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Cet article est un compte rendu des communications du 10e Congrès de la Société internationale d’oncologie gériatrique (SIOG), Berlin, Allemagne, 15–17 octobre 2009, portant sur les enjeux spécifiques de l’évaluation, du traitement, des toxicités des traitements chez les patients âgés dans les domaines du cancer colorectal, du cancer du sein, du cancer du poumon et du cancer de l’ovaire. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse the technical, conceptual and institutional changes from which, through macroscopic pathology, a new medical science (microscopic pathology) emerged. The "early" pathology was mainly implemented by the Ecole de Paris, at the beginning of the 19th century. After 1850, histo-pathology emerged, in German university institutes (which were separate buildings from the wards and from the dissecting rooms of the hospitals). The birth of histo-pathology is also linked with technical improvements in mass manufactured microscopes, with better techniques for fixing and staining histological samples and lastly, in (1848) withVirchow's cellular theory. Among French doctors, only one, the very famous physician Jean-Martin Charcot (1825-1893) was aware of these dramatic changes. Charcot wrote many texts which are testimonies of an epistemological rupture between two very different types of medicine, the old French "médecine d'hôpital" and the new "lab medicine", developed in German speaking countries and based on the microscope.

This paper compares anti-hookworm campaigns conducted in the early twentieth century in France, Germany, Brazil and West India. The populations that suffer from hookworm are not identical in the North and in the South. In tropical and semi-tropical regions hookworm is mainly found among poor peasants and is related to lack of hygiene, while in temperate climates hookworm was a professional disease of miners, a highly organized professional segment. Nevertheless, major disparities in the pattern of hookworm control did not reflect the North-South divide, but a difference between campaigns. These aimed at the eradication of hookworm infection (Germany and West-India) and at alleviating the effects of this infection on populations (France and Brazil). Maps that represented the prevalence of hookworm mirrored the aims of the sanitary campaign in which they were used: eradication of parasitic worms versus the reduction of the handicap induced by these worms. In public health as well, representing is intervening. And vice versa: patterns of intervention shape representations.

Hausväterliteratur designates works aimed at landlords and their wives in order to help them in the management of their estate. Among a wide-ranged list of topics tackled in these sizeable volumes, child welfare seldom fails to appear, though generally rather briefly. We consider in this paper a number of German works, most of them dating from the 17th century, though beginning with Johann Coler (1593) and winding up with Johann Joachim Becher (1714). These works include some advice on how to diagnose and manage the most common ailments, as well as some basic educational principles. A brief "pediatric" pharmacopoeia is often added. Although this review concerns only works in German, we have added references to a document taken from English literature, the diary of the clergyman and landlord Ralph Josselin. Dating from the same period (1643-1683), this document shows us how a landlord and his wife actually treated their sick children, thus shifting from theory to practice. "Hausväterliteratur" can be considered as an early stage of what was later termed "Domestic Medicine".

Rudolf Virchow's teaching was challenged by German physicians in the 1920s. Scientific medicine, they argued, did not provide sufficient tools for patient care. They held Virchow responsible for this state of things. According to Ludolf von Krehl, Gustav von Bergmann or Ferdinand Sauerbruch, Virchow fostered a mechanistic trend in medicine which neglected the human dimension in medical practice. These clinicians claimed that scientific medicine should therefore be complemented at the bedside by a teleological approach, taking into account the purposiveness of vital processes. This was the methodological core of the reform that they intended to promote. Many pathologists alike were preoccupied with the reformatory trend launched by the physicians. Ludwig Aschoff, Paul Ernst, Max Borst and Walter Pagel endeavoured to reform the theoretical foundations of their discipline. However, they did not agree with the physicians' view of Virchow's teaching. Aschoff especially showed that Virchow's initial writings provided in fact an epistemological basis supporting the clinicians' endeavour. In this paper, I examine Aschoff's argumentation. I hope thereby to improve our knowledge of one of the components of the medical reform which took place in Germany during the Weimar period.

From 1899 to 1913, Emil Kraepelin (1856-1926) creates and elaborates the nosographical group of the "manic-depressive insanity". In the 50-60s, Leonhard splits off this homogeneous group and describes unipolar psychosis, bipolar psychosis and cycloïd psychosis (anxiety-elation psychosis, motility psychosis and confusion psychosis). Recent nosographical orientations seem to announce a come-back to Kraepelin's conception of "mood disorders". This paper presents the essential of Kraepelin's "manic-depressive insanity" theory-temperamental basis, integration of mixed states, epidemiological datas- and highlights its dialectical relations with today's theory of bipolarity.

Traditionally cities and towns in historical Europe were perceived as being particularly unhealthy. Terms like 'le handicap urbain' or 'urban penalty' have been introduced in order to emphasize the high death rates in the fast-growing industrial towns of nineteenth century Europe, which significantly exceeded the average rates for rural areas or the whole country. A rising population density was ideal for the transmission of the prevailing infectious diseases. This paper assesses urban and rural mortality change in Imperial Germany, when the country was going through a process of accelerated industrialization and urbanization. It provides an analysis of changes in age-, sex- and disease-specific mortality in urban and rural Prussia. In general, urban mortality in Germany reached its peak after the middle of the century, thereafter urban mortality improved substantially in relative as well as in absolute terms, the gap between urban and rural mortality narrowed and finally disappeared entirely. The largest cities registered the strongest decline in mortality. Obviously they had the potential to overcome the threats of disease or death, and became forerunners of improved health conditions in modern industrialized societies. An analysis of the mechanisms of mortality change in an urban environment during industrialization in the late nineteenth and early twentieth centuries can therefore serve as a paradigm for conditions in highly urbanized industrial societies.