Engendered/endangered: Women, tuberculosis, and the project of citizenship

The anti-tuberculosis campaign of the late nineteenth and early twentieth centuries was an unprecedented display of medical authority and public health purview. With accumulating evidence that the disease disproportionately struck the poor, tuberculosis by the early decades of the century was perceived epidemiologically as embedded in individual practices including hygiene and domestic order. Tuberculosis was in a sense a trope for national degeneration, and as such it became the vehicle for a self-conscious thrust towards national renewal and moral regeneration. This paper uses a feminist Foucauldian framework in its analysis of the anti-tuberculosis campaign. In the case of San Francisco, efforts to combat tuberculosis centred in part on women in their roles as wives and mothers. Women were the gatekeepers of health because they were responsible for keeping the home clean and bacillus free. Not only did this focus become a medical legitimization of women's domestic duties, but it also became a discourse of citizenship. Whether explicitly or implicitly, physicians concentrated their attention on white middle class women in their messages of health maintenance. Within sanatoria, a primary agenda of tuberculosis treatment was the inculcation of middle class behaviour into the working class patients. The anti-tuberculosis campaign was thus a part of the early-twentieth-century project of nationhood where citizenship was largely calculated through the lens of class and race.