Robert William Felkin – 1889 – Tropical Diseases

The mapping of tropical disease patterns by geographers like Felkin represents the first successful attempt to use what has recently been discovered about bacterial theory in association with medical geography and population density to better understand the patterns of disease. Felkin’s maps can be interpreted as the hybridization of both the old and new traditions. Much of the 19th century mapping had as much subjectivity to the map as it had objectivity when it came to interpreting where diseases “resided”. So, some of Felkin’s maps present us with examples of this regionalization of disease that took place in early geographers’ minds as they tried to relate their nineteenth century thinking to the new findings at hand. Some of Felkin’s maps lack the emphasis on region as a cause for disease, and are beginning to steer away from the traditional latitude theory for disease prevailing in the medical geography profession. He retains and applies these older diffusion patterns whenever a new explanation cannot be found for the disease at hand. In essence, the bacteria would be discovered just two years after this book was produced, but physician already knew that there was a “germ” out there that could be used to explain certain disease patterns. The fact that disease causes were discovered from the largest organism down in size, like the African tapeworm and other tapeworms, followed by the ringworm, the housefly, the flea, the livestock borne animalcule responsible for enzootic and epizootic diseases, the abnormal blood cell, the vibrio, the fluke, meant that the last causes to be uncovered in the lab would ultimately be the chemicals underlying the causes for diseases like beri beri and scurvy, the venom of certain animals, the hormones responsible for short stature and large bony structures, the smallest pieces of nature such as the virus and the oblivious “toxin” or “poison”. Those that we could see, would be mapped; those that were invisible to the eye for the time being, bore maps that resembled more the “miasma” of past generations.

The evolution of the zymotic theory of diseases underwent several intersting transgressions during the middle of the second half of the 19th century, its peak era in terms of popularity. Prior to the zymotic theory being popular, geographic theoy was used to explain ho9w and why many diseases developed, and the reasons people often focused upon our reactions to the environment. Meanwhile, an entire sanitation mvoement was developing, with “germs” in general along with “animacules”, the theoretical “virus” and poisons used to give the reason for disease. Throughout the first decades of the nineteenth century, physicians worked hard to understand weather and climate and disease, alongside topography and soil. The natural causes for diseases were common, and the ways to treat disease often based on protecting ourselves from these natural elements due to our inability to fully adapt to their stresses.

The zymosis theory began as an offshoot of one of the many geographic theories for disease already defined based on the natural forms of our environment. Very quickly the zyme component of this theory became a name given to other causes for disease, which by 1850 were being linked directly to people, their living and work settings and population size, density and types in terms of sanitary practices and poverty. During the 1860s, the zymotic theory redirected the focus of disease etiology to the individual and his/her life style and experiences. By 1870, this notion was about to reach its peak in acceptance and popularity as various microscopic causes for disease were being unveiled in potable water sources and regions adjacent to heavily populated, low income suburban settings (namely the Thames River of London).

By 1875, the geography of disease theories were undergoing some major changes in philosophy and presentation. Regional diseases were about to be eliminated from the world disease maps, in exchange for very detailed and more accurate maps depicting regions based upon actual events and more detailed environmental reviews of these claims. This enables the very generic regions depicted early on in the maps to be replaced with accurate narrow bands, small polygon maps depicting the distributions of diseases now better understood as part of the zymotic disease theory. Those diseases still misunderstood but considered zymotic in nature were mapped as well, but notice these maps retain some of the generalized regionalism concepts promoted decades earlier, into which anthropological and cultural statements may often be found hidden. Examples of these incldue the notion that African Tropical races bear a better physique than caucasians when it came to adapting to tropical disease patterns, and African Americans lived and performed better as residents and workers in the states south of Virginia (the initiating theme for the White supremacy movement which grew so rapidly in the 1870s).

Finally, physicians were trained in epidemiology and understood population statistics better when it came to assigning reasons for the the geographical differences noted between endemic and epidemic disease patterns. Diseases like yellow fever, for example, were no longer blamed on slave trade migrations and human adaptation processes in Felkin’s work. They are instead assigned causes related to latitude, climate, travel and the places in the world where people succumb to this recurring problem. The Asiatic Cholera finally has four regions defined–endemic, epidemic, not yet infected and unknown. Also notice how the once highly common small pox epidemic regions found on the earlier disease maps are absent from Felkin’s work. This is because the human population, ecological cause for this disease pattern has become better understood throught the advancements made in vaccinations, the most important outcome of the development of the zymotic disease theory (vaccination, not immunization, which is more a mid-20th century term, and detailed ahead).

The more physical geographic nature of parts of Felkin’s map represent some of the first steps required for developing an understanding of disease ecology. Such a study requires the cartographer have knowledge about the final piece of the medical geography puzzle–the biological and ecological requirements of the microorganisms responsible for diseases caused by such agents, versus the non-biological requirements for diseases of a purely physical or toxic nature.

Until the microorganism and its ecological or living habits were better understood, medical geography remained a study more of topography, climate, rainfall patterns, temperature, humidity, hydrology, soil, aspect, and practically every other measureable feature in nature that was being monitored through the 19th century. Some of the most unique maps of disease behaviors and patterns, depicted the results of whatever causes, events, substances and other things were considered responsible for their diffusion behavior. One major remnant of this very successful imagination beheld by medical geographers during the last quarter of the nineteenth century was the pandemic isolines illustrated by Felkin alonside the more traditional and scientifically accurate depictions of the latitude-based wind patterns on the earth, the general isotherms that form across the earth’s surface, and the precipitation map found in his book on tropical diseases.

Perhaps one of the most interesting examples of Felkin’s hybridized ecological-physiographic theory for disease illustrated by his maps is found on the scurvy map. This map depicts an extensive region rich in scurvy that is very well delineated and is distributed along the shores of Russia, following those landforms (ocean shores) and obviously implying links to physiographic and human transportation spatial features. Scurvy happens due to the nature of shipping and exploration, and the poor nutrition suffered by sailors regardless of where they are. Yet the map shows us that scurvy is very unlikely in the tropics due to James Lind’s work, and mostly becomes an endemic disease whenever the passengers or crew of a vessel pass across large areas of the ocean between continents, mostly across temperate and arctic zones.

Felkin associates these places to disease, not the behavioral differences induced as the unhealthy travel behaviors engaged in within these parts of the world. As people become ill, and find land, they cannot obtain the food stores required to prevent the disease. Not knowing the true cause, writers like Filkin make their very subjective supposition (assumption) and define the place as the cause, not any human behavior or physiological mechanism. These maps define the place where this ailment is experienced based on a logic very similar to that of the theoretical phlogiston so common the decades before–the disease exists, and must have a theoretical cause–“phlogiston” or its substitute “zymosis”. (Before Priestley discovered oxygen, the counter to this elemental discovery, phlogiston, was the cause for disease; it would later be equated with carbon dioxide, but many doctors used the term phlogiston to refer to theoretical pathogens, not true agents responsible for disease by their presence, or lack thereof.)

Just a few years before, ca. 1884-6, Robert Koch became the first to be able to prove that bacteria cause disease. It was still much too early for physicians like Felkin to immediately “change boats” so to speak and believe there to be another cause for cholera that had nothing to directly do with the sea.

In spite of the flawed theory Felkin proposed, the spatial assocaitions required for prove of this theory existed. Throughout the eighteenth and early nineteenth century, nature’s cures for scurvy were the plants available as food and medicine for these early explorers. (My recent page–the most recent header page posted–on Homann details this for 1720 onward.). Those regions that bore this disease often lacked these cures. For this reason, Felkin’s non-specific miasma or cloud-like representation of mid-oceanic portions of his map susceptible to scurvy spread completely across the southern hemisphere, and differ greatly in appearance and form from the very specific scurvy-prone regions in Russia. Thus cases at sea are inferred to be a result of a miasm-like cause for scurvy, whereas closer to land, a very discrete physiographic shoreline defined cause was felt to exist. (Incidentally, scurvy is also the least tropical of diseases in this work by Felkin, one that by title focuses on tropical diseases.). A recurrence of this mid-ocean influence on the cause is seen close to Iceland, where this diffuse miasm-like presentation is repeated for beri-beri, with a distribution at sea between Australia, the Philippines, China and Japan.

(NOTES: THE SOURCE FOR THE FOLLOWING IMAGES IN THE VERY RELIABLE OPEN LIBRARY COLLECTION, WHICH TENDS TO INCLUDE THE ENTIRE PAGE OF A DOCUMENT IN SPITE OF ITS FOLDING OR LARGE SIZE. Different versions of This book can be accessed at archives.org (for full figures and true color) and google books (for easy access/cutting and pasting, and downloading text in various forms). For more on the text in this book and an earlier rendering of my analysis of it, see the related page 1889 – Robert William Felkin – “On the Geographical Distribution of some Tropical Diseases”)

NOTE: Certain “cuttings” of the map repeat for up close comparisons; these are done for the Americas, North America, the USA, with some maps also cut displaying just the Tropical Belt, Central America, South America, Asia-India, Africa, Australia-South Asia, and Australia-New Zealand.

MALARIA

DENGUE

ASIATIC CHOLERA

ORIENTAL BOIL, ENDEMIC HEMATURIA & YELLOW FEVER

Oriental Boil (pinkish), Endemic Hematuria (very dark splotches)

BERI BERI & ORIENTAL PLAGUE

Oriental Plague – by Latitude

Oriental Plague – small regions as foci

TROPICAL DYSENTERY

LEPROSY

YAWS & FUNGUS DISEASE

Fungus Disease region

ELEPHANTIASIS ARABUM

GUINEA WORM

FILARIA

SCURVY

TROPICAL LIVER ABSCESS

MEAN ANNUAL TEMPERATURES

MEAN ANNUAL RAINFALL

PANDEMIC ISOCLINES & PREVAILING WINDS PATTERNS

Felkin’s Diseases, including Scurvy, overlain by Lawson’s Pandemic Isoclines

(the interesting history and politics behind Lawson’s isoclines are reviewed on another page)

Felkin’s Diseases, Excluding Scurvy, overlain by Pandemic Isoclines

Related Chronology Notes

1800-1825

Miasm theory prevails, with idio-miasmatic (body produced) and koino-miasmatic (environmental) subtypes popular during the earlier years

Jenner’s cow pox vaccine undergoes intense scrutiny as to its history and discovery, but is finally linked to Edward Jenner alone by1815.

1837/8 – zymotic theory is defined

1844/5 – zymotic theory is applied and used to illustrate the relation between poverty and illness (this map of the miasma of cholera in the 1830s will be reviewed on another page)

1849-53 – Numerous theories emerge for the second great plague–Asiatic cholera. Geographic, meteorologic, planetary, magnetic, terrene and ecologic causes remain popular, to name a few. Focus is on the environment causing disease.

1856/7 – Royal Academy accepts and begins to follow the zymotic theory and its underlying suppositions proposed by William Farr. Emphasis is switching back to the corporeal cause for disease.

1865 – the zymotic theory is becoming the most popular, with strong movements now favoring sanitation problems and population density as the causes for epidemiological concern; environmental applications to promoting health remain popular (i.e. the establishment of tuberculosis hospitals in montane settings, adn the use of hot water and mineral springs).

1873 – zymotic theory is in full force, strongly supported by documented successes for several disease vaccinations; six or seven diseases preventible by vaccines are defined.

Bythe time Felkin produced these maps, the cause for these conditions were still very much unknown and are perhaps examples of how during the period when the zymotic theory of disease prevailed (ca. 1860-1880), the knowledge of the true germ and its distribution on the earth had yet to be fully understood, and so the distribution of the “poisons” and “viruses” still theorized as causes for scurvy and beri beri were still categorized alongside the known immunizable diseases (measles, mumps, scarlet fever, diphtheria, rubella) and the less definable diseases that lack immunizations like cholera, dysentery, and typhoid.

1875 (about) -Lister’s discovery

1883 – bacterial theory has developed several proofs, but popular opinion has not yet fully changed on behalf of some elders.

Biographical Notes (paraphrased, based on the link below):

He was a member of:-

British Medical Society
Royal Geographical Society (1884)
Royal Geographical Society (Scotland)
Anthropological Society
Ethnological Society (Germany)

He attended:

Medical Graduate Edinburgh University 1884
Medical Graduate Heidelberg (Marbueg) University 1885

He joined the Scottish Lodge of the Theosophical Society in 1886, was a member of the Hermetic Order of the Golden Dawn, the Stella Matutina, Smaragdum Thalasses and Grand Master of the Ordo Tabulae Rotundae.

He was initiated into Freemasonry at the lodge of Edinburgh (Mary Chapel) in 1907.

Dr. Westcott (then) Supreme Magus appointed him an Inspector for Australiasia but it would seem that he never exercised his duties in New Zealand.

Dr. Felkin was a founding member of the Guild of St. Raphael in 1915.

Robert Felkin was an explorer, Missionary, expert in tropical medicine, Mystic and Magician. He knew the famous explorer Livingstone and Gordon of Khartoum.

With the assistance of his wife and daughter, he ran the Smaragdum Thalasses at Whare Ra until his death.

Dr. Felkin is buried with his wife and daughter in the Havelock North Cemetery (New Zealand), facing Whare Ra.

Felkin College is named after Dr. Robert William Felkin

For more on Felkin and his very unique (eccentric?) biographical history, see

http://www.mastermason.com/felkincollege/felkin-bio.htm

Brian Altonen, MPH, MS