INTRODUCTION TO

COMMUNITY MEDICINE AND

BACKGROUND

By:
Dr. Mehroz Imtiaz
 Community
• A collection of people
with common social
characteristics and
generally geographical
proximity
• The physical
surroundings in which
we are usually located
Community Medicine
A branch of medicine that is concerned with the
health of the members of a community,
municipality, or a region.
The emphasis in community medicine is on the early
diagnosis of disease, the recognition of
environmental and occupational hazards to good
health, and the prevention of disease in the
community.
4 Dimensions of Community Medicine
• 1.Paying attention to sociocultural aspects of
patient care
• 2. Coordinating a community’s health
resources in the care of patients
• 3. Identifying and intervening in a
community’s health problem
• 4. Assimilating into a community and
participating in its organizations
Community medicine includes the following
branches:
1. Epidemiology 2. Vital statistics
3. Environmental sanitation 4. Maternal health
5. Child health 6. Rural health
7. Urban health 8. Mental health
9. School health 10. Occupational
health
1. Epidemiology :
The branch of medicine that deals with the study of the
causes, distribution, and control of disease in
populations.

2. Vital statistics:
Quantitative data concerning human life or the
conditions affecting it, such as the death rate, birth rate,
morbidity and mortality rates which are used as health
indicators are called as vital statistics.

3. School health
Its objective is the protection of children from
communicable diseases through personal hygiene e.g.
oral mouth hygiene , vaccination, cleanliness of place ,
water , skin and clothes.
4. Maternal health : The health of females in the
reproductive age 15-45 years , to prevent pregnancy
and labour complications.

5. Child health : It starts since the intrauterine period

till the age of 14 years . Maternal and child health
are dealt with together ( MCH ).

6. Mental health : It deals with mental and

psychological status of the human being .
7 . Environmental sanitation: is concerned with
man's external environment , to make it favorable
for his wellbeing .

8. Rural health: Is the healthcare provided to people

living in rural areas , usually occupied in
agriculture and animal breeding , more exposed
to communicable diseases .
9. Urban health: is the healthcare provided to people
living in urban areas . The problems of urbanization
are multiple including the stress-related diseases, air
pollution diseases , sewage-related diseases etc .
10. Occupational health: is concerned with the health
of people at the workplace , its main objective is to
fit the worker to the work and to make the
workplace suitable for the worker .
MEDICINE IN ANTIQUITY

1. MEDICINE IN ANCIENT TIMES

2. THE DAWN OF SCIENTIFIC MEDICINE
3. MODERN MEDICINE
I. MEDICINE IN ANCIENT TIMES

1. Primitive medicine- wrath of gods - evil spirits

-prayer, sacrifices
2. Indian medicine-226 BC -Ayurvedic - Sushruta-
father of Indian surgery
3. Chinese medicine-2700 BC- First organized body of
medical knowledge- pioneers of immunization.
4. Egyptian medicine: 3000-2500 BC- absorption from the
intestine of harmful substances which gave rise to
putrefaction of blood and formation of pus- eye diseases,
diabetes, rheumatism, polio.

5.Greek medicine- 460-136 BC-Aesculapius – 2 daughters-

Hygeia and panacea. Worshipped as goddess of health and
medicine . Hippocrates-FATHER OF MEDICINE
-Epidemiologist – book- airs, water and places.
6.Roman medicine

Borrowed it from Greek.

Sanitation oriented- good drinking water,
measures to prevent malaria, drainage system,
Galen – 130-205 AD – comparative anatomy and
experimental physiology
Planned cities, public bath rooms, underground
drains.
7. ARAB MEDICINE

• Schools of medicine in different cities –

BAGHDAD, DAMASCUS, CAIRO.
• Avicenna – 21 vols of encyclopedia- canon of
medicine.
• RHAZES- First to observe papillary reaction
to light.
• The word drug, syrup, alcohol and sugar all
Arabian.
 2.THE DAWN OF SCIENTIFIC MEDICINE

1. Revival of medicine 1453-1600 AD

2. Sanitary awakening
3. The rise of public health
4. Germ theory of disease
5. Birth of preventive medicine
Fracastorius

• Theory of
contagion
• Syphilis- STD
• FOUNDER OF
EPIDEMIOLOGY
ANDREAS VASALIUS – 1514- 1564
• Dissections on the
human body and found
some errors in Galens
work.
• First man of modern
science.
• FABRICA- text book
Ambroise pare- 1510-1590
• French barber surgeon
• Father of surgery and
modern forensic
pathology
• A pioneer in surgical
techniques and
battlefield medicine
Thomas sydenham1624-1689
• First distinguished
epidemiologist
• Scarlet fever,
malaria, dysentery,
cholera
17th and 18th century

• Harvey –
Circulation of
blood
• Jenners
vaccination
against small
pox
1682-1771
• Morgagni –
pathological
anatomy
 James Lind

• James Lind (1716-1794)- naval surgeon

advocated the intake of fresh vegetables
and fruits for prevention of scurvy- 1753
• Conqueror of scurvy
 III. MODERN MEDICINE

1.CURATIVE MEDICINE

2.PREVENTIVE MEDICINE
 CURATIVE MEDICINE
     
•During past 100 years specialties in medical science
emerged on the basis of
•Skill: Surgery, Radiology, anesthesia

•Parts of body: ENT, ophthalmology, Cardiology,

Gastroenterology etc.

•Age: Pediatrics, Geriatrics etc

PREVENTIVE MEDICINE

• Achievements are Bacterial vaccines

• Tissue culture virus vaccines
• Eradication of small pox
• Discovery of synthetic insecticides
• Discoveries of anti-malarials, antibiotics,
anti-tubercular, anti-leprosy drugs
History of preventive and social medicine

• Sanitary awakening - mid nineteenth century

– in England
• Edwin Chadwick- in 1832 sanitary conditions
of the labouring populations in Britan
• Good drinking water, Housing, working
condition, accumulation of filth in cities……
CONT… History of preventive and social medicine

• English epidemiologist – John snow- find out

the role of polluted drinking water and spread
of cholera- 1848-54
• William budd- 1856- find out that typhoid is
spreading through unclean drinking water
• Gradually importance of clean drinking water,
clean surroundings were realized.
CONT… History of preventive and social medicine

Louis pasteur – 1860- presence of bacteria in

the air, antirabies treatment in 1883.
1877- Robert koch- anthrax was caused by
bacteria
Cholera vaccine in 1892, introduced
antityphoid vaccine – 1898.
CONT… History of preventive and social medicine

• Antiseptics and disinfectants- 1827-1912

• 1896- Bruce – African sleeping sickness was
transmitted by psetse fly
• 1898- Ronald ross-discovered that malaria is
transmitted by anophelis.
• Evolution of antibiotics- 1929- pencillin
– ALEXANDER FLEMING.
• Anti Tb, anti leprosy,
Modern medicine- 1900 onwards

• Acute infectious diseases came under control

• But diseases like DM, Htn, Cvs, Mental illness
and accidents, cancer – leading cause of death
in developed countries.
• Multifactorial causation of disease.
• Risk factors in the etiology of diseases.
Achievements of community medicine

Eradication of small pox- last case recorded from

Somalia- 1977.
Polio vaccine
Nutritional blindness
Iodine def disorders.
SOCIAL MEDICINE
• Man is not only a biological being but a social being,
and disease has social causes, social consequences
and social therapy.
• Development of epidemiological methods and their
application to the investigation of diseases.
• explains the role of social factors
FAMILY MEDICINE

• A field of specialization in medicine which is neither

disease or organ oriented, it is family oriented .
• The health care is centered on the family as unit