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Lecture2.ANTC68.docx


Department
Anthropology
Course Code
ANTC68H3
Professor
Bryce

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History of Epidemiology
- Hippocrates (460 377 BCE)
o Greek Physician Father of Medicine
o Adhered to the principles of OBSERVATION in medicine
o Believed in HUMORAL theory
Yellow Bile/Fire
Blood/Air
Phlegm/Water
Black Bile / Earth
o Disease comes from an imbalance in nature (anything that upsets the
humours); holistic
o Thought that LOCATION was very important in determining disease outcomes
o Recognized seasonality of epidemics and treatments
o Also believed in miasma (bad air) as a cause of disease
- Anton van Leeuwenhoek (1623 1723)
o Father of microbiology
o Visualized bacteria under the lends of a rudimentary microscope
o Important precursor germ theory
- John Graunt (1620 1674)
o One of the first (not the only one!) to analyze London’s Bills of Mortality
(1662)
o Recognized seasonality of epidemics
o Methods were rudimentary by today’s standards, but recognizing the need for
numerical observation is key
o The Bills of Mortality began late 1500s after the plague, important source of
demographic info (Searchers)
Searchers are old woman that would go district to district to figure out
how many died of what
- Edward Jenner (1749-1823)
o Father of IMMUNOLOGY
o 1796: inoculated gardener’s son with pus from milkmaid’s cowpox blisters
o Injected boy with pus from an active small pox patient and boy was immune
o Vaccination eventually led to eradication of smallpox
- John Snow (1813-1858)
o Father of epidemiology and anesthesiology
o August 1854: London was experiencing yet another cholera epidemic
o Didn’t believe in miasma theory, thought cholera was spread by drinking
water contaminated with fecal waste
o Went door to door to ask where cholera cases were SHOE LEATHER
EPIDEMIOLOGY
o Cause of epidemic broad street pump, removed HANDLE
o No one believed him because cholera deaths were already declining, people
were a fan of the miasma theory, no disease agent found until 1883 by Koch
- Victorian London

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o Big Stink Summer 1858, bad sanitary practises (refuse dumping in streets,
overcrowding + summer heat = massive stink
o Noisy, crowded, dirty, smelly, foggy, polluted, no sewers or clean water,
human and animal waste in the streets, poor people especially children
everywhere, no sunlight because windows were taxed
o No wonder people believed in miasma theory!
- William Farr (1807-1883)
o Father of EPIDEMIOLOGY
o Registrar General of London who emphasized consistency in Bills of Mortality
o Refined Life Table Event History Analysis Form (see Slide 13)
Provides LE at Birth & # of Years Remaining
Way to see how mortality changes with age (if you pass the dangerous
infant mark, probably going to have increased LE in some countries)
o His cause of death and injury classification system precursor to WHO’s
International Classification of Disease (ICD)
- Ignac Semmelweiss (1818-1865)
o Father of Epidemiology
o Hungarian Obstetrician that drew a connection between “invisible invaders”
and poor health
o 1846: compared maternal deaths in clinic run by doctors (13%) vs. midwives
(2%)
o Cause of death due to puerperal fever which was transmitted to women in
labour by doctors who came directly from autopsies without washing hands
o Advised students to wash hands with lime, mortality rates dropped
o He was ignored due to personal difficulties and doctor’s arrogance
o 1865: mental breakdown and committed to an asylum
- Louis Pasteur (1822-1895)
o Father of MICROBIOLOGY
o Demonstrated that fermentation caused microorganisms and not spontaneous
generation
o Developed a heat treatment (pasteurization) to kill microorganisms in milk
o Supported GERM THEROY
- Robert Koch (1843-1910)
o Father of MICROBIOLOGY
o Identified vibrio CHOLERA and tuberculosis bacterium killed miasma theory
o Koch’s Postulates still used today to identify that a disease is caused by a
microbe
Organism must be present in EVERY case of the disease but not in
healthy individuals
Organisms must be capable of being isolated from patient and grown
in pure culture
Specific disease must be reproduced when a pure culture of the
organism is inoculated into a healthy, susceptible host
Organism must be recoverable from the experimentally infected host
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