# When filth became dangerous: the miasmatic and contagionistic origins of nineteenth-century cleanliness practices among Swedish provincial doctors

## TL;DR

The paper explores how ideas about dirt and disease shaped medical practices and cleanliness in 19th-century Sweden, showing that modern hygiene concepts built on older beliefs.

## Contribution

The study reveals that modern cleanliness practices in 19th-century Sweden were rooted in long-standing miasmatic and contagionistic views of disease.

## Key findings

- Provincial doctors' views on dirt and health evolved by blending old miasmatic ideas with new contagion theories.
- A new cleanliness regime emerged in the late 19th century to address perceived hybrid dirt linked to disease.
- Older precedents influenced the rise of public health movements and the medicalization of everyday dirt.

## Abstract

This investigation sheds light on the social history of pathogenic dirt and its significance for shaping medical practices during the nineteenth century. It consists of an analysis focusing on Swedish medicine, using 8800 yearly reports written 1820–1900 by Swedish provincial doctors for the National Board of Health in Stockholm. The main argument is that the provincial doctors’ perceptions of the relationship between dirt and health during this century can be better understood by focusing on similarities in the handling of different kinds of pathological dirt over the course of many decades, rather than seeing interest in cleanliness as something mostly unprecedented. A novel cleanliness regime became dominant during the latter third of the century, meant to counter a new hybrid between everyday dirt – bodily emanations from healthy bodies – and matter believed to have caused miasmatic and contagionistic disease. New ideas about filth and its impact on health played a crucial role in the development of public health and sanitation movements, and were a precondition for everyday dirt becoming a central medical problem around the turn of the twentieth century, but as is shown, they built on old precedents. Thus, the miasmatic and contagionistic approach to disease shaped conceptions of hygiene and cleanliness.