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The Pandemic Arc: Expanded Narratives in the History of Global Health. 大流行弧线:全球卫生史中的扩展叙事。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-23 DOI: 10.1093/jhmas/jrae008
Monica H Green

Using the examples of plague, smallpox, and HIV/AIDS, the present essay argues for the benefits of incorporating the evolutionary histories of pathogens, beyond visible epidemic spikes within human populations, into our understanding of what pandemics actually are as epidemiological phenomena. The pandemic arc - which takes the pathogen as the defining "actor" in a pandemic, from emergence to local proliferation to globalization - offers a framework capable of bringing together disparate aspects not only of the manifestations of disease but also of human involvement in the pandemic process. Pathogens may differ, but there are common patterns in disease emergence and proliferation that distinguish those diseases that become pandemic, dispersed through human communities regionally or globally. The same methods of genomic analysis that allow tracking the evolutionary development of a modern pathogen such as SARS-CoV-2 also allow us to trace pandemics into the past. Reconstruction of these pandemic arcs brings new elements of these stories into view, recovering the experiences of regions and populations hitherto overlooked by Eurocentric narratives. This expanded global history of infectious diseases, in turn, lays a groundwork for reconceiving what ambitions a truly global health might aim for.

本文以鼠疫、天花和艾滋病毒/艾滋病为例,论证了将病原体的进化史--除了在人群中可见的流行高峰--纳入我们对流行病学现象的理解中的益处。大流行弧--将病原体作为大流行的决定性 "角色",从出现到局部扩散再到全球化--提供了一个框架,不仅能够将疾病表现的不同方面,而且能够将人类参与大流行过程的不同方面结合起来。病原体可能各不相同,但疾病的出现和扩散有共同的模式,这些模式区分了那些成为大流行病的疾病,这些疾病通过人类社区在地区或全球范围内扩散。通过基因组分析方法,我们可以追踪 SARS-CoV-2 等现代病原体的进化发展,同样也可以追踪过去的大流行。对这些大流行病弧线的重构为这些故事带来了新的元素,恢复了迄今为止被欧洲中心主义叙事所忽视的地区和人群的经历。反过来,这种扩大的全球传染病史也为重新认识真正的全球健康目标奠定了基础。
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引用次数: 0
The End of the Beginning? Temporality and Bioagency in Pandemic Research. 起点的终点?大流行病研究中的时间性与生物代理。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-23 DOI: 10.1093/jhmas/jrae006
Mandisa Mbali

This paper deals with the ways in which the intellectual and political history of AIDS can assist in the chronological conceptualization of a pandemic such as COVID-19 as it is unfolding. It problematizes the idea of pandemic "beginnings" and "ends" to show that such definitions are shaped by the disciplinary location and thematic foci of relevant scholars. Central to this analysis is the notion that ethical and political contexts affect research on a pandemic in different ways at national and global levels at various points in its trajectory. The article develops this argument in relation to two main themes: firstly, with reference to the history of AIDS research in South Africa; secondly, with the philosophical concept of bioagency to understand the ways in which viruses and humans co-shape the course of epidemics over time. I first make the case for the development of historically informed, long-term ethnographic studies of COVID-19. Using bioagency as a point of departure to consider viruses as social actors, the essay then critiques the notion of bioinformationalism as catalyzing the widening accessibility of biomedical research. Instead, I discuss the biotechnology and pharmaceutical industries as protagonists in the operation of biocapital. I argue that the history of AIDS in South Africa can provide methodological and theoretical insights into how to interpret an unfolding epidemic, outlining an ambitious transdisciplinary research agenda for thinking about the temporality of a pandemic spanning the different, interconnected, scales of life.

本文论述了艾滋病的思想史和政治史如何有助于对 COVID-19 等大流行病按时间顺序进行概念化。本文对大流行病 "开始 "和 "结束 "的概念提出了质疑,以说明此类定义是由相关学者的学科定位和主题焦点所决定的。这一分析的核心概念是:在大流行病发展的不同阶段,伦理和政治背景会以不同的方式影响国家和全球层面的大流行病研究。文章围绕两大主题展开论述:首先,参考南非艾滋病研究的历史;其次,用生物代理的哲学概念来理解病毒和人类共同塑造流行病长期发展过程的方式。我首先提出了对 COVID-19 进行有历史依据的长期人种学研究的理由。文章以生物机构为出发点,将病毒视为社会行动者,然后批判了生物信息主义催化生物医学研究普及化的概念。相反,我讨论了作为生物资本运作主角的生物技术和制药行业。我认为,南非的艾滋病史可以为如何解读正在蔓延的流行病提供方法论和理论上的启示,并概述了一个雄心勃勃的跨学科研究议程,以思考跨越不同、相互关联的生命尺度的流行病的时间性。
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引用次数: 0
Environmental Materialities and the History of Pandemics. 环境物质性与流行病史。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-23 DOI: 10.1093/jhmas/jrae007
Emily Webster

Over the last several decades, a growing group of environmental and medical historians have argued that engagement with the materiality of disease is critical to eroding the false boundaries between environment and health, and especially to the historical study of major epidemics and pandemics. This article evaluates the ways in which environmental and medical historians have engaged materiality when thinking through questions of infectious disease. It argues that far from eschewing cultural constructions of disease and analysis of medical systems, these works demonstrate that engagement with materiality in the study of disease articulates the stakes of medical regimes and practices of healing, and renders legible the multiple scales at which epidemics occur. Addressing key controversies in the use of sources, it provides examples of works that incorporate material objects, biological ideas and actors, and non-humans without falling prey to the extremes of "biological determinism" or "constructivism." It argues that commonalities in the methods employed by these works - utilization of scientific frameworks and data, multispecies analysis, attention to scale, and spatial thinking - reveal unseen and untold aspects of past pandemics. It concludes with a brief example of how these frameworks come together in practice through a case study on the history of enteric fever in Dublin, Ireland.

在过去的几十年中,越来越多的环境史和医学史学者认为,参与疾病的物质性对于打破环境与健康之间的虚假界限至关重要,尤其是对于重大流行病和大流行病的历史研究而言。本文评估了环境史和医学史学者在思考传染病问题时参与物质性的方式。文章认为,这些著作不仅没有放弃对疾病的文化建构和对医疗体系的分析,反而证明了在疾病研究中对物质性的参与阐明了医疗制度和治疗实践的利害关系,并使流行病发生的多种规模变得清晰可见。针对资料来源使用方面的主要争议,该书提供了一些作品实例,这些作品将物质对象、生物观念和行为者以及非人类纳入其中,而没有陷入 "生物决定论 "或 "建构主义 "的极端。文章认为,这些作品所采用方法的共性--利用科学框架和数据、多物种分析、关注规模和空间思维--揭示了过去大流行病不为人知的一面。最后,通过对爱尔兰都柏林肠热病历史的案例研究,简要说明了这些框架在实践中是如何结合在一起的。
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引用次数: 0
In COVID Times: Scholars of Health and Medicine Meet Disaster Studies. 在 COVID 时代:健康和医学学者与灾难研究相遇。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-23 DOI: 10.1093/jhmas/jrae011
Scott Gabriel Knowles

This essay builds on the exciting trove of disaster social science research surfacing since the earliest days of the COVID-19 pandemic. It tracks the ways that both practitioners of medicine and public health, and their social science analogues, have approached the pandemic, explicitly considering the ways they reached for new concepts to explain the temporal phenomena presented by COVID-19 and its global course. The essay highlights a series of interviews conducted in the first two years of the pandemic as part of the COVIDCalls podcast. COVID is the moment for a scholarly convergence that was missed after September 11, and again after Hurricane Katrina, and should not be missed again. Accordingly, this essay explores themes where medicine/health studies and disaster studies seem to offer great help to one another in making sense of our COVID times: the origins of disaster, disasters in combination, and the end of a disaster.

这篇文章以 COVID-19 大流行初期以来出现的令人兴奋的灾难社会科学研究为基础。文章追踪了医学和公共卫生从业人员及其类似的社会科学人员处理该流行病的方式,明确考虑了他们寻求新概念来解释 COVID-19 及其全球进程所呈现的时间现象的方式。这篇文章重点介绍了在大流行的头两年作为 COVIDCalls 播客的一部分进行的一系列访谈。COVID 是一个学术交汇的契机,在 9.11 事件后和卡特里娜飓风后都曾错过,不应再次错过。因此,本文探讨了医学/健康研究与灾害研究似乎可以相互提供巨大帮助的主题,以了解我们的 COVID 时代:灾害的起源、灾害的结合以及灾害的终结。
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引用次数: 0
The Need for Historical Fluency in Pandemic Law and Policy. 大流行病法律和政策需要历史流畅性。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-23 DOI: 10.1093/jhmas/jrae009
Daniel S Goldberg

The primary claim of this essay is that historical fluency is required for effective work in crafting legal and policy interventions as a part of public health emergency preparedness and response (PHEPR). At a broad level, public health law is explicitly recognized as a key systems-level component of PHEPR practice.1 This essay therefore focuses on the extent to which historical fluency is necessary or at least useful to all aspects of PHEPR that draw on or deploy legal and policy mechanisms (e.g., design, planning, implementation, dissemination, monitoring and evaluation, etc.). The essay collectively refers to these legal and policy mechanisms as epidemic law and policy response (ELAPR). Part I explains the concept of historical fluency. Part II explores the foundations of public health law both as a way of highlighting key structural features of ELAPR and in supporting the claim that historical fluency is critical for ELAPR. Part III applies the previous arguments to a specific case study to highlight the promise and power of historical fluency - the outbreak of bubonic plague in San Francisco in 1900. Tracking this essay's pragmatic focus, part IV offers several recommendations for how specifically historical fluency in public health law and ethics can be operationalized in PHEPR practice and policy. Part V summarizes and concludes.

本文的主要主张是,作为公共卫生应急准备和响应(PHEPR)的一部分,要有效地制定法律 和政策干预措施,就必须具备流畅的历史知识。1 因此,本文将重点关注历史流畅性在多大程度上是必要的,或者至少在多大程度上对利用或部署法律和政策机制(如设计、规划、实施、传播、监测和评估等)的公共卫生应急准备和响应的各个方面是有用的。本文将这些法律和政策机制统称为流行病法律和政策应对(ELAPR)。第一部分解释了历史流畅性的概念。第二部分探讨了公共卫生法的基础,以突出 ELAPR 的关键结构特征,并支持历史流畅性对 ELAPR 至关重要的说法。第三部分将前面的论点应用于一个具体的案例研究,以突出历史流畅性的前景和力量--1900 年旧金山爆发的鼠疫。根据本文务实的重点,第四部分就如何在公共卫生法律与伦理实践和政策中具体落实公共卫生法律与伦理的历史流畅性提出了若干建议。第五部分总结并得出结论。
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引用次数: 0
Working Vacations and Adventure: American Women Physician Volunteers to the Labrador Mission of Wilfred Grenfell Before 1914. 工作假期与冒险:1914 年前威尔弗雷德-格伦费尔在拉布拉多传教的美国女医师志愿者。
IF 0.9 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-21 DOI: 10.1093/jhmas/jrae031
Jennifer J Connor

Many accounts, autobiographical and scholarly, emphasize how volunteers portrayed their work in the mission established for fishers by British physician Wilfred Grenfell in Newfoundland and Labrador: as escapist adventure. Scholars have not studied women physicians or their motivations to volunteer, however. This oversight derives from their small number combined with lack of knowledge about this mission's distinction from the foreign medical missions and domestic frontier missions that drew many women physicians to permanent positions. This study therefore discusses two American physicians, Alfreda B. Withington (1860-1951) and Emma E. Musson (1862-1913), who volunteered for summer service with this mission in 1907 and 1909, respectively. Through their publications, biographical sources, and clinical accounts, it reveals the appeal to them of such temporary, accessible volunteer service as a working vacation that rejuvenated. Importantly, it counters the skewed perspective of contemporary accounts in which the connection of Withington and Musson to an international celebrity, Wilfred Grenfell, overrode fuller considerations of their own lives, careers, and experiences. Finally, this examination suggests possible differences in their volunteerism between women physicians and their male counterparts: along with other women professionals, medical women often incorporated volunteer vacation experience into a continuum of similar endeavors in their careers.

许多自传性和学术性的描述都强调了志愿者是如何描述他们在英国医生威尔弗雷德-格伦费 尔在纽芬兰和拉布拉多为渔民建立的传教团中的工作:逃避现实的探险。然而,学者们并没有研究过女医生或她们志愿服务的动机。造成这种疏忽的原因是,她们的人数很少,而且缺乏对这一使命与外国医疗使命和国内边疆使命的区别的了解,而外国医疗使命和国内边疆使命吸引了许多女医生担任长期职位。因此,本研究讨论了两位美国医生,阿尔弗雷达-B-威辛顿(Alfreda B. Withington,1860-1951 年)和艾玛-E-穆森(Emma E. Musson,1862-1913 年),她们分别于 1907 年和 1909 年自愿加入该传教团的夏季服务。通过她们的出版物、传记资料和临床描述,该书揭示了这种临时性的、可获得的志愿服务对她们的吸引力,就像一个可以恢复活力的工作假期。重要的是,该研究反驳了当代报道中的偏颇观点,即威辛顿和穆森与国际名人威尔弗雷德-格伦费尔的联系,压倒了对他们自己的生活、职业和经历的更全面的考虑。最后,本研究还提出了女医生与男医生在志愿服务方面可能存在的差异:与其他女性专业人员一样,女医务人员经常将志愿度假经历融入其职业生涯中的一系列类似活动中。
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引用次数: 0
Safe Sex and the Debate over Condoms on Campus in the 1980s: Sperm Busters at Harvard and Protection Connection at the University of Texas at Austin 20 世纪 80 年代校园中的安全性行为和关于安全套的争论:哈佛大学的精子克星和德克萨斯大学奥斯汀分校的保护联系
IF 0.5 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-14 DOI: 10.1093/jhmas/jrae016
Abena Dove Osseo-Asare
During the 1980s, college students in the United States helped to destigmatize the distribution and use of condoms. They shifted their aims from preventing unwanted pregnancy to stopping the spread of sexually transmitted infections including the newly identified acquired immunodeficiency syndrome (AIDS). Two student-led initiatives to deliver condoms after hours at Harvard University in Cambridge, Massachusetts and the University of Texas at Austin show regional and temporal differences in sexual mores as awareness of AIDS increased. These male students adopted a non-pharmaceutical intervention to prevent pregnancy and disease in the context of increased marketing of Trojan® brand condoms. Interviews with co-founders reveal how the students grappled with backlash from family members and campus administrators less enthusiastic about their popularization of condoms. Co-founders described how media attention affected their college experiences and how condom companies changed campus culture. Overall, large non-pharmaceutical companies such as Trojan® and small condom-resellers such as those at Harvard and the University of Texas at Austin reshaped cultural norms around safe sex as awareness of AIDS grew between 1985 and 1987.
20 世纪 80 年代,美国大学生帮助消除了分发和使用安全套的污名。他们将目标从预防意外怀孕转移到阻止性传播感染(包括新发现的获得性免疫缺陷综合症(艾滋病))的传播。马萨诸塞州剑桥哈佛大学和德克萨斯大学奥斯汀分校的两项由学生领导的下班后发放安全套的活动表明,随着人们对艾滋病认识的提高,性风俗在地区和时间上也出现了差异。在特洛伊® 品牌安全套的营销力度加大的背景下,这些男生采取了一种非药物干预措施来预防怀孕和疾病。对联合创始人的访谈揭示了这些学生是如何应对家庭成员和校园管理人员对他们普及安全套不太热心的反弹的。联合创始人描述了媒体关注如何影响他们的大学生活,以及安全套公司如何改变校园文化。总体而言,随着 1985 年至 1987 年间人们对艾滋病认识的提高,特洁安® 等大型非制药公司以及哈佛大学和德克萨斯大学奥斯汀分校等小型安全套销售商重塑了有关安全性行为的文化规范。
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引用次数: 0
The Influential Influenza: The “Russian Catarrh” Pandemic of 1781-1782 影响深远的流感1781-1782 年 "俄罗斯鼠疫 "大流行
IF 0.5 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-12 DOI: 10.1093/jhmas/jrae025
Matthew P Romaniello
The influenza pandemic of 1781-1782 was remarkably well-documented, with investigations and treatment records produced in Britain, France, Germany, Italy, and Russia. Everyone agreed that outbreak began in St. Petersburg in December 1781 and then spread across northern Europe, but the medical communities’ consensus did not solve all issues. Two questions would inspire years of debate. The first concerned the transmission vector of the pandemic: was it the result of neo-Hippocratic, miasmatic, or contagionist exposure? This was perhaps the greatest concern of the late-eighteenth century, and multiple physicians hoped the latest influenza pandemic could provide an answer. The second was no less difficult – where did the disease originate? This was not only because geography affected both prophylactic measures and treatment options but also produced diplomatic and commercial consequences. Was a quarantine necessary, preventing commercial exchanges? Did the risk of infection result in peace negotiations being delayed, potentially extending the American Revolution and the ongoing naval conflict in the Atlantic? Even if a consensus could be reached that this was a “Russian” catarrh, this would not resolve the method of disease transmission. The pandemic of 1781-1782 was not a turning point in the arguments among neo-Hippocratic, miasmatic, and contagionist physicians, but rather reveals all three positions could be held simultaneously.
1781-1782 年流感大流行的记录非常详实,英国、法国、德国、意大利和俄罗斯都有调查和治疗记录。所有人都认为,疫情始于 1781 年 12 月的圣彼得堡,随后蔓延至整个北欧,但医学界的共识并没有解决所有问题。有两个问题引发了多年的争论。第一个问题涉及大流行病的传播媒介:它是新希波克拉底主义、瘴气还是传染病接触的结果?这也许是 18 世纪晚期人们最关心的问题,许多医生都希望最近的流感大流行能够给出答案。第二个问题的难度也不小--疾病的源头在哪里?这不仅是因为地理位置会影响预防措施和治疗方案,还会产生外交和商业后果。是否有必要进行隔离,阻止商业交流?感染的风险是否会导致和平谈判被推迟,从而可能延长美国革命和正在进行的大西洋海上冲突?即使能就这是 "俄国 "痢疾达成共识,也无法解决疾病传播方式的问题。1781-1782 年的大流行并不是新希波克拉底主义、瘴气主义和传染主义医生之间争论的转折点,而是揭示了这三种立场可以同时存在。
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引用次数: 0
Medicalizing the Body and the Locale: Kala Azar and Disease Thinking in Assam, 1824-1900. 身体与地域的医学化:1824-1900 年阿萨姆邦的卡拉-阿扎尔与疾病思维。
IF 0.5 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-11 DOI: 10.1093/jhmas/jrae021
Bikash Sarma
The article examines two seemingly unconnected occurrences at the nineteenth-century north east frontier of British India. The first is the production of a pathological space via moral, social, and cultural codes enacted by medical topographies on the region since the first Anglo-Burmese war (1824-1826) and the subsequent rise of disease thinking. The second is the ambivalence in disease thinking that is brought to fore through the mysterious malady called kala azar (visceral leishmaniasis), which was geographically designated as Assam fever. This article contends that the geographical designation of kala azar as Assam fever is not just coincidental or a nosological confusion of the late nineteenth century but rather has its origin in the preceding pathological carving of space at the frontier. Further, it explores the troubled ontology between research on malaria and kala azar investigations to show that the old codes enacted by medical topographies hinged upon the era of laboratory medicine.
文章探讨了 19 世纪英属印度东北部边境地区发生的两件看似毫无关联的事情。第一种情况是,自第一次英缅战争(1824-1826 年)以来,该地区的医学地形图通过道德、社会和文化规范形成了病态空间,疾病思维也随之兴起。其次是疾病思维中的矛盾性,这种矛盾性通过被称为 Kala azar(内脏利什曼病)的神秘疾病凸显出来,这种疾病在地理上被称为阿萨姆热。本文认为,将 Kala azar 在地理上命名为阿萨姆热并非巧合,也不是十九世纪末的一种命名学混淆,而是源于此前对边境空间的病态划分。此外,该书还探讨了疟疾研究与卡拉扎尔调查之间存在的本体论问题,以说明医学地形图所制定的旧规范取决于实验室医学时代。
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引用次数: 0
Which Stranger's Disease? Immigration, Immunization, and the Whitening of Cuba in the Age of Atlantic Revolutions. 哪种陌生人的疾病?大西洋革命时代的移民、免疫和古巴白化》。
IF 0.5 3区 哲学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-11 DOI: 10.1093/jhmas/jrae022
Farren Yero
In 1804, Cuban physician Tomás Romay tried and failed to create the first yellow fever vaccine. The article analyzes his experimental efforts, foregrounding the enslaved and enlisted subjects at the center of this early vaccine trial. Though a scientific failure, this brief experiment, the desires and logics embedded within it, and the measures deployed in its wake - in the form of European whitening campaigns - allow us to consider the political uses of immunity during the Age of Atlantic Revolutions. Historicizing these events within the wider geopolitics of the Caribbean, the article explicates the central role that yellow fever immunization played in Cuban authorities' attempts to shore up their political and economic sovereignty in the midst of anti-colonial and anti-slavery resistance. As such, it shows how yellow fever and its threat to social and economic order fits within a broader history of vaccination as a mechanism of colonial governance. Finally, by situating Cuban efforts to prevent yellow fever alongside the health concerns of enslaved people - concerns that arguably informed their resistance to slavery - the article also demonstrates how ideas about immunity and political belonging increasingly intersected through whiteness as an elite ideal in the era that Cuba first became a slave society.
1804 年,古巴医生托马斯-罗迈(Tomás Romay)试图制造出第一种黄热病疫苗,但最终以失败告终。这篇文章分析了他的实验努力,强调了处于这一早期疫苗试验中心的被奴役者和被征召者。尽管这是一次科学上的失败,但这一短暂的实验、其中蕴含的愿望和逻辑,以及实验后采取的措施--以欧洲增白运动的形式--让我们能够思考大西洋革命时代对免疫力的政治利用。文章将这些事件历史性地纳入加勒比地区更广泛的地缘政治中,阐述了黄热病免疫接种在古巴当局试图在反殖民和反奴隶制的反抗中巩固其政治和经济主权的过程中所发挥的核心作用。因此,文章展示了黄热病及其对社会和经济秩序的威胁如何与作为殖民治理机制的疫苗接种这一更广泛的历史相吻合。最后,通过将古巴预防黄热病的努力与被奴役者对健康的关注--可以说这些关注为他们反抗奴隶制提供了依据--结合起来,文章还展示了在古巴最初成为奴隶社会的时代,关于免疫和政治归属的想法是如何通过作为精英理想的白人而日益交织在一起的。
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引用次数: 0
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