Gussow Z
South Med J. 1979 May;72(5):600-4. doi: 10.1097/00007611-197905000-00026.
In the late 1880s it became apparent in Louisiana that leprosy was endemic in the southern part of the state. Initially, the intention was to establish a leprosy hospital in the city of New Orleans, close to medical facilities, and where the bulk of the patients were to be found. The establishment, instead, of an isolated leper colony at the run-down plantation at Carville, 85 miles up-river, was the result of community indifference, misunderstanding of the nature of the disease, and expected depreciation of property values. Fear of the disease was a secondary matter. The practice of locating residential facilities for the chronically ill at long distances from the centers of physician practice and medical research continues to this day. Interestingly, the arguments that permit this to happen have not changed appreciably from those of a century ago.
19世纪80年代末,路易斯安那州南部麻风病呈地方性流行的情况已十分明显。最初的想法是在新奥尔良市建立一所麻风病医院,那里靠近医疗设施,且能找到大部分患者。然而,最终却是在距上游85英里处破败的卡维尔种植园建立了一个隔离的麻风病人聚居地,这是社区冷漠、对疾病本质的误解以及预计的房产价值贬值所致。对疾病的恐惧倒是其次。将慢性病患者的居住设施建在远离医生执业和医学研究中心的地方,这种做法一直延续至今。有趣的是,允许这种情况发生的论据与一个世纪前相比并无明显变化。