Conclusion

Abstract

In the medium run, in the second half of the nineteenth century, the idea of a pathogenic environment would give way to theories focusing on bacteriology and infective agents. In the longer run, the theory would be revived, although not from its mid-nineteenth-century form but from earlier, purer ideas about how environmental and meteorological forces influence health, and about the environment as host not so much to disease as to the living vectors that carry disease. In the short run, however, the medicine of the environment would continue to thrive during the first half of the nineteenth century, and for some learned medical scientists still two or three decades thereafter. The scope of this book ends around the turn into the nineteenth century, a time when — for most European physicians who reflected about epidemic disease — environmentalist thinking was orthodox thinking. In the eighteenth-century form of this idea the miasma theory is submerged in a host of ideas about the sources and causes of epidemics. In the nineteenth-century form, the notion of gaseous rather than particulate means of disease transmission, and of little other than miasmic means, would claim control. Ironically, a simpler theory would thus replace a more complex theory without undermining medical confidence in the efficacy of measures to treat the environment as a source of pathogens.

The enquête was unable not to find what it looked for.¹

Peter