Driven by Fear: Epidemics and Isolation in San Francisco’s House of Pestilence

From the late nineteenth century until the 1920s, authorities required San Francisco’s Pesthouse to segregate the diseased from the rest of the city. Although the Pesthouse stood out of sight and largely out of mind, it existed at a vital nexus of civic life where issues of medicine, race, class, environment, morality, and citizenship entwined and played out. Guenter B. Risse places this forgotten institution within an emotional climate dominated by widespread public dread and disgust. In Driven by Fear, he analyzes the unique form of stigma generated by San Franciscans. Emotional states like xenophobia and racism played a part. Yet the phenomenon also included competing medical paradigms and unique economic needs that encouraged authorities to protect the city’s reputation as a haven of health restoration. As Risse argues, public health history requires an understanding of irrational as well as rational motives. To that end he delves into the spectrum of emotions that drove extreme measures like segregation and isolation and fed psychological, ideological, and pragmatic urges to scapegoat and stereotype victims–particularly Chinese victims–of smallpox, leprosy, plague, and syphilis.

Filling a significant gap in contemporary scholarship, Driven by Fear looks at the past to offer critical lessons for our age of bioterror threats and emerging infectious diseases.