From Big Medical Encyclopedia

GEOGRAPHICAL PATHOLOGY — the medicobiological discipline studying pathology of the person, animals and plants in connection with geographical factors. Medical G. of the item considers value and social factors.

In G.'s development by the item allocate 4 stages. The first, or early, begins with antique medicine (in particular, Hippocrates's statements) and proceeds to the middle of 49 century. The second stage — the 50th years 19 century — 1929. In 1856 it is mute. the scientist A. Muhry offered the term «nozogeografiya», and also presented the first (in many respects imperfect) the distribution map of the major diseases on the globe. In Russia in 1861 the doctor-obstetrician of the Samara medical justice Yu. Ukke proposed outstripped the era about establishment nozogeografichesky about-va; he spoke about practical benefits, to-ruyu can bring researches in this direction. However only in works it is mute. pathologist, epidemiologist, hygienist and historian of medicine And. Girsha G. of the item becomes an independent branch of pathology, the cut is the main object pathology of the person. The third stage of development of G. of the item is connected with a name shveyts. the scientist Askanazi (M. Askanazy) who in 1929 — 1931 together with group of the famous pathologists among whom there were A. I. Abrikosov and L. Ashoff based International in geographical pathology. Its purpose was studying of «a pathological panorama» of various countries of the world of hl. obr. on the basis of comparison of pathoanatomical materials.

The fourth, or the latest, the stage of development of G. of the item which began in the fifties 20 century is characterized by search of new ways of development of G. of the item that is connected not only using new methods of a research, but also with need of review of the original theoretical positions of this discipline.

Methods of studying of G. of the item are extremely various. They can be purely clinical with functional trials, including a so-called serol, and gematol. investigation, and also patofiziol., including working capacity and adaptedness tests of the studied population, pathoanatomical, statistical and experimental if it is required to repeat effect of an adverse effect of these or those environmental factors on laboratory animals and to find ways of their prevention or treatment. Were widely adopted genetic, and also immunobiol. methods. A certain value has a method of the multifactorial analysis because many diseases (especially chronic) are caused by the combined and even consecutive influence of a number of agents; they quite often act during various periods of a life cycle of one individual or the whole population.

The important role was got by statistical methods at epidemiol, researches of infectious and noninfectious diseases. The increasing tendency to carrying out complex researches which are important for geographical pathology is noted. Requirements about obligatory reproduction, new to this science, in an experiment of those patol, forms which manage to be observed in nature express.

In the USSR G. of the item is long developed hl. obr. as regional pathology. The doctrine about a natural ochagovost of infectious diseases was created (see. Natural ochagovost ), such natural and focal diseases of the person as a tick-borne encephalitis, a hemorrhagic nephrosonephritis and group of hemorrhagic fevers, a tick-borne sapropyra of Northern Asia, a paroxysmal rickettsiosis, an alimentary and toxic aleukia, heliotropic toxicosis, poisoning with a poisonous weed (gray-haired trikhodesmy) in Central Asia, the alimentary myoglobinuria connected with consumption of some species of fish molybdenic gout, a strontic chondrodystrophia, a local craw are open, etc. Besides, the Soviet scientists defined the regions of the USSR where the infectious, parasitic, alimentary, endocrine, hereditary or biogeochemical diseases originally open in other parts of the globe were found. Such new forms of regional pathology as the Kola encephalitis and the Magadan pneumopathy are described.

Between the concepts «geographical pathology» and «regional pathology» there is no basic difference as regional pathology represents G. of the item of a certain edge, and the word «edge» often is meant as administrative territorial unit, however, unlike regional pathology, G. the item studies pathology of organisms in connection with the geographical environment of all globe.

Geographical pathology closely adjoins with geography medical (see), geography of the population, anthropology, demography, social hygiene, utility hygiene, hygiene of food and occupational health, general and private epidemiology of infectious, parasitic and noninfectious diseases. It became clear also that G. of the item shall develop in close connection with medical ecology. In spite of the fact that G. of the item adjoins to medical geography, it differs from medical geography as on the main object of research (pathology of organisms), and on methodical receptions. At the same time works of many medical geographers are of great interest to specialists in the area G. of the item. Among these works it is necessary to celebrate researches of the fr. scientist Soar (M. of Sorre) and an amer. the geographer J. May of which the ecological orientation is characteristic. Despite a number of important offers on medical ecology, both of these authors are inclined to explicit underestimation of social factors in interpretation of geography of the population and according to the reasons and origins of diseases.

In 1966 one of founders about-va geographical pathology the Swede, the pathologist F. Henschen published the monograph devoted to bases of historical and .geografichesky pathology. This book to some extent is continuation of works of the same author on history and geography of diseases of the person. Collecting for many years historical documents on existence of these or those diseases in the different countries and during various historical periods, the author added them with the modern statistical data taken from the latest literature and WHO materials. F. Henschen's monograph to a certain extent continues A. Girsh's line since in it materials of a historical order prevail. The monograph has great cognitive value, however some theoretical statements of F. Henschen are not free from neomalthusian views.

Of the item in the USSR differs from G. in the item of the capitalist countries close connection with the organization of health care, social hygiene and medical geography. In development of private questions G. of the item USSR the essential contribution was brought by pathologists P. V. Sipovsky (the description of hemorrhagic fever in Tajikistan), O.K. Khmelnytsky and V. A. Odinokova (a local craw), A. M. Vikhert (atherosclerosis), A. A. Zhavoronkov (a local fluorosis), A. G. Marachev (disclosure of the hereditary nature of regional anemias of Tajikistan, identification of fetalis hemoglobin at natives and the adapted new settlers of the North of the USSR), A. P. Milovanov (a patomorfologiya of processes of adaptation in the north), etc. Considerable interest for G. items have researches of the Soviet medical geographers from which works Moscow are distinguished (And. D. Lebedev), Leningrad (A. A. Shoshin, B. K. Vershinsky) and Irkutsk (V. B. Sochava, E. I. Ignatyev, B. B. Prokhorov, V. M. Meshchenko, I. A. Hlebovich) the schools which did a great job on medico-geographically mapping of the USSR in connection with the problems of health care arising at development of territories.

Of the item studies all manifestations broken or treason of life activity of an organism, including determined only by special researches (a wedge., biochemical, patofiziol, or patomorfol.), while geography of diseases (see. Nozogeografiya ) considers only the expressed diseases, i.e. nosological units. Thus, the item registers G. and investigates not only the developed diseases or their most initial stages, but also «prediseases», i.e. those disturbances in an organism which lead to a disease sooner or later. Of G. the item is important for the territory of the USSR differing in an exclusive variety of external environment especially especially as living conditions in extensive zones (e.g., in the Arctic and Subarctic region, deserts and semi-deserts, mountain areas, the territories differing in the increased seismicity in the huge overpopulated cities, etc.) impose considerable requirements to adaptability of a human body, edges it is not always perfect. In these natural or natural antropurgicheskikh extreme (difficult for accommodation of the person) zones peculiar reactions of an organism on Wednesday and unusual forms a wedge, diseases quite often meet (see. Klimatopatologiya ). The problem of multilateral studying of diseases and patol, the reactions connected with this or that, but hl falls within G.'s scope of the item more and more. obr. production, pollution of the environment that G. inevitably pulls together the item with hygiene. It results in need of deep studying adaptations (see) and disadaptations (see) (i.e. defective adaptation) to these or those natural factors of artificially created zones, and also the influences caused it is human sky activity. Of the item in detail investigates data on all diseases of the person, including on malignant tumors, cardiovascular, infectious, parasitic and hereditary diseases which are unevenly extended to territories of our country and other states. It speaks not only availability of historically developed isolates or customs of the population, but also the fact that some professional harm (e.g., radioactive and chemical) can cause permanent hereditary changes in sexual and somatic cells — mutations.

The Soviet scientists persistently investigate G. of the item of infections and an invasion on a global scale that is important especially at the increased volume of international relations owing to a possibility of a drift of the activators or carriers which are already liquidated or at all never the diseases which were found in the USSR. Of the item studies also pathology of other living beings. In particular, the natural ochagovost of diseases exists also at animals and plants. These diseases can be not only an infectious, but also biogeochemical origin. E.g., deficit or surplus of some microelements in the soil causes blights and animals — a so-called biogeochemical endemia (see. Biogeochemical division into districts ).

Questions G. of the item are periodically taken up in the abstract magazine «Medical Geography» published All-Union in-volume of scientific and technical information of Academy of Sciences of the USSR. Scientific center of systematic researches on G. of the item in the USSR is the laboratory G. of the item. Ying-that morphology of the person of the USSR Academy of Medical Sciences, working in close contact with many scientific and practical institutions.

Abroad is engaged in the organization of researches on G. of the item International in geographical pathology; its works are systematically printed in Schweizerische Zeitschrift fur Pathologie und Bakteriologie.

See also Ecology .

Bibliography: Avtsyn A. P. Introduction to geographical pathology, M., 1972; it, Adaptation and disadaptation from positions of the pathologist, Klin, medical, t. 52, Jvft 5, page 3, 1974, bibliogr.; Avtsyn A. P., etc. The chronic progressing diseases of lungs as regional pathology of some northeast regions of the USSR, Vestn. USSR Academy of Medical Sciences, No. 10, page 3, 1971, bibliogr.; At to e Yu. About establishment of nozogeografichesky society, Mosk. medical gas., No. 36, page 297, 1861; Nepschen F. Grundzuge einer historisehen und geographischen Pathologie, in book: Spez. path. Anat., hrsg. v. W. Doerr u. E. Ueh-linger, Bd 5, 1, B. u. a., 1966; May J. M. Studies in disease ecology, N. Y. „1961; S o r r e M. Les fondements de la fGographie humaina, t. 1—3, P., 1947 — 952.

A. P. Avtsyn.