History and Geography

The ancient Greeks recognized the clinical features of cirrhosis. In about 300 B.C., Erasistratus associated ascites with liver disease. Galen, in the third century A.D., commented on the physical diagnosis, and noted that heavy wine consumption will increase the damage to the liver when inflammation and scirrhus already existed. His contemporary, Aretaeus the Cappadocian, suggested that cirrhosis may evolve from hepatitis, and carcinoma, from cirrhosis. The clinical descriptions left by the...

Subject Index

Account of the Bilious, Remitting Fever by Benjamin Rush (1789), 663 An Account of the Foxglove by William Withering (1785), 695 acquired immune deficiency syndrome (AIDS), 2, 3, 6-7, 41, 46, 96, 185, 205, 298, 301, 366-7, 383-4, 452, 474-5, 490, 503, 530, 541, 547-51, 557, 589, 620, 699, 700, 711, 781, 783, 937, 938, 1052 and Candida albicans, 548 causative agent discovered, 547, 711 clinical manifestations and treatments, distribution and incidence, 547-8 epidemiology and etiology, 547 first...

Diseases

In view of the diverse characteristics of the main diseases of South Asia and of the various factors affecting them, it will be helpful to consider the recent history of the most important of them in turn. Smallpox was held by nineteenth-century medical opinion to be the scourge of India, responsible for more deaths than all other diseases combined. Endemic throughout much of the region, smallpox returned in epidemic strength every 5 to 7 years. So prevalent was the disease between February and...

Basic Perspectives

The Ma-wang-tui manuscripts, the Huang-ti nei-ching, the Nan-ching, and the Shen-nung pen-ts'ao ching are the main sources for our current understanding of the early developmental phase of Chinese medicine, even though the last three may have undergone considerable revisions in later centuries and cannot be considered genuine Han dynasty sources in their entirety. Still, the picture emerging from studies of these sources so far reveals the formation of several complex and multifaceted...

History

The existence of anorexia nervosa in the past has been a subject of much historical debate. Some clinicians and medical historians have postulated that anorexia nervosa was first identified in 1689 by the British doctor Richard Morton, physician to James II (Bliss and Branch 1960 Silverman 1983). The medieval historian Rudolph Bell has dated the origins of anorexia nervosa even earlier, claiming that certain medieval female saints, who were reputed to live without eating anything except the...

Mortality Levels

The reasons underlying this fall in mortality (and the earlier high levels of mortality) have been much debated. Kingsley Davis (1951) argued that India became the home of great epidemics only during the period of British rule (1757-1947), when it was exposed to foreign contact for the first time on such a great scale. India's medieval stagnation was broken down later than that of Europe and so the region fell prey to pathogenic invasions, such as plague, at a later date. But, as in Europe...

Changing Concepts What Constitutes Heart Disease

Concepts about what constitutes heart disease have changed a great deal in the past century. For example, the corresponding section of a predecessor to this work, August Hirsch's Handbook of Geographical and Historical Pathology (1883-6) is entitled Diseases of the Heart and Vessels, not diseases of the heart, and one of the main topics is hemorrhoids. Anatomic linkage of the heart and vessels into a single unit was common in the nineteenth century, as is shown by such titles as Diseases of the...

Geographic Variation in Types of Heart Disease

In many parts of the world, other types of heart disease are more common than coronary heart disease. Endomyocardial fibrosis, for example, is common in the tropical rain forest belt of Africa and South America. The disease has a characteristic pathological process and leads to heart failure, accounting for up to 20 percent of patients with heart failure in Uganda, the Sudan, and northern Nigeria. It can affect people who live in the area as well as those who visit from other parts of the...

Heart Disease

The precise diagnosis of various forms of heart disease was achieved only after the development of pathological anatomy, auscultation, and the stethoscope. Under Chinese medical philosophy, abstract arguments concerning the pulse, combined with heart pain and shortness of breath, were used for diagnosis of heart diseases. Under the heading heart pain, the Hyangyak chipsong pang lists nine different kinds. These entries and similar discussions in other texts composed during the later years of...

Clinical Manifestations Diagnosis Treatment and Control

Lymphocytic Choriomeningitis (LCM) LCM has been found in the Americas, Europe, and Asia, but not in Africa or Australia. Outbreaks are sporadic and often associated with experimental animal colonies. The disease in humans is usually benign, with symptoms resembling influenza. Inap-parent cases (determined by serologic changes) are frequent during outbreaks. Meningitis (with 90 to 95 percent lymphocytes in the cerebrospinal fluid) may occur as a primary symptom of disease, or more usually as a...

Clinical Manifestations and Pathology

The beriberi clinical triad consists of edema and neurological and cardiovascular manifestations. The complex of symptoms resulting from thiamine deficiency, however, has often been confused by the common occurrence of other vitamin deficiencies at the same time. Thus, some of the symptoms that distinguished dry beriberi were indicative of riboflavin deficiency. A diet deficient in thiamine would usually be deficient in other B vitamins as well. Some of the differences in the manifestation of...

Clinical Manifestations

Typhoid fever is an illness characterized by fever and headache. Other early symptoms that may occur are abdominal distension or tenderness, constipation and a few loose bowel movements, cough or bronchitis, and rose spots - a transient rash that usually begins on the abdomen. As the illness progresses, the headache may be more severe and be associated with mental confusion or stupor, the liver and spleen usually become enlarged, and complications such as intestinal hemorrhage, intestinal...

Pathology and Clinical Manifestations

The virus multiplies in the epithelium at the portal of entry. The epithelial cells increase in size and contain an enlarged nucleus with intranuclear inclusions. The developing blisterlike vesicle is intradermal and is surrounded by inflammatory cells, edema, and congestion. Viremia may develop in malnourished infants as an accompaniment to measles, and in patients with extensive burns or in those on immunodepressant drugs. Systematic disease accompanies viremia. The initial lesion at the site...

AD 2001000 The West Reaches Its Nadir

A.D. 200-600 When it was no longer feasible for Rome to defend the frontiers from the barbarians who lurked upon the eastern side of the Rhine-Danube frontier, the empire enlisted them to defend what they coveted. Given land in the empire, the barbarians were partially Romanized and, in return for their land, were asked to defend the frontier. At this point, the third phase of the tripartite strategy comes into play. Because armies were not available in sufficient size to...

African Diseases

Vivax malaria probably arrived in the blood of the first Europeans and, although a relatively benign form of the disease, nonetheless joined in the slaughter by claiming its share of Indian lives. As the Indian die-off progressed, the'Spaniards found themselves forced to look elsewhere for hands to put to work colonizing the Americas, and they chose the black African. By 1518 the transatlantic slave trade was under way, which almost immediately opened a conduit for the transatlantic flow of a...

Alzheimers Disease

In 1906, Alois Alzheimer first described a neurological disorder of the brain associated with global deterioration of cognitive functioning and resulting in severe social impairment. Once thought rare, senile dementia of the Alzheimer's type is the most commonly acquired progressive brain syndrome. Alzheimer's disease begins with insidious intellectual and memory loss as the brain becomes shrunken from nerve cell loss and advances over 5 to 15 years to a chronic vegetative state. Progressive...

Behavioral Disturbances and Social Disorders

People suffering inanition obviously find it impossible to maintain normal social relations. No matter what their cultural definition, ordinary interactions are also affected by the emotional correlates of starvation and by individual and collective efforts to survive under extreme conditions. Famine, as a net result, gives rise to a series of social transformations. Seen as variously altered patterns of interaction, these transformations progressively unfold under deteriorating conditions. For...

Bibliography

Nan-ching The classic of difficult issues, trans. P. U. Unschuld. Berkeley and Los Angeles. Croizier, Ralph C. 1986. Traditional medicine in modern China. Cambridge, Mass. Epier, D. C., Jr. 1980. Bloodletting in early Chinese medicine and its relation to the origin of acupuncture. Bulletin of the History of Medicine 54 337-67. 1988. The concept of disease in an ancient Chinese medical text, the Discourse on Cold-Damage Disorders (Shang-han Lun). Journal of the History of Medicine...

Cholesterol and

Cardiovascular disease involves the blockage of arteries that provide oxygen within the muscular walls of the heart. The death of even a small portion of this muscle from lack of oxygen can result in the disorganization of the heartbeat and thus a failure of the heart to meet the body's oxygen needs. The plaques that build up in blood vessels and that narrow the flow of blood contain a high proportion of cholesterol. The typical diet of affluent Westerners with their high intake of animal foods...

Classical Antiquity The Golden

The time limits of classical antiquity are as protean as all artificial periodization. For the purposes of this discussion, I shall concentrate on Greece from the sixth century B.C. through the Western Roman world into the second century A.D. Overall, the disease picture here suggests societies with significant overpopulation expanding into new territories and experiencing few major epidemics, until a point was reached when exposure to infectious epidemic disease began a process of demographic...

Classification

There are many conditions or deficiencies that result in anemia. This section will identify several types of anemia prevalent today. Awareness of this type of anemia appears in the second half of the nineteenth century. Thomas Addison of Guy's Hospital described a severe, usually fatal form of anemia in 1855. Macrocytes were recognized by Hayem in 1877 he also noted a greater reduction of hemoglobin than of red blood cells in pernicious anemia. In 1880, Paul Ehrlich found large nucleated RBC in...

Classification and Diagnosis

Although shown on an occasional autopsy or dissection, the connection between goiter and the thyroid gland was not clear as a concept. Other diseases of the neck confounded the connection in a living patient. The main confounder was scrofula, which in medieval Latin meant swelling of the glands and today is still used to connote tuberculous lymph glands (or nodes) in the neck. Because obvious and severe goiter affecting large portions of a population occurred only in certain regions, the...

Classification Clinical Manifestations and Pathology

The growing emphasis on physiological mechanisms and electroclinical correlations has led to a classification of the epilepsies by the localization of the electrical abnormality in the brain. The major division is between generalized (centrencephalic) seizures, where the brain activity is spread over the entire cerebral cortex and partial (focal) seizures, which occur when only one part of the brain is involved. Generalized seizures demonstrate bilateral motor activity and involve a loss of...

Clinical Manifestation and Pathology

The onset of disease usually occurs within 12 to 36 hours of ingestion of food contaminated with botulinum toxin. Botulism typically presents with an array of distressing signs of motor nerve dysfunction, including double or blurred vision and difficulty with speech and swallowing. The unabated disease progresses to generalized paralysis and death from respiratory muscle involvement. Diagnosis is confirmed by detecting botulinum toxin in the blood, feces, or wound site of the patient. Depending...

Clinical Manifestations Contemporaneous Observations

To this point we have seen something of the nature, geography, and history of scrofula. We should next examine what it was that contemporaneous observers saw when describing the disease. The classic description was that of Wiseman (1705), a passionate royalist, to whom the Restoration seemed an expression of God's will, which had placed the rightful line of kings back on the throne. The power of the king to cure by the Touch was triumphantly demonstrated again, and if it was good to show that...

Coda

The heart continues to have a central place in Western medicine. Heart diseases are common, and many of the most prominent new approaches to disease in the past few decades have been directed at heart disease. Cardiologists have become the most powerful subspecialists in internal medicine. But the heart has long been central to the broader Western culture as well. The heart is seen as the seat of the emotions - as in the expressions a broken heart, crimes of the heart, a bleeding heart, and a...

Conclusion

In this essay we have presented a broad overview of the specific diseases that may have existed in the pre-Roman Old World and outlined general patterns of health that may have been present as human society became increasingly complex. But because of the limitations imposed by the sources and the research methods used, the picture is incomplete. From skeletal and mummy material we are fairly certain that, depending on geographic location, pre-Roman populations suffered from a number of...

Conclusions

Overall, changes in how goiter was defined progressed erratically. As theories and techniques employed in anatomy and pathology were developed, the concept of goiter shifted from the simplistic idea of a swollen neck, to an enlarged thyroid of several types, to a range of different thyroid diseases. However, early taxonomies did not disappear but persisted along with the new. Along with these changes in taxonomy came parallel changes in purported causes and the possibilities of prevention....

Contact with the Outside World

Early in the sixteenth century, the first Europeans ventured into the Pacific, beginning the waves of foreigners who reached this region carrying assorted new infectious diseases (Oliver 1962). Magellan's ships crossed the Pacific from the Americas to Southeast Asia, making the initial contact with the Marianas Islanders. Within a few decades, Guam was a regular port of call on the Spanish trade route between Mexico and the Philippines, and Spanish missionaries were proselytizing the Marianas....

Control

Strategies for control of typhoid are divided into three categories Identification of carriers in an endemic population is difficult, and eradication of the carrier state costly. This option appears impractical. Interruption of Transmission Where pure water and food can be assured, typhoid transmission is minimal. Solely by improvement of sanitary conditions in the past century in developed countries, the incidence of typhoid fever has declined from 1 in 200 to 1 in 250,000. Mathematical models...

Decline of Rheumatic Fever

Longstaff (1905) may have been the first to suggest that the prevalence of rheumatic fever was decreasing. He deduced this from death certificates in England and Wales during 1881-1900. During these 20 years, 51,666 deaths were attributed to rheumatic fever or rheumatism of the heart, and 3.3 times as many (171,298) to valvular disease of the heart. In comparing the 5-year periods 1881-5 and 1896-1900, death rates per million due to rheumatic fever declined 15.6 percent,...

Dengue

Dengue is an acute febrile disease caused by infection with a group B arbovirus of four serotypes, transmitted by the bite of infected Aedes aegypti and Aedes albopictus mosquitoes. Endemic throughout the tropics and subtropics, uncomplicated dengue is rarely fatal, although return to normal health after an attack may take several weeks. It does not always have a benign course, however, and can be complicated by hemorrhagic manifestations (hemorrhagic dengue) and circulatory collapse (dengue...

Disease Ecologies of East Asia

East Asian scholars have begun only recently to examine Chinese, Korean, and Japanese sources for evidence of the history of disease in East Asia. Research is at a very early stage There is much that we do not know, and some of what we think we know may turn out to be wrong. At present, scholars disagree about basic facts as well as about how to interpret them. It is possible, however, to discuss how disease ecologies changed as East Asian civilization developed, and this essay will consider...

Disease Patterns

The foregoing sketch suggests a distinctive ecological disease pattern for the Middle East and North Africa. Pastoralism and the farmers' reliance on animals for transport, power, fertilizer, and dung fuel have made these occupational groups, living in close proximity to their livestock, vulnerable to zoonoses and to insect-borne diseases, some of which infest domestic or wild animals. Another important disease complex has developed out of the necessity for irrigation the widespread incidence...

Disease Patterns of 15001900

More intensive trade and political contacts with the outside world, especially Europe, developed from the sixteenth to mid-nineteenth centuries. These contacts, accompanied by more extensive long-distance trade within Africa and by widespread patterns of political centralization, helped to spread many infectious diseases. Europeans and Africans began a long commercial relationship with the arrival of the Portuguese in the fifteenth century. Trade grew rapidly over the centuries, and came to...

Disease Source Material

Whether explicitly stated or not, the identification of parasites responsible for past epidemics is always indirect. The truth of this statement is dramatized by the 1918 influenza pandemic that killed millions of people in less than a year and a half (Jordan 1927). Despite early-twentieth-century advances in public health, microbiology, and immunology, an understanding of the variations of the influenza viruses was not attained until the 1970s (Mackenzie 1980 Stuart-Harris 1981). In 1918 and...

Diseases and Epidemics

The first important Arabic medical treatise that elaborately discussed and summarized the Indian system of medicine of this age is Firdaus-al-Hikmat, by Ali ibn Sahl Rabban al-Tabari, who died about A.D. 855. The work of Rhazes, written in this period, deals systematically with head, eye, lungs, and digestive and circulatory systems, along with diseases of women and midwifery. The contents of the author's studies demonstrate his competence and skill in recognizing various diseases, in...

Diseases in Antiquity

Apart from evidence derived from archeological research, the earliest available sources of information on disease in Southeast Asia are references in inscriptions and accounts appearing in traditional texts. Khmer inscriptions of the seventh and eighth centuries A.D., for example, make reference to lice, eye impairments, and dermatitis or ringworm (Jenner 1981). It is difficult to date some of these sources, especially texts, but it is clear that by the time of their appearance there had...

Diseases in the Pre Roman World

In the past 15,000 years, epochal social and cultural changes have created fundamentally different relationships between humankind and the environment. One of the most important innovations has been the domestication of plants and animals, a major factor in the gradual establishment of agriculture as the world's predominant economic base. The development of agriculture brought an increase in seden-tism, in which human groups lived in more or less permanent communities. Associated with farming...

Diseases of Sub Saharan Africa since 1860

Africa was long characterized as the dark continent, impenetrable, disease-ridden, and dangerous. To many Europeans, Africans personified degeneracy and suffering, and their environment seemed a hothouse of fever and affliction. Europeans had good reason to connect sub-Saharan Africa with disease. For centuries, their attempts to penetrate the coastal fringes of the continent had been effectively frustrated by diseases against which they had little or no resistance (Carlson 1984). In the early...

Diseases of Sub Saharan Africa to 1860

Disease in Africa, as elsewhere, has been and continues to be intimately linked with the ways that human populations have fed themselves. Throughout most of the evolutionary journey of Homo sapiens on the African continent (again, as elsewhere), the species existed in small bands of hunter-gatherers with generally fewer than 100 members. As such, individuals were constantly on the move, seldom pausing in one place long enough to foul their water supplies or let their garbage and excrement pile...

Diseases of the Americas 14921700

During the first 200 years of European exploration and settlement of the Americas, native populations experienced catastrophic die-offs from the introduction of acute infectious diseases. Pinpointing which parasites were responsible for this decimation is not a simple matter. European knowledge of the infectious disease process was primitive in the sixteenth and seventeenth centuries, with the result that conquerors, settlers, and clergy were ill-prepared to describe the illnesses they...

Diseases of the Renaissance and Early Modern Europe

The Renaissance in European history was a time of political, intellectual, and cultural change that had its origins in Italy during the fourteenth century. Beginning roughly during the lifetime of the poet Francesco Petrarch, who died in 1374, literati began to look to classical Greece and Rome for models of human political behavior and stylistic models of discourse and artistic representation. This humanistic quest involved the energies of philosophers and artists throughout the fifteenth,...

Distribution and Incidence

Gonorrhea is found worldwide, but documentation of its true extent is lacking. Direct comparisons of incidence among nations are difficult to make because of the wide variation in clinical and diagnostic facilities, the extent of disease reporting, and the degree of care given to case finding. The disease is widespread in both the industrialized and the developing world, but it is likely that the burden on developing nations is greater. It is estimated that the incidence in some large African...

Down Syndrome

Down syndrome, previously called mongolism, is a relatively common condition resulting from the presence of an extra chromosome, number 21, in all the cells of the body. In each human cell, there are 23 chromosome pairs containing basic genetic material that organizes the body's development and physiological functioning. Each pair has a distinctive size and conformation and can be readily identified on microscopic examination. Chromosome pair number 21 is one of the smaller chromosomes. In Down...

Early Modern Europe to the Seventeenth Century

In this period, no single approach to the problem of insanity dominated. Although categories of insanity in the Renaissance derived mainly from the classical system of mania, melancholy, and dementia, which were based on the broad medical doctrine of bodily humors, the implications were diverse in practice. Physicians and lay people alike typically depicted mad persons as wild beasts, devoid of reason. Brutal handling of the insane was commonplace. Yet a pattern of hospital care for the insane...

Ebola Virus Disease

Textbooks on tropical diseases in Africa are well out of date. With the recognition of new and deadly viral infections - Lassa, Marburg, Ebola, Congo-Crimean Hemorrhagic Fever, Rift Valley Fever, and AIDS - the classical descriptions of major diseases such as malaria and yellow fever must be thoroughly revised, and to the roster of more minor ailments can be added dengue, Chikungunya, O'Nyong Nyong, West Nile fever, and others. One must be ready to challenge earlier descriptions of African...

Energy

We return now to the role of carbohydrates and fats. After the realization that carbon, hydrogen, oxygen, and nitrogen together make up the great bulk of food materials, and the development of reasonably good analytic methods for their determination by about 1830, attempts were made in England to assess what quantities of carbon and nitrogen were required for an adequate diet. (Hydrogen and oxygen could be supplied in the form of water.) There was a demand at this time for objective, scientific...

Enterically Transmitted NonA NonB Hepatitis Etnanbh

ET-NANBH is a virus structurally similar to but immunologically distinct from hepatitis A. It has recently been associated with a number of previously inexplicable hepatitis epidemics. As yet the virus has not been grown in culture, but it can be serially passed through monkeys and has been identified by electron microscopy. Biochemical characterization remains to be done. Most epidemics attributed to ET-NANBH have occurred in less developed countries at times when even the normally limited...

Epidemiology and Etiology

Legionellae live in unsalty water and are widely distributed in nature. They thrive particularly well at or slightly above human body temperature, and thus are commonly found on the hot water side of potable water systems and in the recirculating water in cooling towers and other heat exchange devices. The various ways in which Legionellae can go from their watery environment to infect humans are not all worked out, but one method is clear. Aerosols created by some mechanical disturbance of...

Epidemiology

Parkinson's disease usually occurs in late middle life or beyond. The mean age of onset is 58 to 62. Onset before age 30 is rare but is not unknown, and there is a juvenile form of Parkinson's disease. The greatest incidence is in the decade age 70 to 79 years, with an incidence of 1 to 2 per 1,000 population per year. Later the incidence of parkinsonism seems to decline, a finding which, if true, would have important implications about pathogenesis, indicating that the disease is not simply a...

Etiology and Epidemiology

Perhaps no other disease better illustrates the principle of multifactorial causation The tubercle bacillus is a necessary but not the only condition. In addition, the host and the host's environment contribute numerous other causes central to its pathogenesis. Over 30 species of the genus Mycobacterium have been identified, more than 15 of which can cause disorders similar, but not identical, to tuberculosis. Human disease typically is caused by members of the species Mycobacterium...

Etiology and Pathology

At present, the etiology of SIDS remains a mystery. It is not even clear whether SIDS has a single cause, has several causes, or is the result of a combination of factors working together. Before the medical profession took an interest in the sudden, unexplained deaths of infants in the eighteenth century, people attributed the demise of these children to accidental suffocation in bedclothes, or to accidental smothering and overlaying by sleeping parents. Less charitable people accused parents...

Etiology

The signs and symptoms of parkinsonism are caused by a decrease in striatal dopamine due to the loss of dopaminergic neurons in the substantia nigra of the midbrain. At the present time, environmental agents are the primary known cause of parkinsonism exposure to manganese, carbon disulfide, and carbon monoxide are recognized environmental toxins that can produce the disorder. It is also known that drugs that interfere with dopaminergic pathways or receptors - such as phenothiazines, reserpine,...

Eye Ear Nose and Throat Diseases

Many forms of deafness and their supposed causes are discussed in the Tongui pogam. The condition referred to as earache accompanied by purulent ear was probably otitis media. A section on major and minor nose disease includes symptoms suggest ing rhinorrhea, hypertrophic rhinitis, and maxillary sinusitis. There are also many diseases discussed that were associated with inflammation of the throat and mouth. Symptoms in the Tongui pogam are consistent with tonsillitis, diphtheria, uvulitis,...

General Health Conditions in South Asia

South Asia is home to most diseases of humankind surprisingly, yellow fever and some others are absent. The major causes of death include infectious and parasitic diseases such as tuberculosis, diarrhea, malaria, typhoid, gastrointestinal disorders, and a variety of childhood diseases such as tetanus, pneumonia, whooping cough, diphtheria, measles, and other preventable diseases (Nyrop 1984). A health survey in Pakistan during the mid-1970s revealed that nearly 30 percent of the people had...

Genetics

The most intensively studied genetic associations of multiple sclerosis are those within the human leukocyte antigen (HLA) region of the sixth chromosome. The most frequent association in Caucasoid populations is with HLA-DR2, though others, including DQwl, have been reported. The strength of the associations varies in different population groups. R. J. Swingler and D. A. S. Compston (1986), though cautious in interpreting their data, have reported that in the United Kingdom the north-south...

Heterogeneity

Average experience within a group can be a useful indicator, but there are many instances in which the average, and variations on it, are misleading. These occur when the distribution of vital events within a population is uneven. Thus, life expectancy at birth is a misleading measure of survival in seventeenth-century Europe because deaths occurred with two modes, infancy and late adulthood. This example is well known, and authorities regularly point to the rapid increase in life expectancy...

Historical Evidence

Although precise statistical data are lacking, the little that scientists have been able to compile from various anthropological and archaeological sources clearly indicates that throughout most of its existence humankind has had to contend with an extremely high death rate. At least 20 percent and probably more of all newborn babies died before their first birthdays, and for most there was no more than a 50 percent chance of surviving to adulthood. More specific estimates of mortality in...

History and Geography Antiquity

Pica was well known to the ancients Aristotle and Socrates both wrote of the practice of earth eating, and it is known that in Greece, as early as 40 B.C., the sacred sealed earth was used as a sort of magical cure-all. The clays of the islands of Samos, Chios, and Selinos in the Aegean Sea were said to be especially effective. Galen took 20,000 lozenges of the clay from Lemnos back to Rome, and used them to treat poison victims. Pliny the Elder noted that some residents of the province of...

History and Geography Europe

Pellagra has always been associated with maize or corn, a grain native to America and the staple food of the American Indians. Carried to Europe as early as the third voyage of Christopher Columbus, maize was at first of interest chiefly to herbalists investigating the medicinal properties of plants. By the middle of the seventeenth century, however, at least one herbalist observed that the grain might have a deleterious rather than a sanguine effect if consumed in large quantities. An herbal...

History and Paleopathology

Epidemiological studies have shown that bladder stone is a disease of communities where the diet is high in grain or rice and low in animal protein. With dietary changes resulting from improved technology, migration, or cultural shift, bladder stone disease is replaced by renal stone disease. This is well demonstrated over the past two centuries in parts of Britain, France and other European countries, Russia, China, and Turkey. It is therefore not surprising that ancient references to stone...

History of Public Health and Sanitation in the West since 1700

The nature and role of public health are constantly changing, and its definition has been a major preoccupation of public health leaders in the twentieth century. Essentially, public health is and always has been community action undertaken to avoid disease and other threats to the health and welfare of individuals and the community at large. The precise form that this action takes depends on what the community perceives as dangers to health, the structure of government, the existing medical...

History of the Study of Genetic Disease From the Greeks to Garrod

As already stated, the idea that the features of parents could be transmitted to their offspring was ap plied very early in human history in the domestication of animals. Some of the knowledge of good inheritance, the transmission of favorable features, undoubtedly came from observations of bad inheritance. Thus, for some 10,000 years we have been aware to a greater or lesser degree that certain malformations and diseases are hereditary, if not genetic. However, only from the written records of...

Immunology

The knowledge of acquired resistance to disease and the practices connected with it are very old. Ancient medical systems of both East and West offered explanations of why no one got smallpox twice and how one might be protected from getting it at all. But the history of immunology as a science began only 100 years ago with the experiments of Louis Pasteur. This history falls into two distinct periods, roughly before and after World War II. It begins with a fanfare, with the production of...

Info

The final era in the history of disease in Japan before 1600 encompasses the years 1260-1600, which are critical for any real comprehension of the role of pestilence in Japanese history. Yet this period has not been investigated in detail by historians, although they have access to thousands of unpublished records from this era. Fujikawa (1969) has listed some of the epidemics for this epoch, but, as Jannetta (1987) and Hattori (1971) have pointed out, it is likely that he has missed some. A...

Introduction of New Diseases

The introduction of new diseases to a virgin population can be calamitous. The most celebrated case is known as the great dying that followed the introduction of Old World diseases to the New World in the sixteenth century. But contact between virulent disease-causing organisms and nonimmune populations must have been repeated over and over again in the course of human history as civilizations with different disease ecologies came into contact with one another. Thus it is appropriate to ask...

Latin America

Not all Iberian settlement in the Americas took place in areas in which Indians or black slaves formed a servile labor force. Grassland sections of what became Argentina, Uruguay, and southern Brazil were without a sedentary indigenous agricultural population and did not attract extensive European immigration until the latter part of the nineteenth and the twentieth centuries. The areas in which there were sedentary agricultural populations attracted the most attention and as a result suffered...

Medical Background

Though physicians throughout recorded history have been interested in diseases and infirmities that affect sexual performance, the concept that certain forms of sexual behavior constitute a disease in and of themselves is a modern phenomenon. It also seems to be restricted to western Europe and people and cultures descended from or influenced by western European culture. One reason for the development of the concept of sexual deviation as a disease can be found in some of the early modern...

Medical Literature

In 1392 Yi Songgye assumed the throne as King T'aejo and the Yi Dynasty (1392-1910) began. His supporters initiated a sweeping land reform program that began with a cadastral survey of landhold-ing throughout the country and the destruction of previous registers of public and private landhold-ings. New developments in agriculture as well as in science, technology, and medicine followed, stimulating inventions and publications. For example, the agricultural manual called The Art of Farming,...

Mental Illness and Psychiatry Retrospect and Prospect

From our historical survey, several themes emerge concerning the linked development of psychiatry and conceptions of mental illness. Psychiatry as a learned discipline contains no one school of thought that is sufficiently dominant to control the medical meaning of insanity. Given the administrative realities within which mental health professionals currently labor, the move to a standardized diagnostic system may nonetheless win out. It is important for the various factions to share a common...

Mortality

Diabetes represents an underlying and contributing cause of death that places it among the top 10 causes of death in developed countries. In Western countries, DM ranks seventh as a cause of death. In the United States from 1976 to 1983, diabetes was listed as the cause of death in 14.8 per 100,000 population. This rate was considerably higher in Mexico and in the Caribbean, with rates as high as 45 deaths per 100,000 for Trinidad and Tobago. In Africa the mortality rates are generally below 10...

Nonspecific Indicators of Stress

Within the past two decades there has been an explosion of interest in applying the so-called nonspecific indicators of stress to questions of community health. These indicators range from those that apparently mark episodes of acute stress and recovery, such as Harris lines and dental defects, to those that are associated with chronic mal- or undernutrition. Each type of change has been observed to be associated with disadvantaged health status in modern clinical examples, with predisposing...

North America

The indigenous peoples of North America suffered as catastrophic a population decline as did those in what became Latin America. As already suggested, the North American Indians did not live in the same sort of extensive agricultural societies as existed to the south, nor did the new settlers come from a society like those of the Iberian Peninsula. Settlement patterns therefore tended to differ, with family-owned and -operated farms predominating in most of the region except the southeast....

Nutrition and Disease

A revolution in agricultural techniques in northern Europe has been credited with this remarkable population growth (e.g., White, Jr. 1962). Agrarian methods inherited from the Roman Empire were suitable for the warm, dry lands of the Mediterranean and Near East, but proved inadequate on the broad, fertile plains of northern Europe. The old scratch plow that required the double labor of cross-plowing to turn the soil, plodding oxen, and two-field rotation (half of the fields sown in the autumn...

Nutritional Deficiencies and Disorders

The traditional diet of North Africa reflects the geographic divisions of the area. Each country from the Senegal River to the Nile has a littoral and a desert region that are separated from each other by fertile plateaus and arid mountains. Commonly, the littoral food pattern has been based on cereals and fruit the plateau diet, on cereals, olives, sheep's milk, and meat and the desert diet, on dates and camel's milk. The dietary patterns of Middle Eastern countries also reflect geographic and...

Old and New Diseases

The sixteenth century can be considered a watershed in China's disease history. With the coming of European traders to China's southeast coast and the intensification of international commercial activities in South and Southeast Asia, China entered the world community and a few new epidemic illnesses entered China. Scarlet fever, cholera, diphtheria, and syphilis are the more important ones to be added to the reservoir of older diseases that had been ravaging China for centuries. Among the...

Osteoporosis

Osteoporosis is defined as a proportional decrease of both bone mineral and bone matrix, leading to fracture after minimal trauma. It differs from osteomalacia in which there is a normal amount of bone matrix (osteoid) but decreased mineralization. There are two clinical syndromes of osteoporosis. Type I, or postmenopausal osteoporosis, occurs in women aged 51 to 75 it involves primarily trabecular bone loss, and presents as vertebral crush fractures or fracture of the distal radius. Type II,...

Other Epidemics

During the Renaissance period, influenza pandemics recurred frequently enough to be well described by the fifteenth century. At least three influenza epidemics were quite severe during the sixteenth century, those of 1510,1557-8, and 1580. The last in particular resembled the devastating influenza of 1918, in that the first wave occurred in the summer and early fall, and morbidity and mortality were high among young adults. The periodic influenza in the seventeenth century has not been a...

Overview

Despite the diversity, some consensus can be gleaned from the essays, and the epidemiological overview presented here is an attempt to highlight some new findings and old answers as well as the many perennial questions that remain unanswered. Hunter-gatherers and early agriculturalists of the Old World, although hardly disease free, are gener ally held to have been free of epidemic diseases as well as of many other illnesses now regarded as diseases of civilization. In fact, there is some...

Pathogenesis and Etiology

In considering how the geographic, epidemiological, genetic, and pathological data might fit together, it must be stressed that there is no wholly satisfactory framework within which to incorporate all the data. Much evidence has accumulated suggesting an immunologic basis for the disorder in patients with multiple sclerosis. There is abnormal synthesis of antibodies, both inside and outside the brain there are changes in the number and functional activity of peripheral blood lymphocyte subsets...

Physiology of Hemostasis

The mechanisms by which blood loss in mammals is stopped after vascular disruption are complex. Small vascular injuries are sealed by platelets that adhere to the site of damage, where they attract other circulating platelets, so as to form an occlusive aggregate or plug that can close small gaps. Larger defects in vessel walls are occluded by coagu lation of blood - that is, by its transformation from a fluid to a gel-like state. Uncontrolled bleeding and its antithesis, thrombosis (the...

Plague of Athens

The Greek historian Thucydides interrupts his history of the Peloponnesian War between Athens and Sparta to describe the following epidemic in 430 B.C. It was generally agreed that in respect of other ailments no season had ever been so healthy. Previous diseases all turned off into the plague and the rest of the people were attacked without exciting cause, and without warning, in perfect health. It began with violent sensations of heat in the head, and redness and burning in the eyes...

Polydore Vergils 1534 description of the Sweating Sickness from Shaw 1933 2701

The same year (1485), a new disease pervaded the whole kingdom, during Henry's first descent into the island, a pestilence horrible indeed, and before which no age could endure, a well-known fact suddenly a fatal sweat attacked the body wracking it with pains in the head and stomach, moreover there was a terrific sensation of heat. Therefore the patients cast off the bed coverings from the beginning, as some of them suffered less heat if they lay in bed if they were dressed they stripped off...

Population and Disease

Questions such as those above have always intrigued historians of China because the Chinese population has experienced mysterious declines that were possibly caused by widespread epidemics. One such decline of population occurred in north China in the late seventh century, whereas another was a decline in the lower Yangtze region during the ninth century. Other examples are the drastic depopulation of north China during the Mongol dynasty in the fourteenth century, and the decline during the...

Protein

With the discovery of nitrogen as an element toward the end of the eighteenth century, and the development in France of methods for analyzing the amount of nitrogen in different materials, came the discovery that both animal tissues and the animal-like fractions in vegetables contained nitrogen, whereas starch, sugar, fats, and vegetable fibers contained only carbon, hydrogen, and oxygen. After more work, mostly in Germany, it was concluded that these nitrogenous compounds were really all of...

Protein Energy Malnutrition

Protein-energy malnutrition (PEM) or, as it is still sometimes called, protein-calorie malnutrition (PCM), is a term of convenience that refers to a range of syndromes among infants and children of preschool age in whom manifestations of growth failure occur because of protein and energy deficiencies. In most instances this condition besets those in the less developed world of Asia, Africa, and Latin America, where dietary factors are thought to be a crucial part of the etiology. PEM thereby...

Quality of Life

Mortality rates and other statistics derived from them imply that we have measures for the number of years survived. Yet equally measured mortality levels may represent quite different qualitative experiences. In search of ways to capture the quality of life, researchers have selected mortality indexes believed to be more revealing, such as infant or maternal mortality, and have combined vital and economic statistics. One index, used widely to compare the quality of life in Third World...

Quantity of Life

Like other life forms, humans have a characteristic life span, a maximum number of years over which individuals might survive if protected from all hazards. The span is currently unknown. Our only direct evidence about it derives from the age at death of exceptionally long-lived people, and the reliability of this evidence is often marred by poor memory, poor records, and misrepresentation. A few people have lived longer than 110 years, and the number of people surviving to extreme ages has...

Reassessments

By the 1960s the status of nutrition could be summarized as follows 1. Apparently all of the chemical nutrients had been identified, so that it was possible to define an adequate diet in completely chemical terms. 2. There was still a great deal of malnutrition among the poorest people on the earth, mainly because of a lack of quantity of food. And the coarsest foods were too bulky for the small stomach capacities of newly weaned infants. The main problem was therefore one of economic...

Recent Changes

Perhaps because of the prevalence of cardiac disease as well as the symbolic significance of the heart, concern for heart-related diseases has been central to much of what we have come to identify as late-twentieth-century medicine. That includes both high-tech innovations and preventive medicine strategies, such as risk-factor intervention and lifestyle modifications. The echocardiogram is a high-tech approach to cardiac diagnosis based on the reflection of sound waves in the body. The...

Skin Diseases and Leprosy

The texts describe many interesting and important skin diseases, but the most dreaded was certainly leprosy. In ancient Korea leprosy was nonspe-cifically referred to as bad disease. Although various conditions that were included under this rubric were considered malignant and hard to cure, leprosy was probably the major disease. Medical texts of the Yi Dynasty referred to leprosy as big-wind-lepra or big-wind-boil. Leprosy was said to result when a bad wind got into the body, but the disease...

Stature and Health

In conventional terms the standard of living has become practically synonymous with a material standard, and consequently the concept has most often been equated with and measured by per capita income. Yet it can be interpreted much more broadly to encompass the psychological and biological dimensions of human existence (i.e., the quality of life in all of its manifestations). Distinguishing among these components of well-being would not add much that is conceptually meaningful to our...

Stroke

According to World Health Organization diagnostic criteria, a stroke consists of rapidly developing clinical signs of focal (at times global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent causes other than that of vascular origin. Global refers to patients in deep coma and those with subarachnoid hemorrhage (SAH). This definition excludes transient ischemic attacks (TLA), a condition in which signs last less than 24 hours. Strokes are the most...

Terminology

The word goiter (or goitre in Europe) derives from the Latin gutter, but the meaning has shifted from throat or neck to mean specifically an enlarged thyroid gland. An ancient Greek synonym was bronchocele, a term actually used to describe any enlargement in the neck, although it meant literally a swelling or an outpouching of the trachea. Over time this term also came to mean an enlarged thyroid (e.g., the English bronchocele of the eighteenth and nineteenth centuries). Modern synonyms are the...

The Chemistry of Antibody Globulins 193060

The history of protein chemistry is the history of a sequence of innovations in instrumentation and technique, each of them pointing to a new vein of knowledge to be worked. Most of these were fractionation methods proteins could be separated in terms of charge or particle size, and biological activity correlated with the resulting serum fractions or protein fragments. For most of the period, efforts in this area were more or less independent of the work on immune specificity, but they too had...

The Enlightenment

The eighteenth-century period of the Enlightenment has been characterized as the Age of Reason, when the powers of mind reached out to command both nature and human affairs. The goal was the perfectibility of man and of man's lot on earth, and the means to this end was rationality tempered by direct observation. Within this context, all that held back or confounded the development of civilization - whether particular individuals or society as a whole - came under heightened scrutiny, a problem...

The Later Middle Ages

In 1347, the plague began its journey through Europe. When the pandemic ended in 1350, a third of the population of Europe was dead. The population of Europe on the eve of the epidemic has been estimated at 75 million. Although life expectancy at birth was only around 30 years, the very high infant mortality rate artificially lowered this relative to the life expectancy of a person who reached adulthood. Women tended to fare worse, probably as a result of childbirth, although some authors also...

The Pre Columbian Period

The belief that the American Indians were indigenous persisted until relatively recently. But today it is generally accepted that the first Americans were actually wandering Asians who took advantage of the prevailing ice age to cross the Bering Straits from Siberia to Alaska and enter a continent devoid of human life. Then, perhaps 10,000 years ago most of the large ice caps melted and seas rose, inundating the land bridge and sealing off the Asian pioneers in what would later be called the...

The Problem of Mental Illness

The simple title of this section belies the extraordinary scope, complexity, and controversial state of contemporary psychiatric thought. Some have argued that if the myriad types of disorders bedeviling humankind were ranked by the net misery and incapacitation they caused, we would discover that psychiatry captures a larger share of human morbidity than does any other medical specialty. It seems ironic - if not tragic - that a clinical field of such magnitude is at the same time distinguished...