History of public health
Liam J. Donaldson, Paul D. Rutter in Donaldsons' Essential Public Health, 2017
Essentially, the miasma theory was based on the idea that the disease threat came from the external world, in other words, from nature. In contrast, the theory of contagion held that the poison was generated from within the human body. It was then passed from person to person by direct contact or indirectly by their possessions, clothing and bedding. The more superstitious believed that catching the eye of an infected person (the evil eye) was enough. The actions flowing from the theory of contagion seem eminently sensible today. Quarantine on arrival of ships from infected areas was widely applied. Indeed, when the plague came into Europe in the fourteenth century, the Venetian authorities set up a sophisticated system to sift and deny entry to ships that might carry contagion; they also quarantined people and cargoes. Sustaining the miasmist rationale in response to this relatively effective contagionist control measure was the argument that ships carried air from the infected town in its hold so that it became released when the vessel docked in a new area and its hold was opened. This microclimate idea seems particularly absurd in retrospect, but Galen’s reach through the centuries was long.
Disease of town-dwelling Chinese
Kah Seng Loh, Li Yang Hsu in Tuberculosis – The Singapore Experience, 1867–2018, 2019
While knowledgeable and highly regarded, Simpson’s role in history was nevertheless not merely as an individual. His visit to Singapore tied the island to wider trends in imperial medical history. Simpson belonged to a group of public health experts involved in an expanding collaboration with the British Colonial Office, which actively promoted research on tropical medicine between 1895 and 1914.29 This collaboration was driven by two developments. One was the emergence of germ theory in the last two decades of the nineteenth century, which largely replaced the miasma theory of disease. Germ theory did not merely trace diseases to pathogens and parasites, but also shaped their study in distinct fields of research and expertise. Two institutions founded in the late 1890s led the way in this research in Britain: the London School of Tropical Medicine, which trained doctors for the colonial service (and where Simpson taught), and the Liverpool School of Tropical Medicine, which provided experts for outbreaks of disease in the tropics. The second factor, which provided the practical motivation for the research, was the growing concern of the Colonial Office in the health of Europeans based in tropical territories.30
An Example from Medicine
Donald Gillies in Causality, Probability, and Medicine, 2019
Before the rise of the germ theory of disease, the two principal ways of explaining disease causation were contagion and miasma. Contagion was a mechanism by which someone suffering from a disease would transmit it to a person in close contact. Contagions were usually thought of as chemical poisons which were passed, by those suffering from the disease, to anyone near them. Miasmas were putrid atmospheres or bad airs, which transmitted the disease to anyone who breathed them. There was much evidence to support the miasma view, since, for example, malaria occurred in marshlands, and diseases of all kinds were more common in overcrowded slums, barracks, ships and workhouses where the atmosphere often was evil smelling. Moreover, the miasma theory did lead to valuable reforms in preventive medicine. It was held by Chadwick who was perhaps the principal advocate of the construction of sewers in Britain, and who also advocated improved drainage, cleaning and sanitary regulation of buildings. In hospitals it led to a belief in cleanliness, fresh air, avoidance of overcrowding, and so on. Florence Nightingale based her reforms on the miasma theory, and was never converted to the germ theory.
CERAMIC transmission 2020
Published in Journal of Visual Communication in Medicine, 2021
Described the pathological state of the atmosphere was associated with infectious diseases and this became the miasma theory of contagion. I chose the model of a balloon decorated with Tuberculosis bacteria and suggestively full of bad air. The sound attached is a wheeze (Figures 6 and 7).
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