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...

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 and Pathology

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

Clinical Manifestations 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...

History and Geography

Paget's disease is not a new disease, having been suspected in a Neanderthal skull. Although isolated case reports in the mid-nineteenth century describe what is now called Paget's disease, the classical clinical description by Paget and a pathological description by Henry Butlin clarified this entity in 1876. Paget was a major figure in the medical community, having been knighted at the age of 43, at which time he began his observations of the first patient with the bone disease that would...

Miscellaneous

The Chinese character for epilepsy used in the Korean texts implies both seizure with loss of consciousness and insanity. The Tongui pogam discusses a similar condition known as God disease, which is probably equivalent to epilepsy. Both the Hyangyak chipsong pang and Tongui pogam discussed tetanus in connection with strokes. However, since the Koryo era, physicians had been well aware of the relationship between tetanus and wounds. The medical texts discussed ordinary dog bites, mad-dog bites,...

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...

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

Rubens and the question of the antiquity of rheumatoid arthritis. Journal of the American Medical Association 245 483-6. Badui, E., et al. 1987. El coraz n y la artritis reumatoide. Estudio prospective de 100 casos. Archivos del Institute de Cardiologia de Mexico 57 159-67. Buchanan, W. W., and R. M. Murdoch. 1979. Hypothesis That rheumatoid arthritis will disappear. Journal of Rheumatology 6 324 9. Caughey, D. E. 1974. The arthritis of Constantine IX. Annals of the...

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...

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 and Diagnosis

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

Classification Clinical Manifestations and Pathology

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

Clinical 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

The patient with clinically significant emphysema is typically an older male smoker who gives a history of breathing difficulties that increase in severity over time. On physical examination, he is usually thin, with a thoracic configuration (barrel chested) suggesting hyperinflation, and has markedly diminished breath sounds when listened to on ausculation. Airflow obstruction can be demonstrated by slowing of forced expiration. The chest radiograph confirms hyperinflation with a relatively...

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 Diagnosis Treatment and Control

As is often true for helminthic infections, low worm loads may cause few or no symptoms. Large numbers of larvae in the lungs may produce ascaris pneumonitis, with symptoms resembling pneumonia. Allergic reactions can cause asthma attacks. Larvae can reach atypical (ectopic) sites such as the brain, eye, or kidney, where they may produce grave, life-threatening conditions, but such events are fortunately rare. Adult worms in the intestine can cause fever,...

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,...

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...

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 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 in Antiquity

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

Diseases in the Pre Roman World

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

Diseases of Sub Saharan Africa since 1860

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

Diseases of Sub Saharan Africa to 1860

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

Diseases of the Americas 14921700

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

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...

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...

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

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 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,...

Etiology

Although epilepsy can begin at any age, the majority of patients have their first seizure before the age of 20. In fact, the age of onset is often related to the cause. Perinatal injuries, severe hypoxia, developmental brain defects, and genetic metabolic defects are common causes of epilepsy among infants and the newborn. Brain infections such as meningitis and encephalitis often result in damage to some brain cells with subsequent development of epilepsy. Many children experience seizures...

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 Health Conditions in South Asia

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

Genetics

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

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...

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 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

Human schistosome worms were first described from Egypt by Theodor Bilharz in 1851, and their presence was related to disease symptoms by Wil-helm Griesinger shortly thereafter. Both men naturally assumed the worm to be a single species, Distoma haematobium (later named S. haematobium), occurring in the blood vessels of the gut or bladder. That there were two Egyptian species with different egg types was first suggested by Louis Sambon in 1907, who named the second species S. mansoni. A year...

Cl Ii Ii Ii Ii Ii Ii

Top G-banded chromosome spread of a man with Down syndrome (47, XY, +21). The individual chromosome numbers are designated by convention. Bottom ideogram of human chromosome 21 indicating the subregional localization of several genes of interest (see text). (From J. A. Fraser-Roberts and Marcus E. Pembrey 1978, with permission.) Figure III. 1.4. Top G-banded chromosome spread of a man with Down syndrome (47, XY, +21). The individual chromosome numbers are designated by...

Immunology

Infants usually have a passive immunity to rubella because of maternal antibodies acquired transplacental from immune mothers. This passive immunity protects the infant from infection for 6 to 9 months, depending on the amount of maternal antibody acquired. Rubella infection in both clinically apparent and inapparent cases induces a lifelong immunity. Because a significant percentage of rubella infections are clinically inapparent, persons may develop im munity without recognizing that they...

Imported Diseases

The European explorers and missionaries who first contacted the indigenes brought with them diseases common in their own homelands or in the ports they had been visiting. However, in the small isolated communities common throughout this region, most diseases could not be maintained indefinitely and needed to be reintroduced through outside contact after a new pool of susceptibles had developed. Such reintroductions were accomplished by interisland voyaging, trade among different tribal groups,...

Indexes Overlap and Illustrative Materials

By means of two detailed indexes we have attempted to make the information in this work as useful, and accessible, as possible. The larger, general index provides many cross-references and historical synonyms for diseases. The second index lists proper names and supplies the dates and a brief biographical sketch of all historical figures in medicine mentioned by more than one author. Thus, it is possible to consult an entry on, say, the perception of disease in Asia during the eighth century...

Indigenous Disease Agents of North America

Within this varied habitat a myriad of organisms lived and died with the usual range of interrelation ships ecologists have led us to expect. Birds and mammals must have had their parasites, and, it is assumed, sylvan cycles of infection and death took place. To identify these in the lack of any, as yet, human presence is difficult, but insofar as today's known zoonoses cycles in North America have been elucidated, some endemic conditions can be postulated. These would include the bacteria...

Info

The era from 1050 to 1260 marks a time of declining importance of disease in Japan. There were 50 epidemics over 210 years, an average of one outbreak every 4.2 years, compared to one epidemic every 2.9 years in the 700s and one every 3.8 years in the poorly documented 900s (cf. Hattori 1955, 1964 Fujikawa 1969). The killers of the former age retreated into endemicity. As always, the record is most complete for smallpox. Epidemics broke out in 1072, 1085, 1093-4, 1113, 1126, 1143, 1161, 1175,...

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...

Liver Disease

The Hyangyak chipsong pang lists 25 forms of jaundice, but these conditions were not linked to problems of the liver and gallbladder. By contrast, the Tongui pogam reduced all the subdivisions simply to jaundice. Its cause was explained in terms of damp fever, in which the blood evaporates and becomes hot and dark in color. This dark color first appears in the eyes and face, but as it spreads, the whole body becomes yellow. Causes of jaundice included alcohol poisoning, lack of appetite,...

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...

Middle Ages

After the twelfth century, medieval medical knowledge in the Occident ceased to be based solely on a number of scattered Greek and Latin manuscripts carefully collected and preserved for centuries in monasteries and schools. A rapidly growing number of classical medical texts, including the Canon of Avicenna and clinical treatises of Rhazes, were translated from Arabic to Latin. Nonetheless, the theory of four humors and qualities remained the basis for explaining health and disease. It was...

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...

Models of Genetic Transmission

In recent years, medical geneticists have been supplied with a battery of sophisticated analytic tools to be used in conjunction with advanced laboratory techniques for determining the transmission of various traits. These analytic methods have been derived from what is now called the multifactorial (or mixed) model (see Morton 1982). According to this model the observed variation in a trait, such as the clinical presentation of a genetic disease or the liability to develop a complex disorder...

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...

Old World Diseases

Which of the new diseases brought to the New World by the Europeans first touched South America is unknown, but the best documented disease in terms of its progression is smallpox. In 1514 smallpox may have arrived in Panam with a group of Spanish colonists (Hopkins 1983). Because of frequent trade and communication between the isthmus and Peru, smallpox preceded the Spanish into the Inca Empire. A devastating illness of the mid-1520s, characterized by fever, rash, and high mortality, struck...

Other Diseases

Bubonic plague and epidemic typhus, the two most important vector-borne diseases in early modern Europe, seem not to have afflicted early modern Japan. Rather plague was first reported in Japan at the end of the nineteenth century and believed to have arrived on ships from China that carried plague-infested rats. Typhus probably arrived somewhat earlier, but typhus and typhoid were confused in Japan as they were in Europe, so it is difficult to determine which disease is being referred to in...

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...

Pagets Disease of Bone

Paget's disease of bone was described as osteitis deformans, a chronic inflammation of bone by Sir James Paget in an address to the Royal Medical Chirurgical Society of London in 1876. His original description was masterful and thus has withstood the test of time. Paget's disease of bone describes an abnormal osseous (bony) structure whereby isolated and sometimes contiguous areas of the skeleton undergo changes leading to clinical deformity for some of those affected. Clinically affected...

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...

Pathology and Diagnosis

Very few specimens were obtained for histological study. In three adequately preserved liver specimens available, fatty changes and necrosis of hepatocytes and Kupffer cells were noted, necrosis being of the focal type, distributed throughout the liver lobules. Intact cells with hyalinized cytoplasm and ghostlike nuclei (Councilman bodies of yellow fever fame) were seen, as were large amounts of karyorrhectic debris. Inflammatory changes were minimal in the liver and other organs. Comparisons...

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

Beginning with the wave now called the Black Death, plague appeared in Europe at least once every generation between 1350 and 1720. During the late fourteenth century, smaller communities may have been disproportionately affected, for depopulation and deserted villages were uniform phenomena throughout Europe. Indeed, smaller centers may not have remained economically or demographically viable settlements after an episode of plague, leading to the reaggregation of people in villages, towns, and...

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

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

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...

Recent Changes

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

Relapsing Fever

Relapsing fever is a disease characterized by the occurrence of one or more relapses after the primary febrile paroxysm has subsided. Various types of relapsing fever are caused by blood parasites of the Borrelia group. There are two chief forms of the disease the endemic, transmitted to humans by various ticks of the genus Ornithodoros, and maintained among a variety of rodents and the epidemic, caused by a parasitic spirochete, Borrelia recurrentis, which is transmitted by human head and body...