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Commentary

This report is surprisingly short for the county it represents–Kings County, the heart of New York so to speak in terms of population size and density and economic, transportation and migration matters. Nevertheless, the report offers us good insight into the philosophy for the time. The major disease to be concerned with is fever, of which several types are noted but with few fully that are differentiated forms into their true name and symptomatic assocations.

About twenty years have passed since this focus on topography became a major part of local New York medicine. Nearly all of these changes were due to yellow fever and its unique fatality, which contrasted with the primary findings for other fatal diseases like the intermittents (malaria) and remittent (mostly typhoid).

The reports generated in the 1830s year by the New York State Medical Society offer some of the best insights into this period of medical geography history. Another twenty years will have to pass before this form of evaluating disease would reach its peak, allowing for its replacement by the new theory for the time–the zymotic theory for disease during the late 1860s and 1870s. The zymotic theory was based mostly on the principals of contagiousness, and placed a different emphasis on the environment and its role in disease development based on proximity, such as closeness to specific land use, climate, weather and topographic features.

The physicians presenting this on February 8, 1832 are New York City doctors John B Zabriskie, Nelson A Garrison, and John C. Fanning. The primary epidemic they report in this paper is an autumnal bilious fever that took place in 1828, possibly the yellow fever based on time of the year and symptoms.

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