Dynamis

The European fight against the epidemic presence of poliomyelitis: a historical reflection

The European Association against Poliomyelitis and the European vaccination programmes

La búsqueda de una respuesta europea al problema planteado por los brotes epidémicos de poliomielitis en las décadas centrales del siglo XX, desembocó en la creación de un organismo nuevo, la Asociación Europea contra la Poliomielitis en 1951. Los mecanismos de funcionamiento interno y las conexiones internacionales de dicha Asociación fueron subsidiarios de un determinado contexto socio-político que propiciaba este tipo de consorcios. Como muestra este trabajo, su labor en los dieciocho años de existencia fue decisiva para la articulación y el éxito alcanzado por las políticas sanitarias nacionales de inmunización masiva frente a la enfermedad.

The search for a European response to the problem posed by the outbreak of poliomyelitis in the middle decades of the 20th century resulted in the creation in 1951 of a new organization, the European Association against Poliomyelitis. The internal working mechanisms and the international connections of this Association, in particular with the WHO, were subsidiaries of a specific socio-political context that encouraged this type of consortia. The activities developed by this organization in the 18 years of its existence were decisive for both the articulation and success achieved by European national policies of massive immunization campaigns against the disease.

The Cutter incident and the development of a Swedish polio vaccine, 1952-1957

The creation of two different vaccines to eradicate polio stands out as one of modern science most important accomplishments. The current article examines Swedish polio vaccine research, the vaccination campaign and especially how the Cutter incident came to affect Swedish Science, scientists and society in the 1950s. Sweden is one of the few countries that came to produce its own inactivated polio vaccine (IPV) in the 1950s, a type of vaccine they never abandoned. This article highlights the sometimes conflicting approaches between medical science on one hand and media and public on the other. The Swedish researchers did not agree with Jonas Salk's methods for producing a safe vaccine and had reserved attitudes when the Salk vaccine was announced, something that Swedish media disapproved of. After the Cutter incident media's representation of Swedish polio scientists became far more positive. The article also shows the development and distribution of a Swedish IPV and that contrary to some other countries Sweden did not doubt all American manufacturers and imported Salk IPV for the first polio vaccination campaign.

Polio in Italy

The history of polio in Italy is relatively short because the particular social and demographic history of the country has actually compressed the most dramatic history of the polio epidemic into only 40 years, from the first severe epidemic just before World War II to the early 1980s, when the epidemic vanished thanks to an effective and country-wide vaccination campaign. The epidemic, however, had a formidable impact on medicine, public health, social attitudes and culture. An analysis of this case study can illustrate the impact of an epidemic of a severe disease on individual and collective life, and at the same time the efficacy of public health measures against it, and the importance of the social structure, state and private, in coping with the consequences of the epidemics. In this period, the attitude towards the handicapped changed from stigma and isolation to social integration, thanks especially to the changes in health legislation, social action and the initiatives of the patient' associations.

The British Polio Fellowship: its contribution to the development of inclusivity for disabled people

The organizations set up to cope with polio in the years of epidemic outbreaks in Europe constitute an interesting focus in historiography as an example of contemporary patients' associations and mutual aid groups. The main aim of this paper is to reconstruct and analyse the principal highlights in the birth and development of the British Polio Fellowship (BPF) and its historical meaning in the history of polio associationism. The Infantile Paralysis Fellowship (now BPF) was founded in 1939 and, since then, has played an important role in the development of services for disabled people. It was founded as an organization of disabled people, not an organization for disabled people and so has always been an authentic voice of polio-disabled people. Achievements during the past seventy years have included the development of employment for disabled people, improvements in financial benefits, provision of better access, provision of holidays, the creation of opportunities for respirator-dependent people to live in their own homes, and the development of disability sport.

The social sequelae of polio: the beginnings of the associationist movement in Spain (1957-1975)

La respuesta social en España ante la epidemia de poliomielitis se vio condicionada por las limitaciones impuestas por el régimen dictatorial. Las primeras asociaciones que surgieron fueron afines al sistema político o se enmarcaron en los movimientos seglares de la Iglesia católica. Entre los primeros se encuentra la Asociación de Lucha contra la Poliomielitis (ALPE) y entre los segundos la Fraternidad Católica de Enfermos y Minusválidos. El objetivo de la investigación es el análisis de sus idearios, características organizativas y actividades, a fin de comprender el proceso de socialización de las personas con secuelas de poliomielitis y su asunción de unos valores y rasgos identitarios. Ambas asociaciones ofrecen un claro contraste tanto en el funcionamiento asociativo planteado como en el modelo de discapacidad asumido, en clara transición del modelo médico al social. Ofrecer servicios o enseñar a reclamarlos fue otra de las disyuntivas detectadas. Más trascendente fue la transmisión de un modo de sociabilidad (a través de equipos diocesanos y campamentos) que incorporó prácticas democráticas y formó líderes que tendrían protagonismo en el asociacionismo de personas con discapacidad a partir de la transición.

The social response in Spain against the polio epidemic was conditioned by the limitations imposed by the dictatorship. The first associations that emerged were related to the political system or were part of secular movements of the Catholic Church. Among the former is the Association again st Polio (ALPE) and among the latter is the Catholic Fraternity of Sick and Disabled People. They offer a contrast in their functions and their model of disability: a clear transition from the medical to the social model. A further dilemma detected was whether to offer services or teach people how to claim them. More important was the transmission of a model of sociability (through diocesan and camp activities) that incorporated democratic practices and trained leaders who have played an important role in the associations of people with disabilities since the democratic transition.

From the traditional midwife to the female obstetrician: Birth and pinnacle of the profession of licensed midwifery in 19th century Peru

En el Perú como en el resto del mundo hispánico, el siglo XIX fue un momento de profunda transformación del ejercicio de la medicina y particularmente de la obstetricia. Unas de las actrices principales de esta evolución fueron las parteras tituladas cuya profesión nació y se asentó entonces. Hasta ahí, las matronas tradicionales eran las que se encargaban de acompañar a las parturientas, en un universo prácticamente totalmente femenino. A finales del siglo XVIII, los ilustrados peruanos comenzaron a interesarse en la maternidad y el periodo perinatal. Fustigaron principalmente la práctica de las parteras tradicionales y expusieron ante la opinión pública, la necesidad de darles una formación teórica que estuviera bajo la supervisión del cuerpo médico. El discurso ilustrado fue retomado después de la independencia por las autoridades públicas del Estado naciente. El proyecto se concretó gracias a la llegada al Perú de una partera francesa de excepción, Benita Paulina Fessel, mujer emprendedora deseosa de fundar una maternidad bajo el modelo de la de Port-Royal (París). La confluencia de estos factores permitió el nacimiento en 1826 de la primera Maternidad del mundo hispánico con un funcionamiento particular que asociaba un hospital y una escuela de partos, dirigida por Madame Fessel, ella misma ex alumna de la Maternidad de París. La maternidad limeña formó varias generaciones de parteras, que recibieron una excelente formación tanto teórica como práctica y que se impusieron como profesionales competentes. Durante la segunda mitad del siglo XIX las obstetrices, como se les llama desde esa época en Perú, acompañaron cada vez a más mujeres en el trance del parto y resistieron a la presión de los médicos por apropiarse de ese momento esencial en la vida de las mujeres.

In Peru and the rest of the Hispanic world, the 19th century was a time of profound change in the practice of medicine and especially in obstetrics. Among the leading agents in this development were the midwives, whose profession was born and established at that time. Previously, traditional midwives were responsible for accompanying women during labour in an almost entirely female universe. In the late 18th century, enlightened Peruvians became interested in child-birth and the perinatal period. They mainly criticized the practice of traditional mid-wives and presented to public opinion the need for theoretical training under the supervision of medical staff. After Independence, the Enlightenment discourse was resumed by the public authorities of the nascent state. This project became a reality thanks to the arrival in Peru of the French midwife, Benita Paulina Fessel, an enterprising woman who wished to establish the Parisian (Port-Royal) birth model. The confluence of these factors led to the birth in 1826 of the first Maternity Hospital in the Hispanic world with a specific function, which was associated with a Childbirth school led by Madame Fessel, who was herself an alumna of the Maternity Hospital in Paris. Lima Maternity Hospital trained several generations of midwives, who received an excellent theoretical and practical training and established themselves as competent professionals. During the second half of the 19th century, obstetricians, as they were named from that time in Peru, accompanied more and more women in the throes of childbirth and proved able to endure the pressure of doctors and take possession of this essential moment in the life of women.

The purge of midwives in Madrid after the Civil War

Las matronas de Madrid habían conseguido incorporarse a diferentes puestos de la Administración en los años previos a la Guerra Civil. Esto explica que, tras la contienda, la depuración de las mismas se llevara a cabo por parte de diferentes instancias. En el presente trabajo se analizan los procesos de depuración de las que trabajaban en diferentes departamentos de la Universidad Central, las que habían obtenido plaza de funcionarias de prisiones y las depuradas por el Colegio de Médicos de Madrid, que constituyeron la gran mayoría. Después de explicar cómo se formaban los expedientes de depuración por parte del juez instructor correspondiente y de cómo se resolvieron, nos detenemos en los casos de las matronas que recibieron las sanciones más elevadas y en los motivos aducidos por los respectivos jueces para proponerlas.

Midwives in Madrid became incorporated in different positions in the Administration during the years before the Civil War, explaining why the post-war purge took place in various branches. This study highlights the purge of midwives working in different departments of the Central University, those working as prison functionaries or similar occupations, and those purged by the College of Physicians of Madrid, who formed the majority. After explaining how the purge dossiers were compiled by the corresponding examining magistrate and describing the results obtained in each case, we name the midwives who received the most severe punishments and discuss the reasons given in each case.

Ovulation inhibitors and contraceptives: Medical knowledge of the "pill" in Spain during Francoism and the democratic transition (1940-1979)

En este trabajo se explora la recepción y asimilación de los conocimientos sobre la anticoncepción oral en la ginecología española, partiendo de un amplio corpus bibliográfico donde se presta especial atención a las publicaciones periódicas. Establecemos que el trato con las hormonas sintéticas se realizó en España a igualdad de condiciones que en los países de nuestro entorno y que la inhibición de la ovulación fue un recurso terapéutico conocido y empleado en los veinte años posteriores a la Guerra Civil. La indicación anticonceptiva como tal, en cambio, tuvo que vencer las constricciones de un régimen dictatorial, una ideología pronatalista y el dominio de la religión católica que, luego de una década de dudas, extendió a la píldora la condena general de toda esterilización y aborto. Presiones corporativas, admoniciones religiosas y actos directamente represivos no impidieron que hacia 1969 comenzaran a extenderse los primeros servicios médicos de planificación familiar.

This paper explores the reception and assimilation of knowledge on oral contraception by gynaecologists in Spain, starting with an analysis of a wide spectrum of medical publications, especially journals. We observe that the management of synthetic hormones in Spain followed a similar pattern to that in other European countries. Thus, the option of inhibiting ovulation as a therapeutic measure was known and used during the 20 years that followed the Spanish civil war. However, its contraceptive use had to overcome the restrictions of a dictatorial regime, its pro-natalist ideology and the predominance of the catholic church. After a decade of doubts, the church had included the pill in their general condemnation of sterilisation and abortion. Nevertheless, professional pressure, religious admonition and directly suppressive action failed to prevent development of the first contraceptive medical services from 1969 onwards.

Juan Vernet Ginés (1923-2011)