The germ culture: Metaphor, modernity, and epidemic disease

Abstracted from the biological context of disease, epidemics are fundamentally social concepts---events of social transmission within and across groups. Therefore, even the most scientifically technical theories about how disease spreads through a community can also be read as implicit social theories---cultural artifacts that reflect our most basic ideas about what society is and how it works. Here I compare bacteriology (which attributed epidemic disease to the tiny invisible entity of the microscopic germ) with the perspective it challenged and ultimately replaced: miasmatic theory (which blamed the vast invisible entity of corrupted air). In the latter half of the nineteenth century, these once complementary ideas were increasingly treated as irreconcilable opposites and by the end of the 1920s, germ theory had displaced miasmatic theory to become the dominant explanation for epidemic disease.; Industrialization challenged longstanding assumptions about the individual, the group, and the nature of the bond between them. As the individual and the group were increasingly perceived to be in tension with one another, miasmatic theory (with its emphasis on the inherently group-level threat of toxic air), and germ theory (with its far more individualistic understanding of disease transmission), were pulled to opposite poles. In short, miasmatic theory ceased to be plausible because the social theory implicit in it required a conception of social interaction that was increasingly out of sync with the culture and social structure of industrial society. Specifically, miasmatic theory implied (1) a conception of social connection, (2) a style of focusing, and (3) an understanding of agency that---in the wake of industrialization---were fundamentally at odds with and gradually less compelling than those implicit in germ theory.