The depiction of influenza as a separate species of disease first became common during the eighteenth century. During that period, physicians developed competing theories about its etiology (causation) and transmission, including the theory that influenza was contagious. Theories of contagion were held by an increasing number of physicians during the course of the eighteenth century, although the issue remained a contested one, as symbolized by the publication of two separate reports on the epidemic of 1782 by the Royal College of Physicians and the Society for Promoting Medical Knowledge: reports that differed on the question of transmission.
It was because this issue was not settled by an overwhelming preponderance of the evidence that physician's views on this question had political implications that reflect the political and social fissures underlying medical practice in the eighteenth century. This article will examine the political, social, religious, and educational factors that influenced the initiative to investigate influenza as a separate disease, and will argue that these factors also influenced the readiness of some groups of physicians to entertain the hypothesis of contagion in the face of conflicting information. It will also suggest that the divergence of opinion on epidemic diseases reflected the social and educational differences between the graduates of English universities who were eligible for Fellowship in the College of Physicians, and the often equally distinguished “outsiders” who had obtained their medical degrees from other institutions, and who formed competing medical associations.