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This book began life some years ago as a doctoral thesis, prepared under the direction of John Merriman. It is an investigation of conflicting nineteenth-century theories on contagion. Some experts thought that illness was brought in from outside society, particularly by immigrants, others that disease arose from within through a combination of physical and moral imperfections.

The history of public health has been a flourishing field in the last three decades. Yet despite a spate of excellent monographs about various epidemic diseases and many good collections about health and disease in Africa, Asia, The Middle East, Latin America, as well as Europe and North America, the most recent textbook on the history of public health is four decades old.