{"id":930,"date":"2018-05-17T15:53:43","date_gmt":"2018-05-17T15:53:43","guid":{"rendered":"http:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/?p=930"},"modified":"2018-05-17T15:53:43","modified_gmt":"2018-05-17T15:53:43","slug":"miasma-breathing-air-filled-with-contagion","status":"publish","type":"post","link":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/spring2018\/miasma-breathing-air-filled-with-contagion\/","title":{"rendered":"Miasma: Breathing Air Filled with Contagion"},"content":{"rendered":"<blockquote><p>The Author: Zo\u00eb Aber is a History major with a concentration in Environmental Studies at Grinnell College.<\/p><\/blockquote>\n<p>\u201cThey have sought a phantom and found nothing. Their efforts have been as unavailing as those of the child that pursues its shadow or grasps at a moon-beam.\u201d<\/p>\n<p><span style=\"font-size: 20px;\">\u2013 Charles Caldwell, 1831 [1]<\/span><\/p>\n<p>The pursuit of a full understanding of the fear of miasma as it was historically perceived seems nearly as difficult as catching a shadow or moon-beam. Charles Caldwell, however, was referring to the search for a different sort of understanding when he made this comparison \u2013 his was the scientific pursuit of the \u201cchemical agency\u201d that was responsible for the dangers lurking in <span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/www.collinsdictionary.com\/us\/dictionary\/english\/insalubrious\">insalubrious<\/a><\/span> air.<\/p>\n<p>Although the specific understanding of miasma has varied across centuries and locations, miasmas were generally thought to have \u201cemanated from rotting, filthy, or unfinished things and brought essences of disease into the human body.\u201d [2] Disease originated from a thing or place of decay, which meant individual health was closely tied to the land and environment. The 18<sup>th<\/sup> and 19<sup>th<\/sup> centuries were characterized in America by rapid<span style=\"color: #3366ff;\"> <a style=\"color: #3366ff;\" href=\"https:\/\/www.britannica.com\/event\/westward-movement\">westward expansion<\/a><\/span> and a heavy dependence on the land.\u00a0Illness was ever-present, however, <span style=\"color: #000000;\">so <\/span>while American\u2019s relied upon the land, they also were weary of it and always mindful of signs that a place might be unhealthy or miasmatic. Through an examination of the fear of miasma and the popular connection between disease and location, we can begin to understand 19<sup>th<\/sup> century perceptions of land and the environment.<\/p>\n<p>Prior to the widespread acceptance of <span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/www.encyclopedia.com\/science\/science-magazines\/biomedicine-and-health-germ-theory-disease\">Germ Theory<\/a> <\/span>that would slowly take hold in America during the second half of the 19<sup>th<\/sup> century, Miasma theory was the common explanation for the spread of disease. In a similar way to how we cite \u201cgerms\u201d generally for most small ailments that we encounter or attempt to protect ourselves from today, miasma was an earlier system for understanding the origin of diseases. The current colloquial use of \u201cgerms\u201d would be familiar in the era of miasma for its broad inclusion of large numbers of sources and inconsistencies of meaning between individuals. [3]<\/p>\n<p>The concepts behind the theory of miasma have existed within medical thought as far back as <span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/www.biography.com\/people\/hippocrates-082216\">Hippocrates<\/a>\u2019<\/span> <em>Airs, Waters and Places <\/em>c. 400 BC. [4] Despite this long history, influential thinkers of the early 19<sup>th<\/sup> century viewed their belief in miasma as a step forward and away from outdated concepts. This was largely due to the popular belief in<span style=\"color: #3366ff;\"> \u201c<a style=\"color: #3366ff;\" href=\"https:\/\/www.britannica.com\/biography\/Girolamo-Fracastoro\">contagium animatum<\/a>\u201d <\/span>which began in the 15<sup>th<\/sup> century and was the impetus behind practices such as quarantine that characterized the epidemics and plagues of this earlier period. [5] There were far too many aspects of illness that went unexplained by contagion as it was understood at the time, however, so the scientific community turned to a rising \u2018new\u2019 theory that could be readily observed and tested. [6] For example, during a cholera outbreak of 1854 in Lancaster County, Pennsylvania, many believed miasma to be at fault and \u201cwhen they discovered rotting carcasses of animals in the river, they deduced that these were the sources of the corruption responsible for the epidemic.\u201d [7] By associating decay with illness, disease was, in theory, much more easily avoided \u2013 simply remove oneself from any source of contamination or cleans that contaminant.<\/p>\n<figure id=\"attachment_1048\" aria-describedby=\"caption-attachment-1048\" style=\"width: 215px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/rush.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1048\" src=\"http:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/rush.jpg\" alt=\"Portrait of Benjamin Rush, MD. \" width=\"215\" height=\"250\" srcset=\"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/rush.jpg 600w, https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/rush-258x300.jpg 258w\" sizes=\"auto, (max-width: 215px) 100vw, 215px\" \/><\/a><figcaption id=\"caption-attachment-1048\" class=\"wp-caption-text\">Benjamin Rush, M.D. https:\/\/upload.wikimedia.org\/wikipedia\/commons\/7\/7d\/Benjamin_Rush_Painting_by_Peale.jpg<\/figcaption><\/figure>\n<p><span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/www.archives.upenn.edu\/people\/1700s\/rush_benj.html\">Doctor Benjamin Rush<\/a><span style=\"color: #000000;\">,<\/span><\/span> a prominent figure in the discussion of miasma wrote a treatise on the subject, the title of which tellingly included the phrase: \u201cFacts Intended to Prove the Yellow Fever Not to Be Contagious.\u201d [8] The purpose of his treatise was to list the sources of disease and methods for removing or preventing it. Among his extensive list of sources, he included: \u201cExhalations from marshes \u2026 Cotton which had been wetted on board of a vessel \u2026 Air emitted by agitating foul and stagnating water \u2026 Weeds cut down, and exposed to heat and moisture near a house.\u201d [9] From these examples patterns not only of decay, but also of moisture can be seen as highly concentrated areas of disease. He also included methods for elimination from the environment such as:<\/p>\n<blockquote><p>[Miasma] should be covered with water or earth, \u2026 impregnating the air with certain effluvia, which act either by destroying miasmata by means of mixture, or by exciting a new action in the system, \u2026 [creating] large fires. [10]<\/p><\/blockquote>\n<p>Charles Caldwell explained the sources of miasma as: \u201cvegetable and animal matter, more especially the former, in a state of dissolution \u2026 by which I mean the decomposition of dead organic substances, and the reunion of their elements, producing new compounds.\u201d [11] From these sources, the connection between decomposing matter and disease seems rather intuitive and it is no wonder that people felt so strongly that their health was affected by an area when evidence of decay was so obvious.<\/p>\n<p>The location of miasma, however, was not always as easily identified as possible sources were. Such was the case of the \u201cairy and beautiful bluffs that bound the noble prairies of the Upper Mississippi.\u201d Timothy Flint explained in 1832 how these regions were actually subject to much higher levels of disease since:<\/p>\n<blockquote><p>[N]oxious air, from putrid vegetation, and stagnant water in the swamps and bottoms, is specifically lighter than atmospheric air \u2026 it rises from the plains, and hovers over the summits of the bluffs, here finding its level of specific gravity; and that, were it colored, it would be seen overlaying the purer strata of air beneath it. [12]<\/p><\/blockquote>\n<p>While miasma could usually be traced back to an identifiable source, it did not always remain tied to that source and could be carried by the wind or other atmospheric phenomenon. Not only was the location of miasma difficult to predict at times, it was also frequently in direct conflict with human use of the land. Flint described how for the settlers of densely forested areas, the years following the clearing of the land could be highly dangerous:<\/p>\n<blockquote><p>[W]hen the forests are cleared away, the miasm, the noxious air, that used to be absorbed and devoured by the redundant vegetation and foliage of the forests, and incorporated with its growth, thus detached and disengaged, inhaled by the new residents, becomes a source of disease. [13]<\/p><\/blockquote>\n<p>While to a modern reader, the miasm described here seems to be remarkably similar to <span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/ssec.si.edu\/stemvisions-blog\/what-photosynthesis\">photosynthesis<\/a> <\/span>and carbon dioxide, the immigrants who feared disease in their new remote homes would have understood it as an active threat to their new way of life.<\/p>\n<p>In many ways, miasma was a deterrent to practices that would have been most beneficial to a nation that was expanding westward. Places that were damp and filled with decay were seen as highly dangerous, despite their fertility. The agriculturally rich south was seen as far more disease prone and many were warned against travelling there [14]. It is somewhat unclear whether it was simply the large numbers of swamps and other marshy areas in the region that led physicians to believe in the widespread presence of miasma, or if the nature of the air \u2013 which is much warmer and more humid than other American climates &#8211; was also considered a signifier of miasma. Though the land itself was viewed as more or less predisposed to miasma, human intervention could also be a determining factor. Many believed that although <span style=\"color: #3366ff;\"><a style=\"color: #3366ff;\" href=\"https:\/\/www.nationalgeographic.org\/encyclopedia\/irrigation\/\">irrigation<\/a><\/span> allowed new lands to be used for agriculture, \u201cthe watering of dry land and the resultant plant growth led to the formation of poisonous atmospheric effluvia \u2013 that is, miasmata.\u201d [15] Similar to Flint\u2019s discussion of the disease that followed deforestation, irrigation of soil that was composed of decaying material could create the perfect conditions for miasma.<\/p>\n<figure id=\"attachment_1047\" aria-describedby=\"caption-attachment-1047\" style=\"width: 257px\" class=\"wp-caption alignright\"><a href=\"http:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/california.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1047\" src=\"http:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/california-233x300.jpg\" alt=\"Travel Poster which emphasizes the &quot;Climate for Health and Wealth&quot; that California could offer. \" width=\"257\" height=\"331\" srcset=\"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/california-233x300.jpg 233w, https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-content\/uploads\/2018\/05\/california.jpg 389w\" sizes=\"auto, (max-width: 257px) 100vw, 257px\" \/><\/a><figcaption id=\"caption-attachment-1047\" class=\"wp-caption-text\">California Travel Poster https:\/\/images-na.ssl-images-amazon.com\/images\/I\/61C5cd0MEFL.jpg<\/figcaption><\/figure>\n<p>Land was not always to be feared, however, as: \u201ccertain localities, because of the open exposure, dryness, free-drainage, and lack of decomposing organic matter, were judged to be more or less free of atmospheric toxins. [This] was viewed as more than a mere negative advantage but was seen by many as positively therapeutic.\u201d [16] California was seen by many as a haven from sources of disease and as a destination for those who had suffered from miasma in more eastern regions. Lands throughout the country which were deemed as free from decay could be curative and were often visited in the hopes of recovering health.<\/p>\n<p>Miasma was viewed as a concrete connection between health and the land and although it usually did not deter settlement,\u00a0it did offer an explanation for the differences in success and health between regions. As C.B. Valencius explains: \u201cTransferring imbalance and ill health from the surrounding world to the interior of the human body, [miasmas] were the causal mechanism whereby elements of the environment affected individuals\u2019 health.\u201d [17] Belief in the concept of miasma meant that the innate properties and human alterations of the land were direct influences on bodily health. While the specific understanding of miasma may have varied by the individual, their interactions with the land, and even their perception of the environment, it was generally accepted as closely tied to well-being and disease. Seen as a \u2018new\u2019 concept in the early 19<sup>th<\/sup> century, miasma meant progress from backward ways of understanding disease, but it also meant that progress in the form of the cultivation of new lands offered danger to all who attempted it. Miasma was a constant source of fear and trepidation when traveling through the environment. For a nation that was pushing westward, this meant that while the land offered prosperity and opportunity it could also be the cause of failure and great disaster.<\/p>\n<p>End Notes:<\/p>\n<p>[1] Charles Caldwell. <em>An Essay Upon the Nature and Sources of the Malaria or Noxious Miasma, from which Originate the Family of Diseases Usually Known by the Denomination of Bilious Diseases: Together with the Best Means of Preventing the Formation of Malaria, Removing the Sources, and Obviating their Effects on the Human Constitution, when the Cause Cannot Be Removed. <\/em>(Philadelphia: Carey &amp; Lea, 1831), 21.<\/p>\n<p>[2] C. B. Valencius. <em>The Health of the Country: How American Settlers Understood Themselves and Their Land. <\/em>(New York: Basic Books, 2002), 109.<\/p>\n<p>[3] Bonj Szczgiel and Robert Hewitt. \u201cNineteenth-Century Medical Landscapes: John H. Rauch, Frederick Law Olmsted, and the Search of Salubrity<em>.\u201d Bulliten of the History of Medicine <\/em>74, no. 4 (2000): 713.<\/p>\n<p>[4] Ibid, 711.<\/p>\n<p>[5] Erwin H Ackerknecht. \u201cAnticontagionism between 1821 and 1867: The Fielding H. Garrison Lecture.\u201d\u00a0<em>International Journal of Epidemiology<\/em> 38, no. 1. (1 February 2009): 7.<\/p>\n<p>[6] C.E.A. Winslow,\u00a0<em>The Conquest of Epidemic Disease<\/em>. (Princeton, Princeton University Press, 1943), 182.<\/p>\n<p>[7] John B. Osborne. &#8220;The Lancaster County Cholera Epidemic of 1854 and the Challenge to the Miasma Theory of Disease.&#8221; <em>The Pennsylvania Magazine of History and Biography<\/em> 133, no. 1 (2009): 6.<\/p>\n<p>[8] Benjamin Rush. <em>An Inquiry into the Various Sources of the Usual Forms of Summer &amp; Autumnal Disease in the United States, and the Means of Preventing Them: to Which are Added, Facts, Intended to Prove the Yellow Fever Not to Be Contagious. <\/em>(Philadelphia: John Conrad &amp; Co., 1805), title page.<\/p>\n<p>[9] Ibid, 5-10.<\/p>\n<p>[10] Ibid, 45-50.<\/p>\n<p>[11] Charles Caldwell. <em>An Essay Upon the Nature and Sources of the Malaria or Noxious Miasma, from which Originate the Family of Diseases Usually Known by the Denomination of Bilious Diseases: Together with the Best Means of Preventing the Formation of Malaria, Removing the Sources, and Obviating their Effects on the Human Constitution, when the Cause Cannot be Removed. <\/em>(Philadelphia: Carey &amp; Lea, 1831), 28<\/p>\n<p>[12] Timothy Flint. <em>The History and Geography of the Mississippi Valley. <\/em>(Cincinnati, E.H. Flint and L.R. Lincoln, 1832), 38.<\/p>\n<p>[13] Ibid, 37.<\/p>\n<p>[14] Megan Kate Nelson. \u201cThe Landscape of Disease: Swamps and Medical Discourse in the American Southeast, 1800-1880.\u201d <em>Mississippi Quarterly <\/em>55, no. 4 (Fall 2002): 535.<\/p>\n<p>[15] Kenneth Thompson. &#8220;Irrigation as a Menace to Health in California: A Nineteenth Century View.&#8221; <em>Geographical Review<\/em> 59, no. 2 (1969): 198.<\/p>\n<p>[16] Kenneth Thompson. &#8220;The Notion of Air Purity in Early California.&#8221; <em>Southern California Quarterly<\/em> 54, no. 3 (1972): 206.<\/p>\n<p>[17] C. B. Valencius. <em>The Health of the Country: How American Settlers Understood Themselves and Their Land. <\/em>(New York: Basic Books, 2002), 114.<\/p>\n<p>Further Reading:<\/p>\n<p>Gribbin, William. &#8220;Divine Providence or Miasma? The Yellow Fever Epidemic of 1822.&#8221; <em>New York History<\/em> 53, no. 3 (1972): 282-98<\/p>\n<p>Parsons, Gail Pat. &#8220;Puerperal Fever, Anticontagionists, and Miasmatic Infection, 1840\u20131860: Toward a New History of Puerperal Fever in Antebellum America.&#8221; <em>Journal of the History of Medicine and Allied Sciences<\/em> 52, no. 4 (1997): 424-52.<\/p>\n<p>Richmond, Phyllis Allen. &#8220;American Attitudes Toward the Germ Theory of Disease (1860-1880).&#8221; <em>Journal of the History of Medicine and Allied Sciences<\/em> 9, no. 4 (1954): 428-54.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Author: Zo\u00eb Aber is a History major with a concentration in Environmental Studies at Grinnell College. \u201cThey have sought a phantom and found nothing. Their efforts have been as unavailing as those of the child that pursues its shadow or grasps at a moon-beam.\u201d \u2013 Charles Caldwell, 1831 [1] The pursuit of a full&hellip; <span class=\"kuorinka-read-more\"><a href=\"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/spring2018\/miasma-breathing-air-filled-with-contagion\/\" class=\"more-link\">Read more <span class=\"screen-reader-text\">Miasma: Breathing Air Filled with Contagion<\/span><\/a><\/span><\/p>\n","protected":false},"author":29,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[96],"tags":[100,99,43,19],"class_list":["post-930","post","type-post","status-publish","format-standard","category-spring2018","tag-disease","tag-environment","tag-germ-theory","tag-public-health","entry"],"_links":{"self":[{"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/posts\/930","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/comments?post=930"}],"version-history":[{"count":9,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/posts\/930\/revisions"}],"predecessor-version":[{"id":1080,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/posts\/930\/revisions\/1080"}],"wp:attachment":[{"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/media?parent=930"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/categories?post=930"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lewiscar.sites.grinnell.edu\/HistoryofMedicine\/wp-json\/wp\/v2\/tags?post=930"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}