We don’t so often speak of miasmas now, but they once explained all kinds of illnesses the causes of which were not quite clear. Miasmas were invisible vaporous emanations, or “bad air” from decaying organic matter on those foreign parts of moorlands or urban areas. A miasma has never been detected. Whilst miasmic explanations of disease held sway for centuries, we have other theories about the spread of disease now, and so we don’t take miasmas to be a material reality. None the less, the expression remains.

Lacan mentions miasmas in the second chapter of Seminar XI in talking about causes,[1] and which Jacques-Alain Miller takes up in his 1988 seminar Cause et consentement,[2] with the emphasis of a separation of cause and effect, with a cut, stumbling block, distance, deviation, or hole in continuity there, this is what Miller draws from Lacan. Those things where a continuity sustains, such as gravity, may be known as a law except in so far as distance may take its effect there, such as the gravitational pull of the moon effecting the tides.

“…miasmas are the cause of fever—… there is a hole, and something that oscillates in the interval.”[3]  This is how Lacan describes the miasma – that cause of fever which is characterised by a hole, by an effect of something oscillating in the interval between cause and effect.

It seems to me that miasma could be one name of something which may be apparent in our experience, in our clinic, now, in the suffering which the coronavirus brings aside from any material infection. Miasmas could be understood in some regard in the manner of something else which fell out of scientific use – the gaze. Being that which is not the seeing or being seen, not that which can be traced in a continuity, but that which evades, drops out of the laws of visibility, a cause, not a law. And which we attend to in our clinical work, localising, dissipating, distancing, there are any number of ways of working with what can be so distressing in an experience of the gaze.

It seems that in this time of the virus, beyond the microscopic droplets of infected airbourne material which may or may not reach us, there is an atmosphere. A thickening of the air with what is not there, marked by a hole between cause and effect, a miasma, experienced as both foreign and intimate to the body, outside and in.  Aside from the practical measures we may take to care for ourselves and others against the material of the virus, and which is not the realm of psychoanalysis, we work with something which was not necessarily of so obvious before, which perhaps miasma names.


[1] Jacques Lacan, The Four Fundamental Concepts of Psychoanalysis, Seminar XI. Ed. J.-A. Miller, trans A. Sheridan, (Norton: New York/London, 1978), p. 22

[2] Jacques-Alain Miller, Cause et consentement, lesson of 3rd February 1988, delivered at the Department of Psychoanalysis, University of Paris VIII (unpublished).

[3] Jacques Lacan, The Four Fundamental Concepts of Psychoanalysis, Seminar XI, op. cit., p. 22