Heberden Oration, 1963 : The Epidemiology of Rheumatic Diseases
作者： J. H. Kellgren
DOI: 10.1136/ARD.23.2.109
关键词:
摘要: Epidemiology isthestudy ofdisease inpopulations asopposed topatients. Itsobjectives aretodeterminethecauses andbytheir definition to enable ustointroduce preventive measures designed toeliminate disease frompopulations rather thanto cureorrelieve established cases.Inthetimeof William Heberden hadnotemerged asaseparate discipline andPreventive Medicine was practically non-existent. Nevertheless madesomeverypenetrating observations inhis "Commentaries ontheHistory andCureofDiseases", andherecognized that could result fromboth heredity andenvironment. Wheneither orenvironment isthepredominant causeofdisease theproblem isrelatively simple, butifdisease results fromtheinteraction of several genetically-determined characteristics anda variety ofenvironmental conditions allofwhichmay beofequal importance, becomes very complex andthelimited success sofarachieved in Rheumatology maywellbeduetothefact most ofourproblems areofthis kind. Predominance ofeither arewellillustrated bytworarediseases-familial osteochondrodystrophy andUrovskaya Bolezin or Kashin-Beck's (Kotrechov, 1953). Anexample oftheformer isthefamily shownin Fig. 1.Thefather wasofshort stature anddeveloped an awkwardgait inadolescence, followed byosteo5ftu I
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