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Throughout history we humans have had multiple explanations for what causes different conditions or different infectious diseases. In the current era we understand infectious disease to be spread by microscopic pathogens but in times past the average person might subscribe to something like Miasma or Four Humors.

Rather than simply adopting a real world medieval model of disease I wanted to try my hand at thinking through a simple model people might work out. The setting of the fantasy world in question is roughly 15th century tech wise, with the pocket watch being a somewhat recent innovation.

Would the following disease model be something you might believably expect scholars in my world to have come up with?

The model is as follows;

4 Elements

As magic is integral to this world, and the 4 elemental planes are known to exist and have measurable effects by way of rifts where reality is thin, they form the basis of this disease theory. By definition, all of these primal energies are thought to be pure/clean when originating from their respective plane.

Not unlike Miasma theory - "bad" or "corrupt" or "soiled" air is believed to be a vector of disease. However other elements can be soiled or turned bad in this way as well.. Bad water, bad earth, and bad air. Bad fire in this manner cannot exist, as fire is believed to be the great cleanser.

How?

Earth

Earth becomes bad/corrupt when rotting tissue is left upon it or in it without being covered. Feces used as fertilizer is thought to create bad earth in some cases if not handled properly. Bad earth is known to contaminate foods grown in the ground. Still water exposed to bad earth will be corrupted.

Water

Water becomes bad/corrupt when exposed to decaying tissue or excrement. Corrupted water is only believed to spread if it is sitting still - so people might still end up using one side of a river for waste and the opposite side for drinking... Bad water is known to contaminate food it comes into contact with or sicken creatures it is ingested by.

Air

"Bad Air" in this model is not simply that which smells bad. Bad air is created in a couple of ways. Those with an illness that targets the lungs (and has an effect on breathing) are considered to be exhaling small amounts of bad air at all times. Bad air also forms in some places somewhat naturally (swamps being an example). Bad air is known as the most contaminating, with the most potential for spreading quickly among communities.

Fire

Fire is the element of life, of destruction, of cleansing. It is believed fire cannot host such qualities as disease. It is also known to be a decent way to purify other elements, and the process of cooking tends to remove trace bad earth contamination from foods.

Disease

Disease is thought to be caused when one of these "bad" or corrupted sources is consumed by a creature directly or something indirectly corrupted via exposure is consumed. The contamination is then passed onto the creature whos own natural lifeforce will fight to correct the imbalance as the contaminant attempts to corrupt the persons body, this is why disease makes people feel weak (according to the model). The factor or agent causing the problem is not fully understood beyond being some form of corruption / bad force that seemingly seeks to proliferate without prejudice.

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    $\begingroup$ I made an edit in accordance with their reminder before any answers could be added misinterpreting the post :). There was another question additionally included prior but I edited shortly after sphennings' comment. $\endgroup$
    – Squessi
    Commented Jun 24 at 3:48
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    $\begingroup$ @EmberSchott For future reference, Worldbuilding has only two ways to review an idea: the internal-consistency tag and the review-my-idea tag. Both tags have very specific rules that must be followed to avoid closure (read them carefully!). As-asked your question should be closed as opinion-based or not about worldbuilding per the help center (because we don't host questions about the decisions/actions of characters or organizations). We're lenient with new users and hope that you'll embrace one of those two tags should you wish an idea reviewed in the future. Thanks. $\endgroup$
    – JBH
    Commented Jun 24 at 13:08
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    $\begingroup$ @EmberSchott Let's let this one slide. We have a somewhat unwritten rule that states a question cannot be modified in a way that causes existing answers to become obsolete. Rather than risk that, let's just plan for the future. Cheers! $\endgroup$
    – JBH
    Commented Jun 24 at 14:05
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    $\begingroup$ @EmberSchott an interesting implication of your system as stated is that feces and rotting tissue are deemed safe as long as they are put directly onto the plate. Just don't put them into water or onto earth. Otherwise my minor gripe is that "bad air" is a bit too much "on point" for my taste. Broadening it to "air exhaled by ill people" would certainly feel more like "pre science" to me. $\endgroup$
    – datacube
    Commented Jun 25 at 11:29
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    $\begingroup$ Some what of a flaw for the bad water . Where do fish poop? They seem to thrive. Are all fish permanently diseased? There are some peoples that eat mostly fish, they seem fine. $\endgroup$
    – Gault Drakkor
    Commented Jun 25 at 19:32

4 Answers 4

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Parasites, poisons, and non-infectious diseases (cancer, genetic disorders, sensitization to allergens, etc) are confounding factors for any disease model, since each, if assessed accurately, falsifies any claim of the other to universality.

If Mary works in a dusty library and gradually develops a sensitization allergy to dust, she really has been afflicted with a disease by exposure to bad air and removal to good air really will cure her. If John drinks some river water and gets a parasite, he really has ingested invisible animalculi, and destruction of the animalculi really will cure him. If Susan is afflicted with severe chronic heartburn, an excess of the bilious humor really is the cause, and it really is caused by Susan's poor diet in conjunction with her indulging in the sins of wrath, gluttony, and vainglory; correcting her sins and changing her diet to one which balances the humors really will cure her.

I think your established model is fine - although it's not compatible with the European 4-elements model, in which all forms of tangible earth, tangible air, tangible water, and tangible fire are all admixtures of all four elements, not archetypes thereof - each of which has a rarified, pure form which can only be approached asymptotically in the world of human experience.

More generally, to make a plausible disease model or combination of models (i.e. miasmas, curses, the influence of the planets on the humors, and corruption), I think your model should be able to address disparate causes of disease, not just infectious pathogens. Its metaphysics should match the metaphysics of the society - i.e. if astrology is important, the planets' influence should cause or cure diseases. And its errors are most plausible if they misattribute diseases to real causes of other diseases, possibly as an attempt to generalize the ungeneralizable, i.e. explaining cancers in the same terms as pathogens.

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  • $\begingroup$ Hmmm... I will definitely tweak this basis to try to explain other types of ailment; I hadn't considered that when initially designing. I think my modern bias had me so focused on an explanation for infectious disease I hadn't considered that they also would seek to explain ALL disease under one model/cause. $\endgroup$
    – Squessi
    Commented Jun 24 at 22:53
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This is similar to 4-Humors theory

The body is healthy, if its humors are in balance and nothing from outside upsets the balance of hot-cold, wet-moist.

Your system is about as developed from modern view, and does explain enough to be a useful basis to combat plagues: it explains infection via infected ground, water and air, by deeming it corrupt, and putting the infected status on the material. It can even be nigh seamlessly extended to connect to humorism ("corrupted earth damages the blood and increases black bile, treatment is..."), and thus sounds believable enough to appear at the same time as it.

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  • $\begingroup$ The system seems more than enough to be believable and gain and maintain a foothold, even as exceptions and discrepancies are found. The one quibble is it might be a little too sophisticated, in particular the part about "[the body's] own natural lifeforce will fight...this is why disease makes people feel weak". Wouldn't it be simpler to say corruption directly causes weakness and all other symptoms? Sure, the body may fight and cleanse itself, so the disease usually ends. But you're explaining eg fever accurately -- beyond many people's understanding today. Seems a bit too sophisticated? $\endgroup$
    – sfink
    Commented Jun 24 at 18:59
  • $\begingroup$ @sfink good point. Perhaps I should dumb-down that explanation a tad bit to make it feel less advanced? $\endgroup$
    – Squessi
    Commented Jun 24 at 22:55
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    $\begingroup$ @sfink It can be a good explanation for why some people recover while some people die given the same corruption. Some people had weak lifeforce while others stronger. Likely, the theory wouldn't be originator of the lifeforce idea, but implement existing lifeforce ideas within the 4 element corruption framework. Possibly some extension of fire being "alive", sacred, cleansing etc., so everyone has their own internal fire (lifeforce). If the fire is weak, it cannot fight the corruption. Someone's internal fire might burn bright but short, others weaker but longer... $\endgroup$
    – Colombo
    Commented Jun 25 at 3:54
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This is less 'science' than 'human psychology'. Given that this society is at around the 15th century in tech level, microscopy wasn't developed significantly until around the 17th century, so there is no way that even the best educated of people would know any different. At this time, people may even still believe that everything is made up of some combination of the alchemical substances, Sulphur, Mercury and Salt.

So, all that scientists have is theories that they are struggling to test. All the general public has is whichever theory has been publicised the best.

So, as long as the people in your society don't have any way of disproving this theory - and it's better than other, older theories - that's what they will believe.

Hell, people will likely continue to believe this even after it's disproved. It takes time for scientific knowledge to become public, and there are many people who, when faced with convincing scientific evidence that disproves their beliefs, will continue to hold onto their dated beliefs through sheer stubbornness.

Humans are very good at believing absolute nonsense... even today. I could give all sorts of examples, but I won't, since people who have irrationally-held beliefs are for some reason highly likely to be offended by having those beliefs challenged.

So, if you go back to the 15th century, all you need is for 'authorities' to tell the 'masses' that "This is how it is", and as a group, they'll believe it. Even if it doesn't fit the observations.

As for scholars coming up with this... it's entirely believable. We've come up with humorism and miasma theory, and even the theory that disease was caused by evil spirits. The OP's theory isn't actually too far from some of those theories.

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    $\begingroup$ I recon the " miasma theory" comes from the human disgust reaction to the smell - the feeling provoked the suspicion that that was the cause. $\endgroup$
    – Escaped dental patient.
    Commented Jun 24 at 7:51
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    $\begingroup$ Just to make a point 😁 which 15th century society? Japanese? South African? South American? Javanese? Sentinelese? $\endgroup$
    – JBH
    Commented Jun 24 at 14:09
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    $\begingroup$ @JBH It shouldn't matter. No known society in the 15th century had germ theory. $\endgroup$
    – Monty Wild ♦
    Commented Jun 25 at 2:32
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    $\begingroup$ @QuestionablePresence The question isn't about germ theory. It's about whether or not the thinkers of the age could embrace the idea as reality. (See this comment.) And the OP didn't mention "practical outcomes." I suspect you're judging the question by the present when it should be judged by the past - hence my comment to Monty. European thinkers will have a different take over south Asian thinkers in the 1400s. $\endgroup$
    – JBH
    Commented Jun 25 at 15:17
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    $\begingroup$ @QuestionablePresence If we're not to assume 15th century Earth (via the 15th century tech reference), then the question should have been immediately closed as Needs More Details because the culture always matters when it comes to questions about, frankly, the culture. If, instead, we're looking for "plausible sounding," that can only be in reference to what would be plausible in the 15th century (ignoring my issue about which society), in which case our discussion is moot. What's plausible to the reader would be VTC:Too Story-Based or VTC:Opinion-Based since we can't read their minds. $\endgroup$
    – JBH
    Commented Jun 26 at 18:55
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Science is less likely to develop out of a local minima- when the propossed quack-solutions, seem to be working. So strong self-healing powers that activate on auto-suggestion might delay the onset of development for serious medical science until the tools preventing looking into it (microscopes, chemical analysis) are just everywhere.

So, the presence of several quack scientists alleviating the most obvious issues + a fast, irreversible decay once its over (maybe something similar to wild boars- where the parasitic load just kills them once they show any weakness- within weeks) - and medical sience may remain a stunted thing.

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  • $\begingroup$ "Quack" is in the eye of the beholder, usually the future beholder. Until the theory of plate tectonics was generally accepted in the 1960s (yeah, it's that young) the Expanding Earth Hypothesis (1889/1909) was considered sensible science. Beware both anchoring and confirmation bias. 😁 The goal of the OP is to develop a scientific perception considered valid by the peers of the time. $\endgroup$
    – JBH
    Commented Jun 24 at 14:15
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    $\begingroup$ You are right, phlogiston or dark-matter it has to be plausibel at the time. $\endgroup$
    – Pica
    Commented Jun 24 at 17:09
  • $\begingroup$ I'm personally fond of Aether, which actually exists, just not to the density (anywhere near the density) that our classical brother and sisters thought it would be and not in the form they expected. $\endgroup$
    – JBH
    Commented Jun 24 at 19:12

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