Scielo RSS http://scielo.isciii.es/rss.php?pid=0211-953620110002&lang=es vol. 31 num. 2 lang. es http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200001&lng=es&nrm=iso&tlng=es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200002&lng=es&nrm=iso&tlng=es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200003&lng=es&nrm=iso&tlng=es It was in the 1940s that antibiotic resistance arose as an object of study for clinical medicine. Somewhat earlier it had become an important analytical tool for bacterial geneticists. However, the concept of antibiotic resistance as an induced and inheritable trait of microbial species was introduced a generation earlier in the years preceding the First World War. The paper reconstructs the concept that was put forward by the German immunologist Paul Ehrlich in 1907. He came across the phenomenon when trying to develop chemotherapies for trypanosomiasis, the best known of which is African sleeping sickness. However, resistance was studied by him for other than therapy-related purposes. It provided a productive laboratory model for the study of cell functions. Induced resistance to chemicals facilitated the development of ideas on the relation of a parasite's cellular metabolism and of drug action, i.e. by providing a negative proof for the existence of chemoreceptors on the surfaces of parasite cells. This approach does also serve to explain why British and German researchers continued to study the phenomenon of induced resistance in microbes for decades -despite it being absent from clinical medicine. After all, there existed very few chemotherapies of infectious diseases prior to the arrival of the sulfa drugs. Moreover, resistance to such medicines was rarely observed. However, being part and parcel of Ehrlich's theories, his views on resistance were also criticised together with these. It was in particular Henry Dale who would challenge Ehrlich's views of resistance being an inheritable and stable trait of microbes. Instead he insisted that understanding this "wholly mysterious phenomenon" required taking into account some host interaction. Induced resistance, which had come into being as a chance discovery on the chemotherapy of sleeping sickness, thus became one of the more important laboratory models of twentieth-century immunological research. Its early history is largely discontinuous with later work, and antimicrobial resistance as it evolved from 1900 to 1940 followed other trajectories than those which became relevant after 1940. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200004&lng=es&nrm=iso&tlng=es The historiography of penicillin has tended to overlook the importance of developing and disseminating know-how in fermentation technology. A focus on this directs attention to work before the war of a network in the US and Europe concerned with the production of organic acids, particularly gluconic and citric acids. At the heart of this network was the German-Czech Konrad Bernhauer. Other members of the network were a group of chemists at the US Department of Agriculture who first recognized the production possibilities of penicillin. The Pfizer Corporation, which had recruited a leading Department of Agriculture scientist at the end of the First World War, was also an important centre of development as well as of production. However, in wartime Bernhauer was an active member of the SS and his work was not commemorated after his death in 1975. After the war new processes of fermentation were disseminated by penicillin pioneers such as Jackson Foster and Ernst Chain. Because of its commercial context his work was not well known. The conclusion of this paper is that the commercial context, on the one hand, and the Nazi associations of Bernhauer, on the other, have submerged the significance of know-how development in the history of penicillin. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200005&lng=es&nrm=iso&tlng=es In 1947, Ernst Chain moved from Oxford to Rome, hired as head of a new biochemistry department and of a penicillin production pilot plant in the Istituto Superiore di Sanità (Higher Health Institute). Here, he managed to make Rome one of the most important centres in the international network of antibiotic science. However, the development of the state-operated centre was not easy. Political and economic pressures, exerted both from home and abroad, posed many obstacles to the plan devised by Domenico Marotta, the general director of the Institute. The paper reconstructs Chain's venture in Rome, which lasted until 1964, while framing the history of the penicillin production plant in the context of diplomatic negotiations, national politics, and science policies. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200006&lng=es&nrm=iso&tlng=es This paper tells the early history of penicillin patenting in Spain. Patents turn out to be useful instruments for analysing the management of knowledge and its circulation in different professional and geographical domains. They protected knowledge while contributing to standardisation. Patents also ensured quality and guaranteed reliability in manufacturing, delivering and prescribing new drugs. They gained special prominence by allowing the creation of a network in which political, economic and business, industrial power, public health and international cooperation fields came together. The main source of information used for this purpose has been the earliest patent applications for penicillin in Spain between 1948 and 1950, which are kept in the Historical Archives of the Oficina Española de Patentes y Marcas. The study of these patents for penicillin shows their role as agents in introducing this drug in Spain. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200007&lng=es&nrm=iso&tlng=es This paper reviews and contrasts two strategies of infection control that emerged in response to the growing use of antibiotics within British hospitals, c.1946-1969. At this time, we argue, the hospital became an arena within which representatives of the medical sciences and clinical practices contested not so much the content of knowledge but the way that knowledge translated into practice. Key to our story are the conceptual assumptions about antibiotics put forward by clinicians, on the one hand, and microbiologists on the other. The former embraced antibiotics as the latest weapon in their fight to eradicate disease. For clinicians, the use of antibiotics were utilised within a conceptual frame that prioritised the value of the individual patient before them. Microbiologists, in contrast, understood antibiotics quite differently. They adopted a complex understanding of the way antibiotics functioned within the hospital environment that emphasised the relational and ecological aspects of their use. Despite their broader environmental focus, microbiologists focus on the ways in which bacteria travelled led to ever greater emphasis to be placed on the "healthy" body which, having been exposed to antibiotics, became a dangerous carrier of resistant staphylococcal strains. The surrounding debate regarding the appropriate use of antibiotics reveals the complex relationship between hospital, the medical sciences and clinical practice. We conclude that the history of hospital infections invites a more fundamental reflection on global hospital cultures, antibiotic prescription practices, and the fostering of an interdisciplinary spirit among the professional groups living and working in the hospital. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200008&lng=es&nrm=iso&tlng=es This article is an account of a screening programme in search of new antibiotics established by CEPA (Compañia Española de Penicilinas y Antibióticos) and Merck in Madrid in 1954. An exploration of the genealogy for such a programme, its narratives and practices, shows that the main inspiration for this programme was the factory system of production, on the one hand, and Selman Waksman's research agenda on microorganisms of the soil, on the other. In this article, the relationship between industrial production of antibiotics and the research program aimed at identifying new candidate drugs is examined. I suggest that this screening program in search of new antibiotics was organised like industrial manufacturing. The research objects and tools came, both materially and conceptually, from industrial production: a line of artisanship put together in order to obtain a product with the collaboration of every member of the production line. Following the style developed by Selman Waksman in Rutgers, the screening program evaluated samples manually, and the microbiological skills were enhanced with every test. The Madrid team's practice of applying instructions for use led to circulation of knowledge and practices, including research material and microbiological methods. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200009&lng=es&nrm=iso&tlng=es La estatura es utilizada por los pediatras y los antropólogos como medida de salud y bienestar de las poblaciones humanas. En las últimas décadas los historiadores la usan como indicador biológico del nivel vida para explorar el impacto producido por las transformaciones ambientales, sociales y económicas en el bienestar del pasado. Este artículo muestra las contribuciones históricas realizadas al tema por diferentes especialistas y compara la evolución de la estatura de los hombres en Francia y en España. Con datos de los reemplazos militares desde la década de 1770 hasta finales del siglo XX muestra los cambios seculares en ambos países y la existencia de ciclos como consecuencia de periodos de deterioro del estado nutricional. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200010&lng=es&nrm=iso&tlng=es Este artículo reconstruye el importante lugar ocupado por las pasiones en los discursos teóricos y las retóricas profesionales de la medicina española del siglo XIX. Con el fin de ampliar sus recursos explicativos y terapéuticos frente a la enfermedad, pero, sobre todo, de avalar su competencia como expertos en el estudio y la regulación de las pasiones, los médicos españoles asumieron y difundieron toda una serie de planteamientos (como la necesidad de su investigación fisiológica, la insistencia en su potencial patógeno y en la peligrosidad social de su contagio, o la importancia de su análisis semiológico, su diagnóstico diferencial y su terapéutica específica) que no sólo aportaron los fundamentos conceptuales de disciplinas y prácticas emergentes como el alienismo, la higiene o el tratamiento moral, sino que cabría verlos retrospectivamente como anticipadores de presupuestos centrales de las modernas ciencias de la mente. Sin embargo, esta medicalización de las pasiones tuvo finalmente como consecuencia su paulatino descrédito frente al concepto (supuestamente más fisiológico, exento de consideraciones morales y, por tanto, más objetivo) de las emociones, hasta el punto que, para finales del siglo XIX, las pasiones habían desaparecido prácticamente de los discursos científicos en torno a la afectividad y el psiquismo. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200011&lng=es&nrm=iso&tlng=es Statistics seem to give little information about individuals' fates. With the help of patient journals, the interwoven connections between quantitative and qualitative aspects of historical research work can be shown. This example focuses on the patients who, between 1829 and 1864, built up the practice of the lay homeopath Clemens Maria Franz von Bönninghausen in Münster, Westphalia. Questions of practice, the social structure of the clientele, and the diseases Bönninghausen treated are also considered. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200012&lng=es&nrm=iso&tlng=es Se pretende analizar la modulación y transformaciones de los discursos y reivindicaciones socialistas en materia sanitaria durante el periodo comprendido entre 1883 y 1904, con el objeto de demostrar su alto grado de politización y su deseo de integración social y política. En este sentido, se analiza el papel político desempeñado por la salud y la higiene en la construcción de una identidad obrera, así como la tensión y las ambigüedades ideológicas generadas por la necesidad de apropiarse de un discurso ajeno, emitido desde la ciencia, pero necesario para conseguir plantear reivindicaciones que perseguían la inclusión social de los obreros como ciudadanos de pleno derecho y su dignificación. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-95362011000200013&lng=es&nrm=iso&tlng=es O objectivo deste artigo é mostrar a influência dos estudos estatísticos no processo de estabelecimento da luta contra o cancro em Portugal. Numa toada francamente higienista e num quadro de progressiva consciencialização sobre a doença, o lugar do cancro tornou-se cada vez mais visível e incontornável no primeiro quartel do século XX, transformando-se no flagelo dos tempos modernos. Em larga medida, tal visibilidade fez-se à custa da análise estatística, processo que em Portugal assumiu a forma de relatórios, nem sempre completos e não raro subvalorizadores da realidade. Se o impacto destes relatórios não se fez no imediato, foram eles que a médio prazo sedimentaram o estabelecimento político-institucional do Instituto Portugués para o Estudo do Cancro, estruturado em 1923 em modelos internacionais. Por sua vez, os dados obtidos no Instituto permitiram corrigir as lacunas de uma estatística deficiente no tocante à real presença da doença oncológica na estatística sanitária portuguesa dos anos 30.