Gradmann Christoph
Section for Medical Anthropology and Medical History, University of Oslo, Frederik Holts hus, Ullevål terrasse, N-0450 Oslo, Norway.
Stud Hist Philos Biol Biomed Sci. 2010 Sep;41(3):232-40. doi: 10.1016/j.shpsc.2010.04.012. Epub 2010 Jul 31.
This paper reassesses Robert Koch's work on tropical infections of humans and cattle as being inspired by an underlying interest in epidemiology. Such an interest was developed from the early 1890s when it became clear that an exclusive focus on pathogens was insufficient as an approach to explain the genesis and dynamics of epidemics. Koch, who had failed to do so before, now highlighted differences between infection and disease and described the role of various sub-clinical states of disease in the propagation and--consequently--in the control of epidemics. Studying pathologies of men and cattle in tropical countries eventually facilitated the application of such measures in Europe through the screening of healthy carriers of typhoid, which was carried out in 1902. The concept of the carrier state can be understood as a spin-off from tropical medicine into the study and control of infectious disease in Europe. With it travelled assumptions that were typical for colonial and veterinary medicine where the health of indigenous individuals or cattle would be a secondary objective compared to the control of diseases in populations.
本文重新评估了罗伯特·科赫在人类和牲畜热带感染方面的工作，认为其受到了流行病学潜在兴趣的启发。这种兴趣从19世纪90年代初开始发展，当时人们清楚地认识到，仅专注于病原体作为解释流行病发生和动态的方法是不够的。科赫此前未能做到这一点，现在他强调了感染与疾病之间的差异，并描述了疾病各种亚临床状态在流行病传播以及——因此——在流行病控制中的作用。对热带国家人类和牲畜病理学的研究最终通过1902年对伤寒健康携带者的筛查，促进了这些措施在欧洲的应用。带菌状态的概念可以理解为从热带医学衍生到欧洲传染病研究和控制领域。随之而来的是一些在殖民医学和兽医学中典型的假设，即在控制人群疾病方面，与本土个人或牲畜的健康相比，后者是次要目标。
