|
dvd_bratt@yahoo.com
THE
FIFTH DISEASE
-
Diseases are facts of na-ture, whereas diagnoses are
artifacts, words con-structed by human beings.
-
Like so many other things in T&T, dengue fever is
a fashionable disease.
-
Sometimes the name can tell us something about the disease.
Often it does not.
Diseases
are facts of nature, whereas diagnoses are artifacts, words
constructed by human beings.
Although diagnosis is contingent on the concept of disease,
the diagnosis is not the same as the disease.
The disease is the expression of a physiologic malfunction
and its effects can be seen either by the naked eye or through
instruments like the microscope or the lab.
Diagnosis is a name of the disease, just as poinsettia is
the name of a flower.
The core meaning of the diagnosis may very well be completely
different from the disease itself.
Malaria is the name of a disease which we recognise when
we see its effects on the blood but the name malaria is
all wrong and does nothing to characterise the disease.
Malaria means “mal’ aria” which is Italian
for “bad air,” which has nothing, we now know,
to do with malaria the disease, but which was thought to
be the way one got malaria, from “the unwholesome exhalations
of marshes,” as the old textbooks of medicine proclaim.
The power of a diagnosis is the power of words and emotions. Say
“dengue fever” to anyone and they freeze. The
faces go pale, the pulse speeds up, the fingers begin to
tremble and the mouth goes dry. More people die from murders
or vehicle accidents or prematurity here in T&T, but
who cares, none of those words have the capacity to scare
like “dengue.”
Such a simple word, dengue, perhaps from the Swahili “dinga,”
meaning “seizure or cramp,” or from the Spanish,
“dengue,” meaning “fastidious,” both
it is thought influencing the putting of a name, or what
we like to call a diagnosis, to a disease, because sufferers
walk stiffly and erect, due to a painful back and joints.
In fact the Venezuelan words for dengue are even more wonderfully
descriptive: “fiebre de rompe huesos” or “breakbone
fever.”
It has never caught on in T&T. People are just
too in love with “dengue.”
So you have people boldface telling you that they had dengue
fever but they had no fever. Or they had fever with no aches
and the “test” showed they had dengue. Or they
had a cold and cough and want to know “if it could
be dengue?”
Like so many other things in T&T, dengue fever is a
fashionable disease.
Even the word fever has horrible connotations.
Most parents become scared when their children develop a
fever. Feverish children behave differently. They become
quiet; they stop eating; they complain about headaches and
so on.
This “sickness behaviour” sends strong signals
to parents that their child is not well. Our genetic programming
then causes us to react in an appropriate manner by becoming
anxious, fussing around the child more than usual and seeking
advice on what to do.
This normal and expected reaction of the parents is usually
increased by the attitudes of other members of the family
present, especially the grandparents and older uncles and
aunts.
They remember the days when children “used to die from
fever.” These deaths would have happened as late
as the 1950s, ie only 50 years ago.
In those days diseases like measles, malaria and tuberculosis
caused fever and children regularly died from them.
These illnesses are no longer the massive killers they once
were. Our older folks continue to keep alive these dreadful
memories and to influence our local approach to fever. Hence
there is often a great deal of panic whenever a child gets
fever.
It is true that we must remember the past so that we do
not allow these diseases to affect us again but these memories
must be tempered with the knowledge of what our present
reality is.
Sometimes the name of the disease can tell us something
about the disease. Often it does not.
Take the so-called “French disease,” also known
as syphilis, one of the several French combination-words,
often dealing with sex or food, eg French kiss, French letter,
French fries and French toast.
Depending upon someone’s thoughts as to where the disease
came from, syphilis was also known as the Italian, Spanish,
German and Polish disease.
The name “syphilis” was coined by Girolano Fracastoro,
a medieval physician from Genoa. In 1530, he published the
poem “Syphilis sive Morbus Gallicus” (Syphilis
or the French Disease) in which the name of the disease
first appeared and which tells the tale of Syphilus, the
supposed first sufferer of the disease.
Then there is Fifth disease or erythema infectiosum, known
colloquially as “slapped cheek disease” in English
speaking countries, but as “apple cheek disease”
in Japan, because of the defining red rash on the cheeks.
Why Fifth? Because it was the fifth of the common childhood
rashes to be identified and described, the others being
the first, measles; scarlet fever or Second disease; rubella
or German measles, the third; scalded skin syndrome (Fourth
disease) and Fifth disease.
There it might have ended but for the discovery of “Sixth
disease,” also known as exanthema subitum or “sudden
rash.”
But that’s for another day.
|
