Appelboom Thierry, Cogan Elie, Klastersky Jean
Division of Rheumatology and Physical Medicine, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium.
Mt Sinai J Med. 2007 Apr;74(1):36-9. doi: 10.1002/msj.20008.
Proposing a medical diagnosis a posteriori of a person who died a long time ago is not as impossible as it sounds if sufficient medical history is available.A whole book of the Bible is devoted to Job and his trials. The diagnosis of leprosy has been generally accepted by medieval commentators because the verses of the Book speak of ulcers disseminated over the skin, and also because leprosy is an exemplary sanction imposed by way of example by God to punish those who have committed a sin. In this paper, we have taken the different verses with a medical content from the Book of Job, and reconstructed the clinical picture as if the patient had turned up in the 21st century in order to see if the diagnosis of leprosy may be called into question, and to discuss the limits of the medico-historic approach. The clinical picture of the disease consists of deterioration in the general condition, with widespread pain, confusion, skin eruptions, bilious vomiting, and so on. Under these conditions, if Job did exist, and if the retrospective medical history is reliable, the most likely diagnosis is that of scabies rather than leprosy.
如果有足够的病史资料，对很久以前去世的人进行事后医学诊断并非像听起来那么不可能。《圣经》中有一整卷书都在讲述约伯及其苦难。中世纪的注释者普遍接受麻风病的诊断，因为书中的经文提到皮肤出现溃疡，还因为麻风病是上帝施加的一种典型惩罚，用以惩戒有罪之人。在本文中，我们选取了《约伯记》中具有医学内容的不同经文，并重构了临床症状，就好像患者出现在21世纪一样，以探究麻风病的诊断是否可能受到质疑，并讨论医学史方法的局限性。该疾病的临床症状包括全身状况恶化、广泛疼痛、意识模糊、皮肤疹、胆汁性呕吐等等。在这些情况下，如果约伯确实存在，并且回顾性病史可靠，那么最有可能的诊断是疥疮而非麻风病。
