In this perceptual structure, the problem of contagion is of little importance.
Transmission from one individual to another is never the essence of an epidemic
; it may, in the form of 'miasma' or 'leaven', which can be communicated thro-
ugh water, food, contact, the wind, or confined air, constitute one of the
causes of the epidemic, either direct or primary (when it is the sole, operant
cause), or secondary (when, in a town or hospital, the miasma is the product
of an epidemic disease caused by some other factor). But contagion is only
one modality of the brute fact of the epidemic. It was readily admitted that
malign diseases, like plague, had a transmittable cause; it was more difficult
to recognize the same fact in the case of the simple, epidemic diseases (
whooping cough, measles, scarlet fever, bilious diarrhoea, intermittent fever)
[10].
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