This document provides a history of community medicine and public health from primitive times to the modern era. It describes how community medicine evolved from early concepts of supernatural disease causes to organized efforts for disease prevention, health promotion, and treatment through community involvement. Key developments included the ancient civilizations of India, Egypt, and Greece influencing modern medicine, followed by advances during the Roman and Islamic periods and a decline during the Dark Ages before modern community medicine emerged.

1. Introduction and
History of Community
Medicine
Dr.Shahzad A.Daula
MID (UOL) M.Phil. Public Health (Pb)

2. Defnition
Branch of medicine which deals
with the preventive, promotive,
and curative health services
through organized community
efforts.

3. Community
A group of people who have common
characters.
• Can be defined by location, race,
ethnicity, age, occupation, interest in
particular problemgrs or outcomes or
common bonds.

4. Community Medicine or Public Health?
Term use interchangeably
UK----Community Medicine
US----Public Health

5. What is Public Health?
Public Health is the science
and art of preventing disease,
prolonging life, and promoting
health through organized
efforts of society (WHO 1988)


6. Public Health Approach
Public Health Model Medical Model

9. Growth of Community Medicine
Chronologically – over time frompre-historic
Primitive AncientCivilizations
DarkAges Muslim/Arab
Industrial/ Modern

10. 4
1:PRIMITIVE MEDICINE
• The concept of disease in which ancient
man believed =>Supernatural theory of
disease
• Primitive man attributed disease and in
fact all human sufferings to:
- wrath of gods
- invasion of body by ‘evil spirits’ and
- malevolent influence of stars
& planets

11. Evolution of Public Health …
2: Ancient
2-A: Indian / IndusValleycivilisation
• Archeological evidence from Mohenjo-daro and
Harappa– the chief cities of Indian civilizationof
about 2500 to 1500 BC– suggest an elaborate
system of public sanitation; earlydentistry
• Lawsof Manu – code of personalhygiene
• Early Indians set fractures, performed
amputations, excised tumor, repaired hernias
and excelled in cataractextraction
6

12. Evolution of Public Health …
2-B:Egyptiancivilisation (3300BC onward)
• Egyptians postulated that diseasewasdue
to absorption from the intestine of
harmful substanceswhich gaverise to
putrefactionof blood and formation of pus
diseaseswere treated with cathartics,
enema,blood-letting and awide range of
drugs
7

13. Evolution of Public Health …
2-C:Greekcivilisation (c 460- 136BC – golden
period)
• Early leader in Greek medicine was
Aesculapius(c 1200 BC) – a demigod
• Aesculapius bore two daughters:
– Hygiea - worshipped as goddess of health
(preventive medicine)
– Panacea- worshipped as goddess of
medicine (curative medicine) - the
goddess of Universal remedy
8
Rodof Ascelpius

14. Greek contribution to health
• Hippocrates (460-370 BC)– the ‘Fatherof
medicine
• Rejected supernatural theory of disease–
introduced scientific method (why &how)
• Initiated application ofclinical methods in
medicine
• Described that diseaseshad anatural cause:
Airs, Waters and Places– first known
systematic attempt to present causal
relationship between environmental factors
and disease– humoral system
9

15. Evolution of Public Health …
2-D: Romancivilisation (100BC – 300AD)
• Romans borrowed their medicine mainly from
Greeks
• By the 1st century the centre of civilization
shifted to Rome
• They had a keen sense of sanitation –
11

16. Maintenance of health by control of diet and
hygiene
Galen (130-205AD) - Disease is due to predisposing,
exciting and environmental factors
(Epidemiological triad) – his teachings remained
unquestioned for 1400years
12
Roman contribution to health …

17. 13
3: Middle Ages(500-1500AD)
• With the fall of the Roman empire, the medical
schools established in Roman times also
disappeared
• The practice of medicine reverted back to primitive
medicine dominated by superstition and dogma
• It was regarded as immoral to see one's body;
consequently, people seldom bathed
• Dissection of the human body was prohibited –
consequently there was no progress of medicine
• This period is therefore called the "Dark
Ages of Medicine“

18. 4: Arab/Muslim contribution
1. Early 7th century – collecting and translating the
medical knowledge of the Greeks, Persians,
andIndians
2. Saljuqs(Tughril,Alip Arsalan) established hospitals.
Thestaff comprised physician, surgeons and
attendants served and nursedsick
3. Many physicians,Arabs aswell asnon-Arabs,
contributed to themedicine:
– Physicians like Al-Razi, or Razes(841 – 926 AD), and
Ibn-Sina, known as Avicenna (980 – 1037 AD) were
pioneers in the medicalfields
15

19. Muslim contribution to health …
• TheMuslim physicians, following Galen’s
tradition’ highlighted six ‘non-naturals’
composing hygiene
1. Air (or environment)
2. Food& drink
3. Sleeping and waking
4. Movement & rest
5. Retention & evacuation
6. Mental emotions – “passions of thesoul”

21. Healthy People in Healthy Community