MEDICINA SOCIALE. — This is that branch of medicine which aims to remedy the harmful consequences that factors of a physical, chemical, biological, or cultural nature exert upon the physical and moral health of peoples. Given these tasks, it overlaps with social hygiene.
I. IN THE FIELD OF INFECTIOUS DISEASES, OR DISEASES OF OBSCURE ETIOLOGY OR EXOTOXIC ORIGIN
In the field of infectious diseases, social medicine operates by putting into effect the therapeutic and prophylactic measures deemed suitable for overcoming the diseases, restricting their spread, and remedying the possible impairments that they entail. There are infectious diseases that are predominantly fatal, such as cholera and plague; other infectious diseases are predominantly disabling, such as syphilis, tuberculosis, and acute anterior poliomyelitis: for this purpose, social medicine promotes the establishment of lazarets, leprosariums, tuberculosis sanatoriums, Celtic hospitals, hospitals for the treatment of the after-effects of acute anterior poliomyelitis, the after-effects of lethargic encephalitis, etc.In the field of diseases of obscure etiology, malignant tumors occupy a prominent place, and social medicine appeals to public opinion and the responsible authorities for the opening of specialized institutes for the early diagnosis and treatment of the disease, and encourages research aimed at clarifying its etiology.
Among diseases of exotoxic origin are morphinism, cocaine addiction, and alcoholism; social medicine, in conjunction with social hygiene, provides for their prophylaxis through propaganda and by promoting appropriate legislative measures; it also urges treatment, resorting, where necessary, to the work of suitably equipped hospital institutions for dissuasion. It then takes into consideration the industries in which workers are exposed to contracting “diseases caused by work materials.” These include chronic lead poisoning, or saturnism, found among workers producing lead objects, alloys, and lead compounds; carbon disulfide poisoning, found among workers engaged in extracting oils, fats, essences, and resins by means of this compound, among those engaged in the treatment of cellulose alkali and the subsequent operations through to drying, among workers engaged in the cold vulcanization of rubber, etc.; chronic mercury poisoning, or hydrargyrism, found among workers engaged in the manufacture of mercury measuring instruments; and poisoning by iodine, bromine, fluorine, ammonium, etc.
Silicosis has assumed great importance in recent times, to which workers in certain dusty industries are exposed, such as the metallurgical industries (sandblasting workers), the abrasives industry, ceramics, and glassmaking. It is caused by silicon and may lead to disabling pulmonary alterations and the death of the patient. Social medicine establishes appropriate prophylactic regulations and promotes the creation of screening 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, endemic goiter may be recalled; in Italy it is observed in the Valle d’Aosta, Valtellina, and the neighboring regions of Valais and Haute-Savoie, and is presumably due to the action of goitrogenic organic substances present in the soil layers of these regions and carried by the drinking water. It causes a syndrome known as endemic cretinism; small doses of iodine, administered in the drinking water, prevent the disease from arising and worsening, and improve certain physical and mental symptoms.All diseases may acquire social significance. Their importance is related to the number of cases, the severity of the morbid manifestations, and the conditions of time and place; for example, cholera and plague have different significance in Italy and in regions where they are endemic; Q fever, unknown in the past, is acquiring social significance in Italy after an increase in cases of congenital cataract was reported there; an increase in cases of malignant tumors has been recorded; the number of occupational accidents is also increasing.
III. SOCIAL MEDICINE, MATERNITY AND INFANCY, 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 advances social obstetrics through the opening of dispensaries for the medical supervision of pregnant women, supported by social services intended to provide women in need with the material and moral assistance necessary to ensure that medical prescriptions are implemented; it also seeks to establish maternity wards where pregnant women presenting medical, surgical, or obstetric complications may be admitted.Connected with these are the measures aimed at the material and moral protection of infancy, among which the following are important:
IV. M. S. E ISPIRAZIONE MORALE. — Numerosi sono i problemi che s'impongono alla m. s. nel campo morale, fra i quali la moralizzazione dei pubblici spettacoli, dello sport, della cronaca quotidiana, della réclame, ecc.
È ben evidente che non tutti i provvedimenti propugnati dalla m. s. possono trovare rapida attuazione, perché la soluzione di un problema suppone spesso quella di altri problemi complessi. Inoltre si deve tener conto
che i mezzi necessari alla realizzazione delle provvidenze sociali debbono essere tratti dalle tasse e se il loro carico è troppo forte ne soffre tutta la vita economica. La m. s., per poter realizzare il proprio compito, ha bisogno di ispirarsi a motivi di indole superiore, onde trarre la forza propulsiva e la costanza necessarie al raggiungimento dei suoi fini. Il cristianesimo, che insegna ad amare i figli degli uomini come figli di Dio, è fonte inesauribile di energie morali utili allo scopo. Nell'attuazione del suo programma la m. s. deve evitare che una visione troppo unilaterale dei problemi sociali leda i diritti della personalità umana; è necessario tener presente che l'uomo ha un valore proprio prima di avere un valore sociale.