Famine, pestilence and war are three of the "Four Horsemen of the Apocalypse." With increasing malnutrition there is a greater incidence of morbidity and mortality. Severe as these sequels of national underfeeding have been, statistics from famine-swept Russia show that conditions have been underestimated, rather than overestimated. Cheinisse,1 quoting the report of Tarassévitch2 of Moscow to the Health Section of the League of Nations, states that from 1918 to 1921 there were, in Russia, from twenty-five to thirty million cases of exanthematous typhus—about one fifth of the total population—and that deaths from this cause were between two and one-half and three millions. Furthermore, Zlatogorov, Fedorov, Martzinovsky, Lubarsky and others note that famine adds grave trophic complications to the disease, among which are gangrene of the lower extremities and tendency to hemorrhage.
As testimony of the evil effect of malnutrition in regard to epidemic disease in Russia, Professor Otto
FAMINE AND THE INCIDENCE OF COMMUNICABLE DISEASE. JAMA. 1923;80(20):1457–1458. doi:10.1001/jama.1923.02640470035016
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