WORK IN PROGRESS

This section is separated from the other sections due to the timing and nature of these writings.  These are articles I accumulated over twenty or more years of work in this field.  I actually began this work in 1982 about, with the research on Revolutionary War physician Dr. Cornelius Osborn.  But the bulk of the articles requested and reviewed were not obtained until after 1992, once the Osborn research was completed and I was searching for new writing material.

My bibliography of articles to review came from my months of rummaging through and copying pages from the Index Catalogue of the Surgeon General’s Office, a process which by itself itself took about a year or two of on and off reviews to complete, and then binding these copies, reading through them, highlighting what I wanted to order, and then placing these orders with the university library.   Between 1997 and 2000 I ordered about 5500 articles, most prior to 1900, and received about half of these.

The century or more of medical geography history that I plan to cover with this page begins when the field at its peak in understanding and application.  By the middle of the nineteenth century, the germ theory has not yet fully developed although the idea exists of germs and sanitation.  Medical geography was the most common way of interpreting places and health, and used to explain why some places were very unhealthy for certain people.  But people were also still blamed for certain kinds of poor health they experienced.  This poor health and the diseases that were its consequences were often related to temperament, constitution, family inheritance, and personal affect or psychology, and how these results in unhealthy living environments, usually due to filth.

The notion of sanitation and sterilization began to surface within the medical work setting in the 1860s, due to Lister.  Soon it was better understood, and by 1875 pretty much perfected.  Between 1875 and 1881, attempts were made to better understand diseases as consequences of nature’s elements, but especially the invisible elements of nature like germs and viruses, which were still closely linked to poisons and certain known chemical related qualities.  By 1890, the late 19th century theory for disease called zymotic had begun its transition to the microbe concept.  The microbial theory in turn was an outcome of the long lived animalcule disease that had developed and continued to persist throughout the 19th century.  Between 1891 and 1893, it became the bacterial theory.  The virus was still pretty much an unknown, and sometimes linked to the chemical and nutrition theories for some diseases now being published in the medical journals.

One argument that tended to prevail throughout the 19th century, and never covered as its own individual hypothesis, is the “exciting” cause or causes argument for disease.  This term was used into the early 1900s as well to refer to cases where no adequate explanation could be given for illness in relation to time, place and natural history.  In the mid 1800s for example, doctors could see that things like time of the year, climate, amount of precipitation, changes in temperature all tended to help diseases and epidemics arise and develop into epidemic forms.  But many exceptions to the rules they had develop also could be seen–these were linked to unique causes usually referred to as “exciting”, meaning these causes converted what were considered non-pathogenic settings into pathogenic settings.  Since exact causes had yet to be discovered, “exciting” causes tended to satisfy those who were most inquisitive.

From 1900 throughout the World Wars I and II, medical geography changed its roles in medicine.  The older traditional disease mapping of the 19th century was less focused on climate and topography.  Disease maps still presented us with the geographic nature of infectious disease and animal born mechanisms of disease spread, but for the most part came to be devoted to disease migration patterns for organismal diseases that bore a vector-host-microbe ecology, and for certain culturally-linked diseases that seemed to be linked to lifestyles and living patterns.

Medical cartography evolved into a study focused on ecology and viability due to the second world war and the efforts of geographer Jacques Mays.  This focus on disease relied heavily upon our understanding of climate and the ecological theories that were developed.  When the War was over, Mays helped to redefine the field of medical geography by turning it into a study of human and natural disease ecology.   The natural selection and eugenics traditions and philosophies common to the pre-War era remained intact, but with new applications.

Russian medical geographers helped keep this topic alive between 1910 and 1950 by using it to define their macroeconomical interpretation of man and the environment, using its to compartmentalize the earth’s surface into different natural resource-industry settings.  Russian medical geographers also developed some of the best parasitology work in this field due to their experience with so many zoonotic-anthroponotic disease patterns.  Much of this work was ignored by Western Europe and the United States until the 1960s, when the most important writings of these academicians were translated and published in the English language.

The most important period in medical geography to any historian today has to be defined by its initial years, generations and decades. The articles from these earliest years are in the sections noted above on the table of contents [TOC] listing to the right of this page.

The articles in this section appear in two ways. A number of articles considered to be important to the history of this field will be provided as pdfs, the links for which appear at the end of this page. Others will appear a subsections listed beneath the title of this header page in the TOC.

In general, these articles are from a later period in the history of the medical geography profession. There are several periods to not during this phase of American medical history. The earlier period, from about the 1860s to 1883, mostly consist of articles published between the mid-zymotic disease period (ca. 1860/1865) to the early bacterial theory of disease period (1881 onwards). Several other articles may surface and be posted on the more modern interpretation of the animalcules theory as well, when microbes were small enough to be considered bacteria in the modern sense, providing strong evidence for the existence of a bacterial theory a fews years before the official time frame of about 1881/1883. There is also the possibility that some hybridization of these two primarily philosophies for disease may surface as well. As usual, some alternate theories for disease prevailed during this time as well, and so we may see such topics as electropathology being discussed.

Felkin’s work which appears of other pages illustrates this transition in philosophies quite well. Felkin’s maps depict the old and new mapping methods for disease, with miasma appearing on those maps for diseases with causes yet to be identified, such as scurvy, goiter and beri-beri. When we review Felkin’s map on diseases, we find most of them to display very well defined regions for most diseases, not generalized distributions, the best example of which is scurvy.

Beri-beri and scurvy are both nutrition related diseases, meaning they are diseases induced by poor food uptake, an event that is due to human behaviors and can take place anywhere, regardless of time, weather, temperatures, air quality, and place. Since scurvy is a disease of a nutritional and chemical nature, a cause could not be defined due to the focus on environment. Felkin notes scurvy to be a result of being in the far north cold regions, a result of traveling by ship through arctic-subarctic regions. But on his map, it is also a land-born disease, not heavily dispersed over the colder waters. In addition he notes it to be a primarily oceanside problem, more so than many yellow fever maps depicting the same oceanside feature in earlier disease maps.

This oceanshore related history probably pertains to the association of wateredge settings with communities, and the even earlier practice of frequently landing due to an onset of scurvy on board. This landing effectively eliminated the problem by modifying the eating patterns. Since the colonial era, it was known that eating certain oceanside land plants helped to provide the nutrients needed to get rid of scurvy. This history alone led to much of the association made between Russia’s northern oceanshore regions and areas of high scurvy risk according to Felkin’s mapping of the disease.

Such an association could not be as easily made for scurvy presenting at sea near the center of the various oceans. Thus Felkins’s depiction of this on his map is more diffuse, and aerial or atmosphere related, implying an airborn cause.

For some diseases, it was nearly impossible to imagine a cause until the proper amount of knowledge was obtained about human anatomy and physiology. At the time of Felkin’s work, more knowledge was being obtained on the nature and behavior of our endocrine systems, the detailed chemistry of digestion and foodstuffs, and the effects of specific chemicals on the tissues of the body. This knowledge was needed for Felkin to know how to map scurvy–as a cultural and population related event, not an oceanic or maritime related event. To learn these basic features of the human body required more than just a microscope and a very basic understanding of body chemistry. For thisreason, some regions are mapped in interesting ways throughout the nineteenth and early twentieth centuries.

The articles in this section fill in some of the gaps we might have about trying to understand how fields like medical geography, disease geography, medical ecology, disease ecology, environmental ecology and spatial epidemiology developed into the unique specialities that they are today, and why the maps were what they were back then. By 1930, the field of medical geography as it was presented in the 19th century was pretty much extinguished from the journals and medical books. The primary books that remained focused on this knowledge were the tropical medicine epidemiological writings and the Russian zoonotic-anthroponotic (animal-human born disease relationship) writings.

As always, there are overlaps in the articles found in this section with some in the related medical geography article sections. But for the most part, the philosophies and beliefs expressed in these articles are more like the expectations for the time of the bacterial theory, and less a series of examples of incredibly unique philosophies such as those found published between 1780 and 1860.

Some of the more recent but very historically important definitive articles on medical geography shall be included here as well. So try not to ignore these due to the need to click on the links and review the pdfs. The most important of these more recent publications in the field include an article by Jaques Mays entitled Medical Geography, published in 1950. He produced this following his service as a medical and political geographer during the Second World War, a period when this field was about to result in the development of many contemporary global health programs.

WORK IN PROGRESS

(Research note:  Some journal titles are not on the original paper copy; need to see thesis bibliography and notes for more information.)

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ARTICLES

1852.  J. B. Hiester.  Thoughts on the Study of Diseases with reference to Geology.   Communicated to the Medical Society of Berks County, Nov. 4th, 1851.   The Medical Examiner, n.s. vol. 8, pp. 428-437.   LINK:  Thoughts on the study of diseases with reference to geology by Hiester 1852.

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1857.  B. Daniel.  Medical Geography and Endemic Diseases.  Journal of Public Health and Sanitary Review.  Vol. 3.  pp. 249-259.  LINK: 1857 – Medical geography and endemic diseases by BDaniel

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1857.  Review III.  1.  Die Geographischen Verhaltniss der Krankheiten oder Grundzuge der Noso-geographie.  Vils. I and II.  Von Dr. A. Muhry.  Leipzig and Heidelbery, 1856.  8vo, pp. 508.  The Geographical Relations of Disease; or, Outlines of Noso-geography.  By Dr. A. Muhry.  2.  On the Geographical Distribution of Health and Disease.  The article introductory to Plate 35 of, and at p. 117 of, ‘The Physical Atlas of Natural Phenomena.’  By Alexander Keith Johnston, FRSE, FRGS, &c., Geographer at Edinburgh in Ordinary to Her Majesty.  A New and Enlarged Edition.  Edinburgh and London, 1856.  April 1857.  JOURNAL?  pp. 312-322.  LINK: The Geography of Disease, April 1857 (1) .

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1863.  Gavin Milroy.  On the Geographical Distribution of some Epidemic Diseases.  JOURNAL?  Oct. 1863.  pp. 475-486.  LINK: on the geographical and chronological distribution of some epidemic diseases by Milroy 1863.

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1874.  Egbert L. Viele.  The Relations of Topography to Health in Connection with the Principles and Practice of Drainage and Sewerage.  An Address delivered by General Egbert L. Viele, of New York, before the American Public Health Association, at Philadelphia, November 11th, 1974.  JOURNAL?   pp. 449-459. LINK: The relations of topography to health in connection with the principles and practice of drainage and sewage by Viele 1874.

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1877.  James T. Gardner.  Relation Between Topographical Surveys and The Study of Public Health.   The Sanitarian.  A Monthly Magazine.  Vol. 5, no. 54, pp. 386-389.  September 1877.  (Scan was mistakenly followed by B. Daniel, 1857.)   LINK: Relation between topographical surveys and the study of public health by Gardner 1877

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1879.   J. C. Shapard.  Geology and Medicine; or, Rather the “Influence” of Geology on the Physical Development of Man, and in the Production of his Diseases.  The Southern Practitioner.  An Independent Monthly Journal, devoted to medicine and surgery.  Nashville.  April, 1879, Vol. 1, no. 4, pp. 125-129.  LINK: Geology and medicine or rather the influence of geology on the physical development of man by Shapard 1879 .

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1898.  Anonymous.  The Geographical Distribution of Diseases.  Scalpel, no. 3.  pp. 345-348.  LINK:  The geographical distribution of diseases 1898.

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1950.  Jacques M. May.  Medical Geography: Its Methods and Objectives.  The Geographical Review, January 1950.  tp, pp. 9-41. (NOTE:  page 11 scan is partially fed/offset but readable). LINK: Medical geography its methods and objectives by May 1950

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