On the history of epidemiology in England / by Joseph Frank Payne.

  • Payne, Joseph Frank, 1840-1910.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: On the history of epidemiology in England / by Joseph Frank Payne. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the Fatlier of Medicine, lie gave copious records of the climatic and other conditions in connection with the prevalence of epidemics from 1661 to 1675. Unlike Hippocrates, he has not left detailed clinical reports of his patients. He attached little importance, as he himself says, to recording numerous cases. We cannot, however, but regret that this was his decision, for an adequate record of the course and symptoms of some of his individual cases of fever would have been extremely valuable, and would have enabled us to distinguish clearly—what is now some- times difficult—the precise species of fever he was dealing with.* Sydenham’s great principle in explaining epidemics was that of the epidemic constitution of the }^ear. This was something independent of mere heat and cold, moisture and dryness, but due to a certain alteration of tluj air. While this epidemic constitution was the cause of the prevalence of one particular disease—say variola or plague —it also influenced other diseases besides the dominant one; so that when variola, for instance, was prevalent, other diseases partook of a variolous character. Notwith- standing, Sydenham never believed in one disease being changed into another. He insists very strongly on the specific character of diseases, which, he says, are like plants, having each its typical way of beginning, developing, and coming to an end. He himself did much towards discrimi- nating different species of disease. The theory of epidemic constitution has had many defenders, and the view that one dominant epidemic disease impresses some of its own character on other diseases has also been held in quite modern times—with regard, for instance, to diphtheria. Not very long ago the theory of a “ change of type of disease” was actively dis- cussed. I must confess to being very sceptical as to the reality of any such phenomena, but to discuss such a ques- tion now is evidently impossible. 1 would only throw out the hint that the existence and constancy of the laws of contagion were less clearly recognised in Sydenham s time than now, and the diagnosis of the diflerent forms of fever was necessarily less minute, so that what was called the “ epidemic constitution” might often bo explained by the introduction into a particular place of some disease pre- viously unknown there. Hirsch regards inost_ of the epidemics of the “new fever” as due to the diflusion ot an endemic malarial fever from its original seat to other * T. Sydenham ; Observationes Mcdicffi, circa Acutonuii morbonim cura- tioncm, 1G7C.