There are many ways to approach the history of the welfare state, and one's understanding of the subject depends to a large degree on the path one takes and the questions that are asked along the way. This paper will take as its point of entry the social programs created to prosecute the war on tuberculosis and infant mortality in Germany from the turn of the last century through the 1920s, specifically the work of the tuberculosis welfare and infant welfare centers (Tuberkulose- and Säuglingsfürsorgestellen). Preventive social hygiene or medical relief programs (Gesundheitsfürsorge) to combat tuberculosis and infant mortality are central to the history of public health not only because of their role in the epidemiological transition in Germany and other western countries. These programs also have a much broader relevance because the refiguring of the rights and duties of citizenship entailed by the preventive project raises a set of questions concerning the relation between preventive social hygiene, individual freedom and well-being, and modernity that are paradigmatic for understanding the modern welfare state.