El control de la tuberculosis en Cuba desde fines del siglo XIX hasta 1930 / Tuberculosis control in Cuba from the late 19th century to 1930

Introducción: la tuberculosis es una enfermedad infectocontagiosa de evolución aguda, subaguda o crónica, conocida antes del año 1000 a.n.e. Sobre la existencia de la tuberculosis en Cuba hay noticias desde 1630; el conocimiento de los médicos cubanos sobre el mal se presentó en las publicaciones especializadas. Objetivo: presentar los principales aspectos de la historia del control de la tuberculosis en Cuba. Métodos: se siguió le método histórico-lógico, apoyados en la revisión documental. Resultados: en Cuba la lucha contra la tuberculosis se inició a finales del siglo XIX; se presentan las acciones tomadas hasta el año 1930. A finales del siglo XIX se creó la Liga Antituberculosa, la cual a principios del siglo XX tomó carácter nacional; se construyeron dispensarios para el tratamiento ambulatorio de los enfermos; en 1907 el primer sanatorio para el tratamiento internado de los pacientes. Pero después de la segunda década los trabajos de la lucha tuvieron un decrecimiento. En la segunda mitad de la década del 20 se creó una cátedra específica para su enseñanza en la Escuela de Medicina e instituciones que reforzarían, al menos en teoría, el trabajo dirigido hacia la mejora de la situación de la enfermedad en la población. Conclusiones: durante los primeros años del siglo XX, se organizaron los primeros servicios para el tratamiento de la tuberculosis, se inició un incipiente control sobre la enfermedad. Aunque los servicios y acciones fueron insuficientes, constituyeron un intento de mejorar la situación enfermedad en la población(AU)

Introduction: tuberculosis is an infectious contagious disease of acute, subacute or chronic evolution. Known before the year 1 000 B.C., news about its presence in Cuba dates back to 1630. Cuban doctors' knowledge about the condition appeared in specialized publications. Objective: present the main aspects of the history of tuberculosis control in Cuba. Methods: the historical-logical method was applied, supported by document review. Results: the fight against tuberculosis started in Cuba in the late 19th century. A description is provided of the actions taken until the year 1930. The Anti-Tuberculosis League was founded at the end of the 19 th century, and acquired nationwide scope at the beginning of the 20th century. Dispensaries were built for ambulatory treatment. The first inpatient sanatorium was founded in 1907. However, after the second decade, the fight against tuberculosis witnessed a decline. In the second half of the 1920s, a specific professorship was created to be taught at the School of Medicine and institutions which would reinforce, at least theoretically, the work aimed at improving the status of the disease in the population. Conclusions: during the early years of the 20th century, the first services for the treatment of tuberculosis were created and incipient control of the disease was started. Insufficient as the services and actions were, they constituted an attempt to improve the status of the disease in the population(AU)

Beneficencia, caridad y poder en Barcelona. El enfrentamiento entre el patronato para la Lucha contra la tuberculosis y Jaime Queraltó y Ros por el modelo de asistencia sanitaria (1910-1916) / Welfare, charity and power in Barcelona. The conflict between the Board for the Fight against tuberculosis and Jaime Queraltó y Ros on the model for healthcare (1910-1916)

En el año 1910, como consecuencia de los preparativos para la celebración del primer Congreso Internacional de la Tuberculosis en Barcelona, las clases médicas de la ciudad escenificaron un duro enfrentamiento con respecto al modelo asistencial dirigido al tratamiento y prevención de la enfermedad fímica. A lo largo del conflicto, el ginecólogo Jaime Queraltó y Ros fue desterrado por acusar al Patronato de Cataluña para la Lucha contra la Tuberculosis, de fomentar el uso de prácticas asistenciales con el único fin de salvaguardar el alma de sus pacientes de la enfermedad, aun a costa de someterles a operaciones superfluas y cruentas, como fue la cauterización de un tatuaje anarquista que se le practicó a uno de los obreros que visitaban sus dispensarios. El interés que suscitó el llamado "caso del anarquista tatuado" traspasó en pocos meses las fronteras nacionales, convirtiendo al Patronato en objeto de las más duras críticas por parte de diversas instituciones extranjeras, y promoviendo a escala nacional un debate sobre las carencias o los beneficios de un modelo asistencial liberal en el que, lejos de fundarse en los principios de una ciencia secular, las prácticas sanitarias parecían seguir sujetas a una serie de valores higiénico-morales tradicionalmente vinculados con la caridad católica. Más allá de dar cuenta del conflicto entre los médicos, el propósito general de nuestro artículo pasa por analizar la forma en que las posturas enfrentadas respondieron a las distintas corrientes políticas de la ciudad, demostrando así la importancia que las prácticas asistenciales habían adquirido dentro las estrategias electorales de los distintos partidos a principios del siglo XX (AU)

In 1910, as a consequence of the preparations for the first International Congress on Tuberculosis in Barcelona, the city's medical community faced a grave confrontation with respect to the model of healthcare offered for the treatment and prevention of the phymic disease. During the conflict, the gynaecologist Jaime Queraltó I Ros was banished for accusing the Catalonian Board for the Fight Against Tuberculosis of promoting the use of a care practice whose sole objective was saving the patient's souls, even if this meant superfluous and bloody operations, like the cauterization of an anarchist tattoo on one of the workers who attended one of their free clinics. The interest arising from the case of the "tattooed anarchist" spread across the national borders in a few months, converting the Board into the object of harsh criticism from different foreign institutions and causing a nation-wide debate on the deficiencies or benefits of a liberal healthcare model that, far from being based on secular science, seemed to continue being tied to a series of hygienic-moral values traditionally linked to catholic charity. Beyond just giving an account of the conflict between physicians, the general aim of our article goes from analyzing the way in which the conflicting postures answered to different political currents in the city to showing the importance that healthcare had acquired within the electoral strategies of the different political parties in the XX century (AU)

La medicina de los niños en tiempos de Cervantes. Primeras monografías médicas pediátricas en España hace 400 años / Children's medicine in the times of Cervantes. First paediatric monographs in Spain four hundred years ago

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Una perspectiva heterodoxa de la historia de los medicamentos. Dinámicas de inclusión-exclusión de los sueros antituberculosos Ravetllat-Pla en la España del primer tercio del siglo XX / A heterodox perspective on the history of drugs. Inclusionexclusion dynamics of the Ravetllat-Pla anti-tuberculosis serum in the first third of the 20th century

En 1924, momento histórico de auge de la tuberculosis en España, fue fundado el Instituto Ravetllat-Pla con el fin de producir y comercializar un suero antituberculoso fundamentado en una teoría propuesta por el veterinario Joaquim Ravetllat i Stech (1872-1923). La nueva teoría etiopatológica de la tuberculosis propuesta por Joaquim Ravetllat evidenciaba la variabilidad ontológica del bacilo de Koch proponiendo nuevas formas bacterianas que no habían sido descritas. El tisiólogo catalán Ramon Pla i Armengol (1880-1958) encontró en la teoría de Joaquim Ravetllat fundamento a los síntomas clínicos que observaba en sus pacientes por lo que continuó la investigación en alianza con el veterinario. Esta teoría científica fue considerada heterodoxa por la ciencia oficial de la época lo que condujo al establecimiento de un espacio de exclusión en el que el Instituto adoptó la identidad de heterodoxo. Como reacción a la exclusión el Instituto generó otro espacio de inclusión en el que, a través del éxito comercial de sus productos farmacéuticos, su refutada teoría científica fue legitimada y validada socialmente. En el presente artículo, se propone que la consideración de los medicamentos como productos comerciales permite evidenciar la participación activa de los distintos usuarios del suero Ravetllat-Pla en su construcción, reconceptualización y legitimación social. Además, desde las dinámicas de inclusión y exclusión, esta investigación contribuye al entendimiento de los procesos de legitimación del conocimiento desde de la heterodoxia científica (AU)

In 1924, a historically peak time for tuberculosis in Spain, the Ravetllat-Pla Institute was established with the aim of producing and commercializing an anti-tuberculosis serum and researching the variability of the bacteria implicated in this infection. This bacterial form, proposed by Joaquim Ravetllat in the first decade of the 20th century, led to the formulation of a new etiological-pathologic theory of tuberculosis, which upheld the drugs produced by the Institute and was considered heterodox by the official science of the time. The Catalan medical and political network established a space of exclusion leading to the marginalization of the Institute, which, by strengthening its heterodox identity, generated another space of inclusion. In this space, its refuted scientific theory could be socially legitimated and validated through the commercial success of its pharmaceutical products. In this paper, we suggest that the consideration of medicines as commercial products illustrates the active participation of the different users of the Ravetllat-Pla serum in its social construction, re-conceptualization and legitimization. Moreover, from the theoretical framework of inclusion-exclusion dynamics, this research contributes to understanding the processes of knowledge legitimatization by scientific heterodoxy

Acercamiento a la vida y obra del Doctor Ambrosio Grillo y Portuondo / Approach to the life and work of Doctor Ambrosio Grillo y Portuondo

El presente trabajo aproxima a los lectores a la vida y obra del Dr Ambrosio Grillo y Portuondo, ilustre médico cubano, nacido en Santiago de Cuba y fundador de la Liga Antituberculosa de Cuba. Fue el primer presidente del Colegio Médico de esta zona del país. Subvencionó durante el primer cuatrimestre la revista científica Finlay, Órgano Oficial del Colegio Médico de Santiago de Cuba. Además de sus extraordinarias virtudes como galeno, sus coterráneos le consideraron como uno de los mejores alcaldes que tuvo este territorio(AU)

The present work approaches the readers to the life and work of Dr Ambrosio Grillo y Portuondo, distinguished Cuban Physician, born in Santiago de Cuba and founder of the antituberculous Cuban league. He was the first president of the Medical Association of this area of the country. He subsidized during the first four-month period the Finlay scientific magazine, Official Organ of the Medical Association in Santiago de Cuba. Appart from his extraordinary virtues as physician, his fellow countrymen considered him as one of the best mayors that this territory had(AU)

Acercamiento a la vida y obra del Doctor Ambrosio Grillo y Portuondo / Approach to the life and work of Doctor Ambrosio Grillo y Portuondo

El presente trabajo aproxima a los lectores a la vida y obra del Dr Ambrosio Grillo y Portuondo, ilustre médico cubano, nacido en Santiago de Cuba y fundador de la Liga Antituberculosa de Cuba. Fue el primer presidente del Colegio Médico de esta zona del país. Subvencionó durante el primer cuatrimestre la revista científica Finlay, Órgano Oficial del Colegio Médico de Santiago de Cuba. Además de sus extraordinarias virtudes como galeno, sus coterráneos le consideraron como uno de los mejores alcaldes que tuvo este territorio.

The present work approaches the readers to the life and work of Dr Ambrosio Grillo y Portuondo, distinguished Cuban Physician, born in Santiago de Cuba and founder of the antituberculous Cuban league. He was the first president of the Medical Association of this area of the country. He subsidized during the first four-month period the Finlay scientific magazine, Official Organ of the Medical Association in Santiago de Cuba. Appart from his extraordinary virtues as physician, his fellow countrymen considered him as one of the best mayors that this territory had.

[30th anniversary of the "Kuratorium Tuberkulose in der Welt"]. / 30 Jahre Kuratorium Tuberkulose in der Welt.

The "Kuratorium Tuberkulose in der Welt" is a non-profit association to fight tuberculosis (TB) in the world. It was founded by a group of idealist physicians 30 years ago. Its tasks are to fight against TB, especially in developing countries, to propagate the knowledge of TB prevention and therapy, and to promote research in the field of TB. The "Kuratorium" has set up projects in Santa Cruz (Bolivia), Kathmandu (Nepal), Lomé (Togo), Kiev (Ukraine), and Stavropol (Russia). In cooperation with the WHO, the International Union against Tuberculosis and Lung Disease (IUATLD), and local anti-tb-organisations microbiologic laboratories were established for case detection and therapeutic monitoring. Local staffs were trained and strategies to combat TB were implemented. For more than 30 years the "Kuratorium Tuberkulose in der Welt" has worked successfully and beneficially, despite of often difficult political situations. It has received great appreciation for its achievements.

[Centenary of the Royal Dutch Central Association for the Prevention of Tuberculosis]. / Honderd jaar Koninklijke Nederlandse Centrale Vereniging tot bestrijding der tuberculose (KNCV).

The Royal Dutch Tuberculosis Association (Koninklijke Nederlandse Centrale Vereniging tot bestrijding der Tuberculose (KNCV)) was founded in 1903. Since then various interventions against tuberculosis have been introduced on the basis of medical and technological opportunities and in response to the epidemiological situation. The introduction of effective drugs during the 1940s and 1950s was by far the most important development and led to a sharp decline in the annual rate of infection and to the disappearance of tuberculosis as a common disease. Following the appointment of the independent National Policy Committee for Tuberculosis Control, Royal Dutch Tuberculosis Association could concentrate on its innovating tasks: the development of new interventions based on epidemiological data and scientific research.

[Treatment of pulmonary diseases from the 20th to the 21st century]. / Traitement des maladies pulmonaires: du 20ème au 21ème siècle.

In the 21st century, the treatment of pulmonary diseases will undergo fundamental change. The treatment of patients in general and of pulmonary diseases in particular will transcend the vertical and fragmented approach based on analytical and reductionistic disease concepts to emphasize holistic care given by an interdisciplinary team. Extended life expectancies, understandably ones that represent significant progress in 20th century medicine, will lead to considerably higher costs in the healthcare system and to a redistribution of therapeutic resources. Healthcare centers will form that are better equipped to handle the true needs of the patients and provide better continuity of care. Likewise, this nascent century will bring forth one irreversible sociological change, namely the better informed and better educated patient who, by demanding access to medical information in order to profit from modern technological advances, will become an active partner of the healthcare professionals. The Swiss Lung League, which is celebrating its 100th anniversary this year, has been able to tackle the real pulmonological challenges of the 20th century by taking on a pioneering role in the fight against tuberculosis, smoking and setting benchmarks by providing patients with sophisticated respiratory technology like mechanical home ventilation. Unlike other medical disciplines, it recognized early on the importance of working within a healthcare network. Its strength derives from a synergy of the cantonal leagues' medical and social commitment and the Pulmonological Society's scientific support. Indeed, this trend can be observed all over Europe and the USA. This partnership is self-perpetuating and has adapted its own mentalities and structures to scientific progress and the changing needs of pulmonary patients.

[Significance of activities of a medical sanitary detachment from complex expedition if the USSR Academy of Sciences (1925-1930) in the development of surgical treatment for osteoarticular tuberculosis in Iakutiia]. / Znachenie rabot mediko-sanitarnogo otriada kompleksnoí ékspeditsii AN SSSR (1925-1930gg) v razvitii khirurgicheskogo lecheniia kostno-sustavnogo tuberkuleza v Iakutii.

The paper shows the value of the activities of a medical sanitary detachment from the complex expedition of the USSR Academy of Sciences (1925-1930) in the development of surgical treatment for bone and joint tuberculosis and its sequelae in adults from Yakutia. A total of 981 operations were made from 1951 to 1994. Priorities were given to timely surgical interventions, including radical reparative spinal and joint operations, by using the Ilizarov apparatus.