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...

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...

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...

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...

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...

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

Cirrhosis is classified on the basis of morphology and etiology. The morphological classification recognizes three types based on the size of the nodules 1. Macronodular cirrhosis. The liver is firm, large or small in size, with bulging irregular nodules greater than 3 millimeters in diameter. 2. Micronodular cirrhosis. The liver is usually enlarged, and very firm or hard in consistency. The nodules on cut sections appear small and uniform, less than 3 millimeters wide. 3. Mixed micro...

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...

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...

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...

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...

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 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 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 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

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...

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...

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 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

Although syphilis is transferred predominantly by sexual contact, it may also be transmitted in nonsexual ways, such as by close contact with either an open lesion of early syphilis or infected fomites, by Table VIII. 134.1. Etiology, epidemiology, and clinical manifestations of the human treponematoses Table VIII. 134.1. Etiology, epidemiology, and clinical manifestations of the human treponematoses Western Pacific, South America, Caribbean mouth-to-mouth or via drinking, eating utensils sions...

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

Numerous studies have firmly established the primary etiologic agent in periodontal disease as plaque. Plaque is a colorless, soft, sticky film of bacteria that constantly forms on the teeth. Plaque is composed primarily of different and numerous types of microorganisms as well as adherent mucin (a protein and polysaccharide combination), foodstuffs, and cellular debris. One gram of dental plaque contains more than 1011 bacteria. Plaque can calcify to form a local tissue irritant - calculus...

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,...

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...

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 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 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 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 serologic diagnosis of acute, as opposed to chronic, Q fever was considerably helped by the discovery of phase variation in the organism. Coxiellae isolated directly from animals or ticks are in phase 1 in this phase, specific antibodies are induced that are detectable by complement fixation and other serologic tests. When coxiellae are passed serially through chick embryo yolk sacs, phase 2 organisms become predominant. Passage of phase 2 organisms through animals causes the predominant...

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...

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...

Miscellaneous Diseases

In Korea, as in China and Japan, there is no clear historical description of a disease corresponding to diphtheria until the modern age, perhaps because diphtheria is not strongly associated with dramatic epidemics of high mortality. Indeed, mild cases are not unusual, and immunity is often quietly acquired at an early age. Avison (1897) thought it very strange that diphtheria was so rare in Korea. He had seen a few cases that he was certain were diphtheria, but some physicians claimed that the...

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...

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

There have been three major plague pandemics in recorded history the plague of Justinian in the mid-sixth century, the Black Death in the mid-fourteenth century, and the Bombay plague in the late nineteenth century. Apart from the high mortality rates and the social dislocation caused by these pandemics, each initiated a long series of plague epidemics with significant cumulative effects. Before the Arab conquests in the seventh century, plague had recurred cyclically in the Near East following...

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...

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...

Prehistoric Incidence of Disease

Hoyme (1969) I t is easy enough to explain why few diseases entered the New World with man it is far harder to explain the origin of those diseases that man acquired in the New World before the coming of Columbus. The entry of humans into the Nearctic realm through the land bridge of the Bering Straits area up to 35,000 years ago (Yi and Clark 1985) has been assumed to have been sporadic, small scale, and across a harsh environment. More recently, the founding groups have...

Premedical Health Care

A concern with illness has been documented in China for three millennia the earliest written evidence extant today on the theoretical and practical consequences of this concern dates from approximately the eleventh century B.C. At that time, and for centuries to come, it was assumed that the well-being of the living - be it related to success on the battlefield, to an abundant harvest, or to physical health - depended to a considerable extent on their interactions with the nonliving members 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...

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...

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...

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 Present and the Past

Cockburn claimed that tuberculosis had not displaced malaria as the world's number one problem in infectious disease, but like malaria, it has become rare and under control in Nearctica. Like other so-called developed areas, North America has undergone both demographic and epidemiological transitions (Omran 1977) from high birth and death rates to low birth and death rates, and from the predominance of infectious diseases in causing death, to a preeminence of degenerative...

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...

Treatment

The remedies for leukemia in the nineteenth century were few, and none was useful in controlling the disease for any length of time. In the first 50 years following its recognition (Bennett 1845), leukemia was generally accepted as a chronic disease, and the limited therapeutics in the armory of the general physician were applied. Quinine was used for combating fever morphine and opium, for diarrhea iron, for anemia iodine, for external use as an antibacterial and arsenic. In 1786, Thomas...

88 Measles

Measles (rubeola hard measles red measles 9-day measles morbilli) is a common, acute, viral infectious disease, principally of children, with worldwide distribution, that is clinically characterized by fever and a typical red, blotchy rash combined with cough, coryza, or conjunctivitis. It is a vaccine-preventable disease, and its vaccine is one of the vaccines included in the Expanded Programme on Immunization (EPI) of the World Health Organization (WHO). The disease is known by many local...

Vni73 Influenza

Influenza, also known as flu, grip, and grippe, is a disease of humans, pigs, horses, and several other mammals, as well as of a number of species of domesticated and wild birds. Among humans it is a very contagious respiratory disease characterized by sudden onset and symptoms of sore throat, cough, often a runny nose, and (belying the apparent restriction of the infection to the respiratory tract) fever, chills, headache, weakness, generalized pain in muscles and joints, and prostration. It...

Prevention and Treatment

In many other parts of the world, both rich (Scriba et al. 1985) and poor (Prevention 1986), goiter remains endemic (World Health Organization 1960 Stan-bury and Hetzel 1980) with its attendant disfigurement, cretinism, and hypothyroidism. It is worth noting that persons in an endemic area could have any of the diseases that cause sporadic goiter, which is one reason why goiter prevalence never falls to zero even with iodine repletion. For some areas this endemia is a major public health...