Matthew Newsom Kerr's book examines how hospitals could control and govern populations with the view to tackling contagion. Specific focus is given to the institutions of the Metropolitan Asylums Board (MAB) in London in the latter half of the nineteenth century, and the way in which isolation was utilized as a strategy for managing the health of urban localities. The rationale for Contagion, Isolation, and Biopolitics in Victorian London is that very little research has centred on London's isolation hospitals, apart from Gwendoline Ayer's administrative history of the MAB, published in 1971. Similarly, Newsom Kerr notes that there has been ‘no sustained analysis of the place of hospitalization within the broader narratives of public health and urban history’ (p. 7). He addresses this imbalance by reinforcing the importance of London as a centre for the advancement of knowledge about infectious disease and how best to contain it.

Newsom Kerr's focus falls on the institutions under the remit of the MAB, established in 1867 to deal with London's sick poor. Patients were admitted suffering from contagion such as ‘smallpox, scarlet fever, diphtheria, typhus and typhoid’ (p. 3). By 1903, this network of state hospitals included 15 sites with a capacity to treat 9,000. The overarching questions that are explored in this book centre on the governance of these establishments, along with the wider public health considerations, and the policies which dictated who would be sanitarily governed.

Newsom Kerr correctly identifies the importance of isolation hospitals within the urban public health infrastructure of the later nineteenth century. Traditionally, scholars of the hospitals that operated in this era have been concerned with medical diagnostics, and how professionals advanced medical knowledge. Newsom Kerr's examination, however, moves away from this centre, and instead explores how bodies were controlled in the context of the governance of the city. As a result, important questions are raised about the friction between the liberal, Victorian laissez-faire political attitude, and creating sites of social control in the name of preventing epidemics. The fear surrounding the spread of disease was an important factor, as it provided governments with the opportunity to suppress individual will with public support.

Biopolitics, as the title suggests, is also a main focus of the book, and is defined as the technologies used to secure the population, particularly in terms of their bodies. The MAB was instated by central government in order to deal with a city that in the early nineteenth century was deemed the ‘worst governed’ in the empire (p. 173), due to disjointed and overlapping jurisdictions all attempting to rule the capital. This had resulted in ad hoc remedies and inaction to vast epidemics, which were ineffective long-term solutions. The network of isolation hospitals constructed under the MAB created a centrally governed initiative to combat large-scale contagion, and was soon put to the test by a devastating outbreak of smallpox in 1870. This saw 16,000 patients treated in the MAB hospitals over the following 18 months (p. 179). However, most deaths occurred outside institutions, and the solutions were still ad hoc and dictated by parish boundaries. Newsom Kerr states that this was an important event in reinforcing the need for large urban hospitals, rather than small provincial sites. Health care became centralized, made up of specialist institutions for particularly severe outbreaks on the outskirts of the city, town hospitals, floating hospitals in the form of ships on the Thames to isolate contagious cases and an ambulance system to obtain ‘control of the patient from his door to the hospital’ (p. 203). As a result, as Newsom Kerr concurs, the hospitals ‘were not geared against natural processes as much as they were arrayed to work with and through them’ (p. 220).

The strength of the book lies within the balance Newsom Kerr has struck in recounting the importance of the MAB in transforming the public health infrastructure and bringing out the impact on individual parishes and patients. Through highlighting pivotal cases, scandals and legislation, the level of detail emphasizes the conflicting arguments of the period which had to be considered when controlling the spread of disease. Undoubtedly, this book will be important reading for scholars of urban history, as the exploration of the regulation of disease has been researched in great detail, and presents the value of the MAB in this period. However, this book will also appeal to social and medical historians for its consideration throughout of the impact that isolation hospitals had on the control of bodies via confinement in the name of preventing the spread of contagion. This paves the way for future interdisciplinary studies concerning urban public health infrastructure and medical care in terms of the control placed on individuals for the ‘greater good’.