Infection, contagion, and public health in late medieval and early modern German imperial towns

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.