evolution of public health

INTRODUCTION TO THE EVOLUTION OF PUBLIC HEALTH : 

INTRODUCTION TO THE EVOLUTION OF PUBLIC HEALTH Presenter : Dr. Shruti Murthy

CONTENTS : 

CONTENTS Introduction Prehistoric health Primitive Era Indian Chinese Egyptian Mesopotamia Greek Roman Arabian Dark Ages Medieval Ages Renaissance Colonial Era Modern Era Summary References

Slide 3: 

INTRODUCTION

PREHISTORIC PUBLIC HEALTH : 

PREHISTORIC PUBLIC HEALTH Nomadic Existence Magic, spells, folklore Sanitation of camp sites-mythical reasons

Primitive Era : 

DEMONISTIC THEORY Suffering: Demons Health: Good Spirits Witch Doctors Witchcraft i.e Pleasing demons by Charms Armlets Sacrifices- even humans! Gods & Godesses Disease-result of sins Priest Physicians Chastisement -a precondition to treatment Primitive Era FATALISTIC THEORY

Indian Medicine : 

Spirituality & ethics Ayurveda- Science of life Tri-Dosha theory Maintenance of health as a whole Purity & Cleanliness Indian Medicine PURITY

Leading Personalities : 

Charaka- Physician Charaka Samhita Sushruta- Surgeon Sushruta Samhita Atreya Vaghbhat Leading Personalities

Chinese Medicine : 

Chinese Medicine

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Hypothesis Yin and Yang 5 elements, 5 body parts, 5 principles Neijing suwen- on silk Barefoot doctors Acupuncture & Moxification

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Moxification Acupunture

Egyptian Health : 

Egyptian Health

Egyptian Health Practices : 

Intestinal putrefaction of food Disease Treated by emetics, laxatives Yet, Well-established community systems: Public baths Drains collecting rain water Earth closets Personal hygiene-sanitation, loose clothing. Egyptian Health Practices emotions

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Rx- astrologic sign of Jupiter Houses of Life – 1st Dynasty 19th Dynasty- Insurance, sick leave, pensions

Leading Personalities : 

Leading Personalities Edwin Smith Papyrus-3000 BC Purely rational & devoid of any magical thinking Pharmaceutical prescriptions Imhotep -master of all fields Herodotus- Hygienic customs (5th century BC) Hesy-Ra –“Chief of dentists and physicians” Peseshet – “Lady overseer or the Lady Physician”

Mesopotamia : 

Mesopotamia

Hebrew Mosaic Law : 

An extension of Egyptian disease concept Efforts to prevent disease spread Mosaic law/code-human conduct Torah - health related laws & rituals; Segregation of lepers Washing after handling dead body Sanitation of camp sites Communicable disease control Fumigation… Sabbath day Hebrew Mosaic Law

Contd.. : 

Forbid pork Leviticus –isolation of lepers A good level of health, but Lack of health promotion Contd..

Greek Glory : 

Greek Glory Hypothesis- HUMORAL THEORY 4 humors (microcosm) & 4 elements (macrocosm) Any imbalance led to disease Treated by restoring the balance- by herbs Emphasis on individual- physical aspects Games, gymnastics, athletics, exercise Hence, Environmental sanitation suffered

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Temple of Asclepieia- (after Greek God Aesculapius) Medical advice, prognosis and healing Enkoimesis (dream-like state for healing) Leading Personalities

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Aesculapius Hygeia (Preventive medicine) Panacea (clinical medicine)

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Hippocrates – Hippocrates Corpus - Hippocratic oath - First epidemiologist Herophilus - Nerves and blood vessels

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Hippocrates

The Roman Empire : 

Hypothesis- 2 humors (bile & phlegm) -blood letting, magic, folklore Emphasis on State, individual neglected Regular Census Aqueduct, ‘pay toilets’, street repairs… Wealth accumulated, men decayed The Roman Empire

Leading Personalities : 

Leading Personalities Galen – Anatomy & Physiology (apes) Vesalius- Human dissection Celsus(1st Century AD)- surgery rather than supernatural forces/destiny

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Aqueduct

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Public Bath

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Sewers & Rain water drains

Arabian Medicine : 

Arabian Medicine

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Translated Greco-Roman & Indian texts –Hunayn-Ibn-Ishaq Developed Unani Galen,Charaka,Sushruta,Hippocrates Humoral theory Cairo Hospital (8th century)- Hospital-based clinical training Mobile hospital teams-Prison Mobile dispensaries-rural areas Botanical writings of ancient Greeks

Leading Personalities : 

Rhazes (850-923 AD) Continens (unfinished) Book on children’s diseases Avicenna (980-1037 AD) Canon of medicine (diagnosis by pulse & urine) Ibn an-Nafis (1288) Pulmonary Circulation (disproving Galen’s doctrines) Al-Kindi Pharmacology texts Leading Personalities

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Spine surgery Eye Anatomy

Dark Ages (476-1000 AD) : 

Chaotic western states Superstitions & mysticism Saint Styelitis Cholera Epidemic- Mecca pilgrimages Leprosy- Egypt to Asia, Europe Rejection led to eliminiation Dark Ages (476-1000 AD)

Medieval Period (1000-1453 AD) : 

Medieval Period (1000-1453 AD) Severe Pandemics Cholera spread- Six Holy Crusades The Black Death- Bubonic Plague (1348 AD) Asia to Africa, Turkey, Greece, Italy up till Europe Atleast 25 million died in Europe alone 1st official quarantine-Marseilles 1383 Efforts ineffective

Renaissance (1453-1600 AD) : 

Italy Era of Scientific principles Genius Scientists ; Copernicus, Da Vinci, Galileo,… Yet, Trade spread diseases Plague lingered Renaissance (1453-1600 AD)

Colonial Era (1600-1800 AD) : 

3 Plague pandemics – Europe Small pox- America Dr.Edward Jenner-smallpox vaccine Syndenham Colonial Era (1600-1800 AD)

Modern Era (1800-present) : 

4 phases: Miasma Phase (1850-1880) Disease Control Phase (1880-1920) Health Promotion Phase (1920-1960) Social Engineering Phase (1960-present) Family & Community Medicine Primary Health Care Deprofessionalization of Medicine Modern Era (1800-present)

Founding Fathers : 

Founding Fathers Ambroise Pare Battle surgeon Firearm wounds Ligatures & dressings

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James Lind Naval Surgeon Prevention of Scurvy

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William Harvey Blood Circulation 72 beats/ minute Disproved Galen’s Hypothesis

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English Hippocrates Miasmatic theory First distinguished epidemiologist

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Edward Jenner Small Pox Vaccination 1796

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Max Von Pettenkofer Germ Theory 1st Institute of Hygiene A Sanitarian

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Louis Pasteur A chemist Pasteurization Rabies Vaccine Microbiology & Immunology

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Robert Koch Microbiologist Anthrax Culture Media-nutrient agar Koch’s Postulates

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Paul Ehlrich Immunology Salvarsan- ‘Magic Bullet’

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Walter Reed Yellow fever- Aedes Mosquito

Summary : 

Summary

References : 

Park K. Textbook of Preventive & Social Medicine, 19th edition, chp 1, p 1-10 Dhaar G M, Robbani I. Foundations of Community Medicine. Section 1, p 2-10 Anderson C L. Community Health, p 3-16 http://en.wikipedia.org/wiki/Public_health http://www.abpischools.org.uk/res/coResourceImport/resources04/history/timeline.cfm http://www.enotes.com/public-health-encyclopedia/history-public-health References

Thank You : 

Thank You