Wyatt H V
Soc Sci Med. 1984;19(9):911-5. doi: 10.1016/0277-9536(84)90320-4.
Paralysis from poliomyelitis may follow injections yet injections are extremely popular in the Third World. Some injections are given by hospital doctors and nurses but the majority are given by traditional healers, pharmacists and paramedical workers who have acquired syringes. Many injections may be given to a sick child. I suggest that the early use of vaccines did not persuade people of the mystic of injections and that the mystic predated the use of penicillin. The earliest mystical result would have been the injection of quinine for malaria and antrypal for sleeping sickness. The words brilliant, spectacular and dramatic were first used to describe the mass campaigns against yaws and kala-azar in the 1920s and 1930s. A single injection healed the ugly lesions in a week: cause and effect were visible. In the 1950s penicillin was used in mass eradication campaigns. The countries where injections are so popular correspond roughly with the areas of mass eradication programmes. Many or perhaps most of the injections are not sterile and present a great risk of attendant paralysis. Proof that injections are causal may be impossible. Meanwhile we need to know why injections are so popular and how they can be less so.
小儿麻痹症导致的瘫痪可能由注射引起，然而注射在第三世界却极为普遍。一些注射是由医院的医生和护士进行的，但大多数是由传统治疗师、药剂师以及获得了注射器的辅助医疗人员进行的。一个生病的孩子可能会接受多次注射。我认为早期疫苗的使用并未让人们信服注射的神奇之处，而且这种神奇之处在青霉素使用之前就已存在。最早的神奇效果当属注射奎宁治疗疟疾以及注射安锥赛治疗昏睡病。“卓越的”“惊人的”和“戏剧性的”这些词最初是用来描述20世纪20年代和30年代针对雅司病和黑热病开展的大规模防治运动的。一次注射就能在一周内治愈难看的病灶：因果关系一目了然。20世纪50年代，青霉素被用于大规模根除运动。注射如此普遍的国家大致与大规模根除计划的实施地区相符。许多甚至可能大多数注射并非无菌操作，存在极大的导致随之而来的瘫痪的风险。要证明注射是致病原因或许不太可能。与此同时，我们需要弄清楚为什么注射如此普遍，以及如何能降低其普遍性。
