Epidemiology, Historical

In epidemiology, history may play a greater role than in most other medical disciplines, particularly in the challenging activity of teaching epidemiology. The historical roots of efforts to establish causes of diseases in order to develop preventive measures are found in Antiquity. A more dedicated and systematic search was initiated during the Renaissance in the wake of the great health problems that hit the community such as the plague and syphilis. The fight against smallpox with the development of an effective vaccine at the turn of the eighteenth century was a major breakthrough, with its final success of eradication in 1977 when the last patient fell ill. Eventually, evidence-based epidemiology developed both inside and outside the hospital. Hospital-based research made up Semmelweis's fight against puerperal fever (1840s), while Snow's studies of cholera (1850s) were later recognized as the establishment of modern epidemiology. An important step toward megaepidemiology, research based on large numbers, was taken when, in 1856, the first national patient registry was set up in Norway for leprosy, paving the way for registry-based epidemiology. The end of the nineteenth century saw great epidemiological successes in microbiology and public health, while vitamins attracted renewed attention toward the end of the twentieth century, when epidemiology gained another important victory by diminishing the rates of sudden infant death syndrome after having established the face-down sleeping position as a very important risk factor.