Sharp Words: Etiology in Action

Fomites. I jotted the word down. The task seemed simple enough. My fellow workshop participants and I gathered at Memorial University’s Nexus Centre to explore the role of “Environmental Humanities in the Public Realm.” In this session, we thought critically about the texture of words. Our words. The words that were unique to our individual research projects.

I looked at my short list. SalutarySalubrious… derived from the Latin salus (meaning health or welfare) these words rolled around the tongue, a twin tangle of hisses and long vowels. The final word, fomites, was sharp in comparison. Made up of two staccato syllables, it sounded more like a pill you take with your morning coffee… something to be choked down quickly. F O M I T E S. I slowed it down. For the first time, I savored the word.

As a historian of nineteenth-century public health, I have acquired a strange vocabulary. Unlike my usual lexicon of archaic medical terms, the word fomite is not obsolete. Hospital employees might come across it in a newsletter, encouraging them to ditch the neck tie. Parents might read it in a pamphlet on the dangers of toy-sharing during flu season. Fomite, simply defined, means any material object that might convey disease. In a pre-bacteriological context, the definition is a bit more complicated. In 1859, at a major medical convention held in New York City, there was no topic of greater importance. As debates raged over contagion, miasma, and everything in between, it is worth exploring how an ambiguous term worked as both bridge and divider.

But first, I want you to imagine a jacket…

jacketcartoon

In 1858, before the nation’s medical elite crossed swords over the great fomite question, a Staten Island man brought home a jacket. Perhaps it was a dress, the historic record is vague on the exact nature of the item of clothing. But let’s say it was a jacket. Mr. Kramer worked for the Quarantine. Situated on the northern tip of Staten Island, the Quarantine was a hub of action in the rapidly expanding port city of New York. Commercial and passenger ships alike docked in its anchorage, awaiting a clean bill of health.

Mr. Kramer was a garbage man of sorts. His job was to collect discarded clothing and bedding, material that was deemed infectious. These were dangerous, porous items saturated with fomites. He would convey his deadly cargo in an iron scow. Upon reaching a safe distance from the coastline, he would burn the offensive material. For a meager salary (and at great personal risk), he repeated this ritual, night after night. Until one night he didn’t. So began the yellow fever outbreak of 1858.

At least that’s one version of the story.

Mr. Kramer and his wife succumbed to the disease in July. A handful of friends and neighbors, all living within a half-mile radius, soon joined them in the grave. While mid-nineteenth century Americans celebrated thrift, this quality was vilified in the residents of “Ragpicker’s Row.” Mr. Kramer and the suspicious article of clothing were soon the subject of physician’s reports and newspaper headlines. While the riotous events that would unfold on Staten Island a mere two months later cannot be reduced to a single causal thread (more in my dissertation, stay tuned), many contemporary experts believed that it all started with a jacket… and this was unsettling. Who could control the tides of trash? What did that mean for the future of quarantine?

One year later, when medical experts convened in New York for the Third National Quarantine and Sanitary Convention, the debate surrounding disease causation became firmly fixed on single word. Fomites. The longstanding convention that disease could pass from person-to-person through effluvia and exhalations was waning in the early nineteenth century as filth theorists and sanitarians argued in favor of local, external causes of disease. To laymen outside of medical circles, competing etiologies could be summed up in a single phrase: “doctors differ.” And when doctors differed, their authority dwindled. The medical field was desperate for a unified stand.

Fomites conveyed disease. This statement was agreeable to everyone, but its palatability depended on its ambiguity. Most physicians agreed that a jacket could convey yellow fever, but to the contagionist that jacket was a vessel saturated with bodily excretions. To certain sanitarians, however, that same jacket was a tiny transformative bomb that could alter its surrounding environment in a small radius. It was soaked—not with effluvia—but with atmosphere… waiting to consume and transform all that lay its path.

fomites

Dr. Elisha Harris, a physician at the Quarantine, offered a laundry list of examples in which epidemic disease could be attributed to infected material goods. But personal contact with the item in question was not required. With right the conditions, which included high temperatures and increased air moisture, (the “New Orleans Thesis”) the dormant atmospheric particles which had latched onto material goods in their port of origin could be reactivated and released. The fomite therefore created: “new centeres, from which freshly generated or reproduced infection may be diffused.” Old-school contagionists scoffed at such whimsical theories, but their own personal definitions of the term fomite allowed them to agree, at least, on language. They had a word, and that was a start.

A short workshop exercise sparked my fascination with fomites. I now say the word with excitement and its sharp syllables feel electric. Fomites. Derived from the Latin fomes, meaning tinder or kindling, the term was prophetic in that historic moment. When Staten Island residents reduced the Quarantine station to ash in September of 1858, memories of Mr. Kramer and his iron scow were still fresh. That jacket, that small word, fomite, certainly did not cause the events that would unfold… but it did fuel the fire.


 

Acknowledgements: 

Special thanks to Memorial University’s Nexus Centre for Humanities and Social Science Research, workshop organizer John Sandlos and session leader Brittany Luby.

Original illustrations inspired by workshop series on #graphicmedicine hosted by the Hiram College Center for Literature and Medicine.


 

Works Cited & Suggested Reading:

  • New York Board of Councilmen. Proceedings and Debates of the Third National Quarantine and Sanitary Convention held in the City of New York. New York: Edmund Jones & Co., 1859.
  • Harris, Elisha. Pestilential Diseases, and the Laws Which Govern their Propagation. Albany: Charles V. Benthuysen, 1858.
  • Barnes, David S. “Cargo, ‘Infection,’ and the Logic of Quarantine in the Nineteenth Century.” Bulletin of the History of Medicine 88 (2014): 75-101.
  • Strasser, Susan. Waste and Want: A Social History of Trash. New York: Owl Books, 1999.
  • Zimring, Carl. “Dirty Work: How Hygiene and Xenophobia Marginalized the American Waste Trades, 1870-1930,” Environmental History 9, no. 1 (2004): 80-101.

 



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