PUBLIC HEALTH IN THE NEW SOUTH: GOVERNMENT, MEDICINE AND SOCIETY IN THE CONTROL OF YELLOW FEVE

The imperative to control yellow fever fundamentally directed the development of southern and federal public health institutions in nineteenth-century America. The death and disorder yellow fever brought to the South made it the preeminent concern of southern boards of health from their inception, largely in the 1870s, through the first decade of the twentieth century, when the last yellow fever epidemic in the United States occurred in 1905. As a result the professional identity, objectives and achievements of southern public health officials were strikingly different from those of their northern counterparts. The studies upon which historians have based their assessment of American public health in the nineteenth century have focused almost exclusively on the northeastern and midwestern states; this thesis offers an explication of the distinctive character of the southern public health endeavor in order to redress this imbalance and facilitate a more complete understanding of the history of public health in America. In addition, the thesis illuminates the origin of the United States Public Health Service by demonstrating that the Service's acquisition of funding, manpower and authority during a period of impressive growth, 1878-1910, was strongly dependent upon its role in defending the nation against yellow fever. It explicates as well the search for the yellow fever germ, and the impact of Reed's and Carroll's verification of the mosquito vector on public health.;The government involvement that yellow fever commanded arose from its infringement upon the commercial vitality of the South. The panic yellow fever generated brought commercial interactions to a standstill as many communities blockaded themselves against the world to keep out pestilence. Southern legislatures charged their public health officials with two, often conflicting duties: to control yellow fever with quarantine and other measures, and maximally to preserve the flow of commerce. Yellow fever's interference with interstate trade made the disease a national problem as well, and justified federal government involvement in public health. By 1910, yellow fever was no longer the vis formativus of southern public health. Southern public health officials had to look elsewhere to find a new foundation for professional identity, esteem and responsibility.