Kari Nixon's Kept from All Contagion: Germ Theory, Disease, and the Dilemma of Human Contact in Late Nineteenth-Century Literature is a timely book. Published in 2020 amid a global pandemic, the book draws attention to the sociopolitical tensions inherent in “living”—as opposed to “staying alive”—at a critical moment. Nixon examines the “human experience of the Anthropocene” between 1870 and 1900, when “germ theory had ‘gone viral’” (1). Germ theory ushered in, she argues, a “terror of small things . . . a fear of the omnipresent and unseen” and yet failed to offer much beyond this visualization. It, she asserts, “did very little except to highlight human interconnection in its most horrifying configuration” (3). More might have been made of the elision of “seeing” and “doing” in medical discourse; nevertheless, Nixon's claim directs readers to the real focus of her book: the dilemma of human interconnection in a microbial world.

Drawing on Benedict Anderson, Giorgio Agamben, and Julia Kristeva, Nixon interrogates the cost-benefit analysis that underpins the avoidance of exposure to pathogens. Is it worth preserving “bare physical life” (4) at the expense of community (she asks) or mental health (she implies)? Such questions reveal the obvious transhistorical relevance of the book at a time when national lockdowns, face masks, and social distancing have become our new normal. As, during the current pandemic, we strive for ways to remain socially close but physically distant, the shortsighted coining of social distancing is writ large. Nixon historicizes this struggle by examining authors who depict “pure spaces and actions . . . as not simply antiseptic and without contamination, but . . . [as] incapable of sustaining thriving life” (6). Analyzing literary texts in light of public health legislation, professional medical debates, and the politics of hygiene and sanitation, she identifies countercultural narratives—which she terms “biopolitical resistance literature”—that push back against “germ theory's tendency to catalyze isolationism, self-interested social Darwinism, and disregard for common good” (6). “We must embrace our contaminated connectivity . . . to reject risk is to reject real connection with others” she asserts (7). If future editions of the book include a postscript or preface in light of Covid-19, one imagines it will be a complex one to write, given the competing interpretations of “contaminated connectivity.” While “real connection to others” is a vital concern that ought not to be lightly disregarded, in our modern public health context, isolationist regulations are arguably concerned with protecting the very community from which we as individuals abstain. Such nuanced terrain is what makes the book theoretically challenging as Nixon attempts to synthesize—for the most part successfully—universal sentiment with historical contingency.

Her five chapters consider different disease encounters: plague, puerperal (or childbed) fever, tuberculosis, syphilis, and typhoid as they augment interpersonal relationships (friendships, familial ties, marital and sexual relations, and social communities). Pairing each disease with a “specific social or legislative concern,” Nixon establishes a “trifocal” structure (9)—microbial, relational, and sociopolitical—within which to explore the ideological work of germ theory. She employs the concept of “risk encounters” (a useful critical term that she mobilizes throughout the book) to consider how the contagious nature of disease haunted “community mentalities” (10). A range of authors, she argues, exploited the huge metaphorical potential of contagious disease to reflect critically on the fitness of social infrastructures, especially those that discouraged female homosocial friendships and encouraged the isolation, scrutiny, and control of women. Nixon's inclusion of female writers (Mary Shelley, Ella Hepworth Dixon, Charlotte Brontë, Ellen Wood, Mary Elizabeth Braddon) and medical controversies that particularly affected women (debates surrounding obstetricians’ involvement in the transmission of puerperal fever and the implementation and repeal of the Contagious Diseases Acts) is refreshing. She offers provocative close readings that demonstrate the deep conceptual entanglements between the social and the somatic, revealed by the destabilized dichotomy of purity/contamination, and the wide array of forms through which epidemiological metaphors operate, including the discourse of international trade and stock market speculation. Indeed, close reading is where Nixon is at her strongest. Her examinations of tuberculosis and homosocial bonds in Jane Eyre (1847) in chapter 3 and of typhoid in Henrik Ibsen's An Enemy of the People (1882) in chapter 5 are particularly compelling. Her discussion of how sanitary and engineering literature foregrounded microbial symbiosis is a valuable intervention especially in light of recent advancements in microbiome studies. However, I would disagree with Nixon's assertion that Grant Allen's description of “victorious microbes” in The Woman Who Did (1895) has more in common with Richard Preston's The Hot Zone (1994) than with the literary marketplace of the 1890s, given how pervasive this discourse in fact was across both medical and popular genres at the fin de siècle (180). Toward the end of the book, she provides a notable and rich interrogation of the mobile trope of open sewerage systems.

Occasionally the book suffers from a tonal dissonance akin to that which Nixon identifies as a subject of investigation. Her prose style can veer into a sensational register that is at points charming and at others distracting. I take issue with the claim, for example, that “to become diseased is to know that one's body has been infiltrated by an army that cannot be fought” (32). This claim seems untenable given that most people do, on the whole, recover from illness—not to mention its uncritical endorsement of a martial language that many now advocate against. At times, it seems like Nixon has been swept up in the drama of her subject matter, and it is not always easy to separate her authorial narration from Victorian sentimentality: “disease . . . renders the human body physically helpless, the mind prone and defeated, the soul disillusioned and in search of purpose amid tragedy” (32). Despite building her argument around the cultural currency of germ theory at its height after 1870, several of her texts date from an earlier period (1722, 1826, 1847, 1860, and 1863). Nevertheless, Nixon offers important perspectives on the vitalizing role of community, reminding us that we define ourselves always in relation. Her book will have a broad appeal to students and scholars of medical humanities and will be valuable to those interested in topics as diverse as gender, domestic sanitation, middle-class marriage, scientific authority, national identity, and, of course, contagion.