SOCIAL MEDICINE. - It is that part of medicine which aims to remedy the harmful consequences that factors of a physical, chemical, biological, and cultural nature exert on the physical and moral health of peoples. Given these tasks, it interferes with social hygiene.
I. IN THE FIELD OF INFECTIOUS DISEASES, OR OF OBSCURE ETIOLOGY OR OF EXOTOXIC ORIGIN
In the field of infectious diseases, social medicine operates by putting into effect the therapeutic and prophylactic aids deemed suitable to overcome the diseases, to circumscribe their spread, and to repair the possible impairments they entail. There are infectious diseases that predominantly kill, such as cholera and plague; other infectious diseases are predominantly disabling, such as syphilis, tuberculosis, acute anterior poliomyelitis: for this purpose social medicine promotes the establishment of lazarettos, leprosariums, tuberculosis sanatoriums, celtic hospitals, hospitals for the treatment of the after-effects of acute anterior poliomyelitis, of the after-effects of lethargic encephalitis, etc.
In the field of diseases of obscure etiology, malignant tumors occupy a preeminent place, and social medicine engages public opinion and the responsible bodies in the opening of specialized institutes for the early diagnosis and treatment of the disease and fosters research aimed at clarifying its etiology.
Among diseases of exotoxic origin are morphinism, cocainism, and alcoholism; social medicine, in union with social hygiene, provides for their prophylaxis through propaganda and by promoting appropriate legislative measures; it further urges treatment, resorting, where appropriate, to the work of hospital institutes of dissuasion suitably equipped for the purpose. It then takes into consideration the industries in which workers are exposed to contracting "diseases from work materials." Among these are remembered chronic lead poisoning or saturnism, which is found among workers of lead objects, alloys and lead compounds; carbon disulfide poisoning, which is found among workers employed in the extraction of oils, fats, essences and resins by means of such a compound, among those employed in the treatment of alkali cellulose and subsequent operations up to drying, among workers employed in the cold vulcanization of rubber, etc.; chronic mercury poisoning or hydrargyrism, which is found among workers employed in the manufacture of mercury measuring instruments; poisonings from iodine, bromine, fluorine, ammonium, etc.
Great importance has been assumed in recent times by silicosis, to which workers in certain dusty industries are exposed, such as the metallurgical (sandblasters), abrasives, ceramics, and glass industries. It is due to silicon and can be a cause of disabling pulmonary alterations and of the patient's death. Social medicine lays down appropriate prophylactic rules and promotes the establishment of schermographic centers for the early diagnosis and treatment of the disease.
II. IN THE FIELD OF ENDOCRINE DISEASES AND IN VARIOUS OTHERS
In the field of endocrine diseases, mention is made of endemic goiter, which in Italy is observed in the Aosta Valley, in the Valtellina and in the neighboring regions of Valais and Upper Savoy, and is presumably due to the action of organic goitrogenic substances present in the soil layers of these regions, through which the drinking waters pass. It is the cause of a syndrome that goes under the name of endemic cretinism; small doses of iodine, administered with drinking water, prevent the disease from arising and from worsening and improve some physical and mental symptoms.
All diseases can take on social significance. Their importance is related to the number of cases, to the severity of the morbid manifestations, to the conditions of time and place; for example, cholera and plague have a different significance in Italy and in the regions where they are endemic; Q fever, unknown in the past, is acquiring, in Italy, social significance after an increase in cases of congenital cataract was reported there; an increase in cases of malignant tumors has been recorded; the number of accidents at work is also on the rise.
III. SOCIAL MEDICINE, MATERNITY AND CHILDHOOD AND OTHER FORMS OF ASSISTANCE
Another task of social medicine is to provide for the protection of maternity. To this end it promotes the establishment of propaganda offices and gives impetus to social obstetrics with the opening of dispensaries for the medical supervision of pregnant women, flanked by social services aimed at bringing needy women the necessary material and moral support, so that medical prescriptions may be carried out; it also concerns itself with having maternity wards established so that pregnant women presenting complications of a medical, surgical or obstetric nature may be received there.
Connected to these are the measures directed at the material and moral protection of childhood, among which important ones are the clinics for infants and weaned children, flanked by maternal canteens and other social services; the foundling hospitals for the assistance of abandoned children; the rehabilitation homes for wayward children; the orphanages; the boys' villages; the committees against begging; the school patronage societies; the recreation centers, etc. Social medicine also concerns itself with the material and moral assistance of the young man (youth clubs, committees for assistance to soldiers) and of the young woman who goes to work far from her family (works for the protection of young women, women's clubs). Assistance to the old who are without a family or in need is provided in homes for the aged and in hospitals for the chronically ill. Of particular importance is the protection of the worker in his work; social medicine sees to it that labor regulations are respected, especially those intended to protect the worker against occupational diseases and against accidents; it further recommends vocational guidance and, in the most hazardous jobs, psychophysiological selection.
IV. SOCIAL MEDICINE AND MORAL INSPIRATION
Numerous are the problems that confront social medicine in the moral field, among which are the moralization of public entertainments, of sport, of daily news reporting, of advertising, etc.
It is quite evident that not all the measures advocated by social medicine can find rapid implementation, because the solution of one problem often presupposes that of other complex problems. Furthermore, one must take into account that the means necessary for the realization of social provisions must be drawn from taxes, and if their burden is too heavy, the entire economic life suffers. Social medicine, in order to accomplish its task, needs to draw inspiration from motives of a higher nature, so as to derive the propulsive force and the constancy necessary for the attainment of its ends. Christianity, which teaches us to love the children of men as children of God, is an inexhaustible source of moral energies useful to the purpose. In the implementation of its program, social medicine must prevent a too one-sided vision of social problems from injuring the rights of the human personality; it is necessary to bear in mind that man has a value of his own before he has a social value.
Bibliography14 works
Eleuterio Boganelli