Kousoulis Antonis A, Tsoucalas Gregory
London School of Hygiene and Tropical Medicine, London, UK; Society of Junior Doctors, Athens, Greece.
Society of Junior Doctors, Athens, Greece; History of Medicine Department, School of Medicine, National and Kapodistrian University of Athens, Greece.
Infez Med. 2017 Sep 1;25(3):285-291.
The influenza pandemic of 1889 was the first truly global flu outbreak in scope. Characterised by high morbidity and low mortality, it spread rapidly across Europe and the rest of the world along trading routes. It reached mainland Britain in December 1889. The responses of medical practitioners in Britain and the British colonies to the pandemic were heavily featured in the British Medical Journal and reveal a confusing picture around causality, contagion and infection. Cases from the colonies (Cape Town, India, Australia, Samoan Islands, Hong Kong) as presented in the journal are explored in an attempt to reconstruct the mainstream medical belief of the time. The evidence sadly shows a lack of confidence in contagionism, almost complete absence of monocausalism and a vague picture of the epidemic constitution. Original case studies from colonial medical officers as well as editorials triggered a debate in the pages of the BMJ. In this context, the journal succeeded in playing a key role in recording the first thoroughly documented attack of influenza. In a world that was only learning to be interconnected, the BMJ became the point of reference for the British medical establishment, which ranged from London to Scotland and from Africa and India to Oceania.
1889年的流感大流行是首次真正具有全球范围的流感爆发。其特点是发病率高、死亡率低，沿着贸易路线迅速蔓延至欧洲及世界其他地区。1889年12月，它抵达了英国本土。英国和英国殖民地的医生对此次大流行的应对情况在《英国医学杂志》中得到了大量报道，揭示了围绕因果关系、传染和感染的一幅令人困惑的图景。本文探讨了该杂志中呈现的来自殖民地（开普敦、印度、澳大利亚、萨摩亚群岛、香港）的病例，试图重构当时的主流医学观念。遗憾的是，证据显示当时对传染主义缺乏信心，几乎完全不存在单一病因论，对疫情构成的认识也很模糊。殖民地医务人员的原始病例研究以及社论在《英国医学杂志》上引发了一场辩论。在这种背景下，该杂志成功地在记录首次有详尽记录的流感疫情方面发挥了关键作用。在一个刚刚开始学会相互联系的世界里，《英国医学杂志》成为了从伦敦到苏格兰，从非洲、印度到大洋洲的英国医学界的参考点。
