Epidemiology began with early observations of disease patterns but grew as a formal science in the 19th century. Key figures like John Snow, William Farr, and Robert Koch developed epidemiologic study designs and established causality criteria. The mid-20th century saw advances in chronic disease epidemiology and evidence-based medicine. Modern epidemiology now integrates diverse methodologies with evolving biology and societal changes to investigate new health challenges.

1. DR SUNIL.C
HISTORY OF
EPIDEMIOLOGY

2. HISTORY
 STARTED WITH ADAM AND EVE
 EPI= AMONG
 DEMOS= PEOPLE
 LOGOS=STUDY
FOUNDATION WAS LAID
IN 19TH CENTURY

3. DEFINITIONS
 THAT BRANCH OF MEDICAL
SCIENCE WHICH TREATS
EPIDEMICS- PARKIN 1873
 THE SCIENCE OF MASS
PHENOMENA OF INFECTIOUS
DISEASES- FROST 1927
 THE STUDY OF DISEASE,ANY
DISEASE AS MASS PHENOMENON-
GREENWOOD 1934
 THE STUDY OF DISTRIBUTION AND
DETERMINANTS OF DISEASE
FREQUENCY- MACMAHON 1960

4. DEFINITION BY JOHN M LAST
1988
 The study of the distribution and
determinants of health related
states or events in specified
populations and application of
this study to control of health
problems

5. HISTORICAL PHASES
 EARLY EPIDEMIOLOGY—5TH
CENTURY TO 1830
 CLASSIC EPIDEMIOLOGY–
1830—1940
 NEW EPIDEMIOLOGY-- 1940 –
TILL DATE

6. EARLY EPIDEMIOLOGY
 MORE THAN TWO MILLENNIA FROM
HIPPOCRATES [470—400 BC] TO FIRST
THIRD OF 19 TH CENTURY
 THEORIES WERE ELABORATD TO EXPLAIN
THE SPREADING OF DISEASES NOTABLY
THOSE WERE RECURRENTLY STRIKING AND
DECIMATING POPULATION– EPIDEMICS
 HIPPOCRATES --MEDICAL APPROACH BY
PROVIDING CONCISE ,ACCURATE AND
COMPLETE DESCRIPTION OF CLINICAL
CASES INCLUDING TETANUS AND TYPHUS
 IN HIS BOOK ON AIR ,WATER AND PLACES -
--IDENTIFIABLE ARRAY OF NATURAL
EXTERNAL FACTORS

8. 17TH CENTURY
 THOMAS SYDENHAM [1624– 1689]
CIRCUMSTANCES SURROUNDING
THE OCCURRENCE OF CLINICAL
CASES
 IN YEAR 1700 BERNARDINO
RAMAZZINI WROTE IN HIS BOOK –
DE MORBIS ARTIFICUM DIATRIBA
 HIPPOCRATES STATES IN –DE
AFFECTIONIBUS-when u face a sick
person u should ask him from
what he is suffering?

9. THOMAS
SYDENHAM

10. FOUNDER OF OCCUPATIONAL
MEDICINE
 RAMAZZINI -- today regarded as
founder of occupational
medicine—a key section of layer
field of environmental medicine
and epidemiology

12. GIOVANANNI MARIA LANCISI
1654
 A CONTEMPORARY OF
RAMAZZINI-
 ANATOMIST AND CLINICAN
WHOSE de subitaneis mortibus–
pathological investigation of
series of sudden deaths in ROME
probably 1st epidemiological
study of NCDs

13. JOHN GRAUNTS 1620--
1674
 FOUNDER OF DEMOGRAPHY
 THE MAJOR STEPS ARE RECORDING
COUNTING, ACCOUNTING TO
QUANTITATIVE ANALYSIS
 HIS NATURAL AND POLITICAL
OBSERVATION WERE UPON
MORTALITY [1662]
 HIS DATA INCLUDED THREE KEY
INNOVATIONS
 A CRITICAL EXAMINATIONS OF THE SOURCES
 THE USE OF FREQUENCIES
 THE APPLICATION OF METHOD TO TACKLE
PROBLEM

15. LUCRETIUS
 LATIN POET (1-2 CENTURY BC)
 ―DE RERUM NATURA‖
 SEEDS OF DISEASE CAN SPREAD
FROM PERSON TO PERSON

18. GEROCAMO
FRACASTORIUS(1478-1553)
 DE –CONTAGONE ET CONTAGIOSIS
MORBIS
 1ST CLEAR AND COHERENT GERM
THEORY
 VARIETY OF DISEASES CAUSED BY
 TRANSMMISION
 SELF PROPAGATING
 SYPHILIS [1530]

21. GAHLEO-GAHLEI(1564-
1642)
 BEGINNING OF 17 CENTURY
 GRADUAL SPREAD OF
KNOWLEDGE OF PHYSICS TO
OTHER BRANCHES OF STUDY

22. WILLIAM HARVEY
 1578-1657
 EXPERIMENT AND
QUANTITATIVE REASONING WAS
DISCOVERY OF THE
CIRCULATION OF BLOOD.

24. CLASSIC EPIDEMIOLOGY
 ADVANCEMENT OF THE
INDUSTRIAL TRANSFORMATION
OF WESTERN EUROPE
STARTING IN GREAT BRITAN
PROPAGATING FROM MID-18
CENTURY
Eg. CROWD DISEASES

25. WILLIAM FARR
 1807-1883
 INTRODUCED MEDICAL
REGISTRATIONS OF DEATHS
 MIASMATIC THEORY-disease is
transmitted by miasm/ cloud

26. JOHN SNOW[1813—1858]
 A CONTEMPORARY OF WILLIAM FARR IS
QUOTED AS AN EXAMPLE OF BRILLIANT
ANALYTICAL INVESTIGATION
 IDENTIFICATION OF PATHOGENIC
ORGANISM FROM ENVIRONMENT
 CHOLERA[ASIATIC CHOLERA]
 INVESTIGATED THE MAJOR EPIDEMIC
EPISODES IN LONDON[1849—1854]
 ELABRORATED AND PRESENTED A PAPER
ENTILED –ON CONTIOUS MOLECULAR
CHANGES ALONG THE LINES OF PREVIOUS
WORK BY GERMAN PATHOLOGIST JACOB
HENLE[1809—1885]

28. PIERRE LOUIS [1787—
1872]
 INTRODUCED THE NUMERICAL
METHOD IN MEDICINE AND
PRODUCED STATISTICAL
EVIDENCE
 STATISTICAL EVIDENCE OF
BLOOD LETTING IS HARMFUL

29. RUDOLF VIRCHOW[1821—
1902]
 WORKED IN PATHOLOGY IS
REGARDED AS CORNER STONE
OF MEDICINE
 FOUNDER OF CELLULAR
PATHOLOGY
 INTERNATION CLASSIFICATION
OF DISEASE
 DEFINED MEDICINE AS A SOCIAL
SCIENCE

30. ROBERT KOCH[1843-1910)
 DISCOVERED AGENTS OF
SEVERAL DISEASES
 FORMULATED A SET OF
CRITERIA FOR ESTABLISHING
CASUALITY IN
EPIDEMIOLOGICAL STUDIES
 TUBERCULOSIS

31. Robert
Koch

32. EDWARD JENNER
 BORN IN 1749
 ON 14th MAY 1796-HE
INOCULATED INTO A
―VOLUNTEER‖JAMES PHIPPS
WITH COWPOX
LYMPH TAKEN FROM HAND OF A
MILK MAID-SARAH NELMES

33. EDWARD JENNER

35. EXPERIMENTAL
EPIDEMIOLOGY
 JAMES LIND- 1747
HE WORKED ON SCURVY

38. NEWER EPIDEMIOLOGY
INDIVIDUAL STUDIES ON
CANCER, NON RHEUMATIC CVD
CAN BE TACKLED WELL BACK IN
TIME BUT ONE TAKE AS A
CONVINENT TURNING POINT.
DEVELOPMENT OF NEW
EPIDEMIOLOGY--TOBACCO AND
HEALTH STORY

39. PEARL (1938)
 LIFE EXPECTATION OF SMOKERS
AND NON-SMOKERS
 NEWER EPIDEMIOLOGY CLEARLY
HIGH LIGHTS DUAL EXCHANGE.

40. JOHN RYLE(1899—1950)
 FIRST DIRECTOR OF INSTITUTE
OF SOCIAL MEDICINE AT
OXFORD –(2nd WORLD WAR)
 TO INVESTIGATE THE OF SOCIAL
GENETIC, ENVIRONMENTAL AND
DOMESTIC FACTORS ON DISEASE
MORBIDITY.

41. CLINICAL EPIDEMIOLOGY
IN A PARALLEL AND
OPPOSITE MOVE
EPIDEMIOLOGICAL METHODS
OVER SHADOWING VALUE FOR
CLINICAL RESEARCH AND
INCREASE INCORPORATED
INTO A GROWING STREAM
OF IT

42. ARCHIE COCHRANE(1909—
1988)
 ADVOCATED SYSTEMATIC USE
OF RCT.

43. LANGMUIR
 REGARDED AS ―FATHER OF
INFECTIOUS DISEASES‖
 IN 1949 HE ESTABLISHED
EPIDEMIOLOGY SECTION OF
FEDERAL AGENCY.
 PRESENTLY CDC
 EPIDEMIOLOGY INTELLIGENT
SERVICE.

44. TODAY’s EPIDEMIOLOGY
1. EPIDEMIOLOGICAL METHODS
OF INVESTIGATIONS.
2. EPIDEMIOLOGICAL
SUBSTANTIVE NOTIONS
DEVELOPED BY SUCH
METHODS.

45. ADVANCES
1. ADVANCES OF RESEARCH IN SOME
DOMAINS FUNDAMENTAL TO
OTHER FIELDS OF BIOLOGY
2. ADVANCES IN CLINICAL MEDICINE
AT DIAGNOSTIC AND
THERAPEUTIC LEVELS
3. ESCALATING COSTS OF ALL
HEALTHCARE DELIVERY SYSTEMS
4. RENEWED AWARENESS OF
PROFESSIONALS AND GENERAL
PUBLIC

46. TOMORROWS HORIZON

47. THE CHALLENGE OF EVOLVING
BIOLOGY
Sir Richard Doll (Doll, 1993):
―Classical methods of epidemiological
research are proving less and less
productive as the simple problems are
being successfully solved.
They will doubtless continue to be used
to make new discoveries from time to
time …
but without some brilliant new
inspirations, the rate of discovery of
new facts of any importance by the
use of these classical methods must
be expected to slow down.‖

48. THE CHALLENGE OF EVOLVING
BIOLOGY
EXAMPLES
 BIOLOGICAL MARKERS OF EXPOSURE
 INDIVIDUAL SUSCEPTIBILITY
 GENETIC
 ACQUIRED
bring back to the level of etiology
and prevention
the wealth of investigations that the
convergence of epidemiology and
modern biology is now making
possible

49. THE CHALLENGE OF EVOLVING
SOCIETY
 AGEING POPULATIONS
 REPRODUCTIVE RATES BELOW
REPLACEMENT RATE
 POPULATION MIGRATION
 SOCIOECONOMIC AND GENDER
INEQUALITIES

50. THE CHALLENGES OF DIVERSIFICATION Vs
INTEGRATION
 A first axis is methodology
versus substantive studies
 treatment of exposure
measurements and errors of
measurement to reduce
misclassification and improve study
power
 methods in genetic epidemiology
 modeling of the exposure–response
relationship with multiple
longitudinal measurements

51. THE CHALLENGES OF
DIVERSIFICATION Vs
INTEGRATION
• A second axis is diversification of
different fields of substantive interest
 Cancer epidemiology & Epidemiology
of ageing
 Clinical epidemiology
 Application of epidemiological methods
within clinical domain
 Evolving formal methods of optimal
clinical decision making
 ― Evidence Based Medicine‖

52. THE CHALLENGES OF
DIVERSIFICATION Vs
INTEGRATION
 Final axis of diversification tends to
separate
 those who specialize in investigative aspects
for routine or research purposes from
 those who plan and implement interventions
 Clinical medicine – clinical chemist, clinical
pathologist, diagnostic radiologist, etc
 Epidemiology – pure specialist in
etiological and evaluative investigations

53. REFERENCES :-
 PARK’S TEXTBOOK OF PREVENTIVE
AND SOCIAL MEDICINE 20TH
EDITION
 EPIDEMIOLOGY by LEON GORDIS
4TH EDITION
 INTRODUCING THE HISTORY OF
EPIDEMIOLOGY – RODOLFO
SARACCI
 Images from
http://dodd.cmcvellore.ac.in/hom/17%
20-%20James%20Lind.html