Am J Epidemiol 2003; 157:855-856.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
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The First Epidemiologic Text
Departments of Epidemiology, Obstetrics and Gynecology, and Neurology Yale University School of Medicine New Haven, CT 06510
No doubt when Dr. Warren Winkelstein (1) proposed Greenwood’s Epidemics and Crowd-Diseases (2) as the first epidemiology textbook, he was expecting, even hoping, to be trumped by someone with earlier references. Here are some possible candidates.
Greenwood himself published an earlier work in 1932, Epidemiology, Historical and Experimental, which was published jointly by the Johns Hopkins University Press and Oxford University Press (3). Even earlier contenders for the first epidemiology textbook include: The Principles of Epidemiology by Clare Oswald Stallybrass, published in 1931 (4), which focuses on infectious disease but includes discussions of statistical issues and causality using Koch’s postulates; Epidemiology, Old and New by Sir William Hamer, a 1928 publication (5)—although one might argue that this is an account of descriptive epidemiology and not really a textbook; Epidemiology and Public Health: A Text and Reference Book for Physicians, Medical Students and Health Workers by Victor Clarence Vaughan, published in 1922 (6); and Epidemiology: or, the Remote Cause of Epidemic Disease in the Animal and in the Vegetable Creation: with the Causes of Hurricanes, and Abnormal Atmospherical Vicissitudes by John Parkin, published in 1873 (7). The chapters in this book include consideration of "The Doctrine of Contagion" and "Analysis of Modern Theories."
The first reference to the term "clinical epidemiology" may be in the textbook of that title written by Yale professor John Rodman Paul in 1958 (8). Interestingly, in the second edition of the book, a Yale colleague, Alvan Feinstein, is acknowledged for his assistance in preparing that text. Feinstein would go on to write his own texts in clinical epidemiology.
Textbooks in classical times were rare. One of the first Roman texts in obstetrics and gynecology was written in the second century CE by the unfortunately named (for an obstetrician) Soranus, who had nothing to say about perinatal epidemiology (9). Hippocrates’ "Airs Waters Places," written around 400 BCE, is often considered the first epidemiologic text, but this may be the least scientific of his treatises, and books 1 and 3 offer more objective accounts of epidemiology (10). Hippocrates’ "Epidemics," books 2–7, have been most recently translated but are primarily clinical case histories, although book 6, chapter 7, offers insights into a "cough" epidemic at Thasos (11). Interestingly, Wesley Smith, the recent translator of Hippocrates, tells us that the word "epidemics" in Greek means "visits," which "may refer to the itinerant physician’s visits to the towns in which he practices, or more likely to the visitations of diseases in those communities" (11, p. 1). Writing even earlier, around 430 BCE, Thucydides gives an interesting account of the plague epidemic in Athens (12, book 2, chapters 47–54). All considered, Dr. Winkelstein is probably correct in not considering any of the classical texts to be textbooks as the term is currently understood.
Thucydides was not the first to write about epidemiology. A cuneiform tablet circa 1400 BCE from Babylon describes a plague epidemic among prisoners and appears to show an appreciation of the contagious nature of the (unspecified) disease—perhaps making this the first text-tablet of epidemiology (13). This Babylonian tablet may place epidemiology among the oldest of disciplines, not the newer ones, as has long been believed.
REFERENCES
- Winkelstein W Jr. From the editor: the first epidemiology textbook? (Editorial). Am J Epidemiol 2002;156:684.
[Free Full Text] - Greenwood M. Epidemics and crowd-diseases: an introduction to the study of epidemiology. London, United Kingdom: Williams and Norgate Ltd, 1935.
- Greenwood M. Epidemiology, historical and experimental. London, United Kingdom: Oxford University Press, 1932; Baltimore, MD: Johns Hopkins University Press, 1932.
- Stallybrass CO. The principles of epidemiology and the process of infection. New York, NY: Macmillan Publishers Ltd, 1931.
- Hamer W. Epidemiology, old and new. London, United Kingdom: Paul, Trench, Trubner and Company, 1928.
- Vaughan VC. Epidemiology and public health: a text and reference book for physicians, medical students and health workers. St. Louis, MO: CV Mosby, 1922.
- Parkin J. Epidemiology: or, the remote cause of epidemic diseases in the animal and in the vegetable creation: with the causes of hurricanes, and abnormal atmospherical vicissitudes. London, United Kingdom: J and A Churchill, first edition 1873, second edition 1880 (in two volumes).
- Paul JR. Clinical epidemiology. 1st ed. Chicago, IL: University of Chicago Press, 1958.
- Soranus. Gynaecology. Translated by O Temkin. Baltimore, MD: Johns Hopkins University Press, 1956.
- Hippocrates. Translated by WHS Jones. New York, NY: W Heinemann, 1923.
- Hippocrates. Vol 7. Translated by WD Smith. Cambridge, MA: Harvard University Press, 1994.
- Thucydides. Translated by CF Smith. Cambridge, MA: Harvard University Press, 1962.
- Martinez RM. Epidemic disease, ecology, and culture in the ancient Near East. In: Hallo WM, Jones BW, Mattingley GL, eds. The Bible in the light of cuneiform literature. Lewiston, NY: The Edwin Mellen Press, 1990.
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  W. Winkelstein From the Editor: The First Epidemiology Textbook?--Continued Am. J. Epidemiol., May 1, 2003; 157(9): 855 - 855. [Full Text] [PDF]
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