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Benign occipital unicameral bone cyst causing lower cranial nerve palsies complicated by iophendylate arachnoiditis

1974; BMJ; Volume: 37; Issue: 9 Linguagem: Inglês

10.1136/jnnp.37.9.1059

1468-330X

W. G. Bradley, R M Kalbag, P. S. Ramani, B.E. Tomlinson,

Hematological disorders and diagnostics

Background: During the early 19th century, contagionists’ and anti-contagionists’ explanations of disease causes opposed one another, and the Hippocratic miasma theory still predominated. According to that theory, geographic health disparities could be explained by topographical factors: differences in altitude, population density or proximity to a river. This paper summarizes the life of Louis-René Villermé (1782–1863) and his major contributions to social epidemiology that proved the association between poverty and mortality. Methods: We present and reanalyze the data reported by Villermé to study the mortality-rate variations across the 12 districts (arrondissements) of Paris, i.e., 1817–1826 Parisian death rates by district, population density and income indicators. Results: Results obtained with today’s statistical techniques (correlation analysis) support Villermé’s claims of a direct poverty–high death-rate link: the three income indicators that he chose were significantly correlated with at-home mortality: taxation index (r= –0.83, p<0.002), average rent (r= –0.83, p<0.002), trade taxation index (r= –0.67, p<0.05), while population-density variables were not associated with mortality. Conclusion: Villermé was not only a forerunner of social epidemiology, he was also a scientific pioneer by relying on data, not opinions, to challenge or support medical hypotheses.