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American Literary History 14.4 (2002) 858-865
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Contagion and Culture
Martin S. Pernick
"Don't put other people's things in your mouth; their germs will make you sick." Contagion was a vital lesson of childhood acculturation in twentieth-century Western societies. 1 Such warnings equated contagion with infection by microorganisms, using an ancient word to express a core concept of modern medicine. This identification of contagion with germs virtually erased prebacteriological alternative scientific meanings of the term and treated nonbacteriological uses of "contagion" as irrelevant or dangerous unscientific metaphors. 2
However, histories of the relation between contagion and culture radically disrupt these familiar modern associations. First, such histories uncover great variety, change, and controversy in past concepts of contagion. Second, they show that the border between metaphorical and literal meanings of contagion has been contested, indistinct, and movable. Third, they demonstrate that while contagion and culture long have been intimately linked and mutually constructing, the particulars of their relations have varied with the specific time and place.
1. Contagion and Change
Etymologically, contagion derived from the same Latin root as contiguous, meaning "touching." 3 Thus, in ancient and medieval medicine, a contagious disease meant one that spread from person to person by touch. However, controversy raged for centuries over which, if any, specific diseases could be transferred in that way. Many medieval European writers limited the list to eight or fewer, often including epilepsy but excluding smallpox. They were also divided over what was actually transferred by the process of touching. This contagium often was considered to be a specific chemical poison produced by the sick person, although as early as 1658, German Jesuit polymath Athanasius Kircher postulated that contagion might be alive. Other disputes erupted over whether contagion had to involve actually touching a sick person or whether it could be transmitted by solid objects or air that a sick [End Page 858] person had contacted. Sixteenth-century physician-poet Girolamo Fracastoro of Verona promoted this broader concept of intermediated contagion. Contagion also increasingly denoted diseases that grew in numbers or severity with each transmission. Spread rather than touch was the key word in that definition. 4
From the sixteenth through the nineteenth centuries, European imperial expansion and trade were accompanied by the geographic diffusion of diseases such as bubonic plague and smallpox. The seeming portability of such epidemics intensified medical and popular concern over contagion and often led to imposition of quarantines as a specific preventive measure. However, in the mid-nineteenth century, when immigration, urban growth, and industrialization coincided with another wave of epidemic diseases such as cholera, typhoid, and yellow fever, many reformers attributed these outbreaks to the unhealthy conditions of industrial society and advocated projects of hygienic or social change rather than quarantine as the best response.
As a consequence, mid-nineteenth-century concepts of contagion were especially complex and contested. Although opponents of quarantines were sometimes labeled "anti-contagionists," most did not deny that some diseases could be transmitted by some form of contagion. For example, smallpox was widely considered contagious, especially after eighteenth-century experience with inoculation demonstrated that it could be transferred from person to person. However, there was bitter disagreement about the meaning and relative importance of contagion for most other diseases. Medical writers often sought some middle ground, "contingent contagionism," which could synthesize the evidence for and against various forms of disease transmission and might justify combining quarantine with hygiene. Some authors held that both contagion-bearing people and a suitably unhealthy environment were needed to spread disease. Others claimed that bad health conditions by themselves could generate poisons that could then be transmitted from person to person without further help from the environment. 5
Late-nineteenth-century "microbe hunters" such as Louis Pasteur and Robert Koch explained contagion as the interpersonal transmission of infectious microorganisms. Some early disciples, such as Charles Chapin of Rhode Island, hoped the specific focus on microbes would enable public health to shed its responsibility for environmental and social concerns. In turn, those most committed to social and moral medicine, such as Elizabeth Blackwell and Florence Nightingale, rejected...