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EN
Tuberculosis remains a significant cause of human suffering and death in the twenty-first century and represents a relevant public health problem. The article analyzes how the conflict between individual freedom and public health is related to tuberculosis treatment and how they are perceived and managed by the professionals and contacts involved in the process. This is qualitative research, in which semi-structured interviews were conducted with contacts of tuberculosis patients, as well as health professionals from the Epidemiological Surveillance and Family Health Strategy, involved in Tuberculosis Control in the city of Araçuaí, MG.The data analysis verifies the tension between individual freedom and public health, showing that the discontinuity of treatment is related to two political senses of freedom. While in the negative sense the person is considered free when no person or group interferes with his actions, in the positive sense freedom is understood as the self-determination of the individual. Therefore, considering the risks that freedom in the decision not to adhere to treatment (positive sense) may bring to the community, the conception of negative freedom applied by the Brazilian health system is based on interference, requiring conduct and strategies in these cases.
ES
A tuberculose permanece causando sofrimento humano e morte em pleno século XXI, representando um relevante problema de saúde pública. O artigo analisa os conflitos entre a liberdade individual e a saúde pública relacionados ao tratamento da tuberculose e como eles são percebidos e gerenciados pelos profissionais e contatos envolvidos no processo. Trata-se de uma pesquisa qualitativa, na qual entrevistas semi-estruturadas foram realizadas com os contatos dos portadores de tuberculose, bem como, com os profissionais de saúde da Vigilância Epidemiológica e da Estratégia Saúde da Família, envolvidos no Controle da Tuberculose no município de Araçuaí - MG. Na análise dos dados verificou-se a tensão entre a liberdade individual e a saúde pública, evidenciando que a descontinuidade do tratamento se relaciona com os dois sentidos políticos de liberdade. Enquanto no sentido negativo a pessoa é considerada livre quando nenhuma pessoa ou grupo interfere em suas ações, no sentido positivo, a liberdade é compreendida como a autodeterminação do indivíduo. Portanto, considerando os riscos que a liberdade na decisão por não aderir ao tratamento (sentido positivo) pode acarretar para a coletividade, a concepção de liberdade negativa aplicada pelo sistema de saúde brasileiro está baseada na interferência, exigindo condutas e estratégias diante desses casos.
EN
Often perceived as the result of empirical speculation, the sanatorium, intended for the treatment of tuberculosis patients in the first half of the 20th century, was at first sight a therapeutic utopia originating in the medical profession. In this enclosed space, it is the doctor that exercises the authority and their recommendations have the value of injunctions. However, a reversal of this order is depicted in two 20th-century novels: Les “Heures de silence” by the Swiss writer Robert de Traz (1884-1951), and Siloé by Paul Gadenne (1907-1956), a French author who was himself a regular visitor to such care institutions. In these works, the unity of place - the sanatorium - becomes a convenient device for questioning the world of the healthy on three levels: the ego, the relationship to others and the relationship to natural space. Because the "tubercular condition" neutralises the differences between individuals, it questions the primacy of health and paradoxically outlines a balanced lifestyle based on the idiorhythmic alternation between solitude, social life and immanence.
FR
Souvent perçu comme le fruit de spéculations empiriques, le sanatorium, destiné dans la première moitié du XXe siècle à la prise en charge des tuberculeux, se présente de prime abord comme une utopie thérapeutique émanant du corps médical. Dans ce lieu clos s’exerce en effet l’autorité du docteur, dont les préconisations ont valeur d’injonctions. Pourtant, deux romans, Les « Heures de silence », de l’écrivain suisse Robert de Traz (1884-1951) et Siloé, de Paul Gadenne (1907-1956), auteur français qui fut lui-même un habitué des établissements de soins, mettent en scène un renversement. Dans ces œuvres, l’unité de lieu sanatoriale devient en effet un artifice commode pour questionner le monde des bien-portants à trois niveaux : l’ego, la relation aux autres et le rapport à l’espace naturel. Parce que la « condition tuberculeuse » pondère les différences entre les individus, elle remet en cause le primat de la santé et esquisse paradoxalement un mode de vie équilibré, fondé sur l’expérience idiorythmique de l’alternance entre solitude, vie sociale et immanence.
PL
Artykuł przedstawia trzy przykłady z pism francuskiego emigranta - Księdza Pocharda. Ukazuje reakcje współczesnych na pojedynczy przypadek gruźlicy, epidemię ospy w skali wiejskiej, a następnie obserwowaną w Polsce międzynarodową pandemię cholery. 190 lat po przejściu drugiej pandemii cholery w Polsce warto zauważyć, że polityka zdrowotna władz, a także reakcje indywidualne i zbiorowe bardzo przypominają te, których doświadczamy dzisiaj, kiedy Europa jest dotknięta drugą falą Covid-19.
EN
The article presents three examples from the writings of the French émigré - Father Pochard. Through individual tuberculosis, the smallpox epidemic on a village scale and then the international cholera pandemic observed in Poland, the article shows the reactions of contemporaries. 190 years after the passage of the second cholera pandemic in Poland, it is interesting to note that the health policy of the authorities, but also the individual and collective reactions, closely looked like those we experience today in Europe affected by the second wave of Covid-19.
FR
Cet article de Jérémie Fischer intitulé Tuberculose, petite vérole et choléra : d’une contamination isolée à la pandémie. Les maladies infectieuses mortelles dans les Mémoires de l’abbé Pochard (1800-1831), présente trois exemples issus des écrits de l’émigré français. A travers une tuberculose individuelle, une épidémie de petite vérole à l’échelle d’un village puis une pandémie internationale de choléra observée depuis la Pologne, l’article montre les réactions des contemporains. 190 ans après le passage de la deuxième pandémie de choléra en Pologne, il est intéressant de constater que la politique sanitaire des autorités, mais aussi les réactions individuelles et collectives, ressemblent de près à celles dont nous faisons l’expérience aujourd’hui, alors que l’Europe est touchée par la deuxième vague de la Covid-19.
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