Kinzelbach Annemarie
J Hist Med Allied Sci. 2006 Jul;61(3):369-89. doi: 10.1093/jhmas/jrj046. Epub 2006 Mar 15.
From today's point of view, the concepts of "miasma" and "contagion" appear to be two mutually exclusive perceptions of the spread of epidemic diseases, and quite a number of historians have tried to discuss the history of public health and epidemic diseases in terms of a progression from the miasmic to the contagionist concept. More detailed local studies, however, indicate how extremely misleading it may be to separate such medical concepts and ideas from their actual historical context. The article presented here, based on local studies in late medieval and early modern imperial towns in southern Germany, demonstrates to what extent the inhabitants of these towns had notions of both "miasma" and "contagion." Furthermore, a contextual analysis of language shows that they did not see a necessity to strictly distinguish between these different concepts relating to the spread of diseases. Tracing the meaning of "infection" and "contagion," we find that these terms were used in connection with various diseases, and that a change in the use of the expressions does not necessarily imply a change of the corresponding notion. Moreover, a coexistence of differing perceptions cannot--as some historians have suggested--be attributed to a divergence between the academic medicine and the popular ideas of that period. A survey of measures and actions in the public health sector indicates that a coexistence of--from our point of view--inconsistent concepts helped the authorities as well as the individuals to find means of defense and consolation during all those crises caused by epidemic diseases--crises that occurred very frequently in these towns during the late medieval and early modern periods. As the article demonstrates, the interaction during such crises reveals the continuity of ancient rituals and concepts as well as the adoption of new insights resulting from changes in the economical, political, scientific, religious, and social structures.
从今天的角度来看，“瘴气”和“传染”的概念似乎是对流行病传播的两种相互排斥的认知，相当多的历史学家试图从从瘴气概念到传染概念的演进角度来探讨公共卫生和流行病的历史。然而，更详细的地方研究表明，将这些医学概念和观念与其实际的历史背景分离开来可能会产生极大的误导。本文基于对德国南部中世纪晚期和近代早期帝国城镇的地方研究，展示了这些城镇的居民在多大程度上同时拥有“瘴气”和“传染”的观念。此外，对语言的语境分析表明，他们认为没有必要严格区分这些与疾病传播相关的不同概念。追溯“感染”和“传染”的含义，我们发现这些术语与各种疾病相关联使用，而且表达方式的变化并不一定意味着相应概念的改变。此外，正如一些历史学家所认为的那样，不同观念的共存不能归因于那个时期学术医学与大众观念之间的差异。对公共卫生部门措施和行动的调查表明，从我们的角度来看，相互矛盾的概念的共存帮助当局和个人在由流行病引发的所有危机期间找到了防御和慰藉的方法——在中世纪晚期和近代早期，这些城镇经常发生此类危机。正如本文所表明的，此类危机期间的互动揭示了古老仪式和概念的连续性以及对经济、政治、科学、宗教和社会结构变化所产生的新见解的采纳。
