从“魔矿”的碎屑到“致命的粉尘”——19世纪末至20世纪上半叶尘肺病在美国的医学认知变迁

From"Magic Mineral"to"Fatal Dust":The Evolution of Medical Cognitions on Dust Lung Disease in the United States from the End of 19th Century to the First Half of 20th Century

19世纪末至20世纪上半叶,美国人对生产性粉尘特性的认知各不相同、充满争议。部分人认为生产性粉尘的危害性难以确定,应按粉尘类型加以区别;部分人认为生产性粉尘并非引发尘肺病的元凶,只是病原载体;另有人视生产性粉尘为导致尘肺病的罪魁祸首,是工人健康受损及恶劣工作环境的“隐喻”。美国人对不同类型的粉尘及其引发的尘肺病的认知过程并不一致,但彼此相互交织、影响。该认知过程呈现出“希波克拉底式的转向”;借鉴并吸纳他国尘肺病知识等特点。尘肺病的医学知识在美国不同群体间的传播和获悉程度各异,具有不对称性,它由不同时空语境下各涉足方间的互动所决定。

During the period between the end of 19th Century and the first half of 20th century in the United States,diverse assumptions on the nature of industrial dust,which include as follows:the toxic nature of different types of dust was uncertain;dust was just a carrier of germs but not pathogen itself;dust as the killer of workers'health was used as a metaphor for polluted working environment.The evolution of the medical cognitions regarding main types of dust lung disease in the U.S.at that time was not recognized clearly at the same time,in addition,it was controversial and tardy.Furthermore,this process also held the characteristics of the“Hippocratic Turn”and of acquiring knowledge from the foreign countries.The diffusion of this knowledge regarding dust lung diseases essentially points to struggles among special social groups within the specific historical context.