Current Investigations in Clinical and Medical Research

It is commonly considered that the Industrial Revolution marked the beginning of the first measures related to the modern concept of Public Health, understood both in terms of hygiene measures in cities, which received large numbers of workers from the agricultural world, and in terms of the adoption of measures for the prevention, diagnosis, and treatment of diseases. Before this period, we have the testimony of authors such as Michel Foucault, who, in his study of the History of Madness in the Classical Age, described the spaces of exclusion outside the walls of towns and cities. These exclusions, whether due to leprosy or madness, to mention just a few examples, were considered true embodiments of evil, feared and isolated from the community. Our aforementioned author recalls that until the end of the Middle Ages, when Hansen's disease, or leprosy, was eradicated in Europe, thousands of leper colonies existed throughout Christendom. In this article, we will go back to the last decades of the 17th century, when a new relationship between the concepts of life and power began to take shape. This was achieved through the emergence of a new rationality anchored in the Reason of State, and mercantilism as the dominant doctrine in various European countries, understood as a zero-sum economic game. This gave rise to what is known as Biopolitics. Thus, life, which became the criterion and end of the exercise of power, was subject to political value judgments, a process that continued into the 20th century with the establishment of the Welfare State and the measures adopted in 1942 according to the guidelines set by Lord Beveridge.¹

Keywords: Public health, Medical, Europe, Disease

Given that our narrative is grounded in a diachronic perspective, our work must be based on an anamnesis of the different ways in which states have addressed population management, both from the standpoint of improving living conditions and from the perspective of the state's strategic objectives. It is in this context that the concept of the biopolitics of populations emerged, introduced by Rudolf Kjiellén in 1920 and later significantly revisited by Michel Foucault,^2-6 to cite just a few examples. We will also briefly draw on the conceptual contributions of Louis Henry from the field of historical demography, and for the processes of structural change brought about by the Industrial Revolution, we will rely on the studies of Phyllis Deane on this historical process.⁷

Societies existing before the Industrial Revolution were agriculturally based, with high birth and death rates, cyclically plagued by famine due to poor harvests caused by adverse weather, especially droughts, and epidemics such as leprosy and plague. Louis Henry, using the methodology of Historical Demography, schematized the concurrent phenomena of increased mortality and declining birth and marriage rates with the Crisis Diamonds. Furthermore, piles of garbage that were not systematically collected became breeding grounds for rats, whose fleas caused mass infections. We recall the Atlantic Plague in the Kingdom of Castile at the end of the 16th century or the Black Death in medieval times. Even then, it was often the municipalities that took measures to prevent contagion and the spread of disease, and this was to the extent possible, as the population fled the cities.

Phyllis Deane describes how the use of new building materials, such as brick instead of mortar, the channeling of wáter whose previous absence had given rise to professions of another era, such as the water carriers and, moreover, the decline of malaria and the achievement of good harvests brought about a revolutionary change. But what truly occurred was the coexistence of a galaxy of revolutions, whether in transportation, trade, agriculture, and finally, a veritable demographic revolution.

The conditions for the emergence of the first public health policies have been established in the previous comments, the transition from agricultural societies to industrial and urban ones, based on the textile and steel industries, and in general the production of a greater quantity of goods and services.⁸

We have seen that the true moment of becoming aware of the need to adopt systematic public health measures takes place at the same time as the great revolutions, whether the political revolution in France or the industrial revolution in England, the emergence of the concept of citizen Citoyen to whom civil and political rights are recognized prior to the existence of the State itself and based on a contractualist theory of power, in accordance with the liberal demand for minimal State intervention in society and the economy, a minimal State, far removed from the mercantilist theories of the absolute State.

None.

This Short Communication received no external funding.

None declared.

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