{"id":2355,"date":"2021-12-30T09:00:00","date_gmt":"2021-12-30T06:00:00","guid":{"rendered":"https:\/\/tatd.org.tr\/aciltipbulteni\/?p=2355"},"modified":"2022-01-01T20:12:07","modified_gmt":"2022-01-01T17:12:07","slug":"asilama-tarihcesi","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2021\/12\/30\/asilama-tarihcesi\/","title":{"rendered":"A\u015f\u0131lama Tarih\u00e7esi"},"content":{"rendered":"\n
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COVID-19 pandemisinde bir y\u0131l\u0131 geride b\u0131rakt\u0131k. Bu s\u00fcre\u00e7te g\u00fcndemdeki \u00f6nemli ve \u00e7ok tart\u0131\u015f\u0131lan konulardan biri hi\u00e7 \u015f\u00fcphesiz a\u015f\u0131 oldu. Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 olarak ilk doz COVID-19 a\u015f\u0131s\u0131n\u0131 oldu\u011fumuz bu g\u00fcnlerde, bilimin ve geli\u015ftiricilerinin insanl\u0131\u011fa en b\u00fcy\u00fck arma\u011fanlar\u0131ndan olan a\u015f\u0131lar\u0131n tarihteki yerine bakmak istedim.<\/p>\r\n\r\n\r\n\r\n

Modern anlamda bildi\u011fimiz a\u015f\u0131lar\u0131n ge\u00e7mi\u015fi 18. y\u00fczy\u0131la dayansa da i\u00e7lerinde tarih\u00e7i Joseph Meedham taraf\u0131ndan d\u00fczenlenen Science and Civilisation in China <\/em>adl\u0131 serinin bulundu\u011fu baz\u0131 kaynaklar, a\u015f\u0131ya dair ilk uygulamalar\u0131n 1500\u2019l\u00fc y\u0131llarda g\u00f6r\u00fclen \u00e7i\u00e7ek salg\u0131n\u0131 sonucu \u00c7in ve Hindistan\u2019da ba\u015flat\u0131ld\u0131\u011f\u0131n\u0131 s\u00f6yler. Hatta Ian ve Jennifer Glynn, The Life and Death of Smallpox<\/em> adl\u0131 kitaplar\u0131nda, 1600 sonlar\u0131nda \u0130mparator K’ang Hsi’nin \u00e7i\u00e7ek hastal\u0131\u011f\u0131ndan \u00e7ocukken kurtuldu\u011funu ve kendi \u00e7ocuklar\u0131na a\u015f\u0131 yapt\u0131rd\u0131\u011f\u0131ndan bahsetmektedir. \u0130lk y\u00f6ntemlerin, \u00e7i\u00e7ek hastal\u0131\u011f\u0131 nedeniyle olu\u015fan yara kabuklar\u0131n\u0131n \u00f6\u011f\u00fct\u00fclmesi ve burundan \u00fcflenmesi ya da \u00e7i\u00e7ek hastalar\u0131n\u0131n yaralar\u0131ndan al\u0131nan i\u00e7eri\u011fin sa\u011fl\u0131kl\u0131 ki\u015finin cildine inok\u00fcle edilmesi oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\r\n\r\n\r\n\r\n

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1500\u2019l\u00fc y\u0131llarda salg\u0131nlar\u0131n fark\u0131nda olanlar sadece Asyal\u0131lar de\u011fildi …<\/strong><\/p>\r\n\r\n\r\n\r\n

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Modern epidemiyolojinin kurucusu say\u0131lan Frans\u0131z doktor Guillaume De Baillou, Paris\u2019te g\u00f6r\u00fclen salg\u0131nlar hakk\u0131nda ara\u015ft\u0131rmalar yapmakta idi. Epidemiorum Et Ephemeridum Libri Duo <\/em>adl\u0131 kitab\u0131nda veba, difteri ve k\u0131zam\u0131ktan bahsediyordu, 1578\u2019de ise bo\u011fmaca hastal\u0131\u011f\u0131n\u0131 tan\u0131mlayan ilk ki\u015fi oldu. 1613 y\u0131l\u0131 Doktor Agustino taraf\u0131ndan El A\u00f1o de los Garrotillos<\/em> (difteri y\u0131l\u0131) ilan edilirken \u0130spanya\u2019da neredeyse bir y\u00fczy\u0131l boyunca s\u00fcrecek difteri salg\u0131n\u0131 devam etmekteydi. O d\u00f6nemde de hastal\u0131\u011f\u0131n bula\u015f\u0131c\u0131 oldu\u011fu biliniyordu ancak sahip olunan imkanlar ne hastal\u0131\u011f\u0131n bula\u015fmas\u0131n\u0131n ne de \u00f6l\u00fcmlerin \u00f6n\u00fcne ge\u00e7emiyordu. Eski D\u00fcnya k\u0131talar\u0131 aras\u0131nda s\u00fcrekli olarak hastal\u0131klar ta\u015f\u0131n\u0131yordu ama 15. ve 17. y\u00fczy\u0131llar aras\u0131nda devam eden Co\u011frafi Ke\u015fifler, Avrupa\u2019ya ait salg\u0131nlar\u0131 her iki Amerika k\u0131tas\u0131na da g\u00f6t\u00fcrd\u00fc ve yerel halklar \u00e7i\u00e7ek, k\u0131zam\u0131k, sar\u0131 humma ve veba benzeri hastal\u0131klar nedeniyle olduk\u00e7a b\u00fcy\u00fck kay\u0131plar ya\u015fad\u0131.<\/p>\r\n\r\n\r\n\r\n

Mart 1718\u2019e gelindi\u011finde \u0130stanbul\u2019da tarihe ge\u00e7en bir olay ya\u015fanmaktayd\u0131. \u0130ngiliz B\u00fcy\u00fckel\u00e7isi\u2019nin e\u015fi Lady Mary Wortley Montagu, b\u00fcy\u00fckel\u00e7ilik hekimi Charles Maitland\u2019\u0131n g\u00f6zetiminde 5 ya\u015f\u0131ndaki o\u011flu Edward\u2019\u0131 \u00e7i\u00e7ek hastal\u0131\u011f\u0131na kar\u015f\u0131 a\u015f\u0131latt\u0131. \u0130stanbullu ya\u015fl\u0131 bir Rum kad\u0131n taraf\u0131ndan yap\u0131lan i\u015flemi \u0130ngiltere\u2019deki arkada\u015f\u0131na anlatt\u0131\u011f\u0131 mektubunda “\u2026 burada bir dizi ya\u015fl\u0131 kad\u0131n var, bu operasyonu ger\u00e7ekle\u015ftirmeyi kendi i\u015fleri haline getirmi\u015fler … her sonbaharda binlerce ki\u015fiye bunu yap\u0131yorlar … (ve orada) \u00f6len hi\u00e7 kimse yok.” diye yazm\u0131\u015ft\u0131. Lady Montagu, Londra’ya d\u00f6nd\u00fc\u011f\u00fcnde a\u015f\u0131 prosed\u00fcr\u00fcn\u00fc co\u015fkuyla destekledi ancak Do\u011fu halklar\u0131na ait bu tedavi s\u00fcreci ba\u015flang\u0131\u00e7ta b\u00fcy\u00fck bir diren\u00e7le kar\u015f\u0131la\u015ft\u0131. Her \u015feye ra\u011fmen kendi k\u0131z\u0131na da Doktor Maitland taraf\u0131ndan bu a\u015f\u0131y\u0131 uygulatt\u0131 ve takma isimle de olsa a\u015f\u0131y\u0131 destekleyen makaleler yazmaya devam etti.<\/p>\r\n\r\n\r\n\r\n

\u201c1751 y\u0131l\u0131nda Londra\u2019da \u00e7i\u00e7ek nedeniyle 3538 ki\u015finin kaybedilmesi Lady Montagu\u2019yu destekliyordu.\u201d<\/strong><\/p>\r\n\r\n\r\n\r\n

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Neyse ki iki y\u0131l \u00f6nce imm\u00fcnolojinin babas\u0131 Edward Jenner do\u011fmu\u015ftu, b\u00fcy\u00fcy\u00fcp 21 ya\u015f\u0131na geldi\u011finde St. George’s Hospital’da cerrahi ve anatomi e\u011fitimini tamamlayacak ve \u00e7i\u00e7ek a\u015f\u0131s\u0131na farkl\u0131 bir soluk getirmek i\u00e7in \u00e7al\u0131\u015fmalar yapacakt\u0131. Jenner s\u00fct\u00e7\u00fclerin \u00e7i\u00e7e\u011fi hafif ge\u00e7irdiklerini, hatta hastal\u0131ktan korundu\u011funu fark etmi\u015fti, b\u00fcy\u00fckba\u015f hayvanlarda g\u00f6r\u00fclen inek \u00e7i\u00e7e\u011fi nedeniyle hayvanlardaki lezyonlardan bula\u015fan irin onlar\u0131 bir \u015fekilde ba\u011f\u0131\u015f\u0131kl\u0131yordu. 14 May\u0131s 1796’da Jenner, ineklerdeki lezyonlardan elde etti\u011fi a\u015f\u0131y\u0131 ilk olarak bah\u00e7\u0131van\u0131n\u0131n 8 ya\u015f\u0131ndaki o\u011flu James Phipps’e yapt\u0131. 11 ayl\u0131k o\u011flu Robert da dahil olmak \u00fczere 23 vakaya bu a\u015f\u0131y\u0131 uygulad\u0131 ve bulgular\u0131n\u0131 yay\u0131nlad\u0131. Latince\u2019de inek anlam\u0131na gelen vacca<\/em> kelimesinin a\u015f\u0131 (vaccine) ve a\u015f\u0131lama (vaccination) kelimelerine temel olu\u015fturmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n

1800\u2019lerin ba\u015f\u0131nda Jenner\u2019in y\u00f6ntemiyle a\u015f\u0131 Avrupa, Rusya ve Amerika\u2019da uygulan\u0131r olmu\u015ftu. 1836\u2019da Doktor Edward Ballard a\u015f\u0131n\u0131n etkisini artt\u0131rmaya \u00e7al\u0131\u015f\u0131rken meslekta\u015f\u0131 William Farr, The Lancet<\/em> dergisindeki yaz\u0131s\u0131nda salg\u0131nlar\u0131n ileride kendi ad\u0131yla an\u0131lacak \u00e7an e\u011frisi \u015feklindeki seyrinden ve a\u015f\u0131ya ula\u015famad\u0131\u011f\u0131 i\u00e7in halen Londra\u2019da her g\u00fcn be\u015f \u00e7ocu\u011fun \u00f6ld\u00fc\u011f\u00fcnden bahsediyordu. Bunun \u00fczerine 1840’ta \u0130ngiliz h\u00fck\u00fcmeti \u00fccretsiz olarak \u00e7i\u00e7ek a\u015f\u0131s\u0131n\u0131n uygulanmas\u0131na, 1853\u2019te ise do\u011fan her \u00e7ocu\u011fa ilk \u00fc\u00e7 ay i\u00e7inde a\u015f\u0131n\u0131n yap\u0131lmas\u0131na karar verdi.\u00a0<\/p>\r\n\r\n\r\n\r\n

\u00c7i\u00e7ekle m\u00fccadele devam ederken di\u011fer bula\u015f\u0131c\u0131 hastal\u0131klar da h\u0131z kesmedi tabi. Asya\u2019da \u00f6zellikle Hindistan\u2019da bir dizi \u00f6l\u00fcmc\u00fcl kolera salg\u0131n\u0131 patlak vermi\u015f, \u0130ngiliz Doktor John Snow, Londra\u2019daki g\u00f6zlemlerine dayand\u0131\u011f\u0131 On the Mode of Cholera<\/em> adl\u0131 yay\u0131n\u0131nda koleran\u0131n kirli suyla yay\u0131ld\u0131\u011f\u0131n\u0131, ince ba\u011f\u0131rsaklar\u0131n mukozas\u0131na yap\u0131\u015fan bir malzeme i\u00e7erdi\u011fini \u00f6ne s\u00fcrm\u00fc\u015ft\u00fc. Snow\u2019un yay\u0131n\u0131ndan 5 y\u0131l sonra \u0130talyan Doktor Filippo Pacini, kolera bakterisini hastalar\u0131n ba\u011f\u0131rsaklar\u0131ndan mikroskobik olarak g\u00f6zlemledi ve hastal\u0131\u011f\u0131n nedeni olarak ileri s\u00fcrd\u00fc hatta bakterinin virg\u00fcl \u015fekline olu\u015funa bile dikkat \u00e7ekti. Hastalarda b\u00fcy\u00fck s\u0131v\u0131 ve elektrolit kayb\u0131n\u0131n oldu\u011funu, onlar\u0131n tuz eklenmi\u015f intraven\u00f6z su enjeksiyonlar\u0131 ile tedavi edilmesi gerekti\u011fini s\u00f6yledi. S\u00f6yledi s\u00f6ylemesine ancak o d\u00f6nemde yeterince dikkate al\u0131nmad\u0131.<\/p>\r\n\r\n\r\n\r\n

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1850\u2019li y\u0131llarda y\u0131ld\u0131z\u0131 parlayan ancak o d\u00f6nemki kariyerinde daha \u00e7ok kimya \u00fczerine ilerleyen Louis Pasteur, 1877 y\u0131l\u0131nda hayvanc\u0131l\u0131\u011f\u0131 sarsan \u015farbon hastal\u0131\u011f\u0131n\u0131 ve Bacillus anthracis\u2019i<\/em> tan\u0131mlayarak rotas\u0131n\u0131 T\u0131p bilimine \u00e7evirdi. \u0130ki y\u0131l i\u00e7inde Pasteurella multocida<\/em> i\u00e7in a\u015f\u0131 geli\u015ftirdi, bu aten\u00fcasyon y\u00f6ntemi ile laboratuvar ko\u015fullar\u0131nda \u00fcretilen ilk a\u015f\u0131yd\u0131. Tavuklara canl\u0131 bakteri enjekte eden ve hastal\u0131\u011f\u0131n seyrini inceleyen Pasteur, tatile \u00e7\u0131kmadan \u00f6nce asistan\u0131na k\u00fclt\u00fcrdeki taze bakterileri enjekte etmesini s\u00f6yledi ancak asistan\u0131 unuttu, aradan ge\u00e7en zaman sayesinde bakteriler zay\u0131flad\u0131, enjeksiyon yap\u0131lan tavuklarda hastal\u0131\u011f\u0131n hafif seyretti\u011fini g\u00f6zlediler. Tavuklar iyile\u015ftikten sonra canl\u0131 bakteri verdiklerinde ise hi\u00e7birinin hastalanmad\u0131\u011f\u0131n\u0131 g\u00f6zlemlediler. 1880\u2019de ise kuduz \u00fczerine \u00e7al\u0131\u015fmaya ba\u015flad\u0131, hatta kuduzun de\u011fi\u015fen ink\u00fcbasyon s\u00fcresini k\u0131saltmak i\u00e7in en vir\u00fclan su\u015flarla \u00e7al\u0131\u015ft\u0131 ve enfekte materyalleri do\u011frudan tav\u015fanlar\u0131n beynine enjekte etti. 1885’te a\u015f\u0131y\u0131 ba\u015far\u0131l\u0131 bir \u015fekilde kullanana kadar kuduz hakk\u0131nda \u00e7al\u0131\u015fmaya devam edecekti.<\/p>\r\n\r\n\r\n\r\n

Tabi ki her \u015fey g\u00fcll\u00fck g\u00fclistanl\u0131k gitmiyordu. Tarihin ilk a\u015f\u0131 kar\u015f\u0131t\u0131 hareketi olan The Anti-Vaccination Society of America, hastal\u0131klar\u0131n mikroorganizmalar yoluyla yay\u0131lmad\u0131\u011f\u0131n\u0131 \u00f6ne s\u00fcrd\u00fc \u2013 ne kadar tan\u0131d\u0131k!<\/p>\r\n\r\n\r\n\r\n

19. y\u00fczy\u0131l hekimlerinin de a\u015f\u0131 konusunda g\u00fcn\u00fcm\u00fczle benzer sorunlarla m\u00fccadele etti\u011fini s\u00f6ylemek m\u00fcmk\u00fcn.<\/strong><\/p>\r\n\r\n\r\n\r\n

1890 y\u0131l\u0131na gelindi\u011finde ise Shibasaburo Kitasato ve Emil von Behring, kobaylar\u0131 \u0131s\u0131l i\u015flem g\u00f6rm\u00fc\u015f difteri toksini ile a\u015f\u0131lad\u0131lar. Onlardan ald\u0131klar\u0131 serumlarda difteri toksininin zararl\u0131 etkilerini \u00f6nleyen bir madde oldu\u011funu fark edip, maddeye antitoksin, tedavilerine de serum ad\u0131n\u0131 verdiler. Bu sayede 1901’de T\u0131pta ilk Nobel \u00d6d\u00fcl\u00fc’n\u00fc kazand\u0131lar.<\/p>\r\n\r\n\r\n\r\n

19. y\u00fczy\u0131ldan sonraki tarihsel seyir g\u00fcncel a\u015f\u0131lar\u0131n bulunmas\u0131 ile devam etti\u011fi i\u00e7in, yaz\u0131m\u0131 a\u015f\u0131lar\u0131n bulunu\u015f y\u0131llar\u0131n\u0131 payla\u015farak bitirmek istiyorum. 1896-tifo, 1900\u2019ler-kolera, 1942-difteri, 1950-BCG ve bo\u011fmaca, 1955-inaktive polio, 1961-tetanoz, 1962-canl\u0131 oral polio ve influenza, 1968-k\u0131zam\u0131k, 1970-k\u0131zam\u0131k\u00e7\u0131k, 1970\u2019ler-polisakkarid meningokok a\u015f\u0131lar\u0131, 1982-hepatit B, 1988-KKK, 1992-konjuge Hib ve hepatit A, 2001-DaBT ve pn\u00f6mokok a\u015f\u0131s\u0131, 2008-HPV, 2013- rotavirus ve zona, 2015- meningokok B ve ACWY.<\/p>\r\n\r\n\r\n\r\n

Son s\u00f6z olarak<\/em><\/strong><\/p>\r\n\r\n\r\n\r\n

Bakteriyolojihane Osmanl\u0131 Devleti\u2019nde 1892 y\u0131l\u0131nda kuruldu. Ayn\u0131 y\u0131l ilk \u00e7i\u00e7ek a\u015f\u0131s\u0131 \u00fcretim evinin hizmet verdi\u011fini biliyoruz. Cumhuriyet y\u0131llar\u0131nda kuduz, kolera, dizanteri, veba, tif\u00fcs, difteri, tetanoz ve influenza a\u015f\u0131lar\u0131 ve tetanoz, gazl\u0131 gangren, difteri, kuduz, \u015farbon akrep serumlar\u0131 \u00fclkemizde \u00fcretilmektedir. Ancak \u00fclkemizde -maalesef- 1997\u2019de BCG a\u015f\u0131 \u00fcretiminin kesilmesi ile a\u015f\u0131 \u00fcretimi tamamen durdu. A\u015f\u0131 \u00fcretimine devam edebilmemiz \u00f6ncelikli temennilerimden biridir.<\/p>\r\n\r\n\r\n\r\n

\u201c\u00c7i\u00e7ek hastal\u0131\u011f\u0131n\u0131n eradike edilmesi elde etti\u011fimiz en \u00f6nemli k\u00fcresel ba\u015far\u0131yd\u0131\u201d<\/strong><\/p>\r\n\r\n\r\n\r\n

Di\u011fer bir nokta da D\u00fcnya\u2019da ilk yok edilmi\u015f hastal\u0131k olan \u00e7i\u00e7ek hastal\u0131\u011f\u0131… D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc, hastal\u0131\u011f\u0131n eradike edildi\u011fini 8 May\u0131s 1980’de 33. Genel Kurulu’nda resmi olarak duyurdu, onaylad\u0131. Bir de \u00e7ocuk felci a\u015f\u0131s\u0131n\u0131n mucidi Jonas Salk\u2019tan bahsetmek istiyorum. 1955\u2019te kullan\u0131ma giren inaktive edilmi\u015f a\u015f\u0131n\u0131n patenti \u00fczerine kendisine y\u00f6neltilen soruya \u2018Patent yok. G\u00fcne\u015fin patentini alabilir misiniz?\u2019 <\/em><\/strong>yan\u0131t\u0131n\u0131 \u00f6\u011frencilik y\u0131llar\u0131nda duymayan kald\u0131\u011f\u0131n\u0131 sanm\u0131yorum. Modern T\u0131p ve a\u015f\u0131lar konusunda bug\u00fcne gelmemizi sa\u011flayan b\u00fct\u00fcn bilim insanlar\u0131na \u015f\u00fckranla, eradike edilecek nice hastal\u0131klar dile\u011fiyle.<\/p>\r\n","protected":false},"excerpt":{"rendered":"

COVID-19 pandemisinde bir y\u0131l\u0131 geride b\u0131rakt\u0131k. Bu s\u00fcre\u00e7te g\u00fcndemdeki \u00f6nemli ve \u00e7ok tart\u0131\u015f\u0131lan konulardan biri hi\u00e7 \u015f\u00fcphesiz a\u015f\u0131 oldu. Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 olarak…<\/p>\n","protected":false},"author":917,"featured_media":2358,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10,10015],"tags":[10211,10212],"class_list":["post-2355","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mercek","category-sosyal-blog-yazisi","tag-asi","tag-tarihce"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/2355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/users\/917"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/comments?post=2355"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/2355\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media\/2358"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media?parent=2355"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/categories?post=2355"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/tags?post=2355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}