Diego Armús' long-awaited book is not just the story of the medical history of tuberculosis in the city of Buenos Aires. Armús uses the reaction to tuberculosis by those who had it, those trying to cure it and society in general to examine porteño society and its culture. The book covers the period from the 1870s to the introduction of the use of antibiotics in the 1950s, which made tuberculosis much less of a threat. The reaction to tuberculosis is the lens through which the author looks at key aspects of the culture of Buenos Aires. To do this, Armús has examined an extraordinarily wide range of printed sources: government documents, medical journals, labour periodicals and the commercial press. There is not a continuous argument, as the chapters rather tend to be separate entities, and even sometimes within chapters the story is fragmented. However, what the reader has by the end is a picture of the reaction to tuberculosis in Buenos Aires during an 80-year span which reveals a great deal about the society.

Buenos Aires was a city in transition, as immigrants were changing its ethnic make-up and culture while its population was expanding at a remarkable pace and its inhabited areas developing even faster. These changes, plus increasing ‘modernity’, produced a great deal of anxiety, much of which can be seen in the differing reactions to the threat of tuberculosis. These reactions throw considerable light on what the population feared.

The first chapters are the most predictable in that they deal with people attempting to find cures for the disease, but even here all is not as one would expect. Tuberculosis was not an easy disease to diagnose. Until the use of antibiotics became common in the 1950s, the medical profession's ability to cure the disease was not very good and the disease remained unpredictable in its course. Not surprisingly, people with tuberculosis frequently turned to over-the-counter medication; interestingly, most such medicines claimed providence from Europe or the United States, reflecting the supposed cultural superiority of those societies. Great faith was also placed in those who promised cures but were not doctors. This was in part due to the well-known reality that hospitals in the nineteenth century were places to go to die. But even in the twentieth century, when hospitals and sanatoria performed much better, there were not enough beds for all who were ill, and the institutions forced sufferers to be separated from their families. Also discussed is the creation of different types of institution by the state and by private initiatives to try to help those with the disease. As Armús points out, those with tuberculosis were far from meek recipients of the wishes of the medical profession and the state but frequently forcefully asserted their own visions of what should happen to them.

The second half of the book is more unpredictable, since it deals with society's reaction to the disease and throws light on unexpected but intriguing aspects of Argentine culture. For example, when discussing fear of contagion, there is an interesting section on corsets and their supposed contribution to the spread of tuberculosis. Armús also makes clear how fear of certain groups of immigrants was reflected in their supposed proclivity to develop tuberculosis. He also shows that, although men were more likely to have tuberculosis, it was frequently seen as a female disease. Women contracted the disease supposedly because they worked too hard in unhealthy places, or, in the alternative vision seen in the popular culture in tangos and the like, because they had left the respectability of the neighbourhood for the disreputable downtown life of nightclubs and prostitution. Fears of disease reflected or intensified fears created by changing lifestyles, especially among women. We can also see the influence of tuberculosis in discussions of hygiene, factory safety, the design of housing and the need for parks, among other questions. These are important additions to our understanding of how Buenos Aires became the city that it is today.

As the author makes very clear, he has made no systematic attempt to compare Buenos Aires with other societies, though of course references to other countries do appear. Perhaps unfairly, since Armús is explicit that he does not intend to make comparisons, I believe that this is a major weakness of the book. How much of the reaction to tuberculosis (the nature of housing, the growing interest in hygiene and so forth) is parallel to what occurred elsewhere? Were the responses similar, but with unique aspects, or were they very different? This information would say a great deal about the nature of the society. Clearly Buenos Aires as a city was remarkably open to ideas from elsewhere and it is important to know the extent of the impact of imported ideas on porteños’ views about tuberculosis.

Diego Armús has written an important book that tells us much about how the reaction to tuberculosis helped create the modern society of the city of Buenos Aires. The impact was not just on hospitals, sanatoria and those who suffered the disease – tuberculosis also had a significant and interesting impact on many sectors of the city's culture. This is a book well worth reading.