Community medicine

1. A D I L
Evolution of public
health

2. INTRODUCTION
Definition of health :
It is defined as “the state of complete physical,
mental and social well-being and not merely the
absence of disease or infirmity”.

3. INTRODUCTION OF PUBLIC
HEALTH EVOLUTION:
In primitive time, since the
knowledge was limited,man
attributed disease to the wrath
of gods,the invasion of body by
evil spirits and the malevolent
influence of stars and planets.

4. PRIMITIVE MEDICINE:
It was based on
-supernatural theory of disease
⚬disease and human sufferings and
calamities were attributed to the
wrath of god
⚬influence of evil spirits, stars and
planets .

5. ⁻ INDIAN MEDICINE:
In ancient india,the celebrated authorities in ayurvedic
medicine were ATREYA, CHARAKA, SUSHRUTA and
VAGHBHATT.
Of significance in Ayurveda is the “tridosha theory of
disease”.
Disease was explained as a disturbance in the
equilibrium of the three humours;when these were in
perfect balance and harmony,a person is said to be
healthy

6. Hygeine was given an important place in
ancient Indian medicine.
The Indian systems of medicine including
Unani -Tibb and Homeopathy are very much
alive in india even today .
In fact ,they have become part of Indian
culture,and they continue to be an important
source of medical relief to the rural population.

7. CHINESE MEDICINE:
Chinese medicine claims to be the world's first organised
body of medical knowledge dating back to 2700B.C.
The Chinese were early pioneers of immunization.They
practiced variolation to prevent small pox.
The Chinese system of “ barefoot doctors” and
acupuncture have attracted world wide attention in recent
years.

8. EGYPTIAN MEDICINE:
Egypt had one of the oldest civilizations in about 2000B.C.
They believed that disease was due to absorption from the intestine
of harmful substances which gave rise to putrefaction of blood and
formation of pus.They believed that the pulse was “the speech of the
heart”.
In the realm of public health also,the Egyptians excelled.They built
planned cities, public baths and underground drains which even the
modern might envy.They had also some knowledge of inoculation
against smallpox,the value of mosquito nets and the association of
plaque with rats .

9. MESOPOTAMIAN MEDICINE:
There is another civilization in the land which lies between
the Euphrates and Trigris rivers, Mesopotamia (now part of
Iraq),often called the “Cradle of Civilization”as long as 6000
years ago .
In ancient Mesopotamia,the basic concepts of medicine
were religious,and taught and practised by herb
doctors,knife doctors and spell doctors- a classification that
roughly parallels our own internist, surgeons and
psychiatrists.

10. GREEK MEDICINE:
The Greeks gave a new direction to medical thought.They
rejected the supernatural theory of disease and looked
upon disease as a natural process,not a visitation from a
god of immolation.
The Greeks postulated that health prevailed when the
fours humors i.e,phlegm, yellow bile,blood and black bile
were in equilibrium and when the balance was disturbed,
disease was the result.

11. ROMAN MEDICINE:
Public health was born in Rome with the development of
baths,sewers and aqueducts.
The Romans made fine roads throughout their empire, brought
pure water to all their cities through aqueducts,drained marshesto
combat malaria ,built sewerage system systems and established
hospitals for the sick
Galen who was the one of Roman medical teachers observed that
disease is due to three factors - predisposing, exciting and
environmental factors.

12. DAWN OF SCIENTIFIC
MEDICINE:
Fracastorius envisaged the transfer of infection via minute
invisible particles and explained the cause of epidemics
( theory of contagion ).
He became the founder of epidemiology.
Syndenhem made differential diagnosis of scarlet
fever,malaria, dysentery and cholera
He is also regardes as the first distinguished epidemiologist.

13. SANITARY AWAKENING:
A milestone in the history of public health is “great sanitary
awakening”which took place in England in mid-nineteenth
century and gradually spread to other countries.
Industrial revolution of the 18th century sparked of numerous
problems,i.e, creation of slums , overcrowding with all its
ill-effects.
This has led to the enactment of the Public Health Act of 1848 in
England.

14. RISE OF PUBLIC HEALTH:
Great cholera epidemic of 1832 led the birth of
public health in England around 1940.
John Snow,studied the epidemiology of cholera in
London from 1848 to 1854 and established the
role of polluted drinking water in its spread .
It led to the enactment of the Public Health Act of
1848 in England.

15. A comprehensive piece of legislation was
brought into force in England,the public health
act of 1875,for the control of man's physical
environment.
By the beginning of 20th century,the broad
foundation of public health - clean water,clean
surroundings, wholesome condition of
houses,control of offensive traits etc were laid in
all the countries of the western world.

16. GERM THEORY OF DISEASE:
The breakthrough came in 1860,when the French bacteriologist
Louis Pasteur demonstrated the presence of bacteria in air.
He disproved the theory of “Spontaneous generation”. In
1873,Pasteur advanced the “germ theory of disease”.
In 1877,Robert Koch showes that anthrax was caused by a
bacteria.
The discoveries of Pasteur and Koch confirmed the germ theory of
disease.

17. BIRTH OF PREVENTIVE
MEDICINE:
James Lind , a naval surgeon advocated the intake of fresh fruit and
vegetables for the prevention of scurvy in 1753.
Edward Jenner discovered vaccination against smallpox in 1796.
These two discoveries marked the beginning of a new era ,the era of
disease prevention by specific measures.
Preventive medicine got a firm foundation only after the discovery of
causative agents of disease and establishment of the germ theory of these
disease.
Discoveries in preventive medicine are Pasteurs anti-rabies treatment,
cholera vaccine, diphtheria antitoxin etc.

18. MODERN MEDICINE:
It includes :1.Curative medicine
1. preventive medicine
2. social medicine
1) CURATIVE MEDICINE:
It is defined as “treatment of disease by the use of a
drug which produces a reaction that itself
neutralizes the disease”by the introduction of
antibacterial and antibiotic agents.

19. 2.PREVENTIVE MEDICINE:
It is defined as “the art and science of health
promotion, disease prevention, disability limitation and
rehabilitation”.
3.SOCIAL MEDICINE:
It is the study of man as a social being in his total
environment.

20. CHANGING CONCEPTS IN PUBLIC
HEALTH:
In the history of public health, four distinct phases
may be demarcated:
1.Disease control phase( 1880-1920)
2.Health promotional phase (1920-1960)
3.Social engineering phase ( 1960- 1980)
4.Health for all phase ( 1981 - 2000 .A.D)

21. MEDICAL
REVOLUTION:
1) FAMILY MEDICINE :-
It is defined as “a field of specialization in medicine which is neither disease not organ
oriented. It is family oriented medicine or health care centered on the family as the unit -
from first contact to the ongoing care of chronic problems.
2) COMMUNITY MEDICINE :-
The faculty of Community Medicine of the Royal College of Physicians ha defined
community medicine as “that speciality which deals with populations and comprises
those doctors who try to measure the needs of population,both sick and well ,who
plan and administer services to meet those needs and those who are engaged in
research and teaching in the field”.

22. HEALTH CARE REVOLUTION:
HEALTH FOR ALL :-
In 1977,it was decided in the WORLD HEALTH
ASSEMBLY to launch a movement known as “HEALTH
FOR ALL by the year 2000”.
The member countries of WHO at the 30th World Health
Assembly defined Health For All as “ attainment of a level
of health that will enable every individual to lead a socially
and economically productive life “.

23. PRIMARY HEALTH CARE:-
The Alma-Ata Conference defined Primary Health
Care as follows :
“ Primary health care is essential health care
made universally accessible to individuals and
acceptable to them , through their full
participation and at a cost the community and
country can afford”.

24. SUMMARY
Evolution of public health can be known
as:
1.Medicine in Antiquity
2.Dawn of Scientific Medicine
3.Modern Medicine
4.Medical Revolution
5.Health Care Revolution

25. THANK YOU