continued from History of Public Health(part 1).....
THE DAWN OF HISTORY TO THE FALL OF ROME
Elements of Winslow's concept of public health can be found in the earliest evidence of communal living. Paleopathology, the study of fossils and other artifacts, reveals that early Homo sapiens, who were hunter-gatherers, suffered from essentially the same diseases that afflict people today.
In remote parts of the world—in the Amazon, Indonesia, Australia, and Africa—isolated communities exist that anthropologists believe follow lifestyles typical of prehistoric populations. These peoples share the belief that diseases are caused by malevolent supernatural forces. To diagnose, treat, and, in some cases, prevent the spread of these malevolent forces, all primitive societies have created a class of "shamans"—persons specially trained to intervene on the spiritual and physical level. Thus, the most primitive societies provide an "organized" approach to the recognition and management of disease.
The social structure of the earliest primitive villages was probably not very different from that of the earlier hunter-gatherer tribes, and physical amenities were, no doubt, similarly unchanged. However, the establishment of cities brought about major developments. Archaeologists have found that all the great cities of antiquity in Asia, Europe, Africa, and South America had municipal water supplies and sewerage systems. The culmination of ancient sanitary engineering was accomplished in Rome, where aqueducts supplied the city with water in amounts comparable to many modern municipal systems and sewers and drains carried away the wastewater. Part of the great central drain of ancient Rome, the Cloaca Maxima, still serves as part of the sewerage of the modern city.
It was the exigencies of urban living, not considerations of health and disease, that necessitated sanitary engineering. Supernatural explanations of disease did not evoke or require an environmental origin for disease. However, in the fifth and fourth centuries B.C.E., in Greece, an empirical explanation of disease was proposed by the physician Hippocrates and his followers who described diseases in objective terms, and rejected supernatural causes. In his book On Airs, Waters, Places, the relations of disease to physical, social, and behavioral settings are presented for the first time. This book served as a guide for decisions regarding the location of urban sites in the Greco-Roman world, and may be considered the first rational guide to the establishment of a science-based public health.
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