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Journal of Epidemiology and Community Health , 52 , 10, Choosing a Future for Epidemiology. Homogeneity and heterogeneity as situational properties: Producing — and moving beyond? Social Studies of Science , 44, 4, The apportionment of human diversity in Theodosius Dobzhansky, Max K. Hecht, William C. Steere eds. Contested Illnesses. Citizens, Science and Health Social Movements. Social Science Collaboration with Environmental Health. Environmental Health Perspectives , , 11, The socio-exposome: advancing exposure science and environmental justice in a postgenomic era. In , Britain adopted measures of this sort, after attempts at inoculating cattle in had failed completely.

The policy of slaughtering cattle would not be fully accepted right away not till the s given the stiff opposition from foreign cattle traders and urban MPs, who spoke in the name of consumers. In France, sanitary police measures were difficult to enforce—in particular, peasants, veterinarians and even mayors strongly opposed the slaughter of large numbers of sick animals. The attitude of the French representative, Henry Bouley, a veterinarian and one of Pasteur's first companions , was a rough mixture of principles and pragmatism—what some might call hypocrisy.

Under this principle, quarantine would be restricted to the province s attacked by the disease, instead of being extended to the whole country. Bouley's position becomes more credible when we learn that he reported to his minister that the very efficient measures taken at Germany's eastern borders and at the borders of the different states in the Reich would keep French herds safe from rinderpest, and French meat cheap. Though never published, this agreement would form the basis for all subsequent regulations.

Rinderpest does not directly cause human casualties. Even as animal health became a concern for governments, owing to increased meat consumption, hygienists became ever more wary of changes in the ways of preparing and eating meat. City-dwellers and peasants as well were now eating foods, such as ham or offal, that they had previously refused. The typical peasant lunch included strips of ham or bacon, lean as well as fat.

As a local pig-keeping economy continued unabated, this pork-based diet prevailed until the First World War. Town labourers also ate salt pork, usually fried rather than boiled. Rural-dwellers stayed on fatty diets well into the s, whereas townspeople were developing a taste for grilled and roasted meat. More and more people were consuming undercooked meat. Doctors even advised eating red meat. Horse meat which was never eaten raw was considered to be less liable to helminthic infestations and, since it was cheap, they recommended it for tuberculous victims.

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Trichinosis provides us with a case in point for this zoonosis perspective. It shows, once again, how important borders were, and still are, in regulating animal diseases that carry risks for people. A helminthiasis transmitted by eating undercooked or raw meat containing trichinae Trichinella spiralis larvae, trichinosis causes digestive and muscular symptoms, and can lead to fatal neurological and heart complications. In the late s, salt-cured meat from the United States was flooding the European, especially the French, market see Table 1. The previous November, trichinae had, in Lyons and Paris, been found in fifty boxes of bacon strips from New York.

The press soon picked up the story. From to , there had been sixty-six serious outbreaks of trichinosis in Germany, and many deaths. The most serious outbreak occurred in , in Hedersleben, a small town where out of infected persons died. By , the panic was sweeping through Europe. Except for Belgium and Great Britain, most countries prohibited the import of American salt-cured meat. Unlike the Germans, the French supposedly ate thoroughly cooked meat, and no death could be attributed to infested ham or bacon. None the less, as the panic spread, the authorities resorted to prohibiting imports.

From to , no trichinosis was reported in the more than million kilograms of American pork imported into France. But consumers turned away from salt pork, including that of US origin. In fact, the risk was real. According to the chief veterinarian of the Department of the Seine which included Paris , meat inspection agencies fell into one of three categories: 1 those with centralized, technical services that relied on ad hoc arrangements; 2 those that conducted incomplete inspections in order to facilitate exports; 3 rudimentary services managed by local authorities.

At the turn of the century, Belgium and Germany fell into the first group; New Zealand and Denmark, into the second; Great Britain and France, into the third.

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France did not manage fully to centralize meat inspection: neither the law of 21 June Code rural nor the 8 January slaughterhouse act provided for a uniform service throughout the nation. Meanwhile municipal authorities did not welcome veterinarians, at least not until after a 22 January decree in application of the Food Adulteration Act that granted the latter full powers to undertake controls in stores, trucks, slaughterhouses and meat-processing facilities.

But what about meat inspection services in the United States? The practices of the American meat industry were far from honest, let alone sanitary, as Upton Sinclair so capably pointed out. In Chicago, the municipality supervised—lightly—the meat-packing industry.

Meat-packers opposed federal inspections. As of —1, inspection was restricted to salt pork exports. An act of 30 August exempted freshly slaughtered carcases from inspection. Inspection did not become mandatory until President Harrison signed a new act on 3 March But the Pure Food and Drugs Act abandoned an regulation that required examining hogs for trichinae. Yet hog infestation was rife, as D E Salmon, the veterinarian who headed the Bureau of Animal Industry, had frankly admitted in In the s, studies of muscle samples taken from autopsies would show that 16 per cent of persons in the United States were carrying trichinae and that 10 to 20 persons died each year from trichinosis.

Along with other countries, the United States, Austria and Denmark paid no heed to health dangers in foodstuffs. Denmark only made meat inspection mandatory in —6, after an MP's family was infected by trichinae. The German Reichtag repealed, in , the hard-and-fast regulations drawn up by Prussia in ; searching for trichinae was no longer mandatory. Furthermore, veterinarians had come to doubt the cost-effectiveness of inspections based on the microscope.

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In sharp contrast with Germany, pigs bred in France were rarely infested; and this is still the case today. This idea, though sometimes questioned, was widespread when the panic started. Only foreign meats imported from risky areas were inspected. In , this was still standard procedure! Popular views were muddled.


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Liberals staunchly advocated bans. Much to the sorrowful surprise of some veterinary associations, the Academy of Medicine was shifting debate away from public health towards a bitter argument over economic policy.

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Conversely, the Senate turned from a political assembly into a public health chamber. It even held hearings with the chairman a senator of the important Consulting Committee of Public Hygiene to discuss epidemiology. These reports recommended avoiding bans and inspecting cargoes at borders while better informing the public via a poster to be hung in retail shops where salt pork was sold. But Bouley soon called for tougher measures. After all, Germany had banned imports of American ground minced pork a few months earlier. On 18 February, under pressure from public opinion and parliament, the Ministry of Agriculture issued a decree prohibiting imports of US salt-cured meat.

About a year later, again at the Academy, Bouley none the less lost patience when it was pointed out that he had been one of the main supporters of the prohibition. These repeated reversals of policy provide evidence of how poorly the crisis was being managed. The Senate, where rural interests prevailed, was especially vociferous: back-benchers shouted that the salt pork industry and public health doctors were poisoning food. Though staffed with protectionist zealots, the Ministry of Foreign Affairs surprisingly took a stand against prohibition in order to improve trade relations with the United States.

Chambers of Commerce were divided: Bordeaux and Le Havre, where importers were enrolled, opposed the decree, whereas Nantes, the French pork-packing centre, strongly supported it. Importers did their best to have the decree repealed. A few years later, on 23 November , the government, which had always been inclined to lift the ban, backed their efforts, but to little avail since parliament adamantly opposed repeal till January More significantly, public health pundits were to join the cause of repeal.

In the French armed forces, as well as in villages and industrial urban centres, the demand for US salt pork remained strong. Inspectors with microscopes were sent to major ports where US freight was unloaded. It is questionable how effective they were. They took six months to examine 20, tons of bacon seized by customs officers at Le Havre, where three-quarters of the meat came in.


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Inspection turned up a 3 per cent infection rate. In Paris and Lyons the figure rose to 8 per cent; but in Marseilles the results yielded a tiny 0. The microscopes were perhaps less to blame for these findings than the poor training of inspectors. Public health experts ultimately came down on the side of economic liberalism. Apart from the fact that American ground meat was cheaper, their main reason was the extremely few fatalities due to trichinae—in fact, next to none.

For public health doctors, the panic was making a mountain out of a molehill. Their main argument, however, seemed to centre around the ban's ineffectiveness. Driven out of the ports, Yankee ham was illegally entering France through Germany and Belgium. Belgium imported it from England, where many of the cargoes refused entry in France ended up. Some public health experts thought that the time had come for international agreements to be worked out in order to improve sanitary standards in meat-packing plants.

In , Prof. Since importing countries had no means of monitoring industry standards and regulatory agencies abroad, however, such certificates would have had little value. Much the same discussion had already taken place at the Vienna rinderpest conference. By the s, importing countries had their own scientific experts to assess other countries' sanitary arrangements; but lack of information about how to use microscopes, for example tended to impair assessments.

Eighty-five years later, article 30 of the Treaty of Rome would trigger lively debate about extra-governmental supervision—a still unsettled issue, as can be seen in recent EU regulations about offal. But who was supposed to protect food? Besides producers, consumers are necessary for action in favour of protection. Let us take the example of preventing salmonella-related risks. In sharp contrast with previous periods, rather mild outbreaks have occurred during the twentieth century.

In , the situation in France was described as anything but serious: despite an increase in cases of salmonellosis, the number of fatalities had decreased, except among the new-born. Causes of food-poisoning, France —7 Notifications to departmental health services. Staphylococcic infections increased sharply after the Second World War; the ten outbreaks in Table 2 were all reported after By contrast, botulism, rather frequent in the nineteenth century, decreased remarkably during the twentieth, except for during the war. These two tables are considerably biased owing to both the many unreported even unnoticed cases and, for Table 2 , the inclusion of statistics from the war.

After the s however, salmonellosis would become the major cause of food-poisoning, perhaps because S. In France, beef and horse meat were, and still are, major sources of food-poisoning—surpassed only by eggs, owing to the surprisingly high contamination in some cases, nearly per cent in poultry farms during the s. But, clearly, the major source of food-poisoning is the home. Restaurants and cafeterias are inspected more than private houses, and salmonella infections consistently correlate with home-cooked meals.

In , home-cooking accounted for 71 per cent of all cases of food-poisoning in France. The more pessimistic health authorities become about eradicating salmonella in food, the keener they are to put the responsibility for prevention on households. It was hotly debated whether salting and cooking could effectively prevent trichinosis.

Full examinations of cured meat were conducted, all of them leading to the conclusion that cooking was the magic bullet against trichinae. As a consequence, hams and, worst of all, the specialty saucisson de Lyon were deemed not per cent safe. Little wonder that trichinosis signalled a national disaster. They wanted to reinforce surveillance and boost public awareness, given the lack of scientific studies on the effectiveness of salting and cooking.

The precautionary principle, it has been said, provides the state with an excuse for not measuring up to international commitments when health risks have political overtones. Precaution is ultimately a matter of sovereignty. In May , the Minister of Agriculture argued in favour of such a principle before the Chamber of Deputies. He wanted to take the precaution of banning meat imports, even though—and perhaps even because—evidence was lacking for making any sound decision. Regarded by contemporaries as legitimate, this ban came along with slogans about preventing food-poisoning and with measures such as teaching farmers not to feed their pigs rubbish or the guts and blood of recently slaughtered animals.

Our forefathers were fully capable of connecting prevention—primarily the concern of individuals—to precaution— principally the state's responsibility. American historians have pointed accusingly at European protectionism instead of acknowledging the full import of the disease issue. They have, in fact, ruled out the possibility that French or German inspections could have been effective.

There is no use denying that protectionism was a powerful motive for banning American ham and bacon. After all, it was not by chance that, three months after the ban, a customs tariff for livestock and meat was issued in May , the first of several tariffs for farm produce adopted by France. Historians have set this issue in the light of protectionism, which was gaining the upper hand on both shores of the Atlantic—we need but recall the —90 McKinley Tariff. After all, meat-packing was a major industry in the United States, and a leading agricultural export at a time when protecting farmers ranked high on the agenda for all governments.

American losses subsequent to the European bans soared. Having started as a public health issue, the pork ban ended up becoming a matter of protection. Paris lifted the ban at the same time that it promulgated a 25 franc tariff, in October None the less, we can make a good case for the argument that public health was at stake. Like other European countries, France lifted its ban when the US Congress passed the —1 meat inspection laws.

From the start, American ambassadors in Europe had argued that official inspections were the only way to end the dispute. In July , the French parliament passed the first law regulating animals and animal products; and in November, an autonomous Ministry of Agriculture was set up with a veterinary division. Ultimately, as had happened during the rinderpest epidemic, disease was associated with food imports and thus became a central issue; it served as the pretext for the Federal government's first interventions in food quality.

Following the introduction of refrigeration around , the conditions of competition changed in the American meat industry. Parallel to this shift in technology, sanitary issues were upgraded to become a matter to be handled through diplomacy. Awareness was growing of the need to control disease and take preventive action. Not only agriculture ministers but also ministries of foreign affairs and ambassadors were caught up in the dispute. From the start, negotiations took place at the inter-governmental level.

Representatives of several foreign governments paid close attention to the new inspection procedures implemented under the Meat Inspection Law in the United States. In the end, two main factors apparently account for the long-standing obstacles to the establishment of general international regulations about food safety. Urbanization was forcing more and more people to depend on shop-bought food; and new techniques in chemistry were endangering the food supply, being used to adulterate food.

In Brussels, saucissons dits de Bologne were made from the meat of horses that were sick or had died of contagious disease. This did not upset people. Hygiene was appalling, not only in shops but in factories as well. How could things have been any different? In spite of the British Food and Drugs Acts of and the latter remained the basis of food law in the United Kingdom until , controls in Britain were poorly conducted because neither central nor local authorities were keen to enforce them.

It incorporated past laws such as those of 27 March and 5 May against fraud, whether detrimental to health or not, in food and drink mainly wine. Another act of 23 June punished fraud and food-poisoning but without providing for controls. Before , France lacked laboratories for running tests: meat was not legally normalized, and butcheries were not inspected.

There was a need for monitoring the food-processing industry, in particular small family businesses, where conditions were described as extremely insanitary. Besides regulating sampling procedures and methods through the law, the Ministry of Agriculture gained full authority over food hygiene, thanks to market inspectors, veterinarians and customs agents in all, 1 per 50, inhabitants as well as public laboratories only 27 in In the opinion of British hygienists, this centralization helped put teeth into the act.

Throughout the nineteenth century, consumers had often lodged complaints about the absence of labels. Thirty-five years after its passage, the Food Adulteration Act would be rather negatively assessed: it had made markets, not health, more salubrious. Food could be inspected only in the marketplace, since provisions for controls at manufactories were lacking. Since it mainly aimed at improving business practices, the act would later be incorporated in the Consumer Code, not the Public Health Code. As we shall see, much the same would happen to EU legislation, which, from the start, combined measures against food adulteration and for food safety but with major emphasis on the first.

Interestingly enough, France modelled its regulations on proposals emanating from several international congresses. In Europe and the United States, chemists joined the ranks of those asking for inspections. At the second Congress of Applied Chemistry, held in Paris in , an international codex was proposed for coupling trade with hygiene. Belgium played an instrumental role in this process. Also important were non-governmental initiatives, such as the two meetings on food adulteration held in Geneva and Paris under the auspices of the Swiss-based Croix-Blanche in —9.

Some pundits resented France's influence in these various international meetings. Joseph Ruau, French Minister of Agriculture and author of the act declared at the Paris meeting that honesty in business, hygiene, and international cooperation could be harmoniously linked. He thought all this should become part of a Codex Alimentarius.

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