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Anne-Marie Moulin 7 LES SCIENCES HORS D'OCCIDENT AU xxeSIÈCLE 20m CENTURY SCIENCES: BEYOND THE METROPOLIS VOLUME 4 MEDICAL PRACTICES AND HEALTH La matière des ouvrages de cette série doit beaucoup au colloque a les sciences hors d‘occident au XX~siècle P, qui s’est tenu à l’Unesco en septembre 1994. Nos remerciements vont à ses cmrgonisateurs : e à I’Orstom, en particulier à MM.levallois et Winter, alors président et directeur géné rol : sans leur volonté, cet événement n’aurait pas eu lieu ; et à l‘Unesco, en particulier à M. Sasson, directeur général adjoint, dont l’activité fut inlassable. Merci à tous ceux qui firent de cette réunion la promesse de rencontres futures :en parti- culier à Isoline Buisson, à Claude Monnet et Jean-YvesMartin, coordinateurs ; ainsi qu‘à Laurence Porgès, responsable du secrétariat administratif, C. Depont et Mme Rouby qui l’ont assuré. Merci enfin à l‘équipe en charge de la publication des Actes du colloque et à tous les membres du Comité de lecture, qui ont dirigé le choix des textes et veillé longuement à leur retravail. Direction scientifique: Martine Barrère t, Christophe Bonneuil, Yvon Chatelin, Jacques Gaillard, AnneMarie Moulin, Patrick Petitjean, Terry Shinn, Roland Waast. Coordination éditoriale :Marielise Sabrié. Secrétariat: Corinne Dimey, Isabelle Vieira. Traducteurs: Françoise Atvanitis, Olivier de Broca, Sébastien Mollet. Révision des iextes : Nicholas Flay (pour l’anglais), Marielise Sabrié (pour le français). Illustration cartographique :Catherine Valton - ORSTOMKA. Photo de couverfure: Tom Van Sont /Geosphere project, Santa Monica :Science Photo Library. Couverfure et maquette: MarieAgnès Bray. Mise en page: Atelier Christian Millet. LES SCIENCES HORS D'OCCIDENT AU XXE SIÈCLE 20~CENTURY SCIENCES: BEYOND THE METROPOLIS SÉRIE sous LA DIRECTION DE ROLAND WAAST VOLUME 4 MIDECINES ET SANTI MEDICAL PRACTICES AND HEALTH ANNE-MARIEMOULIN ÉDITEUR SCIENTIFIQUE ORSTOM Éditions L'INSTITUTFRANÇAIS DE RECHERCHESCIENTIFIQUE POUR LE DÉVELOPPEMENT EN COOPERATION PARIS 1996 Cet ouvrage a pu être publié grâce au soutien des organismes suivants l'Institut français Centre Technique Organisation des Nations Unies de recherche scientifique de Coopération Agricole pour l'éducation, la science pour le développement et Rurale ACP-UE et la culture en coopération te Centre technique de coopération agricol? et rurale a été fondé en 1983 dans le cadre de la Convention de tomé entre les Etats membres de l'Union européenne et IesEtats du groupe ACP (Afrique,Caraïbes, Pacifique). te CTA est à la disposition des Etats ACP pour leur permettre un meilleur accès à l'information, à la recherche, à la formation et aux innovations dans les domaines du développement agricole et rural et de la vulgarisation. Pour atteindre cet obiectif, le CTA commandite et publie des études; organise et apporte son soutien à des conférences, ateliers et séminaires; édite ou coédite une grande diversité d'ouvrages, comptes rendus, bibliographies et annuaires; renforce les services de documentation dans les pays ACP; et propose un important service de documentation. O ORSTOM Éditions 1996 ISBN : 2-7099-1294-5 (édition complète) ISBN : 2-7099-1297-X (volume 3) ISBN : 2-7099-13003 [volume 6) ISBN :2-7099-1 2953 (volume 1) ISBN :2-7099-1 298-8 (volume 4) ISBN : 2-7099-1301-1 [volume 7) ISBN :2-7099-1 296.1 (volume 2) ISBN :2-7099-1 2996 (volume 5) Lo loi du 11 mars 1957 n'autorisant, aux termes des alinéas 2 et 3 de I'article 41, d'une part, que les x copies ou reproductions stric- tement réservées à l'usage privé du copiste et non destinées à une utilisation collective I) et, d'autre part, que les analyses et les couries citations dans un but d'exemple et d'illuskation,a taute représentation ou reproduction intégrale. ou partielle, faite sans le consentement de I'auteur ou de ses ayants droit ou ayants cause, est illicite x (alinéale'de I'article 40). Cene représentation ou reproduction, par quelque procédé que ce soit, constituerait donc une contrefaçon sanctionnée par les articles 425 et suivants du Code pénal. VOLUME IV MEDECINES ET SANTÉ De la médecine tropicale à la santé au pluriel: introduction d'Anne-Marie Moulin 7 I lA MÉDECINE TROPICALE Harish Naraindas, Poisons, Putrescence and the Weather.A Genealogy of the Advent of Tropical Medicine 31 Laurence Monnais-Rousselot,L'apport d'une colonie dans l'émergence de la médecine tropicale: le cas de l'Indochine française (1860-1939) 57 Sylvia Chiff oleau, L'invention des maladies endémiques: la formation du corps médical égyptien 69 Jean-Pierre Bocquet et Maria Molero, Une hypothèse originale ; la transmission transovarienne des arbovirus de Finlay à nos jours 83 II LES ANNÉES DE TRANSITION ET LE MYTHEDE L'ÉRADICATION llena Löwy,Éradication de vecteur contre vaccination :la Fondation Rockefeller et la fièvre jaune au Brésil, 1923-1939 91 Elena Izmailova, The System of Epidemic Control in the USSR: Short Essay on its History 1 o9 Ehige Lefebvre, L'Orstom au sein du mouvement tiers-mondiste; convergence, rupture et persistance 119 111 UNITÉ ET DIVERSITÉ DE 1~ MÉDECINE Yolanda Texera-Arnal,La recherche dans un institut universitaire du Venezuela :anatomie et pathologie 145 Diana Obregon, La construction sociale de la lèpre en Colombie, 1884-1959 159 Annick Guénel, Entre Chine et Occident: place et rôle de la médecine traditionnelle au Viet-nam 177 Guy Mazars, Maladies et médecine en Inde selon I'Ayurveda 193 LES SCIENCES HORS D'OCCIDENTAU XXe SIkX IV JUSQU'AUBOUT DE LA ROUTE Christian Moretti, Savoir thérapeutique traditionnel face au savoir scientifique ; traduction, transfert evou partage ? 205 Pierre Cabalion, Ethnopharmacologie sous les tropiques ; /'exemple de Vanuatu 21 1 MISE EN CEUVRE DES PROGRAMMES DE SANTE ENTRE ÉTATS, ORGANISATIONS INTERNATIONALES ET POPULATIONS Table ronde autour de Jonathan Mann, avec la participation de Guillaume Dighiero, Pierre Druilhe,Marc Lalemant, René Le Berre, Fernando Lema, Gérard Winter, André Yebakima 225 De la médecine tropicaie à la sanié au pluriel Anne-Marie Moulin Centre national de la recherche scientifique (CNRS), Institut national de la santé et de la recherche médicale (inserm), Unité 158,Hôpital Necker, Paris (France) Le philosophe Cabanis,écrivant en l'an XII de la République française, était persuadé d'assister, en médecine,à l'ouverture d'une nouvelle ère. Dans son ouvrage Révolution et réforme de la médecine (I), il la décrit comme un voyageur,qui parvenu de nuit dans une contrée inconnue,ouvrirait à l'aube sa fenêtre sur un paysage totalement nouveau pour lui. L'idéologie des révolutions médicales a trouvé son point d'orgue dans la révc- lution dite (( pastorienne )) en France, célébrée inlassablement comme l'acte de nais- sance de la médecine moderne. Sur quel paysage inconnu s'ouvrira la fenêtre du XXP siècle? Si le développement des connaissances médicales au cours de ces deux derniers siècles a été considérable et partie prenante dans l'essor de la démographie mondiale, nous ne sommes plus aujourd'hui persuadés du caractère radical de la révolution de la médecine moderne. Le passé n'était pas dépourvu de lumières et de raison. La médecine qui s'enorgueillit de faire reculer la mort reste encore impuissante en maintes occasions.Surtout l'écart grandit entre les prouesses des techniques de pointe et les réalités du grand nombre, si l'on considère le monde en sa totalité. Car, en situant sa fenêtre dans une cité d'Europe, Cabanis excluait sans y penser une grande partie de la planète. Pour son cinquantième anniversaire,I'Orstom a ouvert grand sa fenêtre sur (( les sciences hors d'occident N. L'Office pour la recherche scientifique et technique d'outre- mer (21,depuis sa création en 1944, a vécu les cinquante années mouvementées de la fin de la période coloniale, de la coopération avec le Tiers monde et du redéploie- ment actuel de cette coopération (3).L'intitulé du colloque visait à souligner la fin de la domination du modèle de la science occidentale, et de la considération exclusive du progrès sous les espèces de l'application, du transfert,et de la diffusion de ce modèle. Sciences hors d'occident : l'appellation enregistrait l'existence, (( beyond the Metropolis )) (4,de sciences de plein droit et de plein exercice,sans préciser s'il s'agis- sait de traditions locales développées ou modernisées, ou de surgeons de la science occidentale ayant subi une spéciation par isolement géographique. Elle invitait à la recon- LES SCIENCESHORS OCCIDENTA AU w SI~CLE naissance réciproque de la diversité,tout en livrant une interrogation non résolue sur la nature une et universelle de la science.Car la science occidentale de l'ère post-colo- niale n'a pas abandonné une tradition eschatologique qui projette la cité harmonieuse des savants à la fin des temps,au sein d'une société fraternelle et transparente (5). Ceux mêmes qui proposent une science alternative,une science plus authentiquement (( for the people)),restent largement solidaires de l'idéal baconien et cartésien d'un arbre du savoir dont les fruits seraient un jour partagés par tous dans un Eden pas trop lointain. Le titre même du colloque manifestait cet écartèlement et laissait aux partici- pants le soin de résoudre la contradiction dialectique qu'il contenait. La fenêtre du colloque international qui s'est tenu à Paris du 20 au 27 septembre 1994 ne s'est pas levée sur l'ordonnance majestueuse d'un jardin à la française,mais a vu défiler des visions contrastées, des esquisses fragmentairestelles qu'en prendrait un voyageur emporté par le mouvement incessant de la planète, au seuil de l'an 2000. Le colloque a fait une large place à la médecine. Sans surprise :la médecine est une branche de l'arbre des sciences depuis Bacon et Descartes.A la fin du siècle dernier, elle a renforcé sa revendication d'être une science en s'attachant au laboratoire,devenu le creuset de ses vérités.
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