Summer Salad

January/February 2009


Miasma revisited

The intellectual history of tropical medicine

Volume 38, No.1, January/February 2009 Pages 57-59

Andrew D S Gibson

Tropical medicine arose as an area of medical practice in the last decade of the 19th century. Patrick Manson dominated its early history, and it thrived through the height of the colonial era. With the end of colonialism, tropical medicine underwent an evolution, with the rise of the disciplines of travel medicine, geographic medicine, international health, and global medicine. With the links of tropical medicine to commerce, and tropical medicine’s indirect association with miasma, history might be seen to repeat itself. ‘Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world’. Louis Pasteur, 1876 ‘Alas, what danger will it be to us maids as we are to travel so far?’ Rosalind in William Shakespeare As You Like It, Act 7, Scene 3

The history of tropical medicine began with miasma as a central issue. Rising to prominence in the 18th century, this anticontagionist concept presented the notion that rotting material, waste, filth and stagnant waterways gave rise to gaseous discharges, and that these discharges led to disease.1 This idea may have fed early 19th century ideas that ‘the tropics’ were an unhealthy place, for where better to find such materials?

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