Changing Outlooks in Preventive Medicine

EVERYONE wvill agree that the outlook in the practice of medicine has undergone a markedl change since the coming into operation of the Health Services Act on the 5th Julv of this vear (1948). This date will be recorde(d in history as an eventful one, for, in it, the story of the evolution of medicine has opened a new chapter. I shall not attempt to express an opinion on the merits or demerits of the new Order, as this might involve trespass into the field of party politics, and this, I understand, would not be properly wvithin the terms of the activities of the Ulster Medical Society ! I rather choose to confine my remarks to the changed outlook in public health, and to dlirect attention to the recenit advances in the field of social and preventive medicine. As a means of visualising the expanding scope of preventive medicine and its application to the new social outlook, I feel that it wvould serve a useful purpose if we traced its evolution through the historical phases of its development to its present status. From the (laxvi of historNy man has been engage(i in an en(dless struggle against disease; the desire for knowledge of how to live long and how to avoid disease has persisted throughout the ages. Ihe same demanid has also been expressed by the age-long quest for magical drugs, herbs, philosophers' stones, an(d various charms and elixirs having the reputation of being life preservers. In spite of these irrationial quests, most people have observed some more or less rational codes of law for the preservation of their health. lFhe principles and practice of saniitationl were known very early in Man's history. As you are aware, there is a co(de of sanitary laxw laid down in the early books of the Bible, wlherein Moses commanded the Children of Israel to observe frequent purifications and cleansings; to isolate the sick; to disinfect ho,uses-where plague hla(d prevailed; to destroy infecte(d articles; and to avoi(d contamination of food. Many of these health regulations of the ancienit Hebrews have soun(d common sense underlyinig them: indeed, with little or no modification, some of them are quite appropriate in our modern sanitary co(le. Some of the Mosaic Law is interspersed witlh superstitious practices, but ve couldl learn mUCh from the manner in whichl the legislatioll was framed. Like our mo(lern legislation, there were penal clauses governing infringements; but there wvere also incentives for encouraging obedience. It will be remembered that the mnoral law summarily comprehended in the Ten Commandments is preface(d by the words "I am the Lord thy God, which have brought thee out of the land(i of Egypt, out of the house of bondage"-thus reminding the Children of Israel that the Commandments were of Divine origin,