Miasma

Miasmas get a bad rap. As if the idea that

sometimes the air

takes on a sickening quality and

mixes with stuff from the earth and

forms bad gasses that

cause disease

is somehow...unscientific.

But a lot of good people have believed in bad air.

Wikimedia

Hippocrates lived in ancient Greece among people who believed that illness was punishment from gods.

He suggested, pretty much correctly, that some illnesses might come from our environment--even from the very air we breathe.

Doctors in the middle ages believed the plague was spread by stinky bad air.

They wore those now-iconic, beakish masks with flowers stuffed in the nose to filter out the bad air and protect them from the plague.

(Plague, of course, spread by fleas and rats, was unfazed by the sweet-smelling masks.)

Plague doctor mask. Wikimedia.

Florence Nightingale, and her ward with windows open. Wikimedia.

Washing clothing infected with cholera in the river. Wikimedia.

Florence Nightingale built her hospitals bright and open to the air to purge the miasma and help her patients heal.

People in the nineteenth century thought cholera was caused by the bad air that came with sewage and rotting trash dumped in rivers and streets.

That air can’t have been good for anyone.

But the real public health success happened because the stink of the miasma

--and the belief that it caused disease--

led London leaders to clean up the city, end the dumping of sewage into the rivers and onto streets, and create a citywide sewer system.

Shortly after that success, germ theory came into fashion and bad air went right out.

The belief that some diseases are caused by germs has made us much healthier.

Doctors now wash their hands regularly.

Food at restaurants and grocery stores is stored at temperatures that keep bacteria from growing.

Chlorine prevents us from spreading disease to each other while we swim laps or relax in the pool.

But somewhere along the line, we forgot about the air.

We don't have to choose germs or bad air: Lots of germs that cause disease are spread through the air.

Some of these air-borne germs come to us through dust in the air like fungal spores. Some, like legionella, come through floating water droplets.

And some are in the breath we inhale that someone else has just exhaled, like those germs that cause colds, TB, COVID-19, chicken pox, measles, mumps, pertussis.

As we’ve learned from the COVID-19 pandemic, we can protect ourselves from germs spread through the air by spending more time outside and less time in close contact with other people. We can wear masks.

But adults breathe about 8-10 liters of air every minute. That's a lot.

Sarah Zhang for the Atlantic translates this into soda bottles for us.

Adorable masked child. Photo (and child) by author.

“Think four or five big soda bottles per minute, multiply that by the number of people in a room, and you can see how we are constantly breathing in one another’s lung secretions.”

It’s no wonder we catch 2-3 colds a year.

Image by Dean Moriarty from Pixabay

But why should we be content to breathe air that was so recently in someone else's nose?

We get out of the pool when someone poops in it.

We think it's unacceptable for someone to sell us food that makes us sick.

We would be horrified if a doctor operated on someone without the thorough handwashing routine that comes first.

We don't have to breathe other people's germs.

We can filter and disinfect our air.

We can improve the ventilation in our buildings and bring more clean air in.

We can build indoor spaces that blow the bad air--and our coughs, sneezes, and stuffy noses--away.