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Jeanne E. Abrams, “Spitting Is Dangerous, Indecent, and against the Law!” Legislating Health Behavior during the American Tuberculosis Crusade, Journal of the History of Medicine and Allied Sciences, Volume 68, Issue 3, July 2013, Pages 416–450, https://doi.org/10.1093/jhmas/jrr073
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Abstract
Tuberculosis was the leading cause of death in early twentieth-century America. Reducing the sputum vector of contagion by changing public behavior initially focused on anti-spitting campaigns. According to most Progressive Era health experts, “promiscuous” spitting was a prime culprit in spreading the disease. Beginning in 1896 in New York, towns and cities throughout America passed anti-spitting legislation, sometimes creating tensions between individual liberty and the need to protect public health, and often highlighting class issues. Progressives viewed anti-spitting legislation in a favorable light because they advocated improving the health and well-being of Americans using state-of-the-art medical knowledge and because they often advocated the use of law and the coercive power of the state to impose order on society.