Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World Health

Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World Health

by Kirsten Ostherr
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Duke University Press Books


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Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World Health

A timely contribution to the fields of film history, visual cultures, and globalization studies, Cinematic Prophylaxis provides essential historical information about how the representation of biological contagion has affected understandings of the origins and vectors of disease. Kirsten Ostherr tracks visual representations of the contamination of bodies across a range of media, including 1940s public health films; entertainment films such as 1950s alien invasion movies and the 1995 blockbuster Outbreak; television programs in the 1980s, during the early years of the aids epidemic; and the cyber-virus plagued Internet. In so doing, she charts the changes—and the alarming continuities—in popular understandings of the connection between pathologized bodies and the global spread of disease.

Ostherr presents the first in-depth analysis of the public health films produced between World War II and the 1960s that popularized the ideals of world health and taught viewers to imagine the presence of invisible contaminants all around them. She considers not only the content of specific films but also their techniques for making invisible contaminants visible. By identifying the central aesthetic strategies in films produced by the World Health Organization, the Centers for Disease Control, and other institutions, she reveals how ideas about racial impurity and sexual degeneracy underlay messages ostensibly about world health. Situating these films in relation to those that preceded and followed them, Ostherr shows how, during the postwar era, ideas about contagion were explicitly connected to the global circulation of bodies. While postwar public health films embraced the ideals of world health, they invoked a distinct and deeply anxious mode of representing the spread of disease across national borders.

Product Details

ISBN-13: 9780822336488
Publisher: Duke University Press Books
Publication date: 11/16/2005
Edition description: New Edition
Pages: 288
Product dimensions: 6.13(w) x 9.25(h) x (d)

About the Author

Kirsten Ostherr is Assistant Professor of English at Rice University.

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Copyright © 2005 Duke University Press
All right reserved.

ISBN: 978-0-8223-3635-8

Chapter One


"A movie a week" is with us a national slogan, almost a physical trait absorbed by the children with their mother's milk. HENRY JAMES FORMAN, Our Movie Made Children


In the early twenty-first century, a typical trip to the movies almost anywhere in the United States involves driving to a megaplex and watching a Hollywood blockbuster. The chances of seeing a nonfiction film at such a theater are minimal, with occasional noteworthy exceptions. At this point in history, specific film genres are so closely tied to specific screening venues that the arrangement seems unremarkable (to the extent that it is even recognized). However, this situation did not arise organically out of the natural development of the film industry. On the contrary, the separation of fiction and nonfiction film exhibition was the result of strategic regulatory mechanisms designed to protect motion pictures from censorship (that is, to protect the profits of the Hollywood studios).

While neither the studiosystem nor the Production Code remains in effect today, the vestiges of content regulation are still with us in the form of the ratings system. The idea that a governing body might oversee the distribution of movies to theaters and restrict access to certain types of films thus seems familiar and again, unremarkable. Through the notion of age-appropriate content, the Motion Picture Association of America (MPAA) stratifies the audience according to a system that allows viewers progressively increased access to graphic depictions of sex and violence over time. Although this system might provide a legitimate rationale for preventing nine-year-olds from viewing excessively "mature" content, it does not explain why educational films that have nothing to do with sex or violence are also essentially prohibited from mainstream commercial theaters. One obvious explanation might be that the film industry is a business like any other, and educational films simply do not make money. Another explanation might be that audiences go to the movies to be entertained, and nonfiction films are too serious, pedagogical, or otherwise demanding to be much fun to watch. And yet, until the 1930s, fiction and nonfiction films were exhibited side by side, in the same theaters, often on the same bill. Clearly, then, the prevailing wisdom on what kinds of films make money and what constitutes entertainment has changed over time. A major goal of this chapter is to explain how and why these changes took the shape they did.

But even as fiction and nonfiction film venues have obviously been separated, the boundaries between these categories of film are anything but clearly defined. This might seem paradoxical given the ease of identifying the lone documentary film among the blockbusters when it does make its rare appearance at the local megaplex. However, as many film scholars have noted, fictional films have long depended on the same kinds of realism that endow documentaries with their sense of authenticity, while documentaries, in turn, have always borrowed narrative and other techniques from fiction film genres. In other words, although the exhibition practices associated with educational and entertainment films would seem to imply that these are very different types of films requiring utterly distinct viewing environments, a comparison of their respective modes of representation would suggest the opposite conclusion. This is especially true of the set of films I will be discussing in this book-the films that collectively form the discourse of world health. This archive of films consists of both instructional public health films and Hollywood feature films, and the efforts to separate the two types of films are as interesting and revealing as the degree of overlap in their representational techniques.

Consider the case of Prevention of the Introduction of Diseases from Abroad (1946), and Panic in the Streets (1950). Prevention is a public health film, Panic is a Hollywood film, but both address the invasion of the United States by invisible and deadly contagious diseases hidden within the bodies of immigrants. The history of public health is punctuated by cases of specific nationalities being ostracized as vectors of ethnic ailments, especially in the period of mass immigration to the United States from 1880 to 1924. While certain objective markers of difference, such as language, might easily distinguish ethnic identity, cultural stereotyping often relied more heavily on abstracted forms of visually perceptible signs, and this was especially true in the medium of film. While Prevention is an instructional documentary and Panic is an entertaining fiction, the modes of representing invisible contagions in these films are strikingly similar, despite their production well after the Production Code officially separated education and entertainment in 1934.

In Panic in the Streets, contagious disease enters the United States through the body of an illegal Eastern European immigrant who is shot to death on his first night in the country as retribution for leaving a card game on a winning streak. An autopsy reveals that the man would have died of pneumonic plague anyway, and thus begins a frantic race against time to locate the person who shot the immigrant as well as anyone else who may have had contact with the disease carrier. Since the plague is spread through airborne pathogens, the possibility of mass contamination is great, as is the need for identification and containment of infected persons. Thus, one of the central narrative tensions of the film is set up: how to conduct a search for contagious individuals whose symptoms will be internal and, therefore, invisible, until it is too late to cure them or trace their contacts. Added to the problem of detecting disease carriers is the problem of containment; the search must be conducted secretly in order to prevent public panic and mass evacuation of the city, which could lead to the spread of plague throughout the country. As in many public health films of the period, Panic in the Streets solves the problem of invisible contagions through a visual collapse of bodily signifiers of ethnicity and disease.

The search for carriers of plague thus becomes a search for external markers of internal conditions, and those markers initially take the form of a taste for ethnic cuisine-specifically, shish kebab-as the central clue to the location of potential contacts with the original carrier of plague. The conflation of the signifiers of ethnicity with the signifiers of disease pervades the discourse of world health, with its visual association of disease and permeable national and organic bodily boundaries. In this film, the consumption of ethnic food literalizes the feared border crossing from outside to inside the body, and the embarrassed admission of fondness for this exotic food by a "nonethnic" USPHS officer in Panic in the Streets confirms the paranoia that structures the world of international health regulation.

While both films narrate the pursuit of contagion by the USPHS, Prevention of the Introduction of Diseases from Abroad explains in great detail the techniques for stopping invisible contagions from crossing national borders. Accompanied by a booming, authoritative voiceover, the film consists of documentary footage of immigrants disembarking on Ellis Island and submitting to visual investigation by the camera and the USPHS officers. The status of the onscreen bodies as potentially diseased "others" is narrated through reference to global epidemiological maps that trace the spatial and temporal flow of contagion through a series of displacements. For instance, text from Webster on Pestilence appears onscreen, explaining that, "This disease is constantly present in the Orient, and this fact makes it an ever-present threat to the United States and its possessions." Following this proclamation, documentary images of purportedly diseased bodies in that locale appear onscreen (figure 4). The scene then cuts abruptly to a close-up of a rat, while the voiceover observes, "The germ that causes bubonic plague is carried by fleas that live on rats and other rodents. Rats are great travelers, and vessels at port must use rat guards to keep them from coming aboard" (figures 5 and 6). The metonymic slippage from disease to "Oriental" bodies to rats performs the racialized anxiety about invasion of national and bodily boundaries by invisible contagions that permeates the discourse of world health. Moreover, this sequence encapsulates the film's conception of globalization as the process by which foreign diseases gain entry into the United States-a perspective shared by Panic in the Streets.

The assumption that plague did not exist in the United States until it arrived on a ship carrying foreign seamen clearly identifies global transportation as a primary vector of invasion and contagion. This linkage is explicitly recognized in public health policy, literature, and films, where it is often noted that the modernization of transportation technologies has been attended by an expansion in the scope of communicable diseases. This recognition is often depicted cinematically through epidemiological maps, and in both Panic in the Streets and Prevention of the Introduction of Diseases from Abroad, the imagined lines of movement across the globe posit transportation itself as a conspiratorial agent linked with the contaminating invasion of national borders that inevitably accompanies the process of globalization.

The threat posed by transnational mobility is articulated in Panic in the Streets when the USPHS officer (Dr. Reed) demands that the local newspaper refrain from printing a story on the potential outbreak of plague. The character fears that such an announcement might provoke the widespread "panic" of the film's title, followed by a mass exodus from the infected city, and "anyone who leaves town endangers the entire country." When the mayor resists this logic, understanding the problem as specific to the local community, Dr. Reed asks him if he thinks he's living in the Middle Ages, arguing that, "Anybody that leaves here can be in any city in the country within ten hours. I could leave here today and I could be in Africa tomorrow. And whatever disease I had would go right with me!" By implicitly recognizing the concept of world health, this monologue encapsulates the centrality of disease to the film's understanding of the relationship between the local and the global. Here, interstate and international transportation are themselves understood as threats to public health which can be curtailed only by enforcing immobility on a population contained within closely regulated borders.

As we see in the climactic sequence of Panic in the Streets, the regulation of national boundaries against penetration by invisible contagions takes a form uncannily similar to the sequence from Prevention of the Introduction of Diseases from Abroad described above. The "ethnic" criminal who murdered the original carrier of plague is infected himself, and at the end of the film both the police and the USPHS pursue him in the shipyards of New Orleans. In a desperate attempt at escape, the criminal scales a rope anchoring an outbound vessel to the wharf, but he is foiled, like the rodent in Prevention, by a simple rat barrier (figures 7-9). While viewers of Panic in the Streets may not necessarily have seen Prevention of the Introduction of Diseases from Abroad, there is an assumed audience comprehension of the purpose of the device on the rope, which functions not only to provide narrative closure (the criminal and disease carrier is caught; the rat is prevented from escaping national borders), but also to consolidate a tropic relationship that develops throughout both films between immigration, disease, and criminality. Based on such visual relationships, we can see that the representation of alien and viral invasion-in both educational and entertainment films-is integrally linked to conceptions of nation and globalization within the discourse of world health.

This brief comparison illustrates one of many cases in which the attempted separation of public health and Hollywood modes of representation is circumvented through the different films' shared participation in broader discourses of visuality and disease. As we will see, the rhetoric of contagion pervades the debates about motion picture regulation in the 1930s, but the consignment of medical and health-related themes to the realm of nonfiction educational cinema failed to eliminate the preoccupation with invisible contagions from pictures designated for entertainment purposes only. But why were these film genres separated in the first place?


While films like Prevention of the Introduction of Diseases from Abroad and the earlier How Disease Is Spread (1924) might seem to be motivated by the fairly straightforward and innocuous goal of health education, such films were in fact subject to a great deal of scrutiny, criticism, and, ultimately, censorship. The u.s. government's entry into film production during World War One had persuaded numerous voluntary and commercial organizations of cinema's propagandistic capacities, and after the war, many attempted their own public education campaigns. But as moving images increasingly permeated every aspect of daily life in the United States, reformers became more adamant about the need for standardized regulation of cinema's potentially harmful effects. At the same time that government health surveillance organizations became involved with health film production, the exhibition of health-related motion pictures for entertainment in commercial theaters came under attack.

Debates abounded over the social and artistic role of cinema in the public sphere of the 1930s, and the discourse arising out of these debates was centrally concerned with the intersections of spectatorship and contagion (both moral and biological). The proliferation of treatises on the "educational" versus "entertainment" value of film in this period formed the context for the policy debates that ultimately resulted in the stricter and more heavily enforced content regulation of the Hollywood Production Code in 1934. Because they were seen as excessively realistic, educational films-especially health education films-became casualties of the institutionalized separation of pleasure and instruction that resulted from the revision of the Production Code.

This redefinition of theatrical entertainment effectively functioned as a public quarantine of educational films by restricting their exhibition to noncommercial venues, and this division left the production of health films largely in the hands of government organizations. But cuts in public health funding after World War One and the economic depression of the 1930s severely limited both noncommercial and government public health film-making between World Wars One and Two; by 1934 the realm of commercial health film production was also severely circumscribed. However, despite minimal production of purely educational health films in this period, the years between the end of Hollywood's silent film production in the late 1920s and the beginning of systematic enforcement of the Production Code in 1934 allowed for cinematic experimentation with a variety of topics-including health and medicine-that would later be eliminated from the major studios' repertoires. The films produced during these years, and the debates about how they should be regulated, defined the context for the postwar development of the discourse of world health.


Excerpted from CINEMATIC PROPHYLAXIS by KIRSTEN OSTHERR Copyright © 2005 by Duke University Press . Excerpted by permission.
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Table of Contents

Illustrations ix

Acknowledgments xi

Introduction: Cinema and Hygiene 1

1. Public Sphere as Petri Dish; or, “Special Case Studies of Motion Picture Theaters which are Known or Suspected to be Foci of Moral Infection” 18

2. “Noninfected but Infectible”: Contagion and the Boundaries of the Visible 47

3. From Inner to Outer Space: World Health and the Postwar Alien Invasion Film 79

4. Conspiracy and Cartography: Mapping Globalization though Epidemiology

5. Indexical Digital: Representing Contagion in the Postphotographic Era 155

Conclusion 192

Notes 197

Bibliography 225

Filmography 249

Index 259

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