ASSIGNMENTIntroduction to Public health

Prepared for:Prof. Dr. Mohammad Abdul Bari

Head of Faculty

Prepared by:Dr. S.M. Yasir ArafatID No. 14-2-42-0004

Executive MPH

Faculty of Science & EngineeringDepartment of Public health

ASAUB

April 03, 2015

Historical Overview of Public Health

Historical Overview of Public Health

Introduction:

The history of public health goes back to almost as long as history of civilization.

Primitive medicine (5000 BC)

Suffering was considered due to evil spirit. There was influence of stars and planets.

The concept of disease was known as ‘Supernatural theory of disease’.

Indian medicine

Indian medicine was truly Ayurvedic and Siddha system. Ayurveda dates back to 5000

BC. Celebrated authorities in Ayurvedic medicine were Atreya, Charaka, Susruta and

Vaghbhatt. Tridosha theory of disease i.e. disease occur due to disturbances in equilibrium

of three humors (doshas) known as Vata (wind), pitta (gall), kapha (mucus). Disease was

explained as disturbances of equilibrium of three humors.

Chinese medicine (2700 BC)

It developed basing on two principles- the Yang and Yin. Yang is masculine and active

and Yin is feminine, negative, and balanced between two opposite forces meant good

health. The Chinese proverb goes like this ‘The great doctor is one who treat not someone

who is already ill, but someone not yet ill’. Hygiene, dietetics, hydro-therapy, massage etc.

were used by physicians. Chinese medicine championed immunization, acupuncture and

bare footed doctor.

Egyptian medicine

Egyptian medicine was mingled with religion. Sick was sent to priest for cure. Inhotep

(2650–2600 BC) was considered both a doctor & divinity, “the one who comes in peace, is

with peace”. He is considered by some to be the earliest known architect and engineer and

physician in early history

Mesopotamian medicine

Mesopotamia (now part of Iraq) often called the ‘Cradle of civilization’ as long as 6000

years ago. Babylonian King Hammurabi is known for the set of laws called

Hammurabi's Code, one of the first written codes of law in recorded history which had

provision of killing of doctor who gave wrong treatment (2000 BC).

These laws were inscribed on stone tablets standing over eight feet tall.

The Book Of Leviticus (1500 BC) had guidelines for personal cleanliness, sanitation of

campsites, disinfection of wells, isolation of lepers (affected with leprosy), disposal of

refuses and hygiene of maternity. In Greek the Levites refers to the tribe from whom the

priests were drawn. Leviticus is a manual of regulations enabling the holy King to set up

his earthly throne among the people of his kingdom .

Leviticus rests in two crucial beliefs:

1. The first, that the world was created "very good" and retains the capacity to achieve

that state although it is vulnerable to sin and defilement (corruption);

2. The second, that the faithful enactment of ritual makes God's presence available, while

ignoring or breaching it compromises the harmony between God and the world.

Greek medicine (classic period-460-136 BC)

The early leader in Greek medicine-Aesculapius bore two daughters- ‘Hygiea’ meaning

goddess of health and ‘Panacea’ meaning goddess of medicine. They gave rise to the

dynasties of healer (curative medicine) and hygienist (preventive medicine). Hippocrates

(460-370 BC), who is often called the father of medicine classified diseases based on

observation and reasoning. His lectures & writings were compiled and known as ‘Corpus

Hippocraticum’ contained scientific clinical case histories in 72 volumes.

Roman medicine

Roman civilization succeeded Greek ones. Sanitation developed with development of

baths, sewers, drains and sewerage systems and established hospitals for diseased.

Galen (130-205 AD) observed that disease was due to predisposing, exciting and

environmental factors.

Middle Ages (500-1500 AD):

After the fall of Roman empire medical facilities disappeared and disease was rampant in

Europe- ‘Dark Ages of Medicine’. Health problems were considered as having spiritual

cause and solutions. They were supernatural powers for punishments for sins for

Christians.

The pioneers were Abu Becr (865-925 AD), also known as Rhazes, and Ibn Sina (980-

1037), also known as Avicenna in western world. Rhazes wrote books on Children’s

diseases and distinguished between Measles & Smallpox. Borrowing largely from Greek

& Roman medicine they developed their own system of medicine known as Unani system.

They founded schools of medicines & Hospitals in Baghdad, Damascus, Cairo & other

Muslim capitals. Ibn Sina compiled 21 volumes encyclopedia ‘The Canon of Medicine’.

Arabs developed pharmacology and used syrup, poultices, plasters, pills etc. in healing

diseases. Leprosy, plague(Black Death) in Europe during the 14th century and syphilis

were some of the deadliest epidemics resulted from failure to consider physical and

biological causes. 

Revival of medicine (dawn of scientific medicine, following 1500):

The era of renaissance and exploration (1500 – 1700 A.D) was the rebirth of thinking of

about nature of the world and humankind. There was a growing belief that diseases were

caused by environment, not by spirits and critical thinking about disease causation .

Paracelsus (1453-1541), a critic of Galen & Avicenna, turned medicine towards rational

research. Fracastorius (1483-1553), an Italian physician gave the ‘theory of contagion’.

He became founder of epidemiology and established that infection occurs by transference

of invisible particles and explained cause of epidemics.

Thomas Sydenham (1624-1689), was distinguished epidemiologist. Ambroise Pare

(1510-1590) French Army surgeon advanced Surgery earned title ‘Father of Surgery’.

Later John Hunter (1728-1793) taught the science of surgery.

Rise of public health

Johanna Peter Frank (1745-1821), a health philosopher conceived public health as a

good health law enforced by police and said that the state is responsible for the health of

the people. The great cholera epidemic of 1832 led Edwin Chadwick (1800-1890), a

lawyer to investigate the conditions under which people live in England. His report was

known as “ The Sanitary Conditions of the Labouring Population in Great Britain”, a land

mark in the history of public health (1843).Historical milestone in the evolution of

medicine is the “Great sanitary awaking” , which took place in England in the mid-

nineteenth century & gradually spread to the other countries. Anti filth crusade is called

the ‘The great sanitary awakening’ which led to the enactment of the public health

Act of 1848 in England. After Edwin Chadwick’s investigation of the health of the

inhabitant of England, John Snow an epidemiologist studied epidemiology of cholera

from 1848-1854 and established the polluted water as cause of cholera. Sir John Simon

(1816-1904), first medical officer in England built up system of public health, which later

became the admiration for the rest of the world. William Budd (1856) established

contaminated water as the cause of typhoid fever in rural area of England. Public health

Act of 1875 enacted to control physical environment. American public health developed

after 1850 in English pattern. In the U.S., public health is studied and coordinated on a

national level by the Centers for Disease Control and Prevention. Similarly, other

European countries developed the public health. Public health stood on a foundation at

beginning of 20th century with supply of clean water, clean surrounding, healthy housing

and control of offensive trades.

HISTORICAL MARKERS in the development of Public Health

1792-1750 BC -The Code of Hammurabi – Rules governing medical practice 

1500 BC -Mosaic Law–Personal, food and camp hygiene, segregating lepers, saving of

life as religious imperatives (necessity).

400 BC -Greece–Personal hygiene, fitness, nutrition, sanitation, municipal doctors,

occupational health; Hippocrates–clinical and epidemic observation and environmental

health.

1876-Robert Koch discovers anthrax bacillus.

1879 -Neisser discovers gonococcus organism.

1880 -Typhoid bacillus discovered (Laveran); leprosy organism (Hansen); neumococcus

1882 -Robert Koch discovers the tubercle bacillus.

1883 -Louis Pasteur vaccinates against anthrax, Anti-rabies vaccine.

1884 -Diphtheria, staphylococcus, streptococcus, tetanus organisms identified.

1890 -Anti-tetanus serum (ATS).

1892 -Gas gangrene organism discovered by Welch and Nuttal. 

1893 - cholera vaccine,

1894 - Diphtheria vaccine,

1894 -Plague organism discovered (Yersin, Kitasato); botulism organism

1898 -anti-typhoid vaccine,

1898 -Sir Ronald Ross S, (13 May 1857 – 16 September 1932), was an Indian-born

British medical doctor who received the Nobel Prize for Physiology or Medicine in 1902

for his work on malaria. He demonstrated malaria parasite in the G.I. tract of mosquito.

1827 -1912 - antiseptics & disinfectants

1900 - Walter Reed & his colleagues demonstrated that yellow fever is transmitted by

Aedes mosquitoes.

1923 -Health Organization of League of Nations 

1926 -Pertussis vaccine developed .

1928 -Alexander Fleming discovers penicillin. 

1929-1936 -The Great Depression – wide spread economic collapse, unemployment,

poverty, and social distress in industrialized countries.

1946 -World Health Organization founded.

1955-1960- Polio vaccine

1977 -WHO adopts Health for all by the year  2000

1977 -Last case of smallpox in the world was detected in Somalia on 26 October.

1978 -Alma-Ata Conference on Primary health Care

1978 -Laboratory accident of smallpox occurred in Birmingham (UK) 

1980 - Smallpox has been eradicated from the globe as declared by WHO in May

1981 -First recognition of cases of acquired  immune deficiency syndrome (AIDS).

1989 -International Convention on the Rights of the Child.

1990 -W.F. Anderson performs first successful gene therapy.

1992 -United Nations Conference on Environmental and Development, Rio deJaniero

1992 -International Conference on Nutrition.

1993 -World Conference on Human Rights Vienna.

1994 - International Conference on Population and Development, Cairo.

1998 -WHO Health for All in the Twenty-first Century adopted.  

References

Lectures of ASA University Bangladesh (Prof. M A Bari)

Lectures of DMCH (Prof. M A Zabbar)

Preventive & Social Medicine- K. Park

Text Book of Community Medicine- Rashid, Khabir, Haydar