Bad Air or Germ Invasion?

 This post first appeared on the blog for the Centre for Privacy Studies: https://privacy.hypotheses.org/921

Good health is the most basic condition for a person to live a thriving life and—as we have been witnessing for the last few weeks with the COVID-19 pandemic—countries desperately need their people to be healthy, too. Otherwise, society goes bonkers. Hence, the importance of public health measures to control and prevent the spread of disease.

Le bonheur, et souverain bien de la vie consiste plus en la bonne santé qu'en tous les biens du Monde, puis qu'elle l'entretien et prolonge, et que sans icelle elle est déplaisante. (Andre le Gros, 1625)

[Happiness, chief wellbeing of life, consists more in having good health than in having all goods of the world, since health maintains and prolongs life, and without health, life is unpleasant.]

Last week, Anni discussed public health measures imposed during times of pandemic, which—though necessary for the greater good—can have detrimental implications for people’s right to live free from interference from the state. She shrewdly compared a 1563 English Plague Order with current measures affecting us right now in 2020 because of COVID-19.

But in addition to imposing rules of quarantine, isolation, and other behaviors, early modern authorities, just like our authorities today, also tried to prevent the spread of disease via less draconian measures, especially by giving advice on how to contain the problem. I am curious to know how advice on prevention worked during the long winded Second Plague Pandemic compared to what we get today from our public health officials.

In a time before the germ theory of disease was accepted, some providers of health care believed that diseases could be passed on by bad, stinky air, which they called miasma. This idea, which already existed in Hippocrates' time, was expanded and popularized by Galen, and it was also what many health practitioners believed in the early modern period. In the absence of a visible cause for the disease, the idea that miasma was what caused it made a lot of sense: proximity to those infected with the plague led healthy people to become sick, so the bad air in the vicinity of sick bodies was the primary suspect, especially given the stench that inevitably hang around places where the disease struck. Notice below in Nicolas Poissin’s painting The Plague of Ashdod how a character on the right side covers his nose.

La Peste d'Asdod by Nicolas Poussin (1630)
Source: Wikimedia Commons

In a treatise with the long name Régime de santé, souverain bien de l'homme en ceste vie, observant les préceptes de Hyppoc. et Gal., avec la manière de se préserver contre la peste, André Le Gros, a graduate from the school of medicine in Paris, talked about how to prevent the plague and how to treat it in people affected. On page 11, he suggests

éviter le mauvais air, et principalement celui qui est gâté et infecté de ceste maladie, et ou elle est, et a été ; se retirer des grandes assemblées et compagnies suspectes, se contenir chez soi si on n'est pressé d'affaires ; se tenir nettement, faire bon feu dans le logis, et aux rues aussi, qu'on doit bien nettoyer et en ôter les immondices, et y jeter souvent de l'eau fraiche et nette; parfumer les maisons et chambres avec bois, herbes et drogues de bonne senteur.

[avoid bad air, especially air that is spoiled and infected with this disease, and [places] where it is and has been; withdraw from large assemblies and suspicious companies; contain oneself at home if one is in no hurry due to business; keep oneself clean, make a good fire in the house and in the streets, too, which must be cleaned well and be rid of trash, and [where] fresh and clean water should be thrown often; perfume the houses and rooms with wood, herbs, and drugs that smell good.]

Today we know that stinky air, though unpleasant, is not the cause of the plague. Bacteria named Yersinia pestis cause the disease.  And the germ theory is now so well established that in popular parlance about our current evildoer—the coronavirus—we give priority to mentioning the microorganism. We are capable of imagining these tiny invaders entering our respiratory system to wreck havoc. Invisible little bodies populating the surface of our skin must be flushed with soap and water, or killed with alcohol-based hand sanitizer.

WHO advice for the public to prevent Coronavirus disease (COVID-19)

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Update: A previous version of this post stated that the miasma theory came from Galen, but he in fact expanded upon earlier ideas, including those of Hippocrates. Thanks to Natacha for the correction.

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References:

“Germ Theory of Disease.” In Wikipedia, March 20, 2020. https://en.wikipedia.org/w/index.php?title=Germ_theory_of_disease&oldid=946550640

Jones, Colin. “Plague and Its Metaphors in Early Modern France.” Representations 53 (1996)

Kannadan, Ajesh. “History of the Miasma Theory of Disease.” ESSAI 16, no. 1 (April 1, 2018). https://dc.cod.edu/essai/vol16/iss1/18

Le Gros, André. Régime de Santé, Souverain Bien de l’homme En Ceste Vie, Observant Les Préceptes de Hyppoc. et Gal., Avec La Manière de Se Préserver Contre La Peste . Ensemble La Protestation d’Hyppoc., Mise En Vers François Par Un Ancien Médecin de La Faculté de Paris. Dédié à MM. de Paris, Par Un Docteur de La Mesme Faculté, 1625. https://gallica.bnf.fr/ark:/12148/bpt6k5629510w

“Second Plague Pandemic.” In Wikipedia, March 22, 2020. https://en.wikipedia.org/w/index.php?title=Second_plague_pandemic&oldid=946815591