New Orleans Republican. [volume] (New Orleans, La) 1867-1878, 1875-12-12
Medical Topography.

Medical Topography.
At the annual meeting of the America,
Health Association, in Baltimore, on tn,
tenth of November, DR.. J. S. Billings
United States army. read Il report on thi
important subject After relating briefly
the efforts and results that have previously
been made IN the country, DR.. Billings said
1t needs, however, but a brief exam!na
ton OF these records to prove that a com
prehensive sanitary survey of State will
never be accomplished by State Medca
Society, unless. indeed it should be by the
present State Medical Society of Alabama
under Its peculiar powers as a State board
of health. In all branches of science in
which the Baconian system OF investigation
Is to be pursued with advantage. the
work must be divided between collectors
and collators. 1t is evident that the
foundation of medical topography, as il
should be, must rest upon statistics of dis.
ease. We desire that it shall give us the
following information: l. What is the
healthfulness, absolute and relative, of a
given place > What diseases will proh.
be relieved by residence at that place 5.
What are the causes, local or endemic and
climatic, OF disease! 4. What ATTEMPTS
are being made to improve the topography
OF the place, with reference to its sanitary
condition
1t has been an article of professional! as
| well as popular belief since the DAYS of Hin.
pocrates that the study of the prevailing
diseases of different places, with reference
| to their local causes, is of great value, and
that all work in this direction should he
encouraged as much as possible. MANY
books and essays have been printed u ader
the title OF Medical Topography and to
Judge from the photography of the subject
only, we might fairly suppose that large
! amount of data, scattered and disconnected
it is true, has been obtained and recorded.
But when We come to examine these papers
in detail, it will be found in most cases.
that while Typographical data are given.
the medical part has been left out; that the
majority of them refer to but one form
OF disease, the malarial; and to the condi-
| tions which affect its prevalence, and that
| even with regard to this the information
given Is vague and general. Even the most
complete and satisfactory essays, with the
| exception of the army reports, RELY upon
mortality statistics alone, and these, no
matter how complete, will not furnish the
information necessary for satisfactory in.
| vestigation into the causes of disease,
which is the one great object of medical
topography. We want to know how many
OF ogiven population have been sick. Of
what diseases, and for how long. For this
purpose the statistics of all diseases are not
| OF equal Importance, for we can expect no
special advantage from knowing how MANY
cases of venereal or delirium tremens occur
| In given square, but we must of course
record many facts fol- the same reason that
the pearl diver collects many oysters, be-
cause We do not know whether thew are
valuable or cot. For instance, most per.
sons would say that topography has no re-
latlon to cancer, and yet there are some
curious condolences with regard to its prev
alence in limited localities. Whether il is
possible to obtain for city or district sta
tistics of the prevailing diseases sufficiently
complete to admit OF scientific reasoning
with regard to their causes, is a question of
much interest and Importance.
With regard to certain epidemic diseases,
snch as cholera and cerebro-spinal fever,
records have been obtained in the largest
city in this country with sufficient com.
pleteness to furnish valuable results.
Suppose local medical society-county
OF Observation-Disclosures to collect the
medical statistics of its locality. How ia it
TO set to work! The first suggestion would
be that each member should keep a record
OF the cases of disease which he observes,
and of the locality in which they occur. To
attempt this with any prospect of success it
Is necessary to agree upon a list of diseases
to be recorded, and to select for this list
only such forms Of disease as are easily of
diagnosis, and of which the nomenclature
is uniformly agreed upon. 1t is furthermore
absolutely essential that each physician
shall make his report daily to the secretary
upon a small convenient blank form, to be
placed in stamp ed and directed epyelope
provided for the purpose. If the necessary
medical statistics can be obtained, the re-
mainder of the data for a medical ropo.
graphy can be gathered. Some of the most
interesting points to be noted are those
which seem to be exceptions to the general
rules. We want to know the particulars of
localities where the presence of marshes or
stagnant water does not seem to produce
malaria, where impure and contaminated
water supply has not produced disease, and
where detective traps and escape of sewer
gas in houses has produced NO apprecis bic
Ill efecfs. satisfactory medical topo.
graphy should have reference not only to
the causation. but to the prevention and
cure OF disease. Change Of climate "a q
therapeutic agent is coming more and more
into use, especially as regards diseases of
the lungs, rheumatism, etc. But as vet
physicians have no sufficient data to guide
them in recommending given localities to
their patients. In Europe great use id made
OF health resorts, baths, and mineral waters,
and considerable progress has been made in
determining their effects in different diseases.
For the United States the most of this work
10 yet to be done, except Is regards the me-
Neurological observations.
Finally, it must be remembered that the
medical topography of place is not the
same at different seasons, or in successive
yeare and that continuous series of OBJ.
servations will be necessary to devotion the
full value of this mode of investigation, We
must endeavor to ascertain what the French
call "the medical constitution of q placer
the results of epidemic influences which are
not yet epidemics, and the notifications
which these undergo in different localities.
In medical topography a. q science there
has been little advance for o thousand years.
and 60 long as the present methods are pur.
sued no great additions to our knowledge
in this direction can be expected. Vague
generslities and opinions must be replaced
by, specific information, and from square
miles we must come down to square feet,
The results which we now have obtained
can best be compared to THOSE obtained by
the young chemist VINO made an analysis of
rat, putting the entire animal into his
crucible.
To obtain the statistics of disease, or even
of mortality, which are necessary to make
. truly valuable medical topography, must
be . work of the future, since these data
do not now exit, and can not be obtained
BY any system Of inquiry; and 1t ID respect.
fully submitted whether the time has NOT
arrived to secure such action ON the part of
national, State, county and municipal