Tamm I
Historisches Seminar der Universität, Gesundheitsamt der Stadt Hannover.
Offentl Gesundheitswes. 1990 Feb;52(2):58-64.
Tuberculosis was the major cause of death in 19th century Europe. A fall in the incidence of the disease was first observed in England. In Germany this reduced incidence - along with industrialization - did not take place until the time of the Reich. Scientists in the 19th century recognised various factors as being responsible for the decrease in incidence of the disease. Those who believed in the contagiousness of the disease hoped to be able to control it with preventive and hygienic measures resulting from their findings on the bacteriology of the epidemic. Constitutionalists, on the other hand, attached importance to hereditary factors and believed that "evolution by natural selection" would bring the disease under control. Social hygienists, whose findings at the beginning of the 20th century were a subject of wide discussion, found the disease to be chiefly influenced by eating, working, and living conditions. These assumptions were confirmed by a statistical analysis of the relationship between living conditions and the mortality associated with tuberculosis. It follows that better living conditions would help to reduce the number of deaths from tuberculosis better than any medical preventive measure.
结核病是19世纪欧洲的主要死因。该病发病率的下降首先在英国被观察到。在德国，这种发病率的降低——与工业化一起——直到帝国时期才出现。19世纪的科学家认识到多种因素导致了该病发病率的下降。那些相信该病具有传染性的人希望能够通过基于他们对该流行病细菌学的研究结果而采取的预防和卫生措施来控制它。另一方面，体质论者重视遗传因素，并认为“自然选择进化”会控制这种疾病。20世纪初其研究结果引发广泛讨论的社会卫生学家发现，这种疾病主要受饮食、工作和生活条件的影响。对生活条件与结核病相关死亡率之间关系的统计分析证实了这些假设。由此可见，更好的生活条件比任何医疗预防措施都更有助于减少结核病死亡人数。
