Stallybrass C O
Proc R Soc Med. 1928 May;21(7):1185-210. doi: 10.1177/003591572802100727.
THE SEASONAL VARIATIONS IN DISEASE, AS IS THE CASE IN THE SPREAD OF INFECTIVE DISEASES GENERALLY, DEPEND UPON THREE PRIMARY FACTORS: (1) the presence of the micro-organisms of adequate virulence and infectivity; (2) the means of transmission to (3) the susceptible tissues of the susceptible individual. All other factors, in this relation largely climatic, can act directly only through these three primary factors and are therefore termed secondary. The paper is largely an attempt to express the effect of the variations in the secondary factors in terms of the alterations they produce in the primary factors. The total effect of the three primary factors in the spread of infection is termed "dispersability" and a ratio or measure of dispersability is described. This ratio emphasizes occurrences in the pre-epidemic period.The relationship of temperature and humidity to the alimentary, respiratory and percutaneous diseases and to the ectodermoses, is investigated. In the autumnal group of infections, attention is drawn to the action of carriers in causing a rise in dispersability in the spring and the frequent occurrence of a double wave of dispersability.The effect of climatic changes is often cumulative, and this is most evident in the autumnal group of infections, the seasonal occurrence of which cannot be directly explained by temperature changes, or even by the action of light on phagocytes. The possibility of vitamin deficiency or excess producing cumulative effects is considered.Secular changes in seasonal periodicities are investigated and these are associated with other changes, such as the intrinsic periodicities, mode of spread, etc., the combined changes being described by the terms aggradation and degradation of disease.Slides covering the majority of the infective diseases of temperate climates and exhibiting the secular changes in Liverpool, and various geographical differences, in some 175 curves displayed.
疾病的季节性变化，如同一般传染性疾病的传播情况一样，取决于三个主要因素：（1）存在具有足够毒力和传染性的微生物；（2）传播途径；（3）易感个体的易感组织。在这方面，所有其他因素（主要是气候因素）只能通过这三个主要因素直接起作用，因此被称为次要因素。本文主要试图根据次要因素的变化对主要因素产生的改变来阐述其影响。感染传播中这三个主要因素的总体影响被称为“传播性”，并描述了传播性的比率或度量。这个比率强调流行前期的发病情况。研究了温度和湿度与消化道疾病、呼吸道疾病、经皮疾病以及外胚层疾病的关系。在秋季感染组中，注意到带菌者在春季导致传播性上升以及传播性双波频繁出现的作用。气候变化的影响往往是累积性的，这在秋季感染组中最为明显，其季节性发病不能直接用温度变化甚至光对吞噬细胞的作用来解释。考虑了维生素缺乏或过量产生累积效应的可能性。研究了季节性周期的长期变化，并将其与其他变化（如内在周期、传播方式等）相关联，这些综合变化用疾病的加剧和衰退来描述。展示了涵盖温带气候大多数传染病的幻灯片，并呈现了利物浦的长期变化以及约175条曲线中的各种地理差异。
