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Books, Journals, New Media
September 8, 1999

Tuberculosis: Contagion and Confinement: Controlling Tuberculosis Along the Skid Road

Author Affiliations

Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media


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by Barron H. Lerner, 243 pp, with illus, $42.50, ISBN 0-8018-5898-4, Baltimore, Md, Johns Hopkins University Press, 1998.

JAMA. 1999;282(10):996. doi:10.1001/jama.282.10.996-JBK0908-5-1

Lerner's excellent, thoroughly researched, clearly-formulated book deals with the experiences of tuberculosis (TB) control in Seattle, Wash, during the post–World War II period, especially at the Firland Sanatorium, but the implications speak to TB prevention, and, indeed, to transmissible disease prophylaxis in general.

The book has a number of important leitmotifs. The perception of TB as a disease best explicable in terms of an interaction between microbial cause, the personal characteristics of its victims, and the social environment is recurrent. Although the focus of Lerner's story is the treatment of TB during the antibiotic era, he shows how tactics employed attempted to deal with three aspects of the disease's etiology. Physicians engaged in the struggle with TB in Seattle paid attention not only to the personal characteristics of their patients, their family history, emotional state, and immediate circumstances, but also to their general social background and the alcoholism, unemployment, and poverty from which many suffered. The antibiotic age cannot, in this sense, be said to have ended a more general concern for the soil of disease, displaced by a dominant focus on the seed.