The modern metropolis: a heady cocktail of sex, technology and high finance, with an undertone of sewage.

Can’t taste the shit? Trust me, it’s there.

Along with the rise of the city, the nineteenth century also saw the rise of imperialism, global capital networks and increased state intervention in matters that were previously of a rather, ahem, personal nature.

From New York to London to Paris, there was massive public investment in sewers, running water, the banishment of foul odours and so on. Why the sudden bourgeois obsession with hygiene?

Historians1 have argued that it was one of the ways the “civilized” world distinguished itself from the “uncivilized” hordes. Nowhere was this contrast more visible than in the colonies, where the European parts of town were tarted up to put the natives on notice that this was the proper way to run things.

In cities like Tianjin, in northern China, where multiple imperial powers were in competition with each other for who could grab the largest slice of Chinese territory, the drive to achieve a gleaming hygienic modernity was especially intense. With every outbreak of disease, the imperial powers would close ranks against the Chinese residents, typically by trying to control their movement in and out of the foreign settlements.

The historian Ruth Rogaski makes the point that although Chinese cities traditionally did make provisions for waste management, Chinese elites did not think it was proper for the state to interfere so directly in the lives of its people.

“Qing statecraft held that during health crises such as epidemics, the proper public role of the government and gentry was to distribute free food and medicine, provide burial services, attend to epidemic-fighting religious rituals, and publicize important medical information.”2


In fact the modern Chinese word for hygiene, “weisheng,” was traditionally understood to represent a far more holistic approach to health, such as eating well, taking supplements and doing breathing exercises. The state had nothing to do with it.


By contrast, the colonial state’s approach to maintaining health and hygiene was heavy-handed. They moved polluting industries away from residential areas. They interfered in sacrosanct burial rituals (failure to notify the authorities of a death in the family resulted in a punishment of hard labor). They gathered the homeless and put them to work cleaning the streets. Residents who once defecated in the open fields were now forced at gunpoint to use the government-constructed public toilets. Nonetheless, it worked.

And if it ain’t broke, why fix it, right?

But here’s the rub. It’s becoming increasingly difficult to define the limits to public encroachment on personal health. Should smokers and obese people be treated by publicly-funded healthcare? Should the data collected by our fitbits be accessible to insurers? And although we were given a modicum of control over our health records in the past, should we have this same expectation of privacy in the smart cities of the future?

Understanding the ideological origins and alternative conceptions of public health might better enable us to answer these questions.