[Dr. D. Nicasio Landa, official epidemic doctor during the cholera epidemic of 1854-1855].
In this unpublished work from 1861, which we have transcribed, Dr. Nicasio Landa (1830-1891) is revealed to have been at the forefront in carrying out epidemiological studies in Spain. He traced the medical topography, or geographical pathology, of cholera by provinces, by means of calculating the incidence rate ("millesimal proportion of those infected") and lethality rates ("millesimal proportion of the dead") using the official data on the sick and deceased in the cholera epidemic of 1854-1855, published by the General Directorate of Health and Charity, as well as the data of the population census of 1857. He worked with an infectionist conception and, besides tracing the epidemiological map, he proposed an association of cholera with the geographical constitution of the terrain in order to explain the anomalous distribution of the disease. That same "anomalous" distribution was repeated in the cholera epidemic in Spain in 1885, and in that of 1971, which is in accordance with the environmental characteristics of certain terrains that make possible the maintenance and persistence of the vibrio cholerae, according to recent research explaining the varied endemo-epidemic distribution of cholera.
Viñes
J J
JJ
Medicina preventiva y Salud Pública, Universidad Pública de Navarra. jvinesru@cfnavarra.es