疫情之下的社会分裂——英国医学界关于1832年霍乱的病原学之争

Social Division during the Epidemic:The Debate on the Etiology of Cholera of 1832 in British Medical Community

1832年霍乱在英国流行期间,面对数万人的感染、死亡以及巨大的社会恐慌,医学界经历了一次深刻的思想革命,一场关于霍乱致病原、传播及传染性的病原学之争随之兴起。在这场争论中,传染派认为细菌、病毒、微生物是致病原,通过接触加以传播,强调霍乱具有传染性;非传染派将致病原归结为瘴气,认为人体因吸入瘴气而发病,否认霍乱具有传染性。霍乱病原学之争折射出疫情之下的社会分裂:医学界上层倡导的传染论得到统治精英的支持,因为这为其追求国家权力扩张提供了依据;医学界中下层倡导的非传染论,在工商业阶层及下层民众中广受欢迎,因为它更能反映出社会中下层的经济利益与道德关切。关于霍乱的病原学之争,本质上是医学界不同群体的话语权之争。尽管传染派观点后来被科学证实,但19世纪中后期传染论的失势及非传染论的崛起表明:科学的发展并不总是一个单线式、不断进步的过程,而经常是一个曲折、迂回的螺旋式上升过程,人类对于流行病的认知与探索将永无止境。

During the cholera epidemic 1832 in Britain,the medical community experienced a profound thought revolution in the face of tens of thousands of infections,deaths and a huge social panic.Therefore,a debate on the etiology,such as the origin,spread and infectivity of cholera had arisen.The contagionists believed that bacteria,poison,and animalcule were the causative agents that spread by contact,emphasizing that cholera was infectious,while the anti-contagionists mainly attributed the causative agent to miasma,arguing that humans became ill by inhaling miasma,and denying that cholera was infectious.The debate on the etiology of cholera reflected the social division during the epidemic:the theory of contagionism advocated by the top of the medical profession was supported by the ruling elite because it provided the basis for its pursuit of the strengthening of state power,while the theory of anti-contagionism advocated by the middle and lower levels of the medical profession was very popular among the business class and the lower classes because it better reflected their economic interests and moral concern.The debate on the etiology of cholera was essentially a struggle for the discourse power among different groups in the medical community.Although the theory of contagionism was later confirmed by science,the fall of the contagionism and the rise of the anti-contagionism in the middle and late 19th century showed that the development of science was not always a one-way,progressive process,and often a tortuous,circuitous spiral upward,in which mankind's cognition and exploration of the epidemic will never end.