Miasma was the dominant explanation for communicable disease among the medical establishments of Western Europe and the United States through the first 50-70 years of the nineteenth century. Perhaps, in part, unwittingly anticipating explanations of chronic respiratory disease and cancer related to air pollution, miasmatists attributed many communicable diseases to �bad air� emanating from decaying organic matter. Those who looked for contagion to account for killer communicable diseases, like cholera and puerperal (or childbed) fever, were but a miniscule minority.