Community Medicine Lecture 1

Community Medicine Lecture 1

• The lecture was presented by Dr. Muniba Shamshad, DPT, MSPT-OMPT.
• The lecture covered the history of community medicine and rehabilitation.

History of Community Medicine & Rehabilitation

• Medicine: Study of the evolution of human knowledge across history, including biographies of key figures, discoveries, and inventions.
• 20th Century Medicine: Significant advancements complicated medicine and treatment, but the benefits have not reached all segments of society. The goal involves improving quality of life through prevention, promotion of health for individual communities, or groups.
• Antiquity: Health and illness were interpreted through a cosmological and anthropological perspective. Belief systems were often magical or religious. Historical figures, like Henry Siegerist and Dubos, emphasized medicine's role in cultural integration.
• Primitive Medicine: Attributed illness to supernatural forces (evil spirits), and utilised remedies like herbs. Treatments included procedures like bone setting and trephining (drilling holes into the skull). Practices in India included rituals for snake bites, leprosy, and other conditions.
• Indian Medicine: Traditional knowledge of medicine, represented by Ayurveda (knowledge of Life) and Siddha systems. India has a historically rich record of surgical excellence. The Susruta Samhita and rhinoplasty practices are early examples. Hygiene practices existed in ancient cities like Harappa and Mohenjo-daro. However, the decline of Ayurvedic practices in the 600 AD era was attributed to the lack of state support.
• Chinese Medicine: One of the first organized bodies of medical knowledge. Principles like the balance of Yin and Yang are central. Includes practices such as hygiene, dietetics, hydrotherapy, massage, and herbal remedies. Immunization against smallpox was incorporated.
• Egyptian Medicine: A mix of medical knowledge and religious beliefs. Illness was tied to intestinal absorption of harmful substances. Medical knowledge was recorded on papyrus, describing surgical practices and containing early medical prescriptions.
• Mesopotamian Medicine: The cradle of civilization. Emphasis was on religious principles in medicine, along with Hammurabi's codification of physician conduct.
• Ancient Greek Medicine: Rejection of supernatural theories; instead, used observations. Hippocrates is considered the 'father of medicine'. Focus on clinical observation and application of knowledge. Development of holistic approaches based on the four humours (blood, phlegm, yellow bile, black bile). Consideration of climate, water, diet, clothing & hygiene influences on health.
• Roman Medicine: Emphasized practicality and sanitation. Key figures like Galen. Focused on establishing hospitals and understanding human anatomy and physiology through observation and experiments. An emphasis on public health through water and malaria prevention.
• Middle Ages (500-1500 AD): A complex period mixing religious influence with medical advancements, including the preservation of ancient knowledge in monasteries. The Arab world contributed greatly to medical progress with important figures like Ibn Sina.
• Dawn of Scientific Medicine (1500 AD onwards): Transition from religious to scientific medicine, marked by revolutions in science, industry, politics, and religion, creating a new era of sanitation, medicinal knowledge & awareness of disease.
• Germ Theory of Disease: Louis Pasteur and Robert Koch provided evidence linking bacteria to disease. This revolutionized infectious disease understanding.
• Birth of Preventive Medicine: Public health approaches were founded on scientific discoveries of disease causation. These were marked by improvements in hygiene, sewage, water, the prevention of disease transmission and destruction of disease vectors.
• Modern Medicine: Two broad approaches exist: curative and preventive. Emphasis placed on specialization and disease eradication methods like vaccines and public health interventions. Modern medicine's emphasis is on understanding diseases' complex social, genetic, economic, psychological and environmental factors.
• Modern Preventive Medicine: Combination of health promotion, disease prevention, disability limitation, and rehabilitation is studied.
• Levels of Prevention: This section explores the concepts of primary prevention (health promotions and disease prevention), secondary prevention (early diagnosis and treatment), and tertiary prevention (treating disease in later stages of pathogenesis).
• Social Medicine: This focuses on the relationship between society and medicine, highlighting the social, economic, and environmental influences on health and disease and emphasizing preventative medicine.
• Failure of Medicine: Factors like limited accessibility due to affordability, geographic challenges and limited healthcare services were acknowledged.
• Community Medicine: A discipline aiming to address community health issues, focusing on the health needs of populations. It involves preventive medicine, public health, and social medicine.
• Concepts of Health & Disease: The definition of health. Dimensions including physical, mental, social, spiritual, emotional and vocational aspects of well-being.
• Iceberg Phenomenon of Disease: Provides a visual representation for the understanding that diseases aren't only what we see, but also include hidden diagnoses, as well as the susceptible population, or carriers that are asymptomatic.
• Illness: A condition where natural functions are disrupted such that individuals cannot meet basic personal needs. Acute and chronic illness categorization is noted.
• Disease Control: The aim is to reduce disease incidence, duration, and transmission risk. Disease control aims to reduce the financial burden of diseases on various communities.
• Disease Elimination and Eradication: Elimination involves stopping transmission within a geographical region. Eradication aims to completely remove the disease.
• Natural History of Disease: The way a disease progresses from exposure to full-blown illness in absence of treatment or prevention is explored. This covers pre-pathogenesis (factors contributing to disease prior to onset), and pathogenesis (the development of the disease).
• Incubation Period: The time period between a disease agent's entry into the body and the onset of symptoms (during which a person may look healthy).
• Impairment − Disability − Handicap: Sequence of negative health outcomes from impairment through disability to handicap. Explanations of these three concepts
• Rehabilitation: Combined physical, social, vocational, and psychological methods to restore an individual's functionality and societal integration, following impairment.

Join Dr. Muniba Shamshad as she explores the rich history of community medicine and rehabilitation. This lecture covers key advancements and figures from ancient beliefs to 20th-century practices, shedding light on the evolution of health perspectives across societies.