Tuberculosis has occupied a prominent place in the modern human disease hierarchy. Flourishing in the slums of industrial cities, it has been seen as a paradigmatic disease of the modern era, politicized by social reformers and aestheticized by artists. Sanitation and modern antibacterial treatment promised to vanquish it, but after a plunge its prevalence is on the rise again worldwide. When several decades ago historians of medicine turned away from great doctors toward a broader picture encompassing patients' experiences of disease, tuberculosis captured their imagination. The Innsbruck historian Elisabeth Dietrich-Daum draws on the rich literature and diverse archival sources to study the disease named “die Wiener Krankheit” (16) in the time of Josef II, which spread in staircases, damp apartments, and the embraces of waltz dancers. The disease's prevalence in Vienna remained high longer than in other European cities. Although it reached its peak in the late nineteenth century, in World War I the mortality of tuberculosis was twice the mortality in Berlin and Munich (27).

In the introduction, Dietrich-Daum stresses the importance of combining urban history, historical demography, and epidemiology with social history of medicine to study the “Viennese disease.” I expected an account on the model developed by Charles Rosenberg for New York in his 1962 The Cholera Years and successfully applied by Keith Wailoo for Memphis in Dying in the City of Blues (Chapel Hill: University of North Carolina Press, 2001), where disease is used as a “probe” into social change. This book is, however, a synoptic view of epidemiology, treatment, and social views of tuberculosis in the last two centuries in Austria. The latter, however, is not a stable geographic notion: the early chapters seem to stay within its current boundaries, whereas the middle ones expand to Cisleithania, only to retract again in the twentieth century. Furthermore, although Vienna hardly appears before page 145, the city dominates the second half of the book. Finally, German materials are used abundantly—half of the twelve figures come from German publications—and often in such a way that it is not clear if a statement should apply generally or to Austria only. The fluctuating geographical focus would, however, not be a problem, were it better explained.

Chapters are organized chronologically and thematically. The first chapter engages with the conceptual difficulty of translating diseases of the prebacteriological era—Lungensucht, Schwindsucht and Abzehrung—defined by clinical symptoms into modern categories where each disease is caused by a specific agent. It furthermore discusses the causes and treatments of the disease before the mid nineteenth century. Robert Koch's attribution of the bacillus Mycobacterium tuberculosis as the cause of tuberculosis and the reception of this innovation are reviewed in the second chapter. The third and largest chapter draws on demographic, social, and economic histories to uncover how the exceptionally high prevalence of tuberculosis was linked with the living conditions in Cisleithanian cities, and especially Vienna, around the turn of the twentieth century. It sets the stage for the consideration of therapeutic institutions and modalities in the fourth chapter. The following chapter shows how the decrease in prevalence in the early twentieth century was first reversed by the socioeconomically catastrophic World War I and then continued in the interwar period, when the effects of a weak economy on health were countered by the new welfare and public health measures. The short sixth chapter focuses on the impact of Nazi policies and World War II on the status and numbers of tuberculosis patients. The final chapter, before the Resümee, thoroughly examines the causes of tuberculosis decline between the late nineteenth and late twentieth centuries. The bibliography, including primary sources, is comprehensive; but the orientation is greatly hindered by the lack of an index.

The strong point of this overall well–written and researched book is the social-demographic analysis. Chapters on the twentieth century are more convincing than the earlier ones. The book would have benefited from more ruthless editing—in sections on housing and food in the late nineteenth century tuberculosis is lost from sight for pages—and from bringing into focus the Austrian specificities, beyond the exceptionally high prevalence, the lag behind Germany and the institutional innovativeness of “Red Vienna” in social welfare and public health. For instance, the internationally renowned Austrian scientific and medical work on tuberculosis is treated in a conspicuously cursory manner. Clemens von Pirquet is described as “der Begründer der Tuberkulindiagnostik” (240), but the chance was missed to show how his pediatric and immunological innovations were informed by the described mortality patterns, patients' characteristics, and more generally, urban culture and society of Vienna. Fulfilling the introductory promise of bringing urban history, historical demography, and history of medicine together, in an analytical rather than empirical-descriptive fashion, would have resulted in a richer Sozialgeschichte of “die Wiener Krankheit.”