Epidemic diseases are defined by excess They are dramatic and they attract attention Endemic diseases, on the other hand, are regarded as ?normal? and tend to be neglected Yet it is clear that this contrast can entail inaccurate impressions of risk, as well as disparities in the imperative to action This paper looks at two examples, one from the early modern period and the other from the 19th century The earliest attempts in England to define excess mortality, primarily from plague, came in the form of parish registration, which led, in London, to the publication of Bills of Mortality The first to analyse the Bills in order to define risk was the London tradesman John Graunt The causes of death recorded in the Bills were a reflection of popular opinion, but Graunt used the process of aggregation to reveal mistaken ideas about the most notorious diseases, some of which were endemic rather than epidemic He also regarded ?chronical? diseases as the best measure of the healthiness of a city In the 19th century, the centrality of plague was replaced by that of cholera, which has attracted much attention from social historians Yet the case for public health reform was founded not on the random and comparatively isolated epidemics of cholera, but on the constant mortality caused by what were called the continued fevers, notably typhus and typhoid The Benthamite sanitarians adopted an increasingly simplified, localist approach, which was at odds with professional opinion but was adjusted to the need both to increase popular understanding and to promote official action where it was most likely to be effective When cholera receded, major endemic causes of death remained in the form of respiratory disease and infant mortality Uncertainties and problems of identification and comparability persisted into the 20th century and beyond

中文翻译：

---

“胸毒蛇”：地方病与流行病

流行病是由过度定义的它们是戏剧性的，它们引起了人们的注意。另一方面，流行病被认为是“正常的”。并且往往被忽视 然而很明显，这种对比可能会导致对风险的不准确印象，以及采取行动的必要性的差异 本文着眼于两个例子，一个来自近代早期，另一个来自 19 世纪。英格兰试图定义主要来自瘟疫的超额死亡率，以教区登记的形式出现，这导致伦敦出版了《死亡法案》。第一个分析法案以定义风险的是伦敦商人约翰·格劳特法案中记录的死因反映了民意，但 Graunt 使用聚合过程揭示了关于最臭名昭著的疾病的错误观念，其中一些是地方病而非流行病。他还认为“慢性病”？疾病是衡量一个城市健康状况的最佳指标 19 世纪，瘟疫的中心被霍乱取代，引起了社会历史学家的广泛关注，但公共卫生改革的理由并非建立在随机和相对的基础上霍乱的孤立流行，但由于所谓的持续发烧引起的持续死亡，特别是斑疹伤寒和伤寒 边沁卫生学家采用了日益简化的地方主义方法，