Humboldtian medicine.

Medical geography-the study of the global distribution of human diseases as a function of environmental conditions-was a largely nineteenth-century preoccupation. It incorporated the earlier and contemporaneously continuing interest of medical topography -the description of the medical conditions of particular places. Victorian medical geographers cited J F Cartheuser's De morbis endemiis libellus (1771) as the starting point of their subject; but George Rosen has argued that the first comprehensive medical geography was the Versuch einer allgemeinen medicinisch-praktischen Geographie (vols 1, 2: 1792; vol. 3: 1795), written by the German obstetrician and district medical officer ("Landphysicus") Leonhard Ludwig Finke.1 Major treatises on medical geography appeared over a period of approximately one hundred years, until by the end of the nineteenth century interest in environmental causes of diseases declined, as the development of bacteriology shifted aetiological thinking towards the germ-theory of infectious diseases. One of the greatest representatives of medical geography, to whom Frederick Sargent II has drawn attention,2 was another German, August Hirsch, whose massive, two-volume Handbuch der historischgeographischen Pathologie (vol. 1: 1860; vol. 2: 1862-64) went through a second, threevolume edition (vol. 1: 1881; vol. 2: 1883; vol. 3: 1886), which was translated into English under the auspices of the New Sydenham Society.3 Hirsch was active also as a historian of medicine: in addition to editing the Biographisches Lexikon der hervorragenden Arzte aller Zeiten und Volker, he wrote the Geschichte der medizinischen Wissenschaften in Deutschland (1893). In this textbook, he briefly discussed medical geography, depicting its history as a straight line of development from Finke's Versuch to the second edition of his own Handbuch; on this line a few intervening contributions by other medical