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The history of preventive medicine

        THE HISTORY OF PREVENTIVE MEDICINE

Concepts of preventive medicine as we think of it today started with the Greeks, although undoubtedly there were simple forms of prevention being practiced worldwide before this. In Ancient China the Yellow Emperor spoke about wholism and preventive medicine:
Sages here do not treat those who are already ill; they rather instruct those who are not yet ill. . . The superior physician helps before the early budding of disease. The inferior physician begins to help when the disease has already developed. He helps when the destruction has already set in.
Two thousand years later Huai-nan Tzu wrote:
The good doctor pays constant attention to keeping people well so that there will be no sickness.
Such concepts were adopted by the Greeks-the first western culture to take prevention seriously. From the very beginnings of Greek medicine efforts to preserve health seemed more important than those to cure diseases. Health, they maintained, was a state in which the various elements and forces of the body were in balance. Disease in this way of thinking was a disorder of this equilibrium. It seemed fairly clear that external (environmental) factors were important in causing a poor balance and the Greeks talked a lot about poor nutrition and physical factors. To the Greek the ideal life was one in which nutrition, exercise and rest were properly balanced. Other important factors were the person's age, sex, type of constitution and the seasons.
This ecological approach to medicine, which seems so modern today, led the Ancient Greeks to strive to balance their diet, exercise and environmental factors to keep the mind and body in good health. Unfortunately, because this meant a change in lifestyle, few could actually afford to go along with such elegant theories and as a result it was only the middle and upper classes who had the incentives, money and leisure to pursue these goals. Even though few Greeks actually lived like this the concepts continued to influence medical thought for centuries.
In the Middle Ages people began to realize that there was another major dimension to health which had to be taken into account in addition to the Greek notions. This realization came about with the appearance of leprosy as a serious health hazard in Europe. The primary need to do something about leprosy led the society of the day to band together to isolate people with the disease and to clean up the environment, not just for the benefit of individuals but for that of society as a whole. Preventive public health could be said to have been born at this time.
The Church led the way with its insistence that spiritual and physical uncleanliness were linked. The Old Testament, and especially the book of Leviticus, puts great stress on processes such as menstruation and urethral discharges as being unclean and holds that people with such afflictions should be isolated from the rest of society until they have been purified. So leprosy was treated by the Church in a very literal Old Testament way and sufferers were isolated from the community to protect the healthy. Because this disease was untreatable the individuals became socially dead as they were cast out from life.

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Keywords for this page: The history of preventive medicine