MLJETSKA BOLEST (MAL DE MELEDA): PROMJENE IDENTITETA BOLESTI TIJEKOM POVIJESTI.

MELEDA DISEASE (MAL DE MELEDA): HISTORICAL SHIFTS IN PERCEPTION.

MLJET Island (Croatia); CROATIA

Nowadays, hereditary diseases are viewed through molecular mechanisms, and one of them, which keeps occurring rather frequently in medical publications, has been named after the Island of Mljet. The world first learned about mal de Meleda from a Dubrovnik physician Luka Stulli in 1826. He described it in a number of his island patients as a non-contagious hereditary skin disease, and named it mal de Meleda (a disease of Mljet). After Stulli, numerous scientists continued to investigate its aetiology and distinctive properties, introducing new scientific procedures to research the disease. The article keeps track of the way people and medicine perceived and treated mal de Meleda patients, starting from the early 19th century to the present day. It pays special attention to how the disease was perceived and described in medical literature through history. There are no reports in writing about the disease before the 19th century, but in oral tradition it was perceived as a punishment for the sins of sacrilege, sins of piracy, or even as leftovers of leprosy brought by the crusaders. We investigated if these legends have any support in preserved historical documents and to what extent they are related to real historical events and circumstances. Influenced by the booming research in microbiology, end 19th century physicians believed the disease was an isolated focus of leprosy. However, early 20th century physicians defined it as a hereditary skin disease with changes which distinguish it from other skin conditions. Genetic nature of the disease was later confirmed by molecular science. As for its geographical origin, the most recent medical research has shown that mal de Meleda is not restricted to the island of Mljet, and that it is spread worldwide, particularly in regions that, historically, were the trading routes of the Dubrovnik Republic. This implies that the mutation has spread through migration and persists only because it is not lethal and does not affect reproduction. [ABSTRACT FROM AUTHOR]

U današnje vrijeme velikog zanimanja za molekularnu osnovu nasljednih bolesti, jedna od bolesti koja se razmjerno često pojavljuje u medicinskim publikacijama jest bolest nazvana po otoku Mljetu. O mljetskoj bolesti svjetska je javnost prvi put saznala od dubrovačkog liječnika Luke Stullija, koji ju je još 1826. opisao kao nezaraznu nasljednu kožnu bolest koju je zapazio u nekoliko svojih pacijenata na tom otoku i nazvao je Mal de Meleda (mljetska bolest). Nakon Stullija, brojni su se znanstvenici nastavili baviti etiologijom i identifikacijom mljetske bolesti pa se novi duh istraživanja koji je uslijedio na području znanosti neizbježno odrazio i na način istraživanja ove bolesti. Rad prati promjene u načinu odnošenja medicine i stanovništva prema mljetskoj bolesti i oboljelima od ranog XIX. stoljeća do danas, a posebnu pažnju obraća na to kako je bolest u različitim povijesnim razdobljima doživljavana i opisivana u medicinskoj literaturi. Dok povijesnih izvora o mljetskoj bolesti prije XIX. stoljeća nema, narodna je predaja tradicionalno doživljava kao kaznu za grijehe oskvrnuća, odnosno za grijehe gusarstva ili pak kao zaostalu lepru koju su donijeli križari. U radu se razmatra imaju li predaje uporišta u sačuvanim povijesnim spisima i dokumentima te koliko je njihov sadržaj povezan sa stvarnim povijesnim događajima i okolnostima. Bakteriološki usmjereni liječnici s kraja XIX. stoljeća također nakratko smatraju da je riječ o izoliranom fokusu lepre, no kliničari prvih desetljeća XX. stoljeća bolest definiraju kao nasljednu kožnu bolest s karakterističnim promjenama kojima se razlikuje od ostalih kožnih bolesti. Tek suvremene molekularne analize na razini gena uspijevaju potvrditi pretpostavke znanstvenika daje uzrok bolesti genska deformacija. Sto se tiče geografske rasprostranjenosti bolesti, najnovija medicinska istraživanja potvrđuju da mljetska bolest, usprkos imenu, nije više samo "mljetska", već daje široko rasprostranjena diljem svijeta i to u područjima kojima su stoljećima prolazile trgovačke rute Dubrovačke Republike, pa se pretpostavlja da je populacijsko kretanje rezultiralo i prostornim transferom predaka i gena, te da se mutacija održala samo zato što bolest nije smrtonosna i ne utječe na reprodukciju. [ABSTRACT FROM AUTHOR]

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