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

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 

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.
        
