New public health and old rhetoric

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6935.994 (Published 16 April 1994) Cite this as: BMJ 1994;308:994
  1. P J Vandenbroucke

    There is a discipline in medicine that over the past 200 years has been known by various names: sanitary medicine, public hygiene, public health, social medicine, and community medicine. Its newest incarnation proudly calls itself “the new public health.”1

    Academically the discipline was buried repeatedly because it produced “mere rhetoric.”2,3 The first time this happened was before the turn of the 19th century. The successful hygienic and sanitarian movement of the middle of that century divorced itself from bacteriology, the upcoming science of the 1880s, because bacteriology could not really explain why epidemics happened at certain places and certain times and to certain people. The members of the movement had a point, in retrospect, but their adamant opposition to the new science led to their academic downfall and even ridicule. Hygienism was seen as only “soft” rhetoric, while “hard” bacteriological science would give the real explanations. Nobody had proved hygienists wrong, it was just that nobody was interested in their kind of argument any more.4 Chairs and institutes of hygiene were turned into …

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