Resurrect and Reinvigorate the Miasma Theory

In the two well-organized and coordinated November 2009 public health vaccination sessions in which I participated as a volunteer physician vaccinator, Santa Clara County California provided H1N1 influenza vaccine to approximately 10,000 men, women and children, many of whom lined-up beginning at 1:30 in the dark of night to be sure they would get their vaccine.

As I checked paperwork, inspected vaccine-filled hypodermic syringes, and went through the process of injecting H1N1 vaccine,  I gained an important insight by speaking with the people who were there to get their shots: they understood that prevention of disease, through vaccination, was much better than trying to treat an established influenza infection. They understood that prevention was better than treatment.

The health care reform proposal before Congress pictures systems of highly organized and technologically well equipped facilities staffed by serious people wearing spotless white coats and speaking scientific gibberish such as one would hear on television crime and hospital programs.  When prevention is mentioned, it is focused on esoteric highly technical medical practices and procedures which were unimaginable fifty or one hundred years ago.

Until the germ theory was proposed in the 1800s, people believed the miasma was responsible for serious diseases. Miasma was considered to be a poisonous vapor or mist filled with particles from decomposed matter (miasmata) that caused illnesses. It was identifiable by its foul smell. In its modern incarnation, perhaps we should view polluted water, air, the absence of a protective ozone layer, contamination in food products, hog and cattle waste ponds, destruction of our forests, spoilation of land through unsafe mining practices and similar activities as our miasma.  And perhaps we should, like the people who stood all night waiting in line to get their preventive H1N1 flu vaccine injections, not emphasize treatment of the diseases caused by our new miasma, but prevent these diseases by cleaning up our water supply, enforcing clean air regulations nationwide, appropriately regulating the food industry,  regulating agricultural environmental destruction, controlling clear-cutting and other wasteful forest destruction practices, and preventing mining from using valleys, lakes and homesights as waste pits.

The people who stood in line "got it".  Now, will our state and federal politicians and bureaucracies demonstrate that they, too, understand that prevention is  better than treatment? Or will their deference to special interests, and financial supporters, require continuing sacrifices of health by our ctizens?