TreStoreKøbenhavnskeEpidemier-3.31.2016 11-22-36 PM

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