Prophylaxis and treatment of diseases in western São Paulo state: the Sanitation Service and trachoma in the early twentieth century. / A profilaxia e o tratamento das enfermidades do oeste paulista: o Serviço Sanitário e o tracoma no princípio do século XX.

In 1906, Emílio Ribas reorganized the Sanitation Service and centralized São Paulo state public health services in the state capital. A campaign to combat trachoma, an ophthalmic disease, was implemented as part of this project. This article analyzes this campaign, which provided care for the sick living on rural properties in a process that predated the 1917 Rural Sanitary Code. The empirical data was obtained from government reports, decrees, medical journals and newspapers. We conclude that Ribas, by creating an organization that integrated the efforts of the sanitary districts and the Trachoma Commission medical teams, sought to form a complex apparatus to combat the diseases present in both urban areas and the countryside.

Em 1906, Emílio Ribas reorganizou o Serviço Sanitário e centralizou na capital os serviços de saúde pública do estado de São Paulo. Nesse projeto, a campanha de combate ao tracoma, uma enfermidade oftálmica, foi implantada. Este artigo analisa essa campanha que atendeu os enfermos das propriedades rurais em um processo que antecedeu ao Código Sanitário Rural de 1917. O material empírico foi composto por relatórios governamentais, decretos, periódicos médicos e jornais. Concluímos que Ribas, ao criar uma estrutura que unificou os esforços dos distritos sanitários com as equipes de atendimento das Comissões do Tracoma, buscou formar um complexo aparato para combater as enfermidades presentes tanto nas áreas urbanas quanto na zona rural.

A profilaxia e o tratamento das enfermidades do oeste paulista: o Serviço Sanitário e o tracoma no princípio do século XX / Prophylaxis and treatment of diseases in western São Paulo state: the Sanitation Service and trachoma in the early twentieth century

Resumo Em 1906, Emílio Ribas reorganizou o Serviço Sanitário e centralizou na capital os serviços de saúde pública do estado de São Paulo. Nesse projeto, a campanha de combate ao tracoma, uma enfermidade oftálmica, foi implantada. Este artigo analisa essa campanha que atendeu os enfermos das propriedades rurais em um processo que antecedeu ao Código Sanitário Rural de 1917. O material empírico foi composto por relatórios governamentais, decretos, periódicos médicos e jornais. Concluímos que Ribas, ao criar uma estrutura que unificou os esforços dos distritos sanitários com as equipes de atendimento das Comissões do Tracoma, buscou formar um complexo aparato para combater as enfermidades presentes tanto nas áreas urbanas quanto na zona rural.

Abstract In 1906, Emílio Ribas reorganized the Sanitation Service and centralized São Paulo state public health services in the state capital. A campaign to combat trachoma, an ophthalmic disease, was implemented as part of this project. This article analyzes this campaign, which provided care for the sick living on rural properties in a process that predated the 1917 Rural Sanitary Code. The empirical data was obtained from government reports, decrees, medical journals and newspapers. We conclude that Ribas, by creating an organization that integrated the efforts of the sanitary districts and the Trachoma Commission medical teams, sought to form a complex apparatus to combat the diseases present in both urban areas and the countryside.

A brief introduction of Xiangya's anti-epidemic history in a century. / ç™¾å¹´æ¹˜é› æŠ—ç–«ç®€å².

Based on archival materials, the Xiangya's anti-epidemic history in a century from its establishment to 2020 is divided into 4 stages. The first stage (1906-1926), Edward Hicks Hume and YAN Fuqing, the founders of Xiangya, prevented and controlled smallpox and plague. The second stage (1929-1953), during the resumption of Xiangya, students prevented and controlled cholera, plague, dysentery, typhus, and other infectious diseases. In the third stage (1953-1999), in a peacetime, Xiangya actively fought against schistosomiasis, hydatidosis, malaria, leprosy, tuberculosis and other epidemics. The fourth stage (2000-2020), the era of Central South University. Medical staff in Xiangya fight SARS, influenza A (H1N1) flu, Ebola hemorrhagic fever, coronavirus disease 2019, etc. Over the past hundred years, Xiangya people joined together to spread benevolence and love, apply medical knowledge and skills, combat the epidemic and rescue people in difficulties, which made a great contribution to the motherland and the people.

Remembering Marcel Baltazard, Great Researcher and the French President of Pasteur Institute of Iran.

Dr. Marcel Baltazard (1908-1971), French scientist and former director of Pasteur Institute of Iran, is known in the international arena due to his research on the control of infectious diseases such as plague, rabies, relapsing fever, leprosy, smallpox and tuberculosis. Dr. Baltazard also played a significant role in the launch of vaccination against tuberculosis, cholera and smallpox. Dr. Baltazard's spent the first 13 years of academic life at Pasteur Institute of Casablanca, Morocco, and then 20 years at Pasteur Institute of Iran and over the last five years at Pasteur Institute of Paris. In this paper, the activities of this important and influential researcher in the field of health and medicine are addressed.

Historia de la profilaxis ante las enfermedades contagiosas. Medidas preventivas descritas en el Levítico / História da profilaxia contra as doenças transmissíveis. As medidas preventivas descritas em Levítico / History prophylaxis against contagious diseases. Preventive measures described in Leviticus

Introducción: Los capítulos 13 y 14 del libro de Levítico se centran en la actuación ante la lepra, enfermedad más temida a lo largo de la historia que enfermedades como la Peste Negra o la sífilis. El objetivo del presente artículo es analizar de forma exhaustiva las medidas preventivas de ambos capítulos frente a la lepra bíblica, sus consecuencias y su repercusión a lo largo de la historia. Método: Se examinaron los capítulos 13 y 14 del Levítico en tres versiones diferentes de la Biblia. Posteriormente se analizaron otros documentos de investigadores relacionadas con la temática y manuales de enfermedades transmisibles. Desarrollo del tema: Los hallazgos obtenidos destacan la utilidad de las medidas descritas para controlar la expansión de las enfermedades transmisibles, presentándose la cuarentena como la solución más óptima para promocionar el bienestar y la salud de la comunidad en aquel período, y la higiene era considerada un eje fundamental en este ámbito. Conclusiones: La aplicación de estas intervenciones ha producido beneficios notorios, especialmente en la reducción de la mortalidad, tanto en la población hebrea del período bíblico como en otras sociedades posteriormente, destacando algunas ciudades en durante la Peste Negra; y han instaurado pilares sobre las que descansa la epidemiología y salud pública actual (AU)

Introduction: Chapters 13 and 14 of Leviticus focus on performance against leprosy, most feared throughout history that diseases like syphilis Black Death or disease. The aim of this paper is to analyze thoroughly the preventive measures of both sections from the biblical leprosy, its consequences and its impact throughout history. Method: Chapters 13 and 14 of Leviticus in three different versions of the Bible was discussed. Later, other studies and manuals communicable diseases were analyzed. Development: The findings highlight the utility of the above measures to control the spread of contagious diseases, quarantine appearing as the optimal solution to promote the welfare and health of the community at that time, and hygiene was considered a cornerstone in this area. Conclusions: The implementation of these interventions has produced notable benefits, especially in reducing mortality in both the Jewish population of the biblical period and subsequently other companies, highlighting some cities during the Black Death; and they have formed the pillars on which rests the current epidemiology and public health (AU)

Introdução: Capítulos 13 e 14 de Levítico foco no desempenho contra a lepra, o mais temido por toda a história que doenças como sífilis Peste Negra ou doença. O objetivo deste artigo é analisar cuidadosamente as medidas de prevenção de ambas as secções da lepra bíblica, suas consequências e seu impacto ao longo da história. Método: Capítulos 13 e 14 do Levítico em três versões diferentes da Bíblia foi discutido. Mais tarde, foram analisados outros documentos e manuais de doenças transmissíveis relacionados com as doenças descritas na Bíblia. Desenvolvimento do tema: Os resultados destacam a utilidade das medidas acima referidas para controlar a propagação de doenças transmissíveis, quarentena aparecendo como a solução ideal para promover o bem-estar ea saúde da comunidade na época, e higiene foi considerado um marco na nesta área. Conclusões: A implementação destas intervenções produziu benefícios notáveis, especialmente na redução da mortalidade, tanto a população judaica do período bíblico e, posteriormente, outras empresas, destacando algumas cidades durante a Peste Negra; e eles formaram pilares sobre os quais repousa a epidemiologia atual e saúde pública (AU)

[Leprosy--a stigma in the 21st century]. / Lepra--stigma a XXI. században.

For the initiation of the French journalist Raoul Follereau in 1954 the UNO inaugurated the Leprosy Day (Martyr's Day) that is celebrated on the last Sunday of January every year. Although the bacterium that causes leprosy was isolated by the Norwegian scientist Gerhard Henrik Armauer Hansen in 1873 and from 1982 this disease can be cured with a special pharmaceutical complex, still 219.826 new leprous are detected on Earth every year, according to the data published in August, 2010 by WHO-experts. Ancient Chinese and Hindu source-strings from 600 B. C. are referring to leprosy, however, the disease was imported by the army of Alexander the Great from India around 327-326 B. C. Even the Old and the New Testament from the Holy Bible are mentioning leprosy in several details. During the Middle Ages the Military and Hospitaller Order of St. Lazarus of Jerusalem, established in the Holy Land in 72 A. D., did pioneer work in nursing leprous. In the process of time the medical attendance concerning leprous was organized in special hospitals called "leprosoriums" built on river-banks. Special office and even services were organized for the treatment and isolation of the people infected. Although medical science has prevailed against leprosy, and almost simultaneously even jurisprudence defended the patients' rights via legislation, still mankind can regrettably not get rid of this disease that stigmatizes seriously.

Controle da hanseníase no Estado de São Paulo: análise histórica / Control de la hanseníasis en el Estado de Sao Paulo, Brasil: análisis histórico / Hansen's disease control in the State of São Paulo: a historical analysis

Para controle da hanseníase, doença infectocontagiosa conhecida desde os tempos bíblicos, são mostradas as intrincadas convergências de histórias nacionais, de políticas médicas, governamentais e internacionais. O estudo descreve a história e as ações de controle da hanseníase, a partir do começo do século XIX, no estado de São Paulo, e sua conexão com o desenvolvimento da saúde pública, utilizando análises bibliográficas e documentais.

Para control de la hanseníasis, enfermedad infectocontagiosa conocida desde los tiempos bíblicos, se muestran las intrincadas convergencias de historias brasileñas, de políticas médicas, gubernamentales e internacionales. El estudio describe la historia y las acciones de control de la hanseníasis, a partir del comienzo del siglo XIX, en el estado de Sao Paulo, y su conexión con el desarrollo de la salud pública, utilizando análisis bibliográficas y documentales.

[Learning from the history of leprosy--looking back at one hundred years of medicine at the leprosaria].

This year is the centennial anniversary of the five national leprosaria in Japan. It means that the official accommodation of leprosy patients who were wandering on the streets started in 1909. At that time, the existence of these leprosy patients on the streets was considered as a national shame and also an evidence of falling behind the Western cultured countries. Japanese people and the government were hypersensitive of such notoriety, especially from the Western countries. Some doctors, politicians and bureaucrats were really concerned about the situation and made great efforts to establish the leprosy separation law. It was implemented in 1907, but it took two more years for the preparation of the sanatoria for accommodation. The leprosy separation law has persisted until 1996. It has been revised to the leprosy segregation law in 1931, and to the leprosy isolation law in 1953. Although the law underwent two revisions, the main ideology of isolation has been abundant for almost ninety years. This law has been infamous for its misery and pointed out to be abolished by the WHO. This paper will focus attention on the doctors, politicians and bureaucrats who have worked for the institution of this cruel law, and also discuss the reason why this law had prevailed.

Community dermatology inclusive of leprosy: its past present and future.

The archives of leprosy and its global history are currently evolving in Oxford. A collection of documents and books are housed in the historical library of Sir William Osler under the heading of 'Public Health before and after Osler' and the history of leprosy can be found on http://www.leprosyhistory.org. A striking feature of the old books is their attention to the designation 'Lepra' and the evolution of not just leprosy but of the other differential diagnoses of the eighteenth and nineteenth century such as psoriasis.. Even in the twentieth century, the development of a major interest in Oxford led by Weddell was the innervation of the skin first in psoriasis and then in leprosy, joint meetings with Weddell, Cochrane, Browne, Rees and others over patients with leprosy, to the building of the Cochrane Annex and the work of Colin MacDougal in the Department of Dermatology.

Role of dermatologists in leprosy elimination and post-elimination era: the Brazilian contribution.

Dermatologists in Brazil have always been involved in care of leprosy patients, and have been alternating with public health physicians in the management of control policies. It is worth mentioning that Fernando Terra, founder of the Brazilian Society of Dermatology (BSD) in 1912, established the position of intern dermatologist at the Hospital dos Lizaros, in Rio de Janeiro, in 1913 (Souza-Araújo, 1952; Oliveira, 1991). In 1920, the dermatologist Eduardo Rabello formulated the first national public policy on the control of leprosy in the country, which was called 'Inspection of Prophylaxis of Leprosy and Venereal Diseases'. His son was an enthusiast of dermatological research and his main legacy was the polarity concept of leprosy (Rabelo, 1937). However, from 1930 to 1985, the public health physicians were in charge of the political guidelines that represented the period of establishing the vertical programmatic structure, with compulsory isolation of patients (1933-1962). Moreover, the federal states coordinated the control actions, based on the leprosy prophylaxis campaign. The dermatologists resumed the conduction of the control process in 1986, when multi-drug therapy (MDT) was implemented in the country, and in 1991, when decentralization of public healthcare services to the municipal level took place. In 2003 again, the dermatologists were no longer in control of the national policy. However, active dermatologists have acted in Brazilian references on diagnosis and treatment of Hansen's disease, at municipal, state and national levels. It is true that dermatologists have been getting away from leprosy control actions. And one could ask: who will replace this specialist? In the 'post-elimination' era, when the public primary healthcare technicians no longer consider leprosy of much significance, the knowledge of the expert in this disease and its differential diagnoses will be crucial.

[History of Hansen's disease control policy in the United States].

Federal government set up the institutions for the study and treatment of Hansen's disease patients in Hawaii in 1905. Then in 1917, a legislation was made to build a national leprosarium (leper home), authorize the Surgeon General (SG) to receive into that institution any person afflicted with leprosy who presents himself or herself for care, detention, and treatment, or any person afflicted with leprosy duly consigned to said home by the proper health authorities. The National Leprosarium (later renamed as National Hansen's Disease Center) opened in Carville in 1922. Although promin treatment had started in the early 1940s, the Public Health Service Act of 1944 retained the SG's authority for detention and apprehension. Discharge codes were gradually loosened since then, but the efforts to revise the Act were never successful for a long time. It was in 1985 when the Act was abolished. Provision of long-term care for new patients at the Center was terminated finally in 1997.

O isolamento compulsório em questäo: políticas de combate à lepra no Brasil (1920-1941) / Mandatory isolation at issue: leprosy control policies in Brazil (1920-1941)

Analisa as políticas estatais de combate à lepra (hanseníase) no período 1920-1941, tendo como foco principal o debate e as ações em torno do isolamento compulsório dos doentes. No primeiro período de análise (1920-1930), a prática isolacionista foi definida pelo regulamento sanitário de 1920 como uma política compulsória a ser adotada contra a doença. Entretanto, a escassez de verbas, incertezas biomédicas e as características políticas do período puseram obstáculos à atuaçäo da inspetoria de profilaxia da lepra e das doenças venéreas. Foi somente no segundo período (1930-1941) que o isolamento compulsório tomou vigor. A partir de 1935, com a elaboraçäo de um plano de construçäo de leprosários, promovido pelo governo federal, foi possível pôr em prática a política de isolamento. A criaçäo do Serviço Nacional de Lepra, em 1941, näo substituiu o plano elaborado em 1935, e ainda acrescentou as definições de competências dos poderes federais, estaduais e municipais, como também das associações particulares na profilaxia da doença. Durante todo o processo de construçäo institucional da saúde pública brasileira, no período 1920-1941, o isolamento compulsório dos doentes foi a principal política adotada pelo poder público contra a lepra e esteve associada ao processo de consolidaçäo da capacidade do Estado brasileiro agir sobre territórios e populações. (AU)

O isolamento compulsório em questão: políticas de combate à lepra no Brasil (1920-1941) / Mandatory isolation at issue: leprosy control policies in Brazil (1920-1941)

Analisa as políticas estatais de combate à lepra (hanseníase) no período 1920-1941, tendo como foco principal o debate e as ações em torno do isolamento compulsório dos doentes. No primeiro período de análise (1920-1930), a prática isolacionista foi definida pelo regulamento sanitário de 1920 como uma política compulsória a ser adotada contra a doença. Entretanto, a escassez de verbas, incertezas biomédicas e as características políticas do período puseram obstáculos à atuação da inspetoria de profilaxia da lepra e das doenças venéreas. Foi somente no segundo período (1930-1941) que o isolamento compulsório tomou vigor. A partir de 1935, com a elaboração de um plano de construção de leprosários, promovido pelo governo federal, foi possível pôr em prática a política de isolamento. A criação do Serviço Nacional de Lepra, em 1941, não substituiu o plano elaborado em 1935, e ainda acrescentou as definições de competências dos poderes federais, estaduais e municipais, como também das associações particulares na profilaxia da doença. Durante todo o processo de construção institucional da saúde pública brasileira, no período 1920-1941, o isolamento compulsório dos doentes foi a principal política adotada pelo poder público contra a lepra e esteve associada ao processo de consolidação da capacidade do Estado brasileiro agir sobre territórios e populações.

[The cholera epidemics and the development of public health in Meiji Japan. 2. Strength and weakness of public health politics]. / Le choléra et la naissance de la santé publique dans le Japon de Meiji. 2. Forces et faiblesses d'une politique de santé publique.

We present here the beginnings of public health politics in Meiji Japan (1868-1912). Due to a two century isolation of Japan, public health concepts developed in the West from the end of the 18th century were foreign in premodern Japan. Due to its isolation, Japan was also relatively preserved from some acute infectious diseases such as cholera. In this paper, we investigate the role of cholera epidemics in the emergence of public health concepts in the peculiar context of Meiji Japan. We show that chronic diseases such as tuberculosis and leprosy were neglected for a long time and that the Meiji government set priority on acute infectious diseases that were considered as long as they disturbed public order. Nevertheless, some physicians and government officials considered issues of welfare and poverty. We also review some emerging concepts of social medicine. We try to show that in Japan as well as in western nations public health politics were not exempt of contradictions and paradoxes and a permanent tension existed between coercitive policies and conceptions of welfare and rights to health.

Adolpho Lutz and controversies over the transmission of leprosy by mosquitoes.

During his years of study in Switzerland and Germany, Adolpho Lutz published his first articles on zoology, clinical practice, and therapeutics. In Limeira, São Paulo, he began studies on animal and human diseases caused by germs and parasites. In 1885-86, Lutz traveled to Hamburg to study the morphology of germs related to skin diseases, in conjunction with Paul Gerson Unna, one of Germany's foremost dermatologists. He proposed the inclusion of Hansen's and Koch's bacilli in a new genus. In 1889, Unna nominated his student as physician-in-chief of the Leper Settlement on Molokai Island, Hawaii. From then on, Lutz sustained the theory that the disease was transmitted by mosquitos. He conducted research to prove this theory when he was head of the Instituto Bacteriológico de São Paulo (1893-1908) and, later, after he moved to the Instituto Oswaldo Cruz (1908-1940). Although this research was not successful, on commissions and at congresses in which he participated until his death in October 1940, he still held to his conviction that leprosy was transmitted by mosquitoes.

Prophylaxis and exclusion: compulsory isolation of Hansen's disease patients in São Paulo.

This article aims to retrieve the history of Hansen's disease in Brazil, analyzing the medical thinking of the time and the shaping of health policies that permitted the implementation, in São Paulo, of a prophylactic policy of compulsory exclusion for all Hansen's disease patients. It also analyzes how the structuring and implementation of this policy led to a "São paulo model" that strongly influenced the rest of the country. It addresses the creation of the state's network of leper colonies, their characteristics and the emergence of a veritable "parallel state" that endured until 1967, with complete disregard of all the changes taking place in both national and international prophylactic policymaking.

The anti-leprosy campaign in Colombia: the rhetoric of hygiene and science, 1920-1940.

Since the 1920s, the medical community realized that the strategy of leprosy control based on segregation and persecution of patients was inefficient and expensive. In the 1930s the new liberal government incorporated leprosy within the general sanitary institutions, by merging the Bureau of Lazarettos and the National Department of Hygiene. The disease-apart approach started to be replaced by a more general public health strategy, which involved controlling other illnesses. Prevention and research played a more influential role, and the new sanitary officials saw leprosy in the light of the economic rationality of expenditures, placing more emphasis on therapies and making them mandatory for all patients. Improvements in leprosy treatment became widely known and available. However, the image of leprosy as a special condition and the practice of segregation were deeply entrenched within the Colombian culture and institutions. The rhetoric changed, but to break with several decades of persecution was a difficult task.

[A panorama of Hansen's disease: present status and perspectives]. / Panorama sobre a hanseniase: quadro atual e perspectivas.

The interviewee speaks about the endemic disease, which at present contaminates 4.4 out of ten thousand inhabitants in Brazil, the country with the second highest number of patients. When Tadiana speaks about the Brazilian participation in the program launched by the World Health Organization, she explains that WHO's objective is to extinguish Hansen's disease on the planet until 2005. However, she says that Brazilian main goal is to reduce the occurrence of the disease to less than one case per ten thousand people. In our country, the structure and the organization of this program, which comprehends the education and specialization of professionals in order to guarantee early diagnoses, as well as patients' follow-up during treatment, is developed by Sistema Unico de Saúde (SUS) and has been implemented in all the states of the federation. The chemotherapy treatment lasts about a year, when taken seriously. In many cases, the disease comes back a while later. Tadiana comments on the differences of the disease according to the different regions of the country. It has been extinguished in the South,whereas the rates in the North and Central East regions almost reach endemic peaks. Working close to patients and ex-patients associations, first as a nurse and later in the implementation of policies for Hansen's disease issues, Tadiana Alves Moreira stresses the importance of early diagnoses, which avoid the physical damages and deformities that take place in the advanced stages of the disease, so reducing the stigma over the diseased.

[A study on the measures against Hansen's disease during the Colonial Korea].

In order to evaluate the measures taken against Hansen's diseases during the colonial era in Korea, from 1910-1945, I analyzed both Korean and Japanese materials and carried out field research. The Korean government-general established a hospital in 1916 and executed measures against Hansen's disease. These efforts can be divided into three periods. At first they started as a part of colonial policy. Then, in the middle period, with the change of Japanese policy on Hansen's disease, a Korean association was established and the Hansen's Disease Prevention Act was issued in Korea, aiming at the compulsory isolation of lepers. In the later period, during the war, the inmates were forced into an extremely severe environment and deprived of their human rights. My study shows that their policies changed greatly with the passage of time. Though they started them to relieve the suffering of the lepers in the beginning, they turned to be compulsory isolation of the patients in the later period and to the violation of their human rights.

Building national medicine: leprosy and power in Colombia, 1870-1910.

As imperialist nations rediscovered leprosy in their colonial world in the late nineteenth century, Colombian physicians found endemic leprosy in their own country. The medical community was interested in constructing a national medicine to conform to 'universal' science. To medicalize leprosy, doctors provoked fears through exaggerating the number of leprosy sufferers to demonstrate that charity was incapable of dealing with the problem. The government approved laws of compulsory segregation of leprosy patients in the 1890s, while the 1897 international conference on leprosy held in Berlin gave international sanction to isolation. Lepers actively resisted segregation as a violation of their individual rights. Dr Juan de Dios Carrasquilla studied the disease, experimented with sero-therapy to cure it, and claimed that the flea was its agent of transmission. He combatted segregation and proposed instead a hygienic programme to improve environmental living conditions, but his approach was defeated. When the early twentieth century saw the consolidation of the Colombian state, modernization of the country became a national priority. The government started to take control of lazarettos, enforcing segregation of lepers, who were confined within an area circumscribed by a sanitary cordon. This strategy was a failure, since patients resisted segregation.