Geographic Pathology

a field of medicine that studies the pathology of humans, animals, and plants in relation to geographic factors, and, in the case of humans, social and economic factors as well. Geographic pathology investigates the processes of the organism’s interaction with its habitat and the characteristics of clinical manifestations of diseases in relation to local natural features, the population’s way of life, and social factors. Geographic pathology is closely related to the fields of population geography, anthropology, ecology, demography, social hygiene, community hygiene, nutritional hygiene, and occupational hygiene. The term “geographic pathology” was proposed in 1858 by the German pathologist, epidemiologist, and hygienist A. Hirsch. During 1929-31 the German scientist M. Askanazy founded the International Society of Geographic Pathology, establishing as its purpose the comparison of the pathological panorama in various countries of the world. By 1969 nine conferences of the society had been held, and its papers were published in the Swiss Journal of Pathology and Microbiology.

In the USSR geographic pathology was conceived and developed under the term “regional pathology.” The Soviet scientist E. N. Pavlovskii founded the teaching of the natural endemism of infectious diseases, and L. A. Zil’ber, M. P. Chumakov, A. K. Shubladze, E. N. Levkovich, V. D. Solov’ev, A. A. Smorodintsev, A. V. Churilov, M. K. Kron-tovskaia, and N. N. Sirotinin discovered such naturally endemic diseases of man as tick-borne encephalitis, hemorrhagic nephrosonephritis and a group of hemorrhagic fevers, tick-borne typhus (spotted fever) of Northern Asia, paroxysmal rickettsiosis, alimentary toxic aleukia, heliotropic hepatitis with ascites, poisoning by a weed (Trichodesma in-cana) in Middle Asia, alimentary myoglobinuria associated with eating certain species of fish, molybdenum gout, and strontium chondrodystrophy. Soviet scientists have determined regions of the USSR in which infectious, parasitic, or biogeochemical diseases have been discovered, which were initially discovered abroad.

Geographic pathology in the USSR differs from that in capitalist countries in its organic connection with the organization of public health, social hygiene, and medical geography. Geographic pathology studies all manifestations of disrupted or altered life processes of the organism, including those which can be determined only by special investigations (clinical, biochemical, pathophysiological, or pathomor-phological), while nosogeography (the geography of disease) takes into account only manifested diseases. Thus, geographic pathology records and investigates not only developed diseases or their very first stages but also “pre-diseases”—that is, those disturbances in the body that sooner or later lead to disease. In the USSR, whose territory is characterized by an exceptional variety of environmental conditions, geographic pathology is especially significant, particularly since it is difficult for the human body to adapt to conditions of life in extensive regions (for example, the arctic, deserts and semideserts, high elevations, and territories with greater seismicity). In these regions peculiar reactions of the body to the environment and unusual types of clinical courses of diseases are found especially frequently.

Geographic pathology does detailed investigations of data on malignant tumors and cardiovascular and hereditary diseases, which are unevenly distributed within various countries. This may be explained not only by the historically established isolation or customs of the population but also by the fact that certain occupational hazards (radioactive and chemical ones) may produce stable hereditary changes in sex and somatic cells—mutations. Soviet scientists also study the geographic pathology of other countries. This is important when there are close international ties, because of the possibility of importing disease agents or carriers of diseases already eliminated or never present in the first place in the USSR.

There is also natural endemicity of disease in animals and plants. These diseases may be infectious as well as biogeochemical in origin. For example, a deficiency or excess of certain microelements in the soil produces diseases of plants and animals—so-called biogeochemical endemism.

Problems of geographic pathology are periodically treated in the review journal Meditsinskaia geografiia (Medical Geography), published by the All-Union Institute of Scientific and Technical Information of the Academy of Sciences of the USSR. The International Society of Geographic Pathology deals with the organization of research on geographic pathology abroad.