197 / 205
SUMMARY
Theories o f epidemics
The science o f diseases has been developed from ancient conceptions o f the uni
verse as a composition o f materiel and metaphysical elements. During the Renaissance
with its growth o f research new perspectives were introduced, and gradually the di
seases could be ralated to organs o f the body. With the dawn o f technology in the
20th century diagnoses were made by a combined system o f clinical, biological and
readiological conditions. Theories about epidemic diseases can be followed from an
tiquity. The Greek theories about the humours o f the body and the elements were the
basis o f the theories about the environmental influence on the individual. It was a noti
on o f treatment by the principle o f »Contrario contrarii» (Gal6n about 15 0 A .D .), by
which an analysis o f the composition o f the organism should lead to the right treat
ment.
Also the English physician Thomas Sydenham believed, that the environment had
an important influence, when he advanced the theory o f »the stationary fever» in
1666. Briefly this theory said, that a certain territory and a certain time corresponded
with a certain disease. All patients who were in the same place at the same time would
consequently be suffering from the same disease.
This point o f view was modified in the 1 8th century by the Halle physician Stahl
into the theory which is later called vitalism. Stahl believed, that the soul had the deci
sive influence on the health o f a human being. The soul (God) was supposed to help
itself towards good health. Science was almost blasphemy as it implied the study o f
God. This hostile attitude towards science was by and by replaced by a more active
tendency represented most brilliantly by the Austrian J.P . Frank, who about the year
o f 1800 judged that housing conditions refuse removal, work, food etc. had a decisive
influence on the start o f the disease.
Later in the 19th century these theories were developed further into the miasma-
theory. The supporters o f this theory believed, that epidemic diseases were caused by
a local presence o f a substance, a »miasma», which had an injurious effekt on human
beings. The remedy against it was improvement o f hygiene (housing, drinking-water,
scavenging etc.).
Around 1900 bactoriology broke through, and hereby the explanation o f all epide
mic diseases was supposedly found. This optimism was replaced by a return to the
theory about hygiene having a vital influence on epidemic diseases when in the nine-
teensixties and nineteenseventies the two new branches: virology and immunologi
appeared.
The responsibilities and obligations o f physicians.
The practitioners o f medical art in the Middle Ages were to a great extent clergy
men. They were educated in the monasteries on the basis o f classical authors. The ap
pearance o f secular universities resulted in education o f a number o f professional medi
cal men at the beginning o f the 14th century.
Surgeons with a craftsmanlike education worked at the same time. The three wide
spread diseases o f leprosy, plague and syphilis gave rise to systematical measures taken
by society in the Middle Age. For the lepers St. Jorgensgarde were established. As to
syphilis there were mles about treatment o f infected people and orders to close down
the public baths.
Epidemics o f plague caused the establishment o f a quarantinedepartment. From
this derives the later on much used 40 days’ quarantine.
The oldest regulations for Danish medical service are regulations for »bartskaerere» -
the guild-educated barber-surgeons (about 1500). In 16 19 and 16 4 3 came the first
medical regulations stating the rights and duties o f physicians, pharmacists and sur
geons. Not until 17 4 0 a superior Collegium Medicum was founded, and it became a
195