EVOLUTION OF MEDICINE IN HISTORICAL PERSPECTIVE

The evolution of medicine is a vast and complex journey that spans thousands of years. It began with ancient civilizations like Egypt, India, China, and Greece, where medicine was often intertwined with spiritual and religious practices. Hippocrates, often called the "Father of Medicine," laid the foundation for a more systematic and observational approach in ancient Greece.

1. EVOLUTION OF MEDICINE IN
HISTORICAL PERSPECTIVE
DR ANUJ KUMAR ANIT
JRA1
DEPARTMENT OF COMMUNITY
MEDICINERIMS RANCHI
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2. CONTENTS
❖MEDICINE IN ANTIQUITY
❖DAWN OF SCIENTIFIC MEDICINE
❖MODERN MEDICINE
❖MEDICAL REVOLUTION
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3. MEDICINEIN ANTIQUITY
•Medicine was dominated by Magical and Religious belief which were an integral part of
ancient culture and civilization.
•Health and illness were interpreted in cosmological and anthropological perspective.
•The medicine waspractised by appeasing Gods by prayers ,rituals and sacrifices.
•They believed that disease and all human suffering and other calamities occur due to
punishment of gods, the invasion of body by 'evil spirits' and the bad influence of stars
and planets. The concept of disease known as 'SUPERNATURAL THEORY OF
DISEASE'.
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4. INDIAN MEDICINE(5000BC)
•AYURVEDA AND SIDDHA SYSTEM
•Ayurveda is practised throughout India but the Siddha ispractised
intamilspeaking area of southindia.
•Ayurveda means: Knowledge of lifeor Knowledge
ofprolonginglife.
•Medical knowledge in Atharvaveda developed in to thescience
ofAyurveda.
•Dhanvantari is known as the 'HINDU GOD OF MEDICINE born as
result of churning of ocean during 'TUG OF WAR'between gods
and demons.
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5. Cont...
•The authorities in ayurvedic medicine were Atreya, Charaka,
Sushruta andVaghbatt.
•Atreya: 1stindianphysician and teacher .
•Charaka: He compiled various disease ,theirdiagnosis by
observation and treatment by herbal medicine in 'CHARAKA
SAMHITA ' mention 500 drugs .
•Sushruta: Father ofindiansurgery .He compiled surgical
knowledge at his time known as 'SUSHRUTA SAMHITA ' which not
only include surgery but also medicine ,pathology, anatomy,
midwifery, ophthalmology etc.
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6. Contd...
•.Tridoshatheory of disease : According to Ayurveda , human
health is maintained through the balance of threehumorsor
dosha –Vata(wind), pitta(bile), kapha(mucus).
•Hygiene was given an important place in ancient
indianmedicine .
•The Law of manuwere a code of personal hygiene.
•UNANI MEDICINE:It was introduced into indiaby the muslim
ruler about 10th century A.D.
•HOMEOPATHY : Was propounded by germanphysician Samuel
hahnemanintroduced in india( 1810& 1839)
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7. CHINESE MEDICINE(2700BC)
•Chinese medicine Claims the World’s first Organised Body by
MedicalKnowledge.
•Based on two principle the Yang and the Yin.
•The Yang wasbelieved to be active Masculine Principle and the Yin
wasNegative Feminine Principle. Balance of these opposing force meant
good health.
•The Chinese were early pioneers of Immunization.
•Traditional Chinese medicine that is based on the use of herbal medicine,
acupuncture, massage, hydrotherapy, dietary therapy.
•The Chinese system of"barefoot doctors" and acupuncture have attracted
worldwide attention in recent year.
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8. EGYPTIAN MEDICINE (2000BC)
•They Invented Picture Writing and recordedtheir doing on Papyrus.
•In Egyptian times the art of medicine was mingled with religion.
•Diseases was due to absorptionof harmful substance from the blood
and formation of pus.
•Imhotep: 1stegyptianphysician, architect and builder of step pyramid.
•Pulse “ The speech of the Heart”.
•Edwin Smith papyrus : Describe Head and Neck surgery.
•Ebers papyrus : Unique record of 800 prescription based on 700 drug.
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9. MESOPOTAMIAN MEDICINE (3000 -2000BC)
•"Cradle ofcivilization ".
•The basic consent of medicine were religious,and taught and practised by herb
doctors, Knife doctors and spell doctors.
•Pants and plantsproduct,animalsand their productform thebasicingredients
ofthemedications.
•Oldest medical prescription comes to us from mesopotamia& were written
incunneiformwriting.
•Hammurabi is a great king of Babylon who formulated a set of drastic laws "Code
of Hammurabi' that governed the conduct the physicians and provided for health
practices.
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10. GREEK MEDICINE (460-136BC)
•Civilizers of the ancient world.
•Theytauhgtmen to think: why & how.
•Aesculapius: Son of Apollo( greekgod of medicine ) had two
daughters:-
•Hygeia:Goddess of hygiene& prevention of disease .
•Panacea: Goddess of medicine &cure from disease .
•Aesculapius rod with serpent entwined has traditionally to be
symbolof scientific medicine.
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11. Cont...
•Hippocrates :-Greatest physicians in Greek medicine
•Father ofMedicine.
•1st true Epidemiologist.
•Studied & Classified Diseases.
•Based on Observation & Reasoning.
•Application of clinical methods in medicine.
•Hippocratic oath has become the keystone of medical ethicsand set high
moral standard for medical profession.
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12. Cont...
•His Book “ Airs, water and places "in which he describedthe
effects of environment, diet,& water ,habits of eating and
drinking in proceeding diseases.
•Greek belief: health occurs as results of Based on 4 humans :-
•(a). Phlegm(mucus).
•(b). Yellow Bile(Gall).
•(c).Black Bile(faeces)
•(d). Blood.
•Greek rejected supernatural theory of disease&looked upon
disease as natural process.
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13. ROMAN MEDICINE(1st century BC)
•The Roman borrowed their medicine largely from the Greeks.
•More powerful & practitioner mindset than greek& had keen
sense of sanitation.
•Public health was born with development of public baths,
swears, and aqueducts.
•They brought pure water to all cities and constructed drainage
system to combat malaria.
•Centre of civilization shifted to Rome.
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14. •Galen(130-205A.D);-Roman physicians.
•His important contribution in the field of comparative anatomy
and experimental physiology.
•Observed diseases due to three factors:-
•(a).Predisposing ,b).exciting ,c).Environmental factors.
•His theories continueto be accepted for 1500 years.
Cont...
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15. MIDDLE AGE/ DARK AGE (500-1500BC)
•The Dark age Medicine began with fall of Roman empire.
•Europewas destroyedby wars and
Epidemicslikeplague,small pox,leprosyand Tuberculosis.
•Practice of medicinewasrevertedbacktoprimitive
medicinedominated bysuperstition and dogma.
•RISE OF UNANI MEDICINE:When Europe was
passingthroughdarkages, Arabs translatedGraeco-
Romanmedicalliteratureinto Arab &helpedpreserve ancient
knowledge.
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16. Cont...
•Abu Becr(865-925 AD): The famous physician of Arabs worked on measles,
was the first to observe pupillary reaction & uses mercury as purgative.
•Avicenna(980-1037 AD): He wrote thebook "Cannonsof medicine"
21volume Encyclopaedia ,which formed the basis ofpractice the
UNANIMEDICINE .
•Great contribution of Arabsin thefield ofpharmacologyintroducing large no
ofdrugs ,herbal& chemical.
•Theyinventedtheart of prescriptionwriting.
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17. DAWN OF SCIENTIFIC MEDICINE
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18. REVIVAL OF MEDICINE
•This was an age of IndividualScientific Endeavour.
•Paraceleus(1493-1541):Revived medicine, attacked superstition
& helped turn medicine towards rational Research.
•Fracastorius(1483-1553): "Theory of contagion" He
realisedtransfer of infection via minute invisible particles
andexplained the cause of epidemics.
•Adreas vesalius(1514-1564):"TheFirst man ofmodern Science"
Did lot of Dissection human body.
•Ambroise pane(1510-1590): French army surgeon ,advanced the
art of surgery & earned the title" Father of modern surgery.
•William harveydescribedthecirculationof blood.
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19. SANITARY AWAKENING
•Took place in England & Gradually spread toothercountries.
•" Era of Public health"
•Tremendous impact on behavioursmodification of peoples.
•Edwin Chad wick(1800-1890):-During great cholera epidermic of 1832.
•He investigated health of the inhabitants of large town to improve their
living condition.
•A land mark in the history of public health in great Britain-Report on
"sanitary condition of labouring population" led to improve housing and
working condition.
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20. RISE OF PUBLIC HEALTH
•John Snow : Studied the epidemiology of cholera and
establishedrole of polluteddrinking water in the spread of
cholera.
•Willium Bud: Discoveredtyphoid feverdue topolluted drinking
waterand not by poisonous vapour and sewer gas.
•John Simon: Responsiblefor sanitary reforms & built up a
systemof publichealth. The early phaseof public health
isoftencalled as "Disease control phase".
•By the beginning of 20th Century: the broadfoundationofpublic
health-clean water ,clean surroundings ,wholesome condition
ofhouses.
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21. GERM THEORY OF DISEASE
•Louis pasteur:-He disproved the theory of "spontaneous generation".
•And advanced the " GERM THEORY OF DISEASE" & also demonstrate
the presence of bacteriainair.
•RobertKoch :-Discoveredcausative agents of Tuberculosis, Cholera,
and Anthrax.
•It was goldenage ofbacteriology.
•Microbe after microbesdiscovered inquick succession-Gonococcus ,
TyphoidBacillus , Pneumococcus , CholeraVibrio,DiphtheriaBacillus
etc.
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22. BIRTH OF PREVENTIVE MEDICINE
•Developed as branch of medicine distinctfrom public health.
•Dates back to 18th century.
•James Lind:-Navalsurgeon who advocatedthe intakeof fresh
fruits and vegetablesfor the prevention of scurvy.
•Edward jenner:-Discoveredvaccinationagainstsmall pox.
•Thesetwodiscoveriesmarked the beginningofnew Eraof
disease prevention and specific measure.
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23. MODERN MEDICINE
•The Dichotomy of medicine into two major branches by the end
of 19th century. -Preventive medicine/publichealth,
-Curative medicine.
•After 1900 medicine moved towards specialities infectious
diseases were cured by antibiotics.
•The pattern of diseasebeganto change.
•Developmentof multi factorialcausationof disease.
•Importantgoals whichhaveemergedarepreventionof
disease, promotion of healthand improvementof the quality of
life of individualsand groups or communities.
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24. CURATIVE MEDICINE
•Its primary objective is the removal of disease from the patients
,employs various modalities to accomplish this objective.
•Middleof 20thcentury: Revolutionin" Allopathic medicine" by
theIntroductionofantibacterialand antibioticsagents.
•Curative medicinegatherscientific knowledge, Technical skill,
medicine and machinerynot onlytreat disease but to preserve
life its self.
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25. PREVENTIVE MEDICINE
•Preventive medicine is the science & art of health promotion,
disease prevention, disability limitation and rehabilitation.
•Early victoryofpreventive medicine was in the
fieldofbacterialvaccines, antisera, nutrition,
syntheticinsecticides for control vectorborn disease.
•Discoveryof sulpha drugs, anti-malarials, antibiotic, anti-
tubercular and anti-leprosy drugs
haveimprovedpreventivemedicine.
•Chemoprophylaxisand mass drugs treatment havebecome
important toolsof preventivemedicine.
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26. Cont...
•Concept of disease Eradication and screening for risk
factors of disease and identification of "high risk
groups" began .
•Besidescommunicabledisease,itisconcernedwith
environmental, social, economicand moregeneral
aspects oftheprevention of thedisease.
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27. SOCIAL MEDICINE
•Visualized as evolution of medicine .
•It is definedasstudy ofman associal being inhis environment.
•Itstandson twopillar –medicine and sociology.
•Itemphasizesthe strongrelationbetweenmedicineand social
sciences.
•Itisconcernedwith bodyof knowledgeembodiedin
epidemiologyand the studyof medicalneedsor medicalcare of
society.
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28. CHANGING CONCEPT IN PUBLIC HEALTH
•DISEASE CONTROL PHASE(1880 -1920)-Sanitary
legislations and reforms aimed at the control of mansphysical
environment.
•HEALTH PROMOTIONAL PHASE(1920 -1960)-Two
movements were initiated during this phase –1.Provision of
Basic Health care services through PHC and subcentre.
2.Community Development Program through active
participation of the community
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29. Contd...
•SOCIAL ENGINEERING PHASE (1960 -1980):with the advent
of chronic diseases and the concept of risk theory public health
moved into preventive and rehabilitative mode.
•goals of Public Health and Preventive medicine became
identical i.e. prevention of disease, promotion of health and
prolongation of life.The term COMMUNITY HEALTH thus
came into being .
•HEALTH FOR ALL(1981-2000)-In 1981 WHO pledged “Health
For All" by 2000 to bridge the gap between developing and
developed countries. To achieve this goal the concept of
PRIMARY HEALTH CARE was started.
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30. MEDICAL REVOLUTION
•Medicine has moved from organism to organ and from organ
to the cell, and from cell to the molecular properties.
•It has acquired a promise vast body of knowledge and has
become highly technical, with concept of:
•1. genetic Counselling
•2. genetic engineering
•3. organ transplantation
•4. prenatal diagnosis of genetic diseases
•Modern medicine has entered a new evolutionary stage with
the promise of continued improvement in medical capabilities to
preserve life , if not merely to solve the problems of sickness.
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31. SOCIAL CONTROL OF MEDICINE
•VIRCHOW In 1849 wrote that “medicine is a social science and
politics is medicine on a large scale”.
•As the cost of medical care increased two kind of medical care
came in to existence one for rich and other for the poor.
•Russia was the first country to socialize medicine completely
and to give its citizen a constitutional right to all health services.
•Socialization eliminates the competition among physicians in
search of clients. It ensures social equality that is universal
coverage by health services.
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32. FAMILY MEDICINE
•It is a field of specialization that is neither disease oriented nor
organ oriented.
•It isfamilyorientedmedicine or health carecentred on
thefamilyas the unit.
•Family medicineintegrates the biological, clinicals and
behaviouralscience and is notlimitedby the patientsage, sex,
organ system or diseaseentity.
•Thespecialityof familypractice is speciallydesigned
todeliver"primarycare".
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33. COMMUNITY MEDICINE
•It’s a newcomer in the field of medicine.
•The field concerned with the study of health and disease in the
population of a defined community or group.
•It isdefinedas"ascience and artof
promotinghealth,preventing disease and prolonginglife by
ranges ofinterventionsin closepartnership or
associationwithhealthcaredelivery systemand with
activecommunity participationand intersectoral coordination".
•Its goal is to identify the health problems and needs of defined
populations (community diagnosis) and to plan, implement and
evaluate the extent to which health measures effectively met
these needs.
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34. References
•1.K Park. Man and Medicine: Towards Health For All. In: Park’s
Textbook of Preventive and Social Medicine; 27th edn. Jabalpur, M/s
BanarsidasBhanot Publishers: 2023. pp 1-8.
•3 . R Bhalwaret al. Historical Concepts in Community medicine. In:
Textbook of Community Medicine; 2nd edn. New Delhi, Wolters
Kluwer(India) Pvt.Ltd.:2018. pp 2-7.
•3.AM KADRIet al. Communitymedicine;an introduction .In:
IAPSMtexbookofcommunitymedicine;2ndedn. New delhi,jaypee
brothersmedical publishers:2021 pp6-9.
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35. THANK YOU
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