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Authors: Stephan Talty
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occupation, living situation, physical build, and even temperament were key factors in determining the cause and cure for diseases. In addition, one had to consider the circumstances under which the victim had fallen ill: Was a northwest wind blowing? Was he depressed? Had he been exhausting his vitality by drinking to excess? Each patient was a world unto himself. This was a concept called “specificity.”
Specificity was fatal to the idea of common diseases and common treatments. One man’s cure was considered useless for the next patient, who had a different set of life factors to consider.
When it came to infectious diseases, there were two working theories: miasmism and contagion. Miasmism remained the dominant disease theory of the seventeenth through the nineteenth centuries. The influential English doctor Thomas Sydenham championed the idea beginning in the mid-1600s and developed the notion that noxious vapors emerged from the earth’s rotting center and infected the air of towns and villages, which were then struck by epidemics. It was a dark view of Mother Earth, much different from our own. Odor was a telltale sign of danger to one’s health. “All smell is disease,” wrote the English sanitary activist Edwin Chadwick.
The theory dissipated through European and American life. In Jane Eyre , the orphan asylum where Jane and her sisters live sits in a forest dell that is a “cradle of fog and fog-bred pestilence” and that eventually causes a typhus epidemic that kills a number of the girls. Edgar Allan Poe’s 1839 short story “The Fall of the House of Usher” contains perhaps the most palpable description of miasmism in modern literature. The twenty-first-century reader might interpret the passage as a gothic premonition of death, but the nineteenth-century one would also see something else—a realistic portrayal of airborne disease:
But the under-surfaces of the huge masses of agitated vapor, as well as all terrestrial objects immediately around us, were glowing in the unnatural light of a faintly luminous and distinctly visible gaseous exhalation which hung about and enshrouded the mansion. “You must not—you shall not behold this!” said I, shuddering, to Usher, as I led him, with a gentle violence, from the window to a seat. “… The air is chilling and dangerous to your frame.”
The doctors who advocated miasmism weren’t only following tradition, they were obeying common sense. Who could believe disease was spread by invisible organisms that somehow floated from body to body, instead of the odors from rotting corpses that one could smell and even taste on the tongue? Which made more sense? The idea of contagion was more radical in its view of a hidden world of germs. The miasma theory fell in easily with centuries of folklore about the dangerousness of swamps and bogs, and it chimed with the evidence of one’s own senses. It’s no wonder that it proved remarkably resilient.
Contagion—the idea that disease spreads by direct or indirect contact—was the father of modern germ theory. Its roots went back to the Muslim statesman and medical thinker Avicenna in the eleventh century. By the nineteenth century, it had many supporters but just as many detractors.
M OST OF N APOLEON’S doctors followed the categories of illness invented by Philippe Panel, a groundbreaking French specialist in mental illness, in Nosographie philosophique ou méthode de l’analyse appliquée à la médecine (1798). Panel divided illness into five categories: fevers, phlegmasias (inflammations), hemorrhages, neuroses, and organic lesions. Fever was divided into antiotenic, meningogastric, adenomeningeal, adynamic, ataxic, and adenonervous, each with subdivisions and each requiring its own course of treatment. But as to cause, the miasmatic model ruled.
During the Egyptian campaign of 1798-1801, Napoleon’s future surgeon general, Dr. Larrey, spoke of winds “loaded with the putrid effluvia of animal
Specificity was fatal to the idea of common diseases and common treatments. One man’s cure was considered useless for the next patient, who had a different set of life factors to consider.
When it came to infectious diseases, there were two working theories: miasmism and contagion. Miasmism remained the dominant disease theory of the seventeenth through the nineteenth centuries. The influential English doctor Thomas Sydenham championed the idea beginning in the mid-1600s and developed the notion that noxious vapors emerged from the earth’s rotting center and infected the air of towns and villages, which were then struck by epidemics. It was a dark view of Mother Earth, much different from our own. Odor was a telltale sign of danger to one’s health. “All smell is disease,” wrote the English sanitary activist Edwin Chadwick.
The theory dissipated through European and American life. In Jane Eyre , the orphan asylum where Jane and her sisters live sits in a forest dell that is a “cradle of fog and fog-bred pestilence” and that eventually causes a typhus epidemic that kills a number of the girls. Edgar Allan Poe’s 1839 short story “The Fall of the House of Usher” contains perhaps the most palpable description of miasmism in modern literature. The twenty-first-century reader might interpret the passage as a gothic premonition of death, but the nineteenth-century one would also see something else—a realistic portrayal of airborne disease:
But the under-surfaces of the huge masses of agitated vapor, as well as all terrestrial objects immediately around us, were glowing in the unnatural light of a faintly luminous and distinctly visible gaseous exhalation which hung about and enshrouded the mansion. “You must not—you shall not behold this!” said I, shuddering, to Usher, as I led him, with a gentle violence, from the window to a seat. “… The air is chilling and dangerous to your frame.”
The doctors who advocated miasmism weren’t only following tradition, they were obeying common sense. Who could believe disease was spread by invisible organisms that somehow floated from body to body, instead of the odors from rotting corpses that one could smell and even taste on the tongue? Which made more sense? The idea of contagion was more radical in its view of a hidden world of germs. The miasma theory fell in easily with centuries of folklore about the dangerousness of swamps and bogs, and it chimed with the evidence of one’s own senses. It’s no wonder that it proved remarkably resilient.
Contagion—the idea that disease spreads by direct or indirect contact—was the father of modern germ theory. Its roots went back to the Muslim statesman and medical thinker Avicenna in the eleventh century. By the nineteenth century, it had many supporters but just as many detractors.
M OST OF N APOLEON’S doctors followed the categories of illness invented by Philippe Panel, a groundbreaking French specialist in mental illness, in Nosographie philosophique ou méthode de l’analyse appliquée à la médecine (1798). Panel divided illness into five categories: fevers, phlegmasias (inflammations), hemorrhages, neuroses, and organic lesions. Fever was divided into antiotenic, meningogastric, adenomeningeal, adynamic, ataxic, and adenonervous, each with subdivisions and each requiring its own course of treatment. But as to cause, the miasmatic model ruled.
During the Egyptian campaign of 1798-1801, Napoleon’s future surgeon general, Dr. Larrey, spoke of winds “loaded with the putrid effluvia of animal
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