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PubMed2003

The first international leprosy conference, Berlin, 1897: the politics of segregation.

The present paper examines the first attempts to internationalize the problem of leprosy, a subject hitherto overlooked by historians of imperialism and disease. The last decade of the nineteenth century saw many in the 'civilized countries' of the imperialist West gripped by a paranoia about an invasion of leprosy via germ-laden immigrants and returning expatriates who had acquired the infection in leprosy-endemic colonial possessions. Such alarmists clamoured for the adoption of vigorous leper segregation policies in such colonies. But the contagiousness of leprosy did not go unquestioned by other westerners. The convocation in Berlin of the first international meeting on leprosy revealed the interplay of differing and sometimes incompatible views about the containment of leprosy by segregation. The roles of officials from several countries, as well as the roles of five protagonists (Albert Ashmead, Jules Goldschmidt, Edvard Ehlers, Armauer Hansen, and Phineas Abraham) in the shaping of the Berlin Conference are here examined.

Colonialism↗
PubMedDate not supplied

The first international leprosy conference, Berlin, 1897: the politics of segregation.

The present paper examines the first attempts to internationalise the problem of leprosy, a subject hitherto overlooked by historians of imperialism and disease. The last decade of the nineteenth century saw many in the civilised countries of the imperialist West gripped by a paranoia about an invasion of leprosy via germ-laden immigrants and returning expatriates who had acquired the infection in leprosy endemic colonial possessions. Such alarmists clamoured for the adoption of vigorous leper segregation policies in such colonies. But the contagiousness of leprosy did not go unquestioned by other westerners. The convocation in Berlin of the first international meeting on leprosy revealed the interplay of differing and sometimes incompatible views about the containment of leprosy by segregation. The roles of officials from several countries, as well as the roles of five protagonists (Albert Ashmead, Jules Goldschmidt, Edvard Ehlers. Armauer Hansen, and Phineas Abraham) in the shaping of the Berlin Conference are here examined.

Congresses as Topic↗
PubMed2003

[A study on the measures against Hansen's disease during the Colonial Korea].

In order to evaluate the measures taken against Hansen's diseases during the colonial era in Korea, from 1910-1945, I analyzed both Korean and Japanese materials and carried out field research. The Korean government-general established a hospital in 1916 and executed measures against Hansen's disease. These efforts can be divided into three periods. At first they started as a part of colonial policy. Then, in the middle period, with the change of Japanese policy on Hansen's disease, a Korean association was established and the Hansen's Disease Prevention Act was issued in Korea, aiming at the compulsory isolation of lepers. In the later period, during the war, the inmates were forced into an extremely severe environment and deprived of their human rights. My study shows that their policies changed greatly with the passage of time. Though they started them to relieve the suffering of the lepers in the beginning, they turned to be compulsory isolation of the patients in the later period and to the violation of their human rights.

Colonialism↗
PubMed1988

Collection of circulating stem cells and their use for autograft in adults with acute lymphoblastic leukaemia.

The level of peripheral blood granulocyte-monocytic precursors (PB CFU-GM) was studied serially in 10 adult patients with acute lymphoblastic leukaemia (ALL) in early complete remission after induction chemotherapy. The patients were distributed into 2 main groups according to the morphological French-American-British classification: ALL2 and ALL3. Collection of circulating stem cells (CSC) by cytapheresis was performed in 7 of these 10 patients with satisfactory results, except in 2 ALL2 patients, both of whom had chromosome translocation, which could have been a contributing factor. It appears, moreover, that even with 2 or 3 inductions courses, the more intensive the chemotherapy regimen in previously non-treated patients, the higher the peak of PB CFU-GM and the better the collection of CSC. The measurement of CFU-GM is certainly a less effective indicator of pluripotent stem cells in blood than in bone marrow, and it is probably necessary, but sufficient, to inject 5 times more CFU-GM than normally injected in marrow transplants to allow prompt and stable engraftment. The feasibility of this new graft technique seems for the moment undeniable, the main problem in ALL is the risk of relapse.

Adult↗
PubMed1987

[Hansen's disease: history and policy in the state of São Paulo].

Hanseniasis is an illness whose specific characteristics made it different from all the other illnesses. The stigma surrounding it contributed, throughout the times, to make the "leper" identified as someone who brought with him danger and death, justifying discriminatory procedures. The hanseniasis history study in the state of São Paulo, Brazil, makes the repetition of this posture evident, being observed since the colonial times until the present century the continuity in the adoption of segregation procedures, variable at times, but not in it's intensity. The growth of the hanseniasis prevalence rate in São Paulo, even after the sulphones advent, compells us to reconsider the phenomenon, whose explication extrapolates the atrictly biologic scope, pointing out to the need of a better historic and social analysis of the disease.

Brazil↗
PubMed2003

"Essentially Christian, eminently philanthropic": the Mission to Lepers in British India.

The early history of the Mission to Lepers in India is an interplay between politics, religion, and medicine in the context of British imperialism. The Mission pursued the dual but inseparable goals of evangelization and civilization, advancing not only a religious program but also a political and cultural one. These activities and their consequences were multi-faceted because while the missionaries pursued their religious calling, they also provided medical care to people and in places that the colonial government was unable or unwilling. Within the context of the British imperial program, the work imparted Western social and cultural ideals on the colonial populations they served, inculcated patients with Christian beliefs, and provided medical care to individuals who had been expelled from their own communities. Physical healing was intimately tied to religious salvation, spiritual healing, and the civilizing process.

Charities↗
PubMed2002

Building national medicine: leprosy and power in Colombia, 1870-1910.

As imperialist nations rediscovered leprosy in their colonial world in the late nineteenth century, Colombian physicians found endemic leprosy in their own country. The medical community was interested in constructing a national medicine to conform to 'universal' science. To medicalize leprosy, doctors provoked fears through exaggerating the number of leprosy sufferers to demonstrate that charity was incapable of dealing with the problem. The government approved laws of compulsory segregation of leprosy patients in the 1890s, while the 1897 international conference on leprosy held in Berlin gave international sanction to isolation. Lepers actively resisted segregation as a violation of their individual rights. Dr Juan de Dios Carrasquilla studied the disease, experimented with sero-therapy to cure it, and claimed that the flea was its agent of transmission. He combatted segregation and proposed instead a hygienic programme to improve environmental living conditions, but his approach was defeated. When the early twentieth century saw the consolidation of the Colombian state, modernization of the country became a national priority. The government started to take control of lazarettos, enforcing segregation of lepers, who were confined within an area circumscribed by a sanitary cordon. This strategy was a failure, since patients resisted segregation.

Colombia↗
PubMed2003

Beyond quarantine: a history of leprosy in Puerto Rico, 1898-1930s.

From biblical times to the modern period, leprosy has been a disease associated with stigma. This mark of disgrace, physically present in the sufferers' sores and disfigured limbs, and embodied in the identity of a "leper", has cast leprosy into the shadows of society. This paper draws on primary sources, written in Spanish, to reconstruct the social history of leprosy in Puerto Rico when the United States annexed this island in 1898. The public health policies that developed over the period of 1898 to the 1930s were unique to Puerto Rico because of the interplay between political events, scientific developments and popular concerns. Puerto Rico was influenced by the United States' priorities for public health, and the leprosy control policies that developed were superimposed on vestiges of the colonial Spanish public health system. During the United States' initial occupation, extreme segregation sacrificed the individual rights and liberties of these patients for the benefit of society. The lives of these leprosy sufferers were irrevocably changed as a result.

Colonialism↗
PubMed1996

[Public health and medical corps in transition: the case of Crete at the beginning of the 20th century].

This article deals with the transformation of the public health system in Crete at the turn of the century, when the island was placed under the protection of the European Powers. Cretan archives, especially those from the town of Rethimno, provide a wealth of information on this subject. They show that the new ruling powers, with the declared objective of safeguarding their soldiers, required local authorities to keep a close watch over epidemics, indeed to lock up populations considered dangerous for public health, such as lepers and prostitutes--who did not fail to put up a strong resistance. While providing equipment for hospital facilities, which were still primitive, the Powers also introduced legislation concerning the practice of medicine, from which Muslim Cretans were gradually excluded. The rate at which medical care was provided increased markedly at the beginning of the twentieth century, in particular in the principal towns. The Rethimno notarial archives reveal that this new and well qualified medical corps belonged to the world of prominent citizens, and while ministering to the town's health needs, they held considerable political and economic power.

Colonialism↗
PubMed1993

Parasite virulence factors during falciparum malaria: rosetting, cytoadherence, and modulation of cytoadherence by cytokines.

To determine virulence factors of isolates of Plasmodium falciparum and the potential role of cytokines in cerebral malaria, 46 Malagasy patients presenting with cerebral (n = 10), severe (n = 10), and uncomplicated (n = 26) malaria were enrolled in a study. The capacity of 21 of 46 P. falciparum isolates to form rosettes in vitro and to adhere to human umbilical vein endothelial cells (HUVECs) that express intercellular adhesion molecule-1 receptors and to C32 amelanotic melanoma cells that express mainly CD36 receptors was investigated together with the effects of tumor necrosis factor alpha (TNF-alpha), granulocyte macrophage-colony-stimulating factor (GM-CSF), interleukin-3 (IL-3), and IL-6 alone and in two-by-two combinations on the cytoadherence of infected erythrocytes to HUVECs. Plasma levels of these cytokines were also measured in the patients at admission. The percentage of rosette formation was higher for the isolates from patients with cerebral (n = 6; 19.5%) and severe (n = 6; 30.5%) malaria than for those from patients with uncomplicated malaria (n = 9; 5%) (P < 0.002). The cytoadherence properties of the isolates did not differ among the three groups whatever the target cell used, but adherence to melanoma cells was systematically higher than that to HUVECs. Adhesion to HUVECs was increased more after TNF-alpha stimulation than after GM-CSF, IL-3, or IL-6 stimulation (P < 0.01). Only the combination of TNF-alpha and IL-3 enhanced cytoadherence more than TNF-alpha used alone (P < 0.02). No difference in the modulation of cytoadherence by cytokines was found in relation to the severity of the disease. TNF-alpha and IL-6 levels in peripheral blood were higher in the patients with cerebral and severe malaria than in the patients with uncomplicated malaria (P < 0.005). Most of the patients' sera contained little or no IL-3 or GM-CSF. Our results challenge the role of intercellular adhesion molecule-1 as the principal receptor mediating the cytoadherence of P. falciparum-infected erythrocytes and contrast with data obtained in the murine model.

Adolescent↗