Raúl Necochea López is with the Department of Social Medicine and the Department of History, University of North Carolina, Chapel Hill.
Am J Public Health. 2018 Feb;108(2):196-202. doi: 10.2105/AJPH.2017.304177.
This essay focuses on the use of the concept of "arrest" in Hansen's disease (leprosy) in the United States in the early to middle part of the 20th century, as well as the transformations the concept underwent with the arrival of sulfone drugs and the implications of these changes for patients and public health officers. An "arrest" was a therapeutic outcome characterized by a long course of treatment, noncontagiousness, a very small chance of reactivation, and a need for postdischarge maintenance that depended on sociomedical infrastructures beyond the clinic as well as self-imposed lifestyle limitations. The concept of disease arrest shows that experts and laypeople alike have valued therapeutic outcomes other than "cure" that signal certain optimal therapeutic milestones, despite the practical difficulties they imply and despite the fact that they do not promise a return to a pre-illness stage.
本文聚焦于 20 世纪上半叶美国麻风病（汉森病）中“缓解”这一概念的使用，以及随着砜类药物的出现，该概念所经历的转变，以及这些变化对患者和公共卫生官员的影响。“缓解”是一种治疗结果，其特点是治疗过程漫长、无传染性、复发的可能性极小，并且需要在出院后进行维持治疗，这不仅依赖于诊所之外的社会医学基础设施，还依赖于患者自我强加的生活方式限制。疾病缓解的概念表明，专家和非专业人士都重视除“治愈”之外的治疗结果，这些结果标志着某些最佳治疗里程碑，尽管它们存在实际困难，而且并不能保证恢复到疾病前的状态。
