Field of medicine: History of medicine, microbiology, infectious diseases, public health, and legal medicine.

Audience: Students of the history of medicine and the development of ethics and persons who work in public health, legal medicine, microbiology, or infectious diseases.

Purpose: To show alternative views of the handling of the 1892-1893 epidemics of typhus and cholera in New York City and the impact of quarantine on the lives of Eastern European Jewish immigrants.

Content: Quarantine (physical, social, or mental isolation) is the book's focus. The author shows how politicians of the 1890s tried to restrict immigration by attributing epidemics to certain immigrant groups. The first part of the book addresses an epidemic of typhus, which was imported into New York's Lower East Side by Russian Jews who were fleeing persecution in several European cities. Health department employees forcibly removed persons from their homes to the quarantine hospitals and later prevented ships in New York Harbor from discharging passengers. The second part of the book addresses the cholera epidemic that occurred a few months after the typhus outbreak. These two epidemics galvanized many who wanted to restrict immigration. Part three considers quarantine legislation and focuses on conflicts among federal, state, and local government officials with regard to public health.

Highlights: Markel looks beyond traditional sources of information and examined writings from the American Yiddish press, which allows him to reconstruct the lives of those quarantined. Quarantine was more than the creation of a boundary to prevent contamination of the healthy; it was used to blame selected groups of unwanted immigrants. The management of these outbreaks illustrates that administration of quarantine policy to protect the health of the public should be a function separate from restriction of immigration. The 30 illustrations are in black and white; photographs and maps are fairly sharp in detail and add significantly to the content.

Context: For a historical perspective, Framing Disease: Studies in Cultural History, edited by Rosenberg and Golden (Rutgers Univ Pr, 1992), and Explaining Epidemics and Other Studies in the History of Medicine, by Charles Rosenberg (Cambridge Univ Pr, 1992), should be consulted.

Reviewer: David R. Hinthorn, MD, University of Kansas School of Medicine, Kansas City, Kansas.