regeneration of the state, civil society, the family, and the individual.74 In contrast, the rest of this dissertation will follow particular health agencies that gained solid footholds within different levels of the state. The Victorian faith in progress gave way to the progressive’s faith in efficiency through centralized planning and engineering. In the 1890s, the urban reform movement was a motley crew whose common thread was a desire to transform municipal governance; citizens would no longer manage their own affairs, and the city would become more like a corporation that needed management and specialization.75 This management took the form of boards of control and commissions (in this dissertation, this is best seen in the Provincial Board of Health and the Toronto Harbour Commission, see chapters 7 and 8). These new agencies caused a lot of conflict. However, the reformers were less successful in enforcing a similar regime on federal levels of government, perhaps because technological and planning innovations were not as obvious at that scale.76 (Although the federal Commission of Conservation can be seen as an attempt to do so; see chapter 9.) While these were international debates about shared international problems, the institutional outcome was the emergence of nation-based health movements. During this time, regional, national, and continental scales of expertise were in flux. Harvey uses structured coherence works to explain how international trade, labour migration, and both national and local reforms hung together for a time. My argument is that health reforms helped to solidify a North American, structured coherence, perhaps even an Atlantic coherence. This was not a totality of what took place within those countries, but a coherence of those places linked by the cholera maps of Wendt. Harvey acknowledges that the state has a key role in shaping this structured coherence, and that is where my archive leads as well.77 This coherence shifted away from laissez-faire and high migration

The Conditions of Crisis | 2010 | Paul Jackson | 82 and toward an inward focus on healthy national populations. My purpose has been to show how the state patrolled the borders of this structured coherence and made recommendations at the point of this intersection of growth, environment, decline, and the foreign “elements.”

Endnotes

1 Daniel T. Rodgers, Atlantic Crossings: Social Politics in a Progressive Age (Cambridge, Mass.: Belknap Press of Harvard University Press, 1998). Additionally, this chapter contributes to some recent work that ariculates the geography of the ocean. Some notable examples are, Peter Linebaugh and Marcus Rediker, The Many Headed Hydra : Sailors, Slaves, Commoners and the Hidden History of the Revolutionary Atlantic (United States: Beacon Press, 2001); Philip E. Steinberg, The Social Construction of the Ocean, Cambridge Studies in International Relations, 78 (Cambridge; New York: Cambridge University Press, 2001); Ian Baucom, Specters of the Atlantic : Finance Capital, Slavery, and the Philosophy of History (Durham: Duke University Press, 2005); Ian Baucom, "Atlantic Genealogies," The South Atlantic Quarterly 100, no. 1 (2001). 2 Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980). Joseph L. Atkinson, "Thesis: The Upper Canadian Legal Response to the Cholera Epidemics of 1832 and 1834" (University of Ottawa, 2002). 3 In 1834, the Town of York incorporated into the City of Toronto. George Edgeworth Fenwick and Francis Wayland Campbell, "Cholera in Canada," Canada Medical Journal and Monthly Record of Medical and Surgical Science II (1864): 485-489. 4 Edith G. Firth, The Town of York, 1815-1834 (Toronto: Champlain Society for Government of Ontario, University of Toronto Press, 1966), 241-242. In this archival source no first name of the tailor was given. There are a variety of accounts and histories that outline the 1832 outbreak. For example, a sensational account of the time reported how “Upper Canada hoped that she would be spared from the ravages of the epidemic. Her only hope of escape lay in effective quarantine measures upon the arrival of the infected immigrants in Lower Canada and these proved ineffectual. About 11,000 immigrants reached York and the head of the Lakes during the spring and summer of 1832. Everywhere infection followed them. The existing administrative organization of the Province was inadequate to deal with a sudden and devastating epidemic.” In Marian A. Patterson, "The Cholera Epidemic of 1832 in York, Upper Canada," Bull Med Libr Assoc. 46, no. 1 (1958): 170. 5 Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, 57-60. 6 Evening News, “The Plague’s Path,” Evening News, August 31, 1892, 1. 7 See David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: University of California Press, 1993). 8 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 9 Edward O. Shakespeare, "Report on Cholera in Europe and India," ed. Senate United States. Congress (Washington, DC: 1887). 10 Edward O. Shakespeare, Report on Cholera in Europe and India (Washington: Government Printer Office, 1890), v-vii. 11 Ibid., 9. 12 William G. Eggleston, "Oriental Pilgrimages and Cholera," The North American Review 155, no. 428 (1892). 13 Valeska Huber, "The Unification of the Globe by Disease? The International Sanitary Conferences on Cholera, 1851-1894," The Historical Journal 49, no. 2 (2006): 459. For more on the ISC, see Norman Howard-Jones, The Scientific Background of the International Sanitary Conferences, 1851-1938, History of International Public Health, No. 1 (London: World Health Organization, 1975). W. F. Bynum, "Policing Hearts of Darkness: Aspects of the International Sanitary Conferences," History and philosophy of the life sciences 15, no. 3 (1993). For how control of diseases worked between nations, see also Krista Maglen, "'the First Line of Defence': British Quarantine and the Port Sanitary Authorities in the Nineteenth Century," Social History of Medicine 15 (2002). Patrick Zylberman, "Civilizing the State: Borders, Weak States and International Health in Modern Europe " in Medicine at the Border: Disease, Globalization and Security, 1850 to the Present, ed. Alison Bashford (New York: Palgrave Macmillan, 2006). 14 Huber, "The Unification of the Globe by Disease? The International Sanitary Conferences on Cholera, 1851- 1894," 461. Sheldon Watts, "Cholera and the Maritime Environment of Great Britain, India and the Suez Canal: 1866-1883," International Journal of Environmental Studies 63, no. 1 (2006). 15 Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. David Arnold, "The Indian Ocean as a Disease Zone, 1500-1950," South Asia: Journal of South Asian Studies 14, no. 2 (1991). Michael Christopher Low, "Empire of the Hajj Pilgrims, Plagues, and Pan-Islam under British Surveillance,1865-

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1926" (2007). Edward W. Said, Orientalism (New York: Pantheon Books, 1978). Alison Bashford, "At the Border: Contagion, Immigration, Nation," Australian Historical Studies 33, no. 120 (2002); Peter Baldwin, Contagion and the State in Europe, 1830-1930 (New York: Cambridge University Press, 1999). William Roff, "Sanitation and Security: The Imperial Powers and the Nineteenth Century Hajj," Arabian Studies 6 (1982). 16 Huber, "The Unification of the Globe by Disease? The International Sanitary Conferences on Cholera, 1851- 1894," 462. 17 Ibid.: 464. This method of long distance surveillance, along with clean bills of health, would come to dominate these international relations, for more see John C. Torpey, The Invention of the Passport : Surveillance, Citizenship, and the State, Cambridge Studies in Law and Society (New York: Cambridge University Press, 2000). 18 Bruce Braun, "Biopolitics and the Molecularization of Life," Cultural Geographies 14, no. 1 (2007): 14-15. 19 In the Ontario journal, this meeting was called the “Cholera Conference” but it was one of the International Sanitary Conferences. 20 R.B. Orr, "The Approaching Cholera Conference at Paris: The Extinction of Cholera," Ontario medical journal. 2, no. 8 (1894): 269-270. 21 This time period was also when cholera mutated into a new strain. In the process cholera became able to live outside the human digestive tract. This took place in El Tor, Egypt in 1905 and that cholera strain has taken on that name. 22 H.S. Cumming, "The International Sanitary Conference," American journal of public health (New York, N.Y. : 1912) 16, no. 10 (1926). 23 Shakespeare, Report on Cholera in Europe and India, 821. My emphasis. 24 Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, 50. 25 Howard Markel, Quarantine: East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore, Md.: Johns Hopkins University Press, 1997), 7. 26 Angus MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945 (Toronto, Ont.: McClelland & Stewart, 1990), 47. 27 There is a vast literature that investigates the fear-ridden intersection between immigrants and disease, see Anne Emmanuelle Birn, "Six Seconds Per Eyelid: The Medical Inspection of Immigrants at Ellis Island 1892-1914," Dynamis 17 (1997). A. L. Fairchild, The Rise and Fall of the Medical Gaze: The Political Economy of Immigrant Medical Inspection in Modern America, vol. 19, Science in Context (2006). Alan M. Kraut, Silent Travelers : Germs, Genes, and The "Immigrant Menace" (New York, NY: BasicBooks, 1994). Howard Markel and Alexandra Minna Stern, "The Foreignness of Germs: The Persistent Association of Immigrants and Disease in American Society," Milbank Quarterly 80 (2002). Maglen, "'the First Line of Defence': British Quarantine and the Port Sanitary Authorities in the Nineteenth Century." Krista Maglen, "Importing Trachoma: The Introduction into Britain of American Ideas of An "Immigrant Disease", 1892-1906," Immigrants and Minorities 23, no. 1 (2005). Barbara Miller Solomon, Ancestors and Immigrants, a Changing New England (Univ Of Chicago Press, 1972). N. Molina, "Medicalizing the Mexican: Immigration, Race, and Disability in the Early-Twentieth-Century United States," Radical history review., no. 94 (2006). There is also the connect of disease to specific immigrant neighborhoods, most notably Chinatowns, see T. Fong, "Epidemics, Racial Anxiety and Community Formation: Chinese Americans in San Francisco," Urban History 30 (2003); Susan Craddock, City of Plagues : Disease, Poverty, and Deviance in San Francisco (Minneapolis: University of Minnesota Press, 2000). 28 In 1911, J.S. Woodworth would say about Canadian cities that “it is only in recent years that we are beginning to learn that the city is not a mere aggregation of independent individuals, but rather a certain type of social organism, so the physical city must be considered as a whole and the various parts must be subordinated to the whole.” In Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991), 130. To which Valverde declared this unit was also seen to be in poor health. At the same time the Civic Improvement League, who Woodworth was a member, took on “growth” and said “[t]here is no reason why we should stop the growth of cities and towns, but there is every reason we should why we should properly control that growth. It is not the fact of growth to which objection may be taken; it is the method and character of growth that is wrong, and that produces evils…We cannot prevent large cities from expanding, but we can prevent their expansion in a unhealthy way.” In Canada. Commission of Conservation. and Civic Improvement League of Canada, Civic Improvement League for Canada : Report of Preliminary Conference Held under the Auspices of the Commission of Conservation at Ottawa, November 19, 1915 (Ottawa: Mortimer Co., 1916), 11. This Civic Improvement League was highly worried over the growth of Canadian cities and made claims such as “I do not think there is any city in the world that has grown as fast as Toronto” and “Toronto has doubled its population in nine years”. In Canada. Commission of Conservation. and Civic Improvement League of Canada, Civic Improvement League for Canada : Report of Preliminary Conference Held under the Auspices of the Commission of Conservation at Ottawa, November 19, 1915, 22-23.

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29 Harold L. Platt, Shock Cities : The Environmental Transformation and Reform of Manchester and Chicago (Chicago: The University of Chicago Press, 2005), 11. Platt says: “Every age has its shock city…a centre of problems, particularly ethnic and social problems, and it provoked sharply differing reactions from visitors.” I disagree with this canary-in-the-coal-mine approach to urban history, but there is some truth in the urban shock of the lived experience. 30 Gregory S. Kealey, Toronto Workers Respond to Industrial Capitalism, 1867-1892 (Toronto, Ont.: University of Toronto Press, 1991), 291. See also Michael S. Cross and Gregory S. Kealey, Canada's Age of Industry, 1849- 1896, Readings in Canadian Social History, V. 3 (Toronto, Ont.: McClelland and Stewart, 1982). 31 J.M.S. Careless, Toronto to 1918 : An Illustrated History (Toronto: James Lorimer & Co., 1984), 200. 32 Gareth Stedman Jones, Outcast London: A Study in the Relationship between Classes in Victorian Society (Oxford: Clarendon Press, 1971), 15. 33 Friedrich Engels, The Condition of the Working-Class in Enland in 1844 (Gloucester: Dodo Press, 2007), 33. 34 Ibid., 64. 35 Engels does share many similar fears and concerns as his contemporaries: “The social disorder from which England is suffering is running the same course as a disease which attacks human beings. It develops according to definite laws. It has its crises and it is the last and most violent of these, which decides the fate of the patient. But this final crisis (which may kill a human sufferer) cannot kill an entire nation. The English people must emerge reborn and rejuvenated from this ordeal. Consequently we must welcome any circumstance which bring the disease to a climax. The Irish immigration is hastening this process because the passionate, excitable sides of the Irish character have their effects on the English workers…In the long run this union of the livelier, more mercurial and more fiery temperament of the Irish with the stolid, patient, and sensible character of the English can only be mutually beneficial…it is not surprising that the working classes have become a race apart from the English bourgeoisie…They are two quite different nations, as unlike as if they were differentiated by race.” Ibid., 139. I find this quote quite telling as it gives context the reform movement. I also find this work a clear example of what Foucault was speaking of in terms of race, for more see Michel Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, ed. Mauro Bertani, et al. (New York: Picador, 2003). I will return to other examples of this in following chapters, especially the conclusion. 36 Jones, Outcast London: A Study in the Relationship between Classes in Victorian Society, 133-134. 37 Paul Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984 (New York: New Press, 2003), 345. 38 Rodgers, Atlantic Crossings: Social Politics in a Progressive Age, 3. 39 David Ward, Poverty, Ethnicity, and the American City, 1840-1925 : Changing Conceptions of the Slum and the Ghetto (New York: Cambridge University Press, 1989), 73. 40 Jones, Outcast London: A Study in the Relationship between Classes in Victorian Society, 285-288. 41 In many places Foucault also takes degeneration. He covers the debate in France between Lamarck and Cuvier that I do not have the space to get into, see Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007), 77. Additionally, biological inferiority and improvement has a wide and varied history and not always tied to Darwin, for more see Stephen Jay Gould, "American Polygeny and Craniometry before Darwin: Blacks and Indians as Seperate, Inferior Species," in The "Racial" Economy of Science : Toward a Democratic Future, ed. Sandra G. Harding (Bloomington: Indiana University Press, 1993). 42 For an extensive review of degeneration, see Daniel Pick, Faces of Degeneration : A European Disorder, 1848- 1918 (Cambridge: Cambridge University Press, 1989). 43 Anne McClintock, Imperial Leather : Race, Gender, and Sexuality in the Colonial Contest (New York: Routledge, 1995), 46. 44 Ibid., 41-43. 45 Ibid., 47-48. For an account of speaking back to power through and with science, see Nancy Leys Stepan and Sander L. Gilman, "Appropriating Idioms of Science: The Rejection of Scientific Racism," in The "Racial" Economy of Science : Toward a Democratic Future, ed. Sandra G. Harding (Bloomington: Indiana University Press, 1993). 46 While eugenics is not the research object in this dissertation, I suggest eugenics was perhaps a beneficiary of the relationship between proliferating life and bureaucratic bio-economy. 47 Bill Luckin, "Revisiting the Idea of Degeneration in Urban Britain, 1830-1900," Urban History 33, no. 2 (2006). 48 MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945. R.A. Nye, "The Rise and Fall of the Eugenics Empire: Recent Perspectives on the Impact of Biomedical Thought in Modern Society," Historical Journal 36, no. 3 (1993); Karl Pearson, The Groundwork of Eugenics (London: Dulau and Co., 1909). M.S. Pernick, "Eugenics and Public Health in American History," American journal of public health 87, no. 11 (1997).

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E. Ramsden, "Carving up Population Science: Eugenics, Demography and the Controversy over the 'Biological Law' of Population Growth," Social Studies of Science 32, no. 5/6 (2002). Alexandra Minna Stern, Eugenic Nation : Faults and Frontiers of Better Breeding in Modern America, American Crossroads, 17 (Berkeley: University of California Press, 2005). Annie L. Cot, "'Breed out the Unfit and Breed in the Fit': Irving Fisher, Economics, and the Science of Heredity," The American Journal of Economics and Sociology 64, no. 3 (2005). Daniel Kevles, In the Name of Eugenics (New York: Knopf, 1985). 49 Dorothy Porter, "'Enemies of the Race': Biologism, Environmentalism, and Public Health in Edwardian England," Victorian Studies 34, no. 2 (1991): 161. 50 Ibid.: 168-169. 51 Francis Galton, "Eugenics: Its Definition, Scope and Aims," The American Journal of Sociology 10, no. 1 (1904). This speech was read before the Sociological Society meeting held at the School of Economics in London. The discussion afterwards included the author H.G. Wells, the playwright George Bernard Shaw and the scientist and statistician Karl Pearson. In the 1880s, Karl Pearson had become the first self-declared positivist to hold a professorship in Britain. For more on positivism see Steve Fuller, The Philosophy of Science and Technology Studies (New York: Routledge, 2006). This connection will become clearer below. 52 Galton, "Eugenics: Its Definition, Scope and Aims." 53 I do not have space to investigate a nuanced history of the differences between the professionalization of science, medicine, and social reform on both sides of the Atlantic. But Galton is integral to this professionalization through his own research into the ‘men of science’, see Victor L. Hilts, "A Guide to Francis Galton's English Men of Science," Transactions of the American Philosophical Society 65, no. 5 (1975). John C. Waller, "Gentlemanly Men of Science: Sir Francis Galton and the Professionalization of the British Life-Sciences," Journal of the History of Biology 34, no. 1 (2001). 54 Gilbert Arthur Stelter and Alan F.J. Artibise, The Canadian City : Essays in Urban History (Toronto: McClelland and Stewart, 1977), 448. 55 Robert H. Wiebe, The Search for Order, 1877-1920, The Making of America (New York: Hill and Wang, 1967). The literature on the progressive movement in quite extensive, accordingly the term is highly contested and difficult to define, see Daniel T. Rodgers, "In Search of Progressivism," Reviews in American History 10, no. 4 (1982). For more, see Ward, Poverty, Ethnicity, and the American City, 1840-1925 : Changing Conceptions of the Slum and the Ghetto. Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925. Paul S. Boyer, Urban Masses and Moral Order in America, 1820-1920 (Cambridge, Mass.: Harvard University Press, 1978). David F. Noble, America by Design : Science, Technology, and the Rise of Corporate Capitalism (Oxford: Oxford University Press, 1979). 56 Wiebe, The Search for Order, 1877-1920, 168. 57 For the history of positivism, as movement of thought, Fuller states it is “customary to distinguish between the quasi-political movement called “positivism,” originated by Auguste Comte in the 1830s, and the more strictly philosophical movement called “logical positivism,” associated with the Vienna Circle of the 1930s, both shared a common sensibility, namely, that the unchecked exercise of reason can have disastrous practical consequences. Thus, both held that reason needs “foundations” to structure its subsequent development so as not to fall prey to a self-destructive skepticism. In this respect, positivism incorporates a heretofore absent empiricist dimension into Platonism’s historically risk-averse orientation toward reality. The complexity of this history, typically forgotten by those who identify positivism with a vulgar scientism,” in Fuller, The Philosophy of Science and Technology Studies, 79. This danger is something I have attempted to avoid. I do not see liberal positivists or the health experts as demonstrating vulgar scientism. They are not self-identifying positivists. Rather I want to focus on how their acts of being anti-political and making arguments were based on correlation. 58 Ibid., 80. 59 Ibid., 80-82. Further Fuller says: “Comte thus designed positivism to replace both the church and the sovereign with scientific experts who together would function as a secular priesthood for modern society. “Sociology,” another of Comte’s coinages, referred at once to this political vision and the scientific project that would render it a legitimate form of authority.” 60 Michael James Lacey and Mary O. Furner, The State and Social Investigation in Britain and the United States, Woodrow Wilson Center Series (Washington. D.C.: Woodrow Wilson Center Press ; Cambridge University Press, 1993), 127. 61 Ibid., 142. 62 Ibid., 129. Lacey and Furner’s project focused primarily on Washington. They suggested that before Civil War, the D.C. area had no intellectual community, expect perhaps the 1846 Smithsonian. By 1904 Washington a “professional, technical, and scientific workers” as a single classification made up 15.2 percent of the total resident

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workforce which included architects, but also chemists, draftsman, illustrators, geographers, paleontologists and statisticians and a third of this was “special agents, experts, and commissioners.” 63 Boyer makes a similar assessment of this form of thinking that he calls “positive environmentalism.” This movement pushed for urban moral control through a shift from the individual to the group. This shift to groups influenced a large part of early twentieth century ideology. The task was to investigate this unity and how this movement progressed and deteriorated. Control came from the benevolent manipulation of physical and social environment. In 1912 Ellen Richards called positive environmentalism “evolution from within.” This framework, according to Boyer, could be found in John B. Watson, Frederick W. Taylor, Herbert Croly and John Dewey. The centrality of the environment in shaping human behavior and Edward A. Ross, Social Control in 1901 (who talks about the living tissue of Gemeinschaft and the screws of Gesellschaft and the only controls would be artificial), Charles H. Cooley Human Nature and the Social Order (1902), Simon N. Patten The New Basis of Civilization (1907), in Boyer, Urban Masses and Moral Order in America, 1820-1920, 215-225. Social reformers believed that a new era would emerge in how American cities would become organic cohesive social units and could not be separated. Woodrow Wilson repeated this sentiment in 1911. Reading Boyer led me to Josiah Strong who, in 1898, said: “Every organism is composed of numberless living cells which freely give their lives for the good of the organism” but if it was every cell for itself then the organism would die. The diseases afflicting American cities were the fault of cells that had not learned “great social laws of service and sacrifice” and were “introducing selfishness and disorder into the social organism”, in Boyer, Urban Masses and Moral Order in America, 1820- 1920, 255. 64 Lacey and Furner, The State and Social Investigation in Britain and the United States, 149. 65 Ibid., 155. As Carrol Wright stated in 1890, that “for the statistician must have the spirit of...ethical philosophy, the recognition of the great fundamental law, the principle which governs this world and all things in it, the principle of evolution”. But there also was a push back against this viewpoint. By 1893 President Cleveland coming into power saw this government expansion as wasteful, a Tammany Hall for scientists, see Lacey and Furner, The State and Social Investigation in Britain and the United States, 158-159. 66 Lacey and Furner, The State and Social Investigation in Britain and the United States, 132. 67 Weber claimed that the slave was seen as economic indispensible, but abolition as a political movement did have effects. His example could be debated for quite some time, but I will bracket that as a side issue, for now. 68 Max Weber, Economy and Society: An Outline of Interpretive Sociology, ed. Guenther Roth and Claus Wittich (New York: Bedminster Press, 1968), 991-992. 69 Max Weber, The Theory of Social and Economic Organization (New York Free Press, 1964), 328. 70 Ibid., 399. 71 Wiebe, The Search for Order, 1877-1920, 170. 72 Many historians of planning and cities have followed this history more closely, see Jon A. Peterson, The Birth of City Planning in the United States, 1840-1917, Creating the North American Landscape (Baltimore: Johns Hopkins University Press, 2003). Edward Relph, The Modern Urban Landscape (London: Croom Helm, 1987). Peter G. Hall, Cities of Tomorrow : An Intellectual History of Urban Planning and Design in the Twentieth Century (Oxford, UK; Malden, MA: Blackwell Publishers, 2002). 73 The Chicago School retained, in their social ecology framework, much of the focus on urban environmental conditions. But I do not have the time to get into this now. For more on the Chicago School see Robert Ezra Park, E.W. Burgess, and Roderick Duncan McKenzie, The City, The Heritage of Sociology (Chicago: University of Chicago Press, 1967). Robert Ezra Park, Human Communities; the City and Human Ecology (Glencoe, Ill.: Free Press, 1952). 74 Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925, 17-18. While the social purity movement was concerned about urban vices, its aim was not to repress, rather to re-create and re- moralize, not only the deviants but for the population of Canada as a whole. This was not suppression but regulation. Regulation connoted preserving and shaping. In Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925, 32-33. 75 Michael S. Cross and Gregory S. Kealey, The Consolidation of Capitalism, 1896-1929, Readings in Canadian Social History, V. 4 (Toronto, Ont.: McClelland and Stewart, 1983), 144. 76 Ibid., 158-159. For more see in this collection the Donald Avery chapter entitled “Immigration and Labour”. 77 Bob Jessop, "Spatial Fixes, Temporal Fixes and Saptio-Temporal Fixes," in David Harvey: A Critical Reader, ed. Noel Castree and Derek Gregory (Malden, MA: Blackwell, 2006), 153-154. See also David Harvey, The Limits to Capital (London; New York: Verso, 2006).

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The people bred on marshy coasts and low river margins, where pestilence is generated, live sordidly, without liberty, without poetry, without virtue, without science…Strangers no sooner set foot or attempt to settle on the soil than the endemic terror attacks them as if to bid them begone; and if they remain, their institutions, palaces, and monuments, fall into ruins, as the generations degenerate. —William Farr, Report on the Mortality of Cholera in England, 1848–49, 18521

The opinions of William Farr, one of the founders of health statistics, will become increasingly important in this dissertation; however, here I want to emphasize his description of the relationship between decline, degeneration, and decay. For many health experts and urban reformers, landscapes of marshlands and swamps both represented and produced the cholera crisis. As the last chapter discussed, health experts throughout the Atlantic examined the social relations that produced the cholera crisis—sick migrants and growing cities—and showed how cholera circulated through these interactions. But at the same time throughout the Atlantic, many argued that local environments, particularly marshes and swamps, were actually causing a cholera crisis. This diagnosis had a very long history that incorporated theories of disease causation such as miasma and medical topography. This chapter asks, Why did medical experts become obsessed with marshes more than any other topography, as the environment that produced cholera crisis? How did marshes and cholera become inseparable? Cholera, as a disease crisis, was a cultural anomaly. During the 19th century, cholera had a relatively low death rate and infrequent rate of occurrence. However, cholera was a massive cultural and political disturbance within Canada, North America, and the Atlantic world. The historian Bill Luckin has suggested that “cholera became enshrined as the ‘ultimate’ fever of Victorian Britain and in that sense the Victorian obsession with the infection and its causation was central to the full emergence of pollution as a major social problem in the newly industrializing society; and integral, also to that mode of thought which would, by the end of the century, come to be recognized as distinctively ‘environmental.’”2 Luckin is not alone in connecting cholera to urban pollution and environmental conditions.3 Though his argument summarizes cholera’s connection to cities and environments, he does not explain why the psyches of urban reformers and citizens were so preoccupied with cholera. This chapter will explain this by discussing why citizens and reformers were obsessed with marshland; how

Crisis Environments | 2010 | Paul Jackson | 88 marshes were connected to water and the foreign landscape of India; how medical science understood the ways ecologies produced disease; the discipline of medical topography; and, finally, how filth amalgamated all these fears.

3.1. The Marsh Fixation: Polluted, Threatening, and Foreign 3.1.1. Marshland, pollution, and water Why did marshes hold such a special place in Victorian England and Europe’s march toward civilization? According to Alain Corbin, the French historian of smell, “a whole cosmology was developed around marshes.” This marshy cosmology contained and collected hidden deposits of the unknown, along with whole hidden orders of vegetable matters, sub-soils, organic decomposition, and cycles of subterranean life.4 This hidden and murky landscape produced diseases and crises like cholera. During the 19th century, exploration and scientific knowledge began to scrutinize swamps. For some, the swamp acquired new and increasingly positive associations, such as immersion into the unknown. As both metaphor and material landscape, the swamp was a way of grappling with the unknown and coming to understand complex and contradictory experiences that could not be analyzed or understood with logic. The image of the swampy, marshy murk represented the dark side of modern progress. Mid-Victorian nature writers observed that the swamp appeared to live off its own decay and almost strangled itself by producing an excess of vegetation.5 When this decaying excess was found in cities, these associations acquired added concerns. The British reformer George Godwin conflated marsh reclamation with urban social transformation and exemplified the drive to eradicate the urban marshes. He started his 1859 book Town Swamps and Social Bridges by writing, “There are dark and dangerous places— swamps and pitfalls—in the social world which need bridging over, to afford a way out to the miserable dwellers amidst degradation and filth.” For Godwin, urban swamps both represented and fostered the breakdown of social organization. Swamps were crime, poverty, bad drainage, noxious industries, sickness, unemployment, economic distress, and disease. Swamps could also be ignorance, superstition, overcrowding, pollution, the lack of recreation and education, and especially alcohol—swamp in a cup.6 Culturally, the swamp was associated with sin, death, and decay. Swamps and marshlands became connected with urban pollution and human waste. The geographer Matthew Gandy explains the spatialization of these environments: “The ‘cesspool’ city of the nineteenth century was a place where metaphors of disease and moral degeneration mingled with the threat of women and the labouring classes to middle-class society.”7 A

Crisis Environments | 2010 | Paul Jackson | 89 cesspool marshland was ambiguous and it contradicted the social reformers’ notions of what a modern city should be. Urban marshes were feared because they represented what Gandy calls the urban uncanny, “a spatial defined sense of dread.” Gandy uses Freud to unpack fear in cities: “The urban uncanny is a spatial fetishism of absence, a mythological response to the unseen and the unknown, which weaves together popular misconceptions of how cities function with dominant ideological response to urban disorder.”8 The emphasis on visibility was a common concern. In marshlands, pollution and sewage could be seen in the water, but diseases like cholera were “unseen.” For health experts the swamp was a potential site of sickness where disease could originate and travel invisibly through sewers and water systems. Even before cholera’s water vector was discovered and proven, both citizens and health authorities feared sewers, urban rivers, pumps, even water itself.9 Accordingly, reformers became fixated on the problem of water and waterways. The argument from Canadian Dr. Robert Godfrey in his 1866 speech “Cholera: A Few Practical Remarks on its Prevention” is an example: Every casual observer must have noticed that cholera travels inland, along the different navigable rivers and canals…cholera is propagated and spread principally through the water, which has been contaminated by diseased egesta [feces] from a cholera patient, and I consider that this choleraic poison, when thrown into water, increases its contagious power so rapidly as to effect a river for miles down.10

Godfrey recognized that since immigrants travelled along rivers and oceans, disease outbreaks seemed to follow this water-based transportation system.11 However, according to Godfrey, these migration patterns were not the problem; instead, it was the waterfront landscape that spread the disease and increased its power. Healthy drinking water was possible, but only if municipalities had the political will and economic funding to clean the water or mount an education campaign to boil the water. However, this rationale could not eliminate the persistent fear that accumulated myths and conjecture engendered. Mere proximity to water led to fearful associations. As Maria Kaika has explained, a discursive construction took place between good water (clean, processed, controlled) and bad water (dirty, metabolized, non-processed). While Kaika explores the new clean spaces that were created in association with good water, the phobia of bad water and waterways helps to explain cholera’s role in the eradication of all sites associated with bad water.12 In times of cholera, every river, well, lake, and water cart was in need of reform. Since marshlands were an ambiguous landscape—part land and part water— they were targeted for eradication by urban reformers.

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3.1.2. Marshland as foreign landscape In the drive for water and sanitary reforms, cholera was continuously associated with the landscape and environments of India. While the previous chapter touched on the religious pilgrimages of India as the source of the international cholera pandemics, India’s landscape itself was believed to have brought forth this disease. In its very name—Asiatic cholera—the disease was represented as inherently foreign. And foreign was feared. In England, environmental sanitary reformers, such as Sir Edwin Chadwick, decried India’s “natural propensity” for disease and cholera. John Snow, who discovered cholera’s water vector, at the same time, told the London Privy Council that cholera came from the “eastern centres of its habitual dominion…from the alluvial swamps and malarious jungles of Asia, where it was first engendered amid miles of vapourous poisons, and still broods over wasted nations as the agents of innumerable death.” It was believed that the marshes and swamps constituted the entire nation of India.13 As William Sanderson, a London doctor and urban reformer, said in 1866: Cholera is known to have originated in India, which has long been well- populated…Cholera could originate only in dense masses of population depositing excreta and other animalized matter over surfaces, from which it is carried by the percolation of the rainfall to the sources of the water supply.14

For doctors and health authorities, India was constructed as cholera’s environment niche, an interconnected relationship of urban density, population, and waste. Sanderson and his peers saw this niche as pre-given, almost natural, and deeply connected to a specific place: a British colony and a culture. Throughout the medical journals of the 1800s, authors blamed the people of India for their poor sanitation, and the reports included repeated references to the burning and disposing of dead bodies into the Ganges. No matter where the cholera epidemics broke out, local health experts repeated that cholera’s source was in India. Therefore, India’s people and culture were also to blame for the very ecology that “gave birth” to cholera. An account of cholera’s origin by John A. Benson, a professor of physiology in Chicago, offers the most egregious example of this fear mongering. In 1893, Benson illustrates the unrestrained imagination of the period. Benson’s cholera creation myth begins in the marshland: Up from the dark Plutonian caverns of Erebus, up from the clouded Stygian valley, up from the depths of hell, in the early part of this century, arose the Goddess of Filth, and she wandered around over the face of the globe, seeking for a home to her liking. And coming to the delta of the Ganges, in this low, insalubrious and festering locality, where so many noxious and noisome diseases are generated, and where so many epidemics have arisen and so often swept over the earth with most fatal and desolating effects,—here she met, on dark and stifling nigh, with gaunt Despair. And surrounding her with his bony arms,

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Despair threw her on the foul, dark and slimy ground, and had his will of her. And when the day of her reckoning was reached, here in the neighborhood of Jessore—a town in the center of the delta—in agony and in shame and in desolation, Filth gave birth to the monstrosity yclept [by the name of],—Asiatic cholera. And here she nurtured and fed him, here in this vast pest-house where every conceivable vegetable and animal substance is left upon the soil to rot in the heat and dews of a tropical climate,—here Filth fed her offspring from her own breasts, and as he grew and waxed strong, and his tusks and teeth appeared so that he would chew and tear her dugs, she longed to wean him, and one day as he ferociously fastened himself upon her, she cast him away on the mud, and as his mouth was forcibly torn from the dug, some of her foul milk was scattered around, and falling into the water of the Ganges, as drops, was at once coagulated by the water, and became—the Spirilla Cholerae Asiaticae[sic].15

The quote evokes the themes circling around cholera—India and orientalism; mythical gods and fear; ecology and environment—and ends with a scientific definition. Jessore in Bangladesh was considered to be the endemic origin of cholera, but Benson’s completely mystifying portrayal obscures the science that did exist at the time. This fiction was written in 1893. Robert Koch had discovered the cholera bacterium ten years before, and decades previously Dr. Snow had discovered cholera’s transmission through water. Benson’s book was engaged with and reviewed and, while extreme, his rhetoric indicates some of the widespread assumptions held by health experts. The question for me is, Why did he rely on this mythology of Hindu gods? My suspicion is this “origin” myth was based on fear, an imaginative history written at the end of the western pandemics. As Foucault explains (cited in chapter 1), this “origin” assigned a cause or a root to these crises. London and Toronto had to deal with the effects of the disease whose ultimate cause originated in India. The origin myth made history and current events understandable, and it overlapped with the fears of migrating pilgrim Indian populations (see chapter 2). Myths and theories such as these persisted for very political reasons. My claim is that this myth was built on more than a century of health authorities focusing on the environmental conditions that produced disease outbreaks, and it supported a view of the landscapes of India as productive of un-earthly “evil.” According to these assumptions, all local marsh ecologies were foreign, filthy, and cholera-friendly. As the historian Pamela K. Gilbert explains, all “low-lying, damp areas in England were seen as unhealthy and vulnerable to colonization by disease” because of the connections to “India, and the people and behaviors that were mapped onto the land, were considered by many to constitute an ecological entity productive of evil.”16 These marshy evils were conflated and intertwined; however, this conflation was not dependent on specific

Crisis Environments | 2010 | Paul Jackson | 92 scientific knowledge, but on superficial observation. The British social reformer Henry Mayhew could then call Jacob’s Island in the East End the “very capital of cholera, the Jessore of London,” because this island epitomized his “image of an English India, or an Indian England, an environment whose filth causes an exotic change in the inhabitants’ complexions.”17 The foreign nature of the swamp became a highly visible symbol that was localized and naturalized into the city. Accordingly, every marsh exemplified “a boundary experience with its spatiality rooted in anxieties of displacement and disorientation,” a zone “between the rational and irrational, nature and culture, male and female, the visible and invisible.”18 From the reports and literature of the time there was something that resembled a race to the bottom as each city claimed to be the filthiest, the most stagnant, the most in need of transformation. In response to the cholera outbreak, the Montreal Board of Health stated, “Perhaps there are few other cities more exposed to the operation of all the causes which create or aggravate such disease. Low and marshy grounds, stagnant waters filled with all the elements of miasma (pestilential effluvia), in circumstances most favourable to their malignant influences meet us in every part of this city.”19 The Ganges environment of the marsh became the model from which to examine all local conditions. These correlations helped to explain local ecologies. Utilizing the science of miasma and the practices of medical topography to diagnose the local environment as capable of producing a cholera crisis made this comparison possible.

3.2. Cholera as a Force of Nature Since the time of Hippocrates, medical practitioners had hypothesized on how the environment affected the health of a human body. Climate and place were seen to have vital influences on human health; however, the debate was over how these processes worked. Long after these ancient Hippocrates health practices were discredited, this environmental tradition survived through the miasma theory of disease.20 The miasma theory, that disease was a smell or vapour, persisted partly because the concept remained largely undefined. Miasma was a large umbrella term that sheltered a variety of theories. Health practitioners leading up to the mid-19th century saw diseases as tendencies or inclinations that were brought about by environment forces (rather than the current view that disease is caused by agents, such as micro-organisms and viruses). This miasma theory led to specific methods of diagnosis, but the practices never quite hardened into a discipline. Colonialism and imperialism deeply shaped British and European ideas of disease causation and these ideas were slowly and haltingly constructed.21 A constant concern was how a new climate affected the health and bodily integrity of a European settler. Some

Crisis Environments | 2010 | Paul Jackson | 93 aspects of these practices did take on an institutionalized cast—for example, Dr. Syndenham’s medical meteorology examined the air conditions of England in relation to disease—but, in general, these practices and theories were speculative and formed on an ad hoc basis. Miasma is a particularly useful illustration of this process. Heath experts came to understand cholera through the miasma theory. The miasma theory claimed that disease was a fog, a stain, or a vapour. Perhaps the most famous example comes from malaria, an Italian contraction of mala aria or bad air. Originally, malaria suggested that the exhalations of marshes caused an unwholesome atmosphere.22 The miasma theory hypothesized that diseases could arise spontaneously from local environments given the correct ecological conditions. As William Farr, who long supported much of the miasma theory, stated in his 1868 report on the origin of cholera: Like species of the animal kingdom plagues lie hidden in the strata of past history; they live, they flourish, they perish like organic forms, because they are in their essence successive generations of organic forms at enmity with the corpuscles of which the human race consists. If the algid cholera can be spontaneously generated in Asia, why…not…in Africa, in Europe, in America? We know the summer cholera is generated in London…Why resort to the theory of importation?23

For Farr and many others, cholera arose from the ground. But like many arguments of the time, miasma was articulated as a counter theory to contagion. For the proponents of miasma theory, disease was always a local problem. Miasma claimed cholera was not born in the swamps of India and carried to England, but rather every marsh could be its birthplace. These miasma scientists gathered evidence to show how cholera had a predilection to certain environments: damp low-lying areas; neighbourhoods located near water; and areas along rivers, streams, or canals. Cholera appeared to come with the summer season; after each winter, there was the fear that a new epidemic would return as the summer climate grew. These environmental disease theories connected cholera to hydrology and geology, declaring that cholera had an affinity to water and marshy soils. According to this environmental perspective, each force of nature was given a natural etiology (the manner in which diseases are enabled or caused by forces such as water, electricity, and soils). The hydraulic origin of disease claimed that wind, rain, and fog caused cholera and that that India’s rainy season was responsible for the arrival of cholera.24 The electrical etiology was also connected to water and suggested that, since cholera spread along canals and rivers and since electricity also had an affinity to water, electricity caused cholera.25

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The geological etiology emphasized the relationship between water and “ternary or alluvial soils,” a landscape composed of gravel, sand, or porous limestone. This conclusion came from evidence that all the areas that had experienced cholera outbreaks were on the alluvial terrain. The solution was a belief that paving these terrains would decrease mortality rates. That the cholera epidemic passed by wealthier areas that happened to be paved was seen as proof by many authorities that cholera was associated with alluvial terrain.26 To institute a healthy city, health reformers would have to eliminate all the ecological relationships that fostered disease. This theoretical perspective suggested that local environments and sanitary conditions were the reasons why a cholera crisis broke out. However, these disease sciences cohered around miasma only for a time. The historian Francois Delaporte has documented how the sanitary movement (a general term for groups throughout Europe and North America who instituted urban reforms on the basis of cleanliness) began to dispute purely environment perspectives. This sanitary critique shifted the focus toward cleaning up urban living conditions and homes that were thought to enable disease outbreaks. According to the claims of the sanitary movement, a disease relationship tied together the patient to the filthy environment. During the 19th century, hygienist literature began to increasingly reject the environment basis of disease and the long Hippocratic traditions that gave this framework weight.27 While slowly rendered obsolete, the themes of hydrology and soils did not disappear. After the 1830s, an institutional shift took place in the sanitary movement in France and beyond, from the Hippocratic tradition that singled out factors such as air, sunlight, and dwelling toward human habitats that fostered disease. The sanitarians then attempted to institutionalize new practices to clean, manage, and design away the harmful effects of filthy urban living conditions had on human bodies.28 Despite these developments in science and urban reform, the fixation on marshland and filthy water, along with the solution to pave these unhealthy environments (as will be shown in chapter 8) persisted well into the 20th century.

3.3. The Science of Medical Topography Medical topography was one medical practice that arose from health experts’ obsession over unhealthy local environments. Medical topography investigated how and why certain towns, or areas of towns, were unhealthier than others. Proximity to water was a frequent explanation for poor health. The most popular type of medical topography was an investigation of one town or region through the finely detailed description of the physical geography, the climate, the plants and animals, sources of water, products of the area, ways of life, occupations, size and layout of

Crisis Environments | 2010 | Paul Jackson | 95 the town, number of residents, and birth and death rates. This method was a style of medical writing. The majority of medical topography books, articles, and reports were produced during the 19th century and, by the 1880s, this style was on the wane.29 Nevertheless, since this style was dominant during the settlement of Canada, I suggest that this established how the Canadian colonialist related to the natural landscape, and later how the growth of cities and industry fit into this landscape. Knowledge of the colonial periphery became central to the formulation of western environmental ideas. Since surgeons were on many of the exploration vessels, these concepts included how exposure to new environments influenced human health.30 Medical topography had a vital part in these developments and provided some of the foundational methods for many of the biggest names in 19th-century health science such as Drs. Chadwick, Snow, Virchow, and Pettenkofer.31 The first documented “diagnosis” of Ontario and Toronto took the form of a medical topography. Dr. John Douglas’ Medical Topography of Upper Canada chronicled his time as a British surgeon assigned to Canada during the War of 1812. This document was not written for the colony of Upper Canada; rather, the book was published in London to help other British military campaigns. The report built on previous medical assessments of local environmental conditions around the world. Douglas did not contribute any new insights on the relationship between disease and physiography. He was an observer and described the connection between marsh areas and disease without any direct allusions to any theoretical framework. Nevertheless, Douglas demonstrates how medical experts related to the natural landscape. Consequentially, my claim is this report represented how future Canadian doctors came to understand where they lived. In his diagnosis, Douglas was worried about the sheer amount of water in Upper Canada, with all its lakes, marshes, and numerous rivers. He worried that the land was flat and marshy, abounding with “noxious effluvia.” The waters rose, fell, and flooded. Pools of water, mist, and fog were constant. When speaking about the settlements on Lake Ontario (such as Toronto), Douglas wrote: “Settlements adapted to commercial intercourse prove often unhealthy to their inhabitants. Placed as they generally are on the banks of oozy streams and stagnating rivers; in certain seasons of the year, they contribute materially to the production of sickness.”32 Douglas decried how marshy and natural Toronto was and that in the “sickly seasons the inhabitants of [Toronto] are liable to be attacked by intermittent fever.” Douglas claimed that the sun decomposed the humid soil of Upper Canada and this produced diseases. There was an “evident analogy” between each season and attending diseases; for example, catarrah and pneumonia

Crisis Environments | 2010 | Paul Jackson | 96 came in the springtime.33 Douglas reported that due to the oppressive heat in the summer, the landscape of Toronto and Ontario was almost like a tropical country. The area abounded with “musquitoes” and “the earth swarms with innumerable tribes of insects; and the loose vegetable mould, when exposed to view, exhibits many forms of organized life, not only in passing being, but undergoing a putrescent revolution. The sun, thus operating on a humid soil, and completing the decomposition of so great a mass of organized matter, tends to the production of those diseases by which men, whose constitutions have not been assimilated to the climate, are always liable to suffer.”34 His diagnosis of the region was totalizing: [T]here are few situations in Upper Canada which do not abound with marsh- miasmata, and in which remitting and intermitting fevers are not to be found; and that these fevers are endemic to all those districts of the province, which I have mentioned are being visited by sickness, or to which I have the appellation unhealthy.35

For Douglas, the entire landscape of Ontario produced sickness. Douglas was concerned by what the settlers of Canada called “Lake Fever,” which was thought to come from putrid animal and vegetable exhalations. Even though these exhalations were invisible and chemical analysis had not detected their presence, Douglas claimed: The effect of marsh-miasmata on the human body, is sometimes instantaneous. When marching through an unhealthy tract of the province, I have seen men, who had recently joined the army, suddenly seized with the symptoms of fever. Nausea, lassitude, giddiness, and confused vision…For the most part the human body appears to be insensibly impregnated with marsh-miasmata, and it may be filled with a certain quantity of the poison for a considerable time with producing the symptoms of disease.”36

In this chapter, I claim that this initial assessment of Toronto’s waterfront landscape persisted throughout the rest of the century. Throughout the 19th century, health reformers and politicians repeated the relationship between marshland and sickness, and the reason marsh needed to be eliminated for a general, unspecified, city-wide health (see chapter 8 for Toronto’s marsh reclamation). This view of the landscape remained even though the science behind it changed, infrastructures changed, and cities were built. Many have discussed how the British always assessed their colonies as being inherently sick.37 Canada was no exception. The swampy landscape of Toronto sparked an uncanny feeling of unease and a deep-seated fear of the uncontrollable.

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3.4. Conclusion: Filthy Environments The mucky, watery soil in the marsh also epitomized a particular disease-producing object: filth. Filth was an intermediary between invisible diseases and gasses, and the immenseness of the local swampy landscape. Filth became a vehicle that allowed health experts to simultaneously believe in multiple disease theories, along with moral and aesthetic disgust. Filth could be applied to anything. Filth and cholera enabled each other. Cholera lived in filth. Cholera eroded the borders between filth and the body, as the disease worked under the “logic of material disintegration.” Cholera forced the body to break down, to stop working, and to eliminate vital, albeit filthy, fluids.38 George Godwin—a British architect, journalist, and social reformer— framed disease in this manner: [T]here are certain diseases, of which it is hardly a metaphor to say, that they consist in the extension of a putrefactive process from matters outside the body to matters inside the body—diseases of which the very essence of filth, —diseases which have no local habitation except where putrefiable air or putrefiable water furnishes means for their rise or propagation,—diseases against which there may be found a complete security in the cultivation of public and private cleanliness.39

Filth was not merely passive, rejected waste. Filth was “animated and hostile.”40 Filth was thought to carry and enable cholera. Disease particles lived in filthy piles of rubbish. Municipal government’s core task in the Victorian period was the removal of these decaying matters.41 How filth became animated required scientists to find a different way of medically diagnosing the social relations that lead to a disease crisis. As scientific practices developed into more microscopic spheres, zymosis (a more detailed description of zymosis will come in the next chapter) became the bridge theory that retained an emphasis on filth and the environment of disease, but also incorporated how entities, like germs, could travel.42 The fear of rotting matter was immense and disease was the rotting product of the putrefaction of environmental filth. The historian Christopher Hamlin explains how putrefaction was seen as the “quintessential pathological process” in this period: In a gangrenous wound, the colon of a cholera victim, or the lungs of a consumptive, a similar process of decay of the fabric or fluids of the living body was occurring. This internal decay was thought to have been induced by material outside the body undergoing an identical form of decay. No one could tell when putrefaction was in its pathological mode, nor how small a dose might be dangerous; the sanitarian’s task was therefore to remove decomposable matter and also to prevent its decay. In this way, zymotic analogy both explained pathological change and guided sanitary improvement.43

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Filth was both defined by and enabled putrefaction and decomposition. Filth was the medium for the propagation of the disease germs. On another level, for the zymotic physiologists, disease occurred when parts of the internal body rotted because of the retention of wastes. Disease was a result of the interruption of the flow of matter, poor management in the body, in other words.44 This filth contained a micro-ecology whose putrefying interactions were based on chemical catalytic forces described by the German chemist Justus von Liebig. Liebig, the Darwin of his day in terms of influence and cultural change, extolled the virtues of good waste management in order to guide the formulation of technical alternative for British sanitarians. The combination of chemistry with public health and organic recycling, as Hamlin says, represented providence and could turn “curses into blessings.”45 But if this excess could be channelled toward agriculture then, “praise be.”46 Filth was totalizing: pollution, disease, swamp, privy pit, and street waste. By the end of the 19th century, science and medicine narrowed their focus into the causes of disease. Instead of tackling the intersecting influences—from the environment to natural forces to topographies to foreign marshlands to water systems to filth—science would emphasize the germs, bacteria, and micro-organisms. Two questions that became common to ask during the 19th century were, How did these environmental forces enable a health crisis such as cholera? Who or what was to blame? For a time, the European and the colonial authorities came to a de facto consensus: swamps and marshes were a liability and must be eliminated. Even with this consensus, I find it fascinating that the arguments over and documentation of the evidence of the unhealthy marsh continued. Why did the argument for the elimination of marshes need to be continuously repeated? This focus on the environment persisted and informed the eradication of Toronto’s marsh, known as Ashbridge’s Bay (see Figures 3.1, 3.2, 3.3. The reclamation of this marsh will be covered in chapter 8). The reputed benefits of removing the marsh were assumed to be facts. Marshes were rotting the city. Cholera was rotting the body. Degeneration was rotting the civilization. As we shall see in the next chapter, science sought to provide facts that would explain the relations that turned this “rot” into a crisis.

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Figure 3.1. Ashbridge's Bay, looking southeast. City of Toronto Archives. Fonds 200, Series 376, File 4, Item 70. October 3, 1904.

Figure 3.2. Ashbridge's Bay, looking northeast from north bank of cut. City of Toronto Archives. Fonds 200, Series 376, File 4, Item 63. October 3, 1904.

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Figure 3.3. Ashbridge's Bay, looking east. City of Toronto Archives. Fonds 200, Series 376, File 4, Item 71. October 3, 1904.

Endnotes

1 John M. Eyler, Victorian Social Medicine (Baltimore: Johns Hopkins University Press, 1979), 156. This is a direct quoted from William Farr, Report on the Mortality of Cholera in England, 1848-49. (London: W. Clowes, 1852), xcvi-xcvii. 2 This quote was taken from Harold L. Platt, Shock Cities : The Environmental Transformation and Reform of Manchester and Chicago (Chicago: The University of Chicago Press, 2005), 62. These environmental tendencies were also being discussed and tackled in the cultural and literary realms, however I do not have space to go into this, see L. Jordanova, ""A Slap in the Face for Old Mother Nature": Disease, Debility, and Decay in Huysmans's a Rebours," Literature and medicine 15, no. 1 (1996). 3 For a great overview, see Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854 (New York,: Cambridge University Press, 1998). Pamela K. Gilbert, Mapping the Victorian Social Body, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2004). 4 Alain Corbin, The Foul and the Fragrant : Odor and the French Social Imagination (Cambridge, Mass.: Harvard University Press, 1986), 33-34. 5 David C. Miller, Dark Eden : The Swamp in Nineteenth-Century American Culture (New York: Cambridge University Press, 1989), 3-10. 6 George Godwin, Town Swamps and Social Bridges (New York: Humanities Press, 1972), 15. In fiction and culture, see Gilbert, Mapping the Victorian Social Body. Pamela K. Gilbert, Cholera and Nation : Doctoring the Social Body in Victorian England, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2008). Tina Y. Choi, "Writing the Victorian City: Discourses of Risk, Connection, and Inevitability," Victorian Studies 43, no. 4 (2001). 7 Matthew Gandy, "Rethinking Urban Metabolism: Water, Space and the Modern City," City 8, no. 3 (2004). 8 Matthew Gandy, "The Paris Sewers and the Rationalization of Urban Space," Transactions of the Institute of British Geographers 24, no. 1 (1999): 36.

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9 The water vector was proven, through a variety of methods, but Snow’s discovery through medical mapping of the infected water pump was the most famous. For more, see K.S. McLeod, "Our Sense of Snow: The Myth of John Snow in Medical Geography," Social science & medicine (1982) 50, no. 7-8 (2000). 10 R.T. Godfrey, "Cholera: A Few Practical Remarks on Its Prevention. (Speech Read before the Montreal Medico- Chirurgical Society January 26th 1866)," Canadian Medical Journal and Monthly Record of Medical and Surgical Science 2 (1866): 344. Godfrey also says that “These circumstances, with many others, have convinced me that cholera is propagated and spread principally through the water, which has been contaminated by diseased egesta [feces] from a cholera patient.” This corresponds with how cholera is transmitted and shows how, even in 1866, many experts maintained that marshland didn’t cause cholera, well before 1883 and 1892. While this position contradicts many of the assertions in this chapter, it also shows there was not one truth. 11 Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980), 46. 12 Maria Kaika, City of Flows : Modernity, Nature, and the City (New York: Routledge, 2005). 13 Vijay Prashad, "Native Dirt/Imperial Ordure: The Cholera of 1832 and the Morbid Resolutions of Modernity," Journal of historical sociology. 7, no. 3 (1994): 251. 14 Gilbert, Mapping the Victorian Social Body, 145. 15 In Erin O'Connor, Raw Material : Producing Pathology in Victorian Culture, Body, Commodity, Text (Durham, N.C.: Duke University Press, 2000), 21. Now I could be more generous about this position and suggest how the role of gods can have a place in history. For more on this position, see Dipesh Chakrabarty, Provincializing Europe : Postcolonial Thought and Historical Difference, Princeton Studies in Culture, Power, History (Princeton, N.J.: Princeton Univ. Press, 2008), 75-78. Chakrabarty says that “gods are as real as ideology is—that is to say, they are embedded in practices.” While these are different gods for different purposes, the cholera “gods” were more like feared racial stereotypes, that also get embedded in practices. 16 Gilbert, Mapping the Victorian Social Body, 145. 17 O'Connor, Raw Material : Producing Pathology in Victorian Culture, 47. 18 Gandy, "The Paris Sewers and the Rationalization of Urban Space," 34. See also David Sibley, Geographies of Exclusion : Society and Difference in the West (London: Routledge, 1995). Peter Stallybrass and Allon White, The Politics and Poetics of Transgression (Ithaca, N.Y.: Cornell University Press, 1986). 19 Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, 33. 20 The miasma theory claimed disease outbreaks were causes by fogs, gasses, or even smell. 21 The story of combating cholera paralleled the institutionalization of medical science in government, see Margaret Pelling, Cholera, Fever and English Medicine, 1825-1865, Oxford Historical Monographs (New York: Oxford University Press, 1978). Anne Hardy, "Cholera, Quarantine and the English Preventive System, 1850-1895," Medical history 37, no. 3 (1993). Additionally this framework was applied to the colonies, see Nigel Paneth, "A Rivalry of Foulness : Official and Unofficial Investigations of the London Cholera Epidemic of 1854," American journal of public health. 88, no. 10 (1998). M. Ogawa, "Uneasy Bedfellows: Science and Politics in the Refutation of Koch's Bacterial Theory of Cholera," Bulletin of the History of Medicine 74, no. 4 (2000). Sheldon Watts, "Cholera and the Maritime Environment of Great Britain, India and the Suez Canal: 1866-1883," International Journal of Environmental Studies 63, no. 1 (2006). 22 Malaria’s cause was later found to be a parasite, transmitted by mosquitoes. 23 Gilbert, Mapping the Victorian Social Body, 149. 24 This argument correlated how European cities experienced stormy weather, fog, or dampness just before an outbreak. Evidence was also gathered that cholera was not found in dry and elevated spaces in Europe. For sick patients the pathological hypothesis was that the damp atmosphere stopped the body from perspiring. The body’s vital heat was unable to escape and thus resulted in choleric symptoms. 25 The proof for this theory was that the choleric body experienced “voltaic spasms”, apparently due to electrical currents coursing through the body. 26 Francois Delaporte, Disease and Civilization: The Cholera in Paris, 1832 (Cambridge, Mass.: MIT Press, 1986), 87-89. 27 Ibid., 85. 28 Nancy Tomes calls this group “domestic sanitarians.” During the 1870s and 1880s, this distinct group medicalized households by drawing organic metaphors in relation to the health of human bodies. They created “house diseases” that were found in physical structures, but also whose responsibility fell on women to eradicate these sources. Germ theories became pivotal and shifted the perspective between the metaphorical representations of the body, the house, and the environment. By the second half of the 19th century these were primarily naturalistic terms. The city, as natural or organic system, had become a standard trope. Chadwick regularly said sewage and water pipes were like the body’s circulatory system of arteries and veins. Victorian miasmic theories centered on

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improper disposal of the body’s wastes, with three corresponding sets of circulatory systems of consumption and removal. This further dissolved the boundary of body, house, and city. As typhoid replaced cholera in the 1880s and 1890s, germs were seen to be everywhere. Science had deprived the sight and smell; detection and segregation did little against microscopic germs. In Platt, Shock Cities : The Environmental Transformation and Reform of Manchester and Chicago, 306-307. 29 Caroline Hannaway, "Environment and Miasmata," in Companion Encyclopedia of the History of Medicine, ed. W. F. Bynum and Roy Porter (London; New York: Routledge, 1993), 301-302. As we saw in the last chapter, mostly notably the huge report in early 1890s on India, still looked at the environmental topography in relation to health, see Edward O. Shakespeare, Report on Cholera in Europe and India (Washington: Government Printer Office, 1890). I will show how this perspective persists throughout this dissertation. 30 Richard H. Grove, Green Imperialism : Colonial Expansion, Tropical Island Edens, and the Origins of Environmentalism, 1600-1860 (New York Cambridge University Press, 1995). Grove’s argument is the colonial experience is vital to the formation of western attitudes and critiques of the environment. The seeds of modern conservationism developed as integral part of the European encounter with the tropics, along with local classifications and interpretations of the natural world. Grove suggests that just as Europe expanded into new territories, now placed under its economic yoke, this also opened up new mental domains and new imaginations of nature. Warwick Anderson agrees and claims that disease ecology grew from settler colonial anxieties, see Warwick Anderson, "Ecology and Infection - Natural Histories of Infectious Disease: Ecological Vision in Twentieth-Century Biomedical Science," Osiris. 19 (2004). 31 George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993), 155. 32 John Douglas, Medical Topography of Upper Canada (London: 1819), 5. 33 Ibid., 6. 34 Ibid., 9. This section is also very evocative in descriptions of proliferating life—in this case within and at the landscape scale—that I will get into later in this work. 35 Ibid., 15. 36 Ibid., 22. 37 The best example of this argument can be found in Grove, Green Imperialism : Colonial Expansion, Tropical Island Edens, and the Origins of Environmentalism, 1600-1860. See also: David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: University of California Press, 1993). Anne McClintock, Imperial Leather : Race, Gender, and Sexuality in the Colonial Contest (New York: Routledge, 1995); Vijay Prashad, "The Technology of Sanitation in Colonial Delhi," Modern Asian Studies 35, no. 1 (2001); Mark Harrison, "Quarantine, Pilgrimage, and Colonial Trade: India 1866-1900," Indian Economic and Social History Review 29 (1992). For the USA, see Warwick Anderson, Colonial Pathologies : American Tropical Medicine, Race, and Hygiene in the Philippines (Durham: Duke University Press, 2006). 38 O'Connor, Raw Material : Producing Pathology in Victorian Culture, 49. See also Christopher Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," Victorian Studies 28, no. 3 (1985). 39 Godwin, Town Swamps and Social Bridges, 69. 40 Gilbert, Mapping the Victorian Social Body, xii. 41 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease." p.382. 42 Chapter 2 dealt with international transmission and movement of disease. 43 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," 383. 44 Ibid.: 406. See also Erik Swyngedouw, "Metabolic Urbanization," in In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, ed. Nik Heynen, Maria Kaika, and Erik Swyngedouw (London; New York: Routledge, 2006). Over Ashbridge’s Bay, the retention of these flows became major concern for engineers and health reformers, as we shall see in chapter 8. 45 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," 410. 46 For a discussion of night soil collecting, see also Gandy, "Rethinking Urban Metabolism: Water, Space and the Modern City."

Crisis Science | 2010 | Paul Jackson | 103 Chapter 4 – Crisis Science: Zymosis and the Definition of an Epidemic

Fact: Cholera travels across the Atlantic Ocean in a fog. Fact: Cholera is a vapor that sticks to your body. Fact: Cholera comes from touching a stranger. Fact: Cholera is activated when lightening strikes water Fact: Cholera happens by inhaling bad air in bad places. Fact: Cholera is because Indian and Muslim pilgrims are dirty and heathen. Fact: Cholera comes from dirty water. Fact: Cholera is caused from drinking alcohol. Fact: Cholera is cured by drinking alcohol. Fact: Cholera lives in dirty baggage and rags. Fact: Cholera lives in sandy soils. Fact: Cholera can arise spontaneously from street garbage. Fact: Cholera was birthed by Hindu Gods. Fact: Cholera is due to internal organs disintegrating.

“Facts are stubborn things.” —V.I. Lenin1

In the early 19th century when cholera began infecting Europe and North America, medical experts produced “facts.” People got sick and people died, but no consensus was reached over why or how. Hypotheses were plentiful. Debate was constant. Prescriptions came from everywhere. Facts proliferated.2 Above, I’ve listed a sample of 19th-century views on cholera. As the century progressed, the cause of cholera remained unknown and the fundamentals of disease transmission had yet to be settled upon. Every time an outbreak happened, disease theories shifted and new hypotheses emerged. The rules of science and medicine were continually reshaped. This chapter explores how scientific experts engaged with cholera.3 Proponents of specific disease theories, such as miasma and bacteriology, competed for ideological dominance.4 This chapter interrogates these shifts in scientific thought and practice, but not to show how the current dominant version of science, what many would now call the correct version, came to be. Instead, this chapter investigates why a particular theory of disease, zymosis, endured. The theory of zymosis helped to describe how a disease became an epidemic. According to this theory, an epidemic was the result of ferments or exciters that activated biological forces, and these processes together produced a health crisis. Scientists’ thought that unseen chemical interactions worked on benign forms of life and that these forces produced a highly virulent agent of death. Zymosis explained how diarrhea could be transformed into an Asiatic cholera pandemic. Zymosis endured because the theory was flexible and provided a clear causal explanation that could be applied to the material world. Currently, scientists believe

Crisis Science | 2010 | Paul Jackson | 104 that the zymotic theory is completely wrong.5 However, my argument is that zymosis endured because the theory explained how a disease crisis came to be. In order to illustrate why zymotic imagination was so potent, I will need to outline how different disease theories accumulated over time and how different scientific debates added to confusion around cholera outbreaks. Confusion reigned over the science of cholera partly because cholera was merely one of the many diseases that afflicted Atlantic cities in the mid-to-late 1800s.6 Local endemic diseases, especially “filth diseases” associated with cholera, such as diphtheria, diarrhea, dysentery, typhoid, croup, bronchitis, pneumonia, and tuberculosis, were a part of daily life. For scientists, doctors, and urban reformers, the sheer variety of diseases led to debate over diagnosis and treatment. One of the definitive works prior to the cholera outbreak of 1892 was Wendt and Peters’ A Treatise on Asiatic Cholera. This treatise acknowledged Koch’s recent discovery of the cholera bacilli, but stated that the “essential exciting cause” that made the disease an epidemic was still unknown.7 Wendt and Peters then outlined all the valid, but competing, theories on the cause of cholera: The Water-Miasm Theory of Bayer The Fermentation Theory The Excrementitious-Poison Theory of Snow The Cholerine Theory of Farr Kiehl’s Theory Johnson's Blood-poison Theory Theory of Ilisch—Decomposing-Dejections Bryden’s Monsoon Theory The Organic-Dust Theory of Von Gietl

I assert that the confusion and lack of scientific consensus over what caused cholera did not inhibit reforms. Rather, this uncertainty was productive, as the confusion enabled a wider variety of programs, technologies, and invasive practices to be instituted. During each outbreak, blame for the epidemic became abstracted into a variety of disease theories. Was cholera spread through immigrants who carried the disease into new cities (contagion theory seen in chapter 2)? Or were there elements inherent to local ecological conditions that fostered cholera, allowing disease to burst forth (miasma theory seen in chapter 3)? We now know cholera was imported into counties and cities in the digestive tracts of travellers, who then contaminated the local water supply with infected fecal matter. That the cholera was a local problem that had been introduced by international connections was responsible for the disease’s ambiguity. My claim is that this theoretical ambiguity allowed reformers to deploy various, indeed even conflicting, health recommendations for political ends any time it was opportune.

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4.1. History of Cholera Science: Theories, Disciplines, and Paradigms The transition from one scientific tradition to another is never smooth or distinct. During the 1880s, the discovery of bacteria did not automatically eliminate existing ideas or theories of disease from the disciplines and the many supporting professions of medicine. Rather, scientific facts were mobilized and translated to form a coherent framework.8 As new scientific theories were institutionalized, they were politically and ideologically contested. Scientific statements and practices took time to become incorporated into government, politics, and social relations. While theories were debunked and existing circles of expertise disbanded, this process was slow and halting. As this chapter will show, scientists can hold parallel or contradictory theories at the same time, but so can authorities and the general public. Different and even opposing theories can support one another, and this allows many diverse objects and people to become lumped together in the project of urban health reform. Health officials during the 19th century made a concerted effort to make cities “better”: cleaner streets, improved water infrastructure, new water filtration plants, population monitoring, and marsh reclamation. Debates over disease theories structured political battles and professional careers. In the history of ideas, a revolution of brilliance displacing previous theories is too simple a narrative. Alternatively, Bruno Latour’s historical analysis of how a microscopic actant revolutionizes and rewrites the past is also lacking. Latour’s belief that cholera allowed Koch to discover it, simplifies the accumulation of both knowledge and error. Science and doctors were confused, and they cobbled together claims that were a mix of certainty and uncertainty. The times of scientific transformation were messy. But this messiness was also generative, and speaking beyond one’s expertise was an act of claiming authority during these times of confusion. Many historians of science are enamoured with periods. This chapter on zymosis attempts to show how events and ideas do not fit easily into an “era.” Charles-Edward Amory Winslow, the bacteriologist who chronicled his own era, suggested that 19th-century medical practices can be divided into the era of empirical environmental sanitation (1840–1890); the application of bacteriology along with isolation and disinfection (1890–1910); and the new public health era that included the hygienic education of individuals as well as population and pediatric medicine (from 1910 onwards).9 However, Winslow’s history was written to show how his allies created and instituted the new public health era in the United States. He chronicled his “correct” version of health and envisioned and mythologized the scientific progress he believed himself to be a part of. Similarly, the dominant history of disease is one of

Crisis Science | 2010 | Paul Jackson | 106 discoveries. This history was written to describe how between 1880 and 1900 the bacteriological era triumphed over all other theories. Historians claim that, during this period, the science and technology of discovering bacteria was used to consolidate the aims and methods of public health experts and led them from inclusive concerns over urban environment toward isolating disease agents, people, and their interactions through exclusion. Exclusion in terms of health means establishing social interactions built upon separation.10 Each development was generally framed as an improvement. The majority of the histories of health and science are Whiggish as scientific discoveries are marked as discrete events that signal progress. This chapter writes against this tendency. The medical historian Margret Pelling counters this version of history. She suggests that different scientific eras can be distinguished not by the answers they provided, but by the questions they ask.11 Did immigrants carry disease? How do swamps make people sick? What are the unseen forces that cause illness? Miasma and contagion were not competing or contradictory theories, they were complementary perspectives. Experts could alternate between theories. The cause of disease could be a single agent, but the cause could also be an agent dependent on other forces. During the 18th and 19th centuries, the proprieties of the living organisms were constantly being defined and re-defined. The boundaries between living and non-living entities were in flux.12 Pelling has one of the most nuanced approaches to the history of disease theories and suggests that, rather than bacteriology triumphing as the “correct” science, historians have merely simplified previously existing ideas of disease. Historians, rather than the scientists, found extremely long-standing concepts like germ, species, virus, spontaneous generation, contagion, infection, and miasms in their research only to discard these concepts on the grounds that they were “wrong.” Pelling claims that these concepts are not single but multiple; each term having accumulated layers of meaning over time. The foundation of scientific debates was built on uncertainty. Some writers in these periods used this confusion to oversimplify or discredit ideas they did not agree with. During the 19th century, health experts did not distinguish the new version of the concept from the old. When a scientist or pundit invoked a theory, the historian had to consider folk beliefs; practical experience in agriculture and animal husbandry; modes and metaphors of reproduction; different epidemic crisis and shifts in prevalence of disease; and political, economic, and epistemological conditions. Disease theories are never purely medical concepts.13 The historian of science Michael Worboys concurs with Pelling to say scientific paradigms are not distinct. He argues that during the 1880s and 1890s, a variety of groups used

Crisis Science | 2010 | Paul Jackson | 107 ideas around germs and/or bacteria in order to promote exclusive approaches (as in separation or quarantine). When the bacterium was isolated and described (in the case of cholera, by Robert Koch in 1882), this discovery only added a piece of organic life to the much older rationales and practices of expelling and shunning the sick and those thought to spread disease by contact or mere proximity. Worboys claims that bacteriologists only played a major part in public health after 1895.14 While bacteriology did become a vital institutional practice, previous ideologies were retained to provide a narrative on how to produce a healthy city. Disease theories are imbued with the culture, politics, and fears from which they emerge. Accordingly the practices can be distinguished in the historical record. Germ theorists were scientific, laboratory-based, and objective. Sanitarians were bureaucratic, politically motivated, and brought about improvement by accident.15 My claim is that disease scientists framed as a single scientific object zymosis, germ, and cholera, to create a palimpsest that would be modified and added to again and again. To support my claim, I need to unearth zymosis, a marginalized and debunked theory of disease.

4.2. Zymosis and Farr: The Flexibility of Synthetic Expertise Zymosis was not a descriptive theory. Rather, zymosis was a generative and prescriptive theory; those who believed in it took action and created policy. Zymosis provided a narrative of how epidemics became virulent. Zymosis was also a synthetic theory whose strength lay in the ease of its application to wider and wider spheres. Importantly, zymosis persisted. The theory had staying power. By the turn of the 20th century, health experts in both the City of Toronto and the Provincial Board of Health still invoked the zymotic framework, long after it had been discredited.16 My contention is that the zymotic process was foundational to understanding, not just for understanding the microscopic world and infections of the body, but more importantly for understanding how medical experts’ imagined an epidemic. The theory explained why health crises came to afflict entire cities and nations. The theory of zymosis is important because as an abstraction and idea-force it allowed health experts to shape both urban form and social practices. Zymosis not only defined how the state could structure its response to a crisis, but also how it could imagine crises in the future. The creator of zymosis was Dr. William Farr, the Compiler of the Abstracts in London’s new Registrar General Department. In 1842, William Farr was given the responsibility of classifying diseases for national statistical purposes. He classified what he found by grouping epidemic, endemic, and contagious diseases17 together under a term he invented: zymosis. The

Crisis Science | 2010 | Paul Jackson | 108 term was chosen to emphasize that disease was a process similar to fermentation. At the time, fermentation was not understood as the chemical breakdown of a substance by micro-organisms; rather, fermentation was about extending influence, and influence implied reproduction. Fermentation enabled growth. Farr was not a “scientist,” previously he had only a dabbled in medicine. In those days, the category and profession of scientist was not patrolled like today, because specific disciplines had yet to fully harden. From his position, Farr was essential in establishing state medicine in England, along with methodologies for epidemiology, vital statistics, and demography. Relevant to my arguments, Farr’s zymotic theory directly arose from his engagement with cholera outbreaks during the middle of the 19th century. To give zymosis theory weight, Farr integrated and synthesized the ideas of Justus von Liebig, the German chemist who powerfully explained the interactions between the organic and the inorganic. Following Liebig, interactions between the living and non-living were unseen, molecular, and continuous. Within these unseen interactions arose the very influential concept of catalysis. Catalysis inspired Farr to search for a specific agent that he called a zyme—a ferment or exciter—which could invisibly affect the blood and organs in the human body. This exciter was what made people sick. This zyme was the catalyst of crisis and could be found in the natural world. This exciter was also the reason why some diseases became an epidemic, while other diseases remained benign. Farr envisioned these zymes or materies morbid as highly organized particles of fixed matter like pollen,18 and these zymes caused fermentation. The historian Christopher Hamlin suggests that the fermentation analogy Farr took from Liebig became deeply foundational to the entire scientific engagement with the world.19Additionally, from Liebig came Victorian sanitarian’s fixation on decomposition. As Hamlin summarizes, “[T]he essence of the concept of zymotic disease was that disease was a spreading internal rot, that it came from an external rot, and that it could be transferred to others.”20 Farr was merely incorporating these revelations of the physical world into his specific area of expertise: the classification of disease. Farr was deeply indebted to Liebig, but so were many of his contemporaries, such as Karl Marx.21 Liebig’s chemistry was perhaps equally as influential and foundational to 19th-century thought as the work of Charles Darwin.22 For Farr, the specificity of infectious diseases came not from their causes but from what made them diverge. Diseases had predictable, law-like behaviours, both in the individual patient and in the ways they became epidemics. Farr conceded that infectious diseases were like plants and animals (an analogy that he imported from the British sanitarian Thomas Sydenham, who has been called the father of English medicine).23 During the 1860s, as new scientific

Crisis Science | 2010 | Paul Jackson | 109 developments and practices were taking place, Farr became more interested in the ongoing microscopic and chemical interactions. He synthesized these new developments into his zymotic practices. In his scientific investigations of cholera, he hypothesized the existence of the elementary units of zymotic materials to which he added a new term: zymads. For Farr, the generation, reproduction, and death of specific zymad organic molecules explained the 1866 cholera outbreak in England. Within this framework he could accept the growing germ theory and still adhere to old sanitary reform programs and theories, including the theory of local miasmas.24 Farr claimed these zymotic materials could become airborne or be activated by locally produced organic pollutants given off by living bodies. To name these organic compositions he used the older term “miasmata.” As time went on, Farr relied less and less on the miasma theory, but his combination of germs and miasma allowed him to explain what contagion (disease being spread through touch) couldn’t illuminate. Namely, why did some diseases become a citywide crisis while other diseases did not? This combination could also explain why quarantine appeared to be useless against cholera and how disease could move from place to place even though sick people had had no apparent direct contact with it.25 In general, Farr’s science was not a cataloguing of things in the world; he explained events and crises. His science was not intended to prevent or remove the existence of these zymes or diseases in bodies or cities. Instead, his methods asked, how did diseases get out of control?26 The adoption and application of his work in my archive illustrated how a crisis mindset persisted and shaped the scientific engagement with the world. As Farr declared, “If the latent cause of epidemics cannot be discovered, the mode in which it operates may be investigated. The laws of its action may be determined by observation, as well as the circumstances in which epidemics arise, or by which they may be controlled.”27 Figuring out the cause or source of disease was less important than controlling the crisis. Farr’s science was not one of biological discovery and it didn’t describe how disease affected a patient’s body (this would be left to Koch and Pasteur). Instead, he wanted to understand how to mitigate and control a widespread impending crisis. Farr utilized the language of science; however, his purpose was to reduce consequences of disease. He recommended doing this through government intervention. Farr’s science was a science of the outbreak, the crisis, the emergency. The words zymosis and zymotic dropped out of the scientific literature as the 19th century progressed. By the early years of the 20th century, this language of disease appears sporadically in the archive. In the conventional history of medicine, the zymotic theory “officially” lasted from the mid-1850s to the mid-1870s. My claim is that the imagination inspired by zymosis

Crisis Science | 2010 | Paul Jackson | 110 persisted. Zymosis was invoked by the health experts in Toronto around the cholera crisis of 1892 and beyond, even though bacteriology was well on its way to dominating the discipline of medical science and public health reform. As can be seen with bacteriology, Farr’s expertise was expanded as he synthesized each new scientific development into his existing framework.

4.3. Bacteriology and Persistence of Zymosis In the 1880s, Koch and Pasteur had begun to isolate disease agents in petri dishes and under microscopes. As the consolidation of bacteriology took place, describing bacteria and the different types of species of micro-organisms became ways to solve the problem of disease. Each micro-organism was given a disease form and that form’s presence or absence in a population determined whether or not a medical expert would declare an epidemic. Because of these discoveries, “disease” became an invasion by independent organisms into or onto the body. The development of a modern theory of disease was the creation of an ontology: disease acquired an essence and its entity became real and constant. This constant moved from patient to patient. Thomas Sydenham laid the foundation for this framework in his vision of a natural history of disease. Disease became an in toto organism that grew, lived, and died over long periods of time. Accordingly, disease became a parasite in the world, rather than the embodiment of divine judgment. The bacteriological understanding of disease occurred at the same time that Darwin’s evolutionary theory was gaining broad acceptance. Disease, and what disease did to the human body, raised questions in this evolutionary system about the ascent, descent, and perfectibility of human beings. In this evolutionary system, how could the highest being (human) be killed by the lowest being (bacteria)?28 Bacteriology created a new source of scientific authority for the health disciplines that were gaining a valued reputation through their seeming prevention of epidemics and curing of sickness. As botanists, microscopists, and medical investigators began to describe bacteria as living micro-organisms with ancestries and life cycles, the reality of disease bacteria became hard to ignore. The strength of the bacteriological theory lay in the effects of pathogenic actions of specific micro-organisms when introduced into the body. This meant experts had to figure out both the bacteria’s actions and the body’s reactions. However, by the end of the 19th century, the era of bacteriology and germ discovery, most diseases were not associated with a bacterium. Even those diseases that did were associated with a micro-organism—Asiatic cholera and the bacterium Vibrio cholerae is one example—were not completely trusted as scientifically valid.29

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As bacteriology became increasingly established during the 1880s, it did not undermine or threaten the zymotic analogy of disease. Rather, a particular aspect was grasped upon: the germ. Germs were discrete disease producing life forms. The germ theory of disease solidified and gave a describable object (or what one might call actant) to the zymotic relationship.30 With the rise of bacteriology, scientists transitioned from examining the larger environment according to relations between water and climate and toward concentrating on pathogens in, on, and immediately around individuals. However, it wasn’t until 1895 that the bacteriological era became fully institutionalized and taken up in a variety of practices. By the beginning of the 20th century, terms like germs, cells, and immunity began to be referred to as facts instead of theoretical speculation by scientists, doctors, and health bureaucrats. But this period should not be considered an isolated “era” or a scientific or laboratory revolution. Science became centred on disease-germs, not “bacteria.” Many still believed these disease-germs arose from chemical or non-bacterial theories. Worboys suggests that between 1865 and1882, many scientists spoke of “germs” and that, between 1882 and 1900, the term became interchangeable with “bacteria.” After 1865, the recurring questions about disease were: Did disease germs exists? What were they? Where did they come from? How did they act? Public health officials could continue to view contagia viva and zymotic poisons as living, disease-causing germs. Crucially, the term germ combined two meanings: seed (or spore as exciting cause) and a zymotic poison (a living organism that was influenced by chemical reaction).31 Germ implied growth, but it also suggested the evolution of discrete bodily products and fluids into entities capable of causing disease in a second person. Germs were not fully formed organisms by definition. Instead, a process of germination (similar to the way a plant seed develops) was believed to occur. This often happened outside the body and was related to environmental conditions. The term “germs of disease” grouped together epidemics, but also the creation of sores and pus, along with conditions like cancer. With the rise of the cellular and chemical vision of the body, there emerged a new microcosmic view of the world in which minute constituents had the properties of independent life and worked in an environment of affinity and action on the molecular level.32 Worboys suggests that British medical science’s key metaphor to explaining the disease process was seed and soil. By the end of the 19th century, seed and soil provided the intuitive explanation of sickness and outbreak. Seed and soil validated ideas from the germ and zymotic theories. The germ and the conditions that excited the germ were combined, then grew out of control and became an epidemic. Advances in bacteriology were merely describing the germ,

Crisis Science | 2010 | Paul Jackson | 112 the seed. But understanding how the exciters fermented the seed into a crisis was a concept that was still applied quite liberally. This relationship could be seen in a variety of social, moral, or urban dynamics. Disease was not merely a medical topic; disease was a totalizing social phenomenon.33 My claim is that the idea of the germ persisted and reanimated the framework of zymosis. For writers in the 19th century, the germ borrowed from concepts such as generation, growth, and differentiation (which I summarize in following chapters as proliferation). Additionally, the majority of the doctors and reformers who instituted changes in the 1880s and 1890s were schooled, wrote, and researched in the previous mindset—a framework steeped in miasma, spontaneous generation, and predominately zymotic theory of disease. Zymosis was a transition theory, a conceptual stepping stone from miasma to bacteriology. Take John Simon, Britain’s senior public health official from 1855 to 1876, as an example. At the beginning of his tenure, he was a complete adherent to the theory of zymosis. Zymosis was the theoretical vehicle that moved Simon from anti-contagionist filth theories of Sir Edwin Chadwick to the emerging contagion-germ framework of Koch.34 For many sanitarians, the zymotic theory provided the underlying conceptualization that would unify the new germ theory of disease with the battle against urban filth. The emerging developments in science by Pasteur and Koch—discovering an invisible single living thing that caused each specific disease—became integrated into a state health expertise mindset. However, the identity of disease was less important than the zymotic exciter that led to epidemics. Documenting the microscopic details of bacteria in petri dishes was all well and good, but state medicine had disease crises to deal with. Science became about understanding disease, while the state focused on its management. Zymosis persisted because it provided an explanation, not of the microscopic world of bacteria, but of the epidemic and pandemic. Zymosis explained the constant relationship of how disease got out of control in the population, which could be applied to each new micro-organism that was discovered in the laboratories. In Canada, health experts retained zymosis because of the narrative it gave to events.35 Doctors in Canada used the term zymosis well into the early 20th century. However, my claim is that zymosis was retained, even beyond the mere deployment of the term, through the zymotic imagination of a disease crisis (this imagination will be fully explored in chapter 6). Over time, these visions of disease accumulated and loosely cohered. The debates around epidemic disease were not the clashing of opposite views, nor were they a conflict based on scientific versus unscientific methods and hypothesis. Instead, the general epistemology of the 19th century was steeped in confusion. The relationship in disease control between science

Crisis Science | 2010 | Paul Jackson | 113 and politics produced overlapping views, for disease scientists an increasing professional and personal investment was to isolate and describe the structures of disease causation.36 Through these debates and confusion, the mindset of doctors, sanitarians, and urban reformers shifted. In his book The Double Face of Janus, the historian of health Owsei Temkin, suggests that, for health experts, diseases now had a very specific way of making people sick: Diseases could be bound to definitive causes; hence the knowledge of the cause was needed to elevate a clinical entity or a syndrome to the rank of disease. Moreover, an infection had a beginning and it ended after the annihilation of the invading microbe. Between these two points in time the person in question was sick; before and after he was healthy; consequently health was the absence of disease.37

Accordingly, the symptoms of diarrhea, a persistent fact in places with a compromised water supply, became cholera once the existence of the Vibrio cholerae was found. What this scientific transition toward germ causation gave the scientific community was a narrative. Before, local conditions would always stay the same, but after this transition in thought, “not healthy” existed and was separated from the present moment, as a period of time or an external entity from beyond the local environment. A binary way of thinking emerged; disease was present or not present. Worboys suggests that this shift solidified a pathology of geographic exposure that was centred on newness or recent introduction. In this view, it followed that a Bengali, compared to a European, was less susceptible to cholera because he or she was more accustomed to choleric places. Places were now exposed to a disease. The word epidemic—came upon (epi) a people (dēmos)—implies that, prior to an epidemic, a place was absent of disease: it was healthy. This shift also fed into contemporary ideas about evolution, a shift from belief in acquired characteristics and habituation and toward a theory of inherited evolutionary adaptations.38 Past generations accumulated symptoms that afflicted the healthy present, but local conditions also fostered and enabled this unhealthy present. These concepts and practices accumulated to lead up to the 1892 cholera crisis pandemic.

4.4. Conclusion: The Definition of an Epidemic After all these debates and the cholera outbreak in 1892, the nature of epidemics themselves emerged as a distinct object to be reflected upon. My claim is that the nature of the epidemic crisis was built upon the science, arguments, and imagination of Farr’s zymosis. In 1900, the American Public Health Association commissioned a report by the “Committee to Define ‘What Constitutes an Epidemic.’” This report illustrated both the importance and the indeterminacy of

Crisis Science | 2010 | Paul Jackson | 114 the concepts health experts were struggling with. The point of the committee was to define the word “epidemic,” because many declared that of the past fourteen or more years the term had been misused. Though the committee was dealing with contagious diseases in general, cholera was always mentioned first.39 The experts complained that politicians and the business community would use and not use the term epidemic for different ends at different times, depending on their interests. In 1892, Hamburg officials did not want to officially declare a cholera epidemic because they feared a loss in trade. In the past, epidemic had been defined as the number of cases of contagious disease that existed in proportion to a population, and the rapidity of the disease’s spread over an area. After 1886, international rules declared that if a single case of a disease was found to exist, information on the location and “prevalence” (having great power) of the disease must be sent to neighbouring state and federal governments. The committee complained that this basis for the definition was illogical and impracticable. The committee’s rationale was that when these rules were being drafted, the definition of epidemic meant “epidemic constitution of the atmosphere.” That implied “the entire atmosphere of a neighborhood had become saturated with the poison of an infectious disease...some occult property which enabled it to propagate infection.” The committee declared that by 1900 the times had changed. Science had changed. Now that the germ theory was triumphant, this “bad air” definition was nonsense. However, these medical scientists could not deny that, “in the minds of the public at large, and indeed of many of the profession, the word epidemic still conveys this idea of universal atmospheric contamination. This is greatly to be deplored because…its use inspires an indefinable horror and creates panic” and leads to interventions that do not deal with the sick persons and their “excreta.”40 According to these experts, “epidemic” was too easily interpreted, and therefore too easily used for politics. Since the concept of epidemic was so tainted, the committee’s solution was to omit the word altogether. By the turn of the century, the call to eliminate the definition of the concept of epidemic—even while the science of epidemiology was still emerging—indicated both the overdetermined and fragile understanding of a health crisis event. After the turn of the 20th century, bacteriological science had become dominant in health reforms. Epidemiology was now microbe hunting, and health became simply the removal of bacteria. The interrelations between disease, environment, and evolution were fragmented into a variety of disciplines. Microbe hunting was integral to an understanding of what diseases were present. Scientists like Koch created experiments to find the cholera bacterium and other microbes. These disease discoveries added to the world of things and to the taxonomy of the

Crisis Science | 2010 | Paul Jackson | 115 animal and vegetable kingdom. But isolating an object for crisis could not stop diseases’ wide- ranging influences within environments and across generations.41 My suspicion is that the relations between the germ (seed) with its environment (soil) persisted, only to re-emerge in scientific debates as the epidemiological triad (disease = favourable environment + susceptible host + virulent pathogen).42 Farr contributed to this history by explaining the cause and effect of the crisis: how people and populations got sick to the point of emergency and hypothesizing about what caused this sickness. Looking back, we know that Farr’s descriptions of what took place in the microscopic worlds of swamps and stomachs were inaccurate, but his certainty in a time of uncertainty was how such a small particle of the animal kingdom could cause an international health crisis. He was trying to understand, for the lack of a better term, the agency of disease. In respect to questions of agency of the non-human, I acknowledge that I am directly engaging with the work of Bruno Latour; in many ways, my whole dissertation does. I hesitate to structure my work in his way especially when faced with Latour’s methods and descriptions of actors, networks, or theories of history.43 The actant or object of cholera was deeply intermeshed into deep-seated fears of urban growth and migrating populations. To separate cholera from the environment where it emerged, whether it is the environment of marshland, economic depression, or medical laboratory, is impossible. The bacteriological laboratory did not “raise the world”;44 the disease world was already full of non-human agency, exciters, and uncooperative growing life. Cholera and zymosis helped to explain the crisis and shaped the scientific imagination, so that it could understand the object I’ve chosen to call proliferating life.

Endnotes

1 Lenin is riffing off the American John Adams, when he says, “Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” This chapter hopes to undermine this overdetermined position. Lenin followed this sentence with: “Precise facts, indisputable facts—they are especially abhorrent to this type of author, but are especially necessary if we want to form a proper understanding of this complicated, difficult and often deliberately confused question. But how to gather the facts? How to establish their connection and interdependence?” In V.I. Lenin, "Statistics and Sociology," in Lenin Collected Works (Moscow: Progress Publishers [Marxists Internet Archive], 1964 [1935]). 2 One exceptionally strange theory came from Dr. Henry Hartshore of Philadelphia, who concluded that “the only rational explanation is that the epidemic cause passed over the ocean through the atmosphere, independently of human conveyance… On account of this manner of migration, I propose a new term as applicable to epidemic cholera. It is autoplanatic (from autos, self and planao, to wander) ; that is, wandering under causal conditions peculiar to itself, as distinguished from the conveyance…only through human intercourse.” In Henry Hartshore, "Cholera and Its Migrations," Canadian Practitioner XVIII, no. 3 (1893): 179. The theory that cholera wandered the globe like a mist was published, and I could not find if it was refuted. I think it clearly illustrates how the scientific debate over cholera was very much up for grabs. 3 Historians of cholera science have taken up these debates in a variety of forms, as almost every history of the cholera epidemics tackles these issues. I include many of these histories in this chapter, but one of the landmark

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books is Margaret Pelling, Cholera, Fever and English Medicine, 1825-1865, Oxford Historical Monographs (New York: Oxford University Press, 1978). 4 The critiques of different science and scientists are not limited to debates over disease rather, as Lefebvre states, “A critique of the specialized sciences implies a critique of specialized politics, structures, and their ideologies. Every political group, and especially every structure, justifies itself through an ideology that it develops and nurtures…” in Henri Lefebvre, The Urban Revolution (Minneapolis: University of Minnesota Press, 2003), 136. 5 I’m being extremely polemical here. To be kind, competing truth claims overran the zymosis scientists’ truth claims. I don’t really care who was right or wrong, rather my concern is what practices and technologies emerged from this perspective. 6 For general overviews of cholera in North America, see Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980); Charles M. Godfrey, The Cholera Epidemics in Upper Canada 1832-1866 (Toronto: Seccombe House, 1968); Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: Univ. of Chicago Press, 1962). 7 Edmund Charles Wendt and John C. Peters, A Treatise on Asiatic Cholera (New York: W. Wood and company, 1885), 119. 8 Bruno Latour, The Pasteurization of France (Cambridge, Mass.: Harvard University Press, 1988); Bruno Latour and Steve Woolgar, Laboratory Life : The Construction of Scientific Facts (Princeton, N.J.: Princeton University Press, 1986). 9 Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 215. 10 This summary is taken from Pelling’s work. However this overview conforms to the history of ‘the microbe hunters’ that Winslow celebrated, see C.E. Winslow, The Conquest of Epidemic Disease; a Chapter in the History of Ideas (Princeton, N. J.: Princeton Univ. Press, 1943). Paul De Kruif, Microbe Hunters (New York: Harcourt, 1926). Winslow and De Kruif set the tone for much of the traditional medical historians that Pelling is writing against. In Pelling’s work there is an echo here to Foucault’s outline of the two concepts of power from his 1975 lecture series, and other places. Foucault bases and illustrates these concepts of power by contrasting of the leper (exclusion) to the plague victim (inclusion). For lepers there were rigorous division: a distancing and a rule of no contact. Control and power meant casting these individuals out into a vague, external world, beyond the walls of the community. This exclusion implied disqualification, where “they entered death” and declared dead as they departed. The individual was driven out in order to purify the community. This created a “floating population” between the towns that consisted of beggars, vagabonds, the idle, and libertines. Foucault maintains this disappeared by the end of the 17th century. What arose was the positive concept of power linked to overcoming the disease through a “model of inclusion” that was not completely based on a notion of repression. For the leper a model of exclusion was through division, rejection, and disqualification. This shifted to a continuous control over a plague town that required constant and insistent observation. This was not repression but normalization. Repression becomes a lateral and secondary effect of this positive power of normalization; a power put into place by apparatuses of discipline-normalization. In Michel Foucault, Abnormal : Lectures at the College De France, 1974- 1975, ed. Valerio Marchetti, Antonella Salomoni, and Arnold I. Davidson (New York: Picador, 2003), xix-xxi. 11 Margaret Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," in Contagion : Historical and Cultural Studies, ed. Alison Bashford and Claire Hooker (London; New York: Routledge, 2001), 18. 12 Ibid., 19. 13 Ibid., 16-17. 14 Medical officers and government officials used scientific claims to enhance their authority, along with linking their aims to wider social welfare priorities. For public health doctors, the ideological resources of bacteriological germ theories carved out a new and distinctive professional identity. See Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865-1900 (Cambridge, UK; New York: Cambridge University Press, 2000), 234-235. 15 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 16-17. 16 The persistence of the zymotic theory of disease was not just limited to Toronto or Canada. A U.S. example in 1893 only made the distinction between zymotic or preventable diseases, see W.A. Haskell, "Zymotic Diseases in Chicago. Sanitary Exhibit for the World's Columbian Exposition," ed. Illinois State Board Of Health (1893). 17 Diseases were not bacteria or viruses before Farr’s categories. Diseases were not seen as microscopic species, rather diseases were understood as grouped behaviors or bodily reactions, such as fever, coughing, or diarrhea. Miasma was disease came from a fog, mist, smell or vapour. Contagion means disease was spread by touch. Epidemic was how widespread was a disease within a community. Pandemic indicated how a disease spread over a country or the world. Only until bacteriology did microorganisms become articulated as the cause of illness. Please see the glossary for more definitions.

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18 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor." pp. 26-27. See also John M. Eyler, "William Farr on the Cholera: The Sanitarian's Disease Theory and the Statistician's Method," Journal of the history of medicine and allied sciences 28, no. 2 (1973). 19 Christopher Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," Victorian Studies 28, no. 3 (1985). p. 383. 20 Ibid. p. 386. See also Pat Munday, "Politics by Other Means: Justus Von Liebig and the German Translation of John Stuart Mill's Logic," The British journal for the history of science. 31, no. 111 (1998). L. Rosenfeld, "Justus Liebig and Animal Chemistry," Clinical Chemistry 49, no. 10 (2003). 21 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease." Interestingly, Liebig has also been a profound influence in urban political ecology, along with Marx’ use of the term. In geography, this has taken the form of urban metabolism, see Nik Heynen, Maria Kaika, and Erik Swyngedouw, In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, Questioning Cities Series (London; New York: Routledge, 2006). In particular the chapter: Erik Swyngedouw, "Metabolic Urbanization," in In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, ed. Nik Heynen, Maria Kaika, and Erik Swyngedouw (London; New York: Routledge, 2006). Erik Swyngedouw and Nik Heynen, "Urban Political Ecology, Justice and the Politics of Scale," Antipode 35, no. 5 (2003). Matthew Gandy, "Rethinking Urban Metabolism: Water, Space and the Modern City," City 8, no. 3 (2004). Many geographers and historians attribute Marx’ theories metabolism to his importing Liebig chemcial concepts into political economy. 22 The main difference between Farr and Darwin is the process and interactions that inspired zymosis was abandoned as wrong as a basis of disease interactions, while Darwin’s processes of evolution leading to genetics is celebrated as right. 23 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 26-27. 24 Eyler, "William Farr on the Cholera: The Sanitarian's Disease Theory and the Statistician's Method," 83. 25 Ibid. pp. 85-6. Intially, Farr thought land elevation was the cause of the cholera epidemic of 1848-1849. Even though his report was published right after Snow's theory of waterborne vector of cholera, Farr considered water and sewers as a modifying influence, an equal effect as income. As later he began to accept that cholera could be transmitted through water as merely one way of getting sick, alongside a gas-like vapor as another vector of transmission. For Farr both theories could exist at the same time. 26 My additional claim being Farr’s science is an example of Foucault’s regime of security, in particular the aspects of prevalence and sudden bolting that I explored in chapter 1, see Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007). 27 William Farr, Vital Statistics, ed. Noel A. Humphreys (London: Royal Sanitary Institute, 1885), 318. See Eyler, "William Farr on the Cholera: The Sanitarian's Disease Theory and the Statistician's Method." As early as 1840, “Farr thought he had here hit upon a fundamental natural law of epidemic phenomena, comparable almost to Newtonian physical laws. It was, however, only a descriptive technique, a sort of curvilinear regression.” In Paul E.M. Fine, "John Brownlee and the Measurement of Infectiousness: An Historical Study in Epidemic Theory," Journal of the Royal Statistical Society 142, no. 3 (1979). This universal law of disease causation comes back in the correlation of physics and economics by Irving Fisher, see chapter 9. 28 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 20-24. 29 Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865-1900, 280. 30 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," 387. 31 Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865-1900, 275-279. See also M.S. Pernick, "Eugenics and Public Health in American History," American journal of public health 87, no. 11 (1997). 32 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 28-30. 33 This may be contentious but this claim arose from my reading of the secondary literature, bu also how health experts in my archive framed their own work. To be clearer, disease was an ideology, or an indicator, that reflected upon the whole of society. Accordingly, health could structure social phenomenon, and through these logics disease and sickness would be mediated. Disease also became an avenue for those, outside the sphere of health expertise, could speak to their growing concerns about cities and morality. The method was through acts of synthesis, that I explain elsewhere. 34 Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," 386. 35 However, as Hamlin makes clear that “[b]ecause the zymotic analogy was vague, it is hard to say how influential it was in Victorian medicine. Yet, even some who repudiated it explicitly retained some of the images and

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explanations that made the analogy so powerful.” In the cultural realm Charles Dickens and Charles Kingsley were concerned with zymotic matters. The zymotic consciousness and imagination contributed to agricultural theories, worries about waste and sewage, and the economy of nations; mostly building on Liebig’s influence and interests. Much of this argument hinged on how sewage filth was declared to be wasted in the city. The answer was to be return human wastes to the countryside. This was seen to be retort and disproved Malthus’s theories since sewage was the only fertilizer that increased in proportion to population. (See Ibid.: 404.) That being said, how deeply zymosis settled into the minds of the Victorian public is hard to gauge. 36 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 26-27. 37 In Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865-1900, 283. For the overall argument, see Owsei Temkin, The Double Face of Janus and Other Essays in the History of Medicine (Baltimore: Johns Hopkins University Press, 1977). 38 Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," 20-24. This relationship to evolution can actually be parsed out even further. In science writings there was now an attention paid to agency and the processes of disease. However, confusion arose in the failure to distinguish between material (or influence) which was transmitted between persons or environments, compared to the process of transmission, which could be direct or indirect. Theories of contagion focused on specific materials. While theories of infection focused on the process of transmission. With evolution, transmission was seen in a generational context: the past and the present could not “infect” the future. 39 To be clear, the sequence was not done in alphabetical order. 40 Wm. C. Woodward Benjamin Lee, Elzear Pelletier, Samuel H. Durgin, and Arthur R. Reynolds, "Report of Committee to Define “What Constitutes an Epidemic.”," Public Health Pap Rep. 26 (1900): 178-179. 41 For a much longer history of these ecology of disease versus microbe hunting, see Warwick Anderson, "Ecology and Infection - Natural Histories of Infectious Disease: Ecological Vision in Twentieth-Century Biomedical Science," Osiris. 19 (2004). Interestingly a major figure in this history is Rene Dubos who coined the slogan “Think Globally, Act Locally”. 42 I do not have the space, or the archival evidence, to get into the epidemological triad, but I hope to fully investigate these points in future work. 43 While I do not completely reject Latour, I do reject the ‘flatness’ of networks in actor-network theory. I think it is important to look to for the unevenness in these assemblages. For a hesitant taking up of Latour some examples are: Noel Castree, "False Antitheses? Marxism, Nature and Actor-Networks," Antipode 34, no. 1 (2002). Heynen, Kaika, and Swyngedouw, In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism. 44 Bruno Latour, "Give Me a Laboratory and I Will Raise the World.," in Science Observed, ed. K. D. Knorr-Cetina and M. J. Mulkay (Beverly Hills: Sage., 1983).

Crisis as Proliferating Life | 2010 | Paul Jackson | 119 Chapter 5 – Crisis as Proliferating Life: Positive Evil and the Effects of Malthus’ Principle of Population

In this chapter, I am going to integrate the health sciences of cholera and zymosis with more general fears over degeneration and urbanization. To do so, I need to step back for a moment from the scientific arguments of the 19th century and discuss a phrase that has haunted this work: “Every science creates its own object.” Paraphrasing Michel Foucault,1 this statement has, in many ways, become a truism. However, in this truism, the relationship between science and object has becomes less apparent, more obscure, and difficult to understand. This act of creation opens up more questions regarding agency, events, and effects. The entirety of my struggle with my archive, both in my research and writing, has been an attempt to isolate this relationship. Initially, the answer seemed obvious, even self-evident; all I had to do was confirm the “science” to my “object.” My object has always been cholera, but I faltered when naming my science. At first, bacteriology seemed appropriate, since the cholera epidemic took place in 1892. However, as the last chapter demonstrated, bacteriology had not been fully consolidated, and the disciplines of medicine and biology were full of debate and confusion. Correspondingly, the scientific practices bacteriology displaced were equally a jumble of local environments, miasmas, and medical topography. Epidemiology would solidify as a discipline much later, in part as a consequence of the processes that I am grappling with. Even though by 1892 many threads for classifying epidemics existed, there was no single, isolated science that produced the object of cholera. My science needed to be all of these threads, though, at the same time, none of them were sufficient. Why are these questions important? Why not just tell the story of what happened? The Marxist geographer David Harvey suggests, “Dialectics forces us always to ask the question of every ‘thing’ or ‘event’ that we encounter: by what process was it constituted and how is it sustained?”2 As this research struggled with science and cholera, I would have been reproducing the politics of disease crises if I’d merely accepted my encounters with these “things” as they’d been presented to me. In my mind, a reproduction is unacceptable. Therefore, to be true to my larger project, I must rework the categories of health science and cholera in order to invalidate the politics of crisis. This requires that I rethink my categories. As an object, cholera was not a recently discovered species of a deep-sea fish that an explorer had stumbled upon; it was not some new thing that could be described, named, and fixed. Cholera was not an object that had never seen the light. In many ways, the opposite

Crisis as Proliferating Life | 2010 | Paul Jackson | 120 trajectory took place for cholera. As cholera slowly became isolated and named, the disease had already disrupted cities, hijacked expert opinion, and transformed practices of knowledge. Cholera came with baggage, encumbered by history and myth. The cholera object was drenched with associations and layered with accumulated concepts. In the face of this, I tried a new tactic. I asked myself, What is my science? The science of health boards, Farr’s zymosis, degeneration, and eugenics were insufficient. My struggle, I came to realize, arose from my hesitation to name my object and science. I had hoped that others had described these relationships, or that my object and science could be sorted into existing categories. I need to create new terms to explain the relationship between these processes. I do this reluctantly. Every science creates its own object. My object is proliferating life: a germ that becomes excited within its environment and contains the potential to multiply uncontrollably. My science is bureaucratic bio-economy: state health expertise that became social infrastructures, a state-led push for biological efficiency in urban and national populations. Cholera is embedded in proliferating life and health boards are essential to the bureaucratic bio-economy, but both categories are exceeded by fears, abstractions, and scientific practices. Both science and object rely on one another to the point that they’re symbiotic. My claim is that this symbiotic relationship continued in different forms and at different times. It was an idea that carried force and overtook events. But proliferating life was not merely an abstract concept. If it had been, the fear of this object would have been dismissed the way that zymosis was dismissed. Rather, as David Harvey suggests, if ideas are to be validated, they must leave abstract knowledge and enter into human practice and social relations. According to Harvey, “[O]nce incorporated into human practice, concepts and ideas can become (via technology) a material force.”3 Ideas are social relations and they shape practices. Harvey suggests that Marx’ project was to understand “what is it that produces ideas and what is it that these ideas serve to produce?”4 This project examines how the idea of proliferating life was enabled by way of the cholera crises.5 Though the cholera epidemics waned at the turn of the 20th century, the world was still filled with threats of proliferating life. New sites, populations, and practices were found to embed this object. Many disciplines contributed to and maintained this symbiotic relationship between object and science. Practices of medical topography, William Farr’s zymosis, eugenics, and degeneration were transformed and internalized into particular understandings of the economy. These ideas took hold in the scientific practices as eugenics and degeneration became internalized within the state. This would lead to health experts articulating an ideology of national economies intermeshed with the drive to maintain a vital and productive labour force.

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In the second half of this dissertation, I will explain and document how these practices of bureaucratic bio-economy became institutionalized. The claims that supported and described these relationships arose from what I call synthetic expertise. This object and science emerged unnamed from my archive, but I am not saying this relationship was a secret or hidden. Instead, these relationships were profoundly and necessarily found in-between disciplines and specific expertise; divided by many eyes and orphaned by all. This is why Foucault’s genealogy has been useful as a method to trace these connections, to produce a genealogy of proliferating life.6

5.0.1. Positive evil I named my object proliferating life as a result of my ongoing struggle to understand how disease was framed in the 19th century as a positive evil. The term positive evil arose from my archive in materials about Toronto’s drive for marsh reclamation, in particular, a specific call for reform in 1855. Kivas Tully, an engineer and city council member, was concerned that the harbour appeared to be worsening. The sewers of Toronto and the wastes of Gooderham and Worts Distillery, the major polluter in the area, now emptied into the marshes of Ashbridge’s Bay. The marsh had become a cesspool. Tully proposed that the city completely reshape the ecology of the marsh by deepening the bay waters and dredging the bay floor to allow for more shipping. The city could then reclaim the shallower areas for industrial development. To push the plan, Tully said the “source of these endemic diseases (e.g. cholera) which afflict the citizens would be thus destroyed and what is now a positive evil would be converted into a benefit—and a profit to the city.”7 How could disease, evil, and positivity become intertwined? I find the term positive evil extremely evocative and contradictory, and the way Tully frames it contains an internal tension and gives agency to marshes and disease; in this case, they have a role in producing events and change. The marsh as an evil object to be eradicated had a long history (see chapter 3). However, no single definition can explain the profound ambiguity within the term positive evil. For my purposes, the positive evil of disease has three components. The first component is positive, as in without doubt or debate, both present and evil. Science had confirmed disease’s presence (chapters 3 and 4) and would continue to do so. The second component is positive within the philosophical tradition of positivism, as in science as the basis of truth and rationality. Liberal positivists within the progressive movement dealt with the crisis by pitting science against politics (chapter 2). It’s within the larger movement of positivism that I read evil-disease as being converted into an asset; however, I do not associate positivism with the word

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“positive.” Instead, this claim originated from direct interrogation of positive evil’s meaning within the historical and geographic context when the statement was uttered. Positive as a good is the final component. As a good or property, disease could be converted into a benefit, but required production and created activity. This understanding of positive comes from the notorious political philosopher Thomas Malthus, who clarified the intent of positive evil when he said, “Evil exists in the world not to create despair but activity.”8 Keeping in mind Malthus’ widespread and problematic influence on 19th-century liberal thought, I take this to mean that evil could activate “checks” (as in controls or limitations), both natural and artificial, and these checks could benefit the greater good. The rest of this dissertation will address the ways in which the state and capital generated activity and institutions in response to cholera and proliferating life. To clarify, with this term “positive evil” I will focus on the ways in which proliferating life became an entity or process in the world. But before addressing these processes, I want to focus on Malthus’ concepts and his long-term influence over health authorities’ and scientists’ fears of unchecked growth.

5.1. The Science of Proliferating Life: Malthus, Farr, and Darwin Since I have invoked Malthus, I need to spend some time with his ideas to illustrate the effect they had on 19th-century thought, including the opinions and perspectives of the health experts in my archive. Medical science or fearful mythologies did not monopolize the definition of disease in the world. Authorities struggling with the politics and economics of the 19th century also wondered why a thing like evil-disease existed. For British political economists and liberals in general, disease was seen as a check on large unseen forces and abstract laws, particularly population growth. Thomas Malthus’ apocalyptic and fearful writings offered the strongest and most influential explanation of the principles behind population growth.9 Malthus’ power of population described a fluctuating, uncontrolled human excess that was fuelled by food, sex, and welfare. Malthus feared both the excesses of life and uninhibited lives. In his skewed version of society and nature, population was to be checked within each individual. If it was not checked, Nature would be a severe instructor and would teach nations through famine, war, and disease. These positive/preventative checks were supposed to keep the population in “balance” through the means of subsistence. Accordingly, misery would rain on the shoulders of the poor since “misery has to fall somewhere.”10 For Malthus, once the principles of population were understood, future crises could be predicted, managed, and even controlled. In Malthus’ own words:

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Famine seems to be the last, the most dreadful resource of nature. The power of population is so superior to the power in the earth to produce subsistence for man, that premature death must in some shape or other visit the human race. The vices of mankind are active and able ministers of depopulation. They are the precursors in the great army of destruction; and often finish the dreadful work themselves. But should they fail in this war of extermination, sickly seasons, epidemics, pestilence, and plague, advance in terrific array, and sweep off their thousands and ten thousands. Should success be still incomplete, gigantic inevitable famine stalks in the rear, and with one mighty blow levels the population with the food of the world.11

Epidemics were merely one indication that the population was proliferating out of control. Additionally, if food was plentiful and the misery of hunger was taken away, then other checks, such as vice, would appear.12 Malthusian evils were divine or natural, and they produced activity. Accordingly, when epidemics began to decrease in North America and Europe, evil was not eliminated from the world; instead, as we shall see, more evils—hereditary evils— would arise. Malthusian thought imagined and created a geography of social categories that provincialized Europe. Malthus’ relations were seen as universal “laws.” While Malthus claimed he only cared about political economy and populations, he constructed a powerful narrative about how the world worked and why people acted.13 For Malthus, inequity existed because of these natural laws. A portion of mankind must fall into misery, but only because the land cannot support that growing population. The grinding laws of necessity and misery, and the fear of necessity, were the central means by which population growth was to be restrained and prevented. If population growth was not restrained, overpopulation would occur and greater evils would be unleashed. Therefore, a constant moral authority was needed. One that believed it was “the duty of every individual to remove evil from himself and from as large a circle that he can influence.” Knowledge and reason could then supplant the interplay between unrestrained biological drives and futile attempts to avoid their demographic consequences. In this way, Malthus constructed a realism. Many experts adhered to this realism and extended this ideology even further through their projects. Historian John Eyler claims that, though they might have modified the original tract, all 19th-century liberals were Malthusians to a certain degree. The health experts I have followed internalized Malthusian thought, but it’s difficult to determine with any certainty to what degree.

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5.1.1. Farr’s take on Malthus’ principle of population Dr. William Farr was one example of a modified Malthusian. Since Farr has been central to my arguments, I’ll explain how he transformed Malthus’ project. Farr did not take up Malthusian thought absolutely; instead, he made the principles of population his own. For Farr, population was an issue of balanced proportions. A fully realized and growing national population could be a powerful force, and not to be feared automatically, as in Malthus’ theories. While Farr quibbled with Malthus’ data sets, he also disagreed with those critics of Malthus who believed the solution to overpopulation was to raise the standard of living. Rather, Farr claimed through his health statistics that a reduced death rate corresponded with a reduced birth rate—the “facts” from his numbers suggested equilibrium. As a fervent nationalist, Farr did not fear the rising birth rate as disaster; instead, a managed healthy population promised national vigour and was a potential advantage in the international arena.14 In 1866, Farr wrote: What have we to say when we are told that Europe will be over-run with population if fewer children are destroyed in infancy? England answers for me: over-run the world…It is certainly in conformity with Darwin’s law, that in the struggle for existence, out of which the improvement of species springs, the race which breeds and educates the greatest number of vigorous, intelligent children, has the best chance of winning and holding its own.15

Farr accepted Malthus, but modified these population theories to examine what he called the “human unit.” The human unit was way to measure the “average man” from different nations or states. Once the human unit was quantified, then the value of humans’ mean work time could be determined, and differences could be averaged across national populations. For Farr, quantitative difference between populations was due to a combination of inherent and divine causes, and ongoing environmental influences.16 Farr was one of the first social thinkers in England to turn his attention from environmental to biological reform. According to Farr, if all life could be measured, a monetary value could be placed on human life. Population growth was not inherently bad in itself. He was concerned with the wrong kind of population growth and believed that, if one could isolate or demarcate wrong growth, one could institute reforms to manage or improve these growing populations. Improvement, he argued, should be attempted, “The economic value of the population depends very much on their command over the powers of nature; which they acquire by education.”17 While educational reform flourished around the Atlantic after the beginning of the 20th century, education was only a means to an end. Reformers feared that certain human units could not or would not improve, and if these groups existed within the nation and grew out of control—if this form of life proliferated—it would

Crisis as Proliferating Life | 2010 | Paul Jackson | 125 cause a national crisis. Science could hopefully discover and demarcate those certain groups who could not improve. After doing so, it could isolate them and find the inherent cause or invisible source of their lack or deficiency. Within his shift from environmental to biological reform, Farr concluded that to fight one single disease within the context of the larger population was a waste of effort; another disease or population check would just emerge. Farr envisioned that a whole spectrum of diseases were constantly present yet invisible and could be zymotically excited in a variety of ways. Farr’s more pressing concern was that zymotic diseases disabled and maimed bodies more than they killed. According to Farr, since sick and disabled bodies continued to live on within the nation, this meant that disease, as a means of population check, was actually inefficient, wasteful, and harmful to society. Sick people, more than dead people, became a drain on the national resources.18 The “constantly sick” contributed nothing to “the race.” Farr thought highly infectious epidemics “purifie[d] the race;” however, these epidemic events were too rare and too incomplete. Despite this, Farr argued for the possible beneficial value of epidemics. Diseases indicated other future crises that may be looming and eliminated some of the unproductive segments of the nation. According to Victorian historian Victor Hilts, Farr reintroduced from Malthus the selection idea within a population context. Farr stated: The population of the world is not, as Malthus assumes, redundant…and not only is there a paucity of men of transcendent genius in all countries, but few persons who have occasion to undertake or who accomplish great industrial, political, war-like, or other operations ever find that the men of industry and entire trustworthiness—of whom they can dispose, either in the highest or the lowest departments—are superabundant.19

Farr retained Malthus’ system of checks and balances, yet Farr deemed Malthus’ principles and laws inefficient and in need of improvement. A major part of that improvement involved getting rid of the presence of disease within the productive portions of the national population. Health authorities claimed could to do this, and hence was the reason they were necessary. Farr’s theory of zymosis (discussed in great detail in chapter 4) was a totalizing typology used to indicate the presence of disease, even when evidence was lacking. Over time, Farr expanded his theory of zymotic relations between the germ (seed) and environmental exciters. Farr claimed there were future implications of these diseases beyond the immediate crisis. The historian John Eyler, summarizing Farr, writes that “[e]pidemic disease was a warning of impending racial disaster.” Epidemics warned of deep-seated, invisible, future problems for the entire nation. Within the wider history of the life sciences, this articulation of disease crisis

Crisis as Proliferating Life | 2010 | Paul Jackson | 126 became incorporated into evolutionary theories. With ideas of inheritance, even without any symptoms showing, these invisible evil threats of racial decline were retained in the human body. In the report of the 1866 cholera outbreak, Farr states: To sum up the zymotic theory. It is now held by naturalists that each organ of the body has its proper life; and that it consists of minute centres of action, which have been called cells, globules, organic units, germs, granules, and other names. The cells, like the supposed vesicles of the clouds are now shown to be solids, and Beale proposes to call them “germinal matter,” which is perhaps a description rather than a name…these units of force and life may be designated biads [constituent corpuscles of a living being].20

The object and its relations of this “germinal matter” took on much of the same role as genes, though they weren’t articulated in quite the same way. Farr’s zymads/biads and Darwin’s gemmules (imagined particles of inheritance) were both ways to account for biological change over time. According to Eyler, “Both were elementary biological units having a corpuscular life but not an independent existence.”21 As Farr had incorporated Liebig’s catalyst to understand microscopic relations and Malthus’ principles of population to understand aggregate human life, he similarly incorporated Darwin’s concepts. Accordingly, Farr’s theories changed and transformed, moving away from chemistry and toward biology. But even in the realm of biological heredity, his conceptualization still retained crisis. Darwin’s Origin of Species suggested that evolutionary theory was applicable to the study of disease. Farr began including processes like inheritance and pangenesis in his own theories. Farr could name the presence of disease, even when no effects or symptoms were yet evident. This germinal matter may seem neutral in one period, but be excited in subsequent generations to enable illness. Farr’s theory articulated how the evils of germinal matter would only increase over generations. Disease—as a check on population—now had a generational component; it was what we would call “genetic.” Taking his cue from sheep breeding, Farr stated: All analogy, however, proves that no extensive or permanent degeneration of a race can be accomplished in less than two or three generations. The great change is as slow and insidious as it is certain. It is rarely perceived by its victims; who remain rooted and benumbed on the spot unless they and the community are aroused by sudden and terrible catastrophes. The angel which, it would seem, it has pleased the Almighty Creator and Preserver of Mankind to charge with this dread mission is the Pestilence. Wherever the human race, yielding to ignorance, indolence, or accident, is in such a situation as to be liable to lose its strength, courage, liberty, wisdom, lofty emotions—the plague, the fever, or the cholera comes; not committing havoc perpetually, but turning men to destruction, and then suddenly ceasing, that they may consider. As the lost father speaks to the family and the slight epidemic to the city, so the pestilence speaks to nations in

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order that greater calamities than untimely death of the population may be averted. For to the nation of good and noble men Death is less evil than Degeneration of Race.22

Farr formulated Malthusian laws according to Darwin’s theories on the time frame of generations and inherited characteristics. While the equilibrium between populations and checks was a natural relationship for Malthus, for Farr this could be a site of intervention. Epidemics became canaries in the coal mine; diseases created activity into order to pre-emptively intervene with the slow degeneration of an entire nation. Farr’s ideas—and how they synthesized other ideas from science—was a muddled ideology, but that doesn’t mean he wasn’t listened to. As the above quote illustrates with rhetoric such as evil, positive, mythology, and potential downfall, in Farr’s work health reformers in North America found a solid grounding for much of their practices. Farr’s legacy was widespread, though how widespread is difficult to determine with complete accuracy. Farr was instrumental in the development of state medicine in England and in the establishment of a methodology for vital statistics and demography. Farr’s ideology provided a key pillar for epidemiology and population statistics. His ideas have persisted in economics through concepts like human capital. When he became a medical officer, Sir Arthur Newsholme turned to Farr first, and his own book on vital statistics of 1889 came from his study of Farr’s work. Later, Major Greenwood, a prominent 20th-century epidemiologist, was a major proponent of Farr. John Brownlee, director of statistics of the Medical Research Council of Britain from 1914 to 1927, called Farr the founder of epidemiology in its modern form.23 In the early 20th century, the American economist Irving Fisher admired Farr and incorporated his views into economics (as we shall see in chapter 9).24 What Farr gave these experts and reformers was a clearly articulated science of the future health crisis within populations that had ramifications for future generations. Farr articulated economic arguments for how to manage sickness, growing populations, and human productivity.25 However, sickness was a weak and insufficient population check; because of this, state interventions in health reforms could be rationalized for economic ends. Finally, Farr transferred the burden of improvement from the environment onto individuals, and set the scene for the similar ideas of Social Darwinists like Herbert Spencer and eugenicists like Francis Galton. The problem now was how to distinguish what segments of the population had the potential to proliferate and which ones were superfluous and expendable.

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5.2. Proliferating Life in Practice: An Example from Canada With all these debates and disciplinary arguments, what was a Canadian medical expert to do? What should he or she recommend and implement? To answer this question, I want to focus on Dr. Peter Bryce. Bryce illustrates the ways in which experts dabbled in the disease theories and fears discussed in the previous chapters.26 In Canada, Bryce was one of the best examples of how this intermingling of positivist, eugenicist, improvement, and crisis ideology was put into practice and Bryce deployed the concepts according to his own interests and ends. Bryce was not alone in this endeavour, but he was one of the most vocal health experts and, because of this, is a recurring figure in this project. Bryce also implemented practices first, and then used ideology to support his actions. I want to start with Bryce’s 1919 speech as the Chief Medical Officer of the Department of Immigration and Colonization in Ottawa. The speech was given before the Canadian Public Health Association and in it Bryce called for a federal department of health.27 Bryce also lamented that “a great war” was required “to arouse the people to a sense of the primary national need, the saving of man-power.” As a result of his experiences with the cholera outbreak of 1892, Bryce was acutely aware of the power of the crisis. He articulated the direction his disease crisis ideology had taken, saying: To-day we dream of medicine as never-ceasing in its efforts to trace back the aberrancies of germ-plasma to its ancestral determinants and to be satisfied with nothing less than that such will again incline towards the normal. Already we know of much that can be done in the pre-natal state to minimize potential evil ; while during infancy and the pre-school age yet more can be accomplished… Indeed, when true science shall have controlled the springs of being and when the real purpose of life in its ethical aspects is understood and dominates the activities of men, we shall have a right to view man’s life as an adventurous voyage along a pathway, undulating enough to prevent monotony, gently winding rather than torturous or labyrinthine, bordered with sweet flowers, banked with sturdy forest trees, and having a descent withal so gentle and gradual that it will scarcely be perceived. Then as evening comes on and the pathway passes under the over-arching boughs we shall behold its aeuthanasia[sic]—the final act of a world drama, the sublime summation of a single human personality whose complex is the whole human race.28

As Bryce got older and more secure in his position, he veered increasingly into hyperbole. While he always used poetry and mythology in his policy statements and reports, as time went on, his writing became more baroque and included terms such as “germ plasma” and “the spring of being.” He related science and the divine into poetic relations of harmony. In the above quotation, the project Bryce advocates has no end and is without scale. Expertise was needed to

Crisis as Proliferating Life | 2010 | Paul Jackson | 129 isolate the potential of “evil” to lodge itself into the very springs of being. Additionally, he saw each individual as a stand-in for the whole human race.29 Bryce also indicated his agreement with the much wider transition from germ-disease to germ-plasm. The physical anthropologist and eugenicist Ales Hrdlicka proposed that the environment “excited [the] germ plasm,” which led to evolution. This excitement would produce certain traits that would then be handed down.30 Or, if you followed Farr’s processes, which Bryce did, this excitement would lead to disease crisis and degeneration. But Bryce also worried about the declining birth rate of the “Anglo-Saxon Race” in North America, decrying the fact that the public did not worry about the future implications. Bryce questioned how we could “conserve our energies” to “transmit” the coming generations with the “high physical, mental and moral traditions…which have distinguished this continent for three centuries?”31 His ideas transitioned over time. In 1892, the crisis was a looming cholera pandemic, but by 1919, the crisis had become generational. In 1918, he stated, “Everywhere, from earliest pre-historic man up to our most complex international politics of today, the essence of our problem then was and is now biological.” Bryce had followed Farr’s movement from environmental concerns to biological problems and he remained there for decades, making recommendations and reforms regarding the health concerns of Canada. Bryce had previously been obsessed with the local ecologies of disease, in particular the marshlands and the sanitary conditions of the city. Over time, he became worried about the proliferating life of the city. The fear of urban growth became a generational crisis that combined and was fostered by the urban spatial forms. For Bryce, the overpopulated city had become unruly. Most notable was New York City’s Lower East Side where “a foreign born population swarms the streets.” Bryce vividly contrasted one race of human beings clambering up a hill and the other slipping back into quicksand. He claimed doctors across North America had come across groups who possessed the “stigmata of degeneracy,” such as mimicry and feeblemindedness. The doctors also claimed members of these groups lacked a conscious mind, a will, or cultivated thoughts that kept emotional or automatic responses under control. Bryce was directly applying the theories of Max Nordau, whose 1895 book Degeneration was a vehement attack on modernization and urbanization. Quoting Nordau, Bryce suggested that these degenerates were all obsession, impulse, and moodiness. Bryce decried how the urban population had increased over 1000 percent during the previous century. He quotes Dr. Nordau: As a result of this urbancy alone…All these increased activities, however, even the simplest, involve an effort of the nervous system, a wearing of the tissues.

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Every line we read or write, every human face we see, every conversation we carry on, every scene we perceive through window of the flying express sets in activity our sensory nerves and our brain centres.

The city induced an abnormal degree of neurasthenia (an unsubstantiated medical condition resulting from urban fatigue). Urban industrialized society produced neurasthenia, which was then passed on from generation to generation.32 This increased population and the dominance of the city in everyday life resulted in a newly created urban environment that affected human biology: [T]he absolute view that environment directly impresses itself on upon the germ plasm, affecting it in one or more determinants, which if increased by mal- environment in the first generation extended to the second or third is cumulative in a degeneracy, increasing till idiocy is the result. The anatomical basis is…that of an inherited instability, defective metabolism and tendency to premature degeneration of nerve cells, the actual existing cause of disease being supplied by toxins of by any of the numerous forms of stress and strain incident to modern life.33

The urban environment was now creating a human unit that could not be improved. Bryce had synthesized epidemics, medical statistics, degeneration, and eugenics.34 Additionally, Bryce claimed that because 80 percent of city dwellers were dependent on a daily wage for their “immediate wants,” the social environment dominated these groups’ daily lives. He invoked the future once again, declaring that these problems would increase every decade: “How we are to check the degenerative process of antidote the tendency seems to me to be one of the problems towards which the chief energy of public health workers everywhere today must be specially directed.” As he wrote this tract he lamented how “millions in New York City are shut within its walls with a plague almost as mysterious as that of Athens in the days of Pericles.” He condemned the railway workers’ strike, the high July temperatures, and the stress on the emotional nervous system: Multiply these conditions for the many millions of people of all our great cities and towns and we are forced to ask ourselves…For what good? Are all future generations to be ever and increasingly the creatures of such environment, where the individual personality becomes almost lost or is a pawn in the game where capitalistic knights and kings hold all the moves?35

I have included this full quote to demonstrate the ways in which Bryce wrote, at least rhetorically, against the effects of capitalism. He took it upon himself and was part of a larger movement that aimed to mitigate the effects of urban capitalism. However, Bryce’s critique failed or was co-opted because he sought a solution in the realm of biology under the fearful

Crisis as Proliferating Life | 2010 | Paul Jackson | 131 politics of future crises. He was also profoundly anti-urban. Bryce’s solution to urban degeneration was to go to the countryside: [W]here the hands can touch the kindly bosom of Mother Earth, plant rows in her garden and later gather fresh flowers and fruit seem to me the only solution to the problem of how we are to prevent the rapid degeneration of a race, who once had Anglo-Saxon freemen as their ancestors and were something other than automata, ever drudging and rolling a Sisyphus stone up a mountain of struggle without a top, or exhausted through the thirst of hopeless labor seeking to drink from the golden cup of Tantalus always just beyond their reach!36

If the urban environment can affect people over generations, it stands to reason that a return to idyllic nature could improve populations over generations. Bryce invoked the fears of Nordau’s degeneration, not as individual biological reform, but in terms of urban population. He articulated a wide-ranging view of a new urban environment that would cause the cellular level of citizens to degenerate and lead to instability within both urban and national realms of economy and population. The resulting population, Bryce believed, would be all passion and vice; with no limitations or restraint, they were ready to unleash proliferating life.

5.3. Conclusion: Critiquing Proliferating Life: The Naturalization of Population and Misery

In many ways, these historical concepts, sciences, and practices were attempts to isolate the source of the causes of misery, in particular urban misery. Malthus relied on the “natural” explanation of population growth, looking for principles or laws that could explain why misery and crises existed. Degeneration retained, from the longer Hippocratic tradition of health, how the urban environment could produce a mysterious sickness over generations. Similarly, zymosis acquired a generational inflection, since each scale contained the potential for a sudden bolting of disease. My claim is that all these viewpoints dealt with—or were correlated with— the dangers of proliferating biological life. For some experts, proliferating life was the problem. Other experts believed that the effects of overpopulation in cities would lead to biological decay. These theories were different variations of Malthusian concepts, which further mystified and naturalized the problematic population theory. The long-term effect of Malthus’ work, according to the anthropologist Charles Briggs, was “a new means of legitimating and naturalizing capitalism.”37 Malthus critiqued small, specific, and detailed accounts of society and economy, believing that they overlooked the grand changes that he saw in population dynamics. He claimed his principle of population was

Crisis as Proliferating Life | 2010 | Paul Jackson | 132 universal and could be applied to all of history (and, in my analysis, at any scale). However, as Harvey has explained, Marx showed that Malthus’ law of population, though it claimed to be a universal truth, was historically specific. Briggs concurs, saying that “Malthus used a reified and mathematical discourse in constructing the study of population as an autonomous scientific endeavor and seemingly purifying it…of its connections to politics and history.”38 The power of abstract or mathematical practices did not cease with Malthus, but increased in different forms to frame understandings of nation and the economy, which I will address in later chapters. My purpose here is not to dispute Malthus, especially because the likes of Marx, Engels, and Harvey have already debunked his ideas and the ways in which his ideologies have been repeated.39 Instead, I am following how and why this imagination persisted and became incorporated within medical science and health governance. To put this Malthusian imagination and view of the world in relief, I want to go over some of the critiques of Malthus by those who engaged with concerns similar to my own. I want to distinguish in my archive those who were afraid of proliferating life and tried to manage it from those who saw the changes in population and migration emerging from the relations of capital. Marx’ and Engels’ critiques of Malthus contained many insights that are useful for this discussion of population. For instance, Engels did acknowledge the relation between land and labour to the increase of population, but he inserted science as the savior to these problems and declared that the progress of science was “just as limitless and at least as rapid as that of population.” He goes on to speak of the advances of chemistry and soil science by Liebig that “grows in geometrical progression…what is impossible for science?” Many of Malthus’ critics, including Farr, echoed this retort and saw improvement by science as the solution. However, when Marx engaged with Malthusian fears, he critiqued the principle of population as surplus population. Marx took population out of the Malthusian realm of the apocalypse and re-imagined this process as central to capital. For Marx, the creation of a surplus population was intimately linked to dispossession, alienation, and profit. Surplus is a necessary part of capital and it circulates to produce distinct social relations. Engels summarized the ways these surpluses are produced: “Surplus population or labor power is always bound up with surplus wealth, surplus capital and surplus landed property. Population is too great only when productive power in general is too great.”40 Surplus population is a necessary product of capital, and a condition for the existence of the capitalist mode of production. Capital creates “a mass of human material always ready for exploitation by capital in the interests of capital’s own changing valorization requirements.”41 Marx discusses the different forms of the relative surplus

Crisis as Proliferating Life | 2010 | Paul Jackson | 133 population—the floating, the latent, and the stagnant. He also divides the surplus population into ranks: relative surplus population, stagnant population, sphere of pauperism, and the nomadic population. For Marx, in the industrializing city, the latent surplus population was constantly being transformed; in the countryside, the agricultural labourer is reduced to the bearer of the minimum wage. With the movement of labour, this does not shift the city to country, but it produces a mass of migratory labourers who exist with one foot in pauperism.42 Marx outlined the ways that the growth of capital and the expulsion and/or incorporation of these surplus populations affected wages or channeled/disciplined labour power. “Disposable human material” is both required for industry and produced by industry. Marx discussed how working conditions destroyed the worker’s life, making “the accumulation of misery a necessary condition, corresponding to the accumulation of wealth.”43 For Marx, these relations were not natural and they did not result from disequilibrium in the system. Surplus population emerged from the internal relations of capital. I raise these arguments to show that another analysis of proliferating life44 existed; however, for those in my archive, the object of their concern was feared and thought to be inherently problematic rather than produced by structural forces. As the previous chapters have shown, these surplus populations were not talked about as populations or numbers, but as immigrants, degenerates, and slum dwellers. Foucault is additionally helpful in explaining the relations around the production of population and the ways that experts attempted to demarcate these differences. In Society Must Be Defended, Foucault traces the emergence of race, not as a category but as a process or social relation.45 Foucault looked to the development of biologico-social racism, where the other race is a “permanently, ceaselessly infiltrating the social body, or which is rather constantly being re-created in and by the social fabric.” There are no two distinct races that then clash; instead, a single race becomes divided into a super-race or a sub-race, or as Foucault says, “the reappearance, within a single race, of the past of that race.”46 This chapter has documented how state and health experts focused on future health crises to engage and frame these internal degenerate populations, and increasingly confined their conclusions within racial discourses. Foucault polemically summarized the position of power: “We have to defend society against all biological threats posed by the other race, the subrace, the counterrace that we are, despite ourselves, bringing into existence.” My claim is that Dr. Bryce could have easily said this. Foucault posits that the state becomes directed against itself, its own elements, and this leads to the work of “permanent purification.”47 Foucault explains that, “to treat that population as a mixture of races, or to be more accurate, to treat the species, to subdivide the species it controls, into the subspecies

Crisis as Proliferating Life | 2010 | Paul Jackson | 134 known, precisely, as races. That is the first function of racism: to fragment, to create caesuras within the biological continuum addressed by biopower.”48 Foucault explains how an excess of biopower emerged during the moment when it became “technologically and politically possible for man not only to manage life but to make it proliferate, to create living matter, to build the monster.”49 A race can be isolated from the larger population as an idea that is then brought into material existence through social relations. Through my work, I’ve found that the state feared biological threats within populations or from new migrants necessary for a growing industrial North America, and Bryce’s work and words confirm this.50 These tendencies are what I have called the bureaucratic bio-economy, which is built upon both the circulation of medical discourses and the articulation of particular ideology (that I will explore in chapter 9). I’m arguing that sickness became a way to demarcate groups within a nation, in Foucault’s words, a form of racism against population “fragments.” Experts took up the practice in order to understand and isolate those people who should not be allowed to proliferate in excess. In another way, sickness was framed as a natural outcome of uncontrolled population growth and became internalized in the very biology of certain groups. The state became an artificial check and was rationalized on economic grounds. The costs of degenerates or newcomers could be quantified and related to the decline of national vitality. A growing degenerate race was a future crisis—this is a fragment. Life, on a variety of scales, had the inherent potential to grow out of control. If these groups could not be improved, for example through education and moral fortitude, then a crisis was on the biological horizon. Science was the most insidious way to accomplish these goals because the politics had allegedly been leeched out of these relations.51 But how this was accomplished and how consent was marshalled needs to be explained. In the next chapter, I will illustrate the ways these relations of proliferating life were given a spatial and geographic imagination that was easily understood.

Endnotes

1 Michel Foucault, The Order of Things: An Archaeology of the Human Sciences (New York: Pantheon Books, 1971). This phrase is discussed in the next chapter in terms of economy, see Susan Buck-Morss, "Envisioning Capital: Political Economy on Display," Critical Inquiry 21, no. 2 (1995). 2 David Harvey, Justice, Nature, and the Geography of Difference (Cambridge, Mass.: Blackwell Publishers, 1996), 52. 3 David Harvey, "Population, Resources, and the Ideology of Science," Economic Geography 50, no. 3 (1974): 267. 4 David Harvey, Spaces of Capital : Towards a Critical Geography (Edinburgh: Edinburgh University Press, 2001), 55. 5 In current period I could argue that proliferating life continues to be validated, with additional multiple material and political effects. I will explore this more in the conclusion. 6 For an outline of this method, see Michel Foucault, "Nietzsche, Genealogy, History," in Language, Counter- Memory, Practice, ed. D.F. Bouchard (Ithaca: Cornell University Press, 1977). Foucault also speaks to his methods

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in Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007). 7 Quoted in G. Desfor, "Planning Urban Waterfront Industrial Districts - Toronto Ashbridges-Bay, 1889-1910," Urban History Review 17, no. 2 (1988): 80. My emphasis. 8 T.R. Malthus, An Essay on the Principle of Population, as It Affects the Future Imporvement of Society, with Remarks on the Speculations of Mr. Godwin, M. Condorcet, and Other Writers (Clark, N.J.: Lawbook Exchange, Ltd., 2007 [1798]). I should say here that Malthus is my enemy. I see both Marx and Foucault’s projects as writing against Malthus and his followers. In that one way, among many others, I do not see their work to be adversarial. 9 Malthus and his ideas didn’t come into the world fully formed or new. For a classic environmental history text on this, see Clarence J. Glacken, Traces on the Rhodian Shore (Berkeley: University of California Press, 1967). His ideas haven’t gone away either, and can be read in the highly cited Abdel R. Omran, "The Epidemiologic Transition: A Theory of the Epidemiology of Population Change," The Milbank Quarterly 83, no. 4 (1971). 10 Harvey, "Population, Resources, and the Ideology of Science," 258. 11 Malthus, An Essay on the Principle of Population, as It Affects the Future Imporvement of Society, with Remarks on the Speculations of Mr. Godwin, M. Condorcet, and Other Writers. 12 Vice, as venereal disease, would consequently become an object to be understood through science and health research. 13 C. Briggs, "Malthus' Anti-Rhetorical Rhetoric, or, on the Magical Conversion of the Imaginary into the Real " in Categories and Contexts : Anthropological and Historical Studies in Critical Demography, ed. Simon Szreter, Hania Sholkamy, and A. Dharmalingam (Oxford: Oxford University Press, 2004), 58. 14 John M. Eyler, Victorian Social Medicine (Baltimore: Johns Hopkins University Press, 1979), 150-154. 15 Ibid., 158. 16 Victor L. Hilts, "William Farr (1807-1883) and The "Human Unit"," Victorian Studies 14, no. 2 (1970): 146. See also, William Farr, "The Economic Value of the Population," Population and Development Review 27 (2001; c1877). 17 Farr, "The Economic Value of the Population," 570. Additionally, the role of education is echoed in Louis Althusser, "Ideology and Ideological State Apparatuses (Notes Towards an Investigation)," in “Lenin and Philosophy” and Other Essays (Monthly Review Press, 1971). 18 This position confirmed Farr proposals for more sanitary reforms, that could extend the lives and productivity of the majority of the citizens. 19 Hilts, "William Farr (1807-1883) and The "Human Unit"," 148. 20 Eyler, Victorian Social Medicine, 105. This definition of biads comes from his other writings, in particular, William Farr, Vital Statistics, ed. Noel A. Humphreys (London: Royal Sanitary Institute, 1885). 21 Eyler, Victorian Social Medicine, 106. At the same time B.A. Morel was doing similar work in psychiatry with the effect of acquired traits on the germ plasm, which in his view lead to mental alienation. For more, see Daniel Pick, Faces of Degeneration : A European Disorder, 1848-1918 (Cambridge: Cambridge University Press, 1989). 22 Eyler, Victorian Social Medicine, 156. 23 Ibid., 196. See also Paul E.M. Fine, "John Brownlee and the Measurement of Infectiousness: An Historical Study in Epidemic Theory," Journal of the Royal Statistical Society 142, no. 3 (1979). For parallel history of epidemiology, see Anne Hardy, "Methods of Outbreak Investigation in The "Era of Bacteriology" 1880-1920," Soz.-Präventivmed. 46, no. 6 (2001). Annother example of how this trajectory emerged in demography, see E. Ramsden, "Carving up Population Science: Eugenics, Demography and the Controversy over the 'Biological Law' of Population Growth," Social Studies of Science 32, no. 5/6 (2002). Ramsden’s article looked at the biologist Raymond Pearl who “argued that human populations grow in size according to the same mathematical law that governed all aspects of growth in living organisms, even comparing population growth in a number of western nations to the growth of yeast cells or cells in the tadpole’s tail,” in Ramsden, "Carving up Population Science: Eugenics, Demography and the Controversy over the 'Biological Law' of Population Growth," 863. 24 While I will return to these issues in chapter 9, this is what Irving Fisher calls actuarial science, see Irving Fisher, "Mathematical Method in the Social Sciences," Econometrica 9, no. 3/4 (1941). 25 Farr, "The Economic Value of the Population." 26 While Bryce came up in the first chapter, he repeats throughout the rest of this dissertation because he was verbose, prolific, and present at the major key moments in the development of public health in Canada. He is a particular actor, but also representative of wider ideologies. Valverde called Bryce a social purity activist who was fairly unique in this movement as he did most of his work within the state, for more see Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991). In contrast he has been framed as a defender for the health of First Nations in Canada (he was even profiled on

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CBC in a favorable light), see Megan Sproule-Jones, "Crusading for the Forgotten: Dr. Peter Bryce, Public Health, and Prairie Native Residential Schools," Canadian Bulletin of Medical History 13 (1996). 27 Peter H. Bryce, "The Scope of Federal Department of Health," Canadian Practitioner and Review XLIV, no. 11 (1919). In his mind a Federal Department of Health could: [1] pass legislation; [2] collect information; [3] institute health conditions of our complex life and disease of a social character, such as education; [4] create social and educative agencies for example schools; [5] support the welfare of mothers; [6] provide health for the poorest individual, which meant compulsory health insurance; [7] extend the scientific methods of dealing with diseased immigrants; [8] and equip and establish laboratories. 28 Ibid.: 331. 29 I claim this is also a synecdoche, a particular articulation of crisis that will be described in the following chapter. 30 Lee D. Baker, From Savage to Negro : Anthropology and the Construction of Race, 1896-1954 (Berkeley: University of California Press, 1998), 93. For similar arguments in the United States, and public health in general, see M.S. Pernick, "Eugenics and Public Health in American History," American journal of public health 87, no. 11 (1997). 31 Peter H. Bryce, "Feeblemindedness and Social Environment," American Journal of Public Health VIII, no. 9 (1918): 656. 32 Angus MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945 (Toronto, Ont.: McClelland & Stewart, 1990), 53-54. The quote is taken from Bryce, "Feeblemindedness and Social Environment." 33 Bryce, "Feeblemindedness and Social Environment," 658. 34 Bryce was not alone in intermingling eugenics and zymotic diseases. He just illustrates these shifts. For a particular example of the ideology of eugenics see Francis Galton, "Eugenics: Its Definition, Scope and Aims," The American Journal of Sociology 10, no. 1 (1904). There is a direct connection between Farr and Galton from the Anthropometric Committee of the British Association for the Advancement of Science. From 1877 to 1884, the presidency was, at first, Dr Farr, and afterwards Galton (who was the secretary during Farr’s leadership), for more see Francis Galton, "Final Report of the Anthropometric Committee," Report of the British Associatins for the Advancement of Science (1883). 35 Bryce, "Feeblemindedness and Social Environment," 660. 36 Ibid. Tantalus was wealthy man of legend, but the cup might be a reference to a vessel that leaks after getting too full. 37 Briggs, "Malthus' Anti-Rhetorical Rhetoric, or, on the Magical Conversion of the Imaginary into the Real ", 62. 38 Ibid., 70. 39 See Harvey, "Population, Resources, and the Ideology of Science." 40 Karl Marx, Friedrich Engels, and Ronald L. Meek, Marx and Engels on the Population Bomb; Selections from the Writings of Marx and Engels Dealing with the Theories of Thomas Robert Malthus (Berkeley, Calif: Ramparts Press, 1971), 60. I don’t know what is meant by “too great,” perhaps this means if controlled to equilibrium then everything is fine? 41 Karl Marx, Capital : A Critique of Political Economy. Vol. 1, ed. Ben Fowkes and Ernest Mandel (Harmondsworth: Penguin in association with New Left Review, 1990), 784. 42 Marx, Engels, and Meek, Marx and Engels on the Population Bomb; Selections from the Writings of Marx and Engels Dealing with the Theories of Thomas Robert Malthus, 109. 43 Marx, Capital : A Critique of Political Economy. Vol. 1, 799. 44 At this point I want to give a nod to where the term proliferating life came from, as a distinct articulation against the traditional economic theories. A shock to my thought came from Georges Bataille, and inspired me to settle on proliferation process. However incorporating his arguments is quite tricky. Georges Bataille did two moves for my project. The first move is to show how excess is inherent within social relations and therefore must be engaged with directly. Bataille’s frames growth, excess, population, and death, neither from a moral perspective nor a position of fear. The second move arose from Bataille’s engagement with excess that illuminated the fear of proliferating life that emerged from my archive. Bataille helped to crystallize the fears of Malthus, Farr, and Bryce. Bataille’s basis of the economy discards any notion of equilibrium or natural foundation. Bataille flips the scarcity—within liberal economics—on its head and declares that the actual constant of the economy is excessive energy and wealth. This excess can be used for growth, but if not then the excess will be lost without ‘profit’. The excess will be spent “gloriously or catastrophically,” in Georges Bataille, Accursed Share, Vol. 1: Consumption (New York: Zone Books, 1991), 21. I think where he is getting this much of this from is Marcel Mauss and the potlatch. My thinking on this and struggling with theories of value, see David Graeber, Towards an Anthropological Theory of Value : The False Coin of Our Own Dreams (New York; Basingstoke: Palgrave, 2002). Bataille states that social relations are not organized around an economy of equilibrium or efficiency, rather built upon the fears of these uneven excesses, that are sometimes managed and many times not. For him the politics that arise from this anxiety and fear

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can pose questions, but always fails to solve them. Therefore he recommends embracing “exuberance,” or ways of being fruitful with acts of energy, and never to seek out scarcity and the poverty of experience. He talks of the three luxuries within nature: eating, sexual reproduction, and death. All these luxuries relate to the fragility of the human animal and the exuberant release of energy through the expenditure of activity. There may be some huge slippages between Bataille’s notions of economy and energy that could be helped with an integration of Mirowski history of the physics and the science of economics. However, I found Bataille’s contrarian approach useful, even his celebration of the taboo and impure. Maybe as a way to move forward from the longer history and cultural deadlock around life and death, for more see Mary Douglas, Purity and Danger : An Analysis of Concept of Pollution and Taboo (New York Routledge, 2005). This discussion is continued in my conclusion. 45 For related but differing analysis see Achille Mbembe, "Necropolitics," Public Culture 15, no. 1 (2003). Ann Laura Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things. (Durham: Duke University Press, 1995). 46 Michel Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, ed. Mauro Bertani, et al. (New York: Picador, 2003), 61. As I have shown in chapter 2, McClintock supports this history by saying, “the so-called degenerate races were metaphorically bound in a regime of surveillance…[an anachronism] surviving ominously in the heard of the modern, imperial metropolis.” Anne McClintock, Imperial Leather : Race, Gender, and Sexuality in the Colonial Contest (New York: Routledge, 1995), 56. This corresponds with McClintock’s second social power of degeneration is the legitimacy and urgency for state intervention, see McClintock, Imperial Leather : Race, Gender, and Sexuality in the Colonial Contest, 47-48. 47 Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, 62-63. 48 Ibid., 255. 49 Ibid., 254. Mbembe referred to in the current moment as the “management of the multitudes.” 50 Valverde looks at social purity and “whiteness” in Canadian nationalism and contrasts this with racist fears of the “yellow peril,” see Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925. 51 There is an vast literature on science and the power, politics and economics behind the science industry, for more see Steven Shapin, The Scientific Life : A Moral History of a Late Modern Vocation (Chicago: University of Chicago Press, 2008). Stanley Aronowitz, Science as Power : Discourse and Ideology in Modern Society (Minneapolis: University of Minnesota Press, 1988). David N. Livingstone, Putting Science in Its Place : Geographies of Scientific Knowledge, Science.Culture (Chicago: University of Chicago Press, 2003). David F. Noble, America by Design : Science, Technology, and the Rise of Corporate Capitalism (Oxford: Oxford University Press, 1979).

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While debates over cholera, science, and epidemics were going on between experts and authorities, the object that I have named proliferating life was also taking form. Debates between scientists in medical journals contributed to an understanding of the various spaces and times of biological crises. As Harvey suggests, “deep struggles over the meaning and social definition of space and time are rarely arrived at directly. They usually emerge out of much simpler conflicts over the appropriation and domination of particular spaces and times.”1 Expert knowledge was continually marshalled to engage with cholera and by 1892 assumptions about the cause or “origin” of cholera had transitioned from miasma, to environment, to germ, and finally to bacteria. However, this is a partial trajectory of scientific progress. Scientific development is never a simple story. Confusion reigned. The story of the science of cause and effect of cholera was a shifting pathology that did not follow a clear or direct path and was not limited to textbooks, journals, and laboratories. This dissertation follows the science of the crisis and the outbreak. My claim is that the stories and science of epidemiology (epi, upon; dēmos, people; logos, study) were highly structured by Farr’s theory of zymosis. Additionally, I argue that uncertainty and misinterpretation—built upon the science of zymosis and fears of proliferating life—profoundly affected how crises were imagined. This imagination was built upon a variety of disciplines and had long-lasting effects, but it can be directly related to the epidemic cholera crises. In the last two chapters I discussed the ways in which the zymotic–germ relationship became highly influential in structuring how health experts thought about crisis and was foundational to the notion of proliferating life. The zymotic–germ relationship can be summarized as a single germ/seed that enters a pure body and, finding suitable conditions, grows enough to overwhelm/degrade the body. The 1892 cholera outbreak created multivalent meanings that were contained within the palimpsest of proliferating life. The rest of this dissertation will explore the effects that were unleashed. Cholera is important to this history because of its very specific biology. The materiality of the Vibrio cholerea’s life and cholera’s effect on the body confused health experts and allowed a variety of theories to be read into its disease vectors. There was no simple solution to cholera and, because of this confusion, fear, and correlations arose from the cholera crisis. These confusing fears were then applied to other spheres. What emerged was not merely disease analogies and rhetoric, but a cohesion of a

Imagining the Crisis | 2010 | Paul Jackson | 139 spatial and process-based imaginary. This imagination explained events and, in response to fears of proliferating life, it shaped the management of growth and excess. This imagination of the crisis required future speculation predicated on very Malthusian fears. I claim that this logic and rationale was explained and deployed by health experts not through metaphor (although metaphor was relied upon) but through synecdoche. Synecdoche allowed health experts to read proliferating life in a variety of scales and places.2 These claims were not universal or totalizing, but rather a political rationale that was accessible, flexible, and enabled state intervention. This political rationale was based on liberal positivism, a perspective that saw politics as inefficient. The crisis that could be engaged with as a space and time became shaped by attempts to understand acceleration or an excited biological threat. What emerged was a knowledge of the space and time of potential growth—potential excessive growth. This chapter will show how the relations of zymosis were applied to a variety of spheres and used by health authorities to gain legitimacy. Instituting the particular practices of health experts helped to deal with these abstractions and fears.3 Institutions and experts took on the ostensible mission of protecting cities and nations against future crises, an action imbued with the existing visual imagination of zymosis. This chapter follows acts that made the crisis visible by providing a concept and narrative of the crisis process. Medical concepts of zymosis and germ emerged and combined to form a mental conception and material practices that contributed to a new way of engaging with crisis on a variety of scales. This imagination was not a cartographic imagination being imported into a medical viewpoint. This chapter will demonstrate how a scientific and medical framework became a spatial and temporal imagination that then extended beyond the discipline of health and medical science. Cholera’s particular problem is that the disease didn’t fit many of the categories of other diseases; experts were confused by the environmental influences and microscopic agency. In the face of this indeterminacy, experts turned to myth and used rhetorical flourishes to make coherent arguments. Throughout newspapers and journals of the period, articles on cholera contain a palatable tension between known truths and conjecture Dr. George Johnson, professor of medicine at King’s College, published an article entitled “How Shall We Treat Cholera?’ in the Canadian Medical Journal. He wrote, “The cholera poison, whatever may be its nature and source, whether it be ‘ponderable’ or not, is a reality, and no figment of the imagination.4 The historian Delaporte nicely summarized the popular fears of the period from his case of Paris when he said, “People…spoke of cholera as of a creature of the imagination. Fear led irresistibly to fantasy and, at times, to remarkable bluster and bravado.”5 Fear and disease were seen as

Imagining the Crisis | 2010 | Paul Jackson | 140 working together. As one treatise declared, “If anything could render Cholera contagious it would be the enervating influence of Panic—as when, wanting a contagion of its own, it rides on the contagion of fear.”6 Doctors claimed that through fear, “common cholera” (diarrhea) would be transformed into a cholera epidemic crisis. In the historical documents, there is a constant push toward the tendency to exaggerate Asiatic cholera that exerts itself against a pull to focus on the disease’s biology and transmission. During the 19th century, both cultural and scientific imaginations ran wild because cholera, new and unknown, was feared. As scientists began to produce facts, these facts became intertwined with fear-mongering myths and mutually reinforced them. Fear won out the majority of the time, and this was compounded by the fact that most people, including medical scientists, did not experience cholera by way of the petri dish. The dreadful experiences of cholera came from news articles, government reports, treatment of patients, and sometimes the body. The role of experts was to make the cholera crisis understandable; making the disease visible was part of making cholera understood.

6.0.1. Forms of visualization It was not only in the laboratories and petri dishes where cholera was being made visible. Work by Pasteur and Koch to make the bacterium visual led to a politics of certainty regarding the cause and effect of disease, but this certainty was not complete. By the late 1880s, cholera as a microbe object had been described, but cholera was visualized as a pandemic in a variety of cultural, political, and rhetorical formats. In particular, geographic and spatial details in terms of location of disease (such as the marshes) and the specificity of sites (people, migration, neighbourhoods, ethnicities, and forms of travel) were a part of these visualization processes.7 Fearful abstractions became concrete practices and technologies in these locations and sites. Cholera theories were applied and read into places in a very particular way by health authorities. In this chapter, I am attempting to explain how disease-crisis and proliferating life were visualized in much the same way that historian Susan Buck-Morss sought to explain the concept of the economy: As Foucault told us…every new science creates its object. The great marvel is that once a scientific object is “discovered” (invented), it takes on agency. The economy is now seen to act in the world; it causes events, creates effects. Because the economy is not found as an empirical object among other worldly things, in order for it to be “seen” by human perceptual apparatus it has to undergo a process crucial to science, of representational mapping. This is doubling, but with a difference; the map shifts the point of view so that viewers can see the whole as if from the outside, in a way that allows them, from a

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specific position inside, to find their bearings. Navigational maps were prototypical; mapping the economy was an outgrowth of this technique.8

Buck-Morss looked at relational graphics that linked variables to allow viewers to be able to associate causal relationships in the economy. The designs of these graphic representations of the world were no longer directly dependent on what they attempted to illustrate.9 I would like to put representational mapping in conversation with Timothy Mitchell’s exploration of the philosopher Georg Simmel’s “character of calculability” in terms of the economy. A new politics of calculation became established in the economy as a set of practices involving equivalences, circulations, and social actors to make quantities and performances measurable and comparable.10 The intermingling of the calculations of the economy and the calculations of health are vitally important to this story (to be shown in chapter 9). Comparing equivalences were a method in representational mapping. The experts of the 19th century had no qualms over diagramming a totalizing discourse based on their ideas of medical science. Therefore, the cholera epidemic was visualized in a variety of ways. One influential representation was the way in which the cholera event allegedly came from beyond the borders of cities and nations. In chapter 2, I showed how navigational maps were key expert visualizations of an Atlantic cholera space. In this chapter, I will tackle how scientists, news reporters, authors, and bureaucrats articulated “the disease crisis” in a variety of representational mappings. Before continuing, I want to distinguish the practices of making visible from the work of Bruno Latour. Latour’s The Pasteurization of France described how environmental causes of disease became supplanted. For Latour, the hygiene movement and the scientists who worked with Pasteur were successful because “[t]hey made the enemy visible.”11 Latour suggested that in this historical transition, supplanting the disease was successful because of how bacteriologists made visible “the corrupting forces, the double agents, the miasmas and contagions, and accorded immediate trust to those who might, in identifying them, be able to take measures against them. It was at this precise moment that the microbe and the revealer of microbe appeared.”12 He suggests that the Hippocratic tradition failed in part because no new enemy was revealed. My claim and my archive refute this. Health authorities didn’t stop battling filth, paving streets, and changing the physical environment; rather, practices and rationalities shifted. For me, Latour’s conclusions on visibility and the success of bacteriology are too neat. I grant that it was vastly important to reveal microbes; however, my claim is that the agents of crisis—Farr’s exciters—were still floating around. These invisible enemies still needed to be represented.13 For my purposes, the relations involved in making visibility an act of legitimacy

Imagining the Crisis | 2010 | Paul Jackson | 142 and argumentation did not only happen on the microscopic level. In this chapter, I show how the bacteriologists worked within an accumulation of associations and different ways of making visible that went far beyond the petri dish. These experts marshalled support by relying on a wide variety of visual methods. Latour’s experts had laboratories, but this did not mean that “they raised a world.’” The visions that emerged from the laboratory had to conform to ideologies and cultural assumptions that had existed for some time.14

6.1. Making the Cholera Crisis Visible The scientific imagination, in order to be scientifically validated, required visualization of the invisible interconnected relations around a cholera crisis (for a great example of connections of disease, see Figure 6.1). Scientific proofs needed to be demonstrated to gather support and to make future claims. However, the image of microscopic bacteria cannot be attributed only to Pasteur, Koch, and other the scientists of the late 19th century. The microscopic imagination had existed for quite some time. Almost two hundred years before bacteriology, the Dutch naturalist Antoni van Leeuwenhoek invented the microscope and observed small living “animalcules” in water.15 As the technology of the microscope spread, so did descriptions of entities invisible to the naked eye. During the cholera outbreaks, both Punch magazine and a report for England’s General Board of Health visualized the microscopic inhabitants of London’s water supply. The Board of Health illustration sought to produce an accurate description, while Punch’s depiction was a more monstrous illustration (see Figures 6.2 and 6.3). The scientific visualization corresponded and reflected the rhetorical vision. At the same time, the Cambridge professor Charles Kingsley dramatically described in his treatise The Water Supply of London that when drinking water, “you are literally filled with the fruit of your own devices, with rats and mice and such small deer, paramecia, and entomostraceae, and kicking things with horrid names, which you see in microscoxpes at the Polytechnic.”16 Microscopic disease was simultaneously illustrated through both allegorical and scientific descriptions. These previously invisible microscopic organisms could be written into ecologies, places, and bodies. Once these associations were made, all the sites could then be categorized in what the philosopher Jacques Derrida calls the “well-computed binarism,” where the world is “rigorously divided into remedies and poisons, seeds of life and seeds of death, good and bad traces.”17 While the little, unseen creatures and seeds of death were revealed, the immensity of an epidemic was also visualized through larger-than-life monstrosities. Cholera was imagined to be larger than the city itself. Satirical images also offered profound images and analogies of how

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Figure 6.1. El Paso Health Board. Diagrammatic Travelling Report of the Household. The Canadian Public Health Journal 1, no 12 (1911): 295.

Imagining the Crisis | 2010 | Paul Jackson | 144 invisible diseases worked in cities. Natural features like rivers and marshes that had survived through urban development were given an abominable quality. The magazine Punch published an illustration of the River Thames with her disease “children” in tow, zombie-like creatures emerging from water filled with dead animals. The river became personified as an agent and an unruly problem. Miasmic air pollution was also personified as a creature that hung over the city or enveloped entire neighbourhoods. And cholera was said to be child of Hindu Gods. The allegorical illustrations of disease visualized these processes as insectile, monstrous, ghostly, or alien (see Figures 6.1, 6.3, 6.6, 6.8, 6.9, and 6.10; and see chapter 3 for more discussion). These images and imaginations illustrate the active, ongoing process of making disease understandable. As cholera was made visible—a microscopic bacteria and a deathly skeleton that travelled in the urban infrastructure—water became not only vital to life but also poisonous, containing the seeds of death. The cholera monster inhabited water, sewers, swamps, and rivers. As science and sanitarians’ theories on visualizing these invisible microscopic worlds changed, their enforcing practices could be more speculative and based on conjecture.

Figure 6.2. From Report of the Committee on Figure 6.3. A drop of Thames water, as depicted by scientific Inquires in Relation to the Punch in 1850.19 Cholera Epidemic of 1854.18

Another perspective of the cholera epidemic was demonstrated through large-scale quantitative measures, such as numbers and maps based on death counts. Statistics, in particular the birth and death tables, were profoundly important to visualizing and tracking disease in large populations and documenting how these populations changed over time (see Figure 6.4). Maps were also essential to figuring out how cholera was transmitted. In 1854, one of the fathers of epidemiology, Dr. John Snow, used maps to illustrate cholera’s transmission through London’s

Imagining the Crisis | 2010 | Paul Jackson | 145 water supply. Through mapping, Snow made cholera’s infection vector through the water supply perceptible, which supported many of his previous conclusions (see Figure 6.5).20 These city maps also show the spread and scope of the event, how the disease materially touched down from household to household. These large, aggregate data statistics and maps were profoundly important because they offered evidence of the sudden bolting of the disease in cities and nations. The graph or the spike in numbers took on a powerful argumentative force. Moving beyond the embodiment of disease itself, boundaries, particularly the idea of the gate, were powerful illustrations of the process of getting sick. An editorial called “At Our Gates” in the Canadian Lancet after the 1892 cholera scare declared: “Now that the grim hand of cholera is knocking at our gates it becomes the duty of every medical man to be thoroughly posted as to the best methods of checking this scourge, should it be succeed in gaining a foothold in America...While there is not great danger to be apprehended at present, it is well to remember that forewarned is forearmed.”21 Gates, doorways, entranceways in general, were perhaps the most frequent association made (see Figures 6.7 to 6.10). Gateways illustrated how disease could circulate and how doors or quarantines could be closed. In these images, disease was constantly personified as a death figure that either entered the city through sewers, arose in a room like fog, or was an impoverished “dirty” immigrant coming into the city carrying cholera on his or her back (see Figures 6.7 and 6.8). In this case, the gate symbolized a common relationship in Victorian pathology. Hamlin explains this pathology as “how the pure was corrupted by contact with impurity and in the process transformed into a replica of the impurity that would perpetuate further corruption.”22 The imagery of gates shifted its focus from keeping aspects of the world out to how a national barrier had been compromised. These dynamics resurfaced in 1909 in the famous Canadian treatise called Strangers within Our Gates, written by the social reformer J.S. Woodsworth. The piece worried about the effects of Eastern European immigrants on Canada. Woodsworth ranked races according to their potential for assimilation and their potential for degeneration.23

Figure 6.4. John Snow’s cholera map.

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Figure 6.5. Peter Bryce, “Report of the Secretary: A Hundred Years of Sanitation in Ontario." In Annual Report of the Provincial Board of Health of Ontario Being for the Year 1891, edited by Ontario Provincial Board of Health of. Toronto: Printed by Order of the Legislative Assembly, 1892.

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Once internalized in the country, potential forces could extend influence on the entire nation, just like an infection. Albert L. Gihon, medical director of the U.S. Navy in an address to the 1893 Pan-American Medical Congress, combined many of theses images and associations to declare: Our American vital statistics are not yet piled high enough to form the foundation for a substantial superstructure of demography. The great cauldron in which we are mixing Celts and Saxons, Semites and Aryans, with a seasoning of syphilis, tuberculosis, and insanity, is simmering with what ultimate homogeneity can only be conjectured. When immigration was a tiny stream, however muddy and noisome, poured into a rapid river of pure water, it was soon lost in the crystal fluid; but now that huge sewers are discharging their foetid pestilential torrents into a placid lake that has no outlet, the lake itself becomes turbid and unclean. Already in the culs de sac, which are nearest the open mouths of these foul sewers and receive their floating scum—the prisons, reformatories, almshouses, insane asylums, and hospitals—this filthy, debased, and diseased foreign element is ascendant, and our demographers have a simple task in representing its volume by numerical statistics.24

This anxiety about crossing a boundary clashed with the long-standing imagery based on the free circulation of goods and peoples.

Figure 6.6. Father Thames introducing his offspring to the fair city of London, Punch magazine, 1858. Cholera is the monster on the lower right.

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Figure 6.7.“Right About Face, Mr. Angers,” Toronto Evening News, Friday, June 23, 1893, p.1.

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Figure 6.8. “An Undesirable Emigrant,” Toronto Evening News, Wednesday, August 31, 1892, p.1.

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Figure 6.9. “No Alien Need Apply,” Toronto Evening News, Wednesday, September 5, 1892, p.1.

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Figure 6.10. “Things Coming Our Way,” Toronto Evening News, Friday, September 6, 1895, p.1.

Images of shutting doors coexisted uneasily with the metaphor of the city as an organism drawn from the natural sciences of the 17th century.25 This older organism metaphor amalgamated concepts of free economic exchange and medical science. Circulation became a catchall that connected the free movements of air, water, money, and citizens through the body of the city. Circulatory “health” in the city relied on organic and body metaphors for justification. By the 18th and 19th centuries, people conceived of circulation as an infinite cyclical process. William Harvey in 1628 connected the double circulation of the blood with the metabolic circulation of chemical substances and organic matter. This cyclical circulation was the basis of modern ecology. For the political philosopher Thomas Hobbes, government was obstruction in the veins. The sanitarian Chadwick imagined London renewed as “a social body

Imagining the Crisis | 2010 | Paul Jackson | 152 through which water must incessantly circulate, leaving it again as dirty sewage.” To stop circulation was stagnation; anything stagnant bred pestilence. The contemporary geographer Erik Swyngedouw made this summary: “The brisker the flow, the greater the wealth, the health and hygiene of the city would be…The ‘veins’ and ‘arteries’ of the new urban design were to be freed from all possible sources of blockage.”26 Circulation implied flow of goods. Circulation led to wealth. Free circulation was vital for the economy. But with the rise of international epidemic and the cultural and economic costs, the imagery shifted. For the health of the city and nation some aspects of the flow must be stopped, monitored, and even rejected. This circulation now could import crises. Boundaries had to be maintained through quarantine. Anxiety over the imagery of the entrance of the disease into the organism of the city or country paralleled the progressive moment’s reaction against the free market and economic depression (see chapter 2). My claim is that rather than producing and articulating a new single image or metaphor of a city or nation as a static body organism, health experts looked to unify their position through correlation. These acts of correlation explained and visualized how crisis processes played out on microscopic and national scales.

6.2. The Problems of Representation: Metaphor and Synecdoche So what did these acts of visualization achieve? My claim is that two actions were occurring. The first was a powerful metaphor or analogy: a skeleton could stand in for cholera. The second was an illustration of the relations that allowed cholera to infect a city: crossing a boundary became a crisis. All of these analogies illustrated the relations between sick and healthy. The drive was to make these relations visible and legible. If they could be “seen” and hence understood they’d be manageable as a unified object. Science sought to understand disease relationships so that they could eradicate those agents and processes that enabled sickness, be they immigrants, swamps, touching, or dirty pipes. Scientific validation came from making visual the invisible elements—revealing how they worked in relation to urban places, what conditions fostered their existence—and suggesting how to eradicate and disinfect those places. The primary metaphor used was seed and soil and this was especially influential to the concept of zymosis (as outlined in chapter 4).27 Pelling maintains that additional large organizing analogies could be read into the sciences as explanatory devices of relations of disease, analogies like rotting fruit (and how rot and decay spread from one entity to another); odours and the diffusion of gases; colour dyes in water (how a small amount of material diffused and coloured the whole mass); poisons (how small doses effected entire bodies); and fermentation or

Imagining the Crisis | 2010 | Paul Jackson | 153 putrefaction (which was then connected to reproduction and decay both inside and outside the body, as we have seen with zymosis in chapter 4). Contagion and infection suggested people being affected by the environment. To infect was to dip or to stain, and both were related to impurity. Pollution was connected to an individual’s sense of being separate from his or her environment and how to maintain or regulate this separation. 28 All of these associations fed into the popular and scientific visualization of what happened when people and cities got sick. Susan Sontag has warned of the current period, “it is hardly possible to take up residence in the kingdom of the ill unprejudiced by the lurid metaphors with which it has been landscaped,” which could have easily applied to the scientists of the 19th century.29 Analogies, metaphors, and imagery all do political and cultural work.30 However, when put together, all the different images and metaphors by different writers in various time periods create an over-the-top pastiche that resembles the satirical cartoons of cholera.31 The majority of these metaphors were used only as decoration or rhetorical flourishes in writing. My question is, What are the effects when these baroque decorations accumulate? I want to emphasize that through this pervasive imagery, these metaphors seeped into the period and structured thought. In order to explain the logic of metaphor, I rely on the philosopher Max Black who investigates how language and philosophy interact, particularly through metaphors and models. In his scrutiny of these processes, he highlights the focus and the frame of a metaphor; the substitution view of a metaphor; a system of associated commonplace ideas; how a metaphor organizes and structures views of the world; how a metaphor can remedy a gap in the vocabulary; how this gap is a catachresis but can become literal; and the interaction view of a metaphor where two entitles become active together in a statement. Importantly, Black says, “recognition and interpretation of a metaphor may require attention to the particular circumstances of its utterance.” 32 Generally, metaphors reveal new relationships and allow audiences to see new connections. In the space between the unknown and the known, metaphors allow the expert to speak to the unknown.33 Known sciences such as chemical fermentation and processes such as seed germination and biological decomposition allowed health experts to talk about the unknown forces of epidemics.34 I am not claiming that scientists or the urban citizens believed cholera was an actual skeleton that entered the city by crawling through the sewer pipes. No one took this literally. Instead, the process of tackling the unknown can be understood through the rhetorical device of synecdoche. The device of synecdoche used the act of correlation that had become essential for liberal positivists to maintain the position of science and expertise in place of political discussion.

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6.2.1. Synecdoche and disease My claim is that epidemic crises came to be understood through the combination of zymotic theory and the germ. In this synthesis of germ–zymosis, a specific type of imagination took hold of the medical experts and that imagination was expressed through synecdoche. Similar to metaphor yet distinct, synecdoche is a figure of speech or a term in which a part of something is used to refer to the whole thing. Synecdoche is the substitution of a part for a whole, genus for species, or vice versa. For example, people and social types are emphasized through the description of a single body part that represents their entire being: hippies become “long-hairs.” Other examples include John Hancock to mean signature, and the “city” takes away your garbage instead of specific “trash collectors.” Synecdoche allowed experts to jump from the individual to the population or from the microscopic to the aggregate. I claim this was a successful political strategy used to build consensus around what must be done to combat the problems of the city or nation. What takes place through synecdoche is a jumping in optical resolution, in part validated by the science of bacteriology and visualization techniques such as the microscope. This jumping goes from cell, to organ, internal biological systems, body, social group, urban district, city, nation, the body politic, national economy. This was a particular form of representational mapping. Synecdoche made these specific dynamics on each register relatable and comparable. Synecdoche became a form of root metaphor, perhaps even an inching toward a metaphysical system that was spatial by analogy. Synecdoche made processes that worked in different times, spaces, and scales legible and comparable. Though inadequate, these techniques allowed expertise to be claimed.35 To illustrate the use of synecdoche, I want to use Dr. Peter Bryce’s 1907 speech to the Empire Club, which was entitled “Civic Responsibility and the Increase of Immigration.” Bryce talks about how all the cities in Canada are growing rapidly, at a much higher rate since the turn of the 20th century, for the most part due to immigration. As we shall see in the following chapters, Bryce, a trained doctor and career public servant on the provincial health board, was deeply implicated in the cholera outbreak of 1892. Bryce made a totalizing claim to his audience of Canadian leaders: “[W]e have to realize the fact that a country is an organism and as truly subject to the laws of evolution as is any other individual organism in the vegetable or in the animal world.” Bryce is using a metaphor here, but to back up this claim, to make it more “precise,” he invokes physiology, physics, hydraulics of the blood, mechanics of the muscles, chemistry of blood and food, and, finally, the individual cell. He claims that these sciences can work on different registers. But the knowledge of the necessary interrelationship of all these

Imagining the Crisis | 2010 | Paul Jackson | 155 parts and process are vital. To bring his view of the world home, Bryce ends his speech with the following comments: Finally we take a look at the individual cell itself through a microscope and there study the individual unit that goes to make up the total organism which we call man…If we apply this process of looking at things to society, we shall see perfectly well that in order to study society intelligently, we have to look upon it as an organism made up of individual units, just as the cells make up the individual body. That is to say, society must be studied in connection with, or in relation to its surroundings, its environment, whether external to the body or internal to the body.

For Bryce, this external environment includes climate, food, housing, and workplaces and their “ventilation, lighting and draining.” He continues: “We say, then, that society as a whole, of the city of Toronto, the whole country of Canada, must be made up and measured in accordance with the goodness of that individual environment.”36 What is this individual environment? Bryce does not define it but quickly refers to immigration and goes on to ask the audience to take civic responsibility for the living conditions of these newcomers to Canada. He blames the landlords for creating these poor living conditions and suggests that while, in general, immigration is a good thing for Canada, bad environments can corrupt immigrants or excite them into becoming a crisis. My claim is that Bryce utilized a specific form of representation.37 He enacted synecdoche.38 The significance of synecdoche comes from the crisis relations that it invokes; the seed by itself cannot be separated from the soil because then it would lose all meaning. The immigrant cannot be taken out of the external environment because then Bryce’s argument would lose all meaning. While Bryce deplored all urban living conditions, he was still concerned about a specific type of immigration. He made the distinction between the good British-immigrant-cell from the bad Semite-immigrant-cell. While the environment could activate both, the Semite cell may be more prone to becoming excited by the local conditions. This is why he was talking about immigration, because Bryce was obsessed with the spark and the exciter process that he believed could turn the massive increase of immigration in urban Canada into a crisis, killing the organism by excessive growth or by spreading throughout the nation. There is nothing essentially bad about the immigrant worker; they contribute to the vitality of the national organism.39 Bryce’s act of synecdoche worked between the different registers. He made known or understandable to his audience how the spaces and times of a specific process could lead to crisis, and how these processes worked within both the parts and whole.40

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Bryce’s framework was a sustained and systematic representational mapping, almost a model. Black states: “To speak of ‘models’ in connection with a scientific theory already smacks of the metaphorical.”41 A model is a type of design, an imitation where relative proportions are preserved. In a model, some features are deemed irrelevant. A model represents an original, but therefore requires correct interpretation of this representation. A model is seen as simpler and more abstract, but this must be rejected as an illusion. Going further, an analogue model replicates a structure or web of relationships. Black clarifies: The remarkable fact that the same pattern of relationships, the same structure, can be embodied in an endless variety of different media makes a powerful and a dangerous thing of the analogue model. The risks of fallacious inference from inevitable irrelevancies and distortions in the model are now present in aggravated measure. Any would-be scientific use of an analogue model demands independent confirmation. Analogue models furnish plausible hypotheses, not proofs.42

While Bryce is exemplar in articulating this crisis synecdoche imagination, it is a form of synecdoche analogue model that permeates my archive43 and always without proof. Bryce was unique because he was directly trying to influence policy, by being quite verbose and extremely prolific. But scientists in medical journals, reporters in newspapers, doctors in medical reports, bureaucrats in government reports would also use this form of synecdoche.

6.3. Conclusion: Metaphors and Representation in Geography What does synecdoche add to the ongoing discussions in the literatures of geography, along with science and technology studies, that metaphor does not? In geography, the relationship between metaphor and imagination has been hashed out for quite a while now and I am indebted to those discussions.44 Differences between large metaphors that lie behind methods and science—constitutive—and small metaphors that pepper individual writings–decorative—have been previously illustrated. As the geographer Trevor Barnes suggests, metaphors can gradually acquire a habitual use; they can become dead metaphors. Dead metaphors become literal.45 Barnes suggests that histories themselves are like extended metaphors; they structure the unknown in familiar packages. Metaphors are neither right nor wrong, nor static; rather, they are tasteful or tasteless, appropriate or inappropriate, useful or a hindrance. While Derek Gregory warns that “all metaphors are problematic and that ‘translation terms’…—seemingly general terms used in strategic and contingent ways…—get us a certain distance and fall apart.”46 Gregory suggests that we keep in mind “the clinging mud of metaphor, of the mundanity and

Imagining the Crisis | 2010 | Paul Jackson | 157 materiality of intellectual inquiry.”47 It takes a lot of work for these images and highly repeated statements to become mundane and cringe-worthy.48 At the same time, as the literature suggests, metaphors are powerful in producing new forms of thinking. Metaphors and imagery are useful in developing theory since they produce a creative spark, as can be seen in my archive with Farr and zymosis. Metaphors can structure thought and be used to marshal political support or frame the necessary actions or developments. Their use can be liberatory. Arib and Hesse suggest that “metaphor is potentially revolutionary.”49 Cresswell, working with Lefebvre, claims that “metaphors are acts that encourage some thoughts and actions and discourage others, and this has geographical implications” as they are “geographic acts that encourage spatial thoughts and actions.”50 To focus on merely the metaphors themselves is important, yet even more important is how these metaphors were used and what practices they engendered. Walter Benjamin looked to rehabilitate the allegory as a revelatory instrument. For Benjamin, allegories reveal only because they are broken and they resist mimesis, which suggested to him they might be the only form of language capable to resist the allure of the commodity. For Benjamin, the allegory could inscribe “its own network of ‘magical’ affinities across the space of an inscrutable history.” As Gregory summarizes: “Benjamin sought to bring about an explosion that would bring down the Dream House of History by forcing a discarded, forgotten, even repressed past into an unfamiliar, un-reconciled constellation with the present.”51 Accordingly, I have made a concerted effort to bring zymosis, the germ, and synecdoche in order to bring these abandoned visions of a disease crisis into the present.52 I suggest that doctors and scientists around the turn of the 20th century, such as Bryce, relied on a particular imagination based on synecdoche to inform their methods, policies, and interventions. My claim is that this zymotic–germ imagination invigorated state medicine and public health engagement with cities, which had profound geographical implications. Synecdoche allowed medical experts to jump scale and be expansive in their recommendations. A particular geographic imagination intersected with a persistent medical imagination, and together this produced a rationale for action. These intersecting imaginations took hold and continued long after the cholera crisis of 1892. Catherine Waldby uses the term biomedical imagination and suggests that this viewpoint is inherently speculative and explanatory, a propositional world that it makes for itself.53 Waldby suggests, “Biomedical knowledge gains its greatest legitimacy under conditions of epidemic, allowing it to take extraordinary measures, command extensive social resources and mobilize entire populations in the interests of disease

Imagining the Crisis | 2010 | Paul Jackson | 158 management.”54 My claim is that this biomedical imagination did not enter the minds of the doctors and scientists fully formed; instead, it emerged and was shaped as biomedicine became the dominant framework it is today. As health moved away from emergency practices and toward preventative health—from isolating the sick to researching the sick—a specific viewpoint became consolidated.55 The biomedical imagination contained the zymosis crises’ profound spatial-temporal analogue model. With the zymotic–germ theory’s flexibility and authority from the mouths of self-declared experts, this imagination could be deployed politically. The debates around theories of disease played out through various mediums that included health boards, sanitation practices, immigration, and eugenics. The following chapters will explore how this imagination was instituted.

Endnotes

1 David Harvey, "Between Space and Time: Reflections on the Geographical Imagination," The Annals of the Association of American Geographers v80, no. n3 (1990): 421. 2 Synecdoche can be summarized as “pars pro toto”, a Latin phrase that means part for the whole. This chapter distinguishes the synecdoche device from others representation devices such as metaphor and analogy. Synecdoche is based on correlation rather than likeness. Synecdoche is totalizing by its own conceptual logic, as Christian Anderson pointed out to me. The inspiration for distinguishing synecdoche from metaphor came from Trevor Barnes’ call for specificity when talking about these representational devices, in Trevor J. Barnes, Logics of Dislocation : Models, Metaphors, and Meanings of Economic Space, Mappings (New York: Guilford Press, 1996). See also Trevor J. Barnes and James S. Duncan, Writing Worlds : Discourse, Text, and Metaphor in the Representation of Landscape (London; New York: Routledge, 1992). 3 In Canada these health institutions culminated with the Commission of Conservation and the journal Conservation of Life that articulated a national economic rational for health. This framework led to the unification of the rational ideal between the economies of the body, the nation, and the scientific. 4 George Johnson, "How Shall We Treat Cholera? Speech Read before the Montreal Medico-Chirurgical Society January 26th 1866," Canadian Medical Journal and Monthly Record of Medical and Surgical Science II (1866): 561. 5 Francois Delaporte, Disease and Civilization: The Cholera in Paris, 1832 (Cambridge, Mass.: MIT Press, 1986), 47. 6 A Former Surgeon in the Service of the Honorable-East-India-Company, Epidemic Cholera : Its Mission and Mystery, Haunts and Havocs, Pathology and Treatment : With Remarks on the Question of Contagion, the Influence of Fear, and Hurried and Delayed Interments. (New York: Carleton, 1866). 7 For more on exclusion and stigma, see David Sibley, Geographies of Exclusion : Society and Difference in the West (London: Routledge, 1995). 8 Susan Buck-Morss, "Envisioning Capital: Political Economy on Display," Critical Inquiry 21, no. 2 (1995): 440. For a further discussion on visualization and medicine, see Michel Foucault, The Birth of the Clinic; an Archaeology of Medical Perception (New York: Pantheon Books, 1973). 9 Buck-Morss, "Envisioning Capital: Political Economy on Display," 466-467. Buck-Morss asked an important follow up question to her intervention: “Why is it, today, that theory generally shirks the challenge of envisioning the social? Is it the taboo against “totalizing” discourses? If so, it might be noted that the global system will not go away simply because we theorists refuse to speak about it.” 10 Timothy Mitchell, Rule of Experts : Egypt, Techno-Politics, Modernity (Berkeley: University of California Press, 2002), 8-9. See also, Timothy Mitchell, "Rethinking Economy," GeoForum 39, no. 3 (2008). Timothy Mitchell, "Fixing the Economy," Cultural Studies 12, no. 1 (1998). 11 Bruno Latour, The Pasteurization of France (Cambridge, Mass.: Harvard University Press, 1988), 33. I don’t have the space to get into the deep discussion with his work, but see also Bruno Latour, Pandora's Hope : Essays on the Reality of Science Studies (Cambridge, Mass.: Harvard University Press, 1999); Bruno Latour, Science in

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Action: How to Follow Scientists and Engineers through Society (Cambridge, Mass.: Harvard University Press, 1987). Bruno Latour and Steve Woolgar, Laboratory Life : The Construction of Scientific Facts (Princeton, N.J.: Princeton University Press, 1986). 12 Latour, The Pasteurization of France, 33. 13 I find Latour’s historical descriptions are still within a periodic framework—a before and after—even though he reverses with the effects of translating knowledge, history, and even ‘reality’. One interesting counter example of this from my archive can be seen in Cyrus Edson, "The Microbe as a Social Leveller," The North American Review 161, no. 467 (1895). In this account, the revealer of the microbe opens up the interconnected and bounded nature of humans, and hence affirms the necessity of socialism. 14 Bruno Latour, "Give Me a Laboratory and I Will Raise the World.," in Science Observed, ed. K. D. Knorr-Cetina and M. J. Mulkay (Beverly Hills: Sage., 1983). 15 M. Wainwright, "Microbiology before Pasteur," Microbiology Today 28 (2001). 16 Erin O'Connor, Raw Material : Producing Pathology in Victorian Culture, Body, Commodity, Text (Durham, N.C.: Duke University Press, 2000), 41. 17 Nigel Clark, "The Demon-Seed: Bioinvasion as the Unsettling of Environmental Cosmopolitanism," Theory, Culture & Society 19 (2002): 108. To drop Derrida into this discussion may be problematic, but I find that the division of the world into seeds of death and the circulation of these seeds evocative to the imagination of my archive. 18 Nigel Paneth, "A Rivalry of Foulness : Official and Unofficial Investigations of the London Cholera Epidemic of 1854," American journal of public health. 88, no. 10 (1998). 19 Stephen Halliday, "Death and Miasma in Victorian London: An Obstinate Belief," British Medical Journal 323, no. 7327 (2001). 20 K.S. McLeod, "Our Sense of Snow: The Myth of John Snow in Medical Geography," Social science & medicine (1982) 50, no. 7-8 (2000); T. Koch, "The Map as Intent: Variations on the Theme of John Snow," Cartographica 39, no. 4 (2004). 21 Canadian Lancet, “At Our Gates”, The Canadian Lancet: A Monthly Journal of Medical and Surgical Science, Criticism and News, Toronto, October, (1892), 74. 22 Christopher Hamlin, "Providence and Putrefaction : Victorian Sanitarians and the Natural Theology of Health and Disease," Victorian Studies 28, no. 3 (1985): 389. See also Laura Otis, Membranes : Metaphors of Invasion in Nineteenth-Century Literature, Science, and Politics, Medicine & Culture (Baltimore: Johns Hopkins University Press, 1999). Susan Craddock, "Sewers and Scapegoats: Spatial Metaphors of Small-Pox in Nineteenth Century San Francisco," Social science & medicine. 41, no. 7 (1995). 23 For more immigration and Canada, see James S Woodsworth, Strangers within Our Gates : Or, Coming Canadians (Toronto: The Missionary Society of the Methodist Church, 1908); Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991). 24 Albert L. Gihon, "Sanitary Motes and Beams. Address by the President of the Section: Hygiene, Climatology, Demography, and Marine Hygiene and Quarantine" (paper presented at the Transactions of the first Pan-American Medical Congress, 1st Pan American Medical Congress, Washington, D.C., 1893, September), 1913. 25 Richard Sennett, Flesh and Stone : The Body and the City in Western Civilization (New York: W.W. Norton, 1994). Claire Rasmussen and Michael Brown, "The Body Politic as Spatial Metaphor," Citizenship Studies 9, no. 5 (2005). 26 For the entire take on circulation please see the chapter: Erik Swyngedouw, "Metabolic Urbanization," in In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, ed. Nik Heynen, Maria Kaika, and Erik Swyngedouw (London; New York: Routledge, 2006), 30-32. Circulation is also a vital aspect of Foucault’s notion of security in terms of scarcity, epidemic, and markets, see Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007). The tension between different forms of circulation runs throughout this dissertation. This tension is not only around concepts of circulation, but also the practices and material technologies that allowed circulation to take place. 27 Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865-1900 (Cambridge, UK; New York: Cambridge University Press, 2000). Worboys also suggests that the military metaphor of invading armies and bodily defenses came into the fore in 1880s. This is a huge area that I do not have space to get into, for more please see Mark Harrison, "The Medicalization of War-the Militarization of Medicine," Social History of Medicine 9, no. 2 (1996); Roger Cooter, Mark Harrison, and Steve Sturdy, War, Medicine and Modernity (Stroud: Sutton, 1998).

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28 Margaret Pelling, "The Meaning of Contagion: Reproduction, Medicine and Metaphor," in Contagion : Historical and Cultural Studies, ed. Alison Bashford and Claire Hooker (London; New York: Routledge, 2001), 20-24. 29 Susan Sontag, Illness as Metaphor and Aids and Its Metaphors (New York, NY: Picador, 2001), 3-4. Sontag is not alone in this assertaiton. Similar critiques arise from within science as well, see R.C. Lewontin, "Models, Mathematics and Metaphors," Synthese 15, no. 1 (1963). 30 As Nancy Stepan clarifies the relationship between science and analogy: “One test of the social power (if not the scientific fruitfulness) of an analogy in science seems to be the degree to which information can be ignored, or interpretation strained, without the analogy losing the assent of relevant scientific community.” Nancy Leys Stepan, "Race and Gender: The Role of Analogy in Science," in The "Racial" Economy of Science : Toward a Democratic Future, ed. Sandra G. Harding (Bloomington: Indiana University Press, 1993), 370. See also Evelyn Fox Keller, Refiguring Life : Metaphors of Twentieth-Century Biology (New York: Columbia University Press, 1995). Evelyn Fox Keller, Making Sense of Life : Explaining Biological Development with Models, Metaphors, and Machines (Cambridge, Mass.: Harvard University Press, 2002). Andy Merrifield, "Between Process and Individuation: Translating Metaphors and Narratives of Urban Space," Antipode. 29, no. 4 (1997). Gregory Moore, Nietzsche, Biology and Metaphor (Cambridge: Cambridge Univ. Press, 2002). Otis, Membranes : Metaphors of Invasion in Nineteenth-Century Literature, Science, and Politics. 31 Deleuze too spoke to difference and resemblence when he said: “Analogy is itself the analogue of identity within judgment.” In Gilles Deleuze, Difference and Repetition (New York: Columbia University Press, 1994), 33. To be completely honest while this confused me I find it quite evocative. Deleuze goes on to claim that in classification systems, all branches are relations of analogy. The small units, the little genera or species are determined by perception of resemblances. He continues: “Even neo-evolutionism will rediscover these two related aspects of the categories of the Large and the Small, when it distinguishes the large precocious embryological differenciations from the small, tardy adult, species, or intraspecies differenciations. Alternately, these two aspects enter into conflict according to whether the large genera or the species are taken to be concepts of Nature, both constituting the limits of organic representation, and the requisites equally necessary for classification: methodological continuity in the perception of resemblances is no less indispensable than systematic distribution in the judgment of analogy.” (Deleuze, Difference and Repetition, 34.) I see an echo to what I am describing in this discussion, but do not have the time and space to pursue it. 32 Max Black, Models and Metaphors; Studies in Language and Philosophy (Ithaca, N.Y.: Cornell University Press, 1962), 29. I have to thank David Saparto for the tip on Max Black. For me Black also reinforces Foucault’s toolkit with the power of statements and the importance of the milieu, and perhaps how these statements were taken up (as seen in chapter 1). 33 I am riffing off the British biologist J. Z. Young who, in justifying cybernetic and the machine analogy, explains: “People who have not thought carefully about the use of analogies are apt to take them too literally and to think that by comparing something with something else you can in a subtle way grasp, as they say, what it really is…The point is that comparing something unknown with something already known makes it possible to talk about the unknown.” In C Borck, "Communicating the Modern Body: Fritz Kahn’s Popular Images of Human Physiology as an Industrialized World," Canadian Journal of Communication 32 (2007): 515. 34 Foucault also engages with resemblance in what he calls the ‘human sciences’. These human sciences are the interdisciplinary sciences. The very construction of these sciences relied on other domains of knowledge. This practice I have attempted to capture with ‘synthetic expertise’. For more see, Michel Foucault, The Order of Things: An Archaeology of the Human Sciences (New York: Pantheon Books, 1971), 348. 35 Stuart Hall works with similar aspects of metaphor and explanation when wrestling with ideology: “The falseness therefore arises, not from the fact that the market is an illusion, a trick, a sleight-of-hand, but only in the sense that it is an inadequate explanation of a process. It has also substituted one part of the process for the whole—a procedure which, in linguistics, is known as "metonymy" and in anthropology, psychoanalysis and (with special meaning) in Marx’ work, as fetishism. The other "lost" moments of the circuit are, however, unconscious, not in the Freudian sense, because they have been repressed from consciousness, but in the sense of being invisible, given the concepts and categories we are using.” Stuart Hall, "The Problem of Ideology: Marxism without Guarantees," Journal of Communication Inquiry 10, no. 2 (1986): 37. 36 Peter H. Bryce, "Civic Responsibility and the Increase of Immigration," in The Empire Club of Canada Speeches 1906-1907 (1907, January 31). 37 Deleuze defines representation: [1] identity in regard to concept; [2] opposition that determines objects; [3] analogy that judges; [4] resemblance to objects. Therefore “difference is crucified” by representation where “difference becomes an object of representation always in relation to a conceived identity, a judged analogy, an imagined opposition or a perceived similitude.” (Deleuze, Difference and Repetition, 137-138.) Again, I cannot

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tackle how this intersections with my research, but I hope this gives support to my complete aversion and critique of metaphor and synecdoche. 38 Bryce is also invoking life, labour, and language, for more see Foucault, The Order of Things: An Archaeology of the Human Sciences. 39 The feeble-minded or epileptic, in comparison, did not contribute at all, but more damning there was no potential for them to contribute in Bryce’s mind. They were therefore automatically ‘charges of the state’ and a drain on the nation. But also whose population growth was feared. My question is how expansive and inclusive is that category of ‘charge of the state’. How these fear play out will be explored in the chapter 9. 40 I do not want to make equal these different registers of ideology, certainty, and totalizing logics. Instead I want to emphasize practices of jumping between those registers. 41 Black, Models and Metaphors; Studies in Language and Philosophy, 219. 42 Ibid., 223. 43 Direct examples in this dissertation of synecdoche can be seen in the work of Irving Fisher in chapter 9 and the ideology behind the Rockefeller medical project in chapter 10. Another key example that represents this position can be found in the highly influential Josiah Strong, The Twentieth Century City (New York: Arno Press, 1970 [1898]). “The sudden expansion of the city marks a profound change in civilization, the results of which will grow more and more obvious; and nowhere probably will this change be so significant as in our own country, where the twentieth century city will be decisive of national destiny.” Strong, The Twentieth Century City, 32. This book is all about growth and how government grows accordingly, but also how the government is failing and democracy cannot mange the larger cities. Strong calls for a new social spirit of Christ and morality and ethics to compensate: “This new social conscience, this new social spirit, and this new social ideal all belong to the great social organism which is now become conscious of itself as a result of the new civilization. This organism is as yet extremely imperfect ; how can it be perfected and the new social ideal realized? There are two laws, fundamental to every living organism, which must be perfectly obeyed before society can be perfected ; one is the law of service, the other that of sacrifice. Every organism possesses different organs, having different functions, each of which exists, not for itself but to serve all the others. The eyes sees for the hand and the foot and the brain ; the brain thinks for every member ; the heart beats for every fibre of the organism. If any organ refuses to perform its proper function, there is disease, perhaps death. Again every organism is composed of numberless living cells, each of which, we are told, possesses the power of sensation, of nutrition, or locomotion, and of reproduction. These cells freely give their lives for the good of the organism. Work, play, thought, feeling, all cost the sacrifice of living cells. If these cells were capable of selfishness, and should adopt the motto, “Every cell for itself,” it would mean the dissolution of the organism. When living cells which disregard the laws of the organism enter it, and there multiply, there results in typhoid fever, small-pox, diphtheria, or some other zymotic disease. If these intruders become numerous enough to overcome the law-abiding cells of the body, the result is anarchy, which is death. Individuals may be said to constitute the cells described above, they are endowed with self-consciousness and will. They are therefore capable of introducing selfishness and disorder into the social organism. The great social laws of service and of sacrifice are, accordingly, very imperfectly obeyed; hence the many diseases which afflict society, and which can be cured only by bringing all men under these two laws. But how can this be done?... Let us turn for an answer to the teachings of Jesus. (Strong, The Twentieth Century City, 123-125.) 44 For two overview pieces of metaphor and geography see, T. Cresswell, "Weeds, Plagues, and Bodily Secretions: A Geographical Interpretation of Metaphors of Displacement," Annals of the Association of American Geographers 87, no. 2 (1997). Merrifield, "Between Process and Individuation: Translating Metaphors and Narratives of Urban Space." Additionally, in Valverde’s history of Toronto she says, “What is important here is not so much the clichéd identification of prostitution with diseases of the social body…but rather the way in which certain historically specific groups are organized in relation to one another through the formal organization of images in a complex metaphor.” Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925, 36. Moral panics are multidimensional by definition. Social anxiety comes from the condensation of different discourses and fears. 45 Barnes and Duncan, Writing Worlds : Discourse, Text, and Metaphor in the Representation of Landscape, 10-11. See also Mary B. Hesse, Models and Analogies in Science (Notre Dame, Ind.: University of Notre Dame Press, 1966).

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46 Derek Gregory, Geographical Imaginations (Cambridge, MA: Blackwell, 1994), 7. 47 Ibid., 14. 48 Over the course of this research I have a strong visceral reaction whenever anyone, anywhere, uses a disease metaphor. My most hated example: neoliberalism is like a virus. 49 Barnes and Duncan, Writing Worlds : Discourse, Text, and Metaphor in the Representation of Landscape, 12. 50 Cresswell, "Weeds, Plagues, and Bodily Secretions: A Geographical Interpretation of Metaphors of Displacement," 334. 51 Gregory, Geographical Imaginations, 239. 52 I have attempted to take up Benjamin call in this by doing ‘histories of the present’. 53 Catherine Waldby, Aids and the Body Politic : Biomedicine and Sexual Difference (London; New York: Routledge, 1996), 5. 54 Ibid., 7. 55 These imaginations have continued in different media, for film see Kirsten Ostherr, Cinematic Prophylaxis : Globalization and Contagion in the Discourse of World Health (Durham: Duke University Press, 2005). Kirsten Ostherr, "Contagion and the Boundaries of the Visible: The Cinema of World Health," Camera obscura., no. 50 (2002).

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Chapter 7 – Health Boards Against Cholera: The Emergence of Social Infrastructures

I want to start with a very general claim: currently, we take for granted municipal health boards; we assume that they are necessary. My question is, How did the need for municipal health boards come to be? In this chapter, I will follow how doctors and health reformers in Ontario steadily and methodically insisted on their necessity so as to slowly gain footholds within government. In the 19th century, as each outbreak and disease crisis took place, medical experts instituted themselves further into the state by declaring that their expertise and recommendations would maintain a healthy city. In Canada and the United States, this movement was not at the federal level; the momentum grew out of urban or state-level associations to build government- based health institutions. Consequently, these disparate regional groups became interconnected through professional organizations. My claim is that if health boards, as part of a state bureaucracy,1 had preached only an abstract scientific version for health, the institution would have been declared provisional. As health boards emerged, they could be reduced or eliminated, depending on political whims. Therefore part of the health experts’ mobilization in the state was to make themselves necessary to a wider constituency through political, cultural, and increasingly economic arguments. Cholera had a particular role in these processes. During the 19th century, the cholera outbreaks were one challenge to the political legitimacy of municipal administrations. Many historians have suggested that the cholera epidemic of 1832, perhaps more than any other event, contributed to shaping the direction of public policy and city planning.2 This chapter will show how health boards grew and were made necessary in Toronto and Ontario. My position is that doctors and health experts within government were never an obvious requirement to a city’s functioning; rather, urban public health was made into a requirement. For many politicians and bureaucrats, for example engineers, a heath board’s utility was not automatically apparent. All gains had to be argued and fought over. During times of economic recessions and depressions, health reformers had to move beyond rhetoric to validate their particular state health institutions within the circuits of capitalism. To explore these relations, I will use and extend David Harvey’s discussion of social infrastructures, and I will ground his theory of the capitalist state in the formation of health boards. The upcoming chapters of this dissertation will trace the various responses that arose to cholera outbreaks, and they will ask where health experts’ confidence in their own necessity to Health Boards Against Cholera | 2010 | Paul Jackson | 164 health governance came from. The rest of this dissertation focuses on doctors, scientists, and health reformers and asks why the state became the viable and secure venue for their professions. How did the state become the arena in which to enact their reforms? Ultimately, how did health become integral to the nation?3 How did a particular state formation of health come to be, and what did it enable? What were the ways that health officials sought power within government and how did they hold onto that power? How did combining crisis, fear, and an economic rationale solidify the expert’s position within the state? Expert outrage over a disease crisis was necessary, yet insufficient to create change, as we shall see in the case of marsh reclamation in Toronto (see chapter 8). As time went on, urban health experts reshaped and expanded their arguments and practices to show how their expertise could enhance the productivity of the province and the nation. In the long run, the institutions and science maintained by these regional networks of expertise helped to foster a way for state investments to return to the primary circuit of capital (that would later be called biomedicine). In order to be validated, health expertise and practices needed to be incorporated into the circuits of capital, but not under conditions of the experts’ choosing. Those who responded to disease crises positioned themselves against the vagrancies of the market (see chapter 9).4 During this institutionalization of health, expertise shifted away from dealing with immediate concerns, such as epidemics or injury, and toward fostering life.5 But how can one foster life, and who was going to fund it? My name for what cohered is bureaucratic bio- economy: a state-led social infrastructure that combined health and the economy. The rest of this dissertation will follow how health boards came to form a key part of this bureaucratic bio- economy. Over time, bureaucratic bio-economy, state health expertise in the form of social infrastructure, articulated a push for biological efficiency in urban and national populations. Healthy populations became a primary way that these experts attempted to foster life, and this argument was increasingly based on economic rationales (see chapter 9). Once a common interest centred on health, it was mobilized through different forms of government policies and interventions. The Ontario Provincial Board of Health, the organization that this chapter focuses on, is but one illustration of how this came to be and one part of a wider shift in the professionalization of the medical expertise.

7.1. Medical Professionals, Social Protectionism, and Social Infrastructures Before getting into the details of what happened in Ontario during the 1880s and 1890s, I want to go over some general historical shifts in the relationship between health and the state. Health Boards Against Cholera | 2010 | Paul Jackson | 165

According to Michel Foucault, and he is not alone in making this claim, within capitalism, collective medicine did not transition into private medicine. Instead, a variety of political and cultural processes within capitalism enabled the opposite to occur. Doctors’ services and treatments were not exchanged as part of a market; rather, state actors and agencies indirectly engaged with the social body as a population that fostered the productive force of labour power.6 Accordingly, what occurred was the intersection of medicine and government. However, this process was not ubiquitous, as different nations took on particular state health characteristics. Germany pioneered state medicine. France emphasized urban medicine. Britain focused on labour medicine.7 After the 18th century, the problematization of the noso-politics (disease- medicine politics) was not, says Foucault, “a uniform trend of state intervention in the practice of medicine but, rather, with the emergence of a multitude of sites in the social body of health and disease as problems requiring some form or other of collective control measures.”8 But how did this take place? This chapter attempts to answer this historical question, with attention to the specific and contingent forms. During these transitions, medicine was strengthened, but it was a medicine of general health techniques, a service to the sick, or the art of cures. Over time, a medico-administrative knowledge developed that engaged with life, housing, and habits. Capital investment had a hard time directly intervening in these spheres. Because of this, doctors—a diverse group that spoke for and intervened in the general population in order to foster longevity, health, and the family—gained a particular form of power and authority through the interlacing of medicine and administrative functions within the state. But medicine, like science in general, did not automatically lead to authority and power.9 While doctors’ social position ascended over time, for many others economic gains were not the motivating factor for their entry into the health sector. Accordingly, the mission and scope of the medical expert’s role in the daily lives of the general population was struggled over. Individuals who took up medicine were versatile and expansive thinkers who could move between a variety of health jobs and tasks. In this time, a helpful distinction could be made between sanitarians and medics. Sanitarians included medics as well as laypersons that believed in sanitary reforms and relied on common-sense notions that dirt and filth were unhealthy. Medics, on the other hand, were comprised of four floating groups: [1] physicians (who were graduates of universities, gentlemen who dealt with illness found in the interior of the body); [2] surgeons; [3] apothecaries (who gave drugs and dealt with minor illnesses); and, finally, [4] a group that comprised midwives, nurses, female health practitioners, and quacks (that these were grouped together reveals much about the bigotry and dismissal of non-medical theories of health). Health Boards Against Cholera | 2010 | Paul Jackson | 166

Physicians dealt with the entire system to maintain a healthy body. The other groups were akin to tradesmen and dealt with localized problems on the body, like removing teeth. These medical tradesmen had no diplomas or credentials and, as private contractors, their customers would pay for their services. Over the course of the 19th century, medical expertise and the care of the sick was increasingly transformed into a profession through specialization and stratification. Previously, hospitals were a place of charity, a place where people went to die. Public health was only referred to as street cleaning. As health-based professionals claimed hospitals and street cleaning, those spheres became medical processes of intervention. During specialization and professionalization, the roles of health experts narrowed and included the sanitarian, the laboratorian, the doctor, the bureaucrat, the urban explorer, the moral crusader, and also the charlatan. Medical professionals argued their own necessity in order to legitimize this shift. This necessity was codified through professional codes of conduct and ethics. Medicine and the role of health work became strictly defined within a series of government reforms that professionalized these roles.10 Health historian Pamela K. Gilbert suggests that medicine was transformed from an ad hoc private affair in the early 1800s into a public duty by 1860s. During that time, medical communities created a coherent and professional face “based on the ideal of social centrality and service to the nation; defined not simply as interests of the state or of an elite but as the interests of an inclusive social body whose claims upon the state-as-nation were perceived as both standing separate from and exceeding political and class interests.”11 However, these national claims built upon service to localities and regions. In the process, the medical profession relied on these other medical tradesmen and sanitary-minded laypersons to help push and mobilize for political change on a variety of scales. Medical experts also differentiated their mission and service by regularly opposing corporate enterprises, particularly from intervening in their profession. However, the majority of doctors and medical scientists were liberals and never called for the outright abolishment of capitalism. The historian Paul Starr argues that health professionals did not want a corporate intermediary that would keep their profits. However, the people who took up a health career also held passionate ideological convictions, and they found meaning in protecting human lives against the effects of the free market. Additionally, the health professionals’ success in impeding capital was due, in many ways, to the inability of corporate enterprises to successfully insert themselves between the producer and the consumer of medical care.12 Starr asks a very general, yet crucial, question: “[W]hat sort of commodity is medical care?” Drugs, advice, time, Health Boards Against Cholera | 2010 | Paul Jackson | 167 life—all these examples inadequately explain how capital could directly intervene in medicine and health. As the following chapters will show, health practices and capitalism became intertwined through particular state-funded social infrastructures instead of through private channels. This process was protracted due to the health experts’ authority and rebuffing. In Starr’s history of doctors in the United States, he suggests that American doctors took their professional model from the British system. As Canada was a colony of England, the Canadian health profession and its institutions were even closer to the British model.13 In this model, the medical profession was seen as outside market relations. To explain why, Starr engages with Karl Polanyi’s theory of a double movement: markets expand but, in that expansion, counter-movements of social protectionism arise to curb the devastating effects of capitalism. Doctors and the medical profession were a vital, but particular, part of that social protectionism. Yet Polanyi warns against the view that 19th century protectionism was only the result of class action that served the economic interests of the members of a particular class. Defining classes in purely economic terms is too narrow. Polanyi prefers the more accurate term of “sectional interests” rather than class. Doctors were a sectional interest that did take part in the movement of protectionism, and not primarily on account of their economic interests. However, as I will show, the personal and professional interests of health experts did become internalized within government as one way to alleviate, or at least manage, the effects of capitalism and industrialization. But these health experts were not alone in this drive for social protectionism, and class was part of the social relations of the period. Starr quotes Polanyi who states that class strength relies on winning support outside its own membership and by fulfilling tasks set by interests wider than their own.14 E.P. Thompson is helpful here in the “making” of class as an active process that owes as much to agency as to conditioning. Class is a historical phenomenon, not a structure or category. Class is something that happens in human relationships, which are historical relationships that happen when people feel and articulate the identity of their interests between themselves and against others as a result of common experiences. For Thompson, class is not a thing, or an “it”; it is not something defined mathematically. Class is a relationship: “If we stop history at a given point, then there are no classes but simply a multitude of individuals with a multitude of experiences. But if we watch these men over an adequate period of social change, we observe patterns in their relationships, their ideas, and their institutions. Class is defined by men as they live their own history, and, in the end, this is the only definition.”15 Therefore, the medical professions were a form of collective mobility where, according to Starr, Health Boards Against Cholera | 2010 | Paul Jackson | 168

“skills and cultural authority are to the professional class what land and capital are to the propertied.”16 However, according to Polanyi, how this collective mobility emerged, along with the aims and forms of cooperation, cannot be understood outside the situation of the whole; this includes a wide variety of external events and, in my case, the cholera epidemics. It was how health experts defined themselves—as separate from both politics and capitalism—and their authority that aided their inclusion in the state. As Polanyi states, “The spread of the market was thus both advanced and obstructed by the action of class forces.”17 Medical experts epitomized this since, from within the state, they both reproduced the conditions where capital operated and obstructed market forces when in conflict with their health-based ideology. Medical authority became a form of cultural and class recognition, as this emerging sectional group took up positions of authority. Health experts defined their own roles and their own position in history within the health bureaucracy. At the same time, the ideological battles that took place through these state institutions relied on appeals to the common interest—the “public” in public health. This chapter will show how health experts pushed to create, in Weberian terms, a “bureaucratic agency” in the state that was based on official jurisdictional areas where they could create rules, laws, and administrative regulations. This project was expansive and they lobbied for increased duties, numbers of officials, and budgets to fulfill these duties; the creation of hierarchies, both within institutions and between geographic scales; systems of management based on documents; increased training, specialization, professionalization; and, finally, medical technologies such as laboratories and bacteriological methods.18 However, in contrast to Weber, while cities became dependent on their health expertise, for much of their history, these bureaucrats were far from rational and efficient. These bureaucrats lacked the power and autonomy they called for. Rather than a bureaucratic agency, a guiding force to institute an antibiotic urbanism, these health boards were a complex of human resources whose actions mostly just maintained the city functions. My claim is that health boards were made necessary as a particular form of social infrastructures. For David Harvey, social infrastructures are processes that support life and work under capitalism.19 Social infrastructures are created over time, and must retain a “depth and stability” to be effective forces in supporting life and work. However, “powerful forces” geographically differentiate social infrastructures and maintain these differences so that not all social infrastructures are the same. For Harvey, the reason why is a problem of history. In general, social infrastructures’ roles are to [a] regulate capital and capital-labour relations; [b] define frameworks for class struggle; [c] provide means to produce scientific and technical Health Boards Against Cholera | 2010 | Paul Jackson | 169 knowledge, managerial techniques, and the collection, storage, and communication of information; [d] support institutions that contribute to the reproduction of labour power (health, education, social services, etc.) and cultural life; and [e] forms of ideological control and forums for ideological debate, whose more problematic forms are surveillance and repression.20 Finally, social infrastructures also employ an “immense army of people.” As a general category health boards do not encompass Harvey’s entire definition of social infrastructures. However, health boards as sites of employment did expand after the 1880s in Ontario and around the Atlantic, and this expansion took place during times of economic depressions. Harvey divides the state into the reproduction of capital and the reproduction of labour, and social infrastructures are heavily directed toward the latter. Harvey’s definitions are built on relational dialectics, but social infrastructures are not passive things subject to the forces of capital; they are deeply intertwined with various aspects of capital and social relations. He suggests social infrastructures come together to form a “human resource complex” that cannot quickly adjust to the needs to capital. Instead, these state processes will shape the geography where capital must adapt. In the process, “the circulation of capital transforms, creates, sustains, and even resurrects, certain social infrastructures at the expense of others.”21 So these arrangements of human resource complexes are slowly transformed, but they structure paths and environments where capital adapts in order to produce surplus value.22 Accordingly, as social infrastructures are supported out of capital surpluses, a level of indebtedness to surplus value production must be acknowledged.23 To be clear, social infrastructures are not equivalent to the state, they are specific aspects of the governing apparatus within the state. These medical professionals saw the state, and later the university, as a site of secure employment and as a way to regulate the vagrancies of the market. Once relatively secure, these institutions were used to expand their expertise. In Ontario, since health boards relied on the provincial and municipal budgets, their relations to capital were quite particular—indirectly indebted but not beholden to capital. In the city, health reformers began to fine and monitor polluting industries; regulate the conditions of production; and also monitor residential property owners’ sanitation and privy pits. These responsibilities contributed to and shaped their profession, with calls for charity and government interventions in order to soften the consequences of the market. The rest of this chapter will show how health boards emerged in Ontario as a particular social infrastructure.

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7.2. Cholera Impels the Creation of a Health Bureaucracy in Ontario Health boards became necessary to the state and capital in Ontario because of very contingent historical conditions, in particular the cholera outbreaks of the 19th century. In Dr. Bryce’s 1891 history of public health in Ontario, he claims that Canadian state health was formed to deal with the cholera outbreak in Quebec, and it was inaugurated with the Canadian Sanitary Commission in February 1832. Bryce’s history was obsessed with cholera and was written the year before the pandemic, which is so central to this dissertation’s arguments (see Figure 7.1).24 In Toronto, then named York, on June 21st during the outbreak, the order was given to the town council to form a health committee. Dr. William Warren Baldwin, physician and lawyer, was named president with seven citizens and all fourteen doctors in the city as members.25 Present-day historians support the argument that cholera outbreaks were one of the primary drivers behind establishing state health in the Canadas. For example Logan Atkinson’s research found that when the Upper Canada Legislature created the City of Toronto, in March of 1834, cholera was seen as a continuous threat and created “extra-political pressure” that shaped many of the initial municipal laws and policies. He claims that cholera was even more influential than the political battles between reform and the elite factions of the city.26 Within the City of Toronto Act, there was the provision to protect the citizens from disease threats. A Board of Health composed of aldermen and councillors was created. This health institution was formed in the spring of 1834 to prepare for the cholera outbreak that was declared imminent by the local Toronto newspapers. Of the first nine by-laws passed by the city, three by-laws related to health. One of the most interesting aspects of these by-laws was that they gave quarantine powers to the city, so that the city could employ people and make regulations at its whim. Additionally, the city could raise property taxes to pay for these health reforms, even though at that time getting money from the Bank of Upper Canada required extensive political wrangling.27 These developments were not a historical anomaly. During the 19th century, every time cholera returned to Canada, either as a threat or as the actual disease, government policy and politics increased or were reformed. For example, health legislation was increased again in 1848. The parliament of the United Canadas created a Central Board of Health to directly respond to the recent cholera outbreak and prepare against future disease outbreaks. The policy recommended wide-ranging reforms and recommendations such as how to drain and cleanse, air, and scrub buildings; the best disinfecting agents to use; instructions for the clothing, bathing, and feeding of cholera patients; not giving sugary fruit to patients sick with cholera; a recipe for a healing tincture; and, finally, if the cholera attack was sudden, placing a large mustard plaster between the patient’s Health Boards Against Cholera | 2010 | Paul Jackson | 171 shoulders and pit of the stomach. In addition, the policy suggested that the wealthy segments of the community should contribute financially to the “medical men,” so they could help the health of the “destitute classes.” It also contained specific regulations that were to be enacted during a disease outbreak. During such a period, the Central Board of Health would have sweeping powers to direct all the city by-laws; control the sale of meat and the keeping of swine; direct the cleaning of all underground areas such as cellars and privies; clean up the tanneries; and manage the treatment and burial of the dead, the movement of migrants, the reporting of the sick, and the sheltering of the poor. 28 Additionally, during times of crisis, these powers had the ability to bypass the political process. A quote from the 1854 regulations—revised after another cholera outbreak in Canada—illustrated how far the state thought to intervene during a health crisis. After first admitting that no science had been discovered to prevent cholera, the directions concluded: [The Central Board of Health] would warn the Public against unnecessary alarm, as, in its opinion, nothing will more certainly predispose to disease of any kind, than giving way to depressing fear. The Board therefore, while it condemns in the most unqualified manner, the assembling together of large bodies of persons, as at balls, theatres, races, &c., would recommend cheerful society, by family or other small reunions, as calculated to keep up the buoyancy of the spirits, and thus dispel unnecessary despondency.29

As with most documents that were engaged with health crises during the 19th century, this state policy was not a distant “cold monster”; instead, the writing was flushed with fear and literary flourish, looking to intervene in the small yet cheerful get-together of its citizens.

Figure 7.1. Dr. Peter Bryce. Figure 7.2. Dr. Charles Coverton.

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7.2.1. Scales of health governance The Canadian system of state health was a particular variation of the British system. As each new institutional innovation arose in England, a colonial counterpart structured the Canadian health acts to be in accordance with these legal shifts across the Atlantic. For example, Edwin Chadwick’s famous 1842 Report on the Sanitary Condition of the Labouring Population30 was the basis for the creation of the General Board of Health in Britain: the first modern public health agency that was founded in 1848.31 After the British agency had been established, another cholera pandemic affected Europe and North America, and, accordingly, Canada instituted local, though much weaker, versions of the British board. Canada diverged from Britain in that, rather than having a permanent institution, its Central Board of Health was emergency-based and its powers were deployed when a crisis was looming. After the cholera epidemics disappeared, so too did the board—only to reappear in 1865 when another cholera outbreak returned to Canada.32 When Canada became a nation in 1867, public health was only a committee within the Department of Agriculture. Dr. Frederick Montizambert became the director and held the position for fifty years. In terms of health, the federal government was in charge of supplying the quarantine facilities; the marine hospitals; the medical services in jails and charity organizations; and the collection of vital national statistics. During the second half the 19th century, the medical profession pushed constantly for a stronger federal health program. The main political impetus for increased federal government involvement in health came from British- and American-trained members of the Canadian Medical Association.33 But a national health program would only come to fruition in the early 20th century, so other than securing healthy borders, public health in Canada was predominantly a local affair. The majority of health responsibilities were delegated to the municipalities. Canada was not unique in this regard; across all industrial nations the localism of health affairs made them an urban institution. As the historian of smell Alain Corbin declared of Paris: “[N]ew [local] public health tactics were no longer implemented on an ad hoc basis, as was the case when epidemics had raged; they were meant to be permanent, and they coordinated decisions from within an essentially civic perspective. ‘The invention of the urban question,’ the triumph of the function concept of the ‘town-machine,’ stimulated a ‘topographical toilette’ inseparable from the ‘social toilette’ of cleaning streets and organizing places of confinement.”34 As the 19th century progressed with growing urbanization and industrialization, these local conditions were getting worse and increasingly filthy. Health Boards Against Cholera | 2010 | Paul Jackson | 173

The local sanitary conditions in Toronto had deteriorated substantially between 1869 and 1883. As the complaints of inefficiency and demands for change grew, the Toronto City Commissioner, the Board of Works and Markets, and Health Committee were held responsible and accountable. Toronto’s sanitarian-minded citizens tried to convince the city council that a strong medical municipal bureaucracy would directly help in the effort to clean up the city.35 During the 1870s, the history of public health services in Toronto had reached a turning point. Newspaper editors, politicians, and doctors were all on board to see an end to health threats in their city through a strong and permanent health bureaucracy. The question was how. Many of the sanitarians still found resistance to their lobbying in municipal politics.36 Nevertheless, during this period, discourses and agents of public health slowly began to have a real influence on Toronto’s governance. Doctors and the public health sector had grown substantially and now loudly demanded reform. Public health in Canada slowly moved away from an emergency model for dealing with epidemics and toward a permanent institution that was fully embedded in the workings of city and provincial governments.37 In the 1890s, the health department became a separate municipal structure, not merely an ad hoc committee set up to eliminate minor unsanitary conditions. Even so, this institutionalization was halting. In Toronto, a public health agency was an experiment. Attempts were made to incorporate health practices into other municipal institutions during the 1870s. The duties of Toronto’s health department were merged with the Board of Works, yet the responsibilities and jobs of the health experts and the engineers were at odds with each other and caused friction. Then, in 1878, a separate department of public health emerged in Toronto whose primary preoccupations were filth, diseases, and sanitary tasks. However, this institution lacked the power to enact changes. A powerful and independent Board of Health would not arrive until the 1880s. At the same time, Toronto’s public health officials never confined their actions to the politics and policies of that city. The elite of Toronto’s medical profession were British-trained sanitarians, such as Drs. Canniff, Covernton, and Bryce (see Figures 7.1 and 7.2).38 The majority of the campaigners for public health were a distinct group, usually with training at a graduate school in Europe or the United States. Even Bryce, who did the majority of his education at the University of Toronto, went to Britain to study at the same time that Pasteur and Koch were making their discoveries.39 Accordingly, doctors in Canada relied on British and European medical and scientific expertise to structure their interventions. To coordinate their science and politics, during the 1870s, public health professional associations were formed to Health Boards Against Cholera | 2010 | Paul Jackson | 174 represent Ontario, Canada, and North America.40 Toronto doctors were members of all three associations, attending conferences in the United States, Europe, and throughout the world. For the majority of the Torontonian health experts during this period, their social and class position was in flux. Doctors were not poor, but the health profession was neither a career of instant prestige nor a guarantee of financial security. Unlike today, the medical profession rarely led to wealth, and it was not until the early 20th century that medicine rose in status and compensation.41 Despite this tenuousness, or perhaps because of it, medical experts in Toronto were highly visible and very vocal in local politics, and at the same time participated in the international exchanges of ideas and conferences. They would also talk outside their expertise as “practical visionaries.” They were unafraid of politicians and aggressively fought government, sometimes from within. Through these battles and lobbying efforts, these health experts secured a place within the state bureaucracies. My claim is that this secured position provided these experts with a political base. During the last years of the 19th century and the beginning of the 20th, a group of doctors on the Provincial Board of Health and the Department of Health in Toronto played a dominant role in establishing and formalizing a Canadian public health movement.42 These experts took on their task zealously: teaching, working in hospitals, and volunteering with the Toronto Separate School Board, the Children’s Aid Society, the Humane Society, the Deaconess’s Aid Society, the Canadian Institute, the Industrial Schools, and the Canadian Sanitary Association. In doing this work, they established political support and allies throughout these organizations in their struggle to promote sanitary and health reforms.43 However, this movement was more of an ideological project, as health was never solely a local municipal affair limited to by-laws and nuisance fines. The province became the key scale to push for reform and articulate a health ideology.

7.3. The Provincial Board of Health of Ontario In the mid-1870s, a strong health reform movement that could actively influence the province solidified. The sanitary enthusiasts, a predominately Toronto-based social movement, had been pushing Ontario’s Oliver Mowat government for stronger health laws; in particular, the enthusiasts wanted the government to appoint a royal commission on health similar to the British model. Although Canada had become a nation, boards of health could not be nationwide entities the way they were in Britain because of the specifics of geography and history. In response to this political pressure, the Mowat government commissioned a survey44 to assess Ontario from a health perspective. The response of the survey determined that the public, the Health Boards Against Cholera | 2010 | Paul Jackson | 175 local governments, and even several prominent medical men were ignorant of many of the sanitary laws deemed necessary. The survey also declared that a central supervising body was glaringly absent. The two recommendations from this committee were a province-wide health education campaign and the creation of a permanent central board of health for Ontario. A delegation was sent to the Ontario government at the end of 1879 in an effort to make Mowat see the necessity of these recommendations, but, by early 1880, it became apparent that nothing would pass that year. So the reformers organized an Ontario Branch of the Canadian Medical Association to apply political pressure. The lobbying was successful and the lesson was learned. My claim is that, from the outset, the predominant principle behind the Ontario Provincial Board of Health was to lobby and articulate the common interest. In 1882 the Ontario Legislature passed the act. Premier Mowat remarked on the creation of the Provincial Board of Health: “We have passed this health legislation but have little knowledge of just what there is to do, or its extent, but in any case, Dr. Bryce, its success will finally depend upon your energies.”45 Strangely, or perhaps tellingly, Dr. Bryce was the secretary and mouthpiece of the organization. Bryce would shape public health in Ontario and in Canada throughout his career. Bryce went to work immediately. During the 1880s, Ontario’s provincial government took up the program to push for increased preventative health services within its boundaries. The first report of this new health institution strongly critiqued the existing low expenditures and weak laws for health. The second report was about how the insufficient powers reduced the Provincial Board of Health to a mere advisory body, an institution easy to ignore. The board still had limited powers and its duties were primarily supervisory, except in times of outbreaks of infectious disease. This structure arose because the Provincial Board of Health was modelled after the British system as a watchdog against epidemics. Therefore, success of the state health apparatus depended on the quality of its membership and on the members’ interpretations of their duties. The work of the provincial board lay in preparing, supervising, or enabling local municipalities to act in order to mitigate disease.46 While the Public Health Act of 1882 increased the powers of local boards of health, Bryce and his allies found no one who was actually doing the work locally to even utilize these new powers. The Provincial Board of Health concluded that only with a permanent, salaried Medical Health Officer in all cities and towns throughout the province could these new powers enable change.47 The province went to work to force the creation of these positions even in times of fiscal restraint. By 1884, Bryce had redrafted the health act to compel municipalities to create local boards of health and select a Municipal Health Officer, often times against resistance from local city councils.48 Toronto’s Health Boards Against Cholera | 2010 | Paul Jackson | 176 health institutions political and policy effectiveness was gained only as creatures of the province.49 So, while public health remained a local affair, local health officials’ legitimacy came from above. In Toronto, with the passage of the Public Health Act of 1884, the powers of medical officer Dr. William Canniff had been enhanced, which meant he could outline a systemic approach to stop a disease outbreak.50 Having a powerful local medical officer was deemed a top priority by the provincial authorities because they feared another cholera outbreak. In 1884 cholera had appeared in Naples, Italy, and in the south of France. North American health authorities were bracing themselves to battle against cholera once again. Toronto’s Local Board of Health, which was made up of aldermen and ratepayers, had also begun to prepare. Toronto republished the province’s pamphlet, “How to Ceck the Spread of Contagious or Infectious Diseases.” Although the plans were not put into effect, this coordination showed that there was an attempt to develop a systematic approach to controlling disease. In December of 1884, Dr. Canniff travelled to Washington to speak about the continent-wide defences against cholera, and he promised that cholera would not sneak into North America by the back door of Canada as it had done in 1832.51 The 1884 cholera outbreak was a false alarm; the disease did not reach Canada. However, during 1885 and 1886, the rates of smallpox cases increased.52 Dr. Bryce attacked the city health board because Canniff hadn’t implemented his recommendations during the smallpox outbreak. Toronto’s city health officer was under constant scrutiny, since four of the seven members of the provincial board lived in Toronto. Additionally, both Bryce and Canniff had abrasive personalities with differing viewpoints over the powers and role of local and provincial health officers. Canniff was moving away from health education and toward a highly formal legal approach to fighting disease.53 At the same time, I would suspect that the doctors appointed to these jobs probably had some form of loyalty or obligation to those who gave them job security, even during this resentment and conflict. By the mid-1880s, a relationship between two health institutions had been established and together they moved forward to expand and entrench health bureaucracy in Ontario and Canada.

7.4. Conclusion: The State Becomes a Bastion for Health Expertise During the 1880s, the province became a vital player in shaping the municipalities’ health governance in Ontario. Perhaps more importantly, the provincial institution was controlled by a small group of Toronto physicians.54 This provincial state health institution constantly looked to increase its power and scope. The creation of two health bodies—the province that lacked power Health Boards Against Cholera | 2010 | Paul Jackson | 177 on the ground versus the municipalities that lacked power to refuse—set into motion a long- standing antagonistic relationship. At times these agencies worked together, but in other moments they competed for influence and financial support. There were constant attacks on local boards of health over organizational and management issues. At the same time, younger members of the medical community were beginning to challenge the filth theory of disease, as the bacteriological revolution was ramping up internationally, and they also looked for state support for laboratories. In Ontario, the medical profession and these newly formed state health institutions emerged as provisional experiments. Over time, these experiments hardened into official roles and bodies with distinct separate agendas and tasks. A list of these experiments includes, but is not limited to, urban medical officers; city boards of health; provincial/state boards of health; professional associations; health meetings and conventions; sanitary inspectors; laws, by-laws, policies, and regulations; hospitals that were no longer a place to die; bacteriology laboratories; national boards of health; vital statistics; sanitarian movements; moral reformers; and engineers. In the early 1880s, these institutions and practices were piecemeal formations. By 1920, many of these had become solidified, and many of the practices and methods had been discarded. During this institutionalization process, everything was tenuous. Committees would form. Science would change. Funding would disappear. Boards would be abolished. Importantly, the rise of public health governance took place without a single coherent guiding science; without a definite understanding of what caused disease; against political opposition; and predominately in times of financial crisis and depression. The documents created by these institutions usually contained two practices. The first practice was to tabulate a sick world (counting privy pits, incidents of disease outbreaks, population statistics). The second practice was to justify their continued existence (by invoking history, politics, literature, religion, the natural world, and the future). A problem was given (disease) and then followed by a self-serving solution (health expertise). In the lead up to the 1860s, public health was responding to crises, as epidemics and fevers seemed to arise from cities and also need to be controlled in cities. This tactic of crisis aversion would shape the foundations of these institutions. During this time, a dynamic was internalized within the functioning of the Provincial Health Board. The provincial board’s bureaucratic agency was expressed in that, even if a major disease outbreak threatened Ontario and did not happen, these times of crisis could still be used to institute change. Bryce and the province found that the fear that an epidemic was imminent could be constantly marshalled to lobby for change (as chapters Health Boards Against Cholera | 2010 | Paul Jackson | 178

8 and 9 will illustrate). However, as a form of authority, this bureaucratic agency was fortuitous and questionable, reliant solely on external factors like a cholera outbreak. These health boards, on both the provincial and municipal levels, were examples of social infrastructures. While deeply shaped by epidemics and politically fought over, these infrastructures were also tenuous, and it took extensive political work to just maintain them. In the 1880s, health boards were still emerging. It took thirty to forty years for Toronto and Ontario health departments, and public health in general, to become a national force. By 1892 the foundations had been laid. The debate during the cholera outbreak of 1892 illustrated the conflict within the state over how to deal with a cholera crisis and the responsibility for swamp reclamation. In spite of this conflict, all levels of health governance were against the problems both industry and the market afflicted on those they felt a responsibility to protect. For example, in 1893, Dr. Albert Gihon, the one-time president of the American Public Health Association, when speaking about the hygiene of cholera, declared that “commerce is the enemy of sanitation. Commerce opposes everything that sanitary officers and health officers try to do, and I am delighted when commerce is made to bow.”55 The polluting industries were at fault. The lax shipping lines were at fault. The role of health officers was to correct their faults and make them bow. However, this opposition between capital and health expertise would erode over time, as economic arguments for health increased. As this dissertation will show, a space within this opposition to commerce and markets would become an opportunity for capital investment. During the push for Toronto’s swamp reclamation, health officers’ learned the limits of their aversion to commerce.

Endnotes

1 Bureaucracy is a loaded and highly contentious term, for a discussions see Pierre Bourdieu, Loic J. D. Wacquant, and Samar Farage, "Rethinking the State: Genesis and Structure of the Bureaucratic Field," Sociological Theory 12, no. 1 (1994). In previous chapters, I have flagged some of my concerns with Max Weber and I will get into these issues more in the upcoming chapters. 2 This claim builds on a extensive literature. Harold L. Platt, Shock Cities : The Environmental Transformation and Reform of Manchester and Chicago (Chicago: The University of Chicago Press, 2005), 84-85. Joseph L. Atkinson, "Thesis: The Upper Canadian Legal Response to the Cholera Epidemics of 1832 and 1834" (University of Ottawa, 2002). Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980). Erin O'Connor, Raw Material : Producing Pathology in Victorian Culture, Body, Commodity, Text (Durham, N.C.: Duke University Press, 2000). Pamela K. Gilbert, Mapping the Victorian Social Body, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2004). David Rosner, Hives of Sickness : Public Health and Epidemics in New York City (New Brunswick, N.J.: Published for the Museum of the City of New York by Rutgers University Press, 1995). David McLean, Public Health and Politics in the Age of Reform : Cholera, the State and the Royal Navy in Victorian Britain (London: Tauris, 2006). Walter Sendzik, "Thesis: The 1832 Montreal Cholera Epidemic a Study in State Formation" (National Library of Canada, 2000). Health Boards Against Cholera | 2010 | Paul Jackson | 179

3 I grant that health and nation came together in these forms only for a time. In Canada, national healthcare was a halting process, however at each step health reformers displayed a sense of accomplishment when these two spheres coincided. To get into the healthcare debates of Tommy Douglas’ time is beyond this paper (but there is overlap, or perhaps some contingent foundations, such as Douglas’ belief in eugenics). 4 The shifts and developments in state health were not confined to Canada, rather all nations around the Atlantic Ocean worked within these tendencies, with local particularities. 5 ‘Fostering life’ is a nod to Foucault’s work, see Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007). 6 To clarify some of the definitions here, Foucault says, “The body is a biopolitical reality; medicine is a biopolitical strategy.” From Paul Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984 (New York: New Press, 2003), 321. 7 Foucault’s typology needs some space to be explained in greater detail. German’s state medicine were the trailblazers of systemization, standardization, administration, and medical police. This public health administration was interested in bodies of individuals, insofar as they combined to constitute the nation. Foucault makes the claim that in no other nation was health more clearly statized than Germany. (Ibid., 325.) While by the end of the 18th century, France’s state health linked social medicine to urbanization. There was the need to unify the city for economic and political reasons (due to the large numbers of poor and the existing political tensions). Additionally the fear of city emerged during this period with crowding, factories, towers, and urban epidemics. For France, urban health was provoked a series of panics. Urban quarantine was the model used, in terms of the emergency plan (stay at home, separate zones, surveillance, inspection, disinfection). The political-medical organization was in accordance to a military model. The first objective in the study of the city was to look at the accumulation of refuse, graveyards, and slaughterhouses; and then to push these unhealthy parts of the city to the fringes. “Medicine’s first objective consisted therefore in analyzing the zones of congestion, disorder, and danger within the urban percents”. (Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984, 229-330.) The second objective was the controlling circulation of elements water and air (miasmas), in forms of avenues and parks. The third objective involved urban organization and distribution, in terms of where to place different elements to the shared life of the city, such as water sewage. In general urban medicine was important because: (1) it made the medical profession come into contact with other sciences, such as chemistry; (2) as medicine of the environment the focus became not the “medicine of man, the body, and the organism but a medicine of things—air, water, decompositions, fermentations. It is a medicine of the living conditions of the existential milieu”; and (3) the notion of salubrity, or the best health for the most people, was asserted. Public health emerged to modify and control these environment elements in relation to one another. In contrast, the English’s labour force medicine was a medicine of poor people, and the last objective of social medicine. Generally labour medicine lead to segregation, as it connected the Poor Laws and to the English system in terms of medical assistance of the poor, the control of the labour force, a general survey of public health whereby the wealthy would be protected. The British system was original because it superimposed these three medical systems and made them co-exist: a welfare medicine for the poorest; administrative medicine for general population such as vaccination and epidemics; along with private medicine for those who could afford it. (Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984, 332-336.) While Foucault’s typology helps me to follow general trends in medicine and state health, Toronto and Ontario does not exactly fit into one of these typologies. However, the Canadian system is perhaps the most deeply interconnected to the English system, a cobbled together a system out of all three, with an emphasis on labour force medicine. 8 Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984, 339. 9 For an example of the intersection of scientific research and capital, see Jack Ralph Kloppenburg, First the Seed : The Political Economy of Plant Biotechnology, 1492-2000 (Madison, Wis.: University of Wisconsin Press, 2004). See also, Stanley Aronowitz, Science as Power : Discourse and Ideology in Modern Society (Minneapolis: University of Minnesota Press, 1988). Philip Mirowski, The Effortless Economy of Science? (Durham: Duke University Press, 2004). Steven Shapin, The Scientific Life : A Moral History of a Late Modern Vocation (Chicago: University of Chicago Press, 2008). 10 Pamela K. Gilbert, Cholera and Nation : Doctoring the Social Body in Victorian England, Suny Series, Studies in the Long Nineteenth Century (Albany: State University of New York Press, 2008), 68-70. 11 Ibid., 76-77. 12 Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 215-217. Health and capital did come together in the form of vaccine production much later, but at this time the relations seemed more like speculative investment in scientific medicine. I will discuss these transitions and relations in the conclusion. Health Boards Against Cholera | 2010 | Paul Jackson | 180

13 This claim comes from reading much of the initial formation of these institutions, and journals that included repeated references to the innovations happening in England and London. For an example, see "First Annual Report of the Provincial Board of Health of Ontario Being for the Year 1882," ed. Ontario Provincial Board of Health of (Toronto: Printed by Order of the Legislative Assembly, 1883). 14 Starr, The Social Transformation of American Medicine, 144. See Karl Polanyi, The Great Transformation : The Political and Economic Origins of Our Time (Boston, Mass.: Beacon Press, 2001), 152. Polanyi also states, “A class that has become functionless may disintegrate and be supplanted overnight by a new class or classes. Also, the chances of class in a struggle will depend upon their ability to win support from outside their own membership, which again will depend upon their fulfillment of tasks set by interests wider than their own.” Polanyi, The Great Transformation : The Political and Economic Origins of Our Time, 159. 15 E.P. Thompson, The Making of the English Working Class (London: Gollancz, 1980), 11. 16 Starr, The Social Transformation of American Medicine, 80. 17 Polanyi, The Great Transformation : The Political and Economic Origins of Our Time, 161-162. 18 Max Weber, Economy and Society: An Outline of Interpretive Sociology, ed. Guenther Roth and Claus Wittich (New York: Bedminster Press, 1968), 956. 19 All this being said, the question arises: can social infrastructures be equated to the state? No. However, the state is made up of social infrastructures, but not completely. What is the relationship? This second half of this dissertation attempts to isolate and specify this relationship, at least in regards to health. 20 David Harvey, The Limits to Capital (London; New York: Verso, 2006), 399. Even though Harvey says he doesn’t discusses the reproduction of labour and labour power in Limits (hence the reason why he says he can’t engage a theory of the State), he does, albeit partially, in his discussion of social infrastructures. 21 Harvey’s full quote speak to much of the processes I am following: “The different elements of social infrastructures meld together to form a kind of ‘human resource complex’, greater than the mere sum of its parts. Such a resource complex is hard to change if only become of the strong bonding of seemingly different elements within it…On this account alone, the ‘human resource complex’ is by no means instantly adjustable to capital’s requirements. It forms a part of the of the human geographical environment to which capital must, to some degree, adapt…Already differentiated social infrastructures were the ‘raw materials’ out of which new human resources complexes had to be fashioned…And the organizational form and history of the elements of social infrastructures ensures that political power centers and territorial arrangements exist that are by no means direct expressions of the social relations of capitalism…Our thesis, however, is that the circulation of capital transforms, creates, sustains, and even resurrects, certain social infrastructures at the expense of others. It is hard to get a handle on exactly how.” (Ibid. My emphasis.) This chapter and the following chapter is my attempt to show this ‘how’, in relation to public health. 22 However to be clear, these power relations within these social infrastructures do not directly mirror capital. Harvey does not know how social infrastructures ascend and solidify. My contention is they must be made to be vital or necessary (organic) to capitalism, which, in my books, must involve value, active value circulation. I will attempt to show how this is done in chapters 9 and 10. 23 For Harvey these aspects of the state can only be “superstructures erected upon an economic base”. Even though Harvey says base-superstructure works only in theory and it does not mirror that base. He additionally asks whether social infrastructures are an independent power or a reflection of the economic base? His answer is “The circulation of capital…has to be considered as a continuous process of expansion of value. The circulation of values through social infrastructures is but a moment in this total process.” See Harvey, The Limits to Capital, 400. 24 Peter H. Bryce, "Report of the Secretary: A Hundred Years of Sanitation in Ontario," in Annual Report of the Provincial Board of Health of Ontario Being for the Year 1891, ed. Ontario Provincial Board of Health of (Toronto: Printed by Order of the Legislative Assembly, 1892). 25 Marian A. Patterson, "The Cholera Epidemic of 1832 in York, Upper Canada," Bull Med Libr Assoc. 46, no. 1 (1958). 26 The government’s previous involvement in health issues was limited to the creation hospitals funded by charitable donations, and the monitoring of the medical profession, mostly in terms of fraud. 27 Logan Atkinson, "The Impact of Cholera on the Design and Implementation of Toronto's First Municipal by- Laws, 1834," Urban History Review 30, no. 2 (2002). 28 Canada, Regulations of the Central Board for the Preservation of the Public Health (Montreal: S. Derbishire and G. Desbarats, 1849). 29 Canada. Bureau Central de Santé, "Regulations &C. Adopted by the Central Board of Health under the Act 12 Vict. Cap. 8," (Québec: 1854), 6-7. 30 The British model had important ramifications, as there was tension between local bodies and supervision from central or federal boards. In Britain, the 1848 Public Health Act failed to get officials to work, to show and prove Health Boards Against Cholera | 2010 | Paul Jackson | 181

the merits of central supervision. The government later capitulated to local autonomy powers and the “principle of local self-government in this field created a hodge-podge of conflicting authorities” throughout England. In 1866 Simon was able to pass a Sanitary Act, with the renewed threat of cholera looming. However, by 1868 the legislation was too complex and the British Government appointed a Royal Sanitary Commission. This commission set out the framework of municipal heath for the next 35 years. These developments also influenced Canadian health reforms and institutions, for more see Heather Anne MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890" (University of Toronto, 1983), 153-154. 31 Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854 (New York,: Cambridge University Press, 1998). 32 Paul Adolphus Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930" (University of Toronto, 1979), 13-14. 33 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 161. 34 Alain Corbin, The Foul and the Fragrant : Odor and the French Social Imagination (Cambridge, Mass.: Harvard University Press, 1986), 89. He is not alone in this, see also Rabinow, The Essential Foucault : Selections from the Essential Works of Foucault 1954-1984. Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854; Rosner, Hives of Sickness : Public Health and Epidemics in New York City. 35 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 7. 36 Ibid., 137. See also Heather Anne MacDougall, "Public Health in Toronto's Municipal Politics : The Canniff Years, 1883-1890," Bulletin of the History of Medicine 55 (1981). Heather Anne MacDougall, "The Genesis of Public Health Reform in Toronto, 1869-1890 1982," Urban History Review 10, no. 3 (1982). 37 Medicine Hannah Conference on the History of, Charles G. Roland, and Medicine Hannah Institute for the History of, Health, Disease and Medicine : Essays in Canadian History : Proceedings of the First Hannah Conference on the History of Medicine, Mcmaster University, June 3-5, 1982 (Hannah Institute for the History of Medicine, 1984). Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885- 1925 (Toronto: McClelland & Stewart, 1991). Martin V. Melosi, The Sanitary City : Urban Infrastructure in America from Colonial Times to the Present, Creating the North American Landscape (Baltimore: Johns Hopkins University Press, 2000). Platt, Shock Cities : The Environmental Transformation and Reform of Manchester and Chicago. 38 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 166. 39 Paul Adolphus Bator and Andrew James Rhodes, Within Reach of Everyone : A History of the University of Toronto School of Hygiene and the Connaught Laboratories (Ottawa: Canadian Public Health Association, 1990), 3. Interestingly, Bator lavishes much praise on Bryce calling him a pioneer of health care. 40 The American Public Health Association, formed in 1872, was an important forum for the profession for public discussion. Many Ontario doctors were extensively involved with this organization, see MacDougall, "Public Health in Toronto's Municipal Politics : The Canniff Years, 1883-1890," 155. 41 See Starr, The Social Transformation of American Medicine. 42 This growth was part of larger North American wide progressive movement and connects to chapter 2, see Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 31-32. 43 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 166- 167. 44 See Ontario Archives, RG 49-92-0-1 to RG 49-92-0-8. Select Committee re Public Health, Minute Book, Jan 22, 1878—March, 1878. The health survey was sent out on January 24th 1878, as mostly a fact finding mission. The survey contained questions like: “How far has your Council exercised any authority in relate to the Public Health, and if not, why not?...Is your locality subject to malarial or miasmatic disease, are tuberculosis and exanthematous disorders, typhoid and puerperal fevers and diphtheria prevalent or frequent—and so far as you have observed, can any sanitary means be devised for the prevention of consumption?....What power, in your opinion, should the Legislature entrust to the Officers of Boards of Health as to removal of parties suffering from contagious diseases, in crowded places (to hospitals), or as to isolation, or system of quarantine to be carried out by persons living in houses where small-pox or other dangerous diseases are present?...What effects do Meteorological changes have upon physical health and mental disease?...What influences have different seasons of the year thereupon?...Does gases, drainage, refuse and water quality affect your institution?” 45 Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 59-60. 46 Bryce discovered this need when he carried out his survey of existing local boards. The conclusion over why change wasn’t being done was because of apathy and fear of central government intervention. See MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 156-158. Additionally, if Toronto was any indication, city budgets were a pressing concern. Health Boards Against Cholera | 2010 | Paul Jackson | 182

47 Ibid., 160. But this municipal health officer position was far from neutral. There was the conflict over state health’s size and scope. Many politicians only saw small interventions as necessary and therefore declared there was no need for a Medical Health Officer. In contrast, health reformers predicted a flourishing of unmanageable problems if the Ontario medical officers didn’t acquire the same status as their contemporaries in Britain and the United States. Health reformers saw the role of a medical officer as more than just working for the needs of the municipality. The mandate should include such works as: inspection of houses; isolation of the sick; clean water supply and sewage; the collection of statistics; the publishing of reports; and keeping up on latest medical and scientific developments. Throughout the 1880s there was a divide between the medical elite who wanted to expand state health’s powers and staff, compared to city governments who wanted to keep spending low. For overview see MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 197. Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 84-85. 48 Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 59-60. 49 The phrase ‘creature of the province’ is generally said of all Ontario cities to describe their relations to the province. 50 The city leaders at that time generally disapproved of the expanded role of health. The budget for health was limited to 2 cents per person until 1890. However, when Dr. Sheard came into power 1893, the year after the cholera outbreak, the local board funding was increased to 50 cents per person. Still, the majority of the budget from 1880s-1900 went to street cleaning. 51 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 229. 52 Ibid., 222. The smallpox outbreak had effects on vaccine production, and vaccines will be discussed in the conclusion. 53 Canniff focused on a diphtheria campaign. Diphtheria was huge problem in 1886 and many schools were shut down. Diphtheria was caused by bacillus discovered by Edwin Klebs in 1883 and produced in a culture by Friedrich Loeffler in 1884. Yet most doctors and laymen in Toronto continued to believe the disease was caused by poor sanitation and sewer gas, see Ibid., 248-249. 54 Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 15. 55 Albert L. Gihon, "The Hygiene of Cholera," Canadian Practitioner XVIII, no. 3 (1893): 169. He also talked about the meeting of Bryce's International Conference of State Board of Health and promoted their call for a national board of health. However, he declared this call useless unless governments could be efficient with both their money and manpower. He declares the problem with “health-men” is that just accept the little bits of money. Instead a national health board needed $100,000 or $200,000. Gihon speaks to the power of fear: “The occasion that brings us together just is not actually the presence of an epidemic, but of its attendant cause, because all epidemics have a phobic alter ego, and we have now amongst us really not cholera, but cholera-phobia ; it kills in an aggravated form, but in a mild form I do not know that it is altogether regretted.” Health Experts Recommend | 2010 | Paul Jackson | 183

Chapter 8 – Health Experts Recommend: The Marsh Reclamation Solution

George Henry in his 1831 book The Emigrant’s Guide, or Canada As It Is introduced the town of York and favourably described the local attractions. The town got a good review, but Henry had a warning: [T]here is a great drawback on the score of its unhealthiness of situation on the eastern side of the town, which, it is much to be feared, is irremovable. At the head of the bay, which comes to the east side of York, are some very extensive stagnant marshes; they extend for six or seven miles; and are considered to be the principal agents in germinating the local diseases felt more or less in and about the town.1

However, Henry was mistaken. A hundred years later, these “unhealthy” marshes, which were renamed Ashbridge’s Bay, were completely eliminated. By 1930, Toronto’s promotional material triumphantly declared that the “Ashbridge’s Bay and Marsh have entirely disappeared and in their place the Toronto Harbour Commissioners have created a modern industrial area, known as the Eastern Harbour Terminals.” (For maps, see Figures 8.9 and 8.10.) A new waterfront had been “created out of lands which were covered by water and [were] non-revenue producing.”2 In the space of one hundred years, the unhealthy Ashbridge’s Bay had been transformed from liability to profitability.3 However, to make this reclamation happen, politicians, urban reformers, and health experts had to continually push to transform this landscape. This chapter will cover the drive to reclaim this marsh (see Figure 8.1). While these health reformers ultimately achieved their aims, the reclamation was not under conditions of their own choosing. This chapter will follow how health experts used the cholera outbreak of 1892 to leverage massive changes to Toronto’s waterfront. Additionally, it looks at how state health bureaucrats struggled to institute reforms in spite of their continued impotence to shape politics and public opinion. The marshes of Ashbridge’s Bay were deeply associated with disease, in particular with Toronto’s experience of cholera. The year after Henry’s disparaging review of Toronto’s waterfront, the first cholera pandemic infected cities in Europe and North America, including Toronto. After cholera came upon the people of Toronto in 1832, this new and highly feared epidemic became slowly connected to the already existing marshland–disease relationship (see chapter 3). The ecology of the marsh, the reeds, the muck, the pollution, the flooding river— these were all forms of life proliferating out of control. As the previous chapters have shown,

Health Experts Recommend | 2010 | Paul Jackson | 184 the recurring cholera epidemics disturbed the politics and culture of the 19th century, and Toronto was no exception. While other endemic diseases continued to infect Toronto’s families and children, it was the nature and effects of cholera that dictated and shaped how urban health governance dealt with disease crises (see chapter 7). Cholera’s transmission by tainted water capitalized on Toronto’s health experts’ fears of marshy shorelines and untamable rivers. This chapter’s question is, What was cholera’s role in the industrial redevelopment of Toronto’s waterfront?

Figure 8.1. Town of York, Lake Ontario, and Ashbridge’s Bay.

While a direct causal link between the cholera outbreak of 1892 and the reclamation of what we now call the port lands is tenuous, this dissertation has shown how cholera contributed to the judgment that this natural marsh landscape was a liability. Liabilities need to be dealt with, and so engineers, politicians, and health reformers repeatedly proposed the marsh’s transformation. Contained within this drive for sanitary reform was the vision of converting the infested marsh into beneficial, healthy, and profitable land. If Toronto’s city officials could make this happen, the hope was that the entire city would be renewed, and a bright future ensured. Dreams, hopes, and speculation were continually cast on the creation of new land as profitable and a benefit. But this chapter asks, In the negotiation between disease and economics, what does benefit and profit encompass? In Toronto, health reformers were constantly fixated on the marsh ecology of Ashbridge’s Bay. After the health experts’ diagnosis of the landscape as “sick,” they repeatedly raised plans and solutions to these inherent environmental problems within government and public debates throughout the 19th century. Like the problem of the marsh itself, the solution was also something of a myth, and needed to

Health Experts Recommend | 2010 | Paul Jackson | 185 be stated by these reformers repeatedly. The discussion was never centred on whether or not the marsh should exist; instead, urban reformers asked, What was the best way to clean the water? Where should Toronto dump its sewage? and What was the best way to fill in Toronto’s marshy waterfront? This chapter’s intervention shows how the perceived solution to a crisis is both fragile and contingent.

8.1. Problems and Proposals Accumulate The last chapter showed how, over fifty years of political maneuvering, health crises were required in order for a robust health state infrastructure to cohere. Simultaneously, during the growth of municipal and provincial health governance, Ashbridge’s Bay was continuously invoked as a problem that must be dealt with for health reasons. These state health institutions were concerned with different aspects of the problem at different times; concern included channelling the river and controlling flooding; emphasizing the pollution; and reclaiming the entire marsh for industrial purposes. Different solutions were also tried on an ad hoc basis. One of the first solutions to the perceived health threat of the waterfront was to hire a health expert. In May 1832, even before the first cholera outbreak, the Canadian Freeman reported that the Port of York had received a medical officer. The reason for the position was that much “sickness prevails at present, and the approach of warm weather is likely to increase the evil. — Therefore, the cleanliness of the town, or rather its filthiness, ought to engage the first attention of this officer…[T]he state of the bay, from which a large portion of the inhabitants are supplied with water, is horrible…”4 The port may have been the first public agency to get a health professional in the city, but the medical officer had to deal with a landscape-sized problem far beyond his jurisdiction. Still, it was likely that the port officer’s hands were tied at that time; the health regulations of town of York were rudimentary despite health officers being regular members of colonial administration and exploration ships.5 Although the port and the lakeshore were where the people experienced the marsh and pollution and were where the problems were seen and smelled, the source of the problems came from elsewhere. One persistent problem was the flooding of the Don River. The Don River, the waterway that emptied into Ashbridge’s Bay, was repeatedly targeted as the source of problems and thought to be in need of improvement, management, and redirection. In 1834, the report of Captain Hugh Richardson described the conditions: [T]he Don, like a monster of ingratitude, has displayed such destructive industry as to displace by its alluvial disgorging by far the great part of the body of water

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originally enclosed by the peninsula. The whole of the marsh to the East, once deep and clear water, is the work of the Don, and in the Bay of York, where not its destructive mouths are turned, vegetation shows itself in almost every direction, prognosticating the approaching conversion of this beautiful sheet of water into another marshy delta of the Don…the Don, like a cautious and insidious monster, throws out before it two immense feelers of rushes as piloting its track of ruin; and layer by layer, as brick by brick the fabric rises to completion, steadily and fatally the bottom of the bay rises to the surface.6

The Don River regularly flooded each spring and the watershed above the city was seen to vomit unhealthiness onto urbanizing Toronto. However, nothing was done. Over time, the source—or object—of the problem shifted away from the Don River and toward the marshland that constricted the flow of river into Lake Ontario. Plans began being proposed to solidify the porous marshy lakefront. One year later, Captain Bonnycastle suggested that, since the Don River was dumping silt into Lake Ontario, the city must reclaim “the great marsh…which is at present a fertile source of unhealthiness to the city.”7 The people who lived near the marsh were also targeted as filthy and as contributing to the state of the bay. There was a movement to demolish the huts and shanties on the waterfront because of their poor state of upkeep and the “low moral fortitude” of the inhabitants. During the 1834 cholera outbreak, the squatting settlement on the beach was denounced.8 The mayor of Toronto described them, saying, “I never saw anything in Europe to exceed the loathsome sights met with in Toronto.”9 Over the next fifty years Toronto authorities and politicians attempted to promote public services, a public water supply, and waterfront reforms that would benefit the overall health of the city. Toronto held competitions and sought consultants for plans and designs to improve the water quality.10 However, no plan was instituted and the sources of pollution persisted. By the end of the 1870s, the marsh appeared to be getting fouler and fouler. The city, government, and health professionals created an uneasy coalition to determine and reform the foulness of the marshland. But by the 1880s, health reformers began their attack on Toronto’s government for permitting such unsanitary conditions. This reform movement was comprised of doctors, medical experts for the province, and newspaper writers. Their calls for reform were a mix of outrage and impotence. For the city, the issue was that there were too many unhealthy targets and problems. Debate was constant over which source of disease needed to be dealt with first: privy pits, Ashbridge’s Bay’s pollution, or the lack of sewers. The health experts declared that they all must be cleaned up or eliminated. In the mid-1880s, conflict emerged between Toronto’s health department and the City Engineer’s office, which would oversee sanitary and health matters. This open conflict came to

Health Experts Recommend | 2010 | Paul Jackson | 187 a head over the sewer system.11 In 1886, health experts and engineers were divided over Toronto’s lack of a trunk sewer. The province had first weighed in on this division with the passage of the 1884 Ontario Public Health Act. The law gave the Provincial Board of Health the power to approve or deny all municipal waterworks and drainage projects. The health reformers in the province thought this law could bypass Toronto’s electoral and budgetary “stalling.” A newspaper editorial from the period stated: Too often in the past have necessary public works been delayed or postponed indefinitely by the cry of high taxes. On this occasion it will be well to weigh the expense and loss of life attendant on every epidemic, to which every day delay…renders the city more and more liable, against the comparatively small annual charge on the city treasury involved in the adoption of the scheme.12

Part of the delay was due to questions about which departmental budget line this work would be placed under. This reflected a division between those seeking technical solutions in the form of engineering and sewers and those who wanted massive, citywide health reforms. The interdepartmental rivalries were due to professional jealousy, as both engineers and medical officials had presented environmental solutions to public health during the 19th century. The debate between technological fixes versus societal change was over who would lead the charge of urban transformation. If designs and plans were the starting point, the engineers would be in charge; but if street cleaning, waste treatment, and sewage divergence came first, then the medical experts would direct the changes. While these two groups agreed for the most part on the goals of sanitary reforms, by the end of the 1880s, they had diverged with regard to sanitary implementation and sewer construction.13 The debate became less focused on health and increasingly focused on civic boosterism. During the 1880s, local health officials could no longer ignore pollution and sewage on the waterfront and in Ashbridge’s Bay. The Gooderham and Worts Distillery had become the largest polluter of the bay. Following quickly behind was the Grand Trunk Railway that dumped untreated animal feces from its pigpens into the bay. Dr. William Canniff was Chief Health Officer from 1883 to 1890 when unsanitary conditions of Ashbridge’s Bay became a major point of contention. By 1886, Dr. Canniff was so disgusted with City Hall that he declared Toronto as having the worst sanitation in the civilized world and directly cited the pollution of Ashbridge’s Bay by Gooderham and Worts as evidence.14 With little political support, the situation of the bay had completely stalled, and Canniff enlisted engineer Emerson Coatsworth to create a cut at the eastern end of the marsh that would release the pent up sewage. Residents on the western end wanted the solution closer to them, and requested more frequent dredging of

Health Experts Recommend | 2010 | Paul Jackson | 188 the bay. In July 1886, the city’s slips (where boats docked) were thought to be so detrimental to public health that the Local Board of Health demanded the Waterworks Committee flush the sewers while the Harbour Trust15 dredged the slips. The Harbour Trust, the authority in charge of operating the port and the harbour from 1859 to 1911, was another level of government responsible for Toronto’s waterfront. Neither of these committees responded well to demands from the Board of Health. The Harbour Trust claimed it was beyond its jurisdiction and the Works Committee did not have sufficient pumping capacity. The Toronto Board of Health hired scavengers to do some of the work and requested municipal funds to pay them. Only then did the Harbour Trust step in. But these actions did little good. By 1888, Toronto Board of Health still widely condemned the city’s lack of will and declared the waterfront to be an open sewer. Canniff wrote to Mayor Edward Clarke saying: “[Y]ear after year, I have pointed out the unsanitary state of Ashbridge’s Bay and the necessity of abating the evil. Beyond this I have no authority to proceed without instruction.”16 Still, plans continued to be proposed by health authorities, politicians, and engineers, such as abandoning Lake Ontario as the source of Toronto’s water and engineering pipes from Lake Simcoe. For the next twenty years, Toronto commissioned many American and British experts to produce plans to improve Toronto’s water. All the while, cholera threatened and endemic typhoid and diphtheria continued to make people sick in Toronto.

8.2. Health Experts Diagnose Toronto Dr. Norman Allen followed Canniff as Toronto’s Health Officer. Allen produced a detailed report the year prior to the cholera scare of 1892 that described the conditions of the marsh and gave a sense of the conditions of Ashbridge’s Bay. Allen’s report was a sweeping attack on all of Toronto’s filthy spots. Allen did not directly engage with cholera; his duty was to eliminate all the environmental conditions that could excite any epidemics, but he was particularly obsessed with water-borne diseases like cholera. Allen described and linked all local conditions, in the city, in homes, and in Ashbridge’s Bay to foreign diseases. He pointed out how many diseases could be traced to privy pits: “The presence of foul privy pits has been the most prolific source of these diseases [diphtheria and typhoid], and promises to be the most permanent evil the Department will be called upon to deal with; for here we meet the opposition of a formidable array of landed interest.”17 He called for water closets in every home, and worried about the ventilation of sewers and sewer gas.18 Finally, he complained about unauthorized night soil (feces) dumping at sites around the city, including Ashbridge’s Bay.19

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In his report, Allen dedicated a significant amount of space to the examination of Ashbridge’s Bay, and his findings were submitted to the Toronto Board of Health and the city government. Allen described the topography of the marshland; how water currents could not flow out of the bay; how the marsh was like peat; and he worried that where the rushes grew and collected, “they decompose, giving off foul odors.” If that were not enough, the sewers on Lake Street, Leslie Street, Carlaw Avenue, Morse Street, Logan Avenue, and Booth Avenue emptied into Ashbridge’s Bay. The outlets were constructed out of wooden planks that functioned as large box drains, but they were not airtight so sewage escaped at the water’s edge. When Allen witnessed how they malfunctioned, was outraged: “On June 6th blood could be seen at the sides of the box outlet on Morse Street...[this] sewage is discharged...[and] is almost immediately lodged among the aquatic plants which fringe the shore, and is thereby shut off from the slight currents which at times might tend to carry it away and purify it.”20 But it was the cattle byres of Gooderham and Worts that he denounced as being the primary culprit of impurity in Ashbridge’s Bay: The cattle byres of Messrs Gooderham & Worts are one of the worst sources of pollution. All the drainage from at times 3,000 to 4,000 cattle is discharged into the bay through open wooden sluice way. A number of one-inch iron screens, set permanently in drains at various places, arrest the greater part of the solid manure, which is removed in wagons. All the liquid refuse and washings from the stables, together with such solid particles as can pass the screens, are sent directly into the Bay. The smell arising from this matter is far more offensive than that from a bad sewer. The whole premises are one reeking mass of filth, and it is a marvel that the employees can exist amidst such surroundings. In warm weather bubbles of gas arise form the bottom of the Bay, especially in the vicinity of the sewer outlets; a green scum forms rapidly upon the water, and in the early morning a dense fog hangs over the weeds and the rushes. When this scum forms, the residents in the immediate neighborhood state they suffer extremely from sickness, indeed all whom I consulted complained of illness in their families—diphtheria, sore throat, malaria, nausea, loss of appetite, lassitude and inability to work.21

I’ve used such a substantial quote because Allen’s health assessment in many ways echoes the form and methods of the medical topography tradition (outlined in chapter 3). Allen described the relations between water flow, landscape, plant life, soils, and the human body/worker. But what’s significant is the way in which Allen’s medical topography retained the style of nature writing and how he considered urban features such as sewer infrastructure in these ecological relations. Allen’s proposed solution wasn’t to get rid of the sources of pollution, but to transform the waterfront so the filthy water could be released out into the lake’s deep waters.

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But his extensive recommendations were not enough to spur the city to act. Later, Allen complained, “Since the date of my first report of July 9th, the condition of the bay has become much worse. Persons living in the vicinity of the bay complained loudly of the sickness it is producing. It is certainly no exaggeration to say that any delay in taking immediate steps to improve the present condition of the water would be criminal neglect. This work should be commenced at once, as any delay may give rise to a serious epidemic.”22 Less than a year later, a serious cholera epidemic was looming. In a way, Allen was right. In 1892, the cholera epidemic threatened North America. Though urban health governance had been instituted, it took an epidemic crisis to politically justify these public health institutions and professional careers. The 1892 cholera epidemic illustrated how, even after they’d gained some prestige and job security, the power of health experts was far from total. The health outbreak lent health reformers authority, yet in many ways financial constraints still held reign. Many health experts realized this rationalization and attempted to include financial concerns in their recommendations. As Allen declared in 1891: I would point out to those persons who seem more influenced by a financial than by a humane consideration of this question that any laxity or half-heartedness in regards to health matters is going to injure our business interests. We have a beautiful, healthy, thriving City, and we must maintain its reputation.23

While there was complete consensus over the need to get rid of health liabilities, there remained the struggle over who would bear the cost.

8.3. Conflict on the Waterfront The cholera outbreak of 1892 brought many tensions between health, bureaucratic jurisdiction, budgets, and engineering to the fore. As I explained in the previous chapter, a contentious division existed between health experts in the city and the province. After 1892, this division became a struggle over Toronto’s sanitation and Ashbridge’s Bay. During the 1892 international cholera crisis, Dr. Peter Bryce, then the secretary of the Provincial Board of Health, jumped at the opportunity to enact reforms. Dr. Bryce epitomized the public health official’s use of fear and various scientific arguments in order to prepare for a disease crisis. While trained as a doctor, he pursued a career in government as the official spokesperson of the Provincial Board of Health. His 1891 report to the board, entitled “A Hundred Years of Sanitation in Ontario,” focused almost obsessively on cholera.24 His medical science used whatever theory best met his objectives. Bryce claimed in the Evening News and other newspapers that cholera could live in a

Health Experts Recommend | 2010 | Paul Jackson | 191 baggage trunk for weeks and could be destroyed by sunshine and running water.25 Bryce also believed in contagion theories, calling for the surveillance of all immigrants, and in the purification of the marsh, reiterating that local environments caused disease. This was in 1892, and while the biology of micro-organisms and the transmission of germs were still being debated, very strong evidence on how cholera made people sick existed, evidence that Bryce actively ignored in making his claims. In an interview on September 2, 1892 with the Toronto Evening News, Bryce gave an extensive prescription of what Toronto must do to make the city disease proof. Bryce stated that Ashbridge’s Bay must be put in the “best possible condition before 1893 when it is feared cholera may reach Canada.” To do so, he called for the purification of the bay; the removal of causes of future pollution from the cattle sheds; the placing of the shores in a sanitary condition; and, finally, the complete extinction of the marsh. He declared that all health officials were in agreement that no sewage should go out into the city water supply without treatment.26 Bryce’s frustration with the city’s government, and perhaps Dr. Allen, was palatable. He continued: Whatever is undertaken, however, of this scheme must be done in cold weather. It will not be possible with safety to the public to expose to the air such organic matter as would be thrown up by the dredge form the proposed cut during warm weather or till after the frost comes. The evils caused thereby would be much greater than a polluted bay where organic materials are under water. Nature has been generous in giving to the city an area which is so convenient and which may be utilized in many way so profitably; and it will an unfortunate day when it gives this away, as it has other valuable franchises only to buy them back as it needs develop at an enormous cost.27

Bryce was demanding that the city and Harbour Trust spend the money to reclaim the marsh and not give the project over to private interests. At the same time, he was coordinating with John Henry, Esq., the secretary of the Ashbridge’s Bay Property Owners Association, which was also pressuring the city. Henry pointed out “the urgent necessity there is for placing our city in such a sanitary condition as will make cholera, should any appear amongst us, as little serious as the nature of the disease permits.”28 On September 26, the Property Owners Association gave the City Council its correspondence with Bryce and the Provincial Board of Health from that spring regarding the sanitary conditions and the residents of east end. The property owners had filed nuisance lawsuits against the city for not doing anything about the conditions of the marsh. The Property Owners Association went to the province and circumvented the city probably because it had Bryce as an ally who was helping to push its agenda. Accordingly, Bryce ordered the Toronto Board of Health to “mitigate the evils complained of,” as “instructed to take action”

Health Experts Recommend | 2010 | Paul Jackson | 192 by the powers of province.29 While Bryce and the property owners had been pushing the city to reclaim the marsh even before the cholera pandemic, after the cholera outbreak, their grievances gained greater urgency. Although there was an unfamiliar consensus over the medical diagnosis of Toronto’s unsanitary bay, the need for action was not a foregone conclusion. During the outbreak on September 15, 1892, the Evening News ran a story called “Toronto Is Ready.” Dr. Allen took a dramatically different position than Bryce and declared that there was no possibility of a cholera epidemic in Toronto in 1892. Allen went on to say: And it is prepared...There are no fever spots in this city and no especially dirty slums. Since the first of the month we have had 20 extra inspectors hard at work…They have disinfected the premises themselves in many cases and have distributed over a ton of disinfectant in two weeks. I venture to say that there are few cities in America so well prepared to resist cholera as Toronto is. Cleanliness and proper disinfection are the greatest enemies of cholera. 30

For Allen, this assessment of the marsh and the city was quite a different from the one he had made the year before. From my reading of the archive, his change of mind was not due to any extensive sanitary cleanup of the city or of the marsh that occurred after this first report. Allen’s different tone and call not to reform is puzzling. Perhaps he changed his position because he was defensive after being blamed for the continuing poor sanitary conditions. But Mayor Fleming also backed Allen’s position. The bacteriologist Professor Thomas Hayes took water samples at the intake of the pumping house and, in his King Street laboratory through “exhaustive analysis,” showed that the water was “first-class and almost entirely free of impurities. So there is one cause of fear removed.”31 Local doctors and scientists working for the City of Toronto had a very different view on the city’s susceptibility to cholera than the province. During that fall, the cholera epidemic was contained in New York City and the international emergency receded for the winter season. Nevertheless, all health professionals in Toronto looked to the summer of 1893, assuming there would be a cholera outbreak.32 In the early months of 1893, cholera began to break out in smaller cities in Eastern Europe and the Mediterranean. Throughout 1893, Toronto’s media regularly reported on these events and the ways in which the federal government’s quarantine procedures were unsatisfactory and unsanitary. Dr. J.J. Cassidy’s 1893 annual chairman address to the members of the Provincial Board of Health declared, “[T]o-day the most striking fact in the sanitary world is the deep- seated and universal dread of cholera both in Europe and North America...Recognizing as we do the imminent danger that is present in the use of sewage polluted water and all the readiness

Health Experts Recommend | 2010 | Paul Jackson | 193 with which it becomes charged with the comma bacilli [cholera]...we cannot but look with positive dread at the condition of Toronto’s city water supply.” He claimed that the municipal authorities were “trifling with the grave danger at their gates” by not taking efficient and well- 33 known precautions. The Provincial Board of Health requested new extensive powers to force the city to dredge Ashbridge’s Bay under an 1892 clause of the Ontario government’s orders-in-council regarding contagious disease. The Provincial Board of Health requested additional powers to take any measure needed to force Toronto to become sanitary and to ward off a cholera crisis. The provincial heavyweights, Drs. J.J. Cassidy and Peter Bryce, were appointed to a committee to carry out these health regulations. Passed on April 11, 1893, this regulation34 gave the Provincial Board of Health immense new powers to dictate what it wanted to see done and improvements it wanted to see enacted “medically.” Provincial health officials could now enter a municipality and close up wells, order the removal of privy pits and slaughterhouses, and procure sanitary technologies without the consent of any local authority. Crucial to these new laws was the stipulation that all changes would come at the expense of the local municipality.35 The province could now dictate whatever they wanted and had to bear none of the costs. The provincial health reformers were ready to impose marsh reclamation on the City of Toronto. However, unsanitary as they claimed the marshy waterfront to be, the provincial health officers never used these new extensive powers against Toronto to reform the waterfront. I can only speculate on why the province didn’t make use of the new law they spent time lobbying for through two related arguments: the water was actually clean, and the waterfront transformation had transitioned from a job for a health department to that of an engineering department. The first argument to explain why the province didn’t use its new powers was that the water quality of Toronto was improving, in spite of the rhetoric of provincial health experts. Toronto newspapers constantly reported that the city’s water was healthy. Typhoid fever, diphtheria, and scarlet fever had all been reduced. Dr. Allen and the Toronto Board of Health had been doing extensive work to improve the sanitary conditions over the last two years, albeit on an incremental basis. The municipal health board had been building and staffing an isolation hospital and a smallpox hospital; pushing for more sewers; closing privy pits; and frequently calling for the flushing out of the sewers. On September 21, 1892, a report to Toronto council demanded that it repair the leaky water pipes “to satisfy the citizens,” even though “the water supplied by the city is pure.”36 The Toronto Board of Health alleged that Gooderham and Worts was the major source of pollution of Ashbridge’s Bay. Accordingly, the city’s solicitor gave

Health Experts Recommend | 2010 | Paul Jackson | 194 notice to Gooderham and Worts that it could no longer discharge sewage into the bay. The city solicitor, the municipal health officer, and the city engineer were united to clean up Ashbridge’s Bay and Toronto’s water supply. Dr. Allen and the board of health requested that the city engineer create a plan for Ashbridge’s Bay that would sanitize the marsh and emphasized that no further delay would be tolerated; if need be the health board would be called in to sidestep council protocols. The city council now required that the Municipal Health Officer make a weekly analysis of the city’s water.37 The officer’s analyses were giving the council increasingly cleaner reports. The majority of this action happened in the fall of 1892 during and after the cholera scare. By 1893, changes could be quantified. The Evening News ran an article entitled “The Quality of the Water Is at Present the Best Toronto Ever Had” and stated that the “city’s health, so far as contagious disease are concerned, continues to be first-class.”38 The second argument to explain why the provincial health reformers didn’t use their powers was the work on reclaiming Ashbridge’s Bay was now moving forward with its own momentum. The 1892 cholera crisis had moved this process along, but not as far or as fast as the provincial health reformers would have liked. The city engineering work had been pushed along by the cholera crisis, but in a very particular way. While there was pressure from the province, the private syndicate that had proposed to reclaim the marsh failed to begin work. The private interests, called the Alexander syndicate from New York City, were stalling because they forecasted that they would not make a profit during that fall and winter. Finally, the city council had taken up the mandate to keep the land (and the assumed revenue from the land) in the public coffers. In November of 1892, the city engineer E.H. Keating proposed his plan to improve the bay’s sanitary conditions (see Figure 8.2). This strong push by the city was a response to failed attempts and proposals for waterfront transformation over the past ten years and an effort to prevent the impending cholera epidemic of 1893.39 His proposal was to open up the dammed in marsh, dredge the deep water for shipping, and gradually fill in the marshlands. Keating suggested that there were other cheaper proposals, but concluded, “To carry out such a [private] scheme would, of course, destroy all hopes of utilizing any portion of the bay for shipping, dockage, or commercial purposes which is one the objects of the plan I recommend.”40 The adoption of Keating’s plan was a significant development, because the project remained a public endeavour. The land would stay publicly owned and would be rented or leased to private interests. Importantly, in spite of the sanitary urgency, Keating was advised to hold back on the work until the city made sure the province would not make any future revenue off their work.

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While this municipal waterfront plan was swiftly passed in the fall of 1892, the financing of the plan took longer to organize. The city council agreed to a debenture of $125,000 over forty years. This cost was put to a public vote on December 29, 1892. The electorate rejected this by-law to take on more debt by seventeen votes. Citizens may not have endorsed this project because the city’s debt load was already high. The mayor and council had been elected to reduce the debt and city bureaucracy. But according to the health experts’ alarming statements, the city’s debt should never come before the city’s cleanliness; debt should not trump future cholera deaths. While the fear of cholera helped to create consensus—everyone agreed that the marsh should be reclaimed—the activity required funding and a future return on investment. However, democracy didn’t matter; this vote was circumvented.

Figure 8.2. Keating’s Plan to reclaim Ashbridge’s Bay, 1892.

In the first meeting of city council in 1893, Mayor Robert John Fleming’s inaugural speech began with the problem of Ashbridge’s Bay. The mayor declared that the bay must be made sanitary at once “for the purpose of protecting the public.” The city must produce new land and, if this is done “at a little cost, [the city could] have a valuable property.” He then attacked the Department of Water Works for running up high costs and making no visible

Health Experts Recommend | 2010 | Paul Jackson | 196 changes since the city was still drinking water from the bay. To create a more efficient administration, Fleming put city engineer Keating in charge of the water department. His next topic was waterfront improvement, pointing out that the expansion of rail lands, the construction of Union Station, and the building of new bridges would provide work for the city. He said, “We have secured control of the central water front, and it is incumbent upon us to make the fullest possible use of it.” The mayor ended his speech by suggesting that manufacturing would be drawn to this new land of Ashbridge’s Bay.41 In that same council session, Alderman Small insisted on the necessity of improving the bay against the wishes of the citizens and according to Keating’s plan. The necessary finances had to come from taxes or the city leaders had to go to the province and seek permission to issue the debenture that the Toronto citizens had denied them by democratic processes. In March, the province gave the city permission to issue unsecured loans to finance the marsh reclamation, and permission from the Dominion government soon followed. By May, the City Treasurer made it official and put the debenture into the estimates, though it was not to exceed $140,000. However, the work on dredging and reclaiming the bay had already begun. The first openings in the breakwater were constructed to allow the pollution to escape into Lake Ontario. During the following year, the construction work created a jetty, public works, and new land. Following these waterfront transformations, the pollution was released into the deep water of Lake Ontario. The Evening News writers were optimistic: “If this land is dealt with in an intelligent way it will be the source of considerable revenue for the city.”42 Keating also worked on straightening the Don River and making plans for the Canadian-Pacific Rail lands. With all this work moving forward, the provincial health reformers did not have to use their new state powers to institute their particular sanitary mandate. The fear of cholera and the constructed liability of the marsh had already provided enough leverage. Crucially, dubious financial flexibility got the ball rolling. A question then arises, Which health expert was to be believed? Was Toronto ripe for an outbreak or not? Whose assessment was more accurate, the province’s or the city’s? Choosing a side will not help to understand and contextualize the historical shifts of Toronto’s waterfront. In the archive, the epidemiological facts matter less than what was produced. Was Toronto’s water free of disease? No, Toronto’s water supply carried diseases such as diphtheria and typhoid. But, after the turn of the 20th century, the construction of Toronto’s filtration plant and the institutionalization of chlorine finally eliminated chronic water-borne diseases. Correspondingly, could Toronto’s sanitary condition and Ashbridge’s Bay foster cholera?

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Probably not, but again, facts may mean less than fear and the accumulated cultural associations. Another question could be raised: Were Toronto voters unaware of the impending epidemic or did they make a rational decision to disregard those fears? This is hard to say with any certainty, although perhaps the actual costs of landscape transformation outweighed the potential threat of cholera. At the turn of the 20th century, Toronto’s officials and citizens were dealing with a confusing and distrusted new science of bacteriology, threats that were visible and yet invisible, social “ills,” and increasing urbanization and pollution. Bacteria counts could not compete with the synthetic expertise and totalizing rhetoric of reformers like Bryce who could use science to condemn the sanitary conditions while fostering fears of widespread death. My claim is that the crusading against cholera and Ashbridge’s Bay was less about the spread of cholera and more about fulfilling a dream of Toronto as a clean modern city. People, ecological processes, and ideas had all accumulated to get rid of Ashbridge’s Bay. The marsh that traditionally assumed to be the cause of disease was also a site that promised future revenue for a cash-strapped city. The few obstacles that did not conform to the narrative of transforming liability into profitability was ignored or eliminated.

Figure 8.3. William Oldright. Figure 8.4. J.J. Cassidy. Figure 8.5. Charles Sheard.

One example of the above-mentioned elimination was the way Toronto’s top health bureaucrat lost his job. In February of 1893, Dr. Allen came under attack by the new chairman and committee of the Toronto Board of Health. The Board called for his dismissal due to his “unsatisfactory, extravagant, and un-businesslike manner.” He was criticized for not doing enough work, improper bookkeeping, and the mismanagement of funds.43 At the same time,

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Drs. Cassidy, Bryce, and Oldright (see Figures 8.3 and 8.4) of the Provincial Board of Health laid charges against the local board of health and against Dr. Allen in particular, claiming that he wasn’t tracking down disease nuisances. On February 25, Dr. Allen replied publicly: “Our work should be in the direction of construction and reform, rather than of destruction at this critical time.”44 Nevertheless, he was dismissed. Following the failure of a public vote to raise funds and the continued delay in reclaiming Ashbridge’s Bay, the major official who had downplayed the cholera crisis was fired.45 Dr. Sheard, who replaced him as the Municipal Health Officer, remained in the position for more than ten years afterwards (see Figure 8.5).46 Dr. Sheard confirmed Allen’s claims that Toronto’s water was clean. However, Sheard’s health reports were simple, efficient, and positive; politics and rhetoric were completely absent.47 During his tenure, Dr. Sheard did not come into conflict with the provincial health experts very often.

Figure 8.6. Toronto 1894. “Toronto” from Karl Baedeker. The Dominion of Canada with Newfoundland and an Excursion to Alaska. Leipsic, 1894.

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Figure 8.7. Ashbridge's Bay looking north from north bank of the cut. City of Toronto Archives. Fonds 200, Series 376, File 4, Item 62. October 3, 1904.

Figure 8.8. Ashbridge's Bay marsh. City of Toronto Archives. Fonds 1244, Item 1586 [1910?].

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8.4. Engineering Toronto: Institutions and Marsh Reclamation While the health experts had reached a consensus over the marsh as a source of liabilities and the dissenters had been marginalized, engineers became the profession responsible for “solving” the problem of the marsh. The health reformers had articulated the need and the crisis, but the sanitary changes and the concrete plans came from engineering department. However, even after the push from the 1892 cholera scare, the land reclamation of Ashbridge’s Bay was still a slow and halting process. The elimination of the swamp could not proceed on its own momentum, and outrage from all sectors over the slowness of the waterfront transformation and the lack of water treatment facilities continued. After 1892, the experts increased their scrutiny of the marshland and water-borne diseases through new methods of science and technology. In 1893, the Provincial Board of Health hired a part-time bacteriologist to test water and diagnose disease. In general, the local sanitation moved from an issue of health into the realm of engineering. Willis Chipman, a civil engineer, made the following comment during his address to the Association of Executive Health Officers of Ontario in 1895: The designing of hospitals, hospital appliances, vaccination, disinfection, isolation, quarantine, hygiene…are the problems which can properly be delegated to the medical profession; while the designing and construction of sewerage works, waterworks, garbage crematories and public abattoirs, the maintenance of such works, the cleansing of streets as well as their construction and maintenance; and the systematic scavenging, are problems in sanitary engineering…48

Even after engineer E.H. Keating had submitted his plan and the city had taken action, progress of the transformation of Ashbridge’s Bay’s was still slow. All changes were piecemeal and needed to be fought at each step. By the beginning of 1894, city council requested reports about the work being done, the accounting, and the constant justifications over why the work was going so slowly. By the end of 1894, the “Special Committee re: Manufacturing Industries” took a tour of Ashbridge’s Bay and declared the land ready for occupation, the only piece missing was street access. The committee called for more land to be reclaimed, even if more money was needed to make it happen. The city boosters also appreciated the new beach and suggested residential lots be laid out, like on Toronto’s Island, to lure possible summer residents.49 The incremental approach taken by Keating was in accordance with the mandate of sanitary engineering, as all reports by the city showed that the water quality had improved. The committee reports by Medical Health Officer Dr. Sheard were bizarrely cheerful and repeatedly stated that the health of the city was exceptionally good. During 1894, Ashbridge’s Bay

Health Experts Recommend | 2010 | Paul Jackson | 201 apparently ceased to be an issue for the city, even though the dream of new, profitable land and a shipping centre had yet to be fully realized (see Figure 8.6).50 By 1900 the marsh still remained a problem, although many meetings were held and extensive discussions took place about the transformation of the waterfront in accordance to the reformers’ dreams of revenue-producing lands (see Figures 8.7 and 8.8). During these years, the city continued the work of dredging and filling in the marsh. In spite of this, in 1902, the mayor began to complain about Toronto’s lack of a sewage disposal system. When the new money was made available to the city, the engineers maintained that the sewers were to be the top priority to halt the dumping of Toronto’s sewage into the harbour. The mayor was confident of the city’s debentures. Toronto was in good standing in the money markets in Britain, America, and Canada, and he declared the debt of 1904 and 1905 was now of a “revenue producing character.” In 1906, with financial flexibility now established, the politicians of the time declared that sewers came first, and the city passed the necessary by-law to construct the sewers in 1908.51 Nonetheless, water quality and being able to swim on the waterfront continued to be public issues. In this respect, the conditions of Ashbridge’s Bay were still not in accordance with the plan. The Don River was being straightened and city sanitation was continuing apace, but the complete transformation of the marshland had stagnated. This stagnation may have been caused by the lack of a strong government institution that was directly responsible for Toronto’s waterfront. The Harbour Trust had a tense relationship with the city, even though they were slowly working together to create a deep-water port for Toronto’s shipping interests. Ashbridge’s Bay was a key part of this long-term plan. But there were many restrictions, and permission from the provincial and federal governments was needed to enable this waterfront development. In the end, what got the port lands built was a newly created Toronto Harbour Commission. In 1911, the city formed a “Special Committee re Water Front Improvements” so it could secure legislative permission from the province and federal government to create a new state agency. The city vested power in this Harbour Commission to manage and control Ashbridge’s Bay, including all the city’s shores and beaches. The Commission had to be financially accountable to the city in terms of its transactions and surpluses; the construction of docks, buildings, transportation facilities; and how it levied tolls and other charges; and it could bypass by-laws for efficient regulation of policing and construction. Importantly, the Harbour Commission could create debentures without the approval of the city or the citizens. The Commission was put to the people of Toronto and

Health Experts Recommend | 2010 | Paul Jackson | 202 passed with a two-thirds majority. The mayor fully endorsed this new agency and had no doubt it would do the work for all the citizens; he promised that the improvement of the harbour would be fulfilled.52 The Commission became responsible for the waterfront development, and simply sidestepped municipal politics. By 1912, all three levels of government had accepted the Commission’s plan. The mayor stated: “Ashbridge’s Bay Marsh is undoubtedly destined to become one of Toronto’s greatest assets,” with rail transit and water shipping, the bay “will unquestionably attract large industries that will assist materially in developing our City.”53 That dream for an industrial waterfront had been given the green light; but it was not completed until the 1930s, ten years behind schedule. The reclamation of Ashbridge’s Bay was the centrepiece of the 1912 plan (see Figures 8.10, 8.11, and 8.12). The newly created land was used for industrial production, storage, and transportation; to paraphrase Dr. Bryce, “nature had been utilized so profitably.”

Figure 8.9. Toronto Harbour Commissioners, Waterfront development, 1937. University of Toronto Libraries. [Lower Figure is a detail.]

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Figure 8.10. Plan of the City of Toronto, 1902. Signed by Villiers Sankey, City Surveyor. University of Toronto Libraries.

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Figure 8.11. Ashbridge's Bay from the Disposal Works. City of Toronto Archives. Fonds 1231, Item 936. June 20, 1912.

Figure 8.12. Making ship channel, Ashbridge's Bay. City of Toronto Archives. Fonds 1244, Item 1517, 1912.

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8.5. Social Infrastructures and the State I want to explain the above shifts in landscape and government through David Harvey’s arguments of the relationship between land and capital.54 I do so to illustrate how this dynamic can help me understand the role of the state and the social infrastructures, particularly in regards to health. Harvey’s method is to outline how different processes work together to create things, permanencies, and structures (in his case, spatial configurations). Harvey’s argument on the relationship between the capital and the built environment depends on fictitious capital, investments that take on an “activist role.” To explain this role, Harvey uses terms such as catalytic forcing agent, active moment, and co-ordinating functions/devices.55 My question is, How can the state, in particular social infrastructures within the state, be seen to have a similar role enabling these active moments? Reading Harvey’s insights through Toronto may be helpful to illustrate these dynamics. The circulation of value through the City of Toronto’s loans and credit was used to coordinate and produce a new waterfront spatial configuration. This configuration allowed for further industrial and manufacturing investments. In the built environment, these active moments were not organized rationally, in terms of market efficiency, because the efficient market is a fiction in itself. Also, these spatial structures or investments are not necessarily beneficial. Accumulation does not conform to a particular law of the market, and in spite of the many myths of the economy, no financial returns are guaranteed. Indeed, a strong argument against Toronto’s port lands has been that, in terms of industrial investment, this space never fulfilled the financial returns that were projected.56 For cities, investments are often mistakes, especially since they internalize the contradictions found within capitalism and recreate these contradictions in the built environment.57 These processes are multiple, uneven, always changing, but in some manner become coordinated to produce surpluses, at least on the aggregate.58 These processes are not efficient, as overaccumulation and redundancies are produced. The built form contains aspects that are accidental (conjunctional) and not necessary to the working of capital.59 Capital requires multiple paths of investment for future accumulation and production, which these coordinating functions enable. Now, throughout history, contradictions of capital have led to economic crises. Harvey, in extending Marx, illustrated how contradictions persist and become internalized within particular spatial structures.60 Harvey rubbed together the blocks of capital and the land market and through his method showed that there are important active moments when credit and fictitious capital became coordinating devices to allow the circulation of value to reshape the built environment. With these active moments and coordinating functions, Harvey, in The Limits to Capital, powerfully describes the

Health Experts Recommend | 2010 | Paul Jackson | 206 process of switching between the primary and the secondary circuits,61 and how that has transformed cities over time. Harvey acknowledges that the state has a role in this relationship. The state “intervenes to stabilize accumulation in the face of multiple contradictions,” but importantly the state can only do this by internalizing these contradictions.62 To return to the example of Toronto’s waterfront, the new state apparatus of the Toronto Harbour Commission needed to be established in order to have the flexibility to raise fictitious capital, but this Commission sidestepped the democratic process (even though the Commission was sanctioned by the city council). The state took on an active role to establish new avenues for production and investment. But can the state have a role in enabling active moments? Can the state have coordinating functions through institutional arrangements? My claim is yes, and I hope to show how these roles of the state can be differentiated, though they’re always related to the reproduction of capital and the reproduction of labour.63 Ideologies of health shaped the co- ordination of the built environment, but there were key contingent factors. In the case of Toronto’s waterfront reclamation, private interests were reluctant to step in because there was not a clear return on investment. In the process, health experts became disempowered, as the waterfront development was taken over by engineers. Additionally, debentures were needed for the health reform work to get done, only in the hope for long-term manufacturing investment. Therefore, the state took on an active role in reproducing capital’s built environment. My more general question becomes, In what ways did value circulate through particular social infrastructures such as state health governance? And what were the various paths through which value returned to the primary circuit of production? Harvey’s analysis suggests the most obvious way value circulates is in the form of taxes and consumption that have a direct return to capital.64 But according to Harvey, value can also circulate through social infrastructures by enhancing social conditions; supporting science and technical research; or returning to production via new technologies. Social infrastructures enhance the conditions of surplus value production, yet Harvey states, “the problem…is to identify the conditions, means and circumstances which allow this potentiality to be realized.”65 In this problem I see a tension between social infrastructures as enhancing conditions (healthcare of a population) compared to the state as a path to becoming a material force (for example the science and technology of biomedicine). The enhancing conditions imply that state activities respond only to help populations within a territory. While a path to sphere of production implies that the state took on a coordinating role to enable the realization of value. This dissertation is trying to break down

Health Experts Recommend | 2010 | Paul Jackson | 207 the relationship between the two. Harvey compares the enhancing conditions of social infrastructures to soil productivity, saying that social investments build up over time the way that fertilizer does. Additionally, these investments do not wear out, rather they accumulate (science does not break down unlike machinery in production). These processes open up more questions. In the long run, in what ways do the accumulation of social infrastructures replicate capital’s uneven development?66 If the enhancing conditions of social infrastructures develop over time, and are not perfectly overlaid on capitalism, what contradictions arise? Accordingly, can a segment of that contradiction be channelled into certain areas for long-term future accumulation strategies? This implies that the state can take on a role as coordinating device for value. If these areas or “products” of social infrastructure (for example labour, knowledge, or techniques) can easily be moved67 while the state cannot move, does that have an effect on the social infrastructures themselves? Some of the implications of these questions will be thought through in the conclusion, but health boards as social infrastructures could lobby and shape where investments could be targeted, in this case marsh reclamation rather than sewer investment. But their power was partial and required coordination with other groups and sectional interests. For a time, the health crisis of cholera coincided with the ongoing demand for marsh reclamation and the hopes that the revenue would go to the state. Private interests were given an opportunity to clean up the swamp, but despite the long-term hopes that it could be profitable, in the short run it was not. The social infrastructures of health boards stepped in to push for reforms to protect the city, but their power was not total, they could not get what they wanted with only health-related justifications. Bureaucrats did not have the power that Max Weber claimed; rather, they relied on connections, financial investments, histories of epidemics, and opportune politics.

8.6. Conclusion: Expertise Impotence Despite the dreams of the reformers, this paved over marshland never became one of Toronto’s greatest assets, just as Ashbridge’s Bay was never one of Toronto’s greatest health dangers.68 Even though health reformers, sanitarians, and engineers had come to a consensus that the swamp was a problem that must be eradicated, economics still reigned. Whether the science actually backed up the unhealthiness was perhaps inconsequential. If cholera had returned in 1893 or 1894, one could presume that the marsh reclamation would have taken place in the 1890s, but cholera did not conform to the fears or hopes of the health reformers.69 However, in many ways, cholera did not have to arrive. A variety of scientific arguments could be mobilized

Health Experts Recommend | 2010 | Paul Jackson | 208 at will, depending on the political climate, to bolster the claims that the marshland should be eliminated. However, to declare the marshland simply equalled crisis was adequate, but not sufficient. Even as all these associations had accumulated on the waterfront, financial flexibility and the promise of financial return were still required to start the reclamation process. The Toronto Harbour Commission, an unaccountable state agency, had the institutional flexibility to make these longtime dreams a reality. The role of the Harbour Commission could be seen as similar to that of the Provincial Board of Health, a social infrastructure that was a form of governance that moved away from enabling citizens to manage their own affairs and toward the city being seen like a corporation that needed efficient management and specialization. The health experts learned that a call to reform that combined health, the city, and the environment could only go so far to mobilize change. Instead, a more powerful argument came from combining health, the city, and the economy. Articulating only the ideology of health, or even the threat of death, would hold marginal weight to transform sanitary conditions. Correspondingly, profitability became a vital component that the health reformers learned to mobilize around. It was not a huge retooling of their ideology to include economic arguments, but overtime what emerged was national efficiency through a healthy workforce (see chapter 9). The combination of urban-health-ecology only took the health experts so far. A healthy workforce and industrial productivity had legs, with a healthy dose of fear of death for added leverage. The swamp-sickness fears were not enough, and the reason for failure was not because everyone wasn’t on board to the fullest degree. Consensus did happen (marsh is bad), even if complicated by the competing stories of whether or not Toronto’s water contained bacteria counts. Different priorities existed, as seen in the competing plans between engineers and health experts. As an idea, the 1892 cholera crisis created action, but not by itself. This is why Hamlin’s point that a crisis is always happening (raised in chapter 1) is so perceptive. Conditions do not determine responses. A crisis is not enough; there needs to be active mobilization to transform social relations and landscapes.70 A variety of rationales need to circulate and buttress one another. The activity that the crisis invoked necessarily took place amidst limitation, in this case a high municipal debt load. Capitalism fundamentally limits options. These limitations, including Toronto’s processes of direct democracy, are what the health reformers were railing against and this is why the progressive experts felt so impotent and frustrated. To say that there needed to be an economic motivation behind the marsh reclamation

Health Experts Recommend | 2010 | Paul Jackson | 209 would be too crass, but in addition to the fear of death, a form of economic rationality and some financial gain were needed. In many ways these events would only feed the liberal positivists distain of the ignorant masses that could not see the pure wisdom of their technocratic recommendations. For example, on November 3, 1910, an editorial from the Canadian Engineer had the title “Should the Question of Public Health be Subject to the Vote of the People?” The editors questioned whether communities have to drink polluted water and suffer typhoid because the majority of the citizens are “ignorant, selfish, and content.” The writers decried the fact that there was no law making hygiene compulsory: Education is compulsory. To shoot oneself or one’s neighbor is illegal and punishable. To purchase poison and administer it one’s neighbor his a crime. To poison your neighbor’s water supply and kill him with typhoid and to poison your own water supply and kill yourself with typhoid, are legal methods of committing murder or suicide… Nothing can be done expect educate the public, wait, and re-submit another by-law in the future. Rubbish, foolishness, communal suicide, and sacrifice to a democratic fetish! If a man chooses to purchase arsenic and poisons another, do you take time to educate him to a better view of ethics? No; you hang him. If a community chooses to discharge its intestinal filth, laden with disease germs, into a communal stream, thus poisoning others, do you hang it? No; you commence a slow process of education. You try to make them see the error of their ways. Rubbish! They are never educated. You can no more interpenetrate their minds with the principles of cause and effect than you can make them complete bacteriologists…And so it goes jogging along. In spite of your Provincial Board of Health, your experimentalists, your engineers, and your few enlightened citizens, it is the shadow of death that really does the trick. So, in this so-called “reasoning age” tragedy appears to be the whole road to enlightenment. Peace is the product of war, and health the product of the fear of death.71

The writer went on to ask, what the Commission of Conservation, a newly created federal agency whose central mandate included urban health, would do other than form committees, have meetings, and publish “blue books” that only a few people would read.72 The authors did get around to answering their own title’s polemical question: “We certainly conclude with a negative answer. The public may choose whether they will ride in street cars or walk, whether they will light their streets with gas or electricity, and in all such kindred subjects of public utility. But as to continuing any method which means communal suicide and the poisoning of the stranger within its gates, the public must be denied a voice and State intervention supervene.”73 As the quote illustrates, the health experts and engineers, the reformers of the

Health Experts Recommend | 2010 | Paul Jackson | 210 city—those that fully embodied the liberal positivist aspects of the progressive movement— were deeply frustrated. As the quote above shows, the experts and bureaucrats were a far cry from Max Weber’s personally detached pure types. In many ways, the Provincial Board of Health was not an efficient or objective institution, and did not work according to calculable rules. Weber states, “Bureaucracy develops the more perfectly the more it is ‘dehumanized,’ the more completely it succeeds in eliminating from official business love, hatred, and all purely personal, irrational, and emotional elements that escape calculation. This is appraised as its special virtue by capitalism.”74 My archive contradicts Weber on this point. My contribution is to show not what takes place within the inner workings of bureaucracy, but rather to show how health experts pushed beyond the bureaucracy in relation to events, the economy, different scales of governance, bringing in concepts from other disciplines. To clarify why I am not using the term health bureaucrat, the bureaucrats of the bio-economy contain an ideological and practical tension. My claim is that they took as their mandate “life” and “economy.” This makes them profoundly non-Weberian bureaucrats. In this grand act, health experts were dismissive of the public. They didn’t create consent or allies within the urban poor or the working class. Instead, they began to abstractly speak for “healthy workers” to enhance the national organism. Politics was irrational and wasteful, even the time necessary to circumvent the democratic process was a waste. While the engineers had come to dominate the marsh reclamation process, the medical experts and health boards had moved on to grander issues.75 My argument is that the use of fear of an impending crisis, whose power was brought home during the cholera outbreak of 1892, was then utilized in other disease and health “crises.” As urban health governance became instituted, the power of the epidemic crisis was necessary to politically justify the formation of public health institutions, to maintain professional careers, and to demand land reclamation of the marsh. The 1892 cholera epidemic illustrated this. The 1892 outbreak provided leverage for the health reformers’ authority to eliminate the marsh. But health experts did not have enough leverage to follow through with their recommendations. As professions further specialized, health reformers moved on to other battles and let the engineers deal with building a new landscape. For health experts, the local battle over Ashbridge’s Bay was one part of a larger ideology of a healthy city and nation. The politics of crisis was a powerful lesson that could and would be used in the future. The next chapter will investigate the ideology of these health

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Endnotes

1 In Edith G. Firth, The Town of York, 1815-1834 (Toronto: Champlain Society for Government of Ontario, University of Toronto Press, 1966), 332. 2 City of Toronto Archives. Facts Concerning Toronto Harbour, 1930, (Toronto: Toronto Harbour Commissioners, 1930), 5. 3 I realize this phrase—from liability to profitability—could be, or should be, unpacked further through works like Neil Smith, Uneven Development : Nature, Capital, and the Production of Space (New York, NY: Blackwell, 1984). Smith’s work has deeply informed this work, but I attempted to let the archive speak for itself rather than use language such as “the production of nature”. Similarly, this archival work could be analyzed by way of Schopenhauer’s creative destruction, but I have reservations of overusing that term, and I do not want to distract from the historical narrative. To contextualize this intervention, I suggest the importance in illustrating how historical and geographic particularities temper capital’s transformation of geography. The question of value creation is vital to the process of liability becoming profitability, and I work through value circulation later in this chapter. To invoke value here raises the labour theory of value through commodity production, however, is this discussion limited to Marx and Harvey’s circulation of value? Or can value be extended from the process of resource – production – circulation – surplus value? Some speculative questions come to mind. For example, is there is the active creation of non-value, that justifies investment to shepherd non-value into circuits of capital? I have been struggling these questions, but helped with discussion with Jesse Goldstein’s work on waste and the commons. I have also been influenced by a theory of value through the work of David Graeber, Towards an Anthropological Theory of Value : The False Coin of Our Own Dreams (New York; Basingstoke: Palgrave, 2002). I return to these questions in the next two chapters. 4 In Firth, The Town of York, 1815-1834, 238-239. 5 Richard H. Grove, Green Imperialism : Colonial Expansion, Tropical Island Edens, and the Origins of Environmentalism, 1600-1860 (New York Cambridge University Press, 1995). 6 City of Toronto Archives RG 42 reports box 109. Toronto Harbour Works. Extracts from the Report of Captain Richardson, referred to in Report of Select Committee, 13th of Feb., 1834 7 In G. Desfor, "Planning Urban Waterfront Industrial Districts - Toronto Ashbridges-Bay, 1889-1910," Urban History Review 17, no. 2 (1988): 79. 8 Logan Atkinson, "The Impact of Cholera on the Design and Implementation of Toronto's First Municipal by- Laws, 1834," Ibid.30 (2002): 10. 9 Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980), 77. 10 Ibid., 131-132. 11 The history of sewers has been extensively researched, see Catherine Sylvia Brace, "Thesis: One Hundred and Twenty Years of Sewerage the Provision of Sewers in Toronto, 1793-1913" (University of Toronto, 1993). Catherine Brace, "Public Works in the Canadian City; the Provision of Sewers in Toronto 1870-1913," Urban History Review 23, no. 2 (1995). 12 Heather Anne MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890" (University of Toronto, 1983), 377. 13 Ibid., 385-390. 14 Paul Adolphus Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930" (University of Toronto, 1979), 87. 15 To contextualize the Harbour Trust, this was a separate agency from the municipality of Toronto that was in charge of the harbour, but was not democratically elected. In the current context we might call this agency a public- private partnership. 16 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 385. 17 Norman Allen, "Report on Sanitary Conditions," ed. Toronto Board of Health (City of Toronto Archives. Fonds 200, Series 365, File 6: 1891). This report was written in the first six months of Allen’s reign as Toronto Medical Health Officer. On November 15th 1891, he presented his findings to the Local Board of Health. The report was richly detailed and illustrated how in that time period, in accordance to chapter 3 and 4, a variety of disease theories

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could be combined, including zymotic, miasmic, and bacteriological. Allen reports, “Contaminated air is heavier than pure air, and generally stinking organic vapors are heavier and then, on that account, to hang around localities form which they emanate…In examining into the last 249 cases of zymotic disease as to cause, I find these occurred in 288 houses. Of these 63 per cent had foul privy pits. Experts agree with the view that virus of diphtheria may lie dormant until suddenly an environment of foul and putrescent material affords the requisite for its development, and outbreaks are the result.” (pp.21-22.) Allen backed up his analysis from professor William Oldwright who was part of the Provincial Board Health and who stated how “hundreds of persons are annually killed in our Province by these abominable pits”. 18 The concern over sewer gas was due to how these gases contributed to the overall atmosphere. During warm weather the evaporation of the feces into the air was thought to combine with other city pollution, with deadly results. The science of the time recommended: “To indicate how laden is the air of the City with germs of various kinds it may be said that one minute’s exposure on a glass plate of some medium which aids their growth, will show in twenty-four hours numerous forms to have settled on a surface of six square inches...” (Ibid., 25.) 19 However, in 1891 Dr. Allen declared the city’s water quality as good, even after all these findings in his report. “I beg to congratulate you also upon the improved sanitary conditions of Ashbridge’s Bay and the Don lagoons. Your action in these matters has probably been the means of preventing an epidemic. It is worthy to remark that these parts of the City have been least affected by recent outbreaks, and it is to be hoped that permanent improvement will minimize the possibility of future visitations.” (Ibid., 6.) This contradicts many of the claims from the province, but Allen doesn’t describe what “permanent improvement” would entail. 20 Ibid., 16-17. 21 Ibid., 17. 22 Ibid., 13-14. 23 Ibid., 25. 24 Ontario Provincial Board of Health of and Health Ontario. Dept. of, “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1891). 25 Evening News, “Cholera To Come Next Year,” Evening News, August 25, 1892, 1. 26 Evening News, “Coming Via Canada,” Evening News, September 2, 1892, 1. 27 Evening News, “Coming Via Canada,” Evening News, September 2, 1892, 1. The current resonances, for a redeveloped Toronto’s waterfront, are striking with the historical dreams of the politicians and city leaders. Bryce and Allen different perspectives can be seen in these two articles: The Globe, “An Ounce of Prevention: Some Timely Advice from Dr. Allen,” The Globe, Toronto, Saturday, September 3, 1892, 6; The Globe, “Ashbridge’s Needs,” The Globe, Toronto, Saturday, September 3, 1892, 6. 28 Evening News, “Wake Up Toronto,” Evening News, September 1892, 1. 29 Fonds 200, Series 1078, Toronto City Council proceedings 1892, Appendix A, 326. These issues were also raised during the September 26th meeting of the Toronto city council. 30 Evening News, “Toronto Is Ready,” Evening News, September 15, 1892, 1. 31 Evening News, “Toronto Is Ready,” Evening News, September 15, 1892, 1. However, the city council proceedings spelled his name as “Professor Heys”. 32 As the Canadian Practioner put the situation: “It is an unquestioned fact that the citizens of Toronto should be made aware of, that in their water supply lurks the factor of disease that will, to a great extent, determine the danger and severity of the epidemic of cholera that is likely to visit the city during the coming summer.” The journal declared that medical science could handle cholera, but the city needed pure water and the careless management of the Waterworks Department must be stopped (this illustrated that they are writing in and for a Toronto audience). “The water supply of a great city is one of the most important subjects in its political economy.” The sewage drained into the bay is 20 million gallons a day and while Lake Ontario water is pure and is “nature’s gift to us”, it’s confined by the island and bay and: “It will not be difficult to see, from this rough description, that the bay is little less than a huge cesspool—its waters contaminated and poisoned by the drainage into it from many thousands of people for many decades....What a bottom the bay must present ! How many feet of solid filth must be there...” From Editorial, "Toronto's Water Supply," Canadian Practitioner XVIII, no. 3 (1893): 235. 33 Evening News, “Cholera Not Stamped Out,” Evening News, March 1, 1893, 1. 34 For the record, these regulations covered, in the words of James Morrison Glen, "The Public Health Manual Containing the Public Health Acts of the Province of Ontario and Regulations of the Provincial Board of Health Together with Notes of Decided Cases," (St Thomas [City of Toronto Archives. 341.765026 G48 1908]: The Municipal World Publishers, 1903), 63-68. These regulations are paraphrased, unless otherwise noted: “Whereas the Province appears to be threatened with Cholera during the present year, the Provincial Board of Heath...enacts the following regulations”:

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1. Appoint medical officers of health. 2. Employ sanitary police. 3. If no medical officer of health is available, the province will take possession of any unoccupied land or building to create an isolation hospital in any municipality 4. If deemed necessary by the Provincial Board of Health can make “Houses of Detention” to observe persons suspected of cholera. 5. If any government official does not comply with orders or regulations of the Board or Health Acts he shall be reported and the Board will take measures. 6. Suspected cholera patient must be isolated and kept under observation. 7. If cholera is found to be present, then the medical health officer must remove the person to the isolation hospital, tent, or other place provided. Then the health officer must disinfect and destroy all clothing and disinfect and purify rail-car, steamboat, sailing, vessel carriage or other vehicle which may have been exposed to contagion 8. When cholera patient dies the body shall be wrapped in a sheet saturated with a solution of mercuric chloride (in proportion of 1-500 parts). The body must be put in a coffin as soon as possible, and then surrounded by chloride of lime or “fresh quick-lime”. Then the coffin should be permanently closed and private burial. Everything must be disinfected, and family members not allowed in. 9. “He shall further place in another building or tent which shall be provided, as already prescribed, all persons who may have been exposed to the contagious, and shall supply them with all necessaries until the period of incubation of the disease shall have elapsed, and no such person shall go or be permitted to go abroad until the period of incubation of the disease has elapsed, nor until the clothing or effects worn or carried by or with him or her have been properly disinfected.” 10. The officer will get the cholera person to the hospital, at the expense of the municipality. 11. When anything enters Toronto from an “infected locality” the Toronto (or provincial) medical officer then claim jurisdiction over the port and must inspect all goods and people. 12. The Local Medical Health Officer shall help the Provincial Medical Inspectors to remove the suspected persons from trains and boats, if the people are not residents of the city and cannot pay then the province pays. 13. No rags or clothing shipped into the area may be landed unless properly disinfected. 14. The regulations then explained what the Provincial Medical Inspector did, which mostly entailed the coming and going of goods and people. However, if cholera discovered the inspected is responsible for: 1. detention and isolation of people afflicted or exposed to infection 2. disinfection of clothing 3. disinfection of vehicle 4. notification of places of destination. 15. The Provincial Medical Inspector would act when, or if, the Local Board or Medical Health Officer was neglectful or omitted to follow these Acts. This entailed how, if cholera is found, the Province could then act with all the duties of the local health officer. 16. Duties of Local Boards of Health and Medical Health Officers: a. closing of wells b. removal of privy pit contents c. organizing carts for scavengers and supervise the removal of waste to the dump d. issuing an order that all slaughterhouses be removed outside the limits of the city. 35 Evening News, “Extensive Powers Asked,” Evening News, March 3, 1893, 1. See also, Evening News, “Guardians Of Public Health,” Evening News, May 16, 1. 36 Fonds 200, Series 1078, Toronto City Council proceedings 1892 Sept 21st, Report No.15 of Local Board of Health, Appendix A, 454. 37 Fonds 200, Series 1078, Toronto City Council proceedings 1892, Report No.22 of Local Board of Health, November 24th, 1892. 38 Evening News, “Health Of Citizens,” Evening News, September 25, 1893, 1. 39 For more historical context on this process, see Desfor, "Planning Urban Waterfront Industrial Districts - Toronto Ashbridges-Bay, 1889-1910." 40 Fonds 200, Series 1078, Toronto City Council proceedings, Report No.37 Committee of Works “Ashbridge’s Bay reclamation”, November 21st, 1892. 41 Fonds 200, Series 1078, Toronto City Council proceedings, January 16th, 1893, The Mayor’s inaugural addresses Robert J. Fleming, Appendix C, 1-3. Mayor Fleming also spoke to the plan to transport water from Lake Simcoe,

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but he suggests that this plan would be too costly. He worries that this would also need a debenture and increase the debt load, or the citizen’s taxes. Fleming explained that there had been a tremendous increase in debt over the past few years and would be a future burden, both “unwise and unwarranted”. I could speculate that the solution to turn the marshes into land, to lease, was to pay for the debts incurred during the waterfront clean up. 42 Evening News, “Good Works At Ashbridge’s Bay,” Evening News, September 30, 1893, 1. 43 Fonds 200, Series 1078, Toronto City Council proceedings 1893 February 20th, 1893, Report No. 2, Appendix A, 61. 44 Evening News, “,” Evening News, February 25, 1893, 1. 45 In contrast, MacDougall has a very different take on why Allen was fired. She claims that Allen lost his job because he sought support from the Province for his sanitary report, and he attacked the engineering department. In her words, “Lacking the political acumen of his predecessor, Allen failed to realize that the Toronto’s Tory councils distrusted administrators who depends on the Grits at Queen’s park.” Heather Anne MacDougall, Activists and Advocates : Toronto's Health Department, 1883-1983 (Toronto: Dundurn Press, 1990), 22. This speaks to the division between the city and the province, but this claim doesn’t incorporate the conflict within the heath bureaucrats’ interests, or the cholera crisis of 1892. 46 Interesting, while politically reserved in the city and Ontario, Dr. Sheard attacked the federal government. One of his first projects was to build a disinfection station in Toronto. He criticized Montizambert’s report that inland officers should acquaint themselves with the quarantine measures. He says the problems were all federal and he knew fully well how quarantine worked from the abstract of Sanitary Reports of U.S. Marine Hospital Service in Washington. I find interesting that Toronto doctors relied more on U.S. regulations and guidelines than Canadian ones. See Evening News, “The Quarantine Unsatisfactory: Immigrants from Hamburg Should be Rigidly Disinfected,” Evening News, July 3, 1893, 1. 47 My reading of the archive is, Allen did much of the work and reforms that then paved the way for Sheard to just sit back and reap the benefits. I think Allen was dismissed because he was calm in the face of cholera and did not use the crisis to move his agenda forward, unlike experts such as Bryce. Allen’s agenda was focused on the sanitary condition of the water supply. In the process he fractured the ‘health expertise bloc’, bringing in politics that were against the tone of progressive movement and liberal positivism. Dr. Sheard did extensive work during his tenure, as he attempted to implement bacteriological science for treatment of the entire sewage before reaching in the water supply. However, Sheard also had to struggle with the city engineer, along with some members of council, who said a water treatment plant too costly. In the decade after 1900 the debate of sewage treatment plant continued. From the science of bacteriology and a diagnostic laboratory (that had been established by the Provincials Board of Health in 1890) came the process of the sterilization of sewage and the filtration of water. These methods provided scientific proof of water quality. But many health experts, such as Bryce, were slow to take up these were emerging practices. 48 MacDougall, "Thesis: Health Is Wealth the Development of Public Health Activity in Toronto, 1834-1890", 390. 49 Fonds 200, Series 1078, Toronto City Council proceedings Nov 19th, Report No. 4 of the Special committee re: Manufacturing Industries, 1894, 539. 50 This conclusion arose from extensive reading of Fonds 200, Series 1078, Toronto City Council proceedings, 1894. 51 Desfor, "Planning Urban Waterfront Industrial Districts - Toronto Ashbridges-Bay, 1889-1910," 86-87. Additionally, a massive fire destroyed much of Toronto in 1904, and this changed much of the planning process. For more on the sewers, see Brace, "Thesis: One Hundred and Twenty Years of Sewerage the Provision of Sewers in Toronto, 1793-1913". 52 Fonds 200, Series 1078, Toronto City Council proceedings, Appendix A, Report no. 3, 1911, 1485. 53 Fonds 200, Series 1078, Toronto City Council proceedings, Appendix C, 1912, 21. 54 As a geographer one of David Harvey’s contributions was how he interrogated spatial configuration (land) into the logic of capital. Since I take inspiration from these insights for my own work, therefore I need to outline them. When Harvey talks about the relationship between capital and land, he suggests that fictitious capital has an the activist role that “performs certain important co-ordinating functions and thereby legitimates and justifies the appropriation of rent within the overall logic of capitalist mode of production”. (David Harvey, The Limits to Capital (London; New York: Verso, 2006), 368.) What follows is: “The production of spatial configurations can then be treated as an ‘active moment’ within the overall temporal dynamic of accumulation and social reproduction.” (Harvey, The Limits to Capital, 374.) According to Harvey, the circulation of interest-bearing capital promotes a variety of activities to develop the land for the ‘highest and best use’. This co-ordination and actions does not take place for immediate profit, rather these configurations are in anticipation of future surplus value production. This effort to put land in highest and best use then “shifts land uses and allocations of capital and labour that might not otherwise occur. By looking towards the future, they also inject a fluidity and dynamism into

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the use of land that would otherwise be hard to generate.” (Harvey, The Limits to Capital, 369.) These processes suggest “locational paths for future accumulation and acts as a catalytic forcing agent that reorganizes the spatial configuration of accumulation according to underlying imperatives of accumulation.” (Harvey, The Limits to Capital, 372.) 55 David Harvey, Justice, Nature, and the Geography of Difference (Cambridge, Mass.: Blackwell Publishers, 1996), 64. In terms of methods and in terms of dialectics, Harvey suggests looking for transformative moments or transformative activities and how these activities are internalized into the capital processes as a whole. 56 This is Gunter Gad’s retort against many histories of the Toronto’s waterfront. 57 Harvey’s full quote may illuminate more, “The fact that [the circulation of interest-bearing capital] sometimes forces too hard…or in erroneous directions…simply establishes that the land market necessarily internalizes all the fundamental underlying contradictions of the capitalist mode of production. It thereby imposes those contradictions upon the very physical landscape of capitalism itself. However, it is at the same time a vital co-ordinating device in the struggle to organize the use of land in ways that contribute to the production of surplus value and the structuring of capitalist social formations in general.” (Harvey, The Limits to Capital, 372.) 58 Harvey says “Investment in appropriation, so necessary to the performance of these coordinating functions, is here, as elsewhere, the ‘fountainhead of all manner of insane forms’ and the source of potentially serious distortions. Speculation in land may be necessary to capitalism, but speculative orgies periodically become a quagmire of destruction for capital itself.” (Ibid., 369.) 59 The fact that built form merely exists is therefore not a good judge of why an institution or built environment came to exist. Rather why these forms persist depends on how value returns to different circulations of capital. 60 Harvey, The Limits to Capital, 320. 61 A quick summary of the circuits of capital will help. The primary circuit of capital in the production process where money and resources are converted into commodities and then sold. But money can also flow into fixed capital and consumption fund to create built environment and physical infrastructures, the secondary circuit. 62 Harvey, The Limits to Capital, 449. 63 For capitalism to be reproduced, Harvey outlines in Limits the necessary state conditions. See his chapter on technology (in Ibid., especially 99-104, 122, and 133.) These dynamics of technological change can also take place in regards to the state and science. In the conclusion of this dissertation I follow these threads. 64 Harvey says the concept of ‘productivity’ of flows into social infrastructures can parallel public investment in physical infrastructures. Improvements to social conditions and labour power can have long-term or “salutary” effects on surplus value production. Examples are the state constructing a port and the state improving workers’ health, both have beneficial outcomes. 65 My emphasis. For value in social infrastructures Harvey has no trouble with the role of taxes and consumption. But when he gets into the circulation of value through social infrastructures, I think his method breaks down a little: “Some of the flows into the social infrastructures can therefore be viewed as investments designed to enhance the social conditions for the production of surplus value…Flows to support scientific and technical research, to cite yet another instance, can also return directly to the sphere of production as a material force (new technologies). The immense significance of the social infrastructures ‘moment’ in the total circulation process of capital cannot be denied. Value flows of this sort do not produce surplus value in themselves. They simply enhance the conditions for surplus value production. The problem…is to identify the conditions, means and circumstances which allow this potentiality to be realized.” (Harvey, The Limits to Capital, 401.) 66 Harvey’s entire quote is helpful, “The uneven geographical development of social infrastructures is, in the final analysis, reproduced through the circulation of capital…The social geography which evolves is not, however, a mere mirror reflection of capital’s needs, but the locus of powerful and potentially disruptive contradictions.” (Ibid.) 67 Ibid., 404. 68 Gunter Gad’s argument was that the waterfront area never really was industrial or manufacturing, but used mainly for storage. Indeed Toronto was not an industrial powerhouse compared to many other cities of the period. 69 From an actor-network perspective, this was the “scallop moment” where the nonhuman didn’t cooperate, see Michel Callon, "Some Elements of a Sociology of Translation: Domestication of the Scallops and the Fishermen of St Brieuc Bay," in Power, Action and Belief: A New Sociology of Knowledge, ed. John Law (London: Routledge & Kegan Paul, 1986). 70 Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854 (New York,: Cambridge University Press, 1998). The need to feed just one person who is starving should be enough of a ‘crisis’ to marshal the attention, yet this is rarely enough to enable intervention. 71 Editorial, "Should the Question of Public Health Be Subject to the Vote of the People?," The Canadian Engineer Weekly 18 (1910). See also Charles A. Hodgetts, "The Divided Responsibility in Regard to Public Health [Read

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before the Saskatoon Medical Association]," The Canadian Engineer Weekly 16, no. 10 (1909). Charles A. Hodgetts, An Address on Pure Water and the Pollution of Waterways... Before the Dominion Public Health Conference, Ottawa, October 12th, 1910 (Ottawa: Copeland-Chatterson-Crain, ltd., 1910). 72 The growth over thirty or forty years of state medicine in Canada and the drive to go federal had started to break down, or feel politically impotent. This situation will be explained in more detail in the next chapter. 73 Canadian Engineer, Editorial: “Should the Question of Public Health be Subject to the Vote of the People?” Canadian Engineer, November 3rd, 1910, 583. The stranger within the gates may be, probably is, an allusion to the 1909 ruminations on the immigrant, in James S. Woodsworth, Strangers within Our Gates : Or, Coming Canadians (Toronto: The Missionary Society of the Methodist Church, 1908). 74 Max Weber, Economy and Society: An Outline of Interpretive Sociology, ed. Guenther Roth and Claus Wittich (New York: Bedminster Press, 1968), 975. 75 Additionally the engineering profession had moved on to become embedded within firms and corporations, in the process this engineers took on the problem of industrial relations, Taylorism, and the management of human engineering according to social production within economic rationales. For more see David F. Noble, America by Design : Science, Technology, and the Rise of Corporate Capitalism (Oxford: Oxford University Press, 1979).

The Ideologies of a Health Board | 2010 | Paul Jackson | 217 Chapter 9 – The Ideologies of a Health Board: From Cholera Crisis to National Vitality

Ne pereat populus scientia absente! (Lest the people perish from lack of knowledge!) – Motto of the Ontario Provincial Board of Health

Health is good. And public health is the good for all. But health is not a property; it’s an ideology, a set of ideas and forms of knowledge that needed to circulate. Health experts, a group of professionals who were predominately doctors, formulated an ideology that was framed for the good of all: public health in the common interest. Because people could die from poor health, the stakes were framed as quite high. However, health could not be framed or practised as an act of dominance over the cities and nations. A health board could never be seen only as a specific self-serving project of a particular elite group. These experts and bureaucrats had to marshal and mobilize others into the project of heath. This chapter will explore how medical experts on the Provincial Board of Health included and synthesized different projects, such as economics and immigration, as part of their mandate of disease prevention. In terms of state and ideology, what can health illuminate about the role of common interest and hegemony? The ideology articulated by the Provincial Board of Health was a combination of the fear of disease, the health threats from immigration, and an economic rationality for health. These merged into a national emphasis on a healthy and “vital” population and workforce. In the process, health boards in Canada, and in Toronto particularly, became fully institutionalized and were secure in their position within the state. This chapter will end by examining how the state and the economy were shaped through the ideas of health. In this chapter I ask, How did health become organic or necessary as an ideology? The cultural theorist Stuart Hall frames this nicely: “When, in fact, the whole purpose of what Gramsci called an organic (i.e, historically-effective) ideology is that it articulates into a configuration, different subjects, different identities, different projects, different aspirations. It does not reflect, it constructs, a ‘unity’ out of difference.”1 Health ideology constructed a unity because it was not merely an idea plucked out of a free- floating ether; it was a state health bureaucracy that constructed and defended their position and spoke for the life of the city, the nation,2 and the economy. This formulation I am framing, the bureaucratic bio-economy, constructed a unity around “health.” David Harvey, in his engagement with the state and social infrastructures, suggested that a contradiction exists between particular and community interests, between the interests of the

The Ideologies of a Health Board | 2010 | Paul Jackson | 218 individual and those of the community (based on the intersection of social structures and class). In Harvey’s rudimentary summary, which originates in his reading of Marx, this general contradiction gives rise to the state. Harvey gives two strategies to frame this relationship. The first strategy is that the state is standing above society in order to manage conflict. Therefore, with class power and the independent authority or act of standing above society, the ruling class has to push for its own class interests even though the public face of the state says its actions are for the good of all.3 A good example of this move is when an industry pushes for a clean municipal water supply for the good of all, even though clean water also supports their production process.4 The second strategy is the intermingling of ideology and the state, where class interests are transformed into general interests. An example of this can be found in how doctors worked to institute themselves in the state, thereby gaining class and professional privileges—they were working on behalf of the general good, and life spans were increased. While a bit simplistic in his discussion of the emergence of the state, this and the following chapter will complicate Harvey’s theory of the state. I use Harvey’s framing because it illuminates many dynamics in terms of state health. In both framing strategies, the benefits are uncertain and diffused, but still structured by class power. Harvey quotes Marx when he says, “The class making a revolution appears from the very start…not as a class but as the representatives of the whole of society.” Harvey goes on to say the common interest must be “presented as abstract idealizations, as universal truths for all time.”5 Harvey gives examples of common interest, such as “justice” and “freedom,” and I would like to include “health” or “hygiene.” Harvey goes on to say that the “[s]tate [as a bounded entity] can itself become an abstract incarnation of a ‘moral’ principle (nationalism, patriotism, fascism, all appeal to this to some degree).”6 My contribution here is to examine how health, as an abstract and universal idealization, needed to be put into practice in order to be seen as a “universal truth.” To ground this, I will engage with the first report of the Provincial Board of Health written in 1882. The report contained a section called “The Necessity for such a Board.” To give support and justify its own existence, the board relied on a statement by Dr. Henry I. Bowditch, an abolitionist, an early establisher of health boards in the United States, and one-time president of the American Medical Association. In Bowditch’s speech, before the International Medical Congress of 1876, he declared, “[T]heoretically Public Hygiene is the most important matter any community can discuss, for upon it, in its perfection, depend all the powers, moral, intellectual and physical, of a State.” The Ontario Health Board’s report continued and framed his quote with the following: “Recognizing a growing belief on the part of the people in the

The Ideologies of a Health Board | 2010 | Paul Jackson | 219 axiomatic truth of this statement, carefully appreciating the opinions of the general public, and being actuated by an earnest and solicitous concern for the welfare of the people over whom it has been called to rule…”7 Truth, opinion, and the welfare of all were continuously restated in the process of articulating an ideology of health. However, this was not an act of domination; particular class interests were institutionalized for the good of all, and discussed under the banner of “axiomatic truth.” Common interest, as a fairly ambiguous and opaque term, should be defined before proceeding. Harvey acknowledged this fact and recognized that Gramsci can give further guidance on the intersection between ideology and state. Bob Jessop explains how Gramsci was concerned with specifying the complex relations among a plurality of social forces involved in the exercise of state power in a given social formation. A Gramscian definition of the state is “the entire complex of practical and theoretical activities with which the ruling class not only justifies and maintains its dominance but manages to win the active consent of those over whom it rules.”8 Gramsci’s focus on power and domination through ideology and culture is central to this chapter and essential for my dissertation research, so it requires more elaboration. For the state, there are two modes of class domination: force through coercive apparatus; and hegemony as the successful mobilization and reproduction of the active consent of the dominated groups by the ruling class through intellectual, moral, and political leadership. Hegemony is neither indoctrination nor false consciousness; rather, one must take into account popular interests and demands, along with political shifts and compromises that are required to maintain support. An unstable and fragile system of political relations is produced that utilizes a collective will or common worldview to organize popular culture.9 The geographer Geoff Mann suggests if one takes hegemony seriously, then one “must be able to account not only for the ‘material’ fact of hegemony, but also for how it works ideologically. In other words, it must do more than point out that the ruling bloc is hegemonic and demonstrate the material evidence of its power; it must also explain how and why that hegemony operates in the social life of thought—norms, morality, common sense.” For my purposes, the ideology of health was used as “an active, material force in the making of the world—what Gramsci called an “idea-force.”10 Simply, hegemony is an analytic of how one social group dominates subordinate groups through consent and coercion. The ideological power of health required much more consent than coercion. However, in chapter 1, I assert that the politics of health crisis exists between consent and coercion. These power relations were maintained through the reproduction of social relations,

The Ideologies of a Health Board | 2010 | Paul Jackson | 220 which are foundational to a given social formation. It is my claim that this can be seen in the active construction of social infrastructures. These health-based social infrastructures were both centralized and diffused acts of consent.11 Within these social infrastructures, state power was not merely a bourgeois act of power over a territory, or even a series of acts done for economic reasons, such as gaining class privilege and security. Instead, the state utilized a mix of coercion and consent of a variety of groups. The Marxist state theorist Nicos Poulantzas, following Gramsci, suggests how these processes become unified into a coherent power bloc, which can fracture bourgeois class formations, and forms through the state since it displays its own unity and institutional autonomy.12 While power was consolidated in many ways through institutions that are considered outside of the state, health expertise became integrated into the state through social infrastructures and institutions, such as health boards. The idea-force of health operated materially in social life through active education and the deep embedding of the common interest in “the public.” For the rest of the chapter, I want to explore how the ideology of health was articulated from the social infrastructures of health boards, in particular—but not limited to—the Ontario Provincial Board of Health. Increasingly, health experts achieved consent with economic arguments, which then contributed to a reformulated medical science that held a greater emphasis on eugenics and the vitality of populations.

9.1. “Work to be Done”: Health’s Common Interest To explore how the idea-force of health found wider purchase and became the common interest that made health boards necessary, I want to focus on the Provincial Board of Health’s first annual report. Each annual year-end report would outline the agency’s duties, policies, and practices. The initial report also nicely illustrated its ideological project. The board’s mandate was to spread its views and recommendations—read: ideology—by publishing reports and laws in newspapers and journals, and holding public conventions. That being said, these experts were quite dismissive of the public throughout their literature. In the initial report, Dr. Oldright declared in a section called “Work to be Done”: [W]e are not only staggered at the herculean task which is before us, but we ‘Raise lame hands of faith,’ and, feeling our utter impotence, can find courage only in the thought:—‘Do well your part, therein the duty lies.’ These foes to health are everywhere—in the daily life of the individual, in social life, in commercial and in public life.13

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These “foe battling” tasks included the establishment of new boards in every municipality; the dissemination of sanitary information; the carrying on of sanitary surveys;14 the development of sewage systems and a clean water supply; the necessity of sanitary experiments and scientific research; and the ventilation and heating of housing. The work to be done was not only to create discourses and rhetoric but also to transform life and thought in very material ways. This project was expansive and totalizing from the outset, as you can see by how the piece ends: This work, so extensive in its nature and so difficult in its execution, will require not only the combined support, but the individual interest, of the legislators. From all that has been said it must be evident that the Board will have many difficulties to meet and overcome. It must expect to meet indifference as to the methods it may employ, from an ignorance, in many cases, of the objects to be accomplished. It may find its measures opposed, in some cases, by the supposed self-interest of individuals; and it need not be surprised if the public should think that sanitary legislation, and regulations for the benefit of the public health, ought in all cases to follow, rather than precede, public opinion. But if the voice of science be unanimous as to the necessity for sanitary measures being taken in the interests of public health; if the more thoughtful and intelligent of the public are one in their opinion as to the desirability of sanitary laws being passed; if foreign States press upon the country the urgency for international quarantine and sanitary regulations for mutual benefit and protection; if statistics from the most civilized States of Europe and America incontestably prove the incalculable advantages to the State from the annual saving of many lives and of the expenditure of immense sums of unproductive capital in the treatment of disease and burial of the dead; if thousands of homes desolated by the scourge of epidemic diseases, and untold memories, sad and sorrowful at the thought of what might have been had not pale death cast a sable pall over fair hopes blighted and promises unfulfilled, are not to pass unheeded; then can the wisdom be doubted, the urgency questioned, or the necessity denied, of speedy, thorough, and extended measures being taken by the firm, yet not harsh, hands of the men who guide the ship of State in her appointed course towards the desired haven— the people’s good? Can there be any doubt that the people of the Province are not only willing but anxious that their representatives on the Provincial Board of Health shall have every facility for teaching, disseminating and adopting sanitary laws ‘lest,’ in the words of the motto of the Board, ‘the people perish from lack of knowledge’— ‘Ne pereat populus scientia absente’?15

The statement invoked and intertwined efficiency, urgency, sadness of death, and unproductive capital. These health experts declared they could cure all. Indeed, the logic provided that only the Provincial Board of Health members could guide the “ship of State” toward the people’s good.16 Their knowledge—and the circulation of their knowledge—was necessary to combat the ignorance that frequently led to the needless death of the citizens. The board also attacked those who thought public opinions and democracy must come before public health science, calling them ignorant and self-interested. Provincial health work was expertise: de-politicized “health.”

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One of the most ideological moves is to declare that you are not part of any ideological project. These health experts claimed their own necessity in the name of the people’s good or the common interest. To riff on their motto: People will die without their ideology. In the documents of the Provincial Board of Health, their health ideologies were repeated and refined throughout their history. The ideological rationale to support their institutions can be organized into three pillars: [1] the fear of future epidemics, particularly cholera; [2] the need to monitor the problems of immigration; and, finally, [3] an economic rationality of health, a creeping economism. While these themes were articulated in the initial report of the Provincial Board of Health, these pillars overlapped and became deeply intertwined over time. These three pillars can be seen as health experts’ methods of dealing with proliferating life on different registers: growing bacteria, unruly population, and the hope for efficient management for economic benefits. As statements, these ideologies were constantly repeated and placed into their own history.

9.1.1. Pillar 1: The fear of future epidemics and the obsession with cholera The fear over future epidemics has been a prominent theme throughout this entire dissertation, but what was its power as an idea-force? The board claimed its knowledge about future epidemics was based on the “solid principles” of medical science. These solid principles came from an investigation of what they called “deleterious agencies.” These agencies were discovered after observing how chemical processes and microscopic methods could lead to knowledge of how crises got out of control. The board stated that these methods had caused “the whole scientific world [to be] crowded with an army of workers eagerly endeavoring to solve,— and solving,—the comprehensive problems of biology.”17 My claim is the biology to be tackled was the problem of cholera, a future epidemic brought on through biological forces. However, in terms of such knowledge and the lack thereof, the experts complained that “little thought is given to sanitary matters until some fatal epidemic is present or is threatened, when all wildly seek for relief in some external authority or aid, never dreaming that sanitation like charity begins at home.”18 The board hoped to foster a homegrown sanitary science reliant on synthetic expertise, combining or bringing together disparate disciplines or practices to work on the problem of the epidemic. In 1882, because an epidemic of Asiatic cholera in Toronto was predicted, the Provincial Board of Health circulated a pamphlet, titled “Directions for Preventing the Spread of Asiatic Cholera,” that stated:

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Collections of filth, impure air, and impure water act as hot-beds ready to foster, develop and spread disease…many diseases frequently in our midst as well as to Cholera, and it is well to remember that whatever steps for removing the impurities referred to may now be taken, they will be repaid tenfold in the lessening of the amount of disease in general, even if Cholera should not visit us… In the event of Cholera visiting us, it must be remembered that, as in the case of other infectious diseases, every infected person should be considered a centre of propagation of the disease, its special contagion, contained in the discharges from the bowels and stomach, being transported by air and water, and spreading in proportion to the density and want of cleanliness of the population among whom it occurs. The germs of Cholera, like other organisms, multiply themselves to an unlimited extent, so long as suitable conditions exist for that multiplication.19

This official statement articulated the power of proliferation and the fear of proliferating life that the disease cholera epitomized. This pamphlet, widely circulated throughout the province, linked the power of a crisis to filthy conditions. Since cholera had “special” qualities, disease crises were dependent on the density and dirtiness of local populations. The relationship between germs and a focus on “suitable conditions” re-established the zymotic theory of epidemic crisis. Additionally, the activity in preparing for cholera contained a rationale for the obvious and positive benefits, perhaps a tenfold benefit for health in the common interest. Therefore, whether the disease became an epidemic or not was inconsequential; dealing with cholera was the first step to enacting long-term reforms with widespread benefits. As the Provincial Board of Health persisted and cholera outbreaks faded further into Canada’s past, this historical distance did not lessen its obsession with cholera. The Provincial Board of Health continuously invoked cholera in its documents and polices. Dr. Peter Bryce’s history written in 1891 titled “A Hundred Years of Sanitation in Ontario” is quite revealing, as Bryce only marked cholera events as important. In this report, he invoked both Darwin and Thomas Jefferson, quoted Shakespeare, and referenced the French Revolution—touting equivalent revolutionary triumphs that had taken place in science and government. Bryce claims Upper Canada was always on the cutting edge of disease control, in part due to “the emigration which came in by way of the St. Lawrence had created an ever present danger to the health of the colony.” Bryce’s history focused on cholera almost exclusively, with highly detailed accounts of the official requests and the amounts of money given to cholera-fighting efforts. His history covered cholera’s “zymotic character”; how cholera had come from Hamburg and the United States; past newspapers articles; and death counts from New York. Meteorological details of humidity and how that related to cholera were also covered. Bryce called the early

The Ideologies of a Health Board | 2010 | Paul Jackson | 224 years of health governance in Ontario both crude and imperfect times of “spasmodic activity.” He claimed that “health matters seems only to happen in the midst of death-dealing epidemics. Then and then alone can people be seriously said to have a health-conscience.” Bryce is honest about health experts’ ignorance, saying “those of us of the present generation know nothing of cholera, except as telegraphic reports bring us news of its ravages in far off India and Persia, or occasionally from the shores of the Mediterranean, it is of interest to learn something of the ravages it has been capable of creating.”20 He invokes another Latin phrase semper paratus in armis—“always be prepared by arms.” This is how the Provincial Board of Health needed to behave in order to be prepared. While he established that the last epidemic in Ontario was in 1854, little did he know that cholera would threaten again the very next year. In 1892, when cholera became a potential crisis, Bryce’s history was republished in Toronto newspapers, placing the immediate fears and his health recommendations into a much longer history. Even before the outbreak in Hamburg, Bryce had contextualized his history in The Globe newspaper: “The past is no guarantee, as the west march of cholera from India show that it will follow any beaten track. It will simply travel where it is taken and in these days of rapid ocean transit it will come as readily from Europe to Quebec as to New York. With the many trying international boundary squabbles as present troubling Canada can ill afford to give any excuse for a quarantine...”21 In Bryce’s own account, the potential cholera outbreaks became the foundation of much of the health board’s ideology. But, importantly, Bryce ended his history with tables of newcomers at the Grosse Island quarantine station, linking cholera epidemics to immigration. This concern over immigration foreshadowed his future interests and an expanded federal role in controlling future epidemics.

9.1.2. Pillar 2: Immigration as health threat Worries over sick migrants were always part of health ideology in Ontario and throughout North America.22 During this period, Toronto’s and Ontario’s international connections were a mixed blessing. The Provincial Board of Health’s initial reports did not focus solely on local issues since these health experts saw the need to be kept up-to-date on other nations and their relations with Ontario. The annual report of 1882 declared: “[W]e cannot escape if we would.” The board articulated how countries were close, both geographically and “commercially.” Local experts relied upon and later contributed to medical reports and journals from Britain and the United States. Importantly, in 1882, when the Provincial Board of Health came into being, the health agency took charge of the Immigrant Inspection Service saying, “Now, [the immigrant

The Ideologies of a Health Board | 2010 | Paul Jackson | 225 spreading of disease] will readily be seen how dangerous such a state of affairs may become to public health, and how necessary it is that some united, extended and systematic inspection of such immigrants in transit to the west be carried out.” At the same time, they critiqued the imperfect system of federal quarantine at the ocean ports and declared that there was no provision to inspect and take charge of immigrants, except in Toronto by the Ontario government. The board advised the Ontario government to construct a station on the province’s borders for continuous disease inspection through the westward transportation system.23 This distrust of other levels of government was constant, and was only reinforced during the cholera outbreak in 1892. During the 1892 international crisis, Secretary Dr. Peter Bryce jumped at the opportunity to enact reforms beyond the jurisdiction of the province.24 Bryce called for the surveillance of all immigrants. Bryce became central in convening the International Conference of State Boards of Health, which included representatives from the United States and Mexico. The group met in Toronto at the end of August, then surveyed the eastern seaboard, examining maritime quarantine stations and repeatedly calling for sanitary reforms. Bryce used the cholera crisis, along with his political and professional connections, to institute change locally, nationally, and internationally. On November 1st, at the meeting of the Canadian Medical Association in Ottawa six weeks after the cholera was declared, Dr. Bryce asked the question: “What has this continent to do to protect itself from cholera?”25 This was not simply Bryce’s obsession; fear and stereotypes pervaded and structured this health expertise. The Canadian, Dr. Albert Gihon, also spouted off when speaking on cholera and hygiene: Now, if houses are foul, what do you think of ships? You probably never have seen a Russian Jew when he starts for this country. He is a man who probably has never washed in his life; he is a man who has certainly worn the rags upon him as many years as these rags would hold together. You put the man in a crowded steerage; he becomes seasick (this same thing applies to the women), he vomits, his dejecta are thrown out in that bunk, it becomes saturated with seasickness, and then he becomes choleratic...All these ships are damp ships. We are told that water is the very means of communicating cholera… [but this damp atmosphere transmits] that aqueous vapor, and with it the cholera germ.26

After the 1892 cholera outbreak, the scale of the health intervention had shifted away from only local reforms (see chapter 8), in part because the ideology of health expertise was shifting. Bryce was instrumental in the creation of the Provincial Board of Health. As the board’s first secretary, he led the fight to expand its authority and drafted most of Ontario’s health regulations. Bryce’s career can be seen as moving from concern with local sanitary issues toward more and more totalizing reforms, such as cleaning up the nation, dealing with

The Ideologies of a Health Board | 2010 | Paul Jackson | 226 international threats, and even reforming “Mankind” in general. His writings were social commentaries on the transformation of Canadian society and critiques of rapid urban growth. He was a very religious Presbyterian and an advocate of social gospel.27 By 1898, Bryce was elected the president of the American Public Health Association. After 1900, immigration was increasingly blamed for disease, destitution, and degeneration. After 1902, amendments to immigration laws by Clifford Sifton, the Minister of the Interior, instituted stronger immigration controls and inspections. Immigration medical officers were appointed in Quebec, Halifax, Saint John, Montreal, Winnipeg, Vancouver, and Victoria. By 1903, Bryce had become the Chief Medical Officer of the newly established Federal Immigration Inspection Service. While the doctors patrolled the borders declaring foreigners the vector for disease, a new crisis had emerged from health experts attempting to scientifically determine hereditary feeble- mindedness. The feeble-minded were declared to be swamping the asylums, jails, hospitals, and other charitable institutions. The proof given was that the crime rate was going up. As the Chief Medical Officer of the Department of Immigration, Bryce’s particular hereditarian and degenerationalist views influenced the way immigration policy was carried out.28 Bryce had been concerned with the low “Canadian” birth rates and the high birth rates among immigrants for decades. In 1885, while sitting on an Ontario health committee dealing with infanticide and child abandonment, he suggested that not all births were welcome. While in 1889, as Deputy Registrar General, he worried about the fact that the cities had a lower birth rate than the countryside. In his mind, these birth rates were not caused by economic pressures, they were the result of male and female “neo-Malthusian” propaganda; women who had sympathy for the poor who were burdened with children; and emancipated women, whose ambitions were in public affairs, personal selfishness, and not maternal duties. In a 1903 report, Bryce declared that Ontario’s low fertility could only be taken as evidence “that natural conditions are being interfered with, or being supplanted by those of a preventable character and criminal in tendency.” What was being seeded was a form of social degeneracy that could threaten the Anglo-Saxon race, “the dominant part over inferior races in the march of progress.”29 Bryce saw rural environments as intrinsically healthier places where the people could be free of degenerate effects. The very bodies of generations of factory workers and dwellers of large urban populations showed evidence of this degeneration. By 1914, Bryce declared there were “two underlying principles indissolubly mingled of eugenics and euthenics [the science of controlling environments].” The cure was the careful selection of immigrants on the one hand, and the improvement of the environment on the other. In concert, these policies offered “the

The Ideologies of a Health Board | 2010 | Paul Jackson | 227 potentialities of almost infinite improvement.”30 In an article in Maclean’s magazine, the historian W.S. Wallace put an academic tone to Bryce’s immigration policy when he stated, “The native-born population, in the face of increasing competition, fails to propagate itself, commits race suicide in short; whereas the immigrant population, being inferior, and having no appearances to keep up, propagates itself like fish in the sea.”31 This propagation was just another formulation of proliferating life. Through these ideological moves, proliferating life could be read on many registers and scales, including immigration. As Bryce worked in Ottawa, the health ideology articulated in Ontario was federally reshaped to enforce who was allowed to enter the country and who would be denied, and to frame these choices in increasingly economic terms. Three types of people could be deported: the criminal, the immoral, and the incurably sick. To cure Canada of its health problems, Bryce and his institution began to work to protect the future of Canada from a growing internal immigrant degenerate population.32 Bryce recommended that immigrants who came to Canada and were not rejected be moved to rural communities. Through agriculture they could be productive in the healthier and more natural setting.33 If this did not happen, there would be costs.

Figure 9.1. Charles Hastings. Figure 9.2. Charles Hodgetts. Bryce was not alone in calculating the health costs of immigration. In 1905, five years before taking office as Toronto’s Municipal Officer of Health (see Figure 9.1), Dr. Charles Hastings declared:

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It costs our government at Ottawa $745,000 nearly three quarters of a million, last year for immigration purposes alone. Thousands are being imported annually of Russians, Finns, Italians, Hungarians, Belgians, Scandinavians, etc. The lives and environment of a large number of these had no doubt been such as its well calculated to breed degenerates. Who would think of comparing for one moment in the interests of our country, morally or commercially, a thousand of these foreigners with a thousand of Canadian Birth.34

This health ideology maintained that two populations now existed in Canada: citizens of Canadian birth (the older settler society) and the immigrant population. One population threatened the other by its unhealthy nature.35 The immigrant health threat was not only internalized in their bodies (either carrying disease or future generational biological decline) but also grow as a population, and it would be influenced by environmental conditions. Bryce’s 1907 speech36 to the Empire Club on immigration declared that, between 1901 and 1906, the majority of the estimated 134,000 immigrants that entered Canada were British.37 Bryce was happy about this fact, but he was worried by how many of these migrants stayed in the cities. He was pleased that the British group had settled “in the suburbs and in the outlying parts of the city, we have hundreds and thousands of houses, first shacks, put up two or three years ago, which have now become good houses, filled with British-thinking, British-speaking, British- acting citizens.” In contrast, the other immigrants—he named Hebrews, Italians, Hungarians, and Poles—that had settled in unsuitable environments, had “a right, I repeat, not to our criticism, but to our sympathy and kindly interest.” He uses the findings of Dr. McLaughlin, of the Marine Hospital Service of the United States, to speak to the slums of New York. Bryce admits that these slums were produced by the landlord not the immigrant. The same urban slum conditions were being created in Canada. Bryce echoed a man engaged in missionary work in Toronto who wrote to him and said, “We know what the remedy is, but we don’t know how, or by whom the remedy is to be applied. We require time, money, management, probably most of all management.” Bryce then appealed to the Empire Club to offer both consent and financial support. He cited what the City of Chicago was doing and the new innovations coming from economic professors in order to describe the possible results. In Chicago, he said that the conditions of the few thousand immigrants have yet to be called serious.38 There was a tension or contradiction in Bryce’s views. They were progressive—not quite “social justice,” but critical of bad landlords and aware of a need for better housing—and completely problematic as his belief was in the danger of these communities’ creeping influence over the health of populations. The rationale for improving housing was not to alleviate the structures of poverty

The Ideologies of a Health Board | 2010 | Paul Jackson | 229 but the belief that these environments produced a disease threat that endangered cities and nations. The majority of the progressive movement, and doctors in general, held a similar view of the vagrancies of the market. The repressive politics that Bryce and his ilk propounded were enhanced when integrated with economic arguments of health.

9.1.3. Pillar 3: The economic rationale for national vitality To return to 1882 and the “Work to be Done” agenda from the Provincial Board of Health, my claim is that the economic rationale began as a minor argument and over time came to dominate the ideology. The influence of economic thinking on the development of the public health is a vast literature that I do not have the space to cover here.39 My particular intervention is the way health expertise in Canada, with support throughout the Atlantic medical community, used economic arguments to ensure and buttress its position within the state. The first report of the Provincial Board of Health stated that “statistics from the most civilized States of Europe and America incontestably prove the incalculable advantages to the State from the annual saving of many lives and of the expenditure of immense sums of unproductive capital in the treatment of disease.” Dr. Oldright, in his chairman’s inaugural address to the board, cited a paper by Erastus Brooks40 called “What the State Owes the People—Public Health is Public Wealth,” which was read to the American Public Health Association. He quotes Brooks, who said: If to this result the money value of life is counted, the five or six thousand lives yearly [by public health] will run into some millions of dollars. There Dr. Farr— perhaps the highest authority in the Old World—placed, in his reports as the registrar-general of the Government, the money value of each man, woman, and child in the deaths of England and Wales during the school period, apart from infant mortality, makes a loss to the State of ninety-five million dollars.

This quote illustrates two of my arguments. First, that Farr’s ideas guided and shaped much of the health ideology and science in Canada, and in Ontario in particular. Farr’s understanding of disease was influential, as were his later formulations of the monetary value of health. Second, these experts applied his ideas in their localities, through economic measures or a form of health calculation. Oldright continues: A similar calculation applied to Ontario will give us a saving of nine million, five hundred and forty thousand dollars, which, on the ground that what has been done can be done, will be effected in our municipalities and our people co- operate heartily and generously in their work. And this is exclusive of all allowance...for the greater value of labour in this country.41

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As the Provincial Board of Health became more established, the economic line of argument became more dominant. In the annual report of 1899, Dr Bryce clearly articulates this position in “The Economic Value of Sanitation as a Measure and Means of Social Progress.” This article is wide in scope, covering topics from history and philosophy to the laws of physics and nature, which includes the “science of life saving.” He goes on to refer to Chadwick’s idea that preventable diseases are a direct cause of poverty in both individuals and nations. Bryce worked out the math. The 1899 report, “Adopting English Calculations of the Value to the State of Lives Saved,” stated, “At the end of a period of six years from this date the annual saving would be nearly $4,000,000.” His argument was that within sickness and disease there is the “continuing waste of human life,” and this waste of life was preventable. He relied on an 1870 report by Dr. Simon, stating that “disease, so far as it affects the workers of the population, is direct antagonism to industry; and that disease which affects the growing and reproductive parts of a population must also in fact be regarded as tending to deterioration of the race.”42 Bryce ended with some Tennyson poetry, as was his style. But while Bryce talks about the healthy population in Ontario and Canada, this healthy population did not include everyone. The public health historian Hamlin suggested that the sanitary movement was not a systematic campaign to eliminate all mortality due to illness; instead, “the concern was for some aspects of the heath of some people: working class men of a working age.”43 So while a particular common interest needed to be mobilized, a population that included labouring hands was declared to be vital for a country. As time went on, this economic logic of health became deeply intertwined with ideas about the harms of immigration. The “profits” of health dovetailed with the “costs” of immigration. As Hasting clarifies in a speech read in front of the Ontario Medical Association in June of 1905: “Why then should we permit this [immigrant] embryotic material…to die or degenerate by the thousands annually for the want of proper care?...No medical inspection can recognize the seeds of degeneracy which may be well rooted in this foreign element.” Why should the Canadian people care, he asked, if the merchant, financier, and the professional man have decided that, “there is no money in it?” He contradicted what he believed to be the common assumption, saying: But there is money in it. What other national question could compare in importance with the establishing of a well-organized plan by which the highest development of the youth of that nation can be accomplished?...good physical development, with a high mentality, is the most valuable asset that any nation can have…We as a nation have passed through our infancy, and are now in a rapidly developing childhood, with boundless resources in active process of development and a rapidly increasing population, and must soon become a great and wealthy

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nation, but we must profit by the experience of the Mother Country, and, in fact, all older countries, that ‘as wealth accumulates, men decay.’44

This causal relationship between accumulated wealth and decaying populations was central to the imagination of health ideology. These health experts were against the market and the human costs of financial downturns and depression. In Britain, these worries were couched in poetry about the ills of urbanization and the end of the countryside. But for Canada, a new vast land, concerns over the costs and ills of the city were twofold. Dr. Charles Hasting in 1916, now as Toronto chief health officer, nicely summarizes where this shifting ideology had taken them. He brought economic accounting and fears of the future together: “It is not the epidemics we control but the epidemics that we prevent that help to give us a credit balance at the end of the year.”45 The next year, Hastings wrote an article with similar themes called “The Modern Conception of Public Health Administration in a journal called The Conservation of Life (which I will come back to). His essay began by saying: The great difficulty in the past [in instituting public health] has been the absence of monetary value placed on human life...One reason why advances in preventive medicine have been so slow is that prevention lacks dramatic interest. It lacks those tragic characteristics which always appeal to the masses.46

But like Bryce, many of these reformers had learned that future crises have a dramatic interest and can appeal to the masses. In 1892, this drama came from the cholera outbreak, but my claim is that degeneration of the nation was also perceived as a crisis—the idea of a declining national vitality overtook events.47 At the same time, health reforms, or “improvements,” could help and have long-term economic benefits. This future crisis was scientifically framed as degeneration and eugenics (see chapter 2). For support, Hastings relied on, but did not contextualize, the words of Gladstone as an expert, “In the health of the people lies the strength of the nation.” He emphasized the relationship between “the efficient solution of the problems of public health” and the “prosperity” and “future greatness of our nations.” He declared that all humane or charitable arguments have failed. Instead, they “have to present the economic side of the problem in cold figures of dollars and cents.” To make his argument, Hastings cited Yale University’s Professor Irving Fisher’s Report of the Committee of One Hundred on National Health, calling it “the most valuable and most reliable records we have.” According to Hastings, the report engaged with “the national vitality and setting forth its waste and conservation.”48 This ideology of future health crises in Ontario was part of much more widespread scientific and

The Ideologies of a Health Board | 2010 | Paul Jackson | 232 economic mobilization throughout North America that looked to synthesize national health and economics.49

9.1.4. Health and economy: The limits of synthesizing expertise In 1906, the American Association for the Advancement of Science organized the Committee of One Hundred for National Health in the United States as a response to the campaign by two Yale economists, Irving Fisher and J. Pease Norton. These economists tackled the costs of health directly, and looked to use their discipline to help conserve human resources and simulate “national efficiency.” All this came together as part of the short-lived U.S. National Conservation Commission, which existed between 1908 and 1909.50 Irving Fisher, an economist obsessed with health, was vastly influential throughout this period. While I do not have the space to outline the effects of his work,51 I want to focus on one telling quote: A particle in Mechanics corresponds to an individual in Economics. Space in Mechanics corresponds to Commodity in Economics. Force in Mechanics corresponds to marginal utility or disutility in Economics. Work in Mechanics corresponds to disutility in Economics. Energy in Mechanics corresponds to utility in Economics.52

For me, Irving is using synecdoche in this statement to compare economics and physics. Fisher’s act here was also an example of what I have called synthetic expertise. Fisher was interested in the ways that diverging analyses lead to diverging conclusions. He stated: “The economist has shown that wealth accumulates. The eugenicist may show that men decay.”53 The hope was these two “sciences” could be unified. My claim is that during this period—as a particular North American state-led form of eugenics was articulated and as this health expertise went national—ideological arguments shifted, internalizing economic arguments into the very dynamics of biology. What I am calling a bureaucratic bio-economy was actively referring to the reproduction of labour when it discussed future generations of workers, and the point of intervention was around the aggregate populations of cities and nations. My argument is that the responsibility health experts took on would improve public productivity, or profitability for the common interest. The health-economy ideology emerged from the social relations and the historical context, and I am arguing that the act of preparing for epidemic crises was a key force in this ideology.54 For these health and economic experts, the source of the problem was framed as external to the conditions and communities that these health experts took responsibility for: cholera, immigrant populations, and growing forces of degeneration. These external problems

The Ideologies of a Health Board | 2010 | Paul Jackson | 233 influenced “untainted” bodies and nations, while harmful local environments further enabled these biology-based problems to proliferate out of control. While pervasive, these biology-based conclusions were not the only argument or analysis that existed during this time period. To further explain this ideology, and to put into perspective these ideological conclusions, I want to explore Marx’ law of population and surplus population (that I began to engage with in chapter 5). For my purposes, Marx’ relational method showed how capital unevenly influences and produces the conditions that these experts were dealing with. Health experts were not alone in their outrage; everyone decried the relationship between accumulation of profit and misery. Marx made similar observations as the health experts, but led to very different conclusions. For Marx, “an accumulation of misery, correspond[ed] with [an] accumulation of capital. Accumulation of wealth at one pole is, therefore, at the same time accumulation of misery, agony of toil, slavery, ignorance, brutality, mental degradation, at the opposite pole…” This echoes the claims of Dr. Charles Hastings who said, “as wealth accumulates, men decay.” However, Irving Fisher turned these questions into a disciplinary discussion: “The economist has shown that wealth accumulates. The eugenicist may show that men decay.” My claim here is that this coincidence is not equivalence. My claim has been that the health experts hoped these two sciences could be held together—expertise synthesized within an interdisciplinary context—and, if efficiently managed, the relationship between population and economy could be optimized. Built upon Malthus and Farr, health expertise looked for efficient control through the health governance. Only then would economic benefits be realized through maintaining the equilibrium of labour and land. This wealth-decay statement actually can be traced to British poetry that lamented the enclosures and growth of cities in England, a profoundly anti-urban and pro-equilibrium sentiment. Marx’ analysis is different. While Marx echoes the disgust of misery, Marx diverges because he does not shy away from inequalities, does not call for a return to the countryside, and does not look to maintain an economic equilibrium. For Marx, there is no natural beautiful countryside to return to or conservative golden past to weep for. I want to focus on Marx’ “law” of population and his critique of Malthus in order to make his critique distinct from the content of his statement. For Marx, the labouring population, and the accumulation of capital the workers produced, created the means by which the population itself became “relatively superfluous,” and did so to an always increasing extent. Marx’ law was neither abstract nor based on correlated natural relations between plants and animals; instead, his observations were based on observed historically specific social relations.55 Marx made clear that the relational

The Ideologies of a Health Board | 2010 | Paul Jackson | 234 processes between the reserve army are in proportion to the active labour army, but are also related to the surplus population, “whose misery is in inverse ratio to the torments of labour,” resulting in “the absolute general law of capitalist accumulation.” Accordingly, theories by political economists like Malthus, and the ideologies of synthetic health expertise, only confused and mystified this inherent “antagonistic character of capitalist accumulation.”56 For health experts, being liberals, the blame was given to the victims of capital: urban populations as the seeds of decay and the downfall of civilization. For Marx, uneven wealth accumulation is to blame. I raise these arguments to highlight that health experts sought to find a source or object that brought about biological crisis and economic costs. Once this external object and dynamic had been discovered, “health” could be restored. The scale of this restoration would be national so that it would produce a “vital nation.”

Figure 9.3. The Conservation of Life Figure 9.4. Canadian Association of the Prevention of Journal. Tuberculosis.

9.2. Nationalism and Health Ideology: The Success of Health Boards During the first few decades of the 20th century, the most interesting federal state institution that arose was the Canadian Commission of Conservation.57 The Commission, formed in 1909, was a unique government entity that included projects ranging from animal trapping to hydropower under its umbrella. The Commission published a popular monthly journal entitled The Conservation of Life, a grandiose name by today’s standards (see Figure 9.3). This journal covered topics from wide-ranging industrial sectors,58 and the magazine’s agenda placed

The Ideologies of a Health Board | 2010 | Paul Jackson | 235 doctors, medical science, and the ideology of health at the very centre of this new institution. The journal started in 1914 with a near-manifesto: Conservation of Life is the newer and broader Public Health—it embraces all the Science of Hygiene. It seeks to minimize and prevent as far as possible disease, disability and waste in human life by the betterment of man’s environment and occupation, assuring to all classes of the community those amenities which in their widest sense will produce the highest attainable degree of human efficiency. It is the centre around which gather and by which all our natural resources are vitalized and without which there can be no truly national vitality.59

The Commission put human life at the heart of national environment and resources concerns. Health was to be the guiding force for the nation. The introduction continued: A generation ago in Canada little attention was given to what is public health. The individual was left to kill or cure himself by patent medicines and domestic remedies, varied by an occasional doctor’s visit. To the prevention of disease little thought was given. No longer than twenty five or thirty years ago epidemics of diseases were popularly spoken of as visitations of Providence and punishment for sin. It is true that these epidemics were a punishment for sin, but it was the sin of avoidable ignorance. There has been a revolution since that time. Public health is now the new gospel, and it is a sound gospel. An army of functionaries now act [as] curators of public health all over the world. Another army of scientists and investigators labour at the problems of life and Sanitary science commands the services of many of the world’s devoted and unselfish investigators.

What a change a generation makes, at least rhetorically. Thirty to forty years before, the position of doctors and health reformers within governments and politics had been quite tenuous. Insecure work built on insecure science. However, if you believe their manifesto, a “revolution” had happened. While I question whether a revolutionary change had actually taken place, I must acknowledge that, at this time, many public health officers and experts had reached a high point in their careers in terms of politics and power. The journal continued to explain how new health practices and techniques were emerging so quickly that public health investigators could not keep up. The editors extolled the ways that adoption of scientific methods to prevent disease had now been instituted and was immediately seen to lessen mortality and suffering. But they also claimed these steps were only the beginning (see Figure 9.4). These health experts had established themselves within the government and now looked for new arenas to expand. This new world was framed within the field of combat, and figures like Pasteur were viewed as both “warriors and statesmen.”60 These statements were coming from health bureaucrats who, after fighting for years in local politics, had gained national prominence in an international fight

The Ideologies of a Health Board | 2010 | Paul Jackson | 236 against disease. Before, these experts complained about dirty streets; now, they contributed to the building of nations. Economic arguments for health helped to legitimize institutions such as health boards, as well as health reforms, as necessary and beneficial. This ideology also became a base for further political mobilization at a variety of scales, such as the benefit for a national board of health. In 1910, Bryce, along with his allies in federal and provincial governments, organized the Canadian Public Health Association to push for their goal of a separate federal department—a call they had been making since 1874.61 As part of the health experts’ drive to speak for a national population, the health object became a national concept of biological life whose vitality could be managed and conserved. In the course of forty years, from 1880 to 1920, the sense of crisis shifted from epidemics to a compromised national vitality. However, the ideological kernels existed from the beginning, and were essential to this ideological package. After the First World War, many eugenicists hoped that the war could be used to turn the public’s attention to the importance of national health for a strong military force. In 1918, the former minister of labour and future prime minister of Canada, W. L. Mackenzie King, published his book Industry and Humanity, which illustrated war and industry through the image of Frankenstein, and transitioned to a discussion of germ theory and science—the promise of Pasteur. King stated: If men of different origins have been able, with consummate skill...[are able] to direct mighty physical intellectual forces to serve the ends of Death, are the same men not equally capable of so organizing and directing identical forces, that Life, instead of being destroyed, may be conserved; and that Life’s possibilities may be realized, instead of being forever extinguished. Does Science exist only that Death may triumph? Rather, is it no the supreme aim of Science, “by obeying the law of Humanity to extend the frontiers of life”!62

By the next year, the Canadian Public Health Association congratulated the Dominion government for the introduction of a bill that would institute a federal Department of Health. Bryce, looking backwards to the 1880s, stated: “The vision is from the scientific and social standpoint a pleasing one, and both the public and the medical profession may welcome such an advance in the evolution of the social organism as must prove the greatest benefit to the individual, an enormous saving of effective energy due to a healthy population, and the greatest of all guarantees of a national prosperity.”63 This general turn toward an interest in national health led to the establishment of the federal Department of Health in 191964 whose mandate was to expand and deal with afflictions that endangered the efficiency of the population (such as

The Ideologies of a Health Board | 2010 | Paul Jackson | 237 venereal disease, infant mortality, tuberculosis, and feeble-mindedness). In coordination with this mandate, many reformers thought to increase the health experts’ already active role in immigration. Dr. Sheard said in the House of Commons: “We have had in the past, rushing into this country, without restraint, inspection or restriction, the diseased, the mentally defective, the criminal, the unhappy, the uncertain, the infamous.” And in 1917, another public health expert in parliament, Dr. Michael Steele, called immigrants a “social virus.” The department relied on experts such as Dr. Peter Bryce (Chief Medical Officer of the Department of Immigration), John Andrew Amyot (Deputy Minister of Health, former bacteriologist of Ontario), J.D. Page (Chief of Quarantine), Helen MacMurchy (child welfare), and J.J. Heagerty (venereal disease control branch) who were sympathetic to eugenics.65 As cholera had in the past, the growing immigrant population was the crisis that could destroy both a city’s and a nation’s productivity. After the First World War and with the economic downturn that followed, migration was strongly curtailed as the ideology of health for economic benefits had ascended. This sense of triumph was not only present nationally. The City of Toronto had also come into its own in terms of public health and medicine. Toronto’s public health sector had expanded to become a formidable institution (see Figure 9.5). Dr. Charles Hastings as the Chief Medical Officer of Toronto wrote in the American Journal of Public Health and used grandiose flourishes similar to those of his federal counterparts. In lecturing his American colleagues, Hastings stated: Every citizen is entitled to know what we are doing and why we are doing it, and in return the enlightened public will demand a higher degree of efficiency. They will demand that if these diseases are preventable, that they be prevented, and with an enlightened public sentiment behind us, we can get anything.66

The totalizing confidence behind the belief that “we can get anything” is striking. Especially when, in the very same article, Hastings also declared that public health should never be political. And therein lies the palatable tension in the power of public health. On one side, public health is a seemingly obvious apoliticized good and positive for both city and nation. But, on the other side, there is the sheer amount of propaganda, policy directives, and battles over ideology necessary to institute the obviousness of public health. Citizens had to be enlightened, and Hastings explained how his multiple public health divisions would pound the pavement to educate the public on the benefits of public health. Hastings made it clear that change for any city could happen very quickly. In 1910, Toronto had one public health nurse. By 1916, there were forty-four (see Figure 9.5). Hastings bragged about how much money and staff the city

The Ideologies of a Health Board | 2010 | Paul Jackson | 238 had, and suggested the reason for their budgets could be found in the public’s mind. Importantly, his arguments showed that to gain legitimacy the public would have to see the value of public health. The title of the article was “The Value of a Credit Balance in Public Health Administration.” By this time, a specific ideology was articulated to undergird state health that combined fear of future epidemics, worries over immigration, and an economic rationality. Hastings’ bragging to his U.S. counterparts was not simply hot air; strong health institutions had been constructed. By 1920, Toronto was seen as a model of public health administration. Rockefeller was sending international students to study at the University of Toronto so they could work in the city’s health department and learned from local expertise.67 Dr. Leon Benard a respected French professor of preventative medicine at the University of Paris said in 1922: “The city of Toronto has, I think, developed the best system existing anywhere in the world.” The Commissioner of Health for Maryland agreed, saying that Toronto was the most successful city in terms of infant hygiene. Toronto had become internationally known for its milk and food health policies and regulation. Delegates from a League of Nations conference on contagious diseases asked Hastings for advice on how to the control epidemics. During the 1920s, Hastings would greet foreign visitors.68 The municipal public health officer had become a public dignitary who represented the nation. Public health, as a government institution, was never a presupposed benefit. Public health emerged, and this emergence was a site of struggle. Even in 1913, the Mayor of Toronto gave a speech to the Union of Canadian Municipalities: “Perhaps in no department of civic government is the change so marked as in that of the care of public health. It would be nearer the truth to say that this branch of municipal government is altogether new.”69 Public health reformers were some of the most effective of the champions of the progressive movement since they were able to exert an unprecedented degree of social control in the lives of every citizen. The majority of their activities sought to transform the urban environment, and this had effects on daily life. According to the medical historian Paul Bator, outside the army, the school, and the church, public health was the first time citizens were subjected to attempts to engineer their behaviour. The ideology contained within The Conservation of Life70 indicated a triumphant high point in the ongoing struggle to make health an essential part of government at all scales.

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Figure 9.5. Hastings’s 1916 Diagram of Organization, Department of Public Health. Lower figure is a detail of the above figure.

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9.3. The Ideology of Bureaucratic Bio-economy The Commission of Conservation and The Conservation of Life were the best examples of what I am calling bureaucratic bio-economy because they clearly articulated the health ideology of the time. This ideology was built on the institutional and political work that had been going on for decades, and this ideology had long-term effects. To help frame how health, nation, and the economy intersected, I want to introduce Timothy Mitchell’s work.71 Looking at the history of the 20th century, Mitchell suggests that “the economy” as an object is actually “young.” Mitchell claims “the economy” emerged between the 1930s and 1950s, during the Second World War and was strongly influenced by Milton Keynes’s The General Theory of Employment, Interest and Money from 1936. During this time, “the economy” emerged as a whole, a single market within a country. Mitchell claimed that this new totality provided a new way for a nation-state to represent itself within an international order and a new understanding of growth. This object of “the economy” built upon years of economic science called econometrics (which I consider to be a life science). Econometrics attempted to create a mathematical representation of the entire economic process as a self-contained and dynamic mechanism. Mitchell relies on Philip Mirowski’s history,72 which followed how economists had been translating the new language and imagery of physics into a vocabulary and set of metaphors to imagine the processes of scientific economics since the 1870s. This is a perfect example of what I have framed as synthetic expertise. Words like equilibrium, stability, expansion, contraction, movement, and friction were imported from physics into economics. In Mitchell’s account, Irving Fisher—with his 1892 doctoral dissertation of a mechanized model of the economy—was an exemplar of this tradition.73 This was the same Irving Fisher who was central to the articulation of a national North American eugenics movement based on economics. But in terms of the state and the economy, Mitchell raised a problem: If the economy cannot exist apart from its modes of regulation and representation, it is not clear that these modes can be excluded from the definition of the economy. If capital, for example, exists in the form of private property and property can only exist as a certain structure of legal and political relationships, then these relationships are not something outside of and separate from the economy. It is not clear, in other words, that the state does form an exterior, non-economic sphere, defining the limits of the economy.74

I agree and assert that health and the life sciences—or the combination of economics, health, and nation—articulated a corresponding mode of regulation and representation.75 This vital- economy-health-nation should be seen as equally interior to the processes that led to the

The Ideologies of a Health Board | 2010 | Paul Jackson | 241 emergence of what we now think of as “the economy” and “the state.” This vital-economy- health-nation was embedded in obviously contingent and geographically specific ways. The concept circulated internationally, but its effects are beyond my archive. However, liberal positivist bureaucrats attempted to manage a healthy nation through claims that were anti-conflict and anti-political. The dream for the state was a body that was efficient, coordinated, and balanced, and where management arose from a profoundly synthetic process of expertise. The belief is that this harmony would be reflected in society. But if we are to take Mitchell seriously, the state exists somewhere between institutionalized practices and symbolic identity, so then the state has never been tidy or coherent. Boundaries are drawn between state-society and state-economy in theory, but in practice these spheres are extremely porous and “rather the production of an apparent separateness creates affects of agency and partial autonomy with concrete consequences.” Despite the dreams of the health experts, the state could not be “an actor with coherence, agency, and autonomy.” Mitchell, building from Foucault, claimed the economy replaced the population as the object of the powers of government and the science of politics.76 This new object played a central role in the articulation of a distinctive 20th-century state as a set of bureaucratized science-based technologies of planning and social welfare. The state became inseparable from “the economy,” but at the same time a separation was constructed and patrolled “where the economy is concrete and material and the state abstract and institutional standing apart from the economy’s materiality.”77 This dissertation has shown how the late 19th century was a time where expertise was profoundly structured through synthesis. In my archive, the state, economy, health, science, and population were purposefully made indistinguishable, or made to show how diverse relations could be correlated. The healthy state, as a highly multifarious object, was as slippery and powerful as “the economy,” an object that was built on separated disciplines and categories. I assert that “the economy” is now framed as an institution with stasis that possesses even flows and leads to strength and vitality. In many senses, health posits a similar assertion, a return to stasis. When combined, a healthy economy is one without unproductive excesses or declines. Mitchell’s arguments lead to my question: What were the processes that separated the economy from the state to produce this duality? Or directly from my archive, What shifted after the Commission of Conservation to make its claim that public health was central to both the national state and the economy sound like an anomaly? I hesitate because any answer to these questions will be an extremely general claim. But my reading of history leads me to suspect that, after the rise of Nazism (and a corresponding disfavouring of the disciplines of eugenics and the

The Ideologies of a Health Board | 2010 | Paul Jackson | 242 sciences that supported degeneration), the relations between health, population, and nation were reconfigured.78 I suspect that any natural or bodily associations within these bodies of knowledge, including correlative metaphors and synecdoche, were pried away. These associations were declared distasteful. Or perhaps with the rise of more quantitative methods these modes of argumentation steeply declined. It’s possible the danger of synthesis and correlation became realized and became taboo as specialization increased throughout the 20th century. Additionally, a single, unified solution to all problems that spoke across disciplines could lead to a hugely problematic movement like Nazism. For comparison, take Nazi Germany’s book State and Health that Agamben discussed in Homo Sacer. The book referred to Germany’s population as “living wealth.”79 This living wealth was to be the foundation of a new politics. If there is a living value of people, then the state will care for the biological body of the nation. State and Health of 1942 claimed: We are approaching a logical synthesis of biology and economy…Politics will more and more have to be capable of achieving this synthesis, which may only be in its first stages today, but which still allows one to recognize the interdependence of the forces of biology and economy as an inevitable fact…Fluctuations in the biological substance and in the material budget are usually parallel.80

As I have hoped to demonstrate in this dissertation, there is nothing exceptional in this statement, except for its context and the time when it was uttered, in Germany during the Nazi period.81 What this research complicates is the sense of Nazi “specialness” that partly arose from a belief that the state, the health policy, life, and the economy must be and have always been separate.82 As has been remarked in many places (Foucault’s general argument which Agamben further isolates), Nazism merely amplified the already-existing tendencies in modernity.83 As Ann Stoler maintains, “Racism does not merely arise in moments of crisis, in sporadic cleansings. It is internal to the biopolitical state, woven into the weft of the social body, threaded through its fabric.”84 If this is true, then how becomes the historical question to answer, how this became woven into thought, articulated, and practised in many contingent forms. To say that biology and budget (life and value) had become interchangeable in the beginning of the 20th century was not extraordinary. Therefore, the question for me becomes, What were the existing processes and practices that needed to be validated in order to make this statement able to be widely uttered? I suggest that this logic undergirds the very particular histories of nation and “the economy” that Mitchell covers, and also animates the emergence of the biomedical model of health. Economic arguments for health persist to this day. I am not

The Ideologies of a Health Board | 2010 | Paul Jackson | 243 saying the economic argument is worse than racist arguments of degeneration; both are very dangerous. Ultimately, health is dangerous because it is seen as inherently positive. The drive for parallel equilibrium in life and capital is the danger. Economism is the danger. The moves for either complete separateness or complete interchangeability are equally dangerous. Economic rationality and efficient biology were ongoing practices that later produced theories, concepts, and disciplines. “The economy” was separated from the state, from health, and indeed from all the particularities that led to its emergence through the horrors of eugenics and its implications.

9.4. Conclusion: Charge of the State By way of a conclusion, I want to integrate these themes through the example of the very unremarked category “charge of the state,” to show how this continues to be incorporated in our social relations. What “charge of the state” illustrates is how proliferating life was tamed, made ordinary, and rationalized through the idea of a person as economic “charge” or cost to a nation. As an example from my archive, Bryce amended the Immigration Act with a new clause that stated: That no person liable to become a public charge can enter Canada, except he give bonds satisfactory to the Minister that he will not become a public charge. No person who has had insanity within five years can enter Canada. No epileptic can enter Canada. That is absolute. No feeble-minded person or idiot can enter Canada. We may let in cripples, say a man who has lost an arm, on condition that he give satisfactory evidence that he has an occupation or an art, and is not likely to become a public charge.

Bryce then suggests that if someone who came to Canada goes insane or gets sick, he should be returned to his or her country of origin. The province, city, and hospital doctors must have the power to reject unhealthy individuals because this population “should not have got in and has become a charge to the public, either as a criminal, a lunatic, an epileptic, or a charitable case.” Efficiency within the economic realm made up for biological loss of productivity. With a charge of the state or public charge, disease became rationalized through economic cost.85 Additionally, the fear was that if these charges were to breed out of control, the economic costs would be like runaway inflation and deflation and they would devalue the nation as a whole.86 But these economic arguments of health contained a profound inconsistency. During this period public health experts were also resistant to capital and corporate influence because they saw the free market as irrational, producing imbalances and economic crises that led to bodily harm,

The Ideologies of a Health Board | 2010 | Paul Jackson | 244 unproductive workers, and poor standards of living. But underneath this there was an implicit endorsement of an economy that incorporated Malthusian fears of biology and nature. Capital was a problem because it created disequilibrium, yet, like biology, the economy could be improved. The goal was a state-led healthy liberal capitalism, what I have called bureaucratic bio-economy.

Endnotes

1 Stuart Hall, "Gramsci and Us," Marxism Today June (1987): 19. 2 The most evocative intersection of city and nation in Canada can be seen in the ideological work of the Civic Improvement League, see Canada. Commission of Conservation. and Civic Improvement League of Canada, Civic Improvement League for Canada : Report of Preliminary Conference Held under the Auspices of the Commission of Conservation at Ottawa, November 19, 1915 (Ottawa: Mortimer Co., 1916). 3 David Harvey, "The Marxian Theory of the State," Antipode 8, no. 2 (1976): 81-82. 4 Martin V. Melosi, The Sanitary City : Urban Infrastructure in America from Colonial Times to the Present, Creating the North American Landscape (Baltimore: Johns Hopkins University Press, 2000). 5 Harvey, "The Marxian Theory of the State," 82. 6 For Harvey what is integral to analysis to the state—and which I don’t cover—is how: (a) the bourgeois state became necessary as vehicle for collective violence upon labour and the state as a form of class domination; and (b) how one segment of said class formation controls the state. (Ibid.: 84-85.) However, in my research I found that class rule and segmentation went hand-in-hand with the medical profession’s integration into the state apparatus. As a profession medical doctors didn’t clearly fit into one of Harvey’s positions within the class dynamics of capital. Some other aspects that I do not have the space to fully explore are, how consent was gained and the contradictions between consent and ruling class interests. 7 "First Annual Report of the Provincial Board of Health of Ontario Being for the Year 1882," ed. Ontario Provincial Board of Health of (Toronto: Printed by Order of the Legislative Assembly, 1883), vi. 8 Bob Jessop, The Capitalist State : Marxist Theories and Methods (New York: New York University Press, 1982), 147. 9 Ibid., 148. 10 Geoff Mann, "Should Political Ecology Be Marxist? A Case for Gramsci’s Historical Materialism," GeoForum 40 (2009): 366. 11 Antonio Gramsci, Selections from the Prison Notebooks of Antonio Gramsci (New York: Lawrence and Wishart, 1971). For a blending of Gramsci with Foucault, see Michael Ekers and Alex Loftus, "The Power of Water: Developing Dialogues between Foucault and Gramsci," Environment and Planning D: Society and Space 26 (2008). For a blending of Gramsci with Polanyi, see Michael Burawoy, "For a Sociological Marxism: The Complementary Convergence of Antonio Gramsci and Karl Polanyi," Politics & Society 31, no. 2 (2003). Geoff Mann contributes, saying “[Gramsci] writes both for and to history’s victims, he writes the political on the terms of the economic and the ethico-political because he knows the why of history is, as he says, the ‘‘moment of hegemony.” He is unafraid of the inevitably historically specific claim to the realm beyond history.” In Mann, "Should Political Ecology Be Marxist? A Case for Gramsci’s Historical Materialism," 343. 12 Jessop, The Capitalist State : Marxist Theories and Methods, 155. 13 In Bryce’s article there is no indication of who said these quotes, which he does throughout his writing. 14 I see sanitary surveys as a continuation of the medical topography ‘tradition’, even though at this time this form of health analysis had been deemed less and less useful (for more see chapter 3). 15 "First Annual Report of the Provincial Board of Health of Ontario Being for the Year 1882," XXXVI. My emphasis. 16 Foucault takes apart the metaphor of the ship in Michel Foucault, Security, Territory, Population: Lectures at the College De France, 1977-78, ed. Michel Senellart, Francois Ewald, and Alessandro Fontana (New York: Palgrave Macmillan, 2007), 97. Foucault interprets: “That government is concerned with things understood in this way as the intrication of men and things is readily confirmed by the inevitable metaphor of the ship that is always invoked in these treatises on government. What is it to govern a ship? It involves, of course, being responsible for the sailors, but also taking care of the vessel and the cargo; governing a ship involves taking winds, reefs, storms, and bad weather into account. What characterizes government of a ship is

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the practice of establishing relations between the sailors, the vessel, which must be safeguarded, the cargo, which must be brought to port, and their relations with all those eventualities like winds, reefs, storms and so on.” 17 Ontario Provincial Board of Health of and Health Ontario., “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1882), xiv. Emphasis in text. 18 Ontario Provincial Board of Health of and Health Ontario. Dept. of, “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1882), xi. 19 My emphasis. Covernton and Oldright “Directions For Preventing The Spread Of Asiatic Cholera” (Pamphlet No. 14, issued by the Provincial Board of Health of Ontario) in Ontario Provincial Board of Health of and Health Ontario. Dept. of, “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year (1884), 204-205. Other pamphlets that were circulated were entitled, “How to Check the Spread of Contagious or Infectious Diseases,” “Disposal of Sewage,” and “By-laws suggested to Municipalities.” 20 Peter H. Bryce, "Report of the Secretary: A Hundred Years of Sanitation in Ontario," in Annual Report of the Provincial Board of Health of Ontario Being for the Year 1891, ed. Ontario Provincial Board of Health of (Toronto: Printed by Order of the Legislative Assembly, 1892), 3-16. 21 The Globe, 1892, Cholera Epidemics in Canada, The Globe, August 4, 4. 22 For immigration and racial purity, see Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991). 23 Ontario Provincial Board of Health of and Health Ontario. Dept. of, “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual Report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1882), xxi. 24 The complete story of the 1892 cholera outbreak was outlined in chapter 1, primarily from the sources from the Toronto Evening News. 25 “Meeting of the Canadian Medical Association in Ottawa,” Canadian Practitioner, XVII, November 1st, 1892, 500. 26 Albert L. Gihon, "The Hygiene of Cholera," Canadian Practitioner XVIII, no. 3 (1893): 168. 27 Paul Adolphus Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930" (University of Toronto, 1979), 33-34. 28 Chapter 5 covered Bryce’s views on growth and immigration, in relation to proliferating life. Chapter 2 covered the general views of degeneration and eugenics. 29 Angus MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945 (Toronto, Ont.: McClelland & Stewart, 1990), 53-54. Maclaren quoted directly from Peter H. Bryce, "Feeblemindedness and Social Environment," American Journal of Public Health VIII, no. 9 (1918). 30 I view this eugenics and euthenics dynamic as a twist on the zymosis imagination from chapter 4. For more see Peter H. Bryce, The Ethical Problems Underlying the Social Evil (Toronto: s.n., 1914), 3-4. Where he goes on to speak in terms of synecdoche: “Surely with the individual, since Society is but a microcosm, made up of its units, combined into a living whole. Shall we start with the child at birth? Surely even prior to this, for in the child is to be found the germ of all qualities, physical and mental, of its parents, and even grandparents. Clearly then the qualities of the parents and the sanitary environment in its broadest sense of the mother are of inestimable value and importance to the future of the child and of the nation. Everyone to-day is familiar with the fact of the living organisms, whether plants or animals, being built up from the individual cell being nourished or impeded in its development by its environment, accordingly as this is favorable or the opposite. Evidently then as the plant or animal is constantly influenced by air, sunlight and food, so must the tissue cells, whether pre- natal or post-natal, be daily, even hourly, influenced by their surrounding fluids. But there is much more than this. As the infant obtains its physical pabulum from without, so only by his external impressions do its most complex cerebral cells receive their impressions from without through the special senses, which serve to develop what we call the mind…” 31 MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945, 55. MacLaren suggests that, overall, these arguments were not monolithic. Beliefs were held that there existed real and inherent hereditarian differences that could not be overcome by an improvement in the environment. This view was also repeatedly expressed in the leading medical journals. For example, in 1908 the editors of the Canadian Practitioner asked: “who are to be the fathers of the future children of Canada”?

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32 Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 66-68. 33 Ibid., 69. 34 Ibid., 71. This quotes also anticipates many of the arguments in the next section. The economic arguments over immigration and sanitary reforms made these pillars increasingly hard to parse out. 35 For a longer discussion, with the related divisions within populations with the concept of race, see Michel Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, ed. Mauro Bertani, et al. (New York: Picador, 2003). 36 Bryce’s speech is the same one where he spoke to the “national organism,” raised in chapter 5. 37 Peter H. Bryce, "Civic Responsibility and the Increase of Immigration," in The Empire Club of Canada Speeches 1906-1907 (1907, January 31). Bryce continued to say: “Last year, we had 52,000 people come into Ontario, of this number we had 40,600 British, 1,902 Hebrews, 3,400 Italians, and 6,700 of other foreign races. Whether they remained in Ontario or not does not seriously affect our question or the argument.” 38 Ibid. Another take on the immigration debate was by Dr. Hodgetts (see Figure 2) who by 1920 had followed Bryce to Ottawa from Ontario. Hodegetts declared, “We are receiving in Canada people of many nationalities, both European and Asiatic, many of whom come simply to make money and who are willing to live like swine to make it.” In Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 69. 39 George Rosen suggest that this intermingling of health and economy has a much longer history than covered here. He starts with the “political arithmetic” in the work of William Petty and John Graunt in the 1600s. These English experts counted the statistics of mortality and the important factors in the health of population in relation to the national workforce. This began in the late 1600s and early 1700s with theories of the probability of events in relation to vital phenomena. These arguments were a means to an end, and that end being national prosperity and power. Rosen claims it was these folks who began to push for hospitals and health councils, see George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993), 88-91. The general argument of the economy of health repeatedly appeared in many different forms and practices, see also Viviana A. Zelizer, Morals and Markets : The Development of Life Insurance in the United States (New York: Columbia University Press, 1979). For the economic arguments, see Philip Mirowski, More Heat Than Light : Economics as Social Physics, Physics as Nature's Economics (Cambridge; New York: Cambridge University Press, 1989). Susan Buck-Morss, "Envisioning Capital: Political Economy on Display," Critical Inquiry 21, no. 2 (1995). 40 This was probably published at the a similar time. This article also shows Brooks’ fears of the masses: “Often the battle is against ignorance, prejudice, dirt, and poverty; and often, too, all these are combined into one power to prevent cleanliness and simple decency in the very abodes where men eat, sleep, drink, live, and die. How many, indeed, literally go in pursuit of scarlet fever, typhus fever, diphtheria, and all of the known zymotic diseases! Multitudes not only as it were embrace these plagues, but communicate them, revel in infection and contagion, fretting and scolding until the evil hour of their own folly and ignorance is seen at their own bedsides.” Erastus Brooks, "Sanitary Government - Principles and Facts " American Public Health Association, Public Health Papers 8 (1882). 41 Ontario Provincial Board of Health of and Health Ontario. Dept. of, “Annual report of the Provincial Board of Health of Ontario, Canada, being for the year,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1882),120. 42 Ontario Provincial Board of Health of and Health Ontario. “The Economic Value of Sanitation as a Measure and Means of Social Progress,” Annual report of the Provincial Board of Health of Ontario, Canada, being for the year ... (1899), 26. 43 My emphasis. Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick : Britain, 1800-1854 (New York,: Cambridge University Press, 1998), 12. 44 Charles J. Hastings, "The Duty of the Profession and State as Regards the Mental and Physical Care of Improperly Cared for Children," Canadian Practitioner and Review XXX, no. 7 (1905): 369-370. He would later say: “The inroads of degeneracy is being felt already in most of our larger cities” Europe and France had seen this and were putting forward effort to overcome the “evil” by feeding the youth. He talks about vice and crime, and compares Canadian cities with New York and Chicago. However, this wealth-decay phrase comes from Oliver Goldsmith, 1770 poem “The Deserted Village.” This poem is most likely a response to the enclosure acts and the urbanization of the British population. To put the quote in context: “Ill fares the land, to hastening ills a prey, Where wealth accumulates, and men decay; Princes and lords may flourish, or may fade; A breath can make them, as a breath has made;

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But a bold peasantry, their country’s pride, When once destroyed, can never be supplied.” 45 Charles J. Hastings, "The Value of a Credit Balance in Public Health Administration," American Journal of Public Health: Official Monthly of the American Public Health Association VI, no. 2 (1916): 110. 46 Commission of Conservation Canada, “The Modern Conception of Public Health Administration”, Conservation of life, (1917), 50. 47 Another example of calculating the financial costs of disease outbreaks came from the United States, directly after the cholera outbreak in 1892. Erastus Wiman states: "But in order that the public mind may be aroused to the necessity of taking every possible precaution, it may be well to set forth briefly what might possibly be the consequences to the commerce of the country should cholera find a lodgement in any of the great cities, or become epidemic, as it once before did, in small towns. The actual ascertainable loss involved and the monetary disaster that would follow are so palpable and enormous that it would seem as if there was hardly any precaution which should not be taken by the authorities, either Federal, State or Municipal. Justification for the most extreme measures will be found in the contemplation of the magnitude of the disaster that would occur, if the business of the country were to be seriously interfered with, even by good ground for apprehension, apart from the actual existence of the disease in any considerable number of places." Erastus Wiman, "What Cholera Costs Commerce," The North American Review 155, no. 432 (1892). My emphasis. Erastus Wiman was actually an poor Canadian boy who made it in United States business circles. He argued that poverty was actually a stimulus, see Michael Bliss, A Living Profit : Studies in the Social History of Canadian Business, 1883-1911 (Toronto: McClelland and Stewart,, 1974). 48 Commission of Conservation Canada, “The Modern Conception of Public Health Administration,” 50-51 As Irving Fisher expresses it: “Poverty and disease are twin evils, and each plays into the hands of the other, and from each or both spring vice and crime.” Fisher was given an extensive profile in "Measuring the Nation's Vitality in Dollars and Cents: Prof. Irving Fisher Makes Optimistic Estimates from Facts Involved in Recent Movements in the World of Finance," New York Times 1909, October 31. 49 By 1910, Dr. Bryce’s definition of national health was: “To comprehend adequately the meaning of all that is implied in the term “National Health,” it will be necessary to realize that, while the nation’s health is primarily measured by the number of deaths in any given population, yet, from a national standpoint, it may further be understood as indicating the maintenance of the largest possible number of effective citizens, view from the standpoint of their economic value to the State. Thus, a [rural] nomad population…naturally maintain a very high degree of individual health, and yet, from an economic standpoint, be but little comparable in social effectiveness with a busy industrial urban population living under sanitary conditions which have been rendered so good through present day scientific knowledge as to be compatible with the highest individual health” Conservation Canada. Commission of, Report of the First Annual Meeting : Held at Ottawa, January 18th to 21st, 1910 (Ottawa: Mortimer Co., 1910), 114. He goes to discuss: value of population as a national assets with census numbers, exports and imports; Darwin and evolution; the preservation of infant life and children; comparative analysis with Britain and throughout Canada; and death due to industrial causes. He ends with: “laissez faire methods are not more logical in the face of foes active against public health than they are when a foreign foe in arms attacks our shores. National prosperity in every field is demanding more and more the daily application of the scientific method in every field of human energy which, in a physiological sense, is capable of being weighed and measured as accurately as the number of foot-pounds of work obtainable from the consumption of a given number of pounds of coal, or as the number of kilowatts of electricity from a waterfall of a given height depth and breadth. Public health is no longer to be classed as an imponderable but as a ponderable entity, to be dealt with along lines as exact as the building of a railway of minimum grades, or the getting of a the highest mechanical efficiency out of a well-constructed steam engine.” (His emphasis. p.134.) 50 Fitzhugh Mullan, Plagues and Politics : The Story of the United States Public Health Service (New York: Basic Books, 1989), 56. George Rosen, "Public Health: Then and Now: The Committee of One Hundren on National Health and the Campaign for a National Health Department, 1906-1912," American journal of Public Health February (1972). Irving Fisher and Washington D.C. National Conservation Commission, A Report on National Vitality, Its Wastes and Conservation (Washington: Govt. Print. Off., 1909).

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51 In May of 1907, President Roosevelt quickly endorsed the Committee for the One Hundred by sending a letter to the committee a letter which said: "Our national health is physically our greatest national asset. To prevent any possible deterioration of the American stock should be a national ambition. We cannot too strongly insist on the necessity of proper ideals for the family, for simple living, and for those habits and tastes which produce vigor and make men capable of strenuous service for their country. The preservation of national vigor should be a matter of patriotism. I can most cordially commend the endeavors of your committee to bring these matters prominently before the public.” In "The Committee of One Hundred," Science 27, no. 689 (1908). 52 Fisher (1892) emphasis in original, from Annie L. Cot, "'Breed out the Unfit and Breed in the Fit': Irving Fisher, Economics, and the Science of Heredity," The American Journal of Economics and Sociology 64, no. 3 (2005): 794. 53 Ibid.: 802. In 1913, this movement would late form The Life Extension Institute in the United States and published Irving Fisher and Eugene Lyman Fisk, How to Live: Rules for Healthful Living Based on Modern Science (Authorized by and Prepared in Collaboration with the Hygiene Reference Board of the Life Extension Institute, Inc.), Ninth Edition ed. (New York: Funk & Wagnalls Company, 1916). For the history in relation to public health, see M.S. Pernick, "Eugenics and Public Health in American History," American journal of public health 87, no. 11 (1997). 54 Another example of this shift can be seen through insurance and the work of Louis Dublin, see Louis I. Dublin, "The Reporting of Disease. The Next Step in Life Conservation," Public Health Reports (1896-1970) 29, no. 25 (1914). Louis I. Dublin, Alfred J. Lotka, and Mortimer Spiegelman, The Money Value of a Man (New York: The Ronald Press Company, 1946). 55 Karl Marx, Friedrich Engels, and Ronald L. Meek, Marx and Engels on the Population Bomb; Selections from the Writings of Marx and Engels Dealing with the Theories of Thomas Robert Malthus (Berkeley, Calif: Ramparts Press, 1971), 94. 56 Ibid., 113. For another example, see David McNally, Against the Market : Political Economy, Market Socialism and the Marxist Critique (London: New York : Verso, 1993). 57 In 1915, the Chairman of the Commission Sir Clifford Sifton stated, “it is the function of the Commission of Conservation not so much to do things as to start things, to investigate, to bring about co-relations between different people, individuals and bodies.” In Canada. Commission of Conservation. and Civic Improvement League of Canada, Civic Improvement League for Canada : Report of Preliminary Conference Held under the Auspices of the Commission of Conservation at Ottawa, November 19, 1915. p.2. 58 Commission of Conservation was founded in 1909 and consisted of an advisory body of 12 people that represented all of the provinces and the federal department of the Interior and Agriculture. The commission was divided into seven committees: mines, waters and hyrdo-power, lands, forests, public health, fish, game and fur- bearing animals, and a public relations and publications committee. The commission championed ideas of conservation that were similar to present-day mainstream environmental issues, such as saving the natural world. This movement had been building in Britain and Europe since the 1880s. The Commission was reflecting similar government management of the environment in the US, a federal-environmentalist version of the Progressive Moment. The members looked to improve what they saw as bad management through: policy research and recommendations; information distribution; and the coordination of scientific and technical research to solve problems. However, due to BNA Act—that gave the power over natural resources to the provinces—many of the policies they advocated for did not accord to this national body, since they had no jurisdiction. The commission was abolished in 1921 for a variety of reasons, perhaps due to the severe post-war recession and rising federal deficits. The conservation agenda could not compete with a growth agenda. Post WWI government had shifted towards industrial research for national growth. Michel F. Girard, "The Commission of Conservation as a Forerunner to the National Research Council, 1909-1921," Scientia Canadensis 15, no. 2 (1991). 59 Conservation Canada. Commission of, "Conservation of Life," Conservation of life. (1914). As this chapter will conclude this has a dangerous dynamic in that, “Racial discourse is not opposed to emancipatory claims; on the contrary it effectively appropriates them.” In Ann Laura Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things. (Durham: Duke University Press, 1995), 90. 60 Canada. Commission of, "Conservation of Life," 1. 61 Christopher J. Rutty, "The First Five Years: Public Health and the Canadian Public Health Associations, 1910- 1915," Canadian Journal of Public Health May/June 2009 (2009). 62 W.L. Mackenzie King, Industry and Humanity : A Study in the Principles Underlying Industrial Reconstruction (Toronto: Thomas Allen, 1918), 7. In 1914 Rockefeller invited and funded Mackenzie King’s work. King was employed by the Rockefellers as a company troubleshooter in industrial relations. King created the Industrial

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Representation Plan of the Colorado Fuel and Iron Company after the Ludlow Massacre and fear of bolshevism. Once these fears calmed down he wrote Industry and Humanity. In King’s account he says that in the beginning of the war the Rockefeller foundation began to pull back research into industrial relations and began moving towards medical education, public health demonstration, and war work co-operation. Accordingly Chapter IX of his book is called “Principles Underlying Health” and he incorporates health as the basis of efficiency, suggesting the benefits of garden cities. Interestingly King utilized synecdoche to make claims (see p.17). For more see Jeffrey D Brison, Rockefeller, Carnegie, and Canada : American Philanthropy and the Arts and Letters in Canada (Montreal: McGill-Queen's University Press, 2005). 63 P. H. Bryce, “The Medical Profession as a Public Service for Health,” The Public Health Journal, March, 3, 113- 115 (1919). 64 As Bryce said: “it has required a great war to arouse the people to a sense of the primary national need, the saving of man-power” Peter H. Bryce, "The Scope of Federal Department of Health," Canadian Practitioner and Review XLIV, no. 11 (1919). 65 MacLaren, Our Own Master Race: Eugenics in Canada, 1885-1945, 58. 66 My emphasis. Hastings, "The Value of a Credit Balance in Public Health Administration," 114. 67 Heather Anne MacDougall, Activists and Advocates : Toronto's Health Department, 1883-1983 (Toronto: Dundurn Press, 1990). 68 Bator, "Thesis: Saving Lives on the Wholesale Plan Public Health Reform in the City of Toronto, 1900 to 1930", 334. 69 Ibid., 330. 70 The following discussion by health experts illustrates this position. Conservation Canada. Commission of and Conference Dominion Public Health, Second Annual Report : Including a Report of the Proceedings of the Second Annual Meeting Held at Qubec, January 17-20, 1911 and of the Dominion Public Health Conference Held at Ottawa, October 12-13, 1910 (Montreal: John Lovell & Son, 1911). For example Dr. C.J. Fagan of British Columbia: “We are here for a bigger purpose…I think [national public health] is the greatest step Canada has yet taken. I think [the government has] come to realize the importance of this question of health. The people as a rule do not realize it, they do not see the pressing importance of remedying the existing conditions, and we all know that the conditions existing to-day, if they are permitted to continue, with application to such problems as the existence of slums…of the scientific knowledge which we possess, would lead to the loss of life as one can hardly bear to think of. (138-140) He continues to speak on the dangers of the United States and China and talks of how cholera is still threatening, and how the examination of immigrants is vital. He also ends with “I am not a politician.” 71 See Timothy Mitchell, "Rethinking Economy," GeoForum 39, no. 3 (2008). Timothy Mitchell, "Fixing the Economy," Cultural Studies 12, no. 1 (1998). Timothy Mitchell, "Society, Economy, and the State Effect," in The Anthropology of the State; a Reader, ed. Aradhana Sharma and Akhil Gupta (Malden MA, Oxford: Blackwell Publishing, 2006). 72 See Philip Mirowski, Against Mechanism : Protecting Economics from Science (Totowa, N.J.: Rowman & Littlefield, 1988). 73 The eugenicist Francis Galton also made mechanical models of the economy and society. 74 My emphasis. Mitchell, "Fixing the Economy," 92. 75 Mitchell does not have an exclusive hold of ideas of the nationhood, as these concepts of the nation are quite fraught, see Benedict R. Anderson, Imagined Communities : Reflections on the Origin and Spread of Nationalism (London; New York: Verso, 1991). Matthew Sparke, In the Space of Theory : Postfoundational Geographies of the Nation-State (Minneapolis: University of Minnesota Press, 2005). 76 “Replaced” is perhaps too strong a word, maybe pried away from each other in order to be weighted against one another, Stephen Legg, "Foucault’s Population Geographies: Classifications, Biopolitics and Governmental Spaces," Population, Space and Place 11 (2005). 77 Mitchell, "Society, Economy, and the State Effect," 183-184. To summarize his agenda for dealing with the state he concluded with: [1] abandon the state as a freestanding entity; [2] take seriously the distinction between state and economy as the defining character of the modern political order and the state cannot be dismissed as abstraction; [3] state as decision making or policy as disembodied aspect of state phenomenon is inadequate; [4] the state should be addressed as an effect of mundane processes of spatial organization, temporal arrangement, functional specification, supervision and representation of a world fundamentally divided into state and society or state and economy; and [5] these process create the state as abstraction to the concrete social, or representation to the material economic.

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78 In the case of Germany “Nazi racial theory was supported not only by cranks and quacks but also by men at the highest levels of German biomedical science. Racial science was “normal science,” in the sense that Kuhn have given that expression.” Robert Proctor, "Nazi Medicine and the Politics of Knowledge," in The "Racial" Economy of Science : Toward a Democratic Future, ed. Sandra G. Harding (Bloomington: Indiana University Press, 1993), 346. Proctor shows how widespread this “normal” science was, as racial hygiene and eugenics existed throughout the world. In 1914, eugenics could be found in forty-four American colleges and universities. By 1928 three hundred and seventy-six schools had programs in eugenics, nearly three-quarters of all schools. The medical ideology of hereditarianism, in that nature is more important than nurture and we must look to biology to solve social problems, sought a combination of biological determinism and science would be the technological fix. This meant the medicalization of all social problems and therefore a widespread and expansive project. From another discipline the boundaries between demography and eugenics needed to patrolled and distinguished, for that history see E. Ramsden, "Carving up Population Science: Eugenics, Demography and the Controversy over the 'Biological Law' of Population Growth," Social Studies of Science 32, no. 5/6 (2002). 79 For clarity sake, I will contextualize this section from Agamben’s book. In the state of exception and in the age of biopolitics, the sovereign then decides when a life ceases to be politically relevant. In terms of the Nazi regime this point was achieved where medicine and politics began to assume final form. The physician and the sovereign could exchange roles. In Giorgio Agamben, Homo Sacer. Sovereign Power and Bare Life (Stanford, Calif.: Stanford University Press, 1998), 142-143. For Agamben, racism is not the correct term for the biopolitics of the Third Reich. Instead it is a “care of life” that had grown from the 18th century police science that began to be founded on eugenic concerns and absolutized. For the Nazi regime, biopolitics can be distinguished in terms of the care and growth of citizen’s life, as distinct from politics and police. But when mixed together the police became politics and care of life coincides with fight against the enemy. “The novelty of modern biopolitics lies in the fact that the biological given is as such immediately political and the political is as such immediately the biological given.” So natural heredity is turned into a politic task. “The totalitarianism of our century has its ground in this dynamic identity of life and politics, without which it remains incomprehensible.” This form of totalitarianism is entirely in the horizon of biopolitics. The law to prevent hereditary disease, then eugenic legislation to marriage (related to disease, mental illness, or a ward) took on a different cadence after the Nazis came into power. Agamben admits this cannot be confined to eugenics or to the Final Solution. See Agamben, Homo Sacer. Sovereign Power and Bare Life, 148-149. 80 Agamben, Homo Sacer. Sovereign Power and Bare Life, 145. See also, Giorgio Agamben, State of Exception (Chicago: University of Chicago Press, 2005). Giorgio Agamben, Remnants of Auschwitz : The Witness and the Archive (New York: Zone Books, 2000). 81 With the discussion of statements and milieu, I am attempting to return this discussion back to my take on Foucault’s toolkit, see chapter 1. However details are important, for more see Paul Weindling, Epidemics and Genocide in Eastern Europe, 1890–1945. (Oxford: Oxford University Press., 2000), 200-270. His work focuses on typhus in Germany. He argues over the power of “geo-medicine”: a combination of history, “great doctors” of Germany, geography, and epidemiology. He claims that geopolitik inspired German Nazi hygienist Heinz Zeiss to produce ‘geo-medicine’ a form of medical geography, a very frightening form of medical geography. 82 This argument over the ‘specialness’ of Nazi Germany is a wider cultural reading of how this history is framed. Rhis comes from my reading of Agamben, but Matthew Gandy concurs: “[Agamben] argues that Nazi Germany represents the first ‘radically biopolitical state’ through its eugenic programme to merge the biological with the political, whereby ‘the physician and the scientist move in the no-man’s land into which at one point the sovereign alone could penetrate’. The disciplining of the body becomes ‘the decisive event of modernity’,’ in Matthew Gandy, "Zones of Indistinction: Bio-Political Contestations in the Urban Arena," Cultural Geographies 13, no. 4 (2006). My more general comment is, why was this not seen as decisive movement in North America? Although many do make the claim about the American eugenic movement was equally pivotal. 83 Achille Mbembe, "Necropolitics," Public Culture 15, no. 1 (2003): 23. Mbembe turns these arguments into colonial arguments. But he also talks about the irrelevance of this intervention: “That the technologies which ended up producing Nazism should have originated in the plantation or in the colony or that, on the contrary—Foucault’s thesis—Nazism and Stalinism did no more than amplify a series of mechanisms that already existed in Western European social and political formations (subjugation of the body, health regulations, social Darwinism, eugenics, medico-legal theories on heredity, degeneration, and race) is, in the end, irrelevant.” For Mbembe this is outside the law of Schmitt’s sovereignty to decide the state of exception. That this exists is the important intervention. I partly agree with him—that the source of this power is less important than the effects—however, I wonder what were the long-term, more insidious, effects? 84 Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things., 69.

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85 Bryce, "Civic Responsibility and the Increase of Immigration." Bryce was far from alone in making claims like these. In 1932, Dr. H.M. Cassidy makes similar arguments about the economic value of public health and insurance, quoting Israel Dublin. I do not have the space to work into the insurance arguments. See Dublin, Lotka, and Spiegelman, The Money Value of a Man. Zelizer, Morals and Markets : The Development of Life Insurance in the United States. 86 This sentence is a bit dangerous and polemical, especially because I am attempting to work within the problematic acts of equivalences in my archive. But I do so only to bring out the fallacy of this practice.

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THE VISIBLE AND THE INVISIBLE The Relation Between the Seen and the Unseen Worlds A Power that is Used in Healing the Sick – The Influence of one Mind on Another

From Reverend Doctor Wild November 7th, 1892

The Small Insects and Minute Microbes have their Place and Mission… [T]he need and dependence of the visible upon the invisible is getting to be better understood. Our delicate but real relation to unseen forces and agencies in physical things, is now very manifest. The studies and experiments of the bacteriologist—the practical labors of physicians and the work of the men of science, make us aware of foul invisible gases, of disease producing infinitesimal microorganisms. A few years ago we had no idea how much our health, prosperity and even liberty depended upon the unseen creatures ; the benefits coming to society of our progress in knowledge and practice along the material lines of our nature and surroundings, must be pleasing to us all… …I ask plainly, are there not mental and moral epidemics—actual plagues, are there not sick thoughts and poisonous forces, mentally and spiritually that are contagious and infectious, that by some means pass from one mind to another? For myself I believe there are. I believe it is dangerous for person to mingle and associate much with those who have a corrupt disposition and evil thoughts unconsciously and imperceptibly the evil minded taint and inoculate the good and pure… …The cholera and other microbes have their place and mission in the all wise arrangement in the economy of [nature]. We in our limited knowledge cannot see the good of some things, but the very fact of their existence is proof positive that THEY HAVE A PLACE AND WORK TO PERFORM.” [sic]1

Cholera kills. Reverend Doctor Wild is invoking capital “D” Death with his “unseen creatures.” But what am I implying when I say “cholera kills”? Cholera is merely a micro-organism. Cholera has a life cycle and dies. Cholera enters a human being and reproduces in the digestive tract, causing the bowels to acutely evacuate and that leads to massive dehydration. This is what may cause death. However, acting alone, the micro-organism–cholera has no agency; cholera pulls no trigger.2 Cholera is not unlike diarrhea. Diarrhea is a common experience, but under

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 253 particular circumstances diarrhea can kill you. Diarrhea kills people everyday. What saying “cholera kills” does is conjure up the politics of life and death. Or how politics can become bracketed off when decisions are framed as matters of life and death. When invoking the politics of life and death, I am engaging with Michel Foucault’s discussion of the power “to make live and let die.” I want to write against how the biological objects and processes are brought into these decisions, and how they are frequently imagined to be the cause of death. “Cholera kills” erases the way disease is mediated through layers of institutions, culture, habits, and fear. Can cholera be blamed for death? Or do poverty, urban infrastructures, bacteria counts, water privatization, and medical science allow cholera as death to become a crisis. Cholera as death became separated or differentiated from the micro-organism in a petri dish or in “nature,” and it was cholera as death that had to be tackled or dealt with. I propose that to write a history of cholera as death, calls for a reversal of the normal and the pathological.3 This dissertation has been an attempt to write against my archive where cholera was framed as the epitome of death. In my crumbling documents, cholera was regularly given a supernatural form; visualized and embodied as a threat or as skeletons and ghosts floating over the city. I am also writing against a similar argument from a different perspective, a strong actor-network theory that flattens relationships and imbues a micro-organism with the power and agency to confound scientists and populate itself as a force throughout history.4 In many ways cholera can be said to have scared entire cities and produced particular historical effects, but it never did this alone. Cholera required multiple agents, technologies, and myths to exert the power that both the actor-network theory and Dr. Wild had ascribed to it. Consequently, cholera accumulated so many associations over its history that I could not write only a history of a cholera crisis of 1892. The cholera pandemics and the historical and geographic context of the late 19th century formulated the object–science relationship I have endeavoured to explain over the course of this dissertation: the object of proliferating life and the science of bureaucratic bio- economy. A quick overview of events according to my arguments would be helpful. As the 19th century progressed, cholera broke out around the world with increasing frequency. In Canada, the cholera outbreaks took place from 1831 to 1871. As cholera epidemics became less frequent, there were still flare ups in distant cities and each outbreak was framed as an impending threat to North America. These ongoing cholera crises contributed to the formation of state health institutions that could prepare for disease emergencies. There were many benefits from these institutions for cities and nations; they improved basic sanitary conditions and decreased

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 254 pollution in the water supply. The institutionalization of state health corresponded to, or coincided with, ongoing transformations in free-market capitalism, industrialization, and colonial trade, including economic crises and depressions. One response to these economic downturns and the vagrancies of the market was the rise of the progressive movement within state bureaucracies. Technologies like the telegraph, the Suez Canal, and railways improved transportation and made Atlantic travel easier. The Hajj pilgrimage was under British colonial rule and the surveillance of migrants required management and control. As the transportation of sick migrants increased in speed and frequency, the International Sanitary Conferences began to attempt to manage these movements. The conferences’ growth paralleled the rise of local state health institutions that were directly related to disease outbreaks. By the end of the 19th century, a structure cohered between nations, cities, and other levels of government to deal with international disease crises. Bacteriology had become the scientific discipline within that preventative structure. When cholera threatened North America again in 1892, all these social relations were put in stark relief. The 1892 cholera crisis leveraged many changes. In Toronto, the cholera outbreak led to a strong push to reform the waterfront; engineers became enrolled in the project; plans were passed; and financial funding secured. Internationally, cholera led to more agreements and cooperation; International Sanitary Conferences solidified a scientific consensus; a Pan-American health agency emerged; and a North American “cholera wall” was consolidated. Immigration, feared and maligned by the nativist political communities, took on an explicit health cast. However, when the epidemics failed to materialize, the fear and science around epidemics were transferred to immigrants and engendered a belief in a degenerating national and urban healthy vitality. This contributed to the call for a national, expanded public health sector. The advent of a national board of health was delayed due to budgetary restraints and economic depressions, and health experts increasingly prioritized their economic arguments to defend their continued existence within government. Calculating the costs of labour migration versus the costs of charges of the state incorporated much of this economic rationality into medical expertise. The relationship between nationalism and eugenics instituted an economic rational for health within a rubric of efficiency. William Farr’s theory of zymosis complicates this historical overview and does not cohere with this timeline. The zymotic-germ imagination of crisis persisted long after the theory was dismissed. A heavy cultural anchor existed and, in the process, formulated the object that I have named proliferating life. My claim is that proliferating life is the result of Farr’s zymotic theory augmenting Malthus’ principle of population. My argument is that Malthus provided a

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 255 powerful foundation for the articulation of proliferating life. Proliferating life was taken up in many different forms and at different times as an idea-force. Farr and his cohort incorporated and institutionalized these ideologies, giving Malthus’ ideas technical and material formulations. These technologies were laws; institutions; and disciplines, such as health statistics and surveys; and sciences that included zymotic assessments, bacteriological laboratories, and eugenic practices. How these technologies were put into practice can be seen in the detailed workings of the bureaucracy put into place and expanded by the likes of Dr. Bryce, Dr. Hastings, and many others in Ontario and North America. For this conclusion, my hope is to rethink these predetermined concepts and politics, the politics of the relationship between proliferating life and the variety of state practices called bureaucratic bio-economy. I want to contextualize this relationship within critical theory in order to propose some reversals. These reversals will attempt to engage with the politics of fear and crisis in a different manner. Previous chapters have shown how these ideologies shifted within the state and the many forms of bureaucratic bio-economy, including swamp remediation, national vitality, economic value of life, visualization of threats, and methods to deal with disease crises. I also want to make a claim beyond the historical specificity of my archive. My hesitant assertion is that proliferating life has persisted and perhaps has been formative to the current spatial imagination of crises in regards to life. It appears that this relationship is being restated in a wide variety of sites and places (to name but a few recent examples, this can be seen in Mike Davis’ Planet of the Slums, Club of Rome, metaphors of cancer, and continued debates over immigration). My claim is that over the 20th century, the idea of a world filled with the threats of proliferating life became validated, and the continued validation of this idea has had multiple material effects. My project for this conclusion is to utilize reversals, or a shock to thought, so I can undermine existing concepts and practices that arise from the politics of fear and crisis. I look to move toward a different understanding of health than the one that is widely circulated. Before entering into my concluding discussion, I want to outline how this dissertation contributes to a wider literature, both empirically and theoretically. My empirical contribution comes from researching the cholera outbreak that didn’t happen. I have not found anyone who has written on epidemics that did not happen, but in particular no one has written on the cholera crisis of 1892 from the perspective of Toronto, Ontario. Instead of merely dismissing that event, I embraced this contradiction. As a result, I don’t follow historical change; rather, I ask why ideas and institutions endured. But also I ask how institutions and actors made them themselves necessary or argued on behalf of their necessity. This perspective on the history is a slight

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 256 empirical difference, but an important one. This viewpoint allowed me to emphasize the zymotic theory of disease and its lingering ramifications. Since I was committed to cholera, I don’t follow actors or specific institutions. My theoretical contribution has centred on the crisis and the idea of future crises. Because of my commitment to cholera, my research shifted to theorizing the relationship between proliferating life and bureaucratic bio-economy. My theoretical contribution was to name this object and science. However, this act of naming does not feel like a theoretical contribution or an empirical contribution, though I may be making too great an effort to separate them. This theoretical contribution relied on supporting arguments based in theory, including the implementation of David Harvey’s social infrastructures, the geography of synecdoche, and the practices of synthetic expertise. While I relied on a variety of literatures, I always had urban political ecology literature in mind when writing this project. My contribution to that literature is to suggest that “disease crisis” within the nature of cities is a political force to be reckoned with. I contribute to an explanation of how cholera is a metabolic vehicle that circulates and transforms the urban social relations. Additionally, when cholera infects someone, I see it to be a collective socio-natural moment. My expanded project is to show how human health is central to urban political ecology, and how illness as a socio-natural moment hinges on social reproduction, either in the form of collective support and/or state intervention. In this conclusion, I will be working through the theories this dissertation has already engaged with (Marx, Foucault, Harvey, Mitchell) by utilizing reversals by Canguilhem, Haraway, and Butler. I do so only to both frame and interrogate the interrelated processes of growth, population, and crisis. Granted, these writers have widely divergent projects; however, all deal with death and misery in their own particular ways. To be clear from the outset: Malthus and his followers are my enemies. Marx provides a critique of Malthusian thinking and contributes relational dialectics. And Foucault also critiques Malthus but incorporates the role of state. Canguilhem reverses the category of health. Haraway calls to rebuild the life sciences. Finally, Butler offers a way forward in the form of the framework called precarious life. Marx, Foucault, and Butler all struggle with the ways misery became rationalized or silenced during the implementation of Malthusian ideas and politics. In general, this conclusion hopes to contribute to the critique of the moralized and naturalized relations of capital, resources, and life. Before proceeding to the reversals, I want to justify and contextualize my use of the term bio-economy.

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11.1. Life and Value: Bio-economy and the Relations between the State, Capital, and Health 11.1.1. The limits of bio-economy

I use bio-economy as a very particular historical category. In my project, bio-economy directly reflects how the 19th-century experts from my archive tried to hold together life and the economy. I use bio-economy rather than biocapital to indicate that even as the liberal positivists decried the effects of capitalism, they were far from Marxists. However, using the term bio- economy is slippery territory, and I tiptoe around the current literature that uses this concept. The terms bio-economy and biocapital are contributions from by a very loose group of academics whose work has been extremely helpful to my own project. This literature has attempted to hold together ideas of population, life, capital, and the state.5 In doing so, many of the bio-economy writers read the contemporary period through a mixed version of Marx and Foucault. I appreciate the fact that this literature does not view Foucault and Marx as adversaries. Theories of contemporary bio-economy address concepts such as life, nature, economy, politics, governance, and species. However, I am concerned and at times mystified by the ways this literature attempts to make a variety of categories and terms equivalent. As an example, I will take the work of Michael Dillon and Luis Lobo-Guerrero to distinguish this tendency from my own work. These writers directly engage with Agamben, among others, to unravel “the transformation of life into value, the form of commodity and capital.” As this process is central to my questions and speculations, I want to quote it at length: For, if we describe the spirit of capitalism inspiring the biopolitical imaginary’s bioeconomy as a desiring machine motivated by the regulative ideal of perfect liquidity, such liquefaction aims to install a continuous free flow of circulation, or universal exchange, back and forth between species as classification, as biology and as capital value. The reason is clear. It is the very uncanny congress between these three that engenders and circulates capital value in the first place. Such liquefaction nonetheless transcends the species-thinking upon which it is actually engaged. It effects the dissolution of classification and category, ultimately submitting each to the standard of pure liquidity. An ontology of excess thus remains sequestered in the very species-thinking so otherwise hostile to that which resists species-thinking, in that the logic of species-thinking ultimately exceeds the classification, biologization and valuation which comprises it.6

While theoretically suggestive, this does not help me unpack my archive or understand the processes of change throughout time. I do not think I am stumbling or that I am mystified with this work because the contemporary period is “excessive” (which in their terms means filled

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 258 with greater and faster forms of transcendence and dissolution).7 Instead, I seek a greater materiality and historical specificity to explain the relationship between life and value, including the politics that can contest and challenge these processes.8 Sunder Rajan is more categorical with his term biocapital, which is not only “the systems of exchange and circulation involved in the contemporary workings of the life sciences but also a regime of knowledge pertaining to the life sciences as they become increasingly foundational epistemologies for our times.”9 Nevertheless, Sunder Rajan is concerned about the ways in which current theoretical debates are centred on novelty and emergence. This focus on producing new theory distracts from the fact that all the while we are “tracing the same things.”10 I agree and have actively worked to emphasize the specific social relations around cholera and health boards. In the drive for novelty, I worry about falling into semantic associative word games around terms such as circulation, speculation, and liquidity.11 The slipperiness of moving between the theorizing of life and the economic theories of value should be worked against and complicated, not lubricated. “Life” and “value” are not equivalent, even though certain processes have made them interchangeable over time. How interchangeable and for what length of time is a historical question. The processes of exchangeability may be isolated within the practices themselves, but not in the realm of theory. The neogolism bio-economy comes from the practices and ideologies of the experts in my archive who attempted to bring together life and the economy on a variety of scales. Consequently, I must also be clear that, when interrogating, critiquing, and analyzing these processes, capital must be emphasized over “economy.” For Marx, “the economy” should never be seen to exist within a framework of equilibrium.12 However, anyone using a version of Marx is not prevented from making problematic equivalences. The circulation of Marx is not the circulation of Foucault. I see both Marx and Foucault writing against Malthus, and within that common enemy I find an opening for my project. However, my concern with the literature of bio-economy is performing synthesis for the sake of synthesis (the dangers of working in a post- disciplinary age, as some have called the present academic period). In many ways, this dissertation has found several dangers that lurk in between the disciplines, as well as practices and attempts to make disciplines comparable. I have suggested that synthetic expertise relied on acts of correlation and analogy, which is indebted to the tradition of positivism and model building. Seeing the same relation in various places or scales is a method of claiming some transcendent cause. Believing that both physics and economics work through the same dynamics is to believe that some common law or dynamic exists between them. Believing that the

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 259 principle of population is due to some natural law erases and mystifies the historical particularities. That zymosis and germ-proliferation worked on a variety of scales is a fiction. Cause and effect on a cellular level is not the same as cause and effect within the city; only if urban politics were exterminated could one believe this. I am not saying that the bio-economy literature is practising synthetic expertise; instead, I am saying that the exchangeability of life and value took political, ideological, and financial work to even begin to enable the biomedical model of health. To conclude, I want to cover some of the ways this arose from my archive.

11.1.2. The protracted and particular enabling of medicine and capital Since the bio-economy literature does not help me read my archive in terms of life and value, what other methods and frameworks are there? In this conclusion, I want to ground the health ideologies and practices that brought together life and value in order to raise some threads that arose from my archive. My hope is that this also contextualizes where the historical transformations in previous chapters led. After the 1890s, a wider variety of ideologies, technologies, and interventions that mediated the relationship between health and disease existed. Health professionals could draw from many of these positions, even when they were at odds with one another. One position trumpeted how the state bureaucracies had become a good way for health experts to pursue their goals and expand their influence. As they came to be embedded within the state, the health experts’ class positions slowly rose. However, even by the late 1910s, medical professionals still lacked the power and status they demanded. Health experts repeatedly had to call upon the common interest to maintain their position within the state bureaucracy. At the same time, they were dismissive of the ignorant public who they claimed it was their duty to protect. The necessity of their expertise for healthy cities, workers, and nations was a statement they needed to repeat constantly. The confidence of both the Commission of Conservation and the Toronto Board of Health, seen at the end of the last chapter, was articulated during the upward swing of state health. Simultaneously, health experts and providers were resistant to market encroachment on their domain. Medical experts worked against the vagrancies of the market and corporate influence over their affairs. Health authorities protected their sphere of expertise while acquiescing to market forces. This paralleled the progressive movement’s resistance to the market and its reliance on the state. In this context, capital intervened in this relationship investing in medical science, in the form of research into pharmaceuticals and medical technologies. This capital intervention was hesitant and partial, and the resulting shifts were

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 260 varied. What interests me is how this transition between state health and capital was shaped because medical experts and doctors were ideologically resistant to corporate and capital influence. State health reformers had reached a level of authority in terms of the reproduction of labour, state health institutions, and social infrastructures. However, health was a totalizing project for these synthetic experts and needed new spheres and sectors to expand into. These state health reformers, while feeling triumphant, were unaware that the ground had already shifted underneath their social infrastructures. Speculative investment had set in motion a biomedical model of health. During my historical period, a number of political, economic, governmental, and scientific shifts had effects on these health authorities. Did the ideology of national vitality become overextended and fractured? The secure and honoured job opportunity of the 1880s was a government position, yet by the turn of the 20th century, scientific medicine in the university had taken on that pivotal status-producing role. Professional identities of health began to be based around the university. After the 1890s, the scientist began to outrank the urban health reformer as the new elite of the health profession. At the same time, as Evans suggests, throughout the end of 19th century there was an uneven withdrawal from the policing of epidemics. Post-1892 opposition of the state toward interventionalism from some sectors of society had quieted. The use of disinfection technologies on immigrants at the borders became instituted as a standard process for determining clean bills of health, and this process was seen to be the solution to epidemics. The long arm of state health had been established and had positive effects; unless the reforms came directly into conflict with trade, the debate seemed to be over.13 But health based in the state was not the only agenda that was circulating. Private capital, from sources such as Rockefeller and Carnegie in the United States, had also been developing a de facto national health policy through promising technology to physicians. This is where speculative investment entered the health technology scene. While science had validated the medical profession, this validation only went so far. Corporate capital’s emphasis on scientific medicine diverted attention away from environmental or workplace sources of disease and toward curative medicine that required pharmaceutical interventions.14 What became scientific technological medicine (later named biomedicine) was not a determining force in the development of modern health care but a tool developed by members of the medical profession and corporate class to serve their perceived needs. Biomedicine came about through technologies such as laboratory medicine and X-ray machines. Through this transition,

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 261 endowment funds such as the Rockefeller Foundation and the Carnegie Institute become aligned with the medical profession. These investment streams turned toward medical schools and hospitals.15 “Medicine became an engineering task” that Rockefeller could fund.16 Diseases now indicated an unmet need or demand; the role for Rockefeller was to figure out how to supply that demand.17 In the process, medical science started on a path to become an accumulation strategy.18 These shifts led to greater specialization in practices, roles, and disciplines, in particular the laboratory production of vaccines. For more environmental-minded health reformers, typified by Bryce, vaccines were not seen as immediately useful, perhaps because they focused on population-level immunity rather than on major epidemics crises.19 Health boards as social infrastructures took up the management and production of vaccines gradually in Ontario and beyond. The state supported and underwrote the production of vaccines, but only so far; in another definition, the state provided the seed funding. In response to growing private investments in biomedicine, state health bureaucrats attempted to compete in the marketplace of the laboratory. Canadian health bureaucrats wanted their own national laboratory. It was argued that the institution would have long-term benefit for health and the economy: “The great benefit accruing to the people generally by reason of the research and experimental work is of such a character that it is impossible to estimate its worth in dollars and cents.”20 But this economic argument was too diffuse, even as the U.S. laboratories claimed to alleviate the riskiness of this proposed project. As the national laboratory project failed, vaccine research in Canada took another path. By default, this role fell to the Connaught Laboratories in Toronto.21 I assert that in the long run, this path solidified one sphere of health into the state and another sphere of biomedicine into the circuits of capital.22 The Connaught facilities were based at the University of Toronto and had the slogan “Life-saving products and minimum prices.”23 This institution built on expertise from Toronto’s heath community, including the Toronto and Provincial Boards of Health. During the First World War, the Connaught labs, brought into national service,24 were proud of their “service to the empire” and trumpeted their “national work.” When Banting and Best discovered insulin in the early 1920s, this research breakthrough solidified the already well-established Toronto as a hub of medical research. This led Rockefeller to give one million dollars to the University of Toronto and the Connaught labs, which was used to create Rockefeller’s third centre of research after John Hopkins’ and Harvard’s schools of public health.25

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Over the course of the 20th century, health care, pharmaceuticals, and medical technologies have become a huge market of commodities and services. To return to Starr’s discussion of the medical profession and capitalism (in chapter 7), in terms of health care there was no obvious commodity. The commodity that did arise was pharmaceuticals, yet this was underwritten and mediated by state institutions or social infrastructures. Health in the form of a vaccine could be mass produced. However, the return to the primary circuit of capital took an extremely long time, and it was contingent on a variety of historical factors.26 The commoditization and capitalization of health was neither direct nor clear; this process took a circuitous path. The return to the primary sector was not quick or obvious, and the return required the speculative investment of both state funding and international capital. My question is then, What made it possible for the relations between state health, value, and investments to be marshalled, and what enabled value to return to the primary circuit of capital? I suggest but do not have the space to fully explore David Harvey’s analytic as a guide to applying the dynamic of switching circuits to social infrastructures. My claim is that heath social infrastructures can be seen to take on a very similar role as fictitious capital (as summarized in chapter 8).27 The historical contingencies in the transition to a biomedical accumulation strategy are not a history that I can cover in this dissertation, but I think David Harvey illuminates these shifts. From my initial reading of the archive, I can make some broad statements and raise some question and theories about what took place. Through my Harvey-inspired theory of the state, I will raise some question about the relational aspects of the state, capital, ideologies and practices of health. Granted this summary will have to be abstract. My claim is that the state can coordinate paths for future value realization. The state has the luxury of time to enable or create the conditions under which the potential of productive investments can be realized. Active moments in the state can be isolated throughout history. These active moments are found in the production or transformation of state apparatus. However, this state apparatus must appeal to the common interest in order to be validated. Common interest of health speaks, or attempts to speak, for lives of the population, a population bounded by the nation, province, or city. But because the state internalizes the law of value as an active moment, and transforms state functions toward coordinating speculative activities of future needs, a friction (tension or contradiction) becomes internalized within ideology itself. In the last few chapters, I have been following this process of internalization. State health became focused on how a disease epidemic (crisis) model could help prepare for future health emergencies. This internalization of future needs through the coordination of state

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 263 apparatus made the health social infrastructures seem necessary (organic) to the workings of capitalism. To be blunt, capital cannot circulate if everyone is dead. However, these processes did not end there. Health care became deeply integrated into capital, albeit it in particular ways, depending on geography and history. This health ideology required that experts be focused on saving lives and stopping heath crises, rather than directly engaging with capitalism, either for or against. However, the intersection of the state, health, and capital was not only about the reproduction of labour. State science and health institutions moved ahead (or in the case of research into new microscopic realms) to establish paths, structures, and methods for capital investment, even if there were no guarantees that there would be any profit from the endeavours. The profit motive was not the ideological rational for these developments. But then what helps to guarantee their state health’s necessity? State science investigated disease in the name of fear of death of the city or citizens and in the interest of everyone within its geographically bounded area. This could be a necessary part of the state apparatus’ coordinating device. But because of health’s dominance and power, in the Gramscian sense of hegemony, it’s able to build particular biomedical social infrastructures through accumulated science. A key aspect of the health experts’ ideology, and the argument for their continued existence, was to declare that they could foster and protect the nation. However, health practices and ideologies were not only directed toward the social reproduction of labour or healthy populations. According to Harvey, social reproduction only comprises half of the relations between the state and capital. The state must also support the reproduction of capital and regimes of accumulation. To be clear, how medicine and science became fully intermeshed with capital is a long and intricate process that I do not have the space to cover. But I want to highlight how, during my time period, particular social infrastructures—from health boards to state laboratories to university partnerships—performed integral coordinating functions that enabled and structured a biomedical model of health and the rise of pharmaceutical commodities. How the state was integral to this switching of value is, again, a historical question. In particular, this conclusion on how this shift was not capital-led requires much more research. (I would also like to clarify that this does not reflect a general theory of the capitalist state and regimes of accumulation. I am inserting small theoretical questions that arose from my archive into the particular and contingent transition.) This leaves me with a variety of questions. How was the common interest articulated in these active moments and coordinated in the state? When can the collective or common interest be called upon, for a variety of motives, to direct or channel potentially productive investments?

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Within market rationality, uncertainty and risk can be put to the side if the state steps in and says, “With the value surpluses that comes from the primary circuit we need to channel resources in certain directions, for the good of all.”28 But is it necessary to follow the circulation of capital within the state, organized by particular segments of a class, in order to figure out if there is a direct return to that class? I suspect that the return may be impossible to discern in the present, but over, say, forty years, the general productivity may become visible and noticeable. My question becomes, Do the flows of value and the benefits have to be separated by class? Flows of value could be channelled through the state and pushed and negotiated by a variety of class positions so that over time the surplus value benefits only a certain segment of interests: doctors, scientists, and capitalists like Rockefeller. However, during all this, the state aggregates and diffuses these interests. The circulation of value must be aggregated under the auspices of the common good so that the notion of specific capital investment with a guaranteed return is detached. This underscores Harvey’s point that struggle leaves the spaces of production and is transferred into politics. In the realm of politics, struggle directs the future investment of long- term interests that will benefit the necessary reproduction of capital, the minimal reproduction of labour, and can also provide paths in certain institutional arrangements for future means of accumulation. Those means for accumulation are taken advantage of by capitalists, but there is no direct return to those who made the initial investment. The project for me is to find the institutional arrangements that internalize these relationships; to follow how these flows of value are coordinated by the state as active moments; and to investigate what new paths and avenues for accumulation are produced. I argue that this dissertation has opened some doors to show how this has come about. My large unresolved question—if it can be resolved—becomes, How does value, circulation, and accumulation produce the “healthy” city? 29 The bio-economy literature has been unable to provide a structure that can begin to look for an answer, but Harvey’s relational Marxism can give us some final thoughts on this question. The geographer George Henderson, using Harvey, suggests that processes such as health have become infrastructures that “undergird the value of the commodity called labour power—a commodity that also presents itself in an immense accumulation, called the urban.”30 Commodities such as labour power are not things but the bearers of the social relations from which value is constituted.31 Henderson asks “what accumulates” and how does accumulation work “as a force in the very constitution of society and the environment in which it operates”? Accumulation is uneven. Circulation is fragmented. Value is produced. Surpluses are circulated. As Marx stated in Capital, “Every

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 265 accumulation becomes the means of a new accumulation.”32 My question has been, While managing, improving, and educating proliferating life (microorganisms, urban pollution, sick migrating populations), how was a new means of health accumulation cobbled together through the state? I have attempted to show how the progressive movement and liberal positivists turned to state structures such as health boards, scientific methods, and the promise of marsh reclamation as urban sanitation in response to disease crises. These practices of efficient management were one way to freeze rapid changes or crises into a sense of equilibrium with the surrounding world—the wish of an artificial, antiseptic balanced future.33 Managing epidemics, migration controls, even something banal like creating a flood plan, became infrastructures that tackled proliferating life. Social infrastructures accumulated to produce a healthy city, but as an uneven “thing” and at the expense of other forms of social reproduction. The accumulation strategy that became biomedicine extended this uneven accumulation of the minimal luxuries of health to the few. Value had to be switched between the circuits of capital. Crisis, mobilized by the state, was one way to do this, and within the tertiary circuit, these forms of crisis muted political debate and gave implicit consensus of the common interest. The circulation of value was a halting irrational form that took time, required struggle, and was riddled with missteps and inopportune events. Even if bio-economy and biocapital can help open up the idea of capital, my claim is that the emphasis should be on how events fail to happen; how spokesmen for life and value seem insane; and how these ideas are not just wrong, but frequently ignored. However, I cannot conclude there. I see only dead ends in the politics of crisis, the threat of death, and the common interest of health. In my view, the ideology of health placated social relations. To finish this conclusion, I will argue against the emergent health of silence and luxury, which erased the common precariousness of life. For the “healthy city,” how must specific people and groups within that urban accumulation face precarity and exposure to environmental effects? How do these very people become thought of as superfluous? In my archive, crucial connections were obscured: all life was precarious; capital had intermeshed with the Atlantic world; the expanding settler state of North America needed a larger labour force. These social relations could have been faced by the end of the 19th century, but instead, they were silenced and transformed into fears against external threats. Rallying around living conditions and life, these experts became fixated on death and the crisis of epidemic disease— all the while speaking for life.

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11.3. Theoretical Reversals and Transforming the Politics of Life and Death “In history as in nature, decay is the laboratory of life.” —Karl Marx34

If I want to work toward an anti-crisis politics, I need to refuse the politics of life and death. I feel that the politics that exist under the looming threat of death are limited, unquestioned, and unchallenged. While I know what to advocate against, I am left at an impasse as to what to advocate for. To break out of this framework, I have turned to writers who are quite polemical. In truth, I have an urge to be polemical in the face of health politics. I want to write against how health is framed as inherently positive, to shake up my archive and my theory. To write against how health is occupied within the “making live and letting die.”35 I attempted reversals to see what else is immanent within the processes I have interrogated. The concepts and processes from my archive—from liability to profitability, positive evil, proliferating life, from life to value—envision disease and illness as a property or object rather than a social relation. I want to work against this. Additionally, I turned to these theoretical reversals because I hit a wall. When struggling to articulate my object and science, the following theorists pushed me in productive ways.36 I want to begin by taking up Donna Haraway’s line of inquiry. Haraway is known for destabilizing scientific categories. Her work on the cyborg has been incorporated into urban political ecology in an attempt to reformulate the sub-discipline’s project as cyborg urbanization.37 However, for my research, I do not want to engage with how urban life needs to grapple with socio-technical systems. Rather, I want to take on Haraway’s cyborg in her political intervention. As Haraway states, “[C]yborg politics must insist on noise and advocate pollution.”38 In this tradition and for my purposes, what would be the politics of advocating for cholera? I suggest that advocating for cholera is different than advocating for death. Crucially, my turn toward acceptance of the urban co-inhabitation with the non-human should not be envisioned through the horizon of crisis, but rather through an acknowledgement of the necessary level of shared precarity of life. Accordingly, as I will argue, the absence of sickness is an aberration and a form of biological privilege. Haraway additionally assists my project when she calls for a socialist-feminism theory of the body politic that avoids capitulating to theories of biological determinism of our social position; that works against adopting the capitalist ideology of culture against nature; and that embraces our responsibility to rebuild the life sciences. Haraway suggest that the undeniable

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 267 thing about biology since the late 18th and early 19th centuries is that “biology tells tales about origins, about genesis, and about nature.”39 Biology is the science of life. Accordingly, sociobiology is the knowledge of the self and a form of humanism that promises human unity, which includes a real togetherness with nature, even our own nature. Sociobiology is a fictive strategy, offering a doctrine of biological determinism. As Haraway makes clear: “A nagging question persists when one reads sociobiological texts: does anyone listen to these stories?”40 This research has illustrated that many health experts and practitioners listened quite intently to each other’s stories. I have exposed the problematic aspects of health expertise and science to illustrate the fictive nature of all science.41Accordingly, this dissertation has been part of a collective task to rebuild the life sciences, in my case without crisis and without seeing threats within biology. I see Haraway to be a continuation of Marx’ analysis; he too looked to transform the concepts handed to him with radical critique. As Lefebvre summarizes: “Sooner or later radical critique reveals the presence of ideology in every model and possibly in ‘scientificity’ itself.”42 For my purposes, no model can be realized or generalized. No model can completely determine an object. Lefebvre suggests that critical reflection can replace a model-based form of inquiry. But this inquiry opens up an engagement with the world that explicitly confuses the experimental and the theoretical, as well as empirical and conceptual research. Doing this requires naming ideology from the outset. To build an anti-crisis life sciences and politics requires not fearing the future and accepting the inevitability of disease and death. At first glance this may appear utterly problematic. Why would such a reversal be necessary? I should restate my position again for the sake of clarity. Again, I am writing against Malthus and his crisis-monger followers who promoted eugenics and population management, anti-urban rhetoric, health based on nature, calls for purity, scientific racism, positivism, nativism, and nationalism. However, this does not make me automatically for the opposite—famine, disease, dirt, mystification, myth, and cholera.43 I refuse this binary in order extricate myself from this debate. This binary, which I have bracketed as the politics of life and death, contains a nagging worry that I have been unable to drop. In my archive, everyone and every institution is against cholera. Dr. Wild from the beginning of the chapter, authorities such as Tully and his positive evil, and Malthus and his positive checks, are not advocating for cholera. They envision cholera to have some transcendent role, a divine check. I find this clarity of purpose deeply mystifying, but I am also mystified by the social relations that enable cholera to kill. Correspondingly, in the cholera crisis, voices of authority make it possible to avoid the politics inherent in every decision. This

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 268 profound mystification is representative within the ideology of health. Health is inherently “positive,” a good that resists the onslaught of politics and quiets Haraway’s noise. The philospher and historian of science, Georges Canguilhem in The Normal and The Pathological, has done exactly what I am seeking to do: he reversed the category of health. Canguilhem’s writes, “Health is a set of securities and assurances…securities in the present, assurances for the future…To be in good health means being able to fall sick and recover, it is a biological luxury.”44 This reversal stakes a claim that health is not some a priori pure state of nature. Health is not a form of living before becoming polluted. Disease is not introduced into purity; rather, disease reduces one’s tolerance to environmental and biological processes. Disease reduces a person’s ability to maintain the daily struggle to not die. From this perspective, then, disease can be framed as the whittling away of structures of support (reduced to the point of absolute precarity) and/or the increase of harmful environmental conditions in daily life. Disease, as a social relation, is an everyday negotiation. The greatest amount of reduction is a life of luxury (or health), supported by either privilege or collective social formations. Nikolas Rose summarizes Canguilhem’s definition of health as “life lived in the silence of the organs and their normative struggles to resist death,” which Rose extends to define normality as the “life lived in the silence of the authorities and their normative struggles to ensure social order and tranquility.”45 From this reversal, health becomes a luxury and a privilege. Accordingly, I extend this to say to be for health is to be for silence found in privilege. In comparison, to be for disease is to acknowledge, and to call into question, the infrastructures necessary that maintain these silences. Resistance to death can either be reduced or enhanced quietly for the few but be a loud political discussion for the many. Canguilhem and Haraway give me these paired statements. Health is silence. Cholera is noise.

11.3.1. Reversing proliferating life? How then does my object of proliferating life fit into this reversal?46 To be in favour of the noise of cholera must be distinguished from the health expert’s idea of proliferating life. As this dissertation has argued, proliferating life retains the idea of population; however, this population can include micro-organisms, sick cholera bodies, urban fecal pollution, migration of populations, and the rapid growth of cities. The experts in my archive interrelated and correlated these processes, while I merely named them. For my work, these different processes of proliferation are not equivalent; equivalence was procured for extremely political ends in a particular historical conjuncture. Proliferating life evokes the vigorous escaping and pouring

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 269 forth of life that became intermeshed within health ideologies of control and the fears of death— a site continuously mediated by the state and capital. The experts rationalized the impoverishment of human existence in the name of purity and balance. Fear contributed to the drive for a national equilibrium between improving the productivity of life and controlling certain lives that were not allowed to flourish. Nationally, a crucial tension emerged between the management of life to proliferate (into value) and the fear of life proliferating (into crisis).47 The health experts from my archive did not argue that the cholera crisis existed with the framework equilibrium, economic or otherwise; rather, they argued that the proliferation of life (pollution, bodies, bacteria) was the destabilizing force that disturbed the balance of health and the economy. However, the calls for reform were not argued in terms of economic scarcity, and budgetary restraints were not on the minds of the experts. The cholera crisis articulated an ideology not limited by economic determinism, at least for a time. Proliferating life was seen as the seed of the crisis. From my archive, these fears of the extremes of proliferation were central to what the experts sought to work against in North American cities. These experts worked against their crisis ideas about quick epidemic death or slow death through degeneration. In a similar reversal of Foucauldian biopolitics into necropolitics, the post-colonial theorist Achille Mbembe asks a question relevant to my research: “What is the relationship between politics and death in those systems that can function only in a state of emergency?”48 In my work, one particular state of emergency was the politics around cholera deaths49 caused by the circulation of people around the Atlantic world in 1892. Mbembe’s project is to interrogate “those figures of sovereignty whose central project is…the generalized instrumentalization of human existence and the material destruction of human bodies and populations.”50 Mbembe relies on Hannah Arendt to frame the class of superfluous people: “a mass of human material ready for exploitation—or abandonment.”51 Whether capital may or may not incorporate superfluous populations is a historical question, yet many times throughout history this superfluous population has been framed as a threat. Mbembe’s and Arendt’s cases were the movement of people due to imperialism, war, and/or dispossession. One form of inquiry is not only how these mass migrations are produced but also how urban spaces become the sites where these superfluities mix together and become managed.52 I raise these issues so that they may be put into the larger context of my dissertation. For my dissertation, proliferating life became an idea of the unmanageability of populations that were seen to be the source of death. The response was a desire to stop and control them by any means necessary. My contribution here is to focus on the ways that production of superfluous people and the

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 270 circulation of these populations can be seen as acts that reduce human tolerance to environmental influences (in Canguilhem’s term, disease). This reduction is not confined to living conditions in transit, but describes how people are expelled from existing social infrastructures, state-based and otherwise. Russian Jews were the population targeted during the cholera crisis of 1892. The Russian pogroms and famines produced and demarcated this particular superfluous population. The site to control became the location where this population could potentially proliferate and circulate. My claim is that the crisis and the problem should never have been internalized to the Russian Jews themselves, as something inherent or carried within the biology of a people. Unsurprisingly, racism became the sorting device in this tension between proliferation and life. At the end of the 19th century, the invocation of “race” was ambiguous and slippery, a form of race deeply imbued with poverty and illness. Racism of that time was a markedly different beast than the racism of today. Class and race, poverty and otherness, constituted each other in a variety of ways. For example, Valverde suggests that, for Anglo-Saxons, “race” articulated both a specific race and a vanguard of the human race.53 For my project, Foucault is again helpful as he imbeds racism into the mechanisms of the state. Within the excess of life racism became “a way of fragmenting the field of the biological that power controls. It is a way of separating out groups that exist within a population.”54 As Ann Stoler reads Foucault, concepts and practices are trafficked between class and race within national or colonial boundaries. However, for Foucault, the enemy is constructed not outside the body politic but organically within it. Biological science is not the source of this construction; rather, it is the “biologizing power of the normalizing state.”55 Racism is not the creation of a scapegoat (as this is more than an ad hoc response to crisis); racism is a more permanent social war that practices incessant purification. While Stoler focuses on blood, I suggest that my archive speaks more to growth. Cholera became an object on which to direct this incessant purification. As Bilson declared, in Canada, “[c]holera led to a temporary rediscovery of the poor with every epidemic”56 I have covered in more detail how these relations became seen through cholera when outlining proliferating life and Malthus in chapter 5. The poor population was framed within racial categories, seen as enabling both epidemic and degenerate crises. For health authorities, each cholera crisis was seen as an opportunity. Each crisis allowed them to fine-tune their search for the physical manifestations of potential proliferating life. As well, it allowed them to study the ways urban industrial environments could affect the germ plasma of citizens. Epidemic exciters could unleash the biology of those urban poor populations. Health crises were

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 271 read into the very bodies of the urban working poor. In the historian Erin O’Conner’s reading of the 19th century, there was the production of a “distinctly industrial ethnicity…Imagining a world where race reveals itself in the blots, lumps, spots, and stains of working-class culture, Victorians pictured a humanity profoundly destabilized by dirt.”57 Race became a way for the state to demarcate how life could proliferate among some of the population; while death and sovereignty, materialized and documented through scientific practices, could enable techniques to control these unwanted excesses.58 However, to end this conclusion on the categories of race feels disempowering, like an iron cage of frustration. In contrast to this framing, I want to add one more major concluding point from Judith Butler that shifts again the politics of life and death that arose from this dissertation. Butler moves the discussion forward from the politics of life and death, and suggests that precariousness should be central to the definition of what it is to be living. Butler explains that precariousness emphasizes concrete issues like shelter, work, food, medical care, and legal status as a shared condition of human life. I see this as being in accordance with Nik Heynen’s politics of survival in geography.59 Butler states that precariousness is a general condition, and to deny the general nature of the category is a denial of precariousness itself. Precariousness cannot be reduced to an individual. For Butler, “death is certain” and “life requires various social and economic conditions to be met in order to be sustained as a life.” Butler continues: Precariousness implies living socially that is, the fact that one’s life is always in some sense in the hands of the other… precariousness underscores our radical substitutability and anonymity in relation both to certain socially facilitated modes of dying and death and to other socially conditioned modes of persisting and flourishing.60

Exposure and dependence to others are essential, precariousness is not produced but happens at birth, and “survival is dependent on what we might call a social network of hands.”61 Butler calls for a recognition of the fact that death cannot be avoided, only exposure to death can be reduced through collective means of social reproduction. This precarious exposure to death is central and constant to life. It’s a privilege and a luxury to be able to be silent about this precariousness.62 To be “alive” is to be in the hands of others. Being dependent, being impinged upon, and the social network of hands—these are not costs or “charges,” they are a fact of social relations. This framework challenges as fundamentally problematic the economic arguments of health, at the same time

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 272 indicating the limitations of the 19th-century health ideology. The liberal positivists were against the violence and exposure of capitalism, but this was only the first step. My claim is that a reduction in the “social network of hands” and social reproduction should be seen as a loss of value.

11.4. Conclusion: Toward an Anti-Crisis Politics and a Reflexive Life Sciences

Could that term “abstraction” really apply to these days he spent in his hospital while the plague was battening on the town, raising its death-toll to five hundred victims per week? Yes, an element of abstraction, a divorce from reality, entered into such calamities. Still, when the abstraction sets to killing you, you’ve got to get busy with it. —Albert Camus, The Plague (1947)63

This dissertation’s conclusion might have opened up more questions than it answered. I will attempt to summarize. This dissertation may seem crammed with pairings: precarity–social network of hands, positivism–politics, eugenics–degeneration, disease–health, scarcity–luxury, silence–noise, life–death, and bureaucractic bio-economy–proliferating life. I want to assert that even though these pairings can fall into a binary organization, these binaries are false. Binaries lead to hierachies, which are then vulnerable to judgments of good versus bad. My point is that I am neither for nor against these terms. Instead, I ask, what are the relations among these concepts and what politics arise from these relations? Some methodoligical considerations are necessary to work within these reversals, and to think differently and depart from the politics of life and death. Canguilhem’s method was to not start from a fundamental opposition (life versus death, for example); instead, he asks what processes and actions produce non-binary entities.64 Cholera is a non-binary entity. Cholera must be placed within the broad spectrum of living things. Cholera brings about death from the proliferation of bacteria that is struggling to reproduce and grow. This creates noise within the belly. However, death by cholera is supported by multiple reductions: living conditions during migration; lack of clean water; Atlantic shipping companies; and city governments. To deploy or withhold these social infrastructures is an act that exceeds the bacteria. Death by cholera does not exist in a binary system, even though health experts declared the opposite. For Canguilhem, as Foucault explains, the history of science was not the history of the true; rather, it was how “science spontaneously makes and remakes its own history at every instant.”65 He declared how “an idea becomes a biological concept at the moment the reductive effects, which are tied to an external analogy, become obliterated for the benefit of specific

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 273 analysis of the living being.”66 Foucault called Canguilhem a “philosopher of error,” which is why his methods have been helpful for engaging with Malthus and Farr, who both worked with concepts steeped in error. Canguilhem’s project was to not make everything within science relative but to show how all scientific epistemology is historical. Canguilhem declared that medical practices proceeded before medical theories. He is not alone in this method, both Foucault and Althusser extended his inquiry (get on your knees to pray and you will believe in god).67 For my work, the practices of state intervention against cholera were examples of how rationales and theories could be articulated to theorize a disease crisis. Therefore, scientists’ actual practices needed to be disengaged from the problems that were posed. The question becomes, What are the conditions that “make problems formulatable”? For Canguilhem, each discipline had its own temporality and turned around different critical points; disciplinary history “proceeds by ruptures and mutation”; history should be “of the relations among concepts”; and “theories in which [concepts] function appear after the event”.68 From these methods, how the cholera crisis can be isolated can be seen in my schema of this dissertation. Concepts, and rationalities that produce concepts, are deeply specific even within particular geographies. They are never universal truths. However, health experts formulated robust theories of the world as universal truths that further silenced the politics of the disease. The crisis was formulated, demarcated, and understood under the banner of truth through the conceptual pairings outlined above, but these formulations occurred after the events and practices took place. Once the ideas became formulated, they could be deployed as models. The outcomes became population-level eugenics and national vitality, in part due to the incorporation of practices based on economics rationality and the decline of international epidemics. Health is silence. Cholera is noise. This reversal against health and for noisy cholera hopefully makes a case against the dangers of purity, efficiency, equilibrium, and scarcity. The reversal attempts to articulate an argument against disease as a “positive evil”. Science and positivism were not the solutions. Depoliticized activity to eliminate the source of disease was inherently dangerous, because a silence merely swaddled the systems that increased precariousness. In the economy, silence is equilibrium and an efficient rate of growth: a fictional luxury for some who do not feel the pain of capitalism. Cities were deemed a crisis because they built upon excess and superfluity. Within these fears of proliferating life, the city became formulated as a health crisis. State violence lurked within the activities that sought to control and silence

Reversing the Politics of Life and Death | 2010 | Paul Jackson | 274 supposedly harmful processes within the economy and urbanization. The formulation of the crisis produced landscape changes; infrastructures to institute economic and biological balance; and science based on fear and synecdoche. Within politics of life and death, dealing with crises stifled the noise and naturalized misery. Within these silent social relations, an opening was ripe for capital intervention. The politics of life and death made cholera and disease appear to be devoid of social relations. The politics of life and death made cholera “evil” to begin with. My goal has been to reveal this world of appearances to be modes of dissemblance, alienation, and exploitation.69 As Butler asks, “[A]t which point does ‘decision’ emerge as a relevant, appropriate or obligatory act?”70 Within the politics of crisis, making decisions was necessary, frequently not up for public debate. I have followed positivist or scientific political assumptions declaring the problem of disease could be solved through research and expertise. The experts lived out the thought that disease can be eliminated, crisis can be avoided, and death can be cheated. These were false dreams. The dream of the silence of bowels led to the muffling of poverty. De- politicization came under the banner of health because the equilibrium health experts dreamed of was at risk of becoming overrun by proliferating life. Finally, this conclusion hopes to shed light on what to fight for politically in the landscape of disease and from what position to build viable support. While deeply respectful of the politics of survival and the right to urban life71 as necessary interventions, I am ambivalent about basic needs as a source of politics. Bare life, survival, and needs, these seem to be necessary but perhaps limited calls for solidarity, still restricted to an economy of scarcity and balance. Instead, I wonder about the struggle over the excess of life, or the right to excess (which may be more akin to a struggle over the surplus value). The fears outlined above—fear of the city, fear of the immigrant, and fear of emerging diseases—still persist. To write against the politics of crisis leads me to claim that health must be seen as a luxury within the politics of survival. From the above reversals, health is not a “good”, rather a loudly debated collective social relation. Accordingly, to build an anti-crisis politics requires that we not be afraid of the future or of death. An anti-capitalist, anti-crisis, anti-purity movement would share the burden of disease. Survival must be seen as a collective project because fighting precarity requires a large social network of hands. These reversals are merely the first step. The next step is discovering the technological means to shift social relations. For disease and health, this means rebuilding the life sciences with its ideology on its sleeve and with the shared recognition that all bodies are frail and eventually decay.

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Endnotes

1 Dr. Wild, “The Visible and The Invisible,” Evening News, November 7, 1892, 2. This article was a direct reprint of the reverend’s speech. The piece ended with a notice that the following Sunday morning and evening Dr. Wild would preach to medical students. I love this quote because it echoes both the very academic actor-network theory, and the very popular book The Secret (which I despise). After reading this quote, Christian Anderson asked, what work did cholera perform? This conclusion attempts to answer that question. 2 To be more specific in this intervention, cholera has no agency outside of its social context nor its position in a larger assemblage. I am being a fairly polemical against the power given to diseases by many authors, or what the actor network theory folks would call the “actant”. Granted, cholera is an actor, but is not the same as the scallop or Pasteur’s yeasts. Instead of merely implementing this method, I take a very diluted version of actor network theory. For a more nuanced, and a bit more respectful, approach to actor network theory, see Noel Castree, "False Antitheses? Marxism, Nature and Actor-Networks," Antipode 34, no. 1 (2002). 3 For more on the normal and pathological, see Georges Canguilhem, The Normal and the Pathological (New York: Zone Books, 1989). Canguilhem inspired Foucault, and in terms of the normal and the pathological in Foucault’s writing and theorizing, he also builds on Nietzschean reversals. In terms of the discipline of medical geography see Chris Philo, "A Vitally Human Medical Geography? Introducing Georges Canguilhem to Geographers," New Zealand Geographer 63, no. 2 (2007). Philo has done substantial work in parsing out the differences between medical geography and health geography, along with the movement away from diseases and medical objects. He suggests Canguilhem’s relational understanding of sickness—“disease is normal, there is nothing abnormal about it”—can work towards “a regional geography of human bodies-in-transition”. Additionally, in thinking through my theoretical engagement with this material I found Gibson-Graham’s working of Sedgwick of weak theory helpful, see J.K. Gibson-Graham, A Postcapitalist Politics (Minneapolis: University of Minnesota Press, 2006). Also the discussion of minor history in Ann Laura Stoler, Along the Archival Grain : Epistemic Anxieties and Colonial Common Sense (Princeton: Princeton University Press, 2009). 4 Here I am specifically referencing Bruno Latour, Pandora's Hope : Essays on the Reality of Science Studies (Cambridge, Mass.: Harvard University Press, 1999). 5 Kaushik Sunder Rajan, Biocapital : The Constitution of Postgenomic Life (Durham: Duke University Press, 2006). Catherine Waldby, "Stem Cells, Tissue Cultures and the Production of Biovalue," Health 6, no. 3 (2002). Catherine Waldby and Robert Mitchell, Tissue Economies : Blood, Organs, and Cell Lines in Late Capitalism, Science and Cultural Theory (Durham, N.C.: Duke University Press, 2006). Melinda Cooper, Life as Surplus : Biotechnology and Capitalism in the Neoliberal Era (Seattle: University of Washington Press, 2008). Nikolas Rose, "The Politics of Life Itself," Theory, Culture and Society 18, no. 6 (2001). For a critique of Rose, see Bruce Braun, "Biopolitics and the Molecularization of Life," Cultural Geographies 14, no. 1 (2007). 6 Michael Dillon and Luis Lobo-Guerrero, "The Biopolitical Imaginary of Species-Being," Theory Culture Society 26, no. 1 (2009): 7. I think a major influence of this piece comes from Giorgio Agamben, Profanations (New York, NY: Zone Books, 2007). Particularly the chapter entitled “Species Being”. Agamben follows how “species” has a root in biology, but also in the language of commerce in commodities and money. While this is evocative, I wonder how much emphasis is placed the associations around the word ‘species’, and not in the practices of biology and the economy. 7 I think my critique here bleeds into the Marxist attack on Hegel, who said that all conflict is resolved in thought, and the postmodern attack on Hegel is all conflict is resolved at synthesis and mediation. I think this very general summary comes from Zizek but I could be wrong. However, I haven’t read Hegel so this is a bit of a red herring. But essentially, for me, resolving conflict in thought or synthesis is both a dead end and problematic. 8 While I am not anti-theory or anti-philosophy, I can’t help recalling Marx’ highly repeated phrase from Theses On Feuerbach that “philosophers have only interpreted the world…the point is to change it”. Granted, to change social relations one needs to understand them. 9 Kaushik Sunder Rajan, "Subjects of Speculation: Emergent Life Sciences and Market Logics in the United States and India," American anthropologist. 107, no. 1 (2005): 21. 10 Ibid.: 27. 11 To be honest, I have also struggled with a similar form of thinking based on association-equivalence. Therefore I am highly cognizant of historical specificity of making statements. Concepts cannot be ripped apart from the ‘who, how, and where,’ these statements are uttered. I would think both Foucault and Marx would agree with this point. 12 Timothy Mitchell, "Rethinking Economy," GeoForum 39, no. 3 (2008). Philip Mirowski, Against Mechanism : Protecting Economics from Science (Totowa, N.J.: Rowman & Littlefield, 1988). Bruce Braun, "Towards a New Earth and a New Humanity," in David Harvey: A Critical Reader, ed. Noel Castree and Derek Gregory (Malden, MA: Blackwell, 2006). The Regulation School also works against this tendency see Bob Jessop, "Survey Article:

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The Regulation Approach," The Journal of Political Philosophy 5, no. 3 (1997). Robert Boyer, The Regulation School: A Critical Introduction (New YOrk: Columbia University Press, 1990). 13 Richard J. Evans, "Epidemics and Revolutions: Cholera in Nineteenth-Century Europe," Past & Present, no. 120 (1988): 145. 14 See the chapter by Hutchisson called “Arrowsmith and the political economy of medicine”, in James M. Hutchisson, Sinclair Lewis : New Essays in Criticism (Troy, N.Y.: Whitston Pub. Co., 1997), 116-124. 15 The medical profession did not have the financial means to support hospitals, medical education, and research. While hospitals relied on charity from local wealthy elites, medical research required more money and hence became funded by a wealthy class that took the national stage. For long-term investments the Rockefeller Institute predominated in the United States, see E. Richard Brown, Rockefeller Medicine Men : Medicine and Capitalism in America (Berkeley: University of California Press, 1979), 101. 16 Within the Rockefeller organization, Fredrick T. Gates was the main proponent for financial investment in medical science. This came about after he read the work of the Canadian doctor William Osler in 1897. Gates realized the immense potential existing, in the then underfunded medical research sector. He compared the existing benefits that had already arisen from the Koch and Pasteur institutes, and projected what returns could be achieved with substantial corporate funding. For my larger argument, Gates’ imagination of disease and crisis echoed the zymosis synecdoche imagination (see chapter 6). In a letter to Rockefeller he pondered how, in his words: the body is a microcosm of society; he comparing body immunity to fire engines rushing to the problem; nerves were like telephone wires; the body had a police system and a sewer system; he called each cell a small chemical laboratory; and each organ were great manufacturing centres that made products to supply districts. (Ibid., 120-121.) 17 During this period Rockefeller’s Medical Research Institute had major influence on the direction of health and science. However, it was also criticized in the United States, most famously in Sinclair Lewis, Martin Arrowsmith (Hamburg: Albatross, 1935). Lewis’s book was written with Paul De Kruif who had been fired from Rockefeller for disloyalty. This book looked at class struggle through medicine-based social relations. The story follows the main character from working at the university, to a public health official, to medical clinic, and finally a private research organization that did research in the West Indies. At each stage, as the narrative proceeds, science could alleviate suffering, however instead science is used to serve corporate ends. The novel takes place during the period from 1905 to 1925. The main character is pure ambition, under the lure of German scientific methods in the U.S., however the protagonist doesn’t care about money, only science and discovery. The book fetishizes lab work. The Rockefeller Foundation Institute for Medical Research was the basis of the book’s McGurk Institute. The owner of the Institute’s wife was named “Capitola”. Rich philanthropy only existed to aggrandize itself. When the U.S. entered the war the Institute head rushed to the war department to offer it’s services and worked to produce bio- weapons. The book discusses how value was appropriated by the Institute: “the basic aim of this Institution is the conquest of disease, not making pretty science notes!” says the head of the institute to the scientist (Lewis, Martin Arrowsmith, 345.). The scientist needed to think about broader humanity which meant practical results: “Efficient universal co-operation – that’s the thing in science to-day—the time of this silly, jealous, fumbling individual research has gone by.” (Lewis, Martin Arrowsmith, 346.) Then later: “This is no longer an age of parochialism but of competition, in art and science just as much as in commerce – co-operation with your own group, but those outside it, competition to the death!” There was a strong push to cure something, but never about doing science. For more, see Hutchisson, Sinclair Lewis : New Essays in Criticism. 18 For the political sociologist Bob Jessop, an accumulation strategy is a particular type of growth model. A growth model finds success when different moments in the circuit of capital are unified under the hegemony of one faction, whose composition will vary depending on the stage of capitalist development. In my case, U.S. venture capital combined with the state to support relations between universities, laboratories and health expertise. For Jessop, the successful elaboration of this strategy can be seen in the form of an economic hegemony, or when this work returns to the production process itself. Economic hegemony is achieved when both economic leadership and the accumulation strategy is generally accepted. Jessop says “Such a strategy must advance the immediate interest of other factions by integrating the circuit of capital in which they are implicated at the same time it secures the long- term interests of the hegemonic faction in controlling the allocation of money capital to different areas of investment advantageous to itself.” (Bob Jessop, State Theory : Putting the Capitalist State in Its Place (University Park, Pa.: Pennsylvania State University Press, 1990), 199.) A stable framework is created, but it is not arbitrary stabilized, rather the framework forms within historical and geographic constraints. Jessop grants there is a role for the state, but it must be and must be accepted by all classes. My intervention is to focus on how health achieves this consent by making universal ideological claims—healthy workers, healthy economies—but also through particular forms and practices, such vaccines. 19 In 1885, the Ontario Vaccine Farm started the production of biological responses to infectious disease. This project was partly funded by the Ontario Provincial Board of Health. However, health practitioners and local health

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boards also supported this work through direct payments for these biologicals. The Vaccine Farm, in the small town of Palmerston, was able to produce smallpox vaccines for the Ontario market. Dr. Bryce and others on the Provincial Health Board didn’t want to rely on imported vaccines from Quebec or other nations. Just as cholera spurred urban reform, smallpox spurred vaccine production, for more see Alexandra Minna Stern and Howard Markel, "The History of Vaccines and Immunization: Familiar Patterns, New Challenges," Health Affairs 24 (2005). Smallpox vaccination had been going on in England since the early 1800s. In 1801 more than 100,000 had been vaccinated. But the demand for vaccines overwhelmed production. Moreover, vaccines were unreliable, in terms of the sterility, potency and preservation. The creation of the Ontario Vaccine Farm was in direct response to a smallpox outbreak in Montreal, but also to have a local Ontario source of vaccines for the future. By 1895 Dr. Bryce was already criticizing the farm for the lack of standards, calling for a centralized government facility with newer methods of production. Simultaneously, he was not very enthusiastic over the added work for the board and the financial burden to create such an institution. I think this financial burden argument is actually quite key. It shows either Bryce only cared about money when coming out of his budget, or he thought vaccines was a waste of money. However, by 1910 Bryce had changed his mind. By that period he was working on national scale and pushed for a laboratory to rival the “Rockefeller at Washington or the Marine at New York, or the laboratories at Cambridge and Boston,” see Conservation Canada. Commission of and Conference Dominion Public Health, Second Annual Report : Including a Report of the Proceedings of the Second Annual Meeting Held at Qubec, January 17-20, 1911 and of the Dominion Public Health Conference Held at Ottawa, October 12-13, 1910 (Montreal: John Lovell & Son, 1911), 164, 205-212. Either way the province did not invest in vaccine production. By 1906, Ontario was still importing the bulk of their vaccines. The Vaccine Farm operated until 1916, when the provincial production was completely taken over by the Connaught Laboratories. This shift in production represented a new generation of health experts were taking the reigns of a shifting state health institutional complex. This was a summary of the much more detailed account in W.B. Spaulding, "The Ontario Vaccine Farm, 1885-1916," Canadian bulletin of medical history 6, no. 1 (1989). 20 Conservation Canada. Commission of, "Recommendations of Dominion Public Health Conference," Conservation of life. 1, no. 1 (1914): 40-43. 21 Diphtheria was the disease that spurred the creation of the Connaught Laboratories in Toronto. Much of this push came from a bacteriologist called Dr. John Gerald Fitzgerald. Fitzgerald was well educated, schooled at John Hopkins, Harvard, L’Institute Pasteur, University of Freiberg, and by 1911 he was working at the University of California at Berkley as Associate Professor of bacteriology. He also had connections with New York City’s Health department. This history has been documented in David Anthony Blancher, "Workshops of the Bacteriological Revolution : A History of the Laboratories of the New York City Department of Health, 1892-1912" (s.n.], 1979). However, the history of laboratories in the United States is markedly different than Canada, see Victoria Angela Harden, "Toward a National Institute of Health : The Development of Federal Biomedical Research Policy, 1900- 1930" (1985). In the U.S. laboratories were pushed but were also dependent, to quote Winslow, "As members of this Laboratory Section, we must see that the public understands what the public health laboratory can accomplish both in city and in state. We must ask insistently for the funds needed for its fundamental work; and so soon as the facts are understood we shall obtain the support we need.” C.E. Winslow, "The Laboratory in the Service of the State," American journal of public health (New York, N.Y. : 1912) 6, no. 3 (1916): 233. 22 In Canada, the state health boards experts only started their coordinated push for vaccine production at the 1910 Dominion Public Health Conference. Canadian and Provincial health officers met at the invitation of, and in conjunction, with the Public Health Committee of the federal Commission of Conservation. One of the first demands articulated was a permanent national council of health to be established. This was not new, for more than thirty years health experts had been pushing for a federal health board. The second demand was the founding of a National Public Health Laboratory to manufacture “sera, vira, vaccines, toxines, anti-toxines and other similar products”. (Canada. Commission of, "Recommendations of Dominion Public Health Conference," 65.) The rationale was a national laboratory would engage in medical research, because when “newer communicable diseases to be found on this continent, our only source of information and our only authority to which we can turn for guidance and direction is to the laboratories of the Public Health and Marine Hospital Service at Washington.” (Quoted from Canada. Commission of, "Recommendations of Dominion Public Health Conference," 40-43.) This U.S. laboratory would have long term effects in different forms of state health as it would become the National Institute of Health, see Harden, "Toward a National Institute of Health : The Development of Federal Biomedical Research Policy, 1900-1930". Victoria Angela Harden, Inventing the Nih : Federal Biomedical Research Policy, 1887-1937 (Baltimore, Md.: Johns Hopkins University Press, 1986). 23 Paul Adolphus Bator and Andrew James Rhodes, Within Reach of Everyone : A History of the University of Toronto School of Hygiene and the Connaught Laboratories (Ottawa: Canadian Public Health Association, 1990), 19-20.

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24 During the First World War, the army demanded a large supply of tetanus antitoxins. In 1915 a grant from the Department of Militia and Defence transformed Fitzgerald’s laboratory with a major expansion to produce over 250,000 antitoxins, including also smallpox vaccination. The era between 1914-1918 was the first large-scale immunization program in Canada. To help in their war effort, the laboratory received the donation of 58 acres of land to use and the funds to construct the much larger laboratory. On this land the new Connaught Antitoxin Laboratories and University Farm was opened on October 25, 1917. Fredrick T Gates, the Director of the Rockefeller Institute of Medical Research in New York City attended this opening. The Connaught lab joined the war effort (as Dr. Amyot worked abroad and Dr. Fitzgerald in Canada) and became part of the military health division to institute practices like sanitizing water and utensils, along with troop disinfection procedures. Fitzgerald pushed for vaccination for smallpox and typhoid, and created vaccinations ‘parades’ where all officers and soldiers would publically get vaccinated together. He also used the military to do tests and take samples, especially extensive research on venereal disease. After the war, a stronger and renewed call for national health was pushed for, with claims that more than half of the recruits were physically unfit. When the war ended the 1918 influenza epidemic hit. The Connaught lab worked to produce an antitoxin for the flu. After the passing of influenza, within months the federal government passed an act to create a Department of Health in 1919, and Amyot was on the board. The Dominion Council of Health was put together to make up for the fragmented provincial health systems and included the chief medical officer of every province and five others representatives from labour, women, farmers and medical educators. The first meeting was in 1920 and importantly this new group looked to move beyond communicable diseases and into pediatrics, obstetrics, hospitals and industrial health. (Ibid., 23-25.) 25 Ibid., 29-30. This was one instance of the much larger push to fund medical research and medical education throughout Canada, for more see Jeffrey D Brison, Rockefeller, Carnegie, and Canada : American Philanthropy and the Arts and Letters in Canada (Montreal: McGill-Queen's University Press, 2005). Rockefeller was not alone in the investment in universities and higher education. A key document was Abraham Flexner, Medical Education in the United States and Canada, a Report to the Carnegie Foundation for the Advancement of Teaching, with an Introd. By Henry S. Pritchett (New York: 1910). Since 1904 Rockefeller Institute for Medical Research had been the leader for research in the United States. For more, see Winslow, "The Laboratory in the Service of the State." Blancher, "Workshops of the Bacteriological Revolution : A History of the Laboratories of the New York City Department of Health, 1892-1912". But also see the remarkably similar book chapter to Blancher’s dissertation: Elizabeth Fee and Evelynn Hammonds, "Science, Politics and the Art of Persuasion: Promoting New Scientific Medicine in New York City," in Hives of Sickness : Public Health and Epidemics in New York City, ed. David Rosner (New Brunswick, N.J.: Published for the Museum of the City of New York by Rutgers University Press, 1995). In Toronto Fitzgerald’s Connaught labs became a North American version of laboratory research institute: the intersection between German methods and labs, French institute structure, and university research schools. While these relations had been loosely assembled since the 1880s, corporate funding solidified them. The Connaught lab paralleled what had happened in New York City, with similar experimentation against diphtheria and attempts to give away cures. But both laboratories ended up as profit making, or profit dependent, institutions. In Toronto and New York City these vaccine experiments were underfunded by the state. In New York City Rockefeller stepped up to fill that funding vacuum in 1906 and started giving out grants to city services like the New York City health department. It took until the early 1920s for the medical experts in Toronto to be brought into Rockefeller’s circuit of capital. 26 A complete return to the primary takes a very long time. For example the Connaught Labs were privatized completely in the 1978, bought by Sanofi-Pasteur, the vaccines division of Sanofi-Aventis Group. 27 Harvey frames this term as “what Marx calls ‘fictitous capital’ – money that is thrown into circulation as capital without any material basis in commodities or productive activity”. This is problematic because it has no material basis, but also its distinctive power is its search for material basis, see David Harvey, The Limits to Capital (London; New York: Verso, 2006), 95. 28 Harvey says, “Since the state is a general field of class struggle, it becomes impossible to discern directly which flows of value under its aegis represent the immediate needs of capital and which result from pressures exerted by other classes.” David Harvey, The Limits to Capital (Chicago: University of Chicago Press, 1982), 401. 29 I will give a brutally simplistic overview of the historical record. My material starting point has been the biological entity of cholera and a global epidemic that ensued. This had with no value to the primary circuit of capital. The above is a rough outline in how is ‘non-value’ cholera was brought into the state apparatus as an active moment. The state coordinated this crisis into something manageable: a form of preventative medicine. This both created and reworked: existing institutional apparatus in order to prevent future crises; to ensure the reproduction of labour in cities; the smooth movement of trade with disinfection and quarantine; and, additionally, paths opened up

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for investment for the private sector, that over time became a biomedical-industrial complex. The biomedical model of health both reproduced labour and became a platform for new forms of accumulation. 30 George Henderson, "'Free' Food, the Local Production of Worth, and the Circuit of Decommodification: A Value Theory of the Surplus," Environment and Planning D: Society and Space 22 (2004): 501-502. 31 Ibid.: 491. 32 Karl Marx, Capital : A Critique of Political Economy. Vol. 1, ed. Ben Fowkes and Ernest Mandel (Harmondsworth: Penguin in association with New Left Review, 1990), 776. I must say I am worried that I have de-contextualized this quote from his larger work. 33 How the processes and relationships between urban form and superfluity intersect requires much more work than I have the space to do here. For urban form, Mbembe’s architecture of hysteria is an important contribution. In that this architecture “aims to return to ‘archaic’ as a way to freeze rapid changes in the temporal and political structures of the surrounding world.” Achille Mbembe, "Necropolitics," Public Culture 15, no. 1 (2003): 403. The process of freezing fear into built forms, or permanencies, is promising avenue to pursue. However, the term hysteria is problematic for so many reasons (see the history of medicine and gender), and I don’t think the term gets him where he wants to go. The connotation of irrationally masks how many of decisions are based on so-called rational processes. 34 This quote actually is cited by Bataille, however I cannot find where Marx first said this and therefore I cannot confirm that he wrote this. The quote comes from: Georges Bataille, Visions of Excess : Selected Writings, 1927- 1939, ed. Allan Stoekl (Minneapolis: University of Minnesota Press, 1985). 35 In Foucault’s thinking, power is “the reverse of the right of the social body to ensure, maintain, or develop its life”; power as “the right to intervene in the making of life”, see Ann Laura Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things. (Durham: Duke University Press, 1995), 83. 36 These writers provided a ‘shock to my thought’ that became extremely helpful to articulate my project, so it would be disingenuous to exclude them. But how this ‘shock’ was done is still a little mystifying, so I ask for some patience as I walk through the some of my re-thinking. A caveat: these reversals are not necessary in order to explain my archive as a historical project. I find the discussion useful to broaden and reframe my project. 37 “The urban world is a cyborg world, part natural/part social, part technical/part cultural, but with no clear boundaries, centers, or margins.” In Nik Heynen, Maria Kaika, and Erik Swyngedouw, In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, Questioning Cities Series (London; New York: Routledge, 2006), 12. Matthew Gandy says that cyborg urbanization is a hybrid of machine and organism. Accordingly, urban infrastructures are a vast life support system. Gandy suggests the metaphor is “a useful way of extending existing conceptions of nature in cities by emphasizing the physical vulnerability of the human body as part of a hierarchy of larger-scale social and metabolic systems” Matthew Gandy, "Cyborg Urbanization: Complexity and Monstrosity in the Contemporary City," Sage Urban Studies Abstracts 34, no. 2 (2006): 9. Graham highlights how this perspective is militarily strategy, but he does so by taking as starting point Swyngedouw and Kaika’s intervention that “technological networks (water, gas, electricity, information etc.) are constitutive parts of the urban. They are mediators through which the perpetual process of transformation of Nature into City takes place”, see Stephen Graham, "Urban Metabolism as Target," in In the Nature of Cities : Urban Political Ecology and the Politics of Urban Metabolism, ed. Nik Heynen, Maria Kaika, and Erik Swyngedouw (London; New York: Routledge, 2006), 246. Haraway has a markedly different project. For Haraway there are not pure things. She calls nature one of the impossible things we cannot desire. Haraway declares the boundary between human and animal has been thoroughly breached, so there is a leaky distinction between animal-human and machine, Donna Jeanne Haraway, Simians, Cyborgs, and Women : The Reinvention of Nature (New York: Routledge, 1991), 296. After this breach there is neither biological nor technological determinism. However, the cyborg is not a call to freedom. The cyborg world is the final imposition of a grid of control. The cyborg world is about lived social and body realities, where people are not afraid of their joint kinship with animals and machines. Cyborgs embrace permanently partial identities and contradictory standpoints. Haraway sees potential here as a political form that manages to hold together “witches, engineers, elders, perverts, Christians, mothers, and Leninists long enough to disarm the state”, see Haraway, Simians, Cyborgs, and Women : The Reinvention of Nature, 154-155. Haraway declares that: “The cyborg is a condensed image of both imagination and material reality, the two joined centres structuring any possibility of historical transformation.” Her manifesto is “an argument for pleasure in the confusion of boundaries and for responsibility in their construction”. In Haraway, Simians, Cyborgs, and Women : The Reinvention of Nature, 150. 38 Haraway, Simians, Cyborgs, and Women : The Reinvention of Nature, 176. 39 Ibid., 72. Haraway calls for a reinvention of nature, that is not a reinvention of ourselves. In this conclusion I follow this move by taking apart what constitutes a ‘healthy’ human nature.

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40 Ibid., 74. 41 Ibid., 78-79.The fictional nature of science proposes ‘real facts’ in repeated unexamined contradictions around evolution and nature. Accordingly, the power of naming a thing is the power of objectifying or totalizing. 42 Henri Lefebvre, The Urban Revolution (Minneapolis: University of Minnesota Press, 2003), 66-67. 43 Georges Bataille provides another reversal of the politics of life and death, but he also provides some structure in this method of argumentation. He is quite fitting for my theorizing of cholera as he was derogatorily called an “excremental philosopher”, as a contemporary of his insulted him. For more, see the introduction to Bataille, Visions of Excess : Selected Writings, 1927-1939. The point is not to correct or reverse the hierarchy, rather to abolish the hierarchy. Bataille embraces the reality of death, yet he is not for death. Bataille is polemical, defiantly outrageous and inherently sacrilegious. For Bataille the act of a reversal does not look to replace god with filth, rather the fall of the god destabilizes the allegories and imaginations that support hierarchies. The goal is towards incessant fall, or as I would frame this goal as continuous critique. Nothing is sacred. In Bataille, Visions of Excess : Selected Writings, 1927-1939, xiv-xv. Stoeki suggests that Bataille critique of the elevated is “an attempt to see irreducibly ‘base’ matter in the context of Marxist revolution. Base materialism, unlike pragmatic or functionalist theories of materialism, does not pass beyond the matter in the construction of a ‘scientific’ conceptual edifice. (A materialism that generates abstract “laws” is in complicity with idealism)”. Bataille says: “When the word materialism is used, it is time to designate the direct interpretation, excluding all idealism, of raw phenomena, and not a system founded on the fragmentary elements of an ideological analysis, elaborated under the sign of religious relations.” In Bataille, Visions of Excess : Selected Writings, 1927-1939, 16. 44 Canguilhem, The Normal and the Pathological, 148. 45 Nikolas Rose, "Life, Reason and History: Reading Georges Canguilhem Today," Economy and Society 27, no. 2/3 (1998): 164. 46 My object of proliferating life became articulated through putting my archive in conversation with Bataille, Mbembe, Marx and Foucault and their processes including excess, superfluity, and surplus population. 47 I have tried to articulate proliferating life in variety of ways. There is the movement here between the possibility of surplus value and its debasement, which then can be planned for and stabilized. The problem is an excess of life, but the wrong kind of life. The wrong kind of life is that which can neither be incorporated nor channeled into capital or the state. The excess has the potential to be unruly. This feared unruliness could take place on many registers: the cell, the city, mobs, immoral people. The existence of excess is feared because the potential for growth, un-manageable surplus, uncontrollable proliferating-life. Those who are ‘let to die’ become those groups and aggregations seen as unruly proliferating-life. The term superfluous life could be more invocative for my project. 48 Mbembe, "Necropolitics," 16. 49 Achille Mbembe helps me to summarize Bataille’s concept of death. Bataille withdraws death “from the horizon of meaning”. For Bataille, death encompasses the power of proliferation. Death exists within excess and luxury because death has the potential for unlimited expenditure. Finally, death has become correlated to sovereignty and sexuality and their attendant taboos. “Death is an anti-economy.” Mbembe summarizes Bataille work with death in three ways. [a] Bataille withdraws “death from the horizon of meaning” saying “death is the most luxurious form of life, that is, of effusion and exuberance: a power of proliferation”. For Bataille, life is defective only when death has taken it hostage. Life itself exists only in bursts and in exchange with death. Death destroys what was to be. However, death is not the pure annihilation of being. [b] Bataille firmly anchors death in the realm of absolute expenditure. Life beyond utility, says Bataille, is the domain of sovereignty: “death is therefore the point at which destruction, suppression, and sacrifice constitute so irreversible and radical an expenditure—-an expenditure without reserve-—that they can no longer be determined as negativity. Death is therefore the very principle of excess--an anti-economy. Hence the metaphor of luxury and of the luxurious character of death.” [c] “Third, Bataille establishes a correlation among death, sovereignty, and sexuality. Sexuality is inextricably linked to violence and to the dissolution of the boundaries of the body and self by way of orgiastic and excremental impulses. As such, sexuality concerns two major forms of polarized human impulses—-excretion and appropriation—-as well as the regime of the taboos surrounding them. The truth of sex and its deadly attributes reside in the experience of loss of the boundaries separating reality, events, and fantasized objects.” (Ibid. p.15.) Admittedly when I came across the statement that “Death is an anti-economy” I had trouble wrapping my head of what constituted an “anti- economy” and hence this was a shock to my thinking. One way the anti-economy could be framed as how profiting off death can never be declared nor admitted, even when such profiteers are faced of evidence. As death is a necessary part of being alive and attempts are made to quantify and value the loss of life, death is beyond measurement and is always exceeded, even despite feeble attempts by the insurance industry. Mbembe interprets “death and sovereignty as the paroxysm of exchange and superabundance—or to use [Bataille’s] terminology:

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excess”. For Bataille, death is “the most luxurious form of life, that is, of effusion and exuberance: a power of proliferation”, see Mbembe, "Necropolitics," 15. 50 Mbembe, "Necropolitics," 14. 51 Ibid.: 379. The term superfluous refers to the indispensability and expendability of “both labour and life, people and things.” Mbembe connects superfluous to Marx’ capitalism, which, he posits, is never merely production and consumption, but also requires flow, motion, and circulation. For Marx the objects that represent superfluity serve the needs of circulation only and are linked to the sphere of “satisfactions and enjoyment”. Mbembe claims this sphere of superfluity as a complex arena of social relations central to urban daily life, along with luxury, rarity, and spectacle, yet beyond poverty and necessity. Mbembe relies on Simmel and states that “the ultimate form of superfluity is the one that derives from the transitoriness of things, their floating “with the same gravity in the constantly moving stream of money”. (Mbembe, "Necropolitics," 399.) Superfluity and the commodity are intertwined because in those commodities “which ha[ve] the least utility as an objection of consumption or instrument of production” happen also “to best serve the needs of exchange as such”. He suggests that commodities or forms of labour-power that have no inherent use-value might still be productive, if the needs of exchange are served. In these spaces, exchange and use value may become confused and bewildered. In this bewilderment meaning is emptied, such as the numerical representation of population and wages. These numbers are fact and fantasy, at the same time. Mbembe relates this to the urban form. Mbembe introduces a parallel term of superfluity in his explanation of Jo-burg as a racial city and its transition to a metropolis, see Achille Mbembe, "Aesthetics of Superfluity," Public Culture 16, no. 3 (2004): 374-375. The undistinguishable nature of the fact and numbers builds upon Mary Poovey, A History of the Modern Fact: Problems of Knowledge in the Sciences of Wealth and Society (Chicago: University of Chicago Press, 1998). 52 Mbembe works through excess and proliferation by examining how spaces—boundaries, hierarchies, and zones—are produced in response to urban excesses. He makes the claim that modern cities were founded in the sphere of superfluity. Again, Mbembe’s case is Johannesburg, in the context of colonial occupation in South Africa. My use of these ideas here is not to say that cities such are Toronto and Johannesburg are equivalent, rather to question what produces these processes of superfluity, along with who gains or profits from their management. 53 Mariana Valverde, The Age of Light, Soap, and Water : Moral Reform in English Canada, 1885-1925 (Toronto: McClelland & Stewart, 1991), 109. 54 Michel Foucault, Society Must Be Defended : Lectures at the College De France, 1975-76, ed. Mauro Bertani, et al. (New York: Picador, 2003), 255. Foucault was concerned with state racism, but not in its popular forms. Stoler summarizes this, as “[r]acism is a state affair, confirmed by a set of scientific discourses that bear witness on it”, in Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things., 28. For Foucault, degeneracy was an instrumental vehicle for bourgeois empowerment. However, for historians like Daniel Pick degeneracy was fear and anxiety. I actually don’t see this degeneracy debate as either/or. In terms of the experts I follow, degeneracy was fear, but providing solutions to those fears led to, perhaps not empowerment, but maybe something akin to entitlement. For more on degeneracy, see Daniel Pick, Faces of Degeneration : A European Disorder, 1848-1918 (Cambridge: Cambridge University Press, 1989). 55 Stoler, Race and the Education of Desire: Foucault's History of Sexuality and the Colonial Order of Things., 68. 56 Geoffrey Bilson, A Darkened House: Cholera in Nineteenth-Century Canada, Social History of Canada, 31 (Toronto; Buffalo: University of Toronto Press, 1980), 175. This combination of science and social progress in summarizes by Dr. Strokes in 1872: “What an opportune moment to apply all those scientific forces to preventative medicine and consequently in the social order! There are hundreds of millions of subjects of the Crown of England, whose domestic habits seem to be scarcely above those of the lower animals, and an enormous field of misery, physical and moral degradation, and a constant source of destruction that may extend to the confines of the earth and return back against the west, where the noblest race of men is to be found.” In Bruno Latour, The Pasteurization of France (Cambridge, Mass.: Harvard University Press, 1988), 17. 57 Erin O'Connor, Raw Material : Producing Pathology in Victorian Culture, Body, Commodity, Text (Durham, N.C.: Duke University Press, 2000), 49. This is a much wider discussion that I cannot go into here, but some I have mentioned such as Anne McClintock, Imperial Leather : Race, Gender, and Sexuality in the Colonial Contest (New York: Routledge, 1995). Additionally, see Lee D. Baker, From Savage to Negro : Anthropology and the Construction of Race, 1896-1954 (Berkeley: University of California Press, 1998). Mary Douglas, Purity and Danger : An Analysis of Concept of Pollution and Taboo (New York Routledge, 2005). Warwick Anderson, Colonial Pathologies : American Tropical Medicine, Race, and Hygiene in the Philippines (Durham: Duke University Press, 2006). Keith Wailoo, Dying in the City of the Blues : Sickle Cell Anemia and the Politics of Race and Health, Studies in Social Medicine (Chapel Hill: University of North Carolina Press, 2001). Barbara Miller Solomon, Ancestors and Immigrants, a Changing New England (Univ Of Chicago Press, 1972). Susan Craddock, City of Plagues : Disease, Poverty, and Deviance in San Francisco (Minneapolis: University of Minnesota Press,

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2000); Sandra Harding and Gerard Fergerson, "The "Racial" Economy of Science: Toward a Democratic Future," Isis. 86, no. 1 (1995). Science’s role in these processes should not be forgotten. As Wright remarks that both Butler and Marx have the common thread in that “matter is always being produced; it has no terminus, only the appearance of such”. For Wright, Butler’s work “reveals the constant whir of processes behind the creation of bodies as stable material entities”, in Melissa W. Wright, "A Manifesto against Femicide," Antipode 33, no. 3 (2001): 561. In my research, the experts attempted to understand the processes that produced sick bodies. But the matter produced, for proliferating life, was invisible and circulated, but could still be isolated. This evil was invisible and internal to the smallest particles of the human body, but also an external, divine or transcendent cause. Therefore these experts attempted to produce stability, of bodies and spaces, from the products of the whir of processes. My question becomes what apparatus persisted and structured the creation of potential sick bodies and future generations. But also those who claimed, in the face of degeneracy, that they could produce a healthy vital national workforce. Both are attempts to produce stable entities. The vision of the future shaped material reality— or material affects were the result of the bond between scientific/medical knowledge shaping social relations. Future threats were materialized in the very way biology was seen. 58 What Bataille’s reversal suggests is to accept excess, proliferation, or death, because to ignore these processes leads to a poverty of life, and a politics based on scarcity and fictional equilibrium. 59 See Nik Heynen, "'but It's Alright, Ma, It's Life, and Life Only': Radicalism as Survival," Antipode 38, no. 5 (2006). 60 Thanks to Jen Ridgley for sending this my way, and the right time. Here is the full quote: “To say that a life is precarious requires not only that a life be apprehended as a life, but also that precariousness be an aspect of what is apprehended in what is living. Normatively construed, I am arguing that there ought to be a more inclusive and egalitarian way of recognizing precariousness, and that this should take form as concrete social policy regarding such issues as shelter, work, food, medical care, and legal status. And yet, I am also insisting, in a way that might seem initially paradoxical, that precariousness itself cannot be properly recognized. It can be apprehended, taken in, encountered, and it can be presupposed by certain norms of recognition just as it can be refused by such norms. Indeed, there ought to be recognition of precariousness as a shared condition of human life (indeed, as a condition that links human and non-human animals), but we ought not to think that the recognition of precariousness masters or captures or even fully cognizes what it recognizes. So although I would (and will) argue that norrns of recognition ought to be based on an apprehension of precariousness, I do not think that precariousness is a function or effect of recognition, nor that recognition is the only or the best way to register precariousness. To say that a life is injurable, for instance, or that it can be lost, destroyed, or systematically neglected to the point of death, is to underscore not only the finitude of a life (that death is certain) but also its precariousness (that life requires various social and economic conditions to be met in order to be sustained as a life). Precariousness implies living socially that is, the fact that one's life is always in some sense in the hands of the other. It implies exposure both to those we know and to those we do not know; a dependency on people we know, or barely know, or know not at all. Reciprocally, it implies being impinged upon by the exposure and dependency of others, most of whom remain anonymous. These are not necessarily relations of love or even of care, but constitute obligations toward others, most of whom we cannot name and do not know, and who may or may not bear traits of familiarity to an established sense of who “we” are. In the interest of speaking in common parlance, we could say that “we” have such obligations to “others” and presume that we know who “we” are in such an instance. The social implication of this view, however, is precisely that the “we” does not, and cannot, recognize itself, that it is riven from the start, interrupted by alterity, as Levinas has said, and the obligations “we” have are precisely those that disrupt any established notion of the “we.” Over and against an existential concept of finitude that singularizes our relation to death and to life, precariousness underscores our radical substitutability and anonymity in relation both to certain socially facilitated modes of dying and death and to other socially conditioned modes of persisting and flourishing. It is not that we are born and then later become precarious, but rather that precariousness is coextensive with birth itself (birth is, by definition, precarious), which means that it matters whether or not this infant being survives, and that its survival is dependent on what we might call a social network of hands. Precisely because a living being may die, it is necessary to care for that being so that it may live. Only under conditions in which the loss would matter does the value of the life appear. Thus, grievability is a presupposition for the life that matters. For the most part, we imagine that an infant comes into the world, is sustained in and by

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that world through to adulthood and old age, and finally dies. We imagine that when the child is wanted, there is celebration at the beginning of life. But there can be no celebration without an implicit understanding that the life is grievable, that it would be grieved if it were lost, and that this future anterior is installed as the condition of its life. In ordinary language, grief attends the life that has already been lived, and presupposes that life as having ended. But, according to the future anterior (which is also part of ordinary language), grievability is a condition of a life's emergence and sustenance. The future anterior, “a life has been lived,” is presupposed at the beginning of a life that has only begun to be lived. In other words, “this will be a life that will have been lived” is the presupposition of a grievable life, which means that this will be a life that can be regarded as a life, and be sustained by that regard. Without grievability, there is no life, or, rather, there is something living that is other than life. Instead, “there is a life that will never have been lived,” sustained by no regard, no testimony, and ungrieved when lost. The apprehension of grievability precedes and makes possible the apprehension of precarious life. Grievability precedes and makes possible the apprehension of the living being as living, exposed to non-life from the start.” Judith Butler, Frames of War: When Is Life Grievable (New York: Verso, 2009). pp. 13-15. 61 Ibid. pp. 13-15. 62 However, the solution to precarity is also problematic for Butler: “Precarity designates that politically induced condition in which certain populations suffer from failing social and economic networks of support and become differentially exposed to injury, violence, and death. Such populations are at heightened risk of disease, poverty, starvation, displacement, and of exposure to violence without protection. Precarity also characterizes that politically induced condition of maximized precariousness for populations exposed to arbitrary state violence who often have no other option than to appeal to the very state from which they need protection. In other words, they appeal to the state for protection, but the state is precisely that from which they require protection. To be protected from violence by the nation-state is to be exposed to the violence wielded by the nation-state, so to rely on the nation-state for protection from violence is precisely to exchange one potential violence for another. There may, indeed, be few other choices. Of course, not all violence issues from the nation-state, but it would be rare to find contemporary instances of violence that bear no relation to that political form.” Ibid. p. 26. Therefore precarious populations inherit the problem of state violence, even though the state has become an important way that surpluses are channeled towards social reproduction. Accordingly, those that are declared unproductive become more deeply intertwined with the uneven exposure to death and illness. The unproductive and the unfit are deemed unworthy of support, even as they are produced by a science structured through Foucault’s racism. 63 Albert Camus, The Plague (New York: Vintage Books, 1991), 75. 64 I. Hacking, "Canguilhem Amid the Cyborgs," Economy and Society 27, no. 2/3 (1998). 65 Canguilhem, The Normal and the Pathological, 15. 66 Ibid., 19. 67 Both Foucault and Althusser picked this up. For the ‘knees and believe’ reference see, Louis Althusser, "Ideology and Ideological State Apparatuses (Notes Towards an Investigation)," in “Lenin and Philosophy” and Other Essays (Monthly Review Press, 1971). For their similarities see, Warren Montag, ""The Soul Is the Prison of the Body": Althusser and Foucault, 1970-1975," Yale French Studies, 88 (1995); Roger Deacon, "Theory as Practice: Foucault's Concept of Problematization," Telos 118 (2000). Both Althusser and Foucault were philosophers, yet neither looked to create a tradition or system of thought, such as Cartesian thinking. Instead both looked at how specific systems of thought or concepts functioned in specific historical conjunctures, and never outside history. Althusser looks at the obviousness of thought and how it renders itself that way. For Althusser, ideology has a material existence. For Foucault that is a paradox, and does not use the term ideology and rather he focuses on the body, as it does not presuppose the classic human subject. For Althusser ideology is imminent in its apparatuses and their practices, it has no existence outside them. For example, Spinoza kept the notion of God in order more effectively subvert it (This leads me to ask can the same trick be done with disease and death? Or even health?) This is a much longer history and disciplinary argument which is I think a side debate, see Jean-Sebastien Bolduc and Gerard Chazal, "The Bachelardian Tradition in the Philosophy of Science," Angelaki: Journal of Theoretical Humanities 10, no. 2 (2005). 68 Rose, "Life, Reason and History: Reading Georges Canguilhem Today," 155. 69 This framing is inspired by a re-read of Henderson, "'Free' Food, the Local Production of Worth, and the Circuit of Decommodification: A Value Theory of the Surplus." Henderson, working with Stuart Hall asks, “What sort of

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political surface is [‘disease’] then?” What sort of political struggle coheres there, or not? Diseases flourish in the middle of poverty, along with the lack of good food and clean water. The problem with health, as a site of struggle and dispersed power is it silences what other possibilities there might be. Health has become one of Nancy Fraser’s ‘runaway needs’. In this dissertation I examine when the need of health was depoliticized, or turned into economic concern under the nationalism and international competition, even war. These particular historical events and structures, that I have outlined, structured how health became incorporated within the circuits of capital, as a need. 70 Butler, Frames of War: When Is Life Grievable, 20. 71 See Heynen, "'but It's Alright, Ma, It's Life, and Life Only': Radicalism as Survival." Matthew Gandy, "Planning, Anti-Planning and the Infrastructure Crisis Facing Metropolitan Lagos," Urban Studies 43, no. 2 (2006).

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1600 – British East India Company is formed. 1700s – British East India Company competes with other European traders for control of trade with India. 1757 – British East India Company becomes leading power in India. 1798 – Britain – Thomas Robert Malthus published An Essay on the Principle of Population.

1817 – First Cholera Pandemic (1817-1823)

1817 – August 28 – Official notice by the Government of Bengal that cholera had broken out in the populous town of Jessore. 1817 – September – Cholera in Calcutta 1818 – April and May – Cholera found in Lucknow, Siam, and Cochin China. 1821 – Cholera advanced to northwest India and by rivers and roads into Persia, Arabia, and Asia Minor.

1826 – Second Cholera Pandemic (1826-1837)

1830s – Egypt – Alexandria – Sanitary, Medicine, and Quarantine Board was founded. 1831 – International – February – Russian troops introduced cholera into Poland. 1831 – Britain – October – Cholera arrived England from Hamburg. 1831 – USA – NY – September 6 – Board of Health formed committee to gather information. 1832 – France – April – Cholera reaches Paris. 1832 – Canada – June – Irish immigrants carry cholera to Quebec. 1832 – USA – NY – June – Mayor proclaimed quarantine on almost all ships from Europe and Asia. 1832 – Canada – June 15 – First cholera outbreak; on June 15th cholera had breached the Atlantic Ocean and “America’s last great defense had failed” at Quebec and Montreal. 1832 – Canada – June 21 – Quarantine declared between Upper and Lower Canada, along with New York. 1832 – USA – July – Cholera arrives in the U.S. in Illinois and New Orleans. 1833 – Cholera reaches the Pacific coast and enters Mexico. 1834 – Canada – Second major cholera outbreak. 1834 – France – Paris – Report on the Progress and Effects of Cholera Morbus. 1834 – Britain – New Poor Law of 1834. 1835 – CA – Toronto – Bonnycastle suggests reclaiming marshes of Ashbridge’s Bay. 1838 – Constantinople (Istanbul) – Superior Council of Health is founded with Ottoman and European representation. 1840 – International – Board of Health is created in Tangier, Algeria. 1840 – Germany – Justus von Liebig publishes Organic Chemistry in its Application to Agriculture and Physiology. 1840 to 1890 = medical practices = environmental sanitation

1841 – Third Cholera Pandemic (1841-1859)

1842 – Britain – Farr takes job as Compiler of the Abstracts for the Registrar General Department of London. 1844 – Britain – Friedrich Engels publishes The Condition of the Working Class in England in 1844. 1847 – Ireland – Great famine in Ireland. 1847 – Canada – Toronto – With a population of only 20,000, Toronto had to cope with the arrival of 38,000 starving Irish refugees. 1,100 new immigrants died in fever sheds at Front and Bathurst Streets, and at King and John Streets. 1847 – Britain – After the Indian Mutiny, Britain took official control of India. 1848 – Britain – Cholera reaches England and crosses the Atlantic to Canada and the US (via New York and New Orleans). 1848 – Britain – The Public Health Act established a General Board of Health. Chadwick’s Sanitary Idea and moral crusade created the first urban public health policies. 1849 – Canada – Major cholera outbreak. 1849 – Britain, London – Dr. Snow first publishes his theory of water vector for cholera in an essay “On the Mode of Communication of Cholera”. 1849 – Cholera travels with ‘Forty-niners’ and other pioneers to the Pacific coast and into Mexico.

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1850 – Cholera reaches the East Indies, China, Japan, Korea, and North Africa. 1851 – International – 1st International Sanitary Conference is held in Paris, France. It fails to produce an International Sanitary Convention. 1851 – Canada – Toronto – Minor cholera outbreak. 1852 – Canada – Toronto – Minor cholera outbreak. 1852 – Britain – Farr publishes Report on the mortality of cholera in England, 1848-49. 1853 – Canada – Toronto – Tully repeatedly calls for waterfront transformation. 1854 – Canada – Major cholera outbreak. 1854 – Britain – London – August outbreak in London neighborhood near Golden Square, with over 500 deaths in ten days. This attracts the attention of physician, John Snow and the Broad Street pump in London along with maps. 1856 – Cholera outbreak in Central America. 1856 – International – European Commission of the Danube is established, which takes over certain powers on health issues. 1859 – International – 2nd International Sanitary Conference, Paris, France. 1859 – Britain – Darwin publishes On the Origin of Species.

1863 – Fourth Cholera Pandemic (1863-1875) geographically, the most widespread pandemic

1863 – International – Geneva – International meetings of Red Cross societies are held in Geneva, which eventually lead to the creation of the League of Red Cross Societies in 1919. 1865 – Britain – Neo-quarantine / English system came in (in response to increased travel speeds). 1866 – International – 3rd International Sanitary Conference is held to discuss cholera in Istanbul, Turkey. Also called Cholera Conference in Constantinople. 1866 – Britain – Cholera outbreak. 1866 – Canada – Local cholera outbreaks in Toronto. 1866 – USA – NY – The Metropolitan Board of Health organized with laws with sweeping police powers to safeguard the health and welfare of industrial city. 1866 – Britain – The Contagious Diseases Acts were passed by the Parliament of the United Kingdom to control of prostitutes in naval and garrison towns. 1866 – Canada – Memorandum on Cholera published. 1866 – Canada – A central board of health created and different than the previous board as after 1866 many communities set up permanent boards of health. 1867 – Marx publishes Das Kapital. 1867 – International – First International Medical Congress is held in Paris. 1868 – Britain – Farr published Report on the cholera epidemic of 1866 in England. 1869 – International, Britain – November – Suez Canal opens. 1871 – Canada – Quebec – Local outbreak in Canada.

…The last cholera outbreak in Canada…

1872 – International, USA – The American Public Health Association (APHA) founded. 1873 – USA – Major cholera outbreak. 1874 – International – 4th International Sanitary Conference is held in Vienna. 1876 – Britain – Native Passenger Ships Act. 1878 – USA – Quarantine legislation in response to yellow fever epidemic and creates national system of quarantine. 1879 – USA – A National Board of Health is formed in the United States. The National Board of Health had both money and authority and dominated by members of the APHA. The board continued a nominal existence until 1893. 1880 to 1900 – USA – Six million workers participate in 25,000 strikes.

1881 – Fifth Cholera Pandemic (1881-1896)

1881 – International – 5th The International Sanitary conference in Washington D.C. 1882 – USA – Chinese Exclusion Act allowed the U.S. to suspend immigration. 1882 – Canada – Ontario Provincial Board of Health founded. 1882 – Germany – Koch discovers tuberculosis, in the form tubercles bacillus.

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1882 – USA – John B Hamilton took over the Marine Hospital Service as Surgeon-General and got $100,000 from the House of Representatives annually. The federal law that created the board expired and the Marine Hospital Service took over the responsibility. 1883 – Canada, Toronto – Dr. Canniff becomes Chief Medical Officer (until 1890). 1883 – Germany – Koch discovers the cholera bacilli. 1884 to 1887 – Britain – Severe cyclical depressions. 1884 – Robert Koch goes on a cholera research expedition in Egypt in 1884, one year after he identified V. cholerae. 1884 – Germany, Berlin – July – First Cholera Conference in Berlin. 1885 – Germany, Berlin – May – Second Cholera Conference. 1885 – International – 6th International Sanitary Conference held in Rome, Italy. 1885 – Canada, Montreal – Smallpox outbreak. 1886 – USA – May 4 – Haymarket. 1887 – USA – The Hygienic Laboratory, forerunner of the National Institutes of Health, is created within the Marine Hospital Service in Staten Island, NY. 1888 – Peru – Lima – The American Sanitary Congress held. 1889 – USA – DC – The First International Conference of America States held in D.C. The International Union of American Republics is founded, later renamed the Pan American Union in 1910. 1889 – Paris – Congrès International d’Assistance is held.

1890 to 1910 = medical practices = bacteriology, isolation and disinfection

1890s – Canada – Aggressive immigration campaign by Laurier’s Liberal Government. 1890s – USA – Lynching was on the rise in the 1890s. 1890 – USA – New York – Jacob Riis publishes How the Other Half Lives. 1891 – Canada – Toronto – Dr. Norman Allen Chief Medical Officer till 1893 1891 – International – The International Statistical Institute introduced the International Lists of Diseases and Causes of Death. 1891 – USA – Bureau of immigration was created in 1891 and the medical inspection under Marine Hospital Service created Ellis Island 1892 – International – Russia, Hamburg, NYC – Cholera, in India and the Middle East, targeting Jews in U.S. and Europe. 1892 – Canada – Toronto – Ashbridge’s Bay framed as imminent health emergency and health officials predict cholera outbreak next year. 1892 – International – 7th International Sanitary Conference held in Rome, Italy. 1892 – International – First International Sanitary Convention is approved, proposing such international health measures as quarantine and hygiene practices. 1892 – USA – Peak year for immigration in the 19th century and old European settlers now less than 50 percent. 1892 – USA – Chinese Exclusion Act renewed for ten years by the Geary Act. 1893 – International – 8th International Sanitary Conference held in Dresden, Germany. 1893 – USA – Chicago – Summer World Exposition. 1893 – USA – Harris-Rayner’s National Quarantine Act. 1893 to 1897 – USA – Financial meltdown, then depression, from the failure of National Cordage Company. This sent a financial panic in the markets (hit earlier in other parts of the country) 1893 – USA, New York City – Biggs starts the laboratory for diphtheria and started producing anti-toxins and vaccines, along with smallpox and tetanus. 1893 – Canada, Toronto – Dr. Sheard becomes Chief Medical Officer. 1893 – International – First Pan-American Medical Congress, held in the city of Washington, D.C. 1894 – International – 9th International Sanitary Conference held in Paris, France. 1895 to 1900s – USA – Public Health Service began serving in foreign ports. 1896 – Britain – Quarantine abolished. 1896 – Mexico – Mexico City – Second Pan American Scientific Congress. 1896 to 1914 – Canada – 3 million immigrants enter Canada. 1897 – Britain – The Cleansing of Persons Act passed, an act to permit local authorities to provide Cleansing and Disinfection for Persons infested with Vermin.

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1899 – Sixth Cholera Pandemic (1899-1923) no impact on Western Europe; cholera didn’t reach Americas and mostly affected Asia

1901 to 1911 – Canada – The population grew 43 per cent and Canada became the world’s fast growing country. 1902 – International/USA – International Sanitary Bureau of the Americas is established in Washington, D.C., as the world’s first permanent international health organization. The organization will later become the WHO Regional Office for the Americas. 1902 – Berlin – International Central Bureau for the Campaign against Tuberculosis is founded. 1903 – USA – $100 fine for each person sent back 1903 – France, Paris – Eleventh International Sanitary Conference is held. The meeting agreed to consolidate and codify four existing International Sanitary Conventions, including those on cholera and plague. 1905 – Egypt – New strain of V. cholerae called El Tor strain; first observed among Indonesian emigrants to Egypt. 1907 – France – 9 December – Office International d’Hygiène Publique (OIHP) is created in Paris by the Rome Agreement, and signed by 12 European countries. The new organization includes a permanent secretariat and committee of senior public health officials. 1907 – USA – Immigration commission to root out corruption in immigration stations. 1909 – USA – Rockefeller Sanitary Commission for the Eradication of Hookworm in the United States is initiated. 1909 – Tunis – Charles Nicolle demonstrated that the human body louse was the vector for typhus. 1909 – Canada – JS Woodsworth publishes “Stranger within our Gates”.

1910 onwards = medical practices = new public health, education, population and pediatric

1910 – Canada, Toronto – Chlorination of the Toronto’s water supply. 1910 – Russia – biggest cholera outbreak since 1892. 1912 to 1920 – Canada – Toronto – Toronto Waterfront Development Plan. 1913 – USA – Rockefeller Foundation is created, which includes the International Health Commission. 1914 – International – WWI was the end of free movement of people without passports. 1915 – International – International Health Commission of the Rockefeller Foundation adopts resolution to eradicate yellow fever in the Americas. 1917 – USA – Immigrants required to pass literacy tests. 1918 – International – Global campaign to eradicate yellow fever is launched by William Crawford Gorgas, with the support of the Rockefeller Foundation. It is the first concerted effort to eradicate a human disease. 1919 – Canada – The federal department of health was established. 1919 – League of Red Cross Societies is established. 1920 – International, Geneva – Health Organization of the League of Nations was created in Geneva to assist in the prevention and control of disease. 1923 – International – International Sanitary Bureau of the Americas is renamed the Pan American Sanitary Bureau (PASB). 1924 – International – First Pan American Sanitary Code is adopted. 1930 – Canada – Toronto – The industrial redevelopment of the waterfront is complete.

1961 – Seventh Cholera Pandemic (1961-)

El Tor strain becomes a pandemic.

1991 – Eighth Cholera Pandemic (1991-)

New strain of V. cholerae—Bengal strain; first observed in Bangladesh and India.

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A2.1. People Allen, Norman: the Medical Officer of Toronto for the years of 1890-1892. Bryce, Peter (1853-1932): Secretary to the Provincial Health Board in 1882 to 1904. Bryce’s position was restricted in 1887, making him both Secretary and Chief Officer of Health for Ontario. In 1900, he became the first Canadian President of the American Public Health Association. He took the newly created position Chief Medical Officer for the Departments of the Interior and Indian Affairs in 1904, which also involved being the Officer of the Department of Immigration in 1904. He retired from the civil service in 1921. Canniff, William (1830-1910): physician, medical educator, author, school administrator, and civil servant. He was appointed as Toronto’s first permanent medical health officer on 12 March 1883. Canniff spent the next seven years educating his fellow citizens in basic principles of sanitation and disease control. He looked to modernize the city’s sewer system and waterworks, regulate its food supplies, and promote vaccination and isolation of the sick threatened many vested interests, including those of medical colleagues. He resigned on September 17th, 1890. Chadwick Sir Edwin (1800-1890): an English social reformer, noted for his work to reform the Poor Laws and improve sanitary conditions and public health. One of the reasons why Chadwick believed in improvement to public health was because he believed it would save money. He sought to support himself by literary work such as his work on Applied Science and its place in Democracy, and his essays in the Westminster Review (mainly on different methods of applying scientific knowledge to the practice of government) brought him to the notice of Jeremy Bentham, who engaged him as a literary assistant and left him a large legacy. In 1832, the Royal Commission appointed to inquire into the operation of the Poor Laws employed Chadwick, and in 1833 he was made a full member of that body Cleveland, (Stephen) Grover (1837-1908): the 22nd and 24th president of the U.S. (1885-89 and 1893-97). A New York Democrat, he served as governor of his state 1883-85 before being elected to the presidency. During his first term, he championed civil service reform and revision of the tariff system. Although he was defeated for reelection by Benjamin Harrison in 1888, he was elected again in 1892. His second term was marked by his application of the Monroe Doctrine to Britain’s border dispute with Venezuela in 1895. Cuvier, Georges Léopold Chrétien Frédéric Dagobert, Baron (1769-1832): Cuvier, as a French naturalist, founded the science of paleontology. He is well known for establishing extinction as a fact, being the most influential proponent of catastrophism in geology in the early 19th century, and opposing the gradualist evolutionary theories of Lamarck. Darwin, Charles (Robert) (1809-1882): English natural historian and geologist; a proponent of the theory of evolution by natural selection. While the naturalist on HMS Beagle for the voyage around the Southern Hemisphere 1831-36, he collected the material that became the basis for his ideas on natural selection. His notable works are On the Origin of Species (1859) and The Descent of Man (1871). Dickens, Charles (John Huffam) (1812-70): His novels are notable for their satirical humor and treatment of contemporary social problems, including the plight of the urban poor and the corruption and inefficiency of the legal system. Farr, William (1807-1883): a 19th century British epidemiologist, regarded as one of the founders of medical statistics. He started a medical practice in London. By this time he had become fascinated by medical statistics, a subject that he called “hygology” (derived from “hygiene”). In 1837 he wrote a chapter called “Vital Statistics” for a highly regarded reference book, John McCulloch’s Statistical Account of the British Empire. In January 1837 he established the British Annals of Medicine, Pharmacy, Vital Statistics, and General Science, but it was already discontinued in August. Shortly after graduating he attempted to establish a course in “Hygiology,” but was unable to gain recognition from any educational institution for this project. His wife died of tuberculosis in 1838, after which he secured a post in the General Register Office as the first compiler of scientific abstracts, on an initial salary of £350 per year. He was responsible for the collection of official medical statistics in England and Wales. Fisher, Irving (1867-1947): an American economist, health campaigner, and eugenicist, and one of the earliest American neoclassical economists. Although he was perhaps the first celebrity economist, his reputation during his lifetime was irreparably harmed by his sanguine attitude immediately prior to the crash of 1929, and his theory of debt deflation was ignored in favor of the work of John Maynard Keynes. His reputation has since recovered in neoclassical economics since his work was popularized in the late1950s, and more widely due to an increased interest in debt deflation in the Late-2000s recession. Fisher’s work on the quantity theory of money was one of the major influences on the development of Milton Friedman’s

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“monetarism.” Friedman called Fisher “the greatest economist the United States has ever produced.” Other concepts named after Fisher include the Fisher equation, the Fisher hypothesis, the international Fisher effect, and the Fisher separation theorem. Fleming Robert John (1854-1925): twice Mayor of Toronto (1892-1893 and 2nd incumbency 1896-1897). Born and educated in Toronto’s public schools, he first entered the business world in real estate. From there he moved on to the Toronto Railway Company becoming the general manager in 1905. Fleming’s political career began as an Alderman 1886 to 1890. In 1892 was elected mayor of Toronto. He was reelected in 1896 and the next year as mayor. He resigned in 1897 to accept appointment as an assessment commissioner of Toronto and held that position until 1904. Galton, Sir Francis (1822-1911): English scientist. He founded eugenics and introduced methods of measuring human mental and physical abilities. He also pioneered the use of fingerprints as a means of identification. He was a cousin of Charles Darwin. Harrison, Benjamin (1833-1901): the 23rd president of the U.S. 1889-93; the grandson of William Henry Harrison. An Indiana Republican, he served as a U.S. senator 1881-87. During his administration, Oklahoma was settled and the way was paved for the annexation of Hawaii. Due to deterioration of the economy and labor unrest, he was not reelected. Hastings, Charles John Colwell Orr (1858-1931): an obstetrician and public health pioneer. Dr. Hastings lost his daughter to typhoid because of contaminated milk. At that time, Toronto also had no sewage treatment, and used un-chlorinated water from Lake Ontario. In middle age, Hastings switched from a normal career in obstetrics to an outstanding one in public health. As Toronto’s Medical Officer of Health (1910-29) Hastings crusaded to make Toronto the first city in Canada to pasteurize milk. Hastings became president of the Canadian Public Health Association in 1916 and the American Public Health Association in 1918. Hippocrates (c. 460-377 BC): Greek physician, traditionally regarded as the father of medicine. His name is associated with the medical profession’s Hippocratic oath because of his attachment to a body of ancient Greek medical writings, probably none of which was written by him. Hobbes, Thomas (1588-1679): English philosopher. He believed that human action was motivated entirely by selfish concerns, notably fear of death. He is best known for his treatise Leviathan, or the Matter, Form, and Power of a Commonwealth, Ecclesiastical and Civil (1651). Jenkins, William T. (1855-1921): A doctor who married into Tammany Hall power structures. He was made the Health Officer of the Port of New York during the cholera outbreak of 1892. Later he moved on to be a Health Commissioner of New York City in 1898 and a member of the State Board of Health. Keating, E. H.: Toronto City Engineer from 1892-1898. In the fall of 1892, Council approved his emergency relief plan. The final product, completed in 1893, differed significantly from Keating’s proposal and became “Keating’s channel.” Kingsley, Charles (1819-1875): English novelist and clergyman. He is remembered for his historical novel Westward Ho! (1855) and for his classic children’s story The Water-Babies (1863). Koch, Robert (1843-1910): German bacteriologist. He identified the organisms that cause anthrax, tuberculosis, and cholera. He received the Nobel Prize for Physiology or Medicine (1905). Lachapelle, Emmanuel-Persillier (1845-1918): physician, editor, professor, educational administrator, and hospital administrator. From 1877 he served on the board of the College of Physicians and Surgeons of the Province of Quebec, and he chaired it from 1898 to 1907. When president of the Quebec Provincial Board of Health, founded in 1886, he had a profound effect on that body through his scientific thinking and his activities as a practical hygienist. Lachapelle was also active at the Canadian and international level. In addition to being president of the American Public Health Association, he was president of the Canadian Medical Association, the Canadian representative at the 13th International Congress of Medicine held in Paris in 1900, and an associate member of the Société Française d’Hygiène of Paris. From 1910 to 1914, he sat as an elected member of a reform team on the board of commissioners of the city of Montreal, which at that time was the municipal government. Lamarck, Jean Baptiste de (1744-1829): French naturalist. He was an early proponent of organic evolution, although his theory is not widely accepted today. Leeuwenhoek, Antoni van (1632-1723): Dutch naturalist. He developed a lens for scientific purposes and was the first to observe bacteria, protozoa, and yeast. He accurately described red blood cells, capillaries, striated muscle fibers, spermatozoa, and the crystalline lens of the eye. Liebig, Justus von, Baron (1803-1873): German chemist and teacher. With Friedrich Wöhler, he discovered the benzoyl radical and demonstrated that such radicals were groups of atoms that remained unchanged in many chemical reactions. Lister, Joseph, 1st Baron (1827-1912): English surgeon, inventor of antiseptic techniques in surgery. He realized the significance of Louis Pasteur’s germ theory in connection with sepsis, and in 1865 he used carbolic acid dressings on patients who had undergone surgery.

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Malthus, Thomas Robert (1766-1834): English economist and clergyman. In Essay on Population (1798) he argued that without the practice of “moral restraint” the population tends to increase at a greater rate than its means of subsistence, resulting in the population checks of war, famine, and epidemic. Malthus thought that the dangers of population growth would preclude endless progress towards a utopian society: “The power of population is indefinitely greater than the power in the earth to produce subsistence for man.” Malthus placed the longer-term stability of the economy above short-term expediency. He criticized the Poor Laws, and (alone among important contemporary economists) supported the Corn Laws, which introduced a system of taxes on British imports of wheat. Mayhew, Henry (1812-1887): an English social researcher, journalist, playwright and advocate of reform. He was one of the two founders (1841) of the satirical and humorous magazine Punch. He is better known, however, for his work as a social researcher, publishing an extensive series of newspaper articles in the Morning Chronicle, later compiled into the book series London Labour and the London Poor (1851), an influential survey of the poor of London. McKinley, William (1843-1901): 25th president of the U.S. 1897-1901. A Republican, he favored big business and waged the Spanish-American War of 1898, which resulted in the acquisition of Puerto Rico, Cuba, and the Philippines, as well as the annexation of Hawaii, and brought the U.S. to the forefront of world power. An anarchist in Buffalo, New York assassinated him. Montizambert, Frederick (1843-1929): physician and office holder. In 1866 he obtained a position as assistant physician at the quarantine station on Grosse Island. The quarantine station had been opened in 1832 because of a cholera epidemic. When Montizambert moved there, preparations were under way to cope with another outbreak of cholera. In 1869 obtained the position of medical director at Grosse Île which he held for three decades. He spent 54 consecutive years in the service of public health in Canada. Benedict-Augustin Morel (1809-1873): created theory of degeneration dominated French psychiatry for almost a century after its publication in 1857 because it provided psychiatry with a convincing biological explanation about how abnormal mental conditions were acquired. Combining concepts of acquired traits becoming fixed in germ plasm, drug toxicity, and hereditary transmission, Morel described a progressive generational degeneration starting with neurosis in the first generation, mental alienation in the next, and imbecility in the third, culminating in sterility in the fourth and final generation. What was being passed on was not a specific pathology but a susceptibility of the nervous system to disturbances originating from “overindulgence” of toxic substances such as alcohol. Mowat, Sir Oliver (1820-1903): lawyer, politician, judge, and a Canadian politician, and the third Premier of Ontario from 1872 to 1896, making him the longest serving premier of that province and the 3rd longest in all of Canadian history. He is one of the Fathers of Confederation. Olmsted, Frederick Law (1822-1903): an American journalist, landscape designer and father of American landscape architecture. Olmsted was famous for designing many well-known urban parks, including Central Park and Prospect Park in New York City Pasteur, Louis (1822-1895): French chemist and bacteriologist. He introduced pasteurization and made pioneering studies in vaccination techniques. Powell, John Wesley (1834-1902): U.S. geologist and writer. He directed the U.S. Geological Survey 1881-94. He also directed the Smithsonian Institution’s Bureau of American Ethnology 1897-1902. He wrote Report on the Lands of the Arid Region of the United States (1878). Prudden, T. Mitchell (United States doctor): Koch’s first American student and became hugely influence wrote in Harper’s monthly and weekly, The Century, Popular Science Monthly and The Christian Union. He also wrote a book called The Story of Bacteria to explain bacteriology Riis, Jacob August (1849-1914): U.S. journalist and social reformer; born in Denmark. A police reporter for the New York Tribune 1877-88 and the New York Evening Sun 1888-99, he was a crusader for parks, playgrounds, and improved schools and housing in urban areas. He wrote How the Other Half Lives (1890). Simon, John (1816-1904): Britain’s senior public health official from 1855 to 1876 and became the City of London’s first medical officer of health in 1848, and in that capacity issued annual reports that led directly to the Sanitary Act of 1866. This landmark legislation formed the backdrop for industrial hygiene policy and created the first mandatory, universal, and science-based public health law. Simon’s involvement here helped transform the issue of public health from a political platform to one rooted in scientific investigation and analysis. His reports also provided impetus for the Public Health Act of 1875, which established a comprehensive sanitary code that evolved and lasted for a century. Southwood Smith, Thomas (1788-1861): English physician and sanitary reformer. Southwood Smith was a dedicated utilitarian, and a close friend of Jeremy Bentham. He had a particular interest in applying his philosophical beliefs to the field of medical research. He was frequently consulted in fever epidemics and on sanitary matters by public authorities, and his reports on quarantine (1845), cholera (1850), yellow fever (1852), and on the results of sanitary improvement (1854) were of international importance.

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Sternberg, Brigadier General George Miller (1838-1915): a U.S. Army physician who is considered to have been the first bacteriologist in the United States. He was the 18th U.S. Army Surgeon General from 1893 to 1902. Pioneering German bacteriologist Robert Koch honored him with the sobriquet, “Father of American Bacteriology.” Sydenham, Thomas (1624-1689): was an English physician and became the undisputed master of the English medical world and was known as ‘The English Hippocrates’. His fundamental idea was to take diseases as they presented themselves in nature and to draw up a complete picture of the objective characters of each. Most forms of ill-health, he insisted, had a definite type, comparable to the types of animal and vegetable species. The conformity of type in the symptoms and course of a malady was due to the uniformity of the cause. The causes that he dwelt upon were the evident and conjunct causes, or, in other words, the morbid phenomena; the remote causes he thought it vain to seek after. Tully, Kivas (1820-1905): architect, civil engineer, and civil servant. In 1844 Tully left Ireland for the Province of Canada. He arrived on 30 July in Toronto, where his elder brother, who had also trained as an architect, was in the office of John George Howard gaining experience towards his license as a land surveyor. In the early 1850s, Tully began to seek civil engineering work and institutional clients in preference to general architectural jobs. In 1853 he took on the tasks of improving Toronto’s harbour and planning an esplanade to give access to the wharves after the railways, then under construction across the front of the city, were completed. In March 1853 he was appointed engineer for the Toronto Harbour Trust, a post he would hold until his death. Virchow, Rudolf Karl (1821-1902): German physician and pathologist. He founded cellular pathology. Referred to as “the father of modern pathology,” he is considered one of the founders of social medicine. Weber, Max (1864-1920): German economist and sociologist; regarded as one of the founders of modern sociology. In The Protestant Ethic and the Spirit of Capitalism (1904), he argued that there was a direct relationship between the Protestant work ethic and the rise of capitalism. Woodsworth, James Shaver (1874-1942): a pioneer in the Canadian social democratic movement. Following more than two decades ministering to the poor and the working class, J. S. Woodsworth left the church to lay the foundation for, and become the first leader of, the Co-operative Commonwealth Federation (CCF), a democratic socialist party that later became the New Democratic Party (NDP). Zola, Émile (Édouard Charles Antoine) (1840-1902): French novelist and critic. His series of 20 novels collectively entitled Les Rougon-Macquart (1871-1893), including Nana (1880), Germinal (1885), and La Terre (1887), shows how human behavior is determined by environment and heredity.

A2.2. Disease and Health: Theories/Things ague: malaria or some other illness involving fever and shivering. antitoxin: an antibody that counteracts a toxin. Asiatic Cholera: an infectious and often fatal bacterial disease of the small intestine, typically contracted from infected water supplies and causing severe vomiting and diarrhea. The disease is caused by the bacterium Vibrio cholerae. The 19th century Asiatic Cholera mutated into the present day El Tor cholera. The El Tor does not need a human host to survive, but can live in algae. bacteria/bacterium: a member of a large group of unicellular microorganisms that have cell walls but lack organelles and an organized nucleus, including some that can cause disease. Bacteria are widely distributed in soil, water, and air, and on or in the tissues of plants and animals. Formerly included in the plant kingdom, they are now classified separately (as prokaryotes). They play a vital role in global ecology, as the chemical changes they bring about include those of organic decay and nitrogen fixation. Much modern biochemical knowledge has been gained from the study of bacteria because they grow easily and reproduce rapidly in laboratory cultures. Origin: mid 19th century: modern Latin, from Greek baktērion, diminutive of baktēria ‘staff, cane’ (because the first ones to be discovered were rod-shaped). Compare with bacillus. contagion: the communication of disease from one person to another by close contact. + a disease spread in such a way. + figurative: the spreading of a harmful idea or practice: the contagion of disgrace. Origin: late Middle English (denoting a contagious disease): from Latin contagio(n-), from con- ‘together with’ + the base of tangere ‘to touch.’ contagia viva/contagium vivum: a living germ of infectious disease, either a bacterium or a protozoan parasite. corpuscle: a minute body or cell in an organism, esp. a red or white cell in the blood of vertebrates. + historical: a minute particle regarded as the basic constituent of matter or light. Origin: mid 17th century: from Latin corpusculum ‘small body,’ diminutive of corpus.

Cholera and Crisis: Glossary | 2010 | Paul Jackson | 293 diphtheria: an acute, highly contagious bacterial disease causing inflammation of the mucous membranes, formation of a false membrane in the throat that hinders breathing and swallowing, and potentially fatal heart and nerve damage by a bacterial toxin in the blood. It is now rare in developed countries because of immunization. effluvium: an unpleasant or harmful odor, secretion, or discharge: the unwholesome effluvia of decaying vegetable matter. Origin: mid 17th century: from Latin, from effluere ‘flow out.’ endemic: disease or condition regularly found among particular people or in a certain area. An attribute denoting an area in which a particular disease is regularly found. Origin: from Greek endēmios (native). epidemic: a widespread occurrence of an infectious disease in a community at a particular time. Origin: épidémie, via late Latin from Greek epidēmia (prevalence of disease), from epidmios (prevalent) from epi (upon) + dēmos (the people). epidemiological triad: disease = favourable environment + susceptible host + virulent pathogen eugenics: the science of improving a human population by controlled breeding to increase the occurrence of desirable heritable characteristics. Developed largely by Francis Galton as a method of improving the human race, it fell into disfavor only after the use of its doctrines by the Nazis. euthenics: human improvement can come through altering external factors such as education and the controllable environment, including the prevention and removal of contagious disease and parasites, environmentalism, education regarding home economics, sanitation, and housing. The term was derived in the late 19th century from the Greek verb “euthenein”: “thrive,” “flourish.” Euthenics is distinguished from eugenics primarily in that the latter is concerned with the improvement of the human species through the manipulation of genetic inheritance (using various techniques of selective breeding), while euthenics is concerned with uninheritable improvements in human beings at a particular time and place, though this can have genetic consequences. For example, while eugenics would typically deal with the problem of an inheritable disease such as thalassemia by sterilising sufferers, or by limiting their reproductive rights through legislation, euthenics would approach the problem through allocating more resources to screening for the disease and by education, giving sufferers the chance to make informed decisions about whether or not to have children. euthanasia: the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma. The practice is illegal in most countries. Origin: early 17th century (in the sense [easy death] ): from Greek, from eu ‘well’ + thanatos ‘death.’ gene: (in informal use) a unit of heredity that is transferred from a parent to offspring and is held to determine some characteristic of the offspring: proteins coded directly by genes. + (in technical use) a distinct sequence of nucleotides forming part of a chromosome, the order of which determines the order of monomers in a polypeptide or nucleic acid molecule which a cell (or virus) may synthesize. Origin: early 20th century: from German Gen, from Pangen, a supposed ultimate unit of heredity (from Greek pan- ‘all’ + genos ‘race, kind, offspring’ ). genetic: 1. of or relating to genes or heredity: all the cells in the body contain the same genetic information. + relating to genetics: an attempt to control mosquitoes by genetic techniques. 2. relating to origin; arising from a common origin: the genetic relations between languages. germ: 1. a microorganism, esp. one that causes disease. 2. a portion of an organism capable of developing into a new one or part of one. Compare with germ cell . + the embryo in a cereal grain or other plant seed. Compare with wheat germ . + an initial stage from which something may develop: the germ of a brilliant idea. Origin: late Middle English (sense 2): via Old French from Latin germen ‘seed, sprout.’ hereditarian: of or relating to the theory that heredity is the primary influence on human behavior, intelligence, or other characteristics. malaria: an intermittent and remittent fever caused by a protozoan parasite that invades the red blood cells. The parasite is transmitted by mosquitoes in many tropical and subtropical regions. Origin: mid 18th century: from Italian, from mal’aria, contracted form of mala aria ‘bad air.’ The term originally denoted the unwholesome atmosphere caused by the exhalations of marshes, to which the disease was formerly attributed. microorganism: a microscopic organism, esp. a bacterium, virus, or fungus. natural selection: the process whereby organisms better adapted to their environment tend to survive and produce more offspring. The theory of its action was first fully expounded by Charles Darwin and is now believed to be the main process that brings about evolution. Compare with survival of the fittest. neurasthenia: an ill-defined medical condition characterized by lassitude, fatigue, headache, and irritability, associated chiefly with emotional disturbance.

Cholera and Crisis: Glossary | 2010 | Paul Jackson | 294 nosopolitics/nosology: the branch of medical science dealing with the classification of diseases. Origin: early 18th century: from Greek nosos ‘disease’ + -logy. nosocomial: (of a disease) originating in a hospital. Origin: mid 19th century: from Greek nosokomos ‘person who tends the sick’ + -ial pandemic: disease prevalent over a whole country or the world. Origin: from Greek pandēmos from pan (all) + dēmos (people) pangenesis: A provisional hypothesis advanced by Darwin to explain the phenomena of reproduction in organisms. It rests on the assumptions that the organic units (cells) of which an organism is composed differ from one another according to the function of the organ to which they belong; that they undergo multiplication by budding or proliferation, giving rise to minute gemmules, which are diffused to a greater or less extent throughout every part of each organism; that these gemmules possess the properties which the unit had when they were thrown off; and that when they are exposed to certain conditions they give rise to the same kind of cells from which they were derived. The name is also applied to the theory or doctrine that every organism has its origin in a simple cell called a pangenetic cell. pestilence (archaic) a fatal epidemic disease, esp. bubonic plague. Origin: Middle English (also denoting something morally corrupting): from Old French, from Latin pestilentia, based on pestis ‘a plague.’ putrefaction: the process of decay or rotting in a body or other organic matter. Origin: late Middle English: from Old French, or from late Latin putrefactio(n-), from putrefacere ‘make rotten’. smallpox: an acute contagious viral disease, with fever and pustules usually leaving permanent scars. It was effectively eradicated through vaccination by 1979 (also called variola). Social Darwinism: the theory that individuals, groups, and peoples are subject to the same Darwinian laws of natural selection as plants and animals. Now largely discredited, social Darwinism was advocated by Herbert Spencer and others in the late 19th and early 20th centuries and was used to justify political conservatism, imperialism, and racism and to discourage intervention and reform. spontaneous generation: the supposed production of living organisms from nonliving matter, as inferred from the apparent appearance of life in some infusions. survival of the fittest: the continued existence of organisms that are best adapted to their environment, with the extinction of others, as a concept in the Darwinian theory of evolution. topography: the arrangement of the natural and artificial physical features of an area: the topography of the island. + a detailed description or representation on a map of such features. + Anatomy & Biology: the distribution of parts or features on the surface of or within an organ or organism. tuberculosis; an infectious bacterial disease characterized by the growth of nodules (tubercles) in the lung tissues vaccine: a substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease. Origin: from late 18th century: from Latin vaccinus, from vacca ‘cow’ (because of the early use of the cowpox virus against smallpox). vibrio: a waterborne bacterium of a group that includes some pathogenic kinds that cause cholera, gastroenteritis, and septicemia. Vibrio and related genera; motile Gram-negative bacteria occurring as curved flagellated rods. virus: an infective agent that typically consists of a nucleic acid molecule in a protein coat, is too small to be seen by light microscopy, and is able to multiply only within the living cells of a host. + informal an infection or disease caused by such an agent. + figurative a harmful or corrupting influence: the virus of cruelty that is latent in all human beings. Origin: late Middle English (denoting the venom of a snake): from Latin, literally ‘slimy liquid, poison.’ The earlier medical sense, superseded by the current use as a result of improved scientific understanding, was a substance produced in the body as the result of disease, esp. one that is capable of infecting others with the same disease. zymosis: In medicine, the development and spread of an infectious disease (especially one caused by a fungus). Zymosis was a process in which an agent causes an organic substance to break down into simpler substances; for example, the anaerobic breakdown of sugar into alcohol.

A2.3. General Terms debenture: an unsecured loan certificate issued by a company, backed by general credit rather than by specified assets. + Brit. a long-term security yielding a fixed rate of interest, issued by a company and secured against assets.

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Origin: late Middle English (denoting a voucher issued by a royal household, giving the right to claim payment for goods or services): from Latin debentur ‘are owing’ (from debere ‘owe’), used as the first word of a certificate recording a debt. The current sense dates from the mid 19th century degenerate: 1. having lost the physical, mental, or moral qualities considered normal and desirable; showing evidence of decline: a degenerate form of a higher civilization. See note at depraved. 2. technical lacking some property, order, or distinctness of structure previously or usually present, in particular + Mathematics relating to or denoting an example of a particular type of equation, curve, or other entity that is equivalent to a simpler type, often occurring when a variable or parameter is set to zero. + Physics relating to or denoting an energy level that corresponds to more than one quantum state. + Physics relating to or denoting matter at densities so high that gravitational contraction is counteracted either by the Pauli exclusion principle or by an analogous quantum effect between closely packed neutrons. + Biology having reverted to a simpler form as a result of losing a complex or adaptive structure present in the ancestral form. 3. an immoral or corrupt person. 4. decline or deteriorate physically, mentally, or morally degeneration: the state or process of being or becoming degenerate; decline or deterioration: overgrazing has caused serious degeneration of grassland. + Medicine deterioration and loss of function in the cells of a tissue or organ: degeneration of the muscle fibers. Origin: late 15th century: from Latin degeneratus ‘no longer of its kind,’ from the verb degenerare, from degener ‘debased,’ from de- ‘away from’ + genus, gener- ‘race, kind.’ proliferate: increase rapidly in numbers; multiply + (of a cell, structure, or organism) reproduce rapidly. + cause (cells, tissue, structures, etc.) to reproduce rapidly: electromagnetic radiation can only proliferate cancers already present. + produce (something) in large or increasing quantities: the promise of new technology proliferating options on every hand synecdoche: a figure of speech in which a part is made to represent the whole or vice versa, as in Cleveland won by six runs (meaning “Cleveland’s baseball team”). Origin: late Middle English: via Latin from Greek sunekdokhē, from sun- ‘together’ + ekdekhesthai ‘take up.’

A2.4. Places Ashbridge’s Bay: Ashbridge’s Marsh was five square kilometres in size, it was one of the largest wetlands in eastern Canada. Beginning in 1912, the newly created Toronto Harbour Commission drafted plans to drain and fill the marshlands in response to growing public health concerns, and the need for new port and industrial lands. The Ashbridge’s Bay Reclamation Scheme would become the largest engineering project on the continent at that time, filling in an area from Cherry to Leslie Streets to create the Port Industrial District. By the time work was completed in the 1920s, only a fragment of the original Ashbridge’s Bay remained, and the mouth of the Don River had been dramatically altered. Ganges: a river in northern India and Bangladesh that rises in the Himalayas and flows southwest for about 1,678 miles (2,700 km) to the Bay of Bengal, where it forms the world’s largest delta. The river is regarded by Hindus as sacred. Grosse Island: Grosse Island, on the St. Lawrence seaway, was Canada’s largest quarantine station where ships were inspected throughout the 1800s. Hamburg, Germany: a port in northern Germany, on the Elbe River. Founded by Charlemagne in the 9th century, still the largest port in Germany. Mecca: a city in western Saudi Arabia, an oasis town in the Red Sea region of Hejaz, east of Jiddah, considered by Muslims to be the holiest city of Islam. The birthplace in ad 570 of the prophet Muhammad, it was the scene of his early teachings before his emigration to Medina. On Muhammad’s return to Mecca in 630 it became the center of the new Muslim faith. Hajj ‘(the Great) Pilgrimage’ is the Muslim pilgrimage to Mecca that takes place in the last month of the year, and that all Muslims are expected to make at least once during their lifetime.

Cholera and Crisis: Glossary | 2010 | Paul Jackson | 296 quarantine: a state, period, or place of isolation in which people or animals that have arrived from elsewhere or been exposed to infectious or contagious disease are placed. Origin: mid 17th century: from Italian quarantina ‘forty days,’ from quaranta ‘forty.’ Suez Canal: a shipping canal that connects the Mediterranean Sea at Port Said with the Red Sea. It was constructed between 1859 and 1869 under the direction of Ferdinand de Lesseps. In 1875, it came under British control; its nationalization by Egypt in 1956 prompted the Suez crisis. St. Lawrence River: a river in North America that flows for about 750 miles (1,200 km) from Lake Ontario along the border between Canada and the U.S. to the Gulf of St. Lawrence on the Atlantic coast. York was the name of Toronto, Ontario, between 1793 and 1834. It was the second capital of Upper Canada.

A2.5. Institutions American Public Health Association: The American Public Health Association (APHA) is Washington, D.C.-based professional organization for public health professionals. Founded in 1872 by Dr. Stephen Smith. The Association defines itself as being “the oldest and most diverse organization of public health professionals in the world.” Canada Upper, Central Board of Health: In April of 1849, an act was passed in the House of Upper Canada, “To Make Provision for the Preservation of Public Health in Certain Emergencies.” This act made it lawful for the governor of the province, after due proclamation, to appoint by commission under his hand and seal, five persons to be called, “The Central Board of Heath.” In 1873 and in 1884 further legislation was passed. It was not until the latter date that full authority was given to a Provincial Board to make regulations for the prevention and mitigation of the disease. Canada, Department of Health: Federal Department of Agriculture handles federal health responsibilities until Sept. 1, 1919, when first federal Department of Health created. The new department was created to take charge of all the old federal health functions, largely to do with quarantine and standards for food and drugs, and to co-operate with the provinces and with voluntary organizations in campaigns against venereal disease, tuberculosis and “feeblemindedness,” and to promote child welfare. Canadian Medical Association: The Canadian Medical Association was born in Quebec City in October 1867, just three months after the birth of Canada. 164 physicians who had recognized the need for a national medical body in their brand-new country created the association. They selected Sir Charles Tupper, who would later serve as Canada’s prime minister, as the first president. Commission of Conservation: was founded in 1909 and was an advisory body consisting of 12 people that represented all of the provinces and the federal department of the Interior and Agriculture. The commission was divided into seven committees: mines, waters and hydro-power, lands, forests, public health, fish, game and fur-bearing animals, and a public relations and publications committee. The Commission was reflecting similar government management of the environment in the United States, a federal-environmentalist version of the Progressive Moment. The members looked to improve what they saw as bad management through: policy research and recommendations, information distribution, and the coordination of scientific and technical research to solve the problems. But this national body did not have any jurisdiction for many of the policies they were advocating, due to BNA Act and the power of the provinces over natural resources. The commission was abolished in 1921 for a variety of reasons, perhaps due to the severe post-war recession rising federal deficits, and the conservation agenda could not compete with a growth agenda. Post WWI government had shifted towards industrial research for national growth. Committee of One Hundred on National Health: In 1906, at a meeting of the American Association for the Advancement of Science, Norton read a paper advocating a national department of health. In support of his proposal he stressed the loss to society arising from preventable illness that could be reduced by such an agency. In consequence the AAAS set up a Committee of One- Hundred on National Health with Fisher as president and Norton as executive secretary, and the drive for a consolidated health and welfare department of cabinet status. Eventually in 1912, Senator Robert L. Owen introduced a bill to set up a department but it was defeated largely because of the determined opposition and propaganda of Christian Scientists, the Anti- Vivisection League, and the National League for Medical Freedom, a group representing certain medical sects and commercial interests. At the same time, support for the bill was diminished by dissension in the ranks of its proponents. The Committee of One Hundred insisted on a cabinet department and refused to consider using the Public Health and Marine Hospital Service as a nucleus around which such a federal unit could develop. Connaught Antitoxin Laboratories and University Farm: In 1914 Dr. John Fitzgerald established laboratories in Toronto to produce vaccines for smallpox, rabies, diphtheria and tetanus. Soon after the University of Toronto assumed responsibility for FitzGerald’s enterprise in May 1914, other provinces expressed interest in the Antitoxin Laboratories’ life-saving products, as did the federal government. The facility was named

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the Connaught laboratories in 1917 in honour of Prince Albert, the Duke of Connaught the recently retired Governor General. Beginning in 1922 the laboratories began to mass-produce the newly discovered hormone insulin. Dominion Government of Canada: Dominion is the legal title conferred on Canada in the Constitution of Canada, namely the Constitution Act, 1867 (British North America Acts), and describes the resulting political union. Usage of the term Dominion of Canada was sanctioned as the country’s formal political name in 1867 and it predates the general use of the term ‘dominion’ as applied to the other autonomous regions of the British Empire in 1907. England’s General Board of Health: The first local boards were created under the Public Health Act 1848. The aim of the act was to improve the sanitary condition of towns and populous places in England and Wales by placing the supply of water, sewerage, drainage, cleansing and paving under a single local body. The act could be applied to any place in England and Wales except the City of London and some other areas in the Metropolis already under the control of sewer commissioners. The Act was passed by the incoming Liberal government, under Prime Minister Lord John Russell, in response to urges by Edwin Chadwick. The act created a General Board of Health as a central authority to administer the act. The board was originally to be dissolved after five years, but acts of parliament were passed annually allowing for its continuation. Chadwick was appointed a Commissioner, and the Board was strongly associated with him. The board finally ceased to exist on 1 September 1858. International Sanitary Conferences: were firstly organized by France in 1851. In total 14 conferences took place from 1851 to 1938. The International Sanitary Conferences were the first international convention organized in Europe to deal with the arrival and spread of pestilent diseases, particularly cholera. Koch Institute: In 1891 the scientific division of “The Royal Prussian Institute for Infectious Diseases” is opened. Robert Koch heads the Institute up to 1904. In 1912, 30 years after Robert Koch discovered the tubercle bacillus, the Institute is renamed the “Royal Prussian Institute for Infectious Diseases ‘Robert Koch’.” L’Institute Pasteur: The Institut Pasteur was founded in 1887 by Louis Pasteur, the French scientist whose early experiments with fermentation led to pioneering research in bacteriology. Louis Pasteur was committed both to basic research and its practical applications. As soon as his institute was created, Pasteur brought together scientists with various specialties. The first five departments were directed by two normaliens (graduates of the Ecole Normale Supérieure): Emile Duclaux (general microbiology research) and Charles Chamberland (microbe research applied to hygiene), as well as a biologist, Ilya Ilyich Mechnikov (morphological microbe research) and two physicians, Jacques-Joseph Grancher (rabies) and Emile Roux (technical microbe research). One year after the inauguration of the Institut Pasteur, Roux set up the first course of microbiology ever taught in the world, then entitled Cours de Microbie Technique (Course of microbe research techniques). Life Extension Institute: The Life Extension Institute was an organization formed in the United States in 1913 with the philanthropic goal of prolonging human life through hygiene and disease prevention Its organizational officers included many celebrity-philanthropists such as William Howard Taft, Alexander Graham Bell, and Mabel Thorp Boardman but also genuine medical experts including William James Mayo, Russell Henry Chittenden, and J. H. Kellogg and a “Hygiene Reference Board” of dozens of nationally recognized physicians of that era such Major General William Crawford Gorgas. A major project of the institute which fulfilled its mission to disseminate knowledge was publication of the book How to Live, Rules for Healthful Living Based on Modern Science, now in the public domain. Ontario Provincial Board of Health: The Public Health Act of 1882 created the Provincial Board of Health of Ontario, as it was originally known, and which was the first permanent health care administrative body in the Province. In 1925 it became the Department of Health. In 1930, the Department of Hospitals was established under the direction of the first Minister of Health; that Department became a division of the Department of Health in 1934. Ontario Vaccine Farm founded in the small town of Palmerston in 1885 and was able to locally produce vaccines until 1916. Positivism: (Philosophy) 1. a philosophical system that holds that every rationally justifiable assertion can be scientifically verified or is capable of logical or mathematical proof, and that therefore rejects metaphysics and theism. Origin: from French positivisme, coined by the French philosopher Auguste Comte. + a humanistic religious system founded on this. + another term for logical positivism . 2. the theory that laws are to be understood as social rules, valid because they are enacted by authority or derive logically from existing decisions, and that ideal or moral considerations (e.g., that a rule is unjust) should not limit the scope or operation of the law.

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Rockefeller Institute of Medical Research: in New York City. The original Rockefeller Institute for Medical Research was founded in 1901 by the oil baron and philanthropist John D. Rockefeller, who had earlier founded the University of Chicago in 1889. The Rockefeller University is a private university—originally founded as the Rockefeller Institute for Medical Research and then sometimes called simply Rockefeller Institute—focusing since its inception on the development of both basic science and biomedical engineering. Toronto Harbour Trust: The level of government responsible for Toronto’s waterfront as the authority in charge of operating the port and the harbour from 1850 to 1911. Toronto Harbour Commission: The Harbour Commission was the third organization to manage the Port of Toronto, after the Commissioners of the Harbour of Toronto, known as the Harbour Trust, formed in 1850. The Harbour Trust was formed at the suggestion of the Toronto Board of Trade. On behalf of port users, the Board expressed complaints in the operation of the provincial commission, which made no improvements in the harbour. The harbour was beset by silting problems which needed to be rectified. A referendum was held on January 2, 1911 to approve a new ‘Toronto Harbour Commission’ to take over the harbour and waterfront. The Toronto Telegram newspaper exposed the decrepit condition of the old harbour facilities, and the City and Board of Trade wanted a new Commission set up, similar to the Montreal Harbour Commission of 1908, with much expanded powers over the Harbour Trust. The referendum was passed overwhelmingly. The Toronto Harbour Commission was formed to manage Toronto harbour and waterfront lands in Toronto. United States, Marine-Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the U.S. Merchant Marine, U.S. Coast Guard and other federal beneficiaries. The Service was created by an act of the 5th United States Congress, which was signed into law on 16 July 1798 by President John Adams. As the nation grew, the scope of Marine Hospital Service’s scope of duties grew to include domestic and foreign quarantine and other national public health functions. In 1902, the Marine Hospital Service was renamed the “Public Health and Marine-Hospital Service.” In 1912, the name of the service was changed to the Public Health Service to encompass its diverse and changing mission. United States Marine Hospital Service Bacteriological Laboratory: In 1887, the Marine Hospital Service (MHS) authorized Joseph J. Kinyoun, a MHS physician trained in the new bacteriological methods, to set up a one- room laboratory in the Marine Hospital at Stapleton, Staten Island, New York. Kinyoun called this facility a “laboratory of hygiene” in imitation of German facilities and to indicate that the laboratory’s purpose was to serve the public’s health. This one-room laboratory was created within the Marine Hospital Service (MHS), predecessor agency to the U.S. Public Health Service (PHS), and later the National Institute of Health. United States, National Conservation Commission was appointed in June 1908 by President of the United States Theodore Roosevelt and composed of representatives of the United States Congress and relevant executive agencies with Gifford Pinchot as chairman. It compiled an inventory of U.S. natural resources and presents Pinchot’s concepts of resource management as a comprehensive policy recommendation in a three-volume report submitted to Congress at the beginning of 1909. Roosevelt and Pinchot wanted the Commission to continue, but Congress refused further funding.

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