Murard L, Zylberman P
Centre de Recherche Mèdecine Maladie et Sciences Sociales, Paris, France.
Hist Philos Life Sci. 1995;17(1):31-53.
The dreadful nature of the epidemic of 1870 explains why smallpox, not cholera, played a central role in the French public health regulations. And yet, France went it alone on the matter. The rules required isolation for the contagious sick and mandatory notification of the disease almost everywhere, nevertheless France relied only on persuasion. True, the public health law of 1902 provided the State with new weapons. But would such a mandatory decree be sufficient to awake popular opinion? There was no resistance to the law, like in England or Germany. However, the new regulations took several decades to be enforced, if only because of the poor state of the sanitary administration. Smallpox vaccination was eventually implemented when the authorities discovered that proximity and easier accessibility to services and facilities are of primary importance for patients.
1870年那场疫情的可怕性质解释了为何在法国公共卫生法规中起核心作用的是天花而非霍乱。然而,在这件事上法国却是独自行动。法规要求对传染病患者进行隔离,且几乎在所有地方都要强制报告疫情,尽管如此,法国仅依靠劝导。诚然,1902年的公共卫生法为国家提供了新的手段。但这样一项强制性法令足以唤起公众舆论吗?法国没有像英国或德国那样出现对该法律的抵制。然而,新规定花了几十年才得以实施,这仅仅是因为卫生管理状况不佳。当当局发现服务和设施的便利性及可及性对患者至关重要时,天花疫苗接种最终得以推行。