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Park's Textbook of Preventive and Social Medicine PDF

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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,

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