History and Geography

The word herpes is derived from the Greek verb to creep, and the identification of disease in ancient writings depends upon one's interpretation of the description of physical signs. Thus, one may decide either that a described lesion was of the herpetic type or accept the translation of the term herpes itself. No doubt aphthae and herpetic lesions were not differentiated. The oldest record of disease of the genitalia appears in the Ebers Papyrus (c. 1550 B.C.). The translator commented on the...

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...

Clinical Manifestations and Pathology

This disease is asymptomatic at least half of the time. Symptomatic patients become ill about 2 weeks after exposure. They have an influenza-like illness with fever, chills, myalgias, headache, and a nonproductive cough. Rare manifestations include arthralgias, arthritis, and erythema nodosum. With or without symptoms, the chest roentgenogram may show patchy areas of pneumonitis and prominent hilar adenopathy. A primary fungemia probably occurs in most cases. The calcified granulomas commonly...

Diseases of the Islamic World

The advent of Islamic culture is well defined by the life of the founder of Islam, Muhammad (c. 570 to 632). Shortly after his death, Muslim Arabs began a series of dramatic conquests of the Middle East and North Africa, so that by A.D. 750 their hegemony stretched from Andalusia (southern Spain) to the Sind (modern Pakistan). Islam was gradually established as the predominant religion in these areas, and Arabic became the preeminent language in most of them. In the later Middle Ages, Islam...

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

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...

Clinical Manifestations and Diagnosis

The onset and course of rheumatoid arthritis are particularly variable. Usually, fatigue, weight loss, and generalized aching and stiffness, especially on awakening in the morning, precedes localization of symptoms and the development of joint swelling. These symptoms at times develop explosively in one or more joints, but more often there is progression to multiple joint involvement. The disease may remit spontaneously in the first year or diminish in intensity, only to recur in the same or...

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 Trypanosomiasis Sleeping Sickness

African trypanosomiasis, or sleeping sickness, is a fatal disease caused by a protozoan hemoflagellate parasite, the trypanosome. It is transmitted through the bite of a tsetse fly, a member of the genus Glossina. Sleeping sickness is endemic, sometimes epidemic, across a wide band of sub-Saharan Africa, the so-called tsetse belt that covers some 11 million square kilometers. Although the disease was not scientifically understood until the first decade of the twentieth century, it had been...

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...

Anemia

In archeological skeletal remains, evidence of two types of anemia, although not common, are well known and of considerable biological consequence. Genetic anemias, the less common of the two, are restricted to a few geographic areas of the world. Anemia resulting from malnutrition can occur anywhere. Because of the pitfalls in diagnosing anemia in skeletal material, an understanding of the biological processes involved in this condition is helpful. In anemia there is an abnormal increase in...

Attempts at Control and Prevention

The Black Death was in many ways a completely unprecedented experience for those who suffered through it. Plague had virtually disappeared from the Middle East and Europe during the centuries between the end of the first pandemic in the eighth century and the beginning of the second pandemic, and although the first half of the fourteenth century had been marked by a number of epidemics of other diseases, none approached the Black Death in de-structiveness and universality. Contemporaries...

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...

Bubonic Plague

Although devastating epidemics of bubonic plague were recorded in China since 1331, the surviving Korean literature does not seem to reflect similar episodes. The bubonic plague outbreaks that occurred in Asia from the 1890s to the 1920s were, of course, watched with great interest by bacteriologists and public health workers. Of special concern to Korea was the epidemic that occurred in northwestern Manchuria and spread along the newly constructed railroad lines to various cities of northern...

Cells and Serum

The idea of cells defending the body against invaders was proposed by the Russian zoologist I. I. Mechni-kov. He saw that a yeast infecting a transparent water flea was surrounded by white blood cells that stuck to the yeast and killed it. Mechnikov called the cells phagocytes (Mechnikov 1884 Besredka 1921). As Arthur Silverstein has pointed out, phagocytosis at this time was associated with the pathology of inflammation rather than immunity. The first experimental work on immunity, Pasteur's...

Cellular Immunology and the Selection Theories

It was not, however, the argument from the central dogma that turned immunologists away from the template theory. In spite of the growth of molecular biology in the postwar period, it was the complex phenomena of immune cells and immunized animals that provided the impetus for building the new theory. The theoreticians, especially Frank Macfarlane Burnet, considered themselves biologists and drew their ideas from contemporary thinking in biology. During the 1940s, a number of pieces of evidence...

Challenges to the Diagnosis and New Classifications

The idea of sexuality as a disease entity was undermined, in part, by a better understanding of sexually transmitted diseases and their sequelae, which came about during the last part of the nineteenth century. The discovery and acceptance of the germ theory also undermined the belief that sexual activity caused ailments such as tuberculosis. Medicine, however, did not abandon its emphasis on the disease potential of nonprocreative sex. It was simply placed in another category. The latter is...

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...

Chronic Infectious Diseases

The attention of demographers and others trying to explain the modern rise of population has seldom turned to the chronic infectious diseases. Thus, the steady silent killer, tuberculosis, and the flashy new infection of Renaissance Europe, syphilis, are seldom discussed in this context. Yet there exists a reciprocal relationship between copathogens, acute and chronic. For example, survivors of smallpox might have been weakened by this disease and thus succumbed to tuberculosis. Conversely, an...

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 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 Manifestations Acute Epiglottitis

Acute epiglottitis is a disease of relatively abrupt onset and rapid progression which, if untreated, results in death due to airway obstruction. Illness is characterized by fever, severe sore throat, dysphasia, and drooling. Airway obstruction is rapidly progressive and is associated with inspiratory distress, a choking sensation, irritability, restlessness, and anxiety. In contrast to viral croup, the patient is not hoarse and does not have the typical croupy cough, but the speech is muffled...

Clinical Manifestations Diagnosis and Treatment

O. volvulus, one of several filarial worms that are important human parasites, lives in the cutaneous and subcutaneous tissues. Humans are the only definitive host there is no animal reservoir. Numbers of adult worms, the females of which may reach a length of 50 centimeters, live in large coiled masses, which usually become surrounded by fibrotic tissue generated by the host. In these nodules, which may reach the size of a walnut and are often easily visible on the head, trunk, hips, or legs,...

Clinical Manifestations Morbidity and Mortality

High fever associated with malaise, muscle and joint pains, sore throat, retrosternal pain, nausea, manifestation of liver involvement, bleeding tendency of variable severity, proteinuria, and erythematous maculopapular rash with petechiae are features of the illness, but not of themselves particularly diagnostic. The presence of an enanthem in the oropharynx has been considered by some to have specific diagnostic importance. In early stages, the disease can simulate many illnesses occurring in...

Clonorchiasis

The Chinese liver fluke is a small worm that parasitizes the bile ducts and livers of humans, dogs, cats, pigs, and several wild animals in China, Japan, Korea, and Indochina. It was discovered in 1875, and recently, it was estimated that 20 million individuals in China alone are infected. Eggs are laid in the bile ducts, pass in the feces, and if they reach the proper freshwater snail, undergo a series of stages in this intermediate host. Eventually, free-swimming larvae are formed, which...

Communicable Diseases Parasitic Diseases

Estimates of the 1945-59 period suggest that up to 100 million people in China have had intestinal infestation with parasites causing ancylostomiasis (the hookworm) or ascariasis (the roundworm). Ancylostomiasis remains prevalent in 14 southern provinces, and ascariasis is widespread in most of China. Improved environmental sanitation and night soil management have reduced the prevalence of both parasites, but the limited information available indicates that both...

Conclusion

A historian of science brought up on Thomas Kuhn's concepts of paradigm change and discontinuity in science would probably want to ask whether the clonal selection theory and the massive expansion of the field that followed its acceptance could qualify as the kind of gestalt shift that Kuhn had in mind. Was there a profound discontinuity between the thinking of prewar serologists and that of cellular immunologists after 1957 In the author's opinion, there was not. The new theory had the effect...

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 in Chinese Mortality

Why then did mortality decline Ho Ping-ti's (1959, 1978) findings on the introduction of new crops from the Americas during the sixteenth century provide us with one of the more persuasive answers. These easy-to-grow crops-for example, sweet and white potatoes and maize-may well have substantially stabilized food supplies for the poor in less fertile and mountainous regions. D. H. Perkins (1969), however, suggests that changing cropping patterns and rising traditional capital inputs increased...

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...

Diagnosing Heart Disease Physical Diagnosis

During the mid-eighteenth century, Leopold Auen-brugger, working in Vienna, described a new diagnostic technique. By percussing the chest - that is, by striking the chest and both listening to and feeling the reverberation - he was able to tell, to some extent, what lay within. His method enabled him to ascertain the size of the heart and to determine the presence of fluid in the chest, a common manifesta tion of heart failure. However, because prevailing disease theories placed little...

Diagnosis

Some of the Ma-wang-tui texts refer to various vessels thought to pervade the body without intercon nection. Specific irregularities in the contents and movements of each of 11 such vessels revealed specific illnesses. The Huang-ti nei-ching, however, described 12 vessels, or conduits, which were interconnected. This text advocated the feeling of pulses at various locations of the body to examine movement in the individual sections of the vessel circuit and to diagnose the condition of the...

Diagnosis and Pathology

No two myasthenic patients look alike or have the same signs and symptoms. The classical appearance is unmistakable and is usually associated with bilateral ptosis, weakness of the face, and difficulty in smiling, chewing, and talking. The clinical diagnosis is confirmed by demonstrating electrical defects in transmission at the neuromuscular junction, responsiveness to anticholinesterase drugs, or the presence of the anti-acetylcholine receptor antibody circulating in the patient's blood. The...

Diagnosis and Treatment

The diagnosis is made upon a finding of bartonellas within the red blood cells in acutely anemic patients. Blood and bone marrow cultures are the most useful diagnostic test for carrier cases in the endemic zones. The eruptive phase is easily identified with some clinical experience, but surgical biopsy is required to show the bartonella inside the histiocytes in the Giemsa stain. The cultured tissue is positive. Before the advent of antibiotics the mortality rate from Carrion's disease was...

Diagnosis Clincial Manifestations and Pathology

Diagnosis is by clinical signs, cultivation of Shigella or other bacteria from tissue swabs and feces, and serologic tests to determine species and strains. Differential diagnosis must exclude other agents of dysentery, including other bacteria, viruses, and amebas. Bacteria invade the mucosa of the large intestine, where they cause mucus secretion, edema, and, usually, superficial ulceration and bleeding. The watery diarrhea is probably caused by a toxin that increases the secretions of the...

Digestive Disorders

Gastritis seems to be the major disease in the category of stomach diseases. The Hyangyak chipsong pang and the Tongui pogam described symptoms that suggest gastritis. Gastric ulcer might be the modern diagnosis for the disorder associated with a wound of the stomach spilling blood accompanied by severe stomach pains. A precise diagnosis of peritonitis, intestinal tumors, or obstructions was very difficult in both the East and West in ancient times, but some of the symptoms discussed in the...

Disease and Commerce

In his well-known study Plagues and Peoples, and in subsequent writings as well, the historian William H. McNeill has shown that a useful way to understand the evolution of human society is to examine the complex interactions between and among micro-parasites and macroparasites. Microparasites, in this context, are the microscopic organisms that live off human tissue, sometimes carrying disease and death, sometimes provoking immune reactions in their host that destroy the microparasites, and...

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 Ecologies of Europe

Felt that societies tended to have more males than females among adults because more women than men die between the ages of 25 and 45 (Russell 1977). This generalization, however, is based to a very great extent on the perceived epidemiology of tuberculosis, a disease neither universal nor of equal importance in all societies. In Europe, several generalizations are usually accepted regarding human populations. Since classical times until the Industrial Revolution, cities have harbored more...

Disease Ecologies of South Asia

Disease ecology refers to the intricate human and environmental relationships that form the context of one or a group of diseases. Diseases are not simply biomedical entities rather, they have their physical, environmental, sociocultural, psychological, and even political parameters. Distinctive human and biophysical environmental webs form the context of distinctive groups of human diseases. Major changes in this web, whether brought about by human intervention, environmental catastrophes, or...

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 from AD 1000 to 1500

By about A.D. 1000, most of the better agricultural lands had been settled by village farmers. There was still a frontier in the extreme south, and pastoral groups were important in and near the deserts and in parts of the East African interior, but the pygmy and Khoisan peoples were increasingly being pushed into pockets of marginal jungle or desert - a process that has continued until the present. Farming was often of a slash-and-burn type, with villages moving to seek new lands at intervals...

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 Patterns of 190060

The most explosive and most destructive epidemic ever to strike Africa was the influenza pandemic of 1918-19. Introduced at Sierra Leone in late August 1918, and to ports around the continent in the next several weeks, the disease spread rapidly inland over the newly constructed colonial roads, railroads, and river transport systems. Diffusion was especially rapid on the southern African rail system and on the river steamers in the Belgian Congo. Indeed, so quickly did the disease move by these...

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 Infancy and Early Childhood

In ancient times physicians wrote primarily on the care of infants, and only incidentally about children's diseases, because their concept of medicine stressed the maintenance of health rather than the diagnosis of specific disease entities (for medical perspectives on children during antiquity, see Etienne 1973). The earliest of these pediatric texts known to us was that of Soranus of Ephesus (active around A.D. 100), On Gynecology, which included 23 chapters on infant care (see Soranus 1956...

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 Region in Time and Space

Malaria has been a major cause of morbidity and mortality at least in the historical period throughout Melanesia, except Fiji, New Caledonia, and certain coral atolls. Although the anopheline mosquito vector is present in Micronesia, the Plasmodium parasite has not been introduced. Malaria is also absent from Polynesia (Norman-Taylor et al. 1964 Gurd 1967 Willis 1970 Henderson et al. 1971). The disease was endemic in the aboriginal lands of northern Australia before its eradication in...

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,...

Diseases of Western Antiquity

There are good reasons for believing that diseases and complaints of various kinds and degrees of severity were as much a part of everyday life in classical antiquity as were the assorted battle wounds and injuries so dramatically portrayed from Homer onward. This is indicated not only by the surviving Greek and Latin medical texts and the fragments preserved in Greco-Egyptian papyri, but also by the large corpus of nonmedical Greek and Latin texts, some of which are still being read today. In...

Distribution and Incidence

Although identified only in 1981, AIDS can now be found throughout the world. Spread by sexual contact, by infected blood and blood products, and perinatally from mother to infant, AIDS had been reported in 138 countries by July 1988, according to the World Health Organization. Since HIV infection precedes the development of AIDS, often by as many as 7 to 11 years, the precise parameters of the epidemic have been difficult to define. Estimates suggest that worldwide between 5 and 10 million...

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...

Drug Induced SLE

A syndrome that was indistinguishable from SLE was recognized at the Cleveland Clinic in 1954 in patients who were taking the antihypertensive drug hydralazine. Since then, many drugs have been suspected or have been proven potentially to have such an effect. By far the most consistent SLE-inducing agent is procainamide this drug, used to treat cardiac arrhythmias, was first reported to induce SLE in 1962. After 6 months of therapy, ANA develop in at least half of these cases and after 1 year,...

Early Christian Era East and West

After the collapse of the Roman Empire, Western medicine experienced a period of retrenchment and decline. Healing became an important act of Christian charity, a divine gift freely provided within the framework of the new church and not restricted to professional physicians. Given this religious orientation, Christians healed through the confession of sins, prayer, the laying on of hands, exorcisms, and miracles, occasionally performed by saints or church fathers. In Byzantium, the Christian...

Early Modern Europe 15501800

What began in the Renaissance continued and accelerated in Early Modern Europe, except that new diseases were not a significant factor within Europe. The population recovered surprisingly quickly from plague epidemics. Some of the Italian city-states made grants of citizenship easier to obtain, so as to repopulate. Plague gradually became less common. Venice enjoyed more than half a century without an epidemic before the outbreak of 1630. By the eighteenth century, plague was rare indeed....

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...

Early Urban Environments

Before the domestication of various kinds of birds and mammals, hunter-gatherer societies had little everyday contact with large numbers of animals except, in some cases, dogs. As humans learned to contain, control, and breed pigs, sheep, cattle, goats, horses, and fowl, however, they were forced to share those animals' environments. Although their dietary protein intake thus increased, so too did their exposure to pox viruses, distemper, measles, influenza, and other maladies, all diseases...

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...

Economic Life

Until very recently, about 60 percent of the population cultivated the traditional crops of the Mediterranean - cereals and olive and fig trees - whereas date palms and sugar cane predominated in the southern deserts. Antiquated and inequitable land-holding and tenancy systems have discouraged long-term development by individual farmers, and the traditional but excessive subdivision of land has worked against cost-effective production. This region still must remain vigilant for periodic swarms...

Encephalitis Lethargica

Foremost among recorded encephalitis epidemics was the global pandemic of encephalitis lethargica that emerged in and from Europe during the last years of the Great War and occurred in successive waves throughout the world during the following decade. Although the diagnosis of encephalitis lethargica is sometimes applied to sporadically occurring cases of inflammation of the brain having a strong lethargic or stuporous aspect, this discussion focuses upon the encephalitis pandemic that...

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

Alzheimer's disease is ultimately a neuropatho-logical diagnosis. A wide variety of gross morphological and microscopic changes occur in the brain of patients with Alzheimer's disease. Unfortunately, many of these changes are difficult to distinguish from alterations that occur in the brain of normal elderly persons, who also show some atrophy of white matter and, to a lesser extent, gray matter. Neurochemically, Alzheimer's disease has been associated with a decrease in the activity of the en...

Epidemiology and Phylogenetic Considerations

Table VIII. 11.1 lists the 16 members of the Arenaviridae, their known vertebrate hosts' geographic distribution, date of first finding, and authors) and dates of first description. Four of these are important agents in human disease LCM, Junin, Machupo, and Lassa. In addition, 10 other members of the group are apparently nonpathogenic (for human beings). Epidemiological information about these is scanty, although several particularly Tacaribe and Pichinde have been studied intensively in the...

Epidemiology Distribution and Geography

Palm gathered data via correspondence with medical missionaries worldwide and concluded that the main etiologic factor in rickets is the lack of sunlight. It was much later before scientists linked the variable pigmentation in the races of men with the regulation of vitamin D synthesis (Loomis 1967). The processes of pigmentation and keratinization of the outer layer of the skin (stratum corneum) directly affect the amount of solar ultraviolet radiation reaching...

Epidemiology Distribution and Incidence

The epidemic of a highly fatal disease (later named Ebola virus disease) began in June 1976, with an index case in Nzara, southern Sudan, among workers in a cotton factory. This patient went to a large hospital in Maridi, where the disease spread rapidly among hospital patients and staff. The epidemic ran its course by November 1976. There were 148 deaths in 284 detected cases (52 percent mortality). In 1979 a further outbreak occurred in southern Sudan, with fewer cases and a small number of...

Epidemiology

When the science of epidemiology of the nineteenth century was applied to the study of yellow fever, the epidemiologist was hampered by a lack of knowledge of infectious agents and of vector arthropods in the transmission cycle. Consequently, there was great confusion and an endless diatribe surrounding various hypotheses on how infection could travel so mysteriously from place to place, with infections occurring in people who apparently never had had contact with a case. With Theobald Smith's...

Etiology and Epidemiology

Beginning in the late 1970s, physicians in New York and California reported the increasing occurrence of a rare type of cancer, Kaposi's sarcoma, and a variety of infections including Pneumocystis pneumonia among previously healthy young homosexual men. Because of the unusual character of these diseases, which are typically associated with a failure of the immune system, epidemiologists began to search for characteristics that might link these cases. AIDS was first formally described in 1981,...

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 large majority of bladder stones occur in young boys from rural or impoverished areas. In these regions, the disorder is known as endemic bladder stone disease. Information from both historical and experimental sources points to a nutritional deficiency during infancy or possibly in utero as the major factor in endemic bladder stone formation. Other less common causes of bladder stone are schistosomiasis (producing bladder wall thickening, stricture, and outlet obstruction) as well as...

Etiology Epidemiology and Clinical Manifestations

Because the treponemas that cause yaws, nonvenereal syphilis, pinta (an American disease), and syphilis are morphologically and serologically indistinguishable, it is believed that at least the Old World diseases may represent an evolutionary continuum running from south to north. Yaws, thought to be the oldest, spreads by skin-to-skin contact and flourishes in the hot and moist regions of Africa south of the Sahara where individuals have historically worn little clothing. Syphilis, by...

Etiology Epidemiology and Distribution

Human beings, like guinea pigs and monkeys but unlike many other animals, do not synthesize vitamin C. No doubt this reflects a period of evolution in a vitamin C-rich environment and, with the expansion of the species to all parts of the Earth, less generous climates have inevitably taken a toll due to scurvy. The disease occurs where economic, social, or climatic factors prevent access to an appropriate diet, and frequently has appeared under circumstances where diets are circumscribed,...

European Diseases

Perhaps no other region on the globe has ever experienced such a sudden and devastating ecological assault as the islands of the Caribbean with the arrival of the Europeans. Ship after ship arrived to disgorge humans bearing Old World pathogens in their blood, bowels, and hair, and on their breaths and skin. Disease-bearing insects and rodents winged their way and scampered ashore, while cattle, horses, and especially hogs wobbled down gangplanks on stiff legs to begin munching and trampling...

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,...

Family Income and Infant Mortality in Modern Societies

The infant mortality decline in the Western world described in the preceding section represents one of the truly outstanding achievements of the twentieth century. At the same time, however, it is very clear that this decline has not altered the nature of the traditional socioeconomic differential. Rather, the findings of a wide variety of studies have consistently shown that the lower income groups in all societies have been and continue to be extremely disadvantaged in the probability that...

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...

General Starvation

Starvation, a condition in which the body draws on its own internal reserves for energy, arises from normal processes essential to survival. These processes lead to the disease of general starvation, or undernutrition, only after progressing beyond a threshold where damage resulting in functional incompetencies is done to active tissue. If starvation is not acute, that is, not rapidly induced, dysfunctions incompatible with heavy work are not apparent in nonobese people before the loss of 10...

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...

Geography Topography and Climate

The Middle East and North Africa occupy that part of the Earth's crust where three tectonic plates converge, causing great ranges of high-fold mountains to be thrust up, notably in western North Africa and in the northern tier states of Turkey and Iran. Peaks in the high Atlas Mountains of Morocco and the Taurus range in Turkey exceed 12,000 feet, whereas Mount Damavand, in Iran's Elburz mountains, exceeds 18,000 feet. Running north and south, the Hijaz, Asir, and Yemen ranges are high...

Glomerulonephritis Brights Disease

Glomerulonephritis, an immunologic disease of the kidneys, affects the glomerulus. This structure, a cluster of capillaries, is the filter in the functioning unit of the kidney, the nephron. Inflammation, initiated by immune complexes (defined below), injures the glomerulus. Often the disease is acute, but it may be silent and completely undetected until signs and symptoms of chronic kidney failure prompt a biopsy, leading to diagnosis. Alternatively, this silent disease may prove fatal, and...

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...

Historical Interpretations

Clinical Manifestations and Diagnosis The green skin color of chlorosis, from which it may have derived its name, remains, like the origin of syphilis, one of the more fascinating problems in the history of disease. The conundrum appeared when chlorosis was equated with iron deficiency yet greenish skin in Caucasians was rarely observed in the many cases of hypochromic anemia then being diagnosed. Some of these cases undoubtedly related to the conditions just mentioned in which a hypochromic...

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...