Medical and Health Documents

The AIDS epidemic has posed more urgent historical questions than any other disease of modern times. How have societies responded to epidemics in the past? Why did the disease emerge when and where it did? How has it spread among members of particular groups? And how will the past affect the future.

Author: Fee, Elizabeth
Edited by Elizabeth Fee and Daniel M. Fox
Published: University of California Press, 1988

Sample

Quarantine and the Problem of AIDS
David F. Musto
Men take diseases, one of another.
Therefore let men take heed of their company.
Henry IV, Part 2

In ancient times citizens noted that, occasionally, a disease from a distant locale was sweeping toward them from neighboring villages, or that after a ship from a foreign land reached shore with ill persons aboard, residents in the port city would take ill. Such temporal sequences could not be ignored and, if the illness were a serious one, fears escalated as the illness came closer. Knowing the cause of an illness or its mode of transmission provides the basis for some rational approach to containing the spread of the disease. Prior to the nineteenth century, however, these agents were unknown, and civil authorities were thus left with whatever means seemed reasonable in the wisdom of the time to fight the spread of diseases. Protective measures were based on what we would now consider erroneous explanations for contagion. From this era of scant knowledge comes the origin of the familiar word we use to describe the isolation of the sick or contagious from the healthy. “Quarantine” comes from the Italian word for “forty days,” and refers to the period during which ships capable of carrying contagious disease, such as plague, were kept isolated on their arrival at a seaport.

Today, quarantine has come to mean a marking off, the creation of a boundary to ward off a feared biological contaminant lest it penetrate a healthy population. The essential characteristic of quarantine is the establishing of a boundary to separate the contaminated from the uncontaminated. But to consider only those quarantines of diseases that are infectious or that have short periods of illness, characterized by, say, fever, would be to overlook the deeper emotional and broader aggressive character of this measure. Evidence of this elemental fear of contagion includes such instances as measures taken against yellow fever in the eighteenth century and the growing fear of the AIDS epidemic in the late twentieth century. The assumptions and psychology of quarantine are evident in restrictions against groups thought liable to degrade “racial purity” if allowed to immigrate into a “racially healthy” country. The multiple determinants of quarantine can be seen in a much earlier age also. The social history of leprosy is an enduring and dramatic example of boundaries being drawn around those with a lengthy illness that was highly feared and believed to be highly contagious.

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