Historical Medical Geography

This section details the Medical Geography notes I took from 1995 approximately to 2000.

Most of the work was focused on two projects:

    1. Oregon Trail medical geography
    2. The diffusion of geography thinking in the United States from about 1850 to 1875.  Most of this work I did as part of the Oregon Trail work, and as part of a series of separate studies on the pre-germ theories for disease published throughout the medical journals.

The Topics

There is a sequence to the topics that came into play with medical geography thinking as it evolved during the nineteenth century.

If we were detailed about when and where this philosophy of disease began, we would have to go back to the most traditional of writings by Greek philosophers and scientists.  Their philosophies about disease and place changed very little for the next nearly 2000 years.  There were some writers in medicine during the 18th century who began to develop more detailed renderings of some of the theories for disease out there, such as the relationship drawn between specific landforms and disease, specific seasonal wind flow patterns and disease, and specific weather activities in disease.

The ability to link disease to specific geographic details required that scientists very close attention to the details of the natural history of the areas under review.  It is no wonder the New York medical school then open (the predecessor to Columbia School of Medicine) had a Natural History expert as a professor, and the journal published on medicine for the time from the same city, Medical Repository, had this same individual as it chief editor and contributor.  The most unusual thing about reviewing medical geography is the kinds of topics that appear in the trade magazines for ca. 1790 to 1850.  It is not unusual to find an article on fossil beds, of the discovery of a new coal mine in the vicinity, the unique soils and plants of a partiocular region, or the development of a livestock industry devoted solely to a new breed of sheep.

During the early 1800s, New York had somewhat of an edge over its primary competitor in medicine and medical schooling, Philadelphia, due to the geography of the New York setting.  The early geographers were right in some ways regarding the relationships that may exist between each element of nature and human health and disease.  As suggested by the numerous theories for the numerous epidemics and endemics that took place in specific regions, anything and everything that Nature had in store for a physician had to be analyzed in order to determine whether or not it was the next cause for a major set of fatalities or the next cause for the next sort of plague.  Physicians with the broadest training in natural history would be able to consider as causes everything from comets and meteors, to lightning, clouds, rain and weather, to soil and rock formations, mountains, valleys, and deserts, to plant and animal types, local streams, lakes and mineral waters, to dust, sunlight, swamp gases and natural forces as the cause for the next major epidemic.

  • Meteors and Comets
  • Planetary powers (gravity, magnetism)
  • Physiography (mountains, oceans, deserts)
  • Miasma
  • Effluvium
  • Winds
  • Thunderstorms (clouds, rain, lightning, electricity)
  • Temperature
  • Humidity
  • Sunlight
  • Geology
  • Soil
  • Water
  • Landform
  • Plant types
  • Animals
  • Animalcules
  • Microbes (bacteria)
  • Chemicals
  • P
  • Entia
  • Viruses, etc.

Even before it was called Medical Geography,the study of place, people and disease had some well-established beliefs integrated in medicine.  It is no durprise therefore that in United States medical history the first journal article to make use of this term was by the Famous Saamueal Mitchell, a physician and subsequently congressman of New York who was on staff at one of the two medical school teaching groups in New York City.  I say “groups” because even though there was one true school devoted to medicikne, there was also the College of Physicians and Surgeons.  Each was socially distnct from each other–the first an assemblae of doctors and with teaching facilities who required apprenticeship time and attendence of their lectures to received the medical license.  This was different from the degree offering of the College of Physicians and Surgeons which offered a degree in medicine known as MD but not necessarily the license to practice.  To become a practitioner you still had to be approved of such by the state.  As one might imaging, this split in the medical field early on its existence in the United States caused constant internal political uproars and published claims about the other, an enemy in the advancement of this young and fast growing field.  Between 1812 and 1817, this political dispute reached a peak, making it easier for other professions and their practitioners, like Thomsonians, to take over the medical field.  Ten years later, this continued political dispute would enable Hahnemann’s homeopathy to define its place in the medical field as well.  The passage of laws by New York did little to prevent this turmoil from continuing.  In 1806 laws would be passed about licensure, but a year later the same legislature woul;d be very interested in the newly discovered cure for a hydrophobia (rabies) prominent is some livestock raising communities.   Regular medicine was in now way successful at all between 1805 and 1830, and so its theories for disease and how to best treat them remained open discussions for decades to come.

Meawhile, scholars like Samuel Mitchell continued along his trail set to promote the natural history of medicine.  For this reason he first popularized the use of the term medical geography, and his counterpart in the intercity politics of medical field, Benjamin Rush, a professor who was famous and involved with the other school New York doctors were in dispute with–the Philadelphia School.   Benjamin Rush didn’t invent the term sequent occupancy, but he pretty much defined it for early America in an article written and presents in August of 1786.  Mitchell’s article on Medical Geography and Rush’s article entitled “An Account of the Progress of Population, Agriculture, Manners, and Government in Pennsylvania”   are both very important writings on the history of medical disease in United States history.

Biographies and  Early Accomplishments

The medical topographers and climatologists defined the role of their successors the medical geographers.  A number of physicians covered medical geography in one way shape or form during the 18th century, but it wasn’t until the 19th century that this field blossomed to its fullest potential with American natural history.  Some of the first American writings of these special fields of medicine, disease philosophy and epidemiology produced some very useful writings that we can learn the basics of this field from.  A number of these writers are covered in my special sections on the first disease or medical maps and the first articles published on medical geography.

The following are additional references that are interesting to access and review in order to learn the history of this part of medical geography.

David Ramsay (this very helpful biblio of important essays pulled from Wikipedia)