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Origins and Directions of Inflammatory Bowel Disease pp 103–204Cite as

Etiology and Pathogenesis of IBD — Origins and Directions

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Abstract

The concept embodied in epidemiology involving study of the distribution and the determinants of disease in human populations originated with Hippocrates (370–460 BC) and his “Airs, Waters and Places” (Epidemics I and III) but did not emerge as a distinct discipline until mid 19th century. Organization of the Statistical Society of London in 1834 and the Epidemiological Society of London in 1850,542 together with the seminal descriptions of John Snow543 (1813–1858)(cholera) in 1849 and by W. Budd544 (1811–1880) (London) (typhoid fever) in 1873 had established epidemiology as an important approach to the understanding of human illness but its application to inflammatory bowel disease was not possible for many years. Instances of “nonspecific” inflammatory bowel disease appeared during the nineteenth century, concurrently with a “substantial decline in mortality from intestinal infections,”545 but initial attempts to estimate the incidence, prevalence and demography of inflammatory bowel disease were impractical because of the small number of identified patients, diagnostic uncertainty and limited clinical understanding. J.L. Kantor,546 in a 1929 review of 2500 private patients with digestive complaints in New York, had suggested the proportion of ulcerative colitis admissions as nine in a thousand, contrasting with such estimates as constipation 500 per 1000 and irritable colon 200 per 1000.

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  1. Department of Medicine, University of Chicago, Chicago, IL, USA

    Joseph B. Kirsner M.D., Ph.D., D.Sci. (hon.) (The Louis Block Distinguished Service Professor of Medicine)

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Kirsner, J.B. (2001). Etiology and Pathogenesis of IBD — Origins and Directions. In: Origins and Directions of Inflammatory Bowel Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0326-1_4

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