The Germ of Laziness: Rockefeller Philanthropy and Public Health in the New South. by John Ettling, Harvard University Press, 1981.

By Allen Tullos

Vol. 4, No. 6, 1982, pp. 15-17

Toward the end of his study of the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease, John Ettling writes that "so large a hand has the [Rockefeller] Foundation had in shaping the features of our society that any wholesale indictment of its operational philosophy or potential consequences usually reflects the individual critic's disenchantment with that society itself." Whether or not Rockefeller philanthropy has indeed had such a large hand, as compared with, say, Rockefeller capitalism, Ettling seems more than a bit enchanted. His dramatic, many stranded narrative of the 1909--1914 Southern hookworm campaign reveals how a parade of lives are saved through scientific evangelism, ill gained boodle is well spent, good will accrues to the lords of Standard Oil and encouragement is given to public health professionalization. The South, long the nation's sick and sinful section, takes its medicine, begins to throw off its wormy ways and is restored. No mere intestinal tract, Ettling's analysis is mesmerizing. What then, can be said for the breaking of spells?

Reflecting upon the beginning of decades of international health projects which the Rockefeller Foundation has carried out in the twentieth century, a former staffer


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with the Foundation once told me, "Tropical medicine grew largely from concern with the diseases that white men found when they were making tropical countries into safe places to do business." So does charity's irony begin at home. For the hookworm, that prototypical Rockefeller parasite from which a global do-good was elaborated, was a creature of (at first unsuspected) tropical origin that attracted attention when it was discovered in Southern whites and thought to be their "germ of laziness."

Having reached what Ettling aptly calls an "ecological detent" with its native African hosts, the hookworm was a stowaway on the ship of slavery. Brought to the American South, it found a barefooted welcome between the toes and, circuitously, a new home within the intestinal walls of farm folk living on the sandy Coastal Plain and on Appalachian hillsides. Heavy infections were devastating, especially among the malnourished victims of the cotton economy. The hookworm sapped the blood and took lives outright or left its hosts weakened and susceptible to death from other diseases. Sallow, puff-bellied and easily exhausted, hookworm victims knew nothing of their plight or of how they contaminated the privyless ground around their houses with the shit which carried the eggs and larvae to infect and re-infect.

Then, along came Dr. Charles W. Stiles, son and grandson of Yankee Methodist ministers, well-stooled student in German methods of helminthology, discoverer of the hookworm's abundance in the South. Stiles' specialized training and his obsession with this particular parasite (he called it Necator americanus, the American killer, before its African origins were discovered), allowed him to exaggerate its importance as an historical force. Between Stiles and a number of newspaper popularizers, the hookworm was made to explain everything from the loss of the Civil War, to the section's backwardness and poor whiles' alleged lack of energy. Stiles blamed the fatigue, paleness and small size of cotton mill workers not on their long hours, exploited circumstances and young age, but on the hookworm. He estimated, and Ettling accepts without sufficient evidence, the proposition that forty percent of the Southern population had hookworm infection in 1910 so severe as to keep the South from full incorporation within bustling, modern America.

Ettling interprets the hookworm campaign upon a theme of turn-of-the-century public health philanthropy as secularized missionary work. Parasites substitute for nineteenth century sin in an evangelical crusade carried into the bowels of the New South by John D. Rockefeller (the Father), his son--John Jr., Dr. Stiles (the Prophet) and a host of Northern and Southern preachers' boys. Yet, although Ettling's insight is valuable in explaining zeal and method, its over-emphasis in The Germ of Laziness deflects understanding away from a sufficient inquiry into the false gods served by the missionaries.

Central to the story is Frederick Gates, son of a New York Baptist minister and architect of the Rockefeller philanthropic bureaucracy. Like Dr. Stiles, Gates nurtured obsessions, but of a grander scale: the getting and spending of fortunes. Even while helping the elder Rockefeller systematize and deploy his charity, Gates also helped him corner the Mesabi ore region of Minnesota.

Under Gates, Rockefeller philanthropy, following from Rockefeller money making, had shifted from a baronial manner into the rationalized, deliberative mode of corporate modern. As Gates saw it, the largesse through which a Protestant God had signified Rockefeller's spiritual election demanded as much manly stewardship and close accounting in its disbursal as in its acquisition. Philanthropy ought not prop up those whose obvious lack of will and work had caused their failure in life's competitions. But one could give another chance to those whose weaknesses and debilities grew from causes beyond their control. "Disease," offered Gates, "is the supreme ill of human life, and it is the main source of almost all other human ills, poverty, crime, ignorance, vice, inefficiency, hereditary taint, and many other evils."

It was Walter Hines Page, who, while a member of Teddy Roosevelt's Commission on Country Life, had introduced Dr. Stiles to Gates. North Carolina's Page was a New South publicist with a New York address, a cheerleader for the section's reunion into an America which had set itself the World's Work (the name of Page's magazine) to do. So, in 1909, an eager alliance was struck between a parasitologist who held a hookworm determinist theory of history (and had been looking for a patron since 1902) and a philanthropy ordained by the laying-on of quite visible hands.

The high tone of the mobilization against the hookworm was set by Wickliffe Rose, chosen to be the South-wide administrator of the Sanitary Commission. Rose (Dean of George Peabody College and the University of Nashville, General Agent of the Peabody Fund, Executive Secretary of the Southern Education Board and member of the Slater Fund) had buried his origins as the son of a cotton farming fundamentalist Tennessee preacher under a meticulous persona, giving shape to one of the South's first bureaucratic personalities. Ettling writes that Rose "stood out from his colleagues most noticeably for his deep-seated reluctance to stand out at all. Unlike many of the men with whom he worked, Rose seemed to take genuine satisfaction in anonymity."

The gentlemanly Rose spun newspaper articles and a propaganda campaign, determined the spending of the million dollar budget, chose the physicians to direct each state's organization and sought the alliances he felt were most necessary: with boards of education, public school teachers, women's clubs, doctors' associations. That public health work was needed in the South, there can be no doubt. That the South's first major health campaign was dependent upon private capital and a remotely controlled chain of command had both immediate and ultimate consequences.

The hookworm campaign must also be seen, and this is an Ettling omission, in relation to the emerging bourgeois society of the Piedmont South in the 1890's and 1900's. Here, some oral history, courthouse research or a few afternoons in the local library reveal the particulars of the rise of town elites, shifting patterns of land ownership and mercantile wealth and the enmity between town and country or mill village folk. The builders of those fine Victorian houses which, even now, sit turreted and asymmetrical behind the oak-lined streets of most every city with a railroad to its name were a powerful and rising force in their country's and region's affairs.

These merchants, bankers, lawyers, editors, doctors


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and preachers were not only attuned to strictly local matters, but more and more they were involved with and imitative of national standards and market practices. If a mill owner sponsored community musicians, a uniformed Sousa band, not a hillbilly group, most likely won his nod. Campaigns such as those for hookworm eradication, privy budding, free white public schooling or even mandatory innoculations have to be seen not only as worthy causes of betterment, but as events through which elites influenced appetities, stirred needs, showed condescension, expressed control and re-arranged accustomed patterns of feeling. Such campaigns reflected, even as they attempted to foster and extend, the domains and contentions of social and economic powerholders. With the breaking of Populist resistance, with blacks as well as many poor white males disfranchised by recent state constitutional conventions and with Jim Crow established as the scapegoat for all seasons, New Southerners and their Northern allies could at last settle down to some serious profit taking. As they did, they elaborated only such necessary institutions of the modern state as their laissez faire attitudes begrudged or as an occasionally aroused citizenry could effectively demand. Often, the most persistent elements of this citizenry turned out to be wives or unmarried female kin of these same New South "men of affairs."

When the Rockefeller hookworm crusaders called upon the forms of Southern ritual to shake out converts, the results are not clear to read. In several communities hookworm circuit riders organized camp meeting style gatherings with dinner on the ground, music, speechifying, an instructive sermon and the dispensing of doses of medicine. Yet it seems that much of this was show. Administrator Rose needed to record a large number of "cases treated" in order to please administrator Gates and Rockefellers. Ettling points out that Rose pitted "doctor against doctor in a kind of frenzied competition to roll up the numbers." Dr. Stiles, sidelined by Rose for his lack of organizational diplomacy, estimated that more than half of the folk to whom the medicine was dispensed took it home and threw it away.

In the end, after four years of work, no Southern community could honestly claim that the Sanitary Commission had eliminated the hookworm from its bailiwick. Yet the Rockefellers decided that it was time to move their medicine show to a wider audience. When Gates ordered the tents struck and the stakes pulled, Rose grumbled a bit but complied. In May, 1913, the Rockefeller Foundation set out "to promote the wellbeing of mankind throughout the world." Its first project, eased by the new British ambassador Walter Page, was to carry the hookworm campaign into the colonial territories of Great Britain.

As the Rockefeller Foundation's Hookworm Commission departed the South, the section's poverty remained. It, and not the hookworm, had been the real problem all along. Yet to have faced the origins of New South poverty required an introspection that the hookworm evangelists, busy with their attempts to chase the demons out of dispossessed poor whites, could not allow.