Counts of physicians in the state listings of licensed homeopaths, from 1825 to 1862 (1863-1870 data excluded from these graphs).  The upper left figure demonstrates four years that are important to the establishment of this profession.  The upper right depicts the four major contributors to this growth in numbers.  The lower left depicts stacked, cumulative over time counts from 1825 to 1862, and five peaks years defined by this illustration.  The lower right figure depicts cumulative over time counts, by individual states.

Also important to note is the fact that New York had two major peaks in licensure (1852 and 1857),  followed by Pennsylvania, Ohio and Massachusetts, which shared the growth in this profession with New York in 1857.  

From 1840 to 1850, New York had a number of smaller peaks depicting the growth of practitioners.  

The lower left figure depicts a fifth peak in growth that is historically important to the profession, 1836 +/- 1 year, when German speaking schools were opened in Allentown, PA.

The profession grew quite rapidly once the textbooks and related resources were translated into English, by various local physicians residing across the United States.

Due to the Civil War (1861, esp. 1862 on), the growth of this profession slowed briefly.  Following the Civil war, it took off and became one of the most popular non-allopathic professions, with its own schools, hospitals and teaching clinics or institutions established by the end of the 19th century.  The last official homeopathic teaching hospital closed its doors around 1935 (Portland OR).  Many of the older schools and teaching centers remain in use today as they were purchased by their allopathy competitors.  

Due to their popularity, and their management mostly by religious institutions,  homeopathic schools were at times more popular than the allopathic schools.  A typical hospital managed by a religious group had separate wards for allopaths, eclectics and homeopaths.  In 1852-3 in Ohio, the allopathic wards on occasion had to be shut down due to lack of patients when compared with the other facilities (Ref: Lancet, Western Lancet, and Eclectic Medical Journal articles for the time).  

Homeopathy is popular due to its "philosophy" and the lack of true chemical toxicity for its therapeutic agents.  Homeopaths typically utilized less aggressive methods of therapy than allopathy, and sometimes even eclectic medicine and chiropractics.  Homeopathy also avoided the use of "toxic" plants, chemicals and mineral remedies so common to allopathy.  Yet most people conferred, then as now, that this treatment philosophy is best applied to non-acute medical problems or conditions.

This is the first of several studies initiated to track the migration of homeopaths and homeopathy about the United States during its first decades of practice and growth in popularity.

See on Scoop.itGlobal∑os® (GlobalEOS)

Dutchess County Department of Public Health Responds to Isolated Measles Case.  This was also the case, nearly 100 years before . . . 


A review of the measles flow in the Hudson valley in 1917 depicts events that relate to those of today.  In 1917, a measles epidemic struck this county, producing most of its victims in the southernmost urban center of beacon, followed by the culturally unique population in Rhinebeck, N.Y.  What is interesting here is how much the probability for a measles outbreak back then coincide with what is happening today, both for very similar human behavior and cultural reasons, not because of population density reasons.     


When I returned to my local materials on the local epidemics, my initial expectation was that since Poughkeepsie was the primary commercial / industrial city for this region for much of the 19th century, that this epidemic would take a logical migration route into this county focused very much upon urban population density features.  However, I immediately learned that such behavior was not the case back in 1917, when measles struck this county and managed to infect a total of 245 people (26.9 / 10,000, not age adjusted), two thirds of which were all in the city of Beacon (where I reside).     


So why these differences?   


The city of Beacon is the most frequently traveled destination for early 20th C New York City folk searching for a healthy climate and taking advantage of the retreat facilities established for their use within the local Hudson Highlands.  (It was after all the mountain cure, sanitation period, anti-tuberculosis era.)     


But more important, the largest urban setting, Poughkeepsie, did not rank second to Beacon in terms of Measles.  In fact, it had 1/30th the number of cases. (Was this due to great preventon work going on?)   


The second region for the largest number of cases of measles in the county 98 years ago was Rhinebeck, a village at the northern end of the county and just south of the current quarantine case.     


What makes Rhinebeck area stand out as a potential site, today as in back then, is its cultural heritage.   


Just three years ago, a foreign case came into this region by way of international travels, infecting a childcare facility just across the river in New Paltz.  New Paltz and Rhinebeck are both very "post-modern" in their ways of conceptualizing and practicing personal health care.  The variety of mindbody movements have their major followers in this region (the Omega Institute is a couple of miles away).  The New Paltz State University setting is, need I say, very much "progressive" and "post-modern" in how the community its complementary-alternative medical beliefs and faiths.     


Thus population density alone is not the prime indicator for how a disease can impact a region.  Cultural attributes play a very important role in the local disease diffusion process.  In Disneyland California, as in the Hudson Valley, international travel is a primary concern of local public health officials. Disney’s case 0 is suspected to be from Mexico. The 2012 event was due to international travels.  The late 1980s cases of measles in Rhinebeck may also have this unique international feature to its history.  But one thing’s for sure–the combined rural settings around Rhinebeck and the popular CAM and cultural "explorers" residing in this region make it an interesting region to research, especially when it comes to studying the interactions of Darwinian and Neo-Darwinian features with infectious disease behavior and diffusion.

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State Health Department: Measles Vaccination Remains Vital to Protecting Against Highly Contagious Disease ALBANY, N.Y. (September 21, 2012) – In light of confirmation of a measles case in a school…


"Nidus" is a mid 19th century term used by medical geographers used to describe what we today might call potential hot spots for disease.  A nidus is the "nest", where the first cases develop and from there spread to other locations either radially or along specific kinds of routes such as along a waterway, through a valley, by following a particular assemblage of plants and animals.   Medical geographers in the mid-19th century had perfected this way of understanding disease development, to such an extent that they could use such unusual physiographic features as aspect of a hillside and the slope of that location to define where the disease might fester, due to the "animalcules" or microbes that lives there naturally.  (Unlike what common teachings like to profess, bacteria was the first small organism we related to diseases.)


Since the 1980s, there have been at least four outbreaks of measles in the valley, and they share certain common population, travel, and business or economics features.  And they represent a classic example of the hierarchical diffusion process (see my page on this – ;).


Three of the articles and discussions of these four cases have one town or village as a common source for the cases.  The case that emerged just a day or so ago is somewhat to the north, associated with the local railways system returning a student to his/her college setting.  The case from two or three years aback also involved schools in some way and local international travel–in that case it was the school that allowed 50% of its students to not be vaccinate, per their personal belief or faith.   The association of the Rhinebeck-Bard-Tivoli cases with those in New Paltz across the river also shared university-international travel or foreign students features.


The fourth location to the south is where the first recent mention of this problem returned to the local newspapers, down by the Palisade Mall in lower New York.


See also See also:  


Now, it is easy and at times too easy to draw these comparisons between regions and see similarities.  Culture itself for example is not the cause for this part of the valley showing a tendency to be a nidus.  Statistically, I might call it a covariate.  The main factor in this migration of measles into the eastern U.S. is the population health behavior features, and the fact that the Hudson valley has  a unique behavioral feature–programs that bring together many people who demonstrate a strong support of personal beliefs, personal rights to chose, and "alternative forms of medical beliefs or thinking."  


We all have the right to be "different".  If only we knew how our differences influence the right of others to live a secure life, without fear of that terrible Scarlet letter coming close to our kids, elders, or family members engaged in critical quality of life related health care.  In this case, cultural diversity works against the continued survival of these different communities.  There are some rules that must be followed by all cultures, no matter what sacrifice of personal rights may be required.


We map physical and human geography all of the time when we research spatial epidemiology.  Small scale area analyses may be used to define specific natural ecosystems or niduses required for west nile to develop in this region (I posted my example of successfully using this technique in 2002 and 2003, a while back).  We can also use small area analyses to identify niches of unhealthy communities or shared communal settings.


One has to wonder, how much of this type of cultural analysis of disease (if any) is engaged in locally? 


In the past few days, a comparable social behavioral pattern has emerged recently in Minnesota as well (  ).


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Kiera Driscoll, 5, had a slight fever on Sunday morning, but she seemed to be feeling better after taking some children’s ibuprofen, said her father, Patrick Driscoll. “In fact, she was playing outside that afternoon with my wife and even made a comment that it was ‘the most fun time ever,'” Driscoll said. But then Kiera’s slight fever returned and her cough worsened and included phlegm, Driscoll said. She didn’t have asthma but occasionally had a barking cough as a baby, Driscoll said.


There are seven ways debaters can go with this news story.  The writer of this story and editor of its source took direction #7 — the worst approach.  It will be interesting to see how many ways that those with ulterior motives go with this sad story.


My first impression, however, is, based on the ill-conceived, misdirecting title, that this tale is going to add fuel to the fire already out there about vaccinations, namely linked the events linked to the recent measles outbreaks on both the east and west coasts over the past year.


But these measles outbreaks and the issues they relate to are not related to why this girl died.  She died because she caught the flu, but the flu alone did not give her cardiac arrest and take her life.  One could argue that if she had the shot . . . .   (I don’t know really if she did or didn’t.)  One could also argue that even if she did, it doesn’t matter, since the flu shot available this year doesn’t match the strain that is going around this year.


Still these reasons have nothing to do with this her death.


I next read that she was put on ibuprofen, which reminded me of my freshman years in pharmacology and medicine when myself and others felt the aromatic ring added added to salicylic acid was "bad for you", and toxic to the liver, and reduces the purported effect that salicylates have upon EPA, PC and PG pathways it was felt to work with, unlike tylenol.  All of those "truths" about what makes these common OTCs work and so different from each other are now dead and gone.  Guess I didn’t learn only the facts back then after paying my medical school tuition.


Ibuprofen couldn’t cause the mucus plug that blocked her airway passage, nor did the flu.  It was the asthma medicines that caused these mucus plugs.  This is a classical lesson about the use of asthma medicines in emergent care, that all of us have to learn and relearn as clinicians and as patients (or parents of), lest we forget it at the worst of times.


Up until the 70s, you could by the daturine and analogs needed to "treat" asthma.  I say "treat" in quotes because that’s not really what you are doing.  The Acetylcholinesterase Inhibitors [AChE-Inh’s)  like daturine, hyoscyamine, belladonine, scopolamine, atropine, and the like, work by drying air passages, making the mucus thicker, unable to to be expectorated.  This was the primary reason we stopped the distribution of products like Asthmador and the like in the 70s.  


Today’s  complementary-alternative medical [CAM] field has practitioners who still support this very old line of therapy.  So this story brings us in circles–CAM is also strongly linked to the anti-immunization movement that is now happening.  Could CAM be the reason for her death?  Unlikely. (I hope).  


CAM isn’t responsible for this asthma drug related tragic death, nor is the asthma drug probably (unless it’s an overprescribed  100% AchE-Inh against HEDIS/NCQA/FDA/APhA recommendations), nor the flu shot, nor the use of OTC ibuprofen, nor the flu, nor her history of a flu shot. 


But I am providing this background about the probably cause, forensically, due to the Title of this article.  It is misleading, and very much showboating.  


Kiera Driscoll did not die after catching the Flu, or after getting her Vaccine.  She died due to her need for asthma medications, the administration of the wrong type, and the lack of emergent care received on time.  The flu was a co-morbidity, and initiator, but not the cause.  The Vaccine had nothing to do with this event.  Still, due to Pop Culture, the editor and author wish to follow their ulterior-motive/personal ambitions with their title, pointing their fingers in all the wrong directions.  


This is biased reporting, if ever I wished to see a perfect example of such.  That makes it a lesson for the day in public health.

See on Scoop.itEpisurveillance

Review of the history of Vaccination and Inoculation, and the diseases that have been reduced due to the immunization program. An epidemiological transition a…


I have also posted this in video (minus audio) form at :

I produced a lengthy review of this vaccinated diseases topic that has evolved in recent weeks.  I have been watching the anti-immunization movement grow for quite a few years, and decided it was time to publish my rendering of what this movement could do to the history of medicine and how these diseases can impact the lives of kids who don’t get vaccinated.  This version lacks an incidence-prevalence statistics review, but covers the history of inoculation/vaccination in detail, going back to the 1770s.  A few recent postings show the graphs I was developing for this, with the results of my temporal analysis of the immunization programs and immunizable diseases.  I avoided several “hot topics” for now, but will re-review them and add them in at a later time.  The major point here is to provide a detailed visual presentation of what the diseases look like within the clinical setting.   People seem pretty much decided upon this matter for the time being.  So I may be preaching to the choir with this posting.

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Melinda Gates:  “Americans have “forgotten what measles deaths look like.”


Melinda Gates was very much right about how much too many of us have forgotten.  This set of pictures I have on display here say it all.  As pop culture historians interested only in today, as we personally see it, we remember the least, but retell the past as if we were “experts”.




Ahh, the mistakes we make!!!!

See on Scoop.itEpisurveillance

The disease maps in the 1890 Census provide us with some of the best insights into American medical history just after the bacteria was discovered.  Disease mapping was about to experience a major change in significance, as scientists began to focus on the microbe, something you did not easily map.  We started to focus a lot on population health, due to the development of the sanitary theories for disease popular from the 1870s onward.  This is from a page I posted on the 1890 Census Disease maps, a part of which is focused on the health of Appalachia, where some of the poorest parts of the United States still exist today. 

These maps can actually tell us a lot, if we take a moment and think about the US population during this time.  


Westward Expansion was well underway.  


One direction the US population flowed was directly westward, across the northern edge of Appalachia, through western NY into Ohio and from there over the Illinois and then south the Missouri.  We can see the impacts of these populations on diseases or conditions related to population density and increased likelihood for survival. for example the map of "Old Age."


The US population also continued to follow the eastern ocean shores, forming many large cities, but still decades way from establishing a megalopolis.  Heart disease hugs the short of part of the Atlantic for this reason.  The were some of the most developed parts of the US at the time as well, and demonstrated the impacts of less poverty than the rural mountain regions heading through the Appalachians.  Does this mean the northern New England region and Southern Diets weren’t at all good for the heart?


Consumption is a western slope disease.  Originally noted to be most prevalent in the NY-New England sector, it managed to head deep into the interior but seemed to like a specific environmental setting.  There are two unique strips of this disease, one along the mid-Atlantic oceanic-bays states regions, the other on the western edge of mountain, eastern end of the Great Plains.


Scarlet Fever is very much a population-bound disease, following the migration roads, shipping routes and adjacent railways laid through central Pennsylvania along the Ohio River, staying at the south edge of Ohio, Indiana and then heading back north towards Chicago and the Great Lakes.


Croup wasn’t picky about what side of the mountains it was on.  It was just searching for susceptible kids.  


Diphtheria for some reason has a more northern tendency.  Part of it traverses Pennsylvania, another part follows what seems to be a latitudinally define path, heading north of the mid-latitude line of Ohio, then over the Northern Michigan and Northern Chicago into Wisconsin.  


Childbirth is a product of populations and people.  The Southern coastal state rates were higher than the northern  There are also two very distinct sections of the southern Atlantic states with higher numbers.  For obvious reasons, more people are seen living along the coastal regions, so more babies are born there as well.  Higher birthrates are on the eastern shore of the Mississippi River in Illinois, not the more rural western shore with larger farms in farmland communities.  The shores of the Great Lakes bear more children (shipping towns).  From New England to Ohio and lower Illinois, birth rates remain lower than the same longitude down south, along the Gulf of Mexico.


Finally, stillborns were a happening that occurred nearly everywhere.  This ubiquitous nature of stillborns in the late 1800s is very different from what I expected for midwest farming communities, the medical school books of which are filled with cases and chapters on teratopathy and birth defects.  

See on Scoop.itMedical GIS Guide


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