Department of Ophthalmology and Visual Sciences, and the Center for History of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of English, Washington University, St. Louis, Missouri, USA.
Am J Ophthalmol. 2018 Sep;193:xix-xxvii. doi: 10.1016/j.ajo.2018.06.006. Epub 2018 Jun 12.
This article reviews the history of Cuban epidemic optic neuropathy (1991-1993), which caused visual loss, peripheral neuralgias, and other neurologic symptoms in over 50,000 persons, an incidence of almost 0.5% of the entire population. The clinical findings, etiology, and treatment are described. We then relate the Cuban epidemic to the fictional epidemic of contagious blindness depicted by Nobel Laureate José Saramago in his 1995 novel Blindness. This novel describes an unnamed modern city in which all inhabitants, except the ophthalmologist's wife, are affected with a white, not black, blindness.
Historical review and literary essay.
The sources for the Cuban epidemic were an extensive review of the published literature and personal communications with physicians who treated these patients. Both authors have analyzed the novel and the critical literature about Saramago's writings.
Though Saramago uses the epidemic of blindness as an allegory to comment on human weakness and immorality, he may also have known of the actual Cuban epidemic. Saramago was a lifelong member of the Communist party, as well as a friend of Fidel Castro and admirer of the Cuban government. We have no proof that Blindness was influenced by the Cuban epidemic, but we find it plausible.
It is valuable to examine the real and fictional epidemics side by side, not least because Saramago's novel depicts the actions of an ophthalmologist during an epidemic of blindness. Ophthalmologists may be interested in a novel that uses the language of eyes, vision, sight, and blindness extensively.
本文回顾了古巴流行视神经病变（1991-1993 年）的历史，该病导致超过 50000 人出现视力丧失、周围神经痛和其他神经症状，发病率几乎达到总人口的 0.5%。描述了其临床发现、病因和治疗方法。然后，我们将古巴的流行疫情与诺贝尔文学奖得主若泽·萨拉马戈（José Saramago）在 1995 年的小说《失明》中虚构的传染性失明流行联系起来。这部小说描述了一个没有名字的现代城市，除了眼科医生的妻子外，所有居民都患有白色而不是黑色的失明症。
历史回顾和文学评论。
古巴流行疫情的资料来源是对已发表文献的广泛回顾以及与治疗这些患者的医生的个人交流。两位作者都对小说和萨拉马戈作品的评论文献进行了分析。
尽管萨拉马戈用失明的流行来作为评论人性弱点和不道德的寓言，但他也可能了解到古巴的实际流行疫情。萨拉马戈是共产党的终身成员，也是菲德尔·卡斯特罗的朋友，也是古巴政府的崇拜者。我们没有证据表明《失明》受到了古巴流行疫情的影响，但我们认为这种可能性是存在的。
将真实和虚构的流行病并排进行检查是有价值的，尤其是因为萨拉马戈的小说描述了一位眼科医生在失明流行期间的行动。眼科医生可能会对一部广泛使用眼睛、视力、视觉和失明语言的小说感兴趣。
