Las Topográfias Médicas: una aportación de la Medicina Rural a la Salud Pública / Medical Topographies: A Contribution of Rural Medicine to Public Health

Las Topografías Médicas (TM) o Geografías Médicas, son un género de la literatura médica, cuyos orígenes pueden encontrarse en el tratado de Hipócrates, Sobre los aires, aguas y lugares. El objetivo básico de las TM fue simplemente describir la salud de la población de un lugar determinado, aunque pronto ampliaron su campo de acción, para investigar la influencia del entorno físico y social en las enfermedades que padece la población en zonas geográficas o localidades. El inicio de su desarrollo tiene lugar en el contexto de la Medicina de la Ilustración, y adquirirán su mayoría de edad durante el siglo xix y las primeras décadas del siglo xx, para finalizar su producción en los años setenta del pasado siglo. Las Reales Academias de Medicina tuvieron una importancia decisiva en el desarrollo de las TM, proponiendo una metodología y un contenido homogéneo para la redacción de las mismas y estableciendo premios anuales para las obras galardonadas, lo que permitió mejorar su calidad y homogeneidad. El texto de las TM incluía generalmente un esbozo histórico de la población, la geografía de la zona, la descripción de la flora y de la fauna, con frecuencia de forma muy detalladas, el estudio del clima, de las vías públicas y las viviendas, la descripción de las enfermedades más frecuentes y epidemias, así como la demografía y situación socioeconómica de la población, entre otros. ... En el presente artículo se describe la evolución histórica de las TM, sus contenidos principales, su distribución por autonomías y años, y algunos personajes ilustres relacionados con ellas; aportándose alguna iconografía y copias de los documentos más interesantes por su valor médico o artístico. (AU)

Medical Topographies (TM) or Medical Geographies, are a genre of medical literature, whose origins can be found in Hippocrates’ treatise, On Airs, Waters and Places. The initial objective of TM was simply to describe the health of the population of given place, although they soon expanded their field of action to investigate the influence of the physical and social environment on the diseases suffered by the population in geographical areas or localities. The beginning of their development took place in the context of Enlightenment Medicine, and they came of age during the 19th century and the first decades of the 20th century, ending their production in the seventies of the last century. The Royal Academies of Medicine had a decisive importance in the development of TM, proposing a methodology and homogeneous content for their writing and establishing annual prizes for the award-winning works, which allowed them to improve their quality and homogeneity. The text of the TM generally included a historical outline of the population, the geography of the area, the description of the flora and fauna, often in very detailed form, the study of the climate, public roads and homes, the description of the most frequent diseases and epidemics, as well as the demographics and socio-economic situation of the population, among others. ... This article describes the historical evolution of the TM, its main contents, its distribution by autonomies and years, and some illustrious people related to them, providing some iconography and copies of the most interesting documents due to their medical or artistic value. (AU)

Cosmotellurism in Lombroso's work.

BACKGROUND AND AIM OF THE WORK: Few know that Lombroso was also involved in epidemiological research. In particular, Lombroso's scientific reflections on Medical Geography were addressed to the theme of climate influences and meteorological conditions on human conduct. The authors analyze the scientific production and the works of Lombroso devoted to medical geography. DISCUSSION: Lombroso carried out accurate epidemiological investigations using the statistical method with great modernity, combining health data with geographical and climatic data to demonstrate the relationship between man, the environment and health in a social vision of preventive and curative medicine. CONCLUSIONS: The theory of Cosmotellurism in Lombroso's work is not only a source of unquestionable interest in the History of Medicine. The heritage of Medical Geography within the pre-bacteriological medical culture can continue with its teachings to correctly address the clinician's thinking even in the current historical context in which endemic and epidemic pathologies re-emerge in various parts of the world. (www.actabiomedica.it).

The Human Wallace Line: Racial Science and Political Afterlife.

This paper examines racial science and its political uses in Southeast Asia. It follows several anthropologists who travelled to east Nusa Tenggara (the Timor Archipelago, including the islands of Timor, Flores and Sumba), where Alfred Russel Wallace had drawn a dividing line between the races of the east and the west of the archipelago. These medically trained anthropologists aimed to find out if the Wallace Line could be more precisely defined with measurements of the human body. The paper shows how anthropologists failed to find definite markers to quantify the difference between Malay and Papuan/Melanesian. This, however, did not diminish the conceptual power of the Wallace Line, as the idea of a boundary between Malays and Papuans was taken up in the political arena during the West New Guinea dispute and was employed as a political tool by all parties involved. It shows how colonial and racial concepts can be appropriated by local actors and dismissed or emphasised depending on political perspectives.

'Birth, life, and death of infectious diseases': Charles Nicolle (1866-1936) and the invention of medical ecology in France.

In teasing out the diverse origins of our "modern, ecological understanding of epidemic disease" (Mendelsohn, in: Lawrence and Weisz (eds) Greater than the parts: holism in biomedicine, 1920-1950, Oxford University Press, Oxford, 1998), historians have downplayed the importance of parasitology in the development of a natural history perspective on disease. The present article reassesses the significance of parasitology for the "invention" of medical ecology in post-war France. Focussing on the works of microbiologist Charles Nicolle (1866-1936) and on that of physician and zoologist Hervé Harant (1901-1986), I argue that French "medical ecology" was not professionally (or cognitively) insulated from some major trends in parasitology, especially in Tunis where disciplinary borders in the medical sciences collapsed. This argument supports the claim that ecological perspectives of disease developed in colonial context (Anderson in Osiris 19: 39-61, 2004) but I show that parasitologists such as Harant built on the works of medical geographers who had called attention to the dynamic and complex biological relations between health and environment in fashioning the field of medical ecology in the mid-1950s. As the network of scientists who contributed to the global emergence of "disease ecology" is widening, both medical geography and parasitology stand out as relevant sites of inquiries for a broader historical understanding of the multiple "ecological visions" in twentieth-century biomedical sciences.

At the intersection of medical geography and disease ecology: Mirko Grmek, Jacques May and the concept of pathocenosis.

Environmental historians are not sufficiently aware of the extent to which mid twentieth-century thinkers turned to medical geography-originally a nineteenth-century area of study-in order to think through ideas of ecology, environment, and historical reasoning. This article outlines how the French-Croatian Mirko D. Grmek (Krapina, 1924-Paris, 2000), a major thinker of his generation in the history of medicine, used those ideas in his studies of historical epidemiology. During the 1960s, Grmek attempted to provide, in the context of the Annales School's research program under the leadership of Fernand Braudel, a new theoretical framework for a world history of disease. Its development was inspired by several sources, most notably the French-American Jacques M. May (Paris 1896-Tunisia, 1975), who was then pioneering an opening up of medical geography and movement towards the concept of disease ecology. The cornerstone of Grmek's "synthetic approach" to the field was the notion of "pathocenosis". The diverse uses of this notion in the course of time-from his early agenda focused on a longue durée history of diseases in Western Antiquity to his last, relating to the new epidemiological threat of (re)emerging infectious diseases, specifically HIV/aids-enables us firstly, to note how concepts of ecology sat uneasily alongside those of medical geography; secondly, to assess the reach and limits of his theoretical contribution to historical epidemiology; and thirdly, to understand better the uneven fortunes of his concept of pathocenosis at the end of the twentieth and beginning of the twenty-first centuries.

[Distribution of Xin'an TCM physicians and their medical works and the reasons of its formation of medical center].

Based on the living times, native places and medical works of Xin'an TCM physicians described in the Xin an ming yi kao(Textual Research of Famous Physicians of Xin'an Region), the geographical distribution of ancient TCM physicians was analyzed by using Excel software. It is found that Xin'an medicine was originated from the Eastern Jin Dynasty and highly developed in the Qing Dynasty, and the number of its TCM physicians in the Ming and Qing Dynasties was large than the summation of those from the Eastern Jin Dynasty to the Ming Dynasty. In regard to the district, the distribution of Xin'an TCM physicians was characterized by more in the southeastern and less in the northwestern parts, forming a distribution area concentrated in the three counties of Shexian, Wuyuan and Xiuning. The reasons of such concentration of Xin'an TCM physicians are closely related to the economic growth, the influence of Neo-Confucianism and the density of population.

Debating Diseases in Nineteenth-Century Colombia: Causes, Interests, and the Pasteurian Therapeutics.

This article explores the medical conceptualization of the causes of diseases in nineteenth-century Colombia. It traces the history of some of the pathologies that were of major concern among nineteenth-century doctors: periodic fevers (yellow fever and malaria), continuous fevers (typhoid fever), and leprosy (Greek elephantiasis). By comparing the transforming conceptualizations of these diseases, this article shows that their changing pattern, the idea of climatic determinism of diseases (neo-Hippocratism and medical geography), the weak standing of the medical community in Colombian society, as well as Pasteurian germ practices were all crucial in the uneven and varied reshaping of their understanding.

[From the Local to the Global: French Military Surgeons, Algeria, and "Tropical Pathologies" (1830-1880)]. / Du local au global: Les médecins militaires français, l'Algérie et les "maladies des pays chauds" (1830-1880).

Up to the 1860s, understanding of the disease consists first of a reflection on the ground and the situation of people on this place. This includes the writing of medical topographies and the development of a new science: medical geography. How could extra-European territories contribute to this knowledge and how this knowledge about tropics and their pathologies could contribute to the formation of an epidemiological reflection at a global level? This contribution tries to suggest the role of military doctors in this process, the importance of Algeria in this intellectual training and, finally, how this work on the "hot" countries contributed to the structuring of a professional identity.

Typhoid Fever in nineteenth-century Colombia: between medical geography and bacteriology.

This paper analyses how the Colombian medical elites made sense of typhoid fever before and during the inception of bacteriological ideas and practices in the second half of the nineteenth century. Assuming that the identity of typhoid fever has to be understood within the broader concerns of the medical community in question, I show how doctors first identified Bogotá's epidemics as typhoid fever during the 1850s, and how they also attached specificity to the fever amongst other continuous fevers, such as its European and North American counterparts. I also found that, in contrast with the discussions amongst their colleagues from other countries, debates about typhoid fever in 1860-70 among doctors in Colombia were framed within the medico-geographical scheme and strongly shaped by the fear of typhoid fever appearing alongside 'paludic' fevers in the highlands. By arguing in medico-geographical and clinical terms that typhoid fever had specificity in Colombia, and by denying the medico-geographical law of antagonism between typhoid and paludic fevers proposed by the Frenchman Charles Boudin, Colombian doctors managed to question European knowledge and claimed that typhoid fever had distinct features in Colombia. The focus on paludic and typhoid fevers in the highlands might explain why the bacteriological aetiology of typhoid fever was ignored and even contested during the 1880s. Anti-Pasteurian arguments were raised against its germ identity and some physicians even supported the idea of spontaneous origin of the disease. By the 1890s, Pasteurian knowledge had come to shape clinical and hygienic practices.

[Geography, health and urban development in São Paulo state at the turn of the twentieth century: Domingos Jaguaribe and the construction of the Climate Resort of Campos do Jordão]. / Geografia, saúde e desenvolvimento urbano no interior paulista na passagem para o século XX: Domingos Jaguaribe e a construção da Estância Climática de Campos do Jordão.

The resort towns created in the early 1900s are prime objects for studying the relationship between public health policies and urban and social development. This article analyzes the social and institutional vectors involved in the creation of the resort town of Campos do Jordão from the perspective of the career and works of physician, geographer and businessman Domingos Nogueira Jaguaribe Filho. Geographical studies, medical knowledge and the precepts of urbanization combined with private and development interests in the symbolism and concrete manifestation of the "Brazilian Switzerland".

[Famous scientist in the area of military-medical geography (to the 100th anniversary of the birth of A.A. Shoshin)].

The articale is dedicated to the 100th anniversary of the birth of famous domestic scientist in the area of military-medical geography, organization of health care and pedagogy, laureate of USSR state prize, Ph.D.Med, professor colonel of medical service Aleksei Alekseevich Shoshin (1913-1978). In 1953 he published his study guide "Short course in military-medical geography" and determined aims and tasks of course, clued peculiarities of the influence of physiographic conditions on health, sanitary status and medical support of the forces; gave military medical-geographic characteristics of the main landscape zones and methodology of territory research for possible unit sites. In 1962 AN USSR Publisher published his monograph "Principle of medical geography". In 1964 was published his book "Military-medical geography". In January 1966 A.A.Shoshin was elected as Head of social hygiene and public health organization Chair of the Leningrad pediatric medical institute. He chaired till the end of his life.

Introduction: modern airs, waters, and places.

Twenty-four centuries have passed since the doctrine of AirsWaters Places was articulated in the Hippocratic corpus, promoting a mutually constitutive vision of humankind and climate. Yet the "airs, waters, places tradition" has proved remarkably resilient and adaptable as a framing device for relations among nations, natural and human resources, and human health. Redeployed in diverse historical contexts across time, the relationship between climate and humans has evolved from a dependent one in which human constitution and health are determined by climate to an interdependent one in which humans and climate influence one another. Recent scholarship extends the ways in which historians of colonial medicine, neo-Hippocratic medicine, public health, tropical disease, and race have characterized the climate-human nexus and its attendant politics. Through the exploration of the works of circumnavigators, physicians, physiologists, ecologists, geographers, paleoanthropologists, and economists, contributors to this special issue offer some new and sometimes challenging interpretations of medical climatology: beyond the link between tropical medicine and colonialism, beyond temperate versus tropical, beyond latitude to think of altitude.

Medical climatology in France: the persistence of Neo-Hippocratic ideas in the first half of the twentieth century.

In interwar France the Lyonnais physician Marius Piéry undertook an ambitious Neo-Hippocratic research program to study how atmospheric and terrestrial environments influenced health. Lyon had a number of institutions linked to the colonies and was a center for the training of military physicians. Colonial physicians had a long tradition of contending with the diseases of tropical environments, and their ideas and many returned colonials circulated in Lyon and its region. Piéry was a physician during World War I and published on military medical topics. He also included colonial and military health concerns in his more mature works from the 1930s. An advocate of the close study of the physical sciences, he investigated the radioactive gases of health spas and the effects of altitude on pulmonary tuberculosis, and he directed a meteorological observatory.

A medicina no Brasil imperial: fundamentos da autoridade profissional e da legitimidade científica

This article attempts a fresh analysis of the supposed ornamental nature of medical institutions in Imperial Brazil (1822-1889). The institutions in question were active in the production and validation of scientific knowledge relating to health both public and private in the Empire. In contrast to interpretations which explain medical and hygienic thinking in terms of the immediate interests of dominant elites —forging a medical conscience “from the outside”— the article seeks to highlight the socio-professional dynamics mobilised for the validation and control of medical knowledge according to the same standards of proof prevailing in European hygienic and anatoclinical thought. It is argued that the social position occupied by the Imperial Academy of Medicine was built on meritocratic criteria. It was not the titled nobility which accredited scientific opinion or evidence, but rather the ability to reason in accordance with established scientific standards.(AU)

Contribución al estudio de la bibliografía cubana sobre geografía médica / Contribution to the study of the Cuban bibliography on medical geography

Se explica brevemente la significación de la Geografía al lado de la Medicina y se fundamenta la interdependencia existente entre ambas ciencias. Se describen las primeras comunicaciones sobre la Geografía Médica surgidas al nivel universal y los documentos que dieron inicio a la bibliografía cubana sobre esta disciplina. Se relacionan las obras más importantes escritas al respecto en Cuba a lo largo de los siglos XIX y XX, y se incluyen trabajos del doctor Carlos J. Finlay y artículos publicados en 2 de las revistas médicas cubanas más prestigiosas de todos los tiempos. Mediante este inventario bibliográfico se puede disponer de una referencia científicamente fundamentada acerca del surgimiento, evolución y desarrollo de la documentación científica nacional en el campo de la Geografía Médica(AU)

The significance of Geography side by side with Medicine is briefly explained and the interdependence existing between both sciences is defined. The first communications that appeared in the world about Medical Geography, as well as the documents that gave rise to the Cuban bibliography an this discipline are described. The most important works written in Cuba during the XIX and XX century are mentioned, including papers of Dr. Carlos J. Finlay and some articles published in two of the most prestigious Cuban medical journals of all times. With this bibliographic inventory it is possible to have a scientifically founded reference about the appareance, evolution and development of the national scientific documentation in the field of Medical Geography(AU)

Contribución al estudio de la bibliografía cubana sobre geografía médica / Contribution to the study of the Cuban bibliography on medical geography

Se explica brevemente la significación de la Geografía al lado de la Medicina y se fundamenta la interdependencia existente entre ambas ciencias. Se describen las primeras comunicaciones sobre la Geografía Médica surgidas al nivel universal y los documentos que dieron inicio a la bibliografía cubana sobre esta disciplina. Se relacionan las obras más importantes escritas al respecto en Cuba a lo largo de los siglos XIX y XX, y se incluyen trabajos del doctor Carlos J. Finlay y artículos publicados en 2 de las revistas médicas cubanas más prestigiosas de todos los tiempos. Mediante este inventario bibliográfico se puede disponer de una referencia científicamente fundamentada acerca del surgimiento, evolución y desarrollo de la documentación científica nacional en el campo de la Geografía Médica(AU)

The significance of Geography side by side with Medicine is briefly explained and the interdependence existing between both sciences is defined. The first communications that appeared in the world about Medical Geography, as well as the documents that gave rise to the Cuban bibliography an this discipline are described. The most important works written in Cuba during the XIX and XX century are mentioned, including papers of Dr. Carlos J. Finlay and some articles published in two of the most prestigious Cuban medical journals of all times. With this bibliographic inventory it is possible to have a scientifically founded reference about the appareance, evolution and development of the national scientific documentation in the field of Medical Geography(AU)