#5M

1. Short note on Primitive Medicine

   • Medicine started from sympathy and need to help sick.
   • First doctor was the first man, first nurse the first woman.
   • Prehistoric man had limited knowledge.
   • Attributed disease to gods' anger or evil spirits.
   • This is called supernatural theory of disease.
   • Cure by prayers, rituals, sacrifices to gods.
   • Drove out evil spirits by witchcraft or crude methods.
   • Used charms, amulets for protection.
   • Tried some herbs (effect doubtful or nil).
   • Used stone/flint tools for circumcision, amputation, skull trephining.

2. Supernatural Theory of Disease in ancient times

   • Disease seen as punishment from gods or evil spirits.
   • Evil spirits invade body causing suffering.
   • Malevolent influence from stars and planets.
   • All calamities linked to supernatural forces.
   • No scientific idea of germs or natural causes.
   • Cure by appeasing gods with prayers and rituals.
   • Sacrifices offered to calm gods' wrath.
   • Witchcraft to drive out spirits from body.
   • Charms and amulets used as protection.
   • Herbs given as part of magic ritual to "do something".

3. Key features of the Tridosha Theory in Ayurveda

   • Three doshas: vata (wind), pitta (gall), kapha (mucus).
   • Health when all three in perfect balance.
   • Harmony of doshas keeps person healthy.
   • Disease from disturbance or imbalance in equilibrium.
   • Any one dosha increase or decrease causes illness.
   • Similar to Greek four humors theory.
   • Treatment aims to restore dosha balance.
   • Uses diet, hygiene, herbs, drugs for correction.
   • Part of Ayurveda's knowledge of life.
   • Ancient Indian explanation of disease cause.

4. Contributions of Sushruta to Indian medicine

   • Known as father of Indian surgery.
   • Compiled Sushruta Samhita (800 BC to 400 AD).
   • Book mainly on surgery but covers medicine too.
   • Includes pathology, anatomy, midwifery, hygiene.
   • Described fracture setting and treatment.
   • Performed amputations and tumor excision.
   • Repaired hernias and did cataract operations.
   • Excelled in plastic surgery like rhinoplasty.
   • British learned rhinoplasty from Indian surgeons.
   • Surgery declined later due to ahimsa in Buddhist era.

5. Yin-Yang concept in Chinese medicine

   • Based on two principles: yang and yin.
   • Yang is active, masculine principle.
   • Yin is negative, feminine principle.
   • Good health from balance of these opposites.
   • Imbalance leads to disease.
   • Used hygiene, diet, hydrotherapy for treatment.
   • Massage and drugs also part of therapy.
   • Chinese pioneered variolation for smallpox prevention.
   • Great doctor prevents illness, not just treats.
   • Traditional medicine integrated with modern now.

6. Imhotep and his significance in Egyptian medicine

   • Lived around 2800 BC.
   • Famous physician, statesman, architect.
   • Built step pyramid at Saqqarah.
   • Egyptian medicine peaked in his time.
   • Considered both doctor and divinity (god).
   • Specialization existed: eye doctors, head doctors, tooth doctors.
   • All doctors were state officials, paid by government.
   • Medicine mixed with religion.
   • Physicians co-equals of priests.
   • Homer called Egyptians "best of all" doctors.

7. Main features of the Code of Hammurabi related to medical practice

   • From Babylon, around 2000 BC.
   • First codification of medical practice laws.
   • Set fees for successful treatments.
   • Penalties for wrong therapy (doctor could be killed).
   • Covered conduct of physicians.
   • Doctors divided: herb doctors, knife doctors, spell doctors.
   • Like modern internists, surgeons, psychiatrists.
   • Reflected high social organization.
   • But medicine had no scientific foundation.
   • Oldest medical prescription from Mesopotamia (2100 BC).

8. Short note on Hippocratic Oath

   • From Hippocrates (460-370 BC), father of medicine.
   • Sets high moral standards for doctors.
   • Demands absolute integrity and honesty.
   • Stresses love for mankind and healing art.
   • Keystone of medical ethics worldwide.
   • Famous saying: "Life is short, art long..."
   • Opportunity fleeting, experience treacherous.
   • Judgment difficult.
   • Still used today for professional oath.
   • Guides doctor behavior and patient care.

9. Humoral Theory of disease in Greek medicine

   • Matter made of four elements: earth, air, fire, water.
   • Qualities: cold, dry, hot, moist.
   • In body: four humors - phlegm, yellow bile, blood, black bile.
   • Health when humors in equilibrium.
   • Disease from imbalance or disturbance.
   • Body has innate power to restore balance.
   • Doctor's role is to assist healing process.
   • Similar to Ayurveda's tridosha theory.
   • Based on incorrect foundations but relevant idea.
   • Hippocrates rejected supernatural causes.

10. Short note on the Sanitary Awakening in England

    • Mid-19th century during industrial revolution.
    • Caused slums, overcrowding, filth in cities.
    • High death rates, especially workers (22 years mean age).
    • Cholera epidemic 1832 worsened situation.
    • Edwin Chadwick's 1842 report on sanitary conditions.
    • Highlighted poor housing, working conditions.
    • Started anti-filth crusade.
    • Called "great sanitary awakening".
    • Led to Public Health Act 1848 in England.
    • State took responsibility for public health.

10M

1. Discuss the evolution of Indian medicine, highlighting the contributions of Charaka and Sushruta.

• Origin & Definition

  • Ayurveda = "knowledge of life" → prolong life
  • Siddha similar, mainly Tamil areas
  • Vedic times ~5000 B.C., linked to myths

• Mythological Start

  • Dhanvantari god of medicine from ocean churning
  • Atharvaveda had early medical knowledge → developed into Ayurveda

• Golden Period

  • 800 B.C. to 600 A.D. peak growth
  • Buddhist kings supported: Ashoka (226 B.C.) → state medicine, schools, public hospitals

• Key Figures

  • Atreya (800 B.C.) → first great physician, teacher at Takshashila university
  • Charaka (200 A.D.) → court physician to Kanishka
  • Compiled Charaka Samhita based on Atreya
  • Focus: internal medicine, pathology, 500 drugs listed
  • Example: Indian snakeroot (rauwolfia) used for centuries → reserpine for hypertension later

• Sushruta Contributions

  • Father of Indian surgery
  • Sushruta Samhita (800 B.C.–400 A.D.)
  • Mainly surgery + medicine, anatomy, midwifery, ophthalmology, hygiene, bedside manners
  • Operations: set fractures, amputations, tumor excision, hernia repair
  • Cataract surgery, plastic surgery (rhinoplasty) – British learned from Indians in East India Company days

• Tridosha Theory

  • Vata (wind), pitta (gall), kapha (mucus)
  • Health = perfect balance & harmony
  • Disease = disturbance in equilibrium
  • Similar to Greek 4 humors

• Other Features

  • Hygiene important – Laws of Manu for personal hygiene
  • Mohenjo-daro/Harappa: advanced sanitation, water supply, engineering (2000+ years old)

• Decline & Spread

  • Decline in Moghul period → no state support
  • Spread to Asia (Indochina, Indonesia, Tibet, Japan) like Greek in West

• Modern Systems

  • Unani-Tibb (Greek origin, Muslim 10th century) – strong in Delhi, Lucknow
  • Homoeopathy (Hahnemann 1755–1843) came 1810–1839, India has most practitioners
  • All still alive, rural relief source

• Conclusion

  • From supernatural → scientific, Charaka medicine focus, Sushruta surgery excellence

2. Describe the salient features of ancient Egyptian medicine and its public health advancements.

• Time & Civilization

  • ~2000 B.C., one of oldest
  • Known from picture writing, papyrus records

• Religion-Mixed

  • Physicians = co-equals of priests
  • Trained in temple schools
  • Sick treated in temples
  • No practical anatomy demos – body preservation religious

• Peak Figure

  • Imhotep (2800 B.C.) → physician, statesman, architect (step pyramid Saqqarah)
  • Considered doctor + divinity (god Horus)

• Specialization

  • Eye doctors, head doctors, tooth doctors
  • All state officials, paid by government
  • Homer: Egyptians "best of all" doctors

• Disease Theory

  • Harmful substances absorbed from intestine → blood putrefaction, pus formation
  • Pulse = "speech of the heart"

• Treatments

  • Cathartics, enema, blood-letting
  • Wide drugs: castor oil, tannic acid, opium, turpentine, gentian, senna, minerals, roots

• Key Manuscripts

  • Edwin Smith papyrus (3000–2500 B.C.) → oldest surgery treatise
  • Describes partial paralysis from cerebral lesions/skull fractures
  • Ebers papyrus (1150 B.C.) → 800 prescriptions, 700 drugs

• Diseases Mentioned

  • Worms, eye diseases, diabetes, rheumatism, polio, schistosomiasis
  • Many still present in modern Egypt

• Public Health Advancements

  • Planned cities, public baths, underground drains (modern envy)
  • Knowledge of smallpox inoculation
  • Mosquito nets value
  • Plague linked to rats
  • God of health: Horus

• Dominance & End

  • Dominant ~2500 years in ancient world
  • Replaced by Greek medicine

3. Compare the medical systems of ancient Greece and Rome, with emphasis on Hippocrates and Galen.

• Greek Medicine (460–136 B.C.)

  • Classic period, civilizers of ancient world
  • Thought in 'why' & 'how' terms
  • Aesculapius (1200 B.C.) → staff + serpent symbol
  • Daughters: Hygiea (prevention), Panacea (cure) → curative vs preventive split

• Hippocrates (460–370 B.C.)

  • Father of Medicine, from Cos island
  • Observation + reasoning, classified diseases
  • Rejected magic/supernatural
  • Clinical methods pioneer
  • Corpus Hippocraticum: 72 volumes, first scientific case histories
  • Oath → medical ethics keystone, integrity, love for mankind
  • Epidemiologist: epidemic vs endemic distinction
  • Airs, Waters, Places → environment-health link (climate, diet, water)

• Greek Theory

  • Four elements: earth, air, fire, water
  • Four humors: phlegm, yellow bile, blood, black bile
  • Health = balance, disease = imbalance
  • Body restores equilibrium, doctor assists

• Roman Medicine

  • Borrowed from Greeks (politics Roman, medicine Greek)
  • State supreme, practical-minded
  • Sanitation focus: baths, sewers, aqueducts, roads
  • Drained marshes for malaria
  • Hospitals for sick

• Galen (130–205 A.D.)

  • From Pergamon, emperor's physician
  • Comparative anatomy, experimental physiology
  • Health first: preserve before cure
  • Disease: predisposing, exciting, environmental factors
  • 500 treatises, "medical dictator" 14 centuries
  • Challenged by Vesalius (1543), Harvey (1628)

• Comparison

  • Greek: theoretical, natural process, rejected supernatural (Hippocrates synthetic)
  • Roman: practical, public health infrastructure (Galen analytic)
  • Both humoral-based
  • Greek: Alexandria school, huge library, first university
  • Roman: applied knowledge empire-wide

• Overall

  • Greek foundation of science, Roman systems & sanitation

(Continuing similarly for remaining questions – each in bullet notes to fit A4 page style.)

4. Explain the role of Arabic (Unani) medicine during the Middle Ages, including key figures like Rhazes and Avicenna.

• Middle Ages Context (500–1500 A.D.)

  • Europe Dark Ages: superstition, no progress, dissection banned
  • Arabs advanced, translated Greek-Roman texts to Arabic

• Unani System

  • From Greek, developed own
  • Golden age 800–1300 A.D.
  • Preserved ancient knowledge

• Key Role

  • Schools & hospitals in Baghdad, Damascus, Cairo
  • "Lit brilliant torch from Grecian lamps" (Osler)
  • Pharmacology pioneers

• Rhazes (Abu Beer, 865–925)

  • Baghdad hospital director, court physician
  • Keen observation, inventiveness
  • First: pupillary light reaction, mercurial purgatives
  • Book on children's diseases
  • Distinguished smallpox vs measles clinically

• Avicenna (Ibn Sina, 980–1037)

  • Prodigy, Canon of Medicine (21 volumes)
  • Elevated Islamic medicine zenith
  • Pharmacology: elixir of life search
  • Introduced many drugs, herbal/chemical

• Pharmacology Advances

  • Pharmaceutical chemistry
  • Prescriptions art
  • Syrups, oils, poultices, plasters, pills, powders, alcoholates, aromatic waters
  • Words: drug, alcohol, syrup, sugar Arabic

• Hospitals

  • 60 Baghdad, 33 Cairo

  • Separate departments, sex wards, fountains for fevers
  • Libraries, musicians for patients

• Spread

  • To India 10th century by Muslims
  • Strong till British advent

• Conclusion

  • Bridged ancient to modern, saved knowledge, innovated drugs

5. Discuss the Revival of Medicine from 1453–1600 A.D., mentioning key personalities like Paracelsus, Vesalius, and Pare.

• Period

  • 1453–1600 A.D., individual scientific endeavor
  • After Middle Ages dark

• Background

  • Revolutions: political, industrial, religious, medical
  • Europe woke from "sleep of darkness"

• Paracelsus (1493–1541)

  • Swiss, revived medicine
  • Burnt Galen/Avicenna works publicly
  • Attacked superstition, dogma
  • Rational research turn

• Fracastorius (1483–1553)

  • Theory of contagion
  • Invisible particles transfer infection
  • Epidemics explained
  • Syphilis sexual transmission
  • Founder of epidemiology

• Vesalius (1514–1564)

  • Brussels, human dissections
  • Corrected Galen's errors
  • Fabrica book → anatomy science
  • "First man of modern science"

• Pare (1510–1590)

  • French army surgeon
  • Father of surgery
  • Advanced art: ligatures instead of cauterization

• Other Advances

  • United Company of Barber Surgeons (1540) → Royal College later
  • Sydenham (1624–1689) → English Hippocrates, clinical method
  • Differential diagnosis: scarlet fever, malaria, dysentery, cholera

• Later Links

  • Harvey (1628) blood circulation
  • Leeuwenhoek microscope (1670)
  • Morgagni pathologic anatomy (1682–1771)

• Impact

  • Separated medicine from magic
  • Raised to science status
  • Observation, dissection focus

6. Describe the Sanitary Awakening in mid-19th century England and its impact on public health legislation (e.g., Public Health Act 1848).

• Background

  • Industrial revolution 18th century
  • Slums, overcrowding, filth accumulation
  • High sickness/death: women, children worst
  • Mean age death London 1842: 44 gentry, 22 workers

• Cholera Trigger

  • Epidemics frequent, 1832 major
  • "Father of public health"

• Edwin Chadwick (1800–1890)

  • Lawyer, investigated town health
  • Report 1842: Sanitary Conditions of Labouring Population
  • Highlighted poor housing, work conditions

• Sanitary Awakening

  • Anti-filth crusade started
  • Filth = man's greatest enemy
  • "Great sanitary awakening"

• Key Changes

  • State responsibility for health
  • Public Health Act 1848 enacted

• John Simon (1816–1904)

  • First medical officer of health, London
  • Built admired public health system

• Later Discoveries

  • John Snow (1848–1854): cholera by polluted water
  • William Budd: typhoid by drinking water, not miasma

• Legislation Impact

  • Thames: drinking + sewage source → clean water demand
  • Public Health Act 1875: environment control
  • Disease control phase (1880–1920): cleanliness, garbage, quarantine

• Global Spread

  • To America (Shattuck report 1850), France, etc.
  • Foundations: clean water, surroundings, houses, offensive trades control

7. Explain the contributions of John Snow and William Budd to the understanding of cholera and typhoid transmission.

• Context

  • 19th century cholera epidemics
  • Miasma theory dominant (bad air)

• John Snow (1813–1858)

  • English epidemiologist
  • Studied cholera London 1848–1854

• Key Work

  • Broad Street pump outbreak
  • Mapped cases → linked to one water pump
  • Removed pump handle → outbreak stopped
  • Proved cholera spread by polluted drinking water

• Evidence

  • Two water companies: one polluted → high cases
  • Other clean → low cases
  • Before germ theory known

• Impact

  • Water-borne transmission established
  • Demand for clean water supply

• William Budd (1811–1880)

  • Studied typhoid outbreak rural England 1856

• Key Work

  • Careful observations
  • Spread by drinking water contaminated with feces
  • Not miasma or sewer gas

• Evidence

  • Cases linked to specific water source
  • Rural setting, no sewer issues

• Impact

  • Typhoid water-borne too
  • Supported Snow's ideas

• Overall Contribution

  • Shift from miasma to water transmission
  • Before bacteria identified (Koch later)
  • Paved way for sanitation reforms, Public Health Acts
  • Epidemiology milestone

20M

1. Trace the historical evolution of medicine from antiquity (primitive, Indian, Chinese, Egyptian, Mesopotamian, Greek, Roman) through the Middle Ages to the Dawn of Scientific Medicine, highlighting major milestones and transitions.

• Introduction – Overall Evolution (Park + Suryakantha)

  • Quote: "Those who fail to read history are destined to suffer the repetition of its mistakes"
  • Medicine from sympathy/necessity to control disease
  • Early: medicine man, priest, herbalist, magician – no science
  • Knowledge: intuitive, observational, cumulative experiences
  • History: accomplishments + errors + false theories
  • Evolution stages: advances/halts, from cultures → biological → social sciences
  • Modern: social system, bureaucratized, politicized
  • 20th century: knowledge explosion → complex, costly, unequal
  • Glaring contrasts: developed vs developing, rural vs urban, rich vs poor → "social injustice"
  • Goal shift: treatment → prevention, promotion, quality of life
  • WHO commitment: Health for All, MDGs/SDGs
  • Milestone transition: curative → preventive/promotive (Suryakantha: community medicine focus)

• Primitive Medicine (Antiquity – Park, Suryakantha)

  • Conceived in sympathy, born of necessity
  • First doctor: first man, first nurse: first woman
  • Prehistoric ~5000 B.C.: limited knowledge
  • Disease cause: gods' wrath, evil spirits, stars/planets
  • Supernatural theory: prayers, rituals, sacrifices
  • Cure: witchcraft drive spirits, charms, amulets
  • Herbs: doubtful effect, magic ritual
  • Surgeries: stone/flint – circumcision, amputation, trephining
  • Intermingled: superstition, religion, magic, witchcraft
  • Timeless: persists in Asia, Africa, South America, Australia, Pacific
  • Example: India – snake bite mantras, leprosy as sin punishment
  • Traditional healers: close to people, religion + magic + empiricism
  • Milestone: early improvisation tools
  • Transition: supernatural → cultural/organized systems

• Indian Medicine (Antiquity – Park, Mahajan)

  • Ayurveda/Siddha: truly Indian, little difference
  • Ayurveda: "knowledge of life", prolong life
  • Vedic ~5000 B.C., Atharvaveda base → science
  • Myth: Dhanvantari from ocean churning
  • Key: Atreya (800 B.C.) – first physician, Takshashila
  • Buddhist growth: Ashoka (226 B.C.) state medicine, schools, hospitals
  • Charaka (200 A.D.): Charaka Samhita, court to Kanishka
  • 500 drugs, rauwolfia for hypertension
  • Sushruta: father of surgery, Sushruta Samhita (800 B.C.-400 A.D.)
  • Surgery + medicine, anatomy, midwifery, hygiene
  • Operations: fractures, amputations, tumors, hernias, cataracts, rhinoplasty
  • British learned rhinoplasty East India Company
  • Tridosha: vata (wind), pitta (gall), kapha (mucus)
  • Health: balance, disease: disturbance
  • Similar Greek humors
  • Hygiene: Laws of Manu, Mohenjo-daro sanitation/water
  • Golden age: 800 B.C.-600 A.D.
  • Decline: Moghul no support
  • Spread: Asia (Indochina, Indonesia, Tibet, Japan)
  • Other: Unani (Greek, 10th century Muslim), Homoeopathy (Hahnemann 1810)
  • Milestone: tridosha + surgery excellence
  • Transition: mythological → systematic, state-patronized

• Chinese Medicine (Antiquity – Park)

  • Oldest organized ~2700 B.C.
  • Yin-Yang: yang active masculine, yin negative feminine
  • Balance = health, imbalance = disease
  • Treatments: hygiene, diet, hydrotherapy, massage, drugs
  • Pioneers: variolation smallpox
  • Philosophy: great doctor prevents illness
  • Modern: integrated, barefoot doctors, acupuncture
  • Milestone: preventive focus, immunization early
  • Transition: principles → global attention

• Egyptian Medicine (Antiquity – Park, Mahajan)

  • ~2000 B.C., papyrus records
  • Religion-mixed: physicians = priests, temple schools
  • Imhotep (2800 B.C.): physician + architect (step pyramid) + god
  • Specialization: eye/head/tooth doctors, state-paid
  • Homer: "best of all"
  • Theory: intestinal harmful substances → putrefaction, pus
  • Pulse: "speech of heart"
  • Treatments: cathartics, enema, blood-letting, drugs (castor oil, opium)
  • Manuscripts: Edwin Smith (surgery, paralysis from fractures)
  • Ebers (800 prescriptions, 700 drugs)
  • Diseases: worms, diabetes, polio, schistosomiasis (still today)
  • Public health: planned cities, baths, drains, smallpox inoculation, mosquito nets, plague-rats link
  • God: Horus
  • Dominant 2500 years → replaced by Greek
  • Milestone: sanitation + specialization
  • Transition: religion → practical

• Mesopotamian Medicine (Antiquity – Park)

  • Euphrates-Tigris, ~6000 years ago, Cradle of Civilization
  • Religious concepts: herb/knife/spell doctors (internist/surgeon/psychiatrist)
  • Magic, necromancy, demons classification
  • Geomancy, dreams, liver divination
  • Medical astrology Eurasia
  • Prescriptions on cuneiform tablets, oldest 2100 B.C.
  • Hammurabi (2000 B.C.): Code – first medical laws
  • Fees for success, penalties (death for wrong therapy)
  • High organization, no science
  • Milestone: first code of practice
  • Transition: magic → codified

• Greek Medicine (Antiquity – Park, Mahajan)

  • 460-136 B.C., civilizers
  • Aesculapius (1200 B.C.): symbol staff + serpent
  • Hygiea (prevention), Panacea (cure) – split
  • Hippocrates (460-370 B.C.): father, Cos island
  • Observation, reasoning, rejected magic
  • Clinical methods, Corpus (72 vols), case histories
  • Oath: ethics, integrity
  • Epidemiologist: epidemic/endemic
  • Airs, Waters, Places: environment link
  • Humoral: 4 elements → 4 humors (phlegm, yellow bile, blood, black bile)
  • Balance = health
  • Body restores, doctor assists
  • Alexandria: first university, library 70,000 books
  • Milestone: science separation from magic
  • Transition: supernatural → natural process

• Roman Medicine (Antiquity – Park)

  • Borrowed Greek, politics Roman
  • State supreme, practical
  • Sanitation: baths, sewers, aqueducts, roads
  • Marshes drained malaria
  • Hospitals
  • Galen (130-205 A.D.): emperor physician
  • Anatomy, physiology
  • Health first: preserve before cure
  • Disease: predisposing/exciting/environmental
  • 500 treatises, dictator 14 centuries
  • Milestone: public health infrastructure
  • Transition: Greek theory → Roman application

• Middle Ages (500-1500 A.D. – Park, Suryakantha)

  • Dark Ages Europe: fall Rome, superstition, no dissection
  • Plague, smallpox, leprosy, TB
  • Body rejection, no bathing
  • Arabs advanced: translated Greek-Roman
  • Unani: schools, hospitals Baghdad/Cairo
  • Rhazes: observation, smallpox-measles, children's book
  • Avicenna: Canon (21 vols), pharmacology
  • Drugs, prescriptions, syrups/alcohol
  • Christianity: hospitals, monasteries care
  • Milestone: preservation + pharmacology
  • Transition: dark → revival via Arabs

• Dawn of Scientific Medicine (Post-1500 – Park, Mahajan)

  • Revolutions: political, industrial, religious
  • Revival 1453-1600: individual endeavor
  • Paracelsus: burnt old books, rational research
  • Fracastorius: contagion theory, invisible particles
  • Vesalius: dissections, corrected Galen, Fabrica
  • Pare: surgery father, ligatures
  • Sydenham: clinical method
  • Harvey (1628): circulation
  • Leeuwenhoek: microscope
  • Morgagni: pathologic anatomy
  • Milestone: observation, dissection, science status
  • Transition: magic/dogma → rational/scientific

• Conclusion

  • From supernatural → natural → preventive
  • Major: Hippocrates (clinical), Galen (physiology), Arabs (preservation), revival (anatomy/surgery)
  • To modern: Health for All (WHO)

2. Discuss the concept of "Man and Medicine: Towards Health for All" as per Park, covering the shift from curative to preventive/promotive medicine, social injustices in health, and the role of WHO/SDGs/MDGs in addressing global health inequalities.

• Introduction – Core Concept (Park Main)

  • Title: Man and Medicine : Towards Health for All
  • Quote: history repetition mistakes
  • Man interested control disease from immemorial
  • Early: cure/relief, no science
  • Knowledge: intuition, observation, experiences
  • History: accomplishments/errors/false theories
  • Evolution: cultures → biology → social/behavioral
  • Modern medicine: built on past, social system
  • 20th century: knowledge explosion, complex/costly
  • Benefits not to periphery many countries

• Shift from Curative to Preventive/Promotive (Park + Suryakantha)

  • Old goal: treatment of sickness
  • New: prevention disease, promotion health, quality life
  • Scope broadened
  • Essential socio-economic development
  • Primitive/ancient: curative + magic
  • Greek: natural process, Hippocrates clinical
  • Roman: sanitation preventive
  • 19th century: sanitary awakening preventive
  • Modern: promotive (education, lifestyle)
  • Suryakantha: levels prevention (primordial, primary, secondary, tertiary)
  • Disability limitation + rehabilitation

• Social Injustices in Health (Park)

  • Glaring contrasts: developed vs developing countries
  • Rural vs urban areas
  • Rich vs poor
  • Inequalities distribution resources/services
  • Worldwide criticism: "social injustice"
  • Not penetrated social periphery

• Role of WHO/SDGs/MDGs (Park Updates)

  • Commitment all countries under WHO banner
  • Wipe inequalities health resources
  • Attain Millennium Development Goals (2000)
  • 8 goals, 3 direct health (reduce child mortality, improve maternal health, combat HIV/malaria/TB)
  • Others indirect (poverty, education, environment)
  • 18 health-related targets/indicators
  • Sustainable Development Goals (2015)
  • 2030 Agenda: Transforming our world
  • Health at heart development
  • Reduce poverty, hunger, ill-health, inequality
  • Clean water, gender equality
  • WHO: Health for All (Alma-Ata 1978 primary health care)
  • Barefoot doctors, community workers
  • Global: address inequalities

• Conclusion

  • From curative → preventive/promotive
  • Towards equity, Health for All
  • WHO/SDGs key address injustices

3. Elaborate on the rise of public health concepts in the 19th century, including the industrial revolution's impact, Chadwick's report, the Great Sanitary Awakening, and key epidemiological discoveries (e.g., John Snow's work on cholera), and their global implications.

• Introduction – Rise of Public Health (Park, Mahajan)

  • 19th century milestone: sanitary awakening England
  • Spread other countries
  • Birth public health concept ~1840

• Industrial Revolution Impact (18th-19th Century – Park)

  • Benefits: standard living improvement
  • Problems: slums, overcrowding, filth cities
  • High sickness/death: women/children
  • Infectious: TB, cholera
  • Mean age death London 1842: 44 gentry, 22 workers
  • Cholera epidemics frequent

• Chadwick's Report & Sanitary Awakening (Park)

  • Edwin Chadwick (1800-1890): lawyer
  • 1832 cholera → investigate towns
  • Report 1842: Sanitary Conditions Labouring Population
  • Highlighted poor housing, work, filth
  • Filth = greatest enemy
  • Anti-filth crusade: "great sanitary awakening"
  • Public Health Act 1848: first legislation
  • State responsibility health
  • John Simon (1816-1904): London MOH, built system

• Key Epidemiological Discoveries (Park)

  • Cholera "father of public health"
  • John Snow (1848-1854): London cholera
  • Broad Street pump: mapped cases, removed handle → stopped
  • Polluted water transmission
  • Two companies: polluted high cases, clean low
  • William Budd (1856): typhoid rural outbreak
  • Drinking water feces contaminated
  • Not miasma/sewer gas
  • Before germ theory (Koch)

• Legislation & Phase (Park)

  • Public Health Act 1875: environment control
  • Disease control phase 1880-1920: cleanliness, garbage, quarantine
  • Thames: drinking + sewage → clean demand

• Global Implications (Park, Suryakantha)

  • Spread: America (Shattuck report 1850 Massachusetts)
  • France, Spain, Australia, Germany, Italy, Scandinavia
  • Foundations: clean water, surroundings, houses, offensive trades
  • Public health birth England → world model
  • Shift: individual cure → community prevention
  • Suryakantha: epidemiological triad, multifactorial causation

• Conclusion

  • Industrial woes → sanitary reforms
  • Discoveries: water-borne diseases
  • Global: modern public health, equity focus