Revolutionary Syndicalism and the Development of an Alternative Etiology of Tuberculosis

During the mid- to late 1890s, at roughly the same time that socialists were developing a critique of tuberculosis, the new ideology of revolutionary syndicalism began to address the disease in its propaganda. As the CGT and the bourse du travail movement (a network of local trade union organizations) articulated an intense opposition to electoral politics and a reliance on the working class alone in the struggle to remake society, workers’ health assumed importance as an issue workers themselves needed to take charge of. Syndicalists rejected not only the socialists’ electoralism and reformism in parliament but also the idea that any facet of the official War on Tuberculosis could help the working class.

What most distinguished the syndicalist perspective on tuberculosis from the others was its complete rejection of the medical establishment’s strategy and terms of debate. In place of slum housing, exposure to the bacillus, and moral depravity, the syndicalists targeted overwork and low wages as the chief causes of the disease. They also rejected the casier sanitaire, legislation, sanatoriums, and private charity in favor of “direct action”: intense propaganda and trade union organizing to press for economic demands, backed up by strikes and by the threat of the revolutionary general strike.

Given the syndicalists’ attitude toward existing institutions and authorities, there were a limited number of avenues available to them through which to publicize their position on tuberculosis and other health issues. All organs of the medical establishment and the mainstream press were inaccessible to their subversive, revolutionary ideology. Their oppositional etiology of tuberculosis seems to have been spread largely in the following ways: word of mouth; occasional propaganda posters or pamphlets; union or bourse du travail activities and clinics; and two major publications, the CGT’s La Voix du peuple and the more theoretically oriented anarchist journal Les Temps nouveaux.^[30] The nature of these avenues of expression, combined with the elusive nature of the phenomenon itself, makes it impossible to measure either the diffusion or the reception of the syndicalist critique. However, the alternative etiology of tuberculosis can be assessed and understood contextually through an analysis of the key texts in its development. Although as a general rule, historians both of the French labor movement and of tuberculosis have ignored this aspect of syndicalist agitation, these texts reveal the development of a coherent, medically sophisticated, and relatively widespread understanding of the disease that aggressively took issue with mainstream medical knowledge.

One of the earliest signs that revolutionary syndicalism was developing its own explanation of working-class tuberculosis and consciously rejecting the dominant etiology appeared in a series of articles by Fernand Pelloutier published in various journals between 1894 and 1897.^[31] Pelloutier, whom many historians consider to be the father of revolutionary syndicalism through his leadership of the bourse du travail movement, took a strong, unequivocal stand on tuberculosis. He ridiculed the bourgeois hygienists who ascribed high tuberculosis mortality to excessive population density and to working-class housing lacking sunlight and ventilation.

As noted above in chapter 4, Pelloutier contrasted two Parisian neighborhoods to prove his contention that poverty, not overcrowding, caused high death rates.

The Temple quarter, one of the most unsanitary in central Paris, is occupied both by rich merchants who reside there and by a mass of workers who descend there every day from the quite healthful heights of Ménilmontant. So, where do more people die? In the Temple? No, in Ménilmontant. Isn’t this because in the former, rest and wholesome diets triumph over unsanitary conditions, whereas in the latter, the purity of the air is powerless to neutralize the effects of extraordinary hardships?^[32]

Rather than in overcrowding, Pelloutier saw the cause of tuberculosis (as well as of epidemic diseases) in “the weakening produced in the worker by a despicable diet and hard labor.” Such diseases “would be extinguished at their source if poverty did not prepare soil favorable for their propagation.”^[33]

When Pelloutier first began the series of articles, which were later collected in La Vie ouvrière en France, it is likely that his was a voice crying out in the wilderness. By 1897, however, there were indications that some kindred political spirits were beginning to see tuberculosis and other health problems in the same light. In that year, the Groupe des étudiants socialistes révolutionnaires internationalistes de Paris (ESRI), an anarchist student group formed in 1891, published Misère et mortalité, the group’s sixth in a series of educational pamphlets. The mere fact that disease and mortality warranted a spot in their periodical propaganda writings on contemporary political issues signified a new conception of the role of such questions in a revolutionary movement. Although it was unsigned, the pamphlet was probably written by Marc Pierrot, a doctor who had been active in the ESRI since medical school and who would later prove to be one of the leading syndicalist authorities on health matters in general and tuberculosis in particular.^[34]

The pamphlet took pains to place individual diseases within a broad social and physiological context. To illustrate how this context affected the worker’s body and health, the group used tuberculosis “as the archetype of these general diseases determined by social conditions.” According to this analysis, the disease was most common where certain specific circumstances prevailed, and these circumstances fit exactly into a broad social profile.

[Tuberculosis] strikes above all those who are surmenés, weakened by hardships and by overwork, living in a confined atmosphere, in unsanitary and overcrowded lodgings, in the middle of a dense population. It is therefore in the working class, where all of these conditions are realized, that it finds most of its victims.

Again, as in Pelloutier’s argument, proof of the determinant role of social conditions in tuberculosis could be found in the statistical distribution of the disease in the arrondissements and quartiers of Paris. In the working-class districts, tuberculosis mortality reached levels nearly five times that of the fashionable eighth arrondissement.^[35]

With the publication in 1897 of Misère et mortalité, an important step was taken in the elaboration of the new syndicalist etiology. For one thing, Pelloutier’s dissenting voice found an echo in this anarchist manifesto against physiological exploitation. Moreover, as it was almost certainly written by a medical doctor (Pierrot), it presented a more fully theorized medical argument—at greater length and in more detail—than had Pelloutier’s articles.

By 1904, both the ideology of revolutionary syndicalism and the issue of tuberculosis carried much more weight in France’s public sphere. The syndicalist alternative to the dominant etiology had progressed significantly in terms of exposure and sophistication. Tuberculosis even showed signs of becoming part of the standard, familiar ammunition of labor propaganda. In spring 1904, for example, the local bourse du travail in Paris (at the time officially known as the Union des syndicats de la Seine) decided to publish a pamphlet on the causes of tuberculosis and its relevance to the workers’ movement. Paul Delesalle, a veteran of ESRI and a leading figure in the CGT, initiated the proposal, and the executive committee of the Union des syndicats agreed that workers needed to know more about the disease they all too often experienced. The committee did not want a general work on tuberculosis but something that would shed light on “the determinant causes of this terrible illness among workers[:]…poverty, overwork, lack of substantial nourishment”; they wanted, “in a word,…a union propaganda brochure.” A militant from the barbers’ union, Raymond Dubéros, was chosen to write it.^[36]

By the end of August, Dubéros had produced the pamphlet, and unions in the Paris region were working hard at getting it the widest possible audience. Dubéros had given the Union des syndicats the propaganda it had asked for; in fact, he managed in sixteen pages to turn a medical question into a trade union recruiting appeal. He based the appeal on a simple syllogism: “Tuberculosis is the sickness of poverty”; “to eliminate poverty is to eliminate tuberculosis”; “only [unions] are capable of effectively fighting tuberculosis, because only their action strives to eliminate poverty.”^[37] Not only was Dubéros’s pamphlet the first of the syndicalist texts to be devoted exclusively to tuberculosis but it also crossed the indistinct line separating theoretical critique from pragmatic program. As a direct call to action, the union’s brochure added a new dimension to the syndicalist etiology of tuberculosis.

Nearly simultaneously with Dubéros’s pamphlet, there appeared in Les Temps nouveaux another document that marked a new stage in the syndicalist understanding of tuberculosis. Between July and December 1904, the newspaper published a series of nineteen articles by Dr. Marc Pierrot entitled “The War on Tuberculosis and the Sanatorium Question.” Taken together, the articles represent no less than a complete medical textbook on tuberculosis—from an anarchosyndicalist perspective. Pierrot, who was a regular contributor to Les Temps nouveaux as well as an ESRI alumnus, took pains to explain germ theory, physiology and other medical concepts in a manner comprehensible and relevant to laymen. In place of inflammatory rhetoric or theoretical generalizations, Pierrot gave his readers an exhaustive exposition of the causes, prevention, and treatment of tuberculosis. He also gave household advice for avoiding the disease and for dealing with it rationally when it appeared. In sum, Pierrot attempted to combine an accessible medical treatise refuting the dominant antituberculosis strategy with a practical handbook on tuberculosis for working-class families.^[38]

Pierrot’s series of articles in Les Temps nouveaux and Dubéros’s La Tuberculose, mal de misère, both of which appeared in 1904, presented the alternative etiology of tuberculosis in its mature form, fully articulated and taking its place within the political program of revolutionary syndicalism. It is significant that the oppositional view reached maturity at that time. The CGT’s biennial congress in Bourges, at which it decided to focus its agitation on a single issue, the eight-hour day, took place in September 1904. The International Tuberculosis Congress in Paris, during which the disease was front-page news in all national newspapers, took place in October 1905. Dubéros’s pamphlet was published and Pierrot’s series in Les Temps nouveaux was well under way by the end of August 1904.

This chronology is important. Had these texts appeared slightly later, it might be plausible to dismiss the syndicalist antituberculosis propaganda on either of two grounds: that the movement attempted to refashion as many “workers’ issues” as possible in terms of long workdays, having already put all of their eggs in that basket (at Bourges); or that syndicalists seized on tuberculosis as fodder for agitation once it became a familiar and highly visible issue in the public eye. In other words, syndicalist propaganda might have opportunistically seized on any issue, including tuberculosis, that was being discussed by mainstream newspapers or politicians or that suited its immediate strategic needs. Instead, it seems that ideological forces within revolutionary syndicalism itself led to the appropriation of tuberculosis as a major topic of propaganda. These forces were rooted in the movement’s split from socialism and in its “holistic” tendencies, that is, its insistence (inspired by Pelloutier) on the importance of health, education, and general welfare in the overall economic struggle. A closer examination of the principal elements of the syndicalist critique illustrates the ways in which tuberculosis became a lightning rod and focal point of agitation.