Nightingale

Nightingale “initially dismissed Koch’s theory and continued to advocate for sanitary reform. . . eventually and grudgingly accepted the theory, but with reservations . . . she believed it overemphasized the agency and power of germs over the problem of unhealthy sanitary condition.” Even after she believed in germs in late 1880s, “she questioned their origin. She contended that filth produced germs and that sanitary measures were thus needed to prevent their spread. Koch’s research in India suggested the reverse. . . Koch and Nightingale disagree about what came first” (Down, 107-108). “She remained intellectually committed to miasma theory and questioned the existence of microbes, but she did play an important role in establishing a set of practices that contributed to the field of epidemiology . . . her method and subjects of analysis mattered more than her position on any given theory” (111). [Down doesn’t grasp the significance of paradigm change (Kuhn) int reconceptualizing and reordering a “set of practices” Practices do not exist in vacuo; they necessarily fall back on one theory (miasmatic theory) or another (germ theory – PS].