Brief introduction and history of Community Medicine

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