HISTORY OF EPIDEMIOLOGY

DR SUNIL.C

HISTORY

STARTED WITH ADAM AND EVE EPI= AMONG DEMOS= PEOPLE LOGOS=STUDY

FOUNDATION WAS LAID IN 19TH CENTURY

DEFINITIONS

THAT BRANCH OF MEDICAL SCIENCE WHICH TREATS EPIDEMICS- PARKIN 1873

THE SCIENCE OF MASS PHENOMENA OF INFECTIOUS DISEASES- FROST 1927

THE STUDY OF DISEASE,ANY DISEASE AS MASS PHENOMENON- GREENWOOD 1934

THE STUDY OF DISTRIBUTION AND DETERMINANTS OF DISEASE FREQUENCY- MACMAHON 1960

DEFINITION BY JOHN M LAST 1988

The study of the distribution and determinants of health related states or events in specified populations and application of this study to control of health problems

HISTORICAL PHASES

EARLY EPIDEMIOLOGY—5TH CENTURY TO 1830

CLASSIC EPIDEMIOLOGY– 1830—1940

NEW EPIDEMIOLOGY-- 1940 –TILL DATE

EARLY EPIDEMIOLOGY MORE THAN TWO MILLENNIA FROM

HIPPOCRATES [470—400 BC] TO FIRST THIRD OF 19 TH CENTURY

THEORIES WERE ELABORATD TO EXPLAIN THE SPREADING OF DISEASES NOTABLY THOSE WERE RECURRENTLY STRIKING AND DECIMATING POPULATION– EPIDEMICS

HIPPOCRATES --MEDICAL APPROACH BY PROVIDING CONCISE ,ACCURATE AND COMPLETE DESCRIPTION OF CLINICAL CASES INCLUDING TETANUS AND TYPHUS

IN HIS BOOK ON AIR ,WATER AND PLACES ---IDENTIFIABLE ARRAY OF NATURAL EXTERNAL FACTORS

17TH CENTURY

THOMAS SYDENHAM [1624– 1689] CIRCUMSTANCES SURROUNDING THE OCCURRENCE OF CLINICAL CASES

IN YEAR 1700 BERNARDINO RAMAZZINI WROTE IN HIS BOOK –DE MORBIS ARTIFICUM DIATRIBA

HIPPOCRATES STATES IN –DE AFFECTIONIBUS-when u face a sick person u should ask him from what he is suffering?

THOMAS SYDENHAM

FOUNDER OF OCCUPATIONAL MEDICINE

RAMAZZINI -- today regarded as founder of occupational medicine—a key section of layer field of environmental medicine and epidemiology

GIOVANANNI MARIA LANCISI 1654

A CONTEMPORARY OF RAMAZZINI-

ANATOMIST AND CLINICAN WHOSE de subitaneis mortibus– pathological investigation of series of sudden deaths in ROME probably 1st epidemiological study of NCDs

JOHN GRAUNTS 1620--1674

FOUNDER OF DEMOGRAPHY THE MAJOR STEPS ARE RECORDING

COUNTING, ACCOUNTING TO QUANTITATIVE ANALYSIS

HIS NATURAL AND POLITICAL OBSERVATION WERE UPON MORTALITY [1662]

HIS DATA INCLUDED THREE KEY INNOVATIONS

A CRITICAL EXAMINATIONS OF THE SOURCES THE USE OF FREQUENCIES THE APPLICATION OF METHOD TO TACKLE

PROBLEM

LUCRETIUS

LATIN POET (1-2 CENTURY BC)

“DE RERUM NATURA” SEEDS OF DISEASE CAN SPREAD

FROM PERSON TO PERSON

GEROCAMO FRACASTORIUS(1478-1553)

DE –CONTAGONE ET CONTAGIOSIS MORBIS

1ST CLEAR AND COHERENT GERM THEORY

VARIETY OF DISEASES CAUSED BY TRANSMMISION SELF PROPAGATING

SYPHILIS [1530]

GAHLEO-GAHLEI(1564-1642) BEGINNING OF 17 CENTURY

GRADUAL SPREAD OF KNOWLEDGE OF PHYSICS TO OTHER BRANCHES OF STUDY

WILLIAM HARVEY

1578-1657

EXPERIMENT AND QUANTITATIVE REASONING WAS DISCOVERY OF THE CIRCULATION OF BLOOD.

CLASSIC EPIDEMIOLOGY

ADVANCEMENT OF THE INDUSTRIAL TRANSFORMATION OF WESTERN EUROPE

STARTING IN GREAT BRITAN

PROPAGATING FROM MID-18 CENTURY

Eg. CROWD DISEASES

WILLIAM FARR

1807-1883 INTRODUCED MEDICAL

REGISTRATIONS OF DEATHS

MIASMATIC THEORY-disease is transmitted by miasm/ cloud

JOHN SNOW[1813—1858]

A CONTEMPORARY OF WILLIAM FARR IS QUOTED AS AN EXAMPLE OF BRILLIANT ANALYTICAL INVESTIGATION

IDENTIFICATION OF PATHOGENIC ORGANISM FROM ENVIRONMENT

CHOLERA[ASIATIC CHOLERA] INVESTIGATED THE MAJOR EPIDEMIC

EPISODES IN LONDON[1849—1854] ELABRORATED AND PRESENTED A PAPER

ENTILED –ON CONTIOUS MOLECULAR CHANGES ALONG THE LINES OF PREVIOUS WORK BY GERMAN PATHOLOGIST JACOB HENLE[1809—1885]

PIERRE LOUIS [1787—1872] INTRODUCED THE NUMERICAL

METHOD IN MEDICINE AND PRODUCED STATISTICAL EVIDENCE

STATISTICAL EVIDENCE OF BLOOD LETTING IS HARMFUL

RUDOLF VIRCHOW[1821—1902] WORKED IN PATHOLOGY IS

REGARDED AS CORNER STONE OF MEDICINE

FOUNDER OF CELLULAR PATHOLOGY

INTERNATION CLASSIFICATION OF DISEASE

DEFINED MEDICINE AS A SOCIAL SCIENCE

ROBERT KOCH[1843-1910)

DISCOVERED AGENTS OF SEVERAL DISEASES

FORMULATED A SET OF CRITERIA FOR ESTABLISHING CASUALITY IN EPIDEMIOLOGICAL STUDIES

TUBERCULOSIS

Robert Koch

EDWARD JENNER

BORN IN 1749 ON 14th MAY 1796-HE

INOCULATED INTO A “VOLUNTEER”JAMES PHIPPS WITH COWPOX

LYMPH TAKEN FROM HAND OF A MILK MAID-SARAH NELMES

EDWARD JENNER

EXPERIMENTAL EPIDEMIOLOGY JAMES LIND- 1747HE WORKED ON SCURVY

NEWER EPIDEMIOLOGY

INDIVIDUAL STUDIES ON CANCER, NON RHEUMATIC CVD CAN BE TACKLED WELL BACK IN TIME BUT ONE TAKE AS A CONVINENT TURNING POINT.

DEVELOPMENT OF NEW EPIDEMIOLOGY--TOBACCO AND HEALTH STORY

PEARL (1938)

LIFE EXPECTATION OF SMOKERS AND NON-SMOKERS

NEWER EPIDEMIOLOGY CLEARLY HIGH LIGHTS DUAL EXCHANGE.

JOHN RYLE(1899—1950)

FIRST DIRECTOR OF INSTITUTE OF SOCIAL MEDICINE AT OXFORD –(2nd WORLD WAR)

TO INVESTIGATE THE OF SOCIAL GENETIC, ENVIRONMENTAL AND DOMESTIC FACTORS ON DISEASE MORBIDITY.

CLINICAL EPIDEMIOLOGY

IN A PARALLEL AND OPPOSITE MOVE EPIDEMIOLOGICAL METHODS OVER SHADOWING VALUE FOR CLINICAL RESEARCH AND INCREASE INCORPORATED INTO A GROWING STREAM OF IT

ARCHIE COCHRANE(1909—1988)

ADVOCATED SYSTEMATIC USE OF RCT.

LANGMUIR

REGARDED AS “FATHER OF INFECTIOUS DISEASES”

IN 1949 HE ESTABLISHED EPIDEMIOLOGY SECTION OF FEDERAL AGENCY.

PRESENTLY CDC EPIDEMIOLOGY INTELLIGENT

SERVICE.

TODAY’s EPIDEMIOLOGY

1. EPIDEMIOLOGICAL METHODS OF INVESTIGATIONS.

2. EPIDEMIOLOGICAL SUBSTANTIVE NOTIONS DEVELOPED BY SUCH METHODS.

ADVANCES

1. ADVANCES OF RESEARCH IN SOME DOMAINS FUNDAMENTAL TO OTHER FIELDS OF BIOLOGY

2. ADVANCES IN CLINICAL MEDICINE AT DIAGNOSTIC AND THERAPEUTIC LEVELS

3. ESCALATING COSTS OF ALL HEALTHCARE DELIVERY SYSTEMS

4. RENEWED AWARENESS OF PROFESSIONALS AND GENERAL PUBLIC

TOMORROWS HORIZON

THE CHALLENGE OF EVOLVING BIOLOGY

Sir Richard Doll (Doll, 1993):“Classical methods of epidemiological

research are proving less and less productive as the simple problems are being successfully solved.

They will doubtless continue to be used to make new discoveries from time to time …

but without some brilliant new inspirations, the rate of discovery of new facts of any importance by the use of these classical methods must be expected to slow down.”

THE CHALLENGE OF EVOLVING BIOLOGY

EXAMPLES BIOLOGICAL MARKERS OF EXPOSURE INDIVIDUAL SUSCEPTIBILITY

GENETIC ACQUIRED

bring back to the level of etiology and prevention

the wealth of investigations that the convergence of epidemiology and modern biology is now making possible

THE CHALLENGE OF EVOLVING SOCIETY

AGEING POPULATIONS REPRODUCTIVE RATES BELOW

REPLACEMENT RATE POPULATION MIGRATION SOCIOECONOMIC AND GENDER

INEQUALITIES

SOCIAL EPIDEMIOLOGY

THE CHALLENGES OF DIVERSIFICATION Vs INTEGRATION

A first axis is methodology versus substantive studies treatment of exposure

measurements and errors of measurement to reduce misclassification and improve study power

methods in genetic epidemiology modeling of the exposure–response

relationship with multiple longitudinal measurements

THE CHALLENGES OF DIVERSIFICATION Vs INTEGRATION

• A second axis is diversification of different fields of substantive interest Cancer epidemiology & Epidemiology

of ageing Clinical epidemiology

Application of epidemiological methods within clinical domain

Evolving formal methods of optimal clinical decision making

“ Evidence Based Medicine”

THE CHALLENGES OF DIVERSIFICATION Vs INTEGRATION

Final axis of diversification tends to separate those who specialize in investigative aspects

for routine or research purposes from those who plan and implement interventions

Clinical medicine – clinical chemist, clinical pathologist, diagnostic radiologist, etc

Epidemiology – pure specialist in etiological and evaluative investigations

REFERENCES :-

PARK’S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 20TH EDITION

EPIDEMIOLOGY by LEON GORDIS 4TH EDITION

INTRODUCING THE HISTORY OF EPIDEMIOLOGY – RODOLFO SARACCI

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