History of Epidemiology

The Greek physician Hippocrates is sometimes said to be the father of epidemiology.[4] He is the first person known to have examined the relationships between the occurrence of disease and environmental influences.[5] He coined the terms endemic (for diseases usually found in some places but not in others) and epidemic (for disease that are seen at some times but not others).[6]

One of the earliest theories on the origin of disease was that it was primarily the fault of human luxury. This was expressed by philosophers such as Plato[7] and Rousseau,[8] and social critics like Jonathan Swift.[9]

When the Black Death (bubonic plague) reached Al Andalus in the 14th century, Ibn Khatima hypothesized that infectious diseases are caused by "minute bodies" which enter the human body and cause disease. Another 14th century Andalusian-Arabian physician, Ibn al-Khatib (1313–1374), wrote a treatise called On the Plague, in which he stated how infectious disease can be transmitted through bodily contact and "through garments, vessels and earrings."[10]

In the middle of the 16th century, a famous Italian doctor from Verona named Girolamo Fracastoro was the first to propose a theory that these very small, unseeable, particles that cause disease were alive. They were considered to be able to spread by air, multiply by themselves and to be destroyable by fire. In this way he refuted Galen's miasma theory (poison gas in sick people). In 1543 he wrote a book De contagione et contagiosis morbis, in which he was the first to promote personal and environmental hygiene to prevent disease. The development of a sufficiently powerful microscope by Anton van Leeuwenhoek in 1675 provided visual evidence of living particles consistent with a germ theory of disease.
Original map by Dr. John Snow showing the clusters of cholera cases in the London epidemic of 1854

John Graunt, a professional haberdasher and serious amateur scientist, published Natural and Political Observations ... upon the Bills of Mortality in 1662. In it, he used analysis of the mortality rolls in London before the Great Plague to present one of the first life tables and report time trends for many diseases, new and old. He provided statistical evidence for many theories on disease, and also refuted many widespread ideas on them.

Dr. John Snow is famous for his investigations into the causes of the 19th Century Cholera epidemics. He began with noticing the significantly higher death rates in two areas supplied by Southwark Company. His identification of the Broad Street pump as the cause of the Soho epidemic is considered the classic example of epidemiology. He used chlorine in an attempt to clean the water and had the handle removed, thus ending the outbreak. (It has been questioned as to whether the epidemic was already in decline when Snow took action.) This has been perceived as a major event in the history of public health and can be regarded as the founding event of the science of epidemiology.

Other pioneers include Danish physician P. A. Schleisner, who in 1849 related his work on the prevention of the epidemic of tetanus neonatorum on the Vestmanna Islands in Iceland[11]. Another important pioneer was Hungarian physician Ignaz Semmelweis, who in 1847 brought down infant mortality at a Vienna hospital by instituting a disinfection procedure. His findings were published in 1850, but his work was ill received by his colleagues, who discontinued the procedure. Disinfection did not become widely practiced until British surgeon Joseph Lister 'discovered' antiseptics in 1865 in light of the work of Louis Pasteur.

In the early 20th century, mathematical methods were introduced into epidemiology by Ronald Ross, Anderson Gray McKendrick and others.

Another breakthrough was the 1954 publication of the results of a British Doctors Study, led by Richard Doll and Austin Bradford Hill, which lent very strong statistical support to the suspicion that tobacco smoking was linked to lung cancer.