Shorter E
Department of History of Medicine, Faculty of Medicine, University of Toronto, Canada.
Scand J Work Environ Health. 1997;23 Suppl 3:35-42.
Multiple chemical sensitivity as a "disease" has emerged as a descendant of food allergy, which, in the 1920s and 1930s, was considered to be responsible for much human suffering and symptoms of disease. After the onmarch of the clinical ecological movement in the 1950s, interest has been focused on the environment, and concern about food allergies and chemical sensitivity has reached epidemic proportions. "Active hazardous waste sites" and "workers exposed to toxic chemicals" are at the top of the list of public worries. The public believes manufactured chemicals to be more dangerous than natural ones, although toxicologists regard the risks as equal. Originally, symptoms of patients were explained as "allergies", but since the 1960s the concept of "chemical sensitivities" has become a big-time diagnosis. The ideas of the clinical ecologists diffused rapidly into the community aided by public media. Today organizations like "Chemical Victims" and "National Foundation for the Chemically Hypersensitive" have thousands of members. Although the diagnosis of the disease is very vague, suffering patients believe that the clinical ecologists can offer them something that traditional medicine cannot: sympathy, recognition of pain and suffering, a physical explanation for their suffering, and active participation in medical care. Ecologic medicine thus soared in the patients' esteem, not just because of the content of the objective diagnoses that ecologic practitioners were able to supply, but because of the subjective nature of the doctor-patient relationship they were able to offer.
多重化学物质敏感症作为一种“疾病”,是食物过敏的衍生物。在20世纪20年代和30年代,食物过敏被认为是导致许多人类痛苦和疾病症状的原因。20世纪50年代临床生态学运动兴起后,人们的关注点转向了环境,对食物过敏和多重化学物质敏感症的担忧已达到流行程度。“活跃的危险废物场地”和“接触有毒化学物质的工人”位列公众担忧之首。公众认为人造化学物质比天然化学物质更危险,尽管毒理学家认为两者风险相当。最初,患者的症状被解释为“过敏”,但自20世纪60年代以来,“化学物质敏感症”的概念已成为一种重要的诊断。在公共媒体的帮助下,临床生态学家的观点迅速传播到社区。如今,像“化学物质受害者”和“化学物质过敏症全国基金会”这样的组织拥有数千名成员。尽管这种疾病的诊断非常模糊,但痛苦的患者认为临床生态学家能为他们提供传统医学无法提供的东西:同情、对痛苦的认可、对其痛苦的身体解释以及积极参与医疗护理。因此,生态医学在患者心目中的地位飙升,这不仅是因为生态医学从业者能够提供的客观诊断内容,还因为他们能够提供的医患关系的主观性。