Reading Tomes as a starting point?

I think that Tomes book is very important in that is laid the groundwork for much of the critique of medicalization in other texts. The book works well to deconstruct the discursive history of germs position it as not simply pooping up randomly at a unique time in history, but rather that germ theory is part of a long narrative of medical, cultural and social history. This allows us to understand germ theory as a social construct, rather than simply medical fact, especially in the way that the theory impacted the daily lives of gendered and racialized populations.
I also think that showing how germ theory can be both oppressive as well as utilized by groups to improve their social condition is a crucial distinction that the text makes. But despite of this, I think at times Tomes seems to underestimate the impact that this germ theory has as a tool of social control. Germ theory and medicalization were often used to initiate social policy that excluded and separated non-white heteronormative groups from social equality. Although this text was in many ways a starting point of other works, I don’t think Tomes emphasizes the oppressive facets of the implications of germ theory as much as necessary.
One text that looks at germ theory, as a tool of oppression is Contagious Divides: epidemics and race in San Francisco's Chinatown by Nayan Shah. This text clearly owes a great deal to Tomes and she is referenced many times, but Shah takes the understanding of germs much further. The text, written about three years after Tomes, shows how a discursive history of linking of the Chinese immigrant population in San Francisco to being disease ridden. Through this linking Chinatowns were established and made into ghettos to keep the Chinese population separate from the remainder of the population in fears that disease would be spread. Also, this historical creation of an image of the Chinese as a dirty, disease-ridden population allowed them to be legislatively discriminated against. Thus heteronormative whiteness was reinforced as moral, just and upstanding, but also cleanly and free of disease.

Perhaps without Tomes test such scholarship as Shah’s would not have been possible, so in that regards it is very much a crucial text, but it could have taken the marginalizing impacts of germ theory a bit further in the work.

http://www.ucpress.edu/books/pages/9144.php