Löwy I
Hôpital des Enfants Malades, Paris.
Rev Synth. 1995;116(1):27-54. doi: 10.1007/BF03181266.
In the 1910's and 1920', thanks to the conjunction of scientific views concerning the specificity of anti-bacterial antibodies, of lay ideas about the existence of anti-bacterial antibodies and of the perceived importance of developing a syphilis test for public health officials, the community of serologists collectively transformed a relatively inefficient diagnostic test described by Wassermann in 1906 into an "incontestable scientific fact". This "scientific fact" established the equivalence: Wassermann positive individual=person infected with the germ Treponema pallidum, the etiological agent of syphilis. It modified the boundaries of the nosologic entity "syphilis", medical practices, professional attitudes, lay perceptions of syphilis, and health policies. In the 1950's, however, discrepancies between Wassermann test data and epidemiological data and, on the other hand, the development of specific anti-treponemal tests, destabilized the previously stabilized "scientific fact". A high percentage of Wassermann positive individuals were redefined as "biological false positifs", that is persons who suffered from chronic affections able to induce positive results of the Wassermann test. The equivalence Wassermann positive person=individual infected by Treponema pallidum was replaced by the equation: Wassermann positive person=individual infected by Treponema pallidum or biological false positive. The new perception of the Wassermann test again changed scientific views, professional practices and lay beliefs. The history of the Wassermann reaction illustrates the complicated interaction between "scientific facts" and "social facts", and the mutual shaping of both.
在20世纪10年代和20年代,由于关于抗菌抗体特异性的科学观点、关于抗菌抗体存在的大众观念以及公共卫生官员认为开发梅毒检测很重要这三者的结合,血清学家群体共同将瓦塞尔曼在1906年描述的一种相对低效的诊断测试转变为一个“无可争议的科学事实”。这个“科学事实”确立了这样的等价关系:瓦塞尔曼反应阳性个体 = 感染梅毒病原体梅毒螺旋体的人。它改变了疾病分类实体“梅毒”的界限、医疗实践、专业态度、大众对梅毒的认知以及卫生政策。然而,在20世纪50年代,瓦塞尔曼测试数据与流行病学数据之间的差异,以及另一方面特异性抗梅毒螺旋体检测的发展,动摇了之前稳定的“科学事实”。高比例的瓦塞尔曼反应阳性个体被重新定义为“生物学假阳性”,即患有能够导致瓦塞尔曼测试呈阳性结果的慢性疾病的人。瓦塞尔曼反应阳性个体 = 感染梅毒螺旋体的个体这一等价关系被以下等式所取代:瓦塞尔曼反应阳性个体 = 感染梅毒螺旋体的个体或生物学假阳性个体。对瓦塞尔曼测试的新认知再次改变了科学观点、专业实践和大众观念。瓦塞尔曼反应的历史说明了“科学事实”与“社会事实”之间复杂的相互作用,以及两者的相互塑造。