Park's Textbook of Preventive and Social Medicine

942 Pages·2016·46.24 MB·English

The Book is dedicated to the revered memory of my husband
DR. JOHN EVERETT PARK
BA, MD. DPI, FLPILA. FAMS,
the founder of this title

PREFACE,

11 is indeed qvatifying tha: th.s book as seen Iwenly two
and is now enceting the twenty-third eckion with a brand aes look, This new
edition ‘s in keeping with the tradition of velease of new editions et sequlat
laxerva.s. with the objective ro ntecch “he pace of everchanging subject matt,
‘The books has been thoroughly updaced and revised

The Chapter ar Communicable Diseases new contsins dhe rew treatment
yuidelines released by WHO (2013) for HIVIAIDS and Decemiber 2014 guidelines
fox pos-exposure proalislaxis of HIV ané use of cotrimoxazole ia HIIV cases. New
hreatinent and dlagnostle ditectves (2013) agamst malaria by Government of
ladies have been incorporated. WHO las issued updined guidance an definitions
tf c9928 and tteattment of tUberculusis te accomodate diagnosis uslny Xpert, MIBY
RIF and other WHO endorsed meleculat tests These definitions now replace the
2006 definitions. Extensive work is going on in MDR-TB investigations and
weatment in different situations, ¢g., adult tubercular cases, paediatric cates, TB
with BIVAIDS., during pregnancy ete. These regimens have been covered it
derail, Ebola Virus Disease naa been included in re-emerging Diseases, Soil
remsmitted helmimhiasis contains naw matter,

Chapter on Health Programmes In India now contains new plans introduced in
2018 and 2014 i.2., National Healt Mision, National Urban Health Mission,
HMNCH(+A strategy (2013), India Newborn Actlon Plar, (20141 ete, The chapter
also contains details about NACP-IV, latest on RINTCP, malaria und leprosy

‘The other topics of interest ate Glohal Hunger Index. the currant situation
about Millenium Development Goals, revised classification of adverse events
following immunization, the new aod updated matter about child and materral
niorlaily, Mission Indradhamcsti Gaunelied on 25th December 20141, and many
more. 12" Five Year Plan seplaves the 11” Plan

In conclusion, [ wish to express my graitude to all those unde-graduate and
postgreduate students whose comments and encouragement has helved me to
wep the book upto-date

Lastly, | extend my appreciation 10 Mr. Brij Mohan Bkanot for the care
beestowed in publication of this book

Jabalpur K. PARK
January 2015,
‘CONTENTS

Chepter Page
MAN AND MEDICINE. : TOWARDS HEALTH FOR ALL 1
2. CONCEPY OF HEALTH AND DISEASE 18
3. PRINCIPLES OF EPIDEMIOLOGY AND EPIDEMIOLOGIC HETHODS. 52
Ans ot Lpideria.on9 88 Aosoriotur seu entation a
Fpidemolnyial appreats soc Uses o epldemiclogy 91
inte ané ates 5S Intetion sens epi cae 2
aseusenen: of snartahny 36 Diceage ansmision 4
Hangame of needy oD terme iat
[Bpidemolozic methods ee Tenunipinn agente ts
Tslpive eeicem.clog, ss Disease prevention and cont] na
‘nalyiealepidersiclony 70 Dishes Ig
Excetmactal epidemiology 8 Inveethation ofan epidemic 131
4. SCREENING FOH DISEASE 135
Concept of sreznin. 135 Sencvity and spits 139
Tees of stcenn 15 Problems ot the bordering rit
Cetin for sentnirg ar
5. FPIDEMIOLOGY OF COMMUNICABLE DISEASES 143
I. Respiratory infections
Sung. ue Diptera 159
Chickepex 118 ‘Whucpiny cna 18
ezsae 146 Meningococcal mein 183
that 10 Peace sahatony nesters 167
Mums ase Sans 14
(nflenca ass Tbsreslose 176

1H, Intestinal infections

Potente voz Food noteng 238
Viral hepatis 210 Amaebinsie aL
‘cute clathoaal Deaves 221 ‘evar a2
Choletn 208 oksner tle 243
Type fear 288 Deacunevtase
IL, Arthropad-borne infections

Dengue aadroe. 216 LynphatleFlaraste 210
Maia 28

1, Zaonoses

Vira acer
ahi 2% Brucella 200
“alo love. 22 Tanti 291
Aopanese encophaits 2a Plague a2
ca eal Munn sabwonalons 20m
CChikunmnya tur By

Richttal dieses Persil nese
Tickets noses 29 Tasniose 02
Sow typhus x0 siyeaea eionase ‘03
Mune ye 00 Laweanaeats 201
Tk eyphus a

Qrever 201
¥. Surface infections

Trash. 08 sm 330
Totsnus ain Yew aa
Lepiosy ale AIDS. 23
VL. Emerging ond reeanterging infectious Hisenses 8
VEL Hospital acquired infections a9
6. EPIDEMIOLOGY OF CHRONIC NON-COMMIINICABLE, 362

DISEASES ASD CONDITIONS

Gantiowandar ant 286 Gane. 381

Conor Bt danse 366 Diabotes 302

Hrperenaion ae Obesly 307

stroke a Bindacss an

Rheumatic heart disease | 278 Aceldanrs and tnjues v1
7. HEALTH PROGRAMMES IN INDIA oe
8, DEMOGRAPHY AND FAMILY PLANNING a
9," PREVENTIVE MEDICINE IN OBSTETRICS, s20

PAEDIATRICS AND GERIATRICS

10. NUTRITION AND HEALTH 608
TL MEDICINE AND GOCTAL SCIENCES 663
12, ENVIRONMENT AND HEALTH 703
13, HOSPITAL WASTE MANAGEMENT 189
14, DISASTER MANAGEMENT 1s
18, OCCUPATIONAL HEALTH 503
46, GENFTICS AND HEALTH 20
17, MENTAL HEALTH ast
18, IICALTH INFORMATION AND BASIC MEDICAL STATISTICS: ana
19, COMMUNICATION FOR IEALIIE EDUCATION asa
20. JICALTH PLANNING ANP MANAGEMENT 868
21, HEALTH CARE OF THE COMMUNITY 890
22. INTERNATIONAL HEALTH os
ABBREVIATIONS 926

INDEK sea
Man and Medicine :
Towards Health for All

“Those who jolt to read history are destined to suffer the repetition of tes ralstakes”

eon time immemril a: has veer. ineeretel in tite
to gomol theeage. The mecnne ray he privy To
Feedba: gn the wayeinn, at unlit ie pias 596"
une ener ican andi € bang ea Io the te In ae
nvost plate ahsence af sclematie eacical inow-edge,
Gheuld cor ba fat 3p say that the cael) przctifonets
madleire ceatisuted no:ning to sae allesntio of ace
Euflerine om dacaee, Medical Fnowlede i fae, lew see
erivell to ry grat dearen, Rom Fy inl etd
Sbservélional propoaiiaes atl ssaliee sp
leer enn afte. Watery of saedlene Cus careeoes
Stevie ot aecemplisyzents and etars, false theovies and
Shsinformation and misakec inteprettocs, Is ee a
uly of the evoktion of man and of human hsidede
floor Soe ager of the bioyreran f aminerr inuelyels
tik ele’ oped maicnes nf he discoooren al nae
Br ditiegs hiticeal peed, ane af tha cverchanghng
Soceapl, Sauls and aojsctives of medica. In he course of
4s evaltion, sich srooeeded by eages, vith advances ar
batts, medicine nos down richly om the editors sulci
OF wich isis a pal, neal nfm baal ond asso
sree wel i tary Tepid aa Sachin a
‘Estos Nal ith oil onthe ae of fhe as the
crucible of time, veecieice has evelked sof mio 2 sacl
Sate emily soresueatied and poliiaec. The
explesioc" of knavsedqe during the 20th cencary es made
soiree none crt ls ul Inve repli bt Hit
bbonefes of makin ene Ii rol yet rmnimaed the
social potighary is iany counties. The glaring sentiaate
the state of hazlts bekvean =2e ceveoped and developing
Countscs, seen the vara, and sobet arene, ane oe3veer
‘eich and poor hse atte ovkdiide erticer: 28
‘acid ejuton® The ous lmecn of ml sen, cle
basta ortho Worl Fladih Qnyenalin, Wy yn cl
a wnequaiies:0 the dlteallon of Aut “sawed Ae
Services nad stam the Mlleiain Dacclooment eats Uae
ool cf moceen medicine is na cenger reevely treatment
AAthowss, Tae atzer kl more heportant yea 5 which have
fsinsius ns paversim of disease, aeurebtio= Ul heal nd
Inmpeotenen 5: he yuaiy af Heo aeigugts we guns
or communes. I avaae vor, the So0pe dc MUN ae
hhimederably broadened darmg yecent years. It Is aka
fignaced 06 an essendal compozest of socie-aeouorsie
evelopment

|, MEDICINE IN ANTIQUITY

to ancient des, seals and Uncas yere Inte geet a
<soumological and anthecpolngteal potspectve. Medicine Was
dominated by magizal and vellglous balla we:ch were 30

invegenl pact of gucient cules and civlbations Ulensy
Sogo, the medical svslocan. ay ella el every culate
hall devsloed mate of mci, eid medical hen
Ter des epee of i hisery oF rare Dubos Hos os
flog "urcint sels ec rece we He che?
‘Teeter nes and playa arg tain tensa: 9! cathy
‘asluner (21 Sue hove le ae gant lationship beter
tadisine ei hun ncancemen, ang aesiarl cf
Inelcing ata gken petal suute be iieued grin 15
fetieaen and haman aikonesment al that tse,"

Dhlosaphy. Eekgon, ceonoms. condFions, fine of
government, eduearion, seianee an aspiations of ke
eople

Primitive medicine

i nas been truly aid char <aedicine sas conceived in
syrcpacny gr bom out af neces: we the tat doctor
Saas the fied “aes aid the id orien, he “sl nse, The
Brehlclode man, macsated by Terre at senpelly ene
Tinea, wae alaays a he behest of fee dred, yng le
provide See, in times of eknare and steing

Binoy We huwwcals woe lined, the pri mit
trate dlagaae, arin “tall human sates nd other
aloes 0 the unath af gods, "ie Invasion of ily he
‘el spiix" and she makvolest influence of sais and
plunets, The concept of dlease in whiea =e ancient man
Teteved "surnam ae she “supsaraciral teary of digas
As lisies satay iv: line peated eons
promi sels Uw pages, a's and taetices, esr out
‘Dil pie frim the human had fy weechera and other
crude ineans 36. using craze end amulets fo prenect
hiesel€ against the icinenee ef ev epirts. The
fdncistcalien ot corre herbs or douse whose: elle ty
Shel rn by, hopes harmlese rey ves bo Id
fo Tera of magi isi ane ated ath the rae 19 “>
omothing™. Thate Is alse evldence That ovehialae max
Inmprovised| stone aod. cline Ietarcerts wea wrley he
petlormec cienncisons, amputacons aad tephining ot
Salle Tie ue obviuna cat medicine in fe prehistoric
Fn Faboar 8000 BC.) ns alain wil pares
region, magie nd wie

Primitive mecicize is tine ess, if we ok avound the
varie find ta he rasients wf rite rece ai
veil rane par ths suule ~ in Rea, Alien, Seal
Bieriom Auawata nd Pas Paci late, she xine

oy eh elseone In wich the pride tnan believed is as

‘evr as today. For example ic rela. one ray afi seat the
Falk of curing sncke bites oy *mamése". sewers suen as
Worcs fetemrotee as Buu! sunishcionl lor eme'e pest
2 BANS AELILINE: SINAKES ne9LIH Oh ALL

fens i som cubres. altsoush pcm se waa cay he
oetset, Ws progeny "the so-called "vadiona: heals” cas
‘ound eveymtars They 02 Use 16 the pasate and thet
oteaanty ene based on varie combiastses of religion
marred ume

indon medicize 3)
The “wal wets thal ses tea'y Vag in rig asl
inzeloyrnea are che Syutedda and tie Sa sess
Aysrwela is yactsed srsoaghout Ineo, oul the adhe
foto's pratiaee in he Uailspaniing aceae of Socth
din sees eesteme des very few both in theo ted
Fractge (a). Aysrveda ly cet erie the Nermexe
Dil Pp newnsge by aie fe va he prolerype Ns
pili raved au ak 19 tho Vel ¢ fone, oul SEO B.C.
Shatng Cis psced, medica: hitary was asenc'a oe wl.
nytelogieal"pctes, sages and. seers. Dhemvartes, the
{lind god of snedicine i sakdc have 2een born as.a rest
fof she ching of "e aceazs dung at otis betwee
forks sind sem, cernling tw sere Fa
fesionacatdalge in Ihe schataverdn fone OF Fae fe
oiles yad:aly ceweloped ino the se-eacs 0° Ayuncoda,

In anctent Inca, thy cesbrate sehen Ayur-elic
rmudicing were Am, Casey, Searls nd Vagal
lew {abot 00 B.C.) ackneledgal ds the ft 2a
Tecan pyran ane teacher. He “ved ta the sveiet
Uunbesty gt Taksheshis, about 2U cries west of anders
Rouaipicel 5). Ayurveda wizessec temendaus growth and
cevolypment shin ce Boedhil smes Hing. Aazola
1228 RCT age che qher Budhid bingy "pabonbedd
Dynesedan ag Sly “sae ne ai al ae areola
Sediang ail pul hospitals. Cnaraia 200 3. tha mont
Sopulb: nace In Ay-rvedis"edicine, 0s 2 coud Beysilan
fo the Luddist king Nocichla, Uassd on the teachlzgs of
Aiciy, Charaka commled I's tana trealie on merce

The "Chaney Sarah C>ien ilene song SI cee
The “nate weaccool jmuneifal vias wenyieed fo.
ceumrciles oy the arian physicians, Yetore reseipine
uzctee Naw. ra roet ane found speracalety eet in

the Eeasmnent ef hypectasion,

Amany the wang dainguissed nomics in
aegdlcive, that of Sustsa. the “ther of India S250
Hanes cat 2 seosaineace cle comes the suigical
Tnowledge a is tee in his clare "Susmsta Samhita”
Tlie Taal tig rlewie ws very! Iy wgat S221 F.C,
sal 400 82. Toh Sis wah mails dowered 19
Fieger, (alee ichadesnediome, asology, shalom
midwiess, oahthalaology. sygiexe ane oedside masters
Te eathy Indians set faces. performed ampztatons,
tcked tamous, repstwed sundae one envebed bare
Asralions mad yineresecr (6). ig tene Ht le Bra
Digscians aha on att a2 vPectuamy nt ia,
Sutgenns in the days of Ese eka Company (7. However,
uring Beddhis:simes. dian supers sulted 3 sothock
because of devine of shines (xonrvilenel

OF agoiicanes im Agurveds Ie the “dosha thoes ot
aisense". The doakas of fimors ate: 21a i8indl, pita ga
lnc kapha tacus) biscase was explained as 0 dieucoance
Seige evviibsig of he chow hares; wes thee wane
tooled lence la cen «pea i 19 be Sally
Tp Tiig neon of menses tly inl 10 The Mn
aur humo bntieakemecleins, Mecica hasotans acme
that thee was flee exctange of ‘ought and exoeionce
pepses tze Hesly, fab, Peesion, Crosk.and Senin
Sovclam, Toe Sense of Choral ane Soerng were
ireaaeel nat Peaies nl Bese alae 220 AD.

en

Hiyglane was eum au nesses ao fo ier nin
ronliges Toa fart Wns wot coef peter
‘niiews Acehnese war salions ef Meaherco-cato and
Fee ithe Pale aly qucgueret ies af vey ROO
froncoril sire 5) sich “awed satier adeaneed
“pu mle of aston nave spohy axl enginesting. Ta
agile wy of Inna ecole we batons 80 L1G: an
DIM AD. Dering the Megha, period ae esosequent years
‘yarwoa dv med due so ca of State suport

Malic’ hie ora mat hel Tear alors has payed
Ay these era le Goode rae an ea ot
F aes apie on Indies, Invi, The ental
canner ge Segue, oxy Une Goes medicine ba doe
ie Rares ol Ara ante Ph

Montes eust be” acca 20 er lenses oF
srvlsne nti Unt Tile wae Eel, etch ore
trav uf disn nevis, The Usint:ih sete of med:ene
‘chose acne raced {9 che ancient Greek medicine as
Tnvedcesd fro india by the Meslis clas abos: ‘he 10m

penuiy’ AD. by ake Tt ceacen the Unant agen uf
facie was Lira entenciee la est Wave al eles
harahie Delhi, Aagarhy Lauhcine aod Fydemiee “Sf
Chvoget Slee sao ircer wsuteacte Milt eles i
Thay il elect of thr Gelics fe the 16th estar
Hesocepathy, which was pecpaundee >) Samuel

UUscnemsor {1766 184u) ef Geimany gained tacchele 1m
India uring 2510 anc 18 9, ets 2 syst oF aa nacor
dynamics gaged en "necinvene of hacnae by Une 2 ll
Banuvts af a drig thal, i healthy percha, pedis
np ns suntan in-brrc élgtens Beta lel
Hoon ie practical Fr mover nour, sat Tin
dais 40 finoe te lest umber of penetiCeners oF Mis
Syne athe wore 1!

Ts ci teas of nate lading nari ae
Homovopetne age very Tel ale fm Tee noent olgy fa
lacy, they have becorce oar. of Incian celtoe. and they
Contaus fo be an ixpowant source o! edial sli! tothe
‘ai population

Chinese medicine

Chinese nates clan vi 2 wcll fal ansaid
tol alc seth dry neh ks 2700 Bs) Th
Sy bn on fay ovine vs ~ the ay wal he yin. The wan
‘hollowed va bea elie msculice prncin' the yin
pesative femizine principle. The tslonce of thuce twa
Sppesiag towces inzant good teath. Hesiens. dietstics
yaretherapy, massage, drugs wre all used by tke Chi3ese
pagsciane

The Crinase were ely pioceers of immunization. They
ised vaialaon te areventsmallpon. 9 a Csineee. "Pw
(reot cacion's a3e whe ene nor semoans who ie aleeady iT
Sut somacne not jet il. Tae Chvese ave great “ai
theistradidenal medicing, shieh os tally ineagrved ith
roders medisine, Tze Chinese sera at “barstoot doctors”
End accupaactuse hive avbocted worldwide attention i
fecentyeats 17).

Egyptian medicine

Lgyp: had one of che idest ciilions in abet
2OOU LE. Alot i imow: about ancient Panel beers Foy
invenoed ‘niche wering ane. seoarded Pu dete ow
Parstes fe Faystian tines. tho el of melieue wen haled
fathreligine, Fesmriay aire soon feu ess
Trang Sn sowsg's within the Taupe. They Fes halped
ress came “oe cick who we lug the Reps
remment, Thowe were no oractea! demonatatioas
ratory, for Exyttian wile sina let preservation
Of the hrman bail. Fyyor an med cree eachee is paak x.
the dogs ce Ineotep 8G) B.C.) asa was testes a8 2
Haterrters aichitee!, Guider ob the. rep ggramid. at
Souqerah and pevsian. The Cayprans worshipped many
uss Tmotep as corsidered soth a dactar and ciinin,
Syectaizacon prvalled in Lgyoton tines. Taete were eve
‘helo, head doctors ae¢ teath eactars. ib these destors
‘sows cial paid by tha State, Homer epealing of the
‘Saeto ofthe ancient world considered the Eqypcazs o be
the ise best of al" 23),

Enyrtian icine as la from pensive, Thay aaiieved
thee ciyenee ti die i absonpcon fom the Teterene ob
hrf suhsianens wich gave fae to pisetaeion o: blood
ne fine us Te bellaved thatthe ules eee “the
Sosnch fine near: Deeosss mare taated yuh cacnare,
‘hms, aloedatting and a wade range of crags. The bast
ibsout mediel manusarets beronging to the Layton times
fue the Edwin Stith papyras (OWN 2500 IC, and tke
here popu (1160 Uc. The Ldwin Saath papyeue, the
eldest Reatse on surers, accvratety describes part!
Daast Zalowing cereoral “eons in shullfractaes. The
EEbere papyncs which sae found vith 9 mmr on the backs
oftne Nig few uniane oad af serne 800 prevention bases
xome RD dupe, Castor fnntrse' opine, oxrenie
fenian, veves. moray tel "9" las were al el by Us
Eruption panics. gral her GP dene are oe
ping pagel such ae wnteng, et agave, line,
Theunattsr, Nis and selawsmiaets nforawaleyy hess
trl sl poaeal it oeade:™ Fay

In the zeal o pualic health aio, tne Egyptians excelled,
They bat plansed cies, public bates and codarvound
rains which even “bw "vader tint ons Ta sal also
‘some krone of Feveslvin agains selpox, the val
HE poauity nate nd he nsaalion 9 plgne lh re
“Their gut ot tenis Foun, Faye monten cep
Adonai lace nine geen wt fn seat 3010 yo
thes Ha planta by Gaur

Mesopotamian medicine

Conamporary itis anclhat Fayprian cites, Tram
exited anothor culzton ina lands ee nee fe
Lupttaies and Tigis ress, Mesopmaza fant part of Ka),
ter ralled the "Cradle of Cvs” aang 8 GO yale
aye.

Iu ancien Mesopotamia, the ose concenrs of medicine
sweie rligions, al naaghr esd practi by kerb doctors,
nile doctors an pall nets a classfiensen thac mage
ierllel; our cunt inerists evegeone and proche
Moscmotamia was the cradle of aagie and necomans
Morita! students were bus in claesiving "deaans”, the
causes of diseases. Georsarey, the imazpreration of da
‘bd Hepatoweapie dination ine live: was considesed the
for ‘of lite! fe chavacoteie_ of chext retical lor
Simrusiane, Babylonians and Assyrians were the aathavs of
‘puriteal asvology hich Hloscished in the whase of Lurasla
Prosevipsone were writen cn table's, in canelforn sling
The oldest reecical prestepsion “comes cas Ham
Mssnpetarni, dating aack ta 2100 BC.

Hamnaucals, 9 gral Kiva of Babylon sho we avound
UK HC. ton felatenl tel of rhalic ows ove a te
Coe of lamaurabs sae gavenned the senha ol year
find eovideo for health practices (el). Doatacs whose

praceiel therapy prow wrong, ta he ds af sing ele
Dates veating re odien acts, ncudiag fees ratatle 3
lysis Zr satisfactory services and peaaities fr hamufl
Theragy ase contained in tae Mooylonion Cade of
Hosimcrobi. 20 way “ist couPenion of medical prastca
ar the rude of Homma tered high Gagres af
sil organbatieny, he essing nf eee woe Jaws F
Seen foun,

‘Gnck medi

Tha eassic poviod af Gack medicrse was tha year 180 -
16 WE. Tee Greeks enjoyed the rapzation ~ thee uleare
ofthe anciest weed. Thay taugat men to tank tems at
‘wane "hove An ual face: tn Greck meaicine was
Aaseulapies (1280 B.C}, Aeselapics Sone hen daghrene
Hyslea geal Panarie "Tee ined hire, Bogle
‘eats (27) Sa rte un he eal a Hagin 05
Sforasipped ae tze goddess oh henkh, and Punazea se
qedeers ol mesiine, Ponacea and Uiygiea gave ose to
ynastiee of reaiers feurtive ciedicine’ ana hygieusts
ipeoventive ‘osdivine) with diflerne phlowoohies, Ths the
Seligiontg Oswoss eungyenedietan ad yeeveRtve
feaciciae Gagan carly dnd tor ras # reales rae Kel
Tygiea Ipressaton? i at juesor tatsanwale arcorg ‘he
intellectuals; out Patooea ure) gets ne -ash.Asseulaps is
‘Ail enesishod in stedicn cities his ta, enmuined by 3
‘ernert,cuntinues tobe the evcba, of medicine

By for “ee grezast ohyale‘na in Greek madirine ws
Liigpocrares Feo" 70 H.C.) whe i often cae the "Falher
‘of Mecisiee". He wae born of th litle sland ot Coe, the
Aenean 2a, about 480 8G. Re studied and. clasitied
‘Saucy hereon ubsecvalion geal concen Hl ebeileted
the eacktionso magic fe eat, an all Yasin
few apienach ta euleine Le spleaton of brie)
Imetnods in tedicice. tippocrat’s lees ana wntngs, 28
ompied Inter by Slexandian scholars iota the "Capes
Hioposssicsm", encompassed all oranrex of medicine ais
TD wokesve wok eyegi lhe Heel selnhe liceal case
eta: Seta the sings Hiprsa'e Iter Deca
favorites wah piysleiaes, seh aa "Lite m sor, Se a (al
‘medicine! tong, ppactunty Hacting, expesionce tear seit
Bre jsagenent sles", and "kets we i wove Joe
Imankino. tere i love for the act of fealing” His tamoise
Dis Die *Hinacrate nh" bar became 1 Rowson of
‘retical oobi sete Pgh tral stale fie he 6nd
Drofessie and demarids absciute ilogtty of lorlucy
Tipooeiats wil atwags he reparcee as ond of tha masters}
the medal at.

Huperiales at ale an shideininlager, Sloe “ae
Gistinguised betware dleeases waveh were lei ene
those thin were endorie, he was, be tac, the fiat tue
epilamilogis. Fe war constantly seeking tha causes 0
fqsenes, He sted suc things as climate, weaves, clothing
[Snr babi of enka md le eles Hy tae
Eciving dence is baie never a Places”
Sond toatl wn aeelal meting and yg, Th
Tippoceatic concept of health and disease sessed th:
relation between mar and hie envconcaent.

Tn suet, the Cranks gata near diteetion te mana
Ahoughe, They tejecd the aupernarusal theacy af seas
nd inoind upan dlsvave ae 9 natural process, not

‘Slkatlaa from a god of insolation. The Gracks baLeve
that mater eas sade op af four elements ~ aarti, al tir
land water. sheve elesente had the cocreszonding cualitie
fof being cold, iy, hat and malst and were vepiasected |
the bea by the feur aumoc ~ phlesm. yellow ble. loo
sid aul isle — siesr te the iss they” in
Ayursces The Grvalo postleiel al Pusah pooled
sshur she fur huamers waren neaibeice a wt ge hy
Belen some disirl, dheoe ae thy “eu The aise
Touy senssraitt ka enue sso renatin? vf bonne
separ ad asthe ysis iene le
Ferthie healing prnenss. Whi the Allene thuery il
Hisiocrsten wat" hosed ou tscornst loanuetis, the
ccieap af tie inea‘e capaci, af the holy oF seria I
Grebancas sa the egilum tha: cone’ tae Teel i
egkvveleractta modetn med.cie 5)

Cheameclieg amonser postipnocintc saedien, centees
swans Almrendei’s Fuge saeeuza, the dees Latovriy tn the
SBorle wien sc tame a bbvary contains, sees 70,000
only “Ty. tig hese Of amveina emmy ecient et
Belure 200 BC me 80 B.C. canard of pup
frleclatel ithe. gchool yl A soar. whic enlace
‘Mane gy lhe snl raine of erage si
ignosrale ohachiongi e_gua Ihe Alwéndety shoe,
fal “he. nen Petar mets. The: Hider a sche
Shane theskntny of eiace ne ay pata eran
‘cd ciseg Ito the satus of a science. Thay had selen Ibe
froth, although not senile seessiedga. The glomus
(Greek sollanion fell nto deca and ne sucesstia by the
Roncan cklizaten,

Roman medicine

By the the Cerny B.C. te cenme of <tulkzaton elted
ta Rome, The Harzawe bortuved shalt meciine large mm
the Greeks ishom shey had conquezed. Wille the poles ct
tha werle became Harn. medicine terained Greek. the
poliial pllosophy of the Momans. tke State and not the
Facto was cupreme.

‘Th Retr wae a yoo pot mca mil th
the Cracka, They hae 4 lan sahon Mf saris Pu
Tanti se own In Rome is the devclopment nf Rats,
aever and. aquecuct. ze Romans mate “ine roads
thioughaut hel expe, oro pure wate to al thle ces
thiogh aqusdicts. drained arshes to combat mara,
Dt sewarage nyse and esalsced hospltl ort sick

An uttending Tes nrciry Por medial veaulnny
soe Qala [1SD-205 AD. wen anes bore ie Grete
Prgmn Asie Mina in Tutt Hor ene pect 1
the Rowar. seine, Mincet Avrabus, PEs myertect
fsinteasiora were in th Hak of cnet analy 2nd
fxpertsaria; nhusology. Galen aga" ahvad ot his thn Ia
hig views aou: Peaks ane cisaase. About henlth he sted
“Sines both iz fnpcttance ane 19 thne, beach prosedes
diseace, 2a'we cught co consicer Zist haw bent ay 32
preserved, ard then tow ane may best cure dieesse” [16
Rout diseare, Galen cbsenved tout diecnae ts cue to three
faciox. ed-jpasing. euting ond exctormenca tetas 3
truly mocern icea, The duces of Hinpoeaces sed Galen
‘este olen in eon eines tar anproeliss were xo Zenen
Tite's whee the other abale, Tre wrhor of serve 300,
anton on sia subict, Cab was Bwalya “inert
Eulanor" fhe, rll far lane ie Ieee, le
Cesings nf wana Baron rdcines Thy ane stp
wr manned lesnoaks anaicive for Herta HS
feashinge and sion, were chahangjee fh anatcish
Unsalue in 1508, od tha phuaplogie, Wlae: Havsey In
1628, ance: 1900 yeate ar he Ceath

Middle ages
“The pried betwee

50 and 18ND A.D. ie generally

own 25 "Midcle Ages". dics the fa of xe Hamar sa,
he mecca! selioos ertabehed in. Reman mae 30
cireppeares, Furie wae ravage, be disease and aesalaa
lige soaitwos. lesrusy end scbereuloss ‘The practice af
hchvine raver nd Wel orimitive medcize Cominntee a,
taper ion ane agi ‘Re'eetion of see hed and
leat of thw sprit Lerarne the secreted ooseen ot
Fetter In egal ae hema hp seo one's 208
Piceqetly peop wieie kaha. Diogoren et the
hhursan Sid wae wahisival. Couseayue tere wo 1
progress of nadicane Tho medtwval jerind i INeretore caled
the atk Agee nf Medicine” ~ ina ol grow” srl of Soc
Douileal change, of egression ant oatesion 17)

‘When Lurape wae gassing through the Dark Ages, the
fuabe stola a eiazsh ove! the vest af the stolizaia™ Thay
teatslaed she Gracca-Romen medial ean.@ nls Abie
nd fepal presen liv. ancunl Kskaige, Rorcosieg
langue from ‘oy Gree nkl Resse, he ceveloped “het
four gavin oF mocicine hovm ae the Unant seen 0
medicine, They founded schools of medicine and hospile
in Baghdad, Damascus, Cato nnd o2cer luslin rantal
The arabs Ut a biliont torch trom Greesan lacs, se
Osler Leaiers in Aral wradiene wee the Povsiay, Aina
Fs (Q4-928} aks kent vara ne Te Sion FEO
TQS71 isu a Avice wo shy weelers wel, Rao a5
a lector of 8 logge Hospial ie Bagtlad ard a court
Shsician as well, Nosed far seen observation ard
Invectivecesr, he asthe tt ro obsetre pupillary renin
1 Ight fo use teow inl pungocves; and to publish the fest,
‘noah book ox Chile's diseases (72. Heascune, te te
sont hig veyed sala his Sone on ematne wal
vumeles whi he cieinguised eFvially Suieano woe at
frtelleceaal pradiay. He some 21 ohne
Encyclopaedia, the “Canon of Medicine”. wzich wne to
leave ite mark or mecieal Georg and practice. Me 3s
respensibl Tor elevating llatie iediine fo Fs zrith In the
Tite ages. Tha greates:cmtidoytion et rage cera,
‘eae the fel 0° pha raeology. Sucking the "een
Tse Uevebol pharemsmtinal cata ilteicing
Tego maradier of ui, erbel sl erie Ponous
haempcology ty inontel ee at of eit-g presenters,
Br av inherited ov oct modern pharmacies. Ube
Inedcee a wide varge of ta9s, ole, poulics. plasters,
lis, prevder,alpaaolates ud aeommaie waters, Ile woret
Mag, aleohal, sp azal sugae are all Avablan (22). The
olde age noe ins wna OO A
Doving cn tu/sulexe middle ages, Shestianicg exerted
‘atolesome influence. The spread of Chestcits led 0 te
esablishmect oF hospitals, Earls medieval hospitals rarely
Specialized! in treatment of the sic Lsually the eck wore
receed ‘or he surpese of supolyirg that bocily wants wr
taveing to llr epi meee, The fe hoopla on mene
In Enel gail Yorn O97 8 TWP yeah
reign, shain of onpitale speang up fear Berar
Boair= thew wre mene Thal hy Baghdad. and #3 Io
Caio, Some hnaqil, Ike Calis Al Manaus esl separate
Enpaetserts for various alsa, sacs for ath sees,
Teatntans 79 cool tever patents, Usvarles, masicians and

Pring bag mide ser, cen istics hw

‘aunsstorieg” hecdeal ly teks, sain ed ate § also
ear ny They moneluies evel Su i oe Fen
‘ll varls incaing Kings nnd: jascum, The mo aly helped
Ineteren the selon inawledge bat else sender, active
Teall rf ang eave tothe sik,