PandemiX Center, Department of Science and Environment, Roskilde University, Universitetsvej 1, Postbox 260, 4000 Roskilde, Denmark.
Med Hist. 2023 Jan;67(1):57-73. doi: 10.1017/mdh.2023.13. Epub 2023 Jul 18.
Intermittent fever is a historical diagnosis with a contested meaning. Historians have associated it with both benign malaria and severe epidemics during the Early Modern Era and early nineteenth century. Where other older medical diagnoses perished under changing medical paradigms, intermittent fever 'survived' into the twentieth century. This article studies the development in how intermittent fever was framed in Denmark between 1826 and 1886 through terminology, clinical symptoms and aetiology. In the 1820s and 1830s, intermittent fever was a broad disease category, which the diagnosis 'koldfeber'. Danish physicians were inspired by Hippocratic teachings in the early nineteenth century, and patients were seen as having unique constitutions. For that reason, intermittent fevers presented itself as both benign and severe with a broad spectrum of clinical symptoms. As the Parisian school gradually replaced humoral pathology in the mid-nineteenth century, intermittent fever and koldfeber became synonymous for one disease condition with a nosography that resembles modern malaria. The nosography of intermittent fever remained consistent throughout the second half of the nineteenth century. Although intermittent fever was conceptualized as caused by miasmas throughout most of the nineteenth century, the discovery of the Plasmodium parasite in 1880 led to a change in the conceptualization of what miasmas were. The article concludes that the development of how intermittent fever was framed follows the changing scientific paradigms that shaped Danish medicine in the nineteenth century.
间歇热是一个具有争议性的历史诊断,它曾被用来描述良性疟疾和近代早期及 19 世纪初的严重传染病。在其他一些更古老的医学诊断在不断变化的医学模式下消失的情况下,间歇热“幸存”到了 20 世纪。本文通过术语、临床症状和病因学研究了 1826 年至 1886 年期间丹麦对间歇热的诊断方法的发展。在 19 世纪 20 年代和 30 年代,间歇热是一个广泛的疾病类别,其诊断为“寒疫”。19 世纪初,丹麦医生受到希波克拉底学说的启发,认为患者具有独特的体质。因此,间歇热既有良性的,也有严重的,其临床表现多种多样。随着 19 世纪中叶巴黎学派逐渐取代体液病理学,间歇热和寒疫成为一种疾病的同义词,其病谱类似于现代疟疾。在 19 世纪的后半叶,间歇热的病谱一直保持不变。尽管在 19 世纪的大部分时间里,间歇热被认为是由瘴气引起的,但 1880 年疟原虫的发现导致了人们对瘴气概念的改变。本文的结论是,间歇热的诊断方法的发展遵循了塑造 19 世纪丹麦医学的不断变化的科学范式。