From Big Medical Encyclopedia

GEOGRAPHY MEDICAL — the industry of geography and medicine studying natural and social factors and conditions in certain territories for the purpose of identification of their influence on the state of health of the population.

Modern G. is presented to m by system medico-geographical and medical - biol, sciences, such as medical climatology, medical parasitology, medical landscape science, a nozogeografiya, medical cartography, etc. All of them are engaged in comprehensive study of natural and territorial and territorial and production complexes, identification of influence of environmental factors on health of the person, establishment of an etiology and pathogeny of separate nosological forms, studying of territorial distinctions in the state of health of people, drawing up the short-term and long-term medikogeografichesky forecast.

Along with medical geography the geographical directions of a number of medical disciplines, such as geographical pathology (see), geographical hygiene, geographical epidemiology, etc. gained development.

The concept «geography medical» was entered into science in 17 century by B. Ramazzini. To it indicated the need of development of such scientific direction still Hippocrates in the treatise «About a Cart Spirits, Waters and Areas» (apprx. 424 BC) and Ibn-Xing (Avicenna) in «A canon of medicine». Their views gained later development in Paracelsus, T. Sydenham's works. In 1792. L. Finke published the first guide to G. of m. «Experience of the general medico-practical geography», in Krom all data on natural environmental factors, their adverse influence on health of the person and measures for the prevention of this influence were generalized.

The early medico-geographical studies in Russia belong to the second half of 18 century. The foundation was laid for this work by the doctor V. Ya. Gevitt who made during 1754 — 1756 the medico-geographical description of the city and fortress Kizlyar on the instructions of the director of Medical office P.3. Kopdoidi.

Especially wide scope was received by medico-geographical and medico-topographical descriptions in 19 century when it was in total executed apprx. 300 such works and is described more than one third of the territory of Russia, including and a little studied its suburbs. The big merit in the organization of medico-geographical studying of Russia belongs to medical justices of provinces in the Provision on which the duty of doctors to make «the physical and topographical description of the province, with detailed explanation of what joins a part medical most» was specified. The methodical management and practical help to doctors in this work various public organizations, e.g. Ob-in gave the Russian doctors in St. Petersburg, the considering G. to m of Russia «a subject of the sincere and lawful desires», Russian geographical about-in, etc. They were initiators of development of special programs of medico-geographical descriptions, promoted their reviewing and the edition (e.g., in 1870 — 1871 two volumes of the special «Medico-geographical collection» under the editorship of S. P. Lovtsov and G. I. Arkhangelsky were published).

Along with medico-topographical and medico-geographical descriptions (see) which were sources of the fullest information on that time on natural, social and working conditions of the certain regions of Russia and their alleged influence on health of the population, emergence and territorial spread of diseases, during the same period appear numerous works, e.g. G. M. Gertsenshteyna, L. I. Godyntsa, P. A. Peskov, etc., on studying of territorial distinctions in incidence of the population and features of geographical spread of separate diseases of the person depending on natural, social and working conditions, napr, N. I. Toropov, E. Shperk, N. I. Kashin's works, etc.

Qualitatively new stage in G.'s development by m began during the Soviet period. The preventive direction of the Soviet health care set for this science the new public tasks, and progress medical, biol, and geographical sciences opened ample opportunities in studying of social value of factors and conditions of the environment and their influence on health of the population.

The significant role in G.'s development by m was played by the doctrine E. N. Pavlovsky (1939) about a natural ochagovost of a number of transmissible diseases (see. Natural ochagovost ) and development on this basis of the principles of studying of geography of prirodnoochagovy and parasitic diseases,

A. P. Vinogradov (1938) concept about biogeochemical provinces which allowed to analyze a biogeochemical situation of certain regions of the country, and the theory of malyariogenny landscapes estimating natural complexes on degree of danger of a disease of malaria of the population living here developed by V. N. Beklemishev (1948).

Works on studying of social effects of environmental pollution as production and household waste are important for G.'s development by m.

Objects of studying of G. of m are territories of the certain republics, edges, areas, areas, the cities and rural settlements, major new buildings and new economic land development. The purpose of modern medico-geographical researches consists in detection of set, characteristic of this specific territory, natural and social (social and production) the factors and conditions which are exerting impact on health radical or again arriving to this territory of the population, and also possible change of these factors and conditions under the influence of economic activity of the person.

Studying of natural factors and conditions is carried out taking into account territorial differentiation of the environment, in relation to objectively existing natural and territorial complexes (geosystems) — zones, natural provinces, landscapes, etc., forming as a result of difficult interaction of separate components of the environment: a ground layer of the atmosphere together with a soil cover; surface, subsoil and underground waters, vegetation and fauna. Each of such natural and territorial complexes is characterized by factors and conditions, positively or negatively influencing health of the population. Special attention is paid on natural factors which are capable to cause a disease of the person at certain social and working conditions. Such natural factors, the caused geophysical., geochemical or biotic (biocenotic) specifics of natural and territorial complexes (see. Biogeocenosis ), received in G. m the name of natural premises of diseases of the person. Natural premises of a number of transmissible and parasitic diseases, so-called biogeochemical local diseases (e.g., a local craw, caries of teeth, a fluorosis, etc.), allergic diseases, mycoses are studied in detail.

The social and production factors and conditions exerting impact on health of the population are studied in relation to the existing or again forming territorial and production complexes (the economic region, industrial hubs and the centers) within which they are rather homogeneous.

Medico-geographical studying of various regions of the country gives the chance of their typification on the similar natural, social and production factors and conditions exerting impact on health of the population. On this basis it is obviously possible to carry out medico-geographical zoning of the territory of the country or its certain areas (see. geographical zoning ). In the sixties 20 century such division into districts are spent in the territory of Siberia and the Far East.

In development of productive forces, changes of territorial placement of the industry, page - x. productions, improvement of municipal services of the cities, transformation of the environment there is a transformation of natural, social and production factors and conditions of certain regions of the country. In this regard extremely important value is gained by development of the medico-geographical forecasts giving the chance beforehand to expect the nature of influence of new factors and conditions of the environment on health of the population.

Medico-geographical researches in character are complex. They reflect medico-geographical specifics of certain regions of the country, its possible change as a result of economic activity of the person. It gives the chance to practical health care as in the old, already made habitable areas, and especially in again developed territory it is purposeful to develop the regional systems of actions directed to preservation and promotion of health of the population, prevention of diseases including by elimination of their natural premises, to improve structure local to lay down. - professional, and protivoepid, institutions, total quantity and a profiling of beds, medical staff, etc. Special medico-maps, napr in this respect can give big help, to a series of cards or separate cards reflecting territorial distribution within the USSR of diseases with a natural ochagovost (bronchial asthma and other nosological forms).

medico-geographical researches are conducted in the Soviet Union by research teams of specialists in the area G. of the m working in research in-ta of Academy of Sciences of the USSR, the USSR Academy of Medical Sciences, allied and the republican Ministries of Health and also at departments of medical in-t and geographical f-tov state. high fur boots. In some medical in-ta and on geographical f-takh state. high fur boots courses of lectures according to G. are given by m. Highly skilled training of specialists in the area G. of m from doctors, geographers and biologists is carried out through a postgraduate study. Problems G. of m are systematically discussed at various meetings and congresses. Four all-Union meetings on problems G. of m and apprx. 20 republican and regional conferences and thematic symposiums are held.

In Geographical about-ve the USSR are created and successfully departments and G.'s commissions of m work. At presidium Geographical about-va Coordination and methodical council for medical geography is organized. All-Union in-that scientific and technical information of Academy of Sciences of the USSR since 1957 the abstract magazine «Medical Geography», and also the special edition «Results of science is issued. Medical geography». Of m abroad develops preferential in the nozogeografichesky plan and is directed to studying of features of territorial spread of separate diseases of the person. Systematic researches on G. of m are conducted in Bulgaria, Czechoslovakia, Germany, Japan, Great Britain, the USA, the Netherlands where there are research teams of the specialists working in research in-ta of a medical and geographical profile. The most capital works on G. of m performed abroad are the «Atlas of spread of infectious diseases» (Welt Seuchen Atlas) published in Germany (1952 — 1957), a series of the nozogeografichesky cards published American geographical about-vom and also capital work of Mei (J. M of May, 1958) «Ecology of diseases».

Since 1952 as a part of the International geographical union the constant Commission on medical geography is created, the Soviet specialists take part in work a cut. Meetings of the Commission are dated for the international geographical congresses which are carried out each four years worldwide.

Geography military-medical — the section of military medicine studying natural and social factors and conditions in areas of accommodation of troops and conducting combat operations in aspect of their influence on health of staff and the organization of medical support of troops in peace and wartime.

Soldier. - the medical geography was issued in the independent scientific direction in the 40th 20 century on the basis of the theoretical generalization of a large number of military medico-geographical descriptions of the certain regions of Russia and the foreign states executed within 18 — 19 centuries. The most fundamental of them are N. Evfanov (1860) works, V. F. Stolyarova (1870), I. JI. Yavorsky (1889), etc. Number of general-theoretical provisions soldier. - medical geography contains also in M. Ya. Mu's works firewood (1826), I. I. Enegolma (1813), R. S. Chetyrkin (1834), A. A. Charukovsky (1836), I. I. Atlasova (1911), etc.

Great value in formation the soldier. - medical geography had the experience of medical providing troops during the Great Patriotic War of 1941 — 1945 on various battlefields which showed importance and need of special military medico-geographical researches for planning and implementation medical and evacuation, protivoepid and a dignity. - a gigabyte. actions.

Further development of theoretical provisions soldier. - medical geography received in A.S. Georgiyevsky's works (1952), A. A. Shoshina (1948, 1951, 1952, 1953), N. K. Sokolova (1952), etc.

Objects of modern medikogeografichesky researches are territories of military districts, separate garrisons, areas of military exercises, battlefields, the strategic and operational directions. The purpose of researches consists in studying of possible influence of natural and social factors and conditions (a relief, hydrography, soils, climate, vegetation and fauna, features of structure, resettlement, work and life of the population, development of productive forces, a road network, transport and communication, incidence of the population, a dignity. condition of settlements, medical establishment and shots) on health of staff of troops and medical providing in peace and wartime. At the same time possible change of these conditions during fighting is in every possible way considered, especially at use by the opponent of weapon mass - defeats.

Problems of military medico-geographical studying of territories of placement and possible fighting of troops are:

— detection of natural and social factors and conditions of the studied territories influencing health of staff of troops, definition of character and extent of this influence;

— development of recommendations about training of staff and medical service to activity in this territory and on the organization of medical providing troops in its limits.

Military medico-geographical studying of the territory has complex character, the wide range of specialists the soldier takes part in it. - medical services — organizers, epidemiologists, parasitologists, hygienists, clinical physicians of various profile, specialists of medical supply.

The standard program of military medico-geographical studying of the area includes the following sections: general characteristic of the territory; the natural and social conditions influencing health of staff and the organization medical and evacuation, a dignity. - gigabyte. and protivoepid, actions in troops; local resources of medical supply.

On the basis of results of a military medico-geographical research on the indication of governing bodies the soldier. - medical services are formed military medico-geographical descriptions (see), the military medico-geographical characteristics, military medico-geographical references which are directory documents. Each of these documents is formed according to special programs and contains a text part and appendices in the form of military medico-maps, schemes, tables and other illustrations. The data placed in these documents and recommendations shall be full and reliable. They are used for scheduling to lay down. - professional, actions of a part (connection) in peace time and during the planning medical and evacuation, a dignity. - a gigabyte. and anti-epidemic actions in troops during fighting. If necessary some of these data shall be specified by conducting military medico-geographical reconnaissance and medical investigation (see).

Practical value of military medico-geographical studying of the territory consists that it gives the chance to medical service purposefully to organize actions for the prevention of diseases in troops, to beforehand prepare forces and means of medical service for work in certain conditions.

Bibliography: Avtsyn A. P. Introduction to geographical pathology, M., 1972, bibliogr.; B I to about in V. P., etc. Medical geography, in book: Sov. geography, under the editorship of I. P. Gerasimov, page 396, M., 1960; Voronova. G. Geografiya and medicine, in book: Sov. geography during construction of communism, under the editorship of V. D. Bykov, etc., page 129, M., 1963; E of vfa-N about in N. Mediko-topografiya of the Kiev military district, Kiev, 1866; Medical geography, under the editorship of E. N. Pavlovsky, M. — L., 1961; Medical geography, Results of science, under the editorship of A. D. Lebedev, century 1 — 6, M., 1964 — 1974; Problems of medical geography, under the editorship of. A. A. Sho-shina and E. I. Ignatyeva, L., 1962; Socha-v and V. B. Geografiya and ecology, L., 1970, bibliogr.; Chaklin A. V. Regional features of spread of malignant tumors, L., 1963, bibliogr.; Sh about sh and A. A N. Fundamentals of medical geography, M. — L., 1962, bibliogr.; it, Military-medical geography, L., 1964.

E. I. Ignatyev; N. K. Sokolov (soldier.).