A nosedive into the American obsession with cleanliness that explains how this middle-class attitude was formed. Although social reformers had crusaded for better sanitation in the first half of the 19th century, it was the Civil War that impelled America on the road to cleanliness, asserts Hoy, coauthor of From Dublin to New Orleans (not reviewed). Quoting liberally from contemporary sources to give a sense of time and place, she concludes that it was the desire to cut death rates in army camps that spurred creation of the US Sanitary Commission. British experience in the Crimean War had strongly suggested that sanitation was essential to the survival of troops, and by the Civil War's end military personnel and civilians alike had absorbed the lesson that dirt was linked to sickness. In subsequent decades, periodic outbreaks of cholera, yellow fever, and typhoid drove home the message. Hoy depicts settlement workers in the big cities teaching immigrants -- the ""great unwashed"" from the European countryside -- that cleanliness was the American way. Middle-class social reformers directed similar efforts at African-Americans moving to northern cities from the rural south; cleanliness was seen as the way to assimilation and acceptance. In the 20th century, soap manufacturers and their advertising agents joined with educators and health officials in promoting hygiene as the key to success, and according to Hoy the message was irresistible. The author sees America's quest for cleanliness as peaking in the 1950s, when women still had the time and the means to pursue it. Today, she states, the dirt theory of disease has been replaced by more scientific explanations, busy working women care less about spotless households, and factors other than a whiter-than-white shirt are seen as essential to financial success. Occasionally repetitious and overly detailed, but in toto a spirited account of changing American mores.