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Paper short abstract:

This paper analyses past and contemporary examples of the health-environment coupling via a philosophical and historical analysis. The variability of this relationship is due to several factors, such as conceptualisations, healthcare practices and scientific theories.

Paper long abstract:

The paper shows past and contemporary examples of the pathogenic and salutogenic conceptualisations of the environment (and related terms such as landscape and place) with respect to health in the history of medicine and healthcare practices. The variability of the health-environment coupling is due to several factors, such as the meaning assigned to both environment and health by cultures, disciplines, and branches of sciences, as well as the evolution of the practices of health, or the changing role of the body in medicine. Starting, for instance, from the Corpus Hippocraticum the role of the environment has been causally related to several symptoms and conditions. Humoral pathology, derived from the Corpus Hippocraticum and Galen's theory, was often accompanied by miasma theory, according to which the environment was mostly identified with air. Miasma theory was then questioned during the nineteenth-century London epidemic of cholera and it was later replaced by the germ theory. The introduction of germ theory radically changed the comprehension of the relationship between environment and health and it may have intensified the separation between health and environment. These theories show different pathogenic conceptualisations of the environment, with implications for healthcare practices and treatments. During the contemporary history of medicine, the pathogenic account of the environment remains preponderant. Yet, in this paper, I will briefly sketch also the main characteristics of the so-called salutogenic account in medicine, which is based on the positive role of the environment for health. I retrace it in the history of medicine and contemporary psychology.