1809, Medical Climatology

Weather and Disease

Ricketson’s interests in Air and Climate as these relate to health and disease are the reason why this topic formed the first chapter of his book following its introduction. This may in part have been due to his attempts to mimic some of Cheyne’s representation of the same topics in his own book An Essay on Health and Long Life, but is equally important to interpret as suggesting this was the most popular theory for most of the diseases for much ofthe time during the 18th and early 19th centuries. The three major reasons why Air and Weather could be related to disease onset focused on: the impacts of temperature and humidity on the body and state of activity, the influences of lightning on the body and in theory mind, the influences of overall average temperature climate patterns on one’s tendency to become disease-ridden and for community settings to become endemic or epidemic in nature for particular disease types. All other physiographic, topographic, geologic, pedologic and other environmental features were influenced directly by climate and weather. One could reason that although a soil is potentially problematic, it does not become problematic until the water dispersed by local weather and climate cause it to become dissolved and infect the local drinking water, or if you were one who believed in the miasma theory and had a knowledge of basic soil and geological chemistry, felt that water was the reason the soil gets filled and water and thereby frees or emanates its preserved gases within, or how and why a particular rock typesuch as limestone is force to release its carbion dioxide into the air, a gas injurious to the body and its need for oxygen. As for the local topography, it is the major features of topography, the mountains, valleys, ravines, river beds, valleys, etc. that guide and direct weather through most terrains, and it is the way these land surfaces cause their plants to grow, their animalsto migrate, their rainfall patterns to fall and them help to form the local lakes and swamps, that are responsible again for directing the unhealth air and weather patterns. To Ricketson, everything in nature could control and manipulate the dispersal of air and weather that was either good or bad for us, as so succinctly stated in the following paragraph taken from his book:

Dr. Ricketson was probably familiar with the notion that the world in general could be viewed as have three major climatic regions: frigid, temperate and tropical. It was already common knowledge within the medical profession that a “torrid” zone existed where many diseases lie. The torrid zone in in the tropics, that part of the world which is fairly humid and hot for much of the time, and where numerous forms of fever and various forms of plague and pestilenced erupted whereever the people who resided there were not already acclimated to this part of the globe. One common notion about disease at this time therefore pertained to this entire acclimation issue. It was often felt that individuals unable to acclimate to living in a new place with a new climate had some sort of “temperament” or predisposition that made them susceptible to catching diseases in in such areas that they resided. Quite often, the best evidence for this problem at an individual’s level seem to be the eruption of disease within or on their bodies soon after moving to a new region for a permanent stay. For example, if a person moving into a region had a susceptibility to a particular disease and moved in to a place where the disease was known to exist, wtih local carriers moving about, then that new resident would carry the same malady if he/she had the right temperament and acclimation problems. In this way it was felt that acclimation could be the cause for various skin abnormalities, discolorations, sensitizations, burnings, ulcerations, exudations, and sloughing off that took place for some removing to a tropical setting. An individual moving into an area where highly infectious diseases like measles and small pox occasionally recurred did not catch this form of scabbing with fever if he/she was already acclimated to it. Those never exposed to such climate before, as well as its form of fever, were most suceptible.

This same ideology was true for the colder parts of the world as well, such as the New England and New York areas, and in particular, the Hudson Valley according to Ricketson’s observations. For this reason, Shadrach Ricketson became a medical climatologist and studies and documented the local temperature states in relation to local disease patterns. His contributions to the local medical profession with regard to this special insterst of his was his recording and reporting of temperatures of the Valley area where he resided to the Medical Repository. These reports were not published at all on a regular basis, and may have not even been reported to Samuel Mitchell on a regular basis by Ricketson, except for the review of temperatures recorded in 1808, and published in 1809. But like many physicians, it seems likely that Ricketson could have reviewed these temperatures on a daily basis on his own, keeping mental or journal records on these observations until some sort of medical climatologic sense could be made of such observations in relation to the local disease patterns. A brief report of Ricketson’s observations was published in the Medical Repository; it is as follows:

Ricketson associaed the following diseases with his observations of weather:

Typhoid Icteroides
Scarlatina, with sore throat
Coughs
Colds
Rheumatism
Influenza, or influenza-like maladies
Remitting Fever
Typhus Fever
Chicken Pox
Mumps
Chin Cough

The identification of some of these diseases assocaited with the seasons, time of the year and related weather patterns are obvious. As for the “Chin-Cough”, Robert Thomas’s timely book. The Modern Practice of Physic . . . and . . . the Diseases of All Climates . . . with an Appendix added by Edward Miller, MD of New York (1813, Collins & Co., New York), identifed Whooping Cough or Pertussis as bearing this specific name locally. The same book identifies “Typhoid Icterodes” as “Yellow Fever.” Intermittent and Remittent fevers are those associated with malaria, typically treatable with the Peruvian bark then sold by pharmacies (quinine had yet to be isolated and discovered).

If we review this summary at a seasonal level, we find these diseases are more easy to understand as important local issues. Some of these are endemic to the region, others epidemic or introduced in some way, shape or form. Some of these diseases are predominant during the hottest months of the year in the late summer and early autumn. Some are totally non-seasonal in nature. This particular reported was provided around the end of the year in 1808, and so represents autumnal and winter diseases. This means that the air is getting chilly, and as Ricketson suggests, “a change which ought to advertise all to put on flannel next [to] the skin.” The seasonal diseases for this time are primarily “coughs, colds, rheumatisms, &c.”, “Remitting and Typhus Fevers”, a single case of Intermittent Fever, “a few cases that resembled influenza,” “Chicken Pox, Mumps, and Chin Cough” (whooping cough), and “several deaths by the Small Pox . . . weekly recorded.” In terms of disease ecology, seasonality, and weather, Ricketson’s listing provides us mostly with diseases related to vector (mosquito) transmissions such as the varioius forms of malarias (intermittent and remittent fevers) and yellow fevers.

The possible mention of typhus (‘typhus fever”) is a close-quarters population phenomenon spread by rodents and small mammalian vermin in the city setting. The coughs and colds are, back then, as they are today. The rheumatism could be of rheumatic fever origin. Robert Thomas defines it of two forms–acute and chronic–with the acute form resulting in significant body temperature changes and the chronic resulting in barely and fever or inflammation. The rheumatism in much less likely to strike children than adults. These features as defined by Thomas (published just two years alter) suggest that this is the traditional rheumatism of contemporary times, with prolonged or chronical complications including arthritis and heart valve damage.

Chicken Pox and measles are the typical highly contagious diseases spread eaasily and rapidly within closed quarters, a typical daylong want and need during this time of the year, whether at work or at home. Ricketson notes the ongoing, subacute generation of recurrent cases of measls on a weekly basis within the local urban setting, more endemic in nature that epidemic, a sign of the state of inocculation or vaccination for these diseases at the present time. Two other closed-quarters diseases, also most prevalent in children, namely mumps and “chin cough” or whooping cough, were in Ricketson’s mind (as well as Benjamin Rush, the physician of Philadelphia popularizing this point of view throughout the years prior to this time), distal in nature, perhaps due to some very well localized form of contagion, one that could be modified by changes in local climate patterns each year around this time.

Perhaps the most important detail to note here is Ricketson’s use of the term “Indian Summer”, a term he and another colleague invented and commonly made use of within such presentations. A number of similar reports appear in the Medical Repository about this time, but Dr. Ricketson’s name is not linked to them and so it is hard to determine whether they were produced by him or another medical professional in charge of documenting these important medical climatology epdeimiological observations.

These records were kept and reported by Dr. Ricketson during the time that he lived in New York City. During this time he was in regular communication with the medical school and related journal staff. It is therefore important to note that Ricketson was in regular and perhaps fairly constant communication with his associates also interested in medical climatology, with much of these being a result of his published book. This means that his familiarity with other parts of New York may in fact also be to his advantage, such as when it came to engaging in any ongoing communications with the peers of his profession.

Irrefutable evidence supports the notion that his professional lifestyle appears to be focused on preventive medicine and epidemiology. His epidemiological work was already well demonstrated by the study he performed and its resulting article published by the Medical Repository about the recurring problem of influenza epidemics within the state and countryside located fairly close to the edge of the temperate and frigid zone regions of North America where he was residing at the time (Dutchess County, New York). Ricketson performed a fairly impressive epidemiological study of Influenza with the goal of determining its seasonality and predictable meteorological or climatic causes. He also had more than just a partial familiarity with the inoculation-vaccination studies and work underway within the medical field. As part of his own services to the community, he engaged in similar work as well, helping to improve upon the preventive measures already taken within the city environment by many of the local physicians. Ricketson notes this as well in his three month report near its end, when he writes:

Dr. Ricketson’s climate and medicine work was published in one other medical journal — the American Register out of Philadelphia. He published the following two articles in Vol. 6 of this magazine for 1809. One was for the diseases and health of New York City in the Summer, and the other for the Fall. These are as follows: