Breivik Edvard, Gradmann Christoph
Molde sjukehus.
Seksjon for medisinsk antropologi og medisinsk historie Institutt for helse og samfunn Universitetet i Oslo.
Tidsskr Nor Laegeforen. 2014 Apr 8;134(7):732-5. doi: 10.4045/tidsskr.13.0783.
Diphteria played a key role in establishing the bacteriological model for explaining infectious disease. This understanding of bacteriological factors spurred research that culminated in the development of diphteria antitoxin, the first effective therapeutic cure for an epidemiological disease. Prior to the introduction of antitoxin, isolation and disinfection were regarded as the key defences against diphteria. The opportunity to combine antitoxin therapy with existing methods for combatting the disease was a key factor for the rapid spread of the antitoxin. Diphteria antitoxin was first used in Romsdal county in 1895. Initially the serum had to be ordered from manufacturers abroad, which restricted its application in the district. Few available doctors and long transport routes were reasons that prevented the antitoxin from reaching its full potential. Industrial manufacturing methods were an obstacle to serum production in peripheral areas. In Norway, production of serum gradually got underway in Kristiania, which was one factor that caused mortality from diphteria to decline faster there than in other parts of the country. In this article we will elucidate the relationship between the centre and the periphery in the spread of medical advances by studying the implementation of diphteria antitoxin in Romsdal county.
白喉在建立解释传染病的细菌学模型方面发挥了关键作用。对细菌学因素的这种认识推动了相关研究，最终促成了白喉抗毒素的研制，这是第一种有效治疗流行病的疗法。在抗毒素引入之前，隔离和消毒被视为对抗白喉的关键防御措施。将抗毒素疗法与现有的疾病防治方法相结合的机会是抗毒素迅速传播的一个关键因素。1895年，白喉抗毒素首次在罗斯达尔郡使用。最初，血清必须从国外制造商订购，这限制了其在该地区的应用。医生数量有限和运输路线过长是阻碍抗毒素充分发挥作用的原因。工业生产方法是周边地区血清生产的一个障碍。在挪威，血清生产逐渐在克里斯蒂安尼亚展开，这是导致该地区白喉死亡率比该国其他地区下降更快的一个因素。在本文中，我们将通过研究罗斯达尔郡白喉抗毒素的实施情况，阐明医学进步传播过程中中心与周边地区的关系。
