Medical practice surrounding tuberculosis (TB) treatment in two nineteenth-century Scottish charitable hospitals reveals that in developing empirically-positioned constructs of this and related diseases, medical practitioners drew upon social assumptions about women and the working classes, thus reinforcing rather than shedding cultural notions of who becomes ill and why. TB is a social disease, its distribution determined by relationships among human groups; primary among these is the patient-practitioner relationship, owing to the social role of medical treatment in restoring the ill to both health and society. To clarify the influence of cultural context upon the evolution of medical constructs of TB, I examined Glasgow Royal Infirmary (GRI) and Royal Infirmary of Edinburgh (RIE) ward journals, admissions registers, and institution management records from 1794 through 1905. Medical practice at the turn of the nineteenth century was dominated by observation and questioning of the patient, concordant with conceptions of physicians' labor as mental rather than physical. This changed with the introduction of the stethoscope in the 1820s, which together with the dissection of the poor allowed by the 1832 Anatomy Act ushered in disease concepts emphasizing pathological anatomy. Relationships between patient and practitioner also altered at this time, exhibiting distrust and medical dominance. The mid-Victorian era was notable for clinicians' increasing interest in immorality's contributions to ill health, absent in earlier practice and linked to conceptions of women and the working classes as inherently pathological. In 1882, discovery of the tubercle bacillus challenged existing nutritional, hereditary, and environmental explanations for TB. Although practitioners utilized bacteriological methods, this discovery did not revolutionize diagnosis or treatment. Rather, these older models were incorporated with perceived behavioral, environmental, and biological degradation of the working classes, rendering marginalized groups "soil" prepared for the "seeds" of disease -- at risk, but also to blame. This framework, in which marginalized groups contribute to their increased risk for disease through refusal to accord with hegemonically-established "healthy" behavior, persists. As a result, meaningful change in TB rates will need to address these longstanding contributions of social inequality to Western medical treatment.

In nineteenth-century France, in rural areas, women washed laundry in the nearest streams or in the sea and hung the linens where they could, on lavender bushes, rocks and grass fields, where it had a quaint, if not artistic quality. In villages, laundresses washed linens in fountains, or other water sources, which were often found at or near the center of town. In either case, laundresses operated in public spaces without problem. I argue that, in Paris, changing ideas about the functioning of city space, the management of public hygiene and decisions about the use of public space, made laundresses and laundry operations matter out of place in the city. This study will demonstrate the changes laundering and laundresses underwent during the nineteenth century in Paris, making them out of place. City administrators and public health officials changed the occupation and places where laundry could be done as they sought to render laundry and laundresses invisible within Paris. In the early nineteenth century the Préfet de la Seine forbade women from using the river banks. In the mid-nineteenth century complaints about the disgraceful aspect of women laundering on the river prompted the Préfet to try to eliminate bateaux-lavoirs. In the late nineteenth century the discovery of microbes focused attention on laundry and laundresses and their potential to transmit diseases prompting another wave of hygiene regulations and questions about closing bateaux-lavoirs and lavoirs. The Préfet and Conseil d'Hygiène's struggle to make them invisible by moving them into approved facilities continued until the end of the nineteenth century. Studying laundresses and laundry sheds light on how the shifts in politics, changes in acceptable uses of public space and public hygiene affected working women. It illustrates the manner in which public hygiene- the Conseil de Salubrité and later the Conseil d'Hygiène, functioned and to what degree they could demand changes to the city in the name of hygiene. Through identifying subtle policy shifts, historians may learn how laundry demonstrates policies on the use of urban space, public hygiene or issues about work.