The Filth Disease: Typhoid Fever and the Practices of Epidemiology in Victorian England by Jacob Steere-Williams (review)

For decades, public health practitioners have located the origins of epidemiology in Britain in the mid-nineteenth century, with John Snow’s famous study of the 1854 London cholera epidem‐ ic. His spatial analysis implicating the Broad Street Pump and the Southern and Vauxhall Water Com‐ pany is often seen as a work of unparalleled in‐ spiration and heroic scientific genius. However, in The Filth Disease: Typhoid Fever and the Practices of Epidemiology in Victorian England, historian Jacob Steere-Williams unveils a vibrant world of Victorian epidemiological practice and emerging professionalization far more expansive than this traditional narrative suggests. In this engaging look at nineteenth-century British public health, Steere-Williams explores the origins of the field of epidemiology, looking to high-profile and explos‐ ive epidemics of typhoid fever to trace how epi‐ demiological practice formed, how its boundaries were negotiated, and how evolving theories of transmission and investigative practices shaped etiologies of typhoid. Crucial to this analysis is Steere-Williams’s methodical examination of the extensive Medical Officer of Health Reports pro‐ duced by urban and rural sanitary officials in their search for the index case in outbreaks of the “Filth Disease.” Through these reports and SteereWilliams’s sharp analysis, the dual role of typhoid in public health becomes evident: first, as a lens through which to examine the changing nature of public health and the emergence of epidemiology as a unified profession; and second, as a model disease, shaping epidemiological practice, public health epistemology, and urban and rural concep‐ tions of cleanliness and filth during the same peri‐ od.