Throughout most of the past, ideas about the means and necessity of providing for the health of the general community were based on notions of what ensured an individual’s well-being. At this personal level, measures that we might consider motivated by aesthetic choices (rather than fully developed ideals of cleanliness and the health necessities of personal hygiene) were interwoven with practices designed to minimize exposure to disease and injury. In a narrow sense, public health practices refer only to the organization of care for the sick of a community and the implementation of epidemic controls. Public sanitation includes all collective measures taken to protect the healthy from disease. Yet even today many believe that what ensures the health of an individual should be reflected in the rules for maintaining the public’s health.

Through much of the past and present, the view of “public” health has involved a compromise between available community resources and the ideals of health maintenance at the individual level. Thus, in order to examine the history of public health and sanitation before the 1700s, it is necessary to include some discussion of the ideas and ideals of personal hygiene along with the development of concepts that led to genuine public health practices. “Basic” sanitary organization largely comprised rudimentary sanitation and sanitary law, care of the sick poor, provision for public physicians, and epidemic controls.

Sanitation

Archaeological records testify to the antiquity of communal efforts to provide clean water and dispose of human and animal wastes. The engineering achievements of some peoples, such as the ancient Peruvians in the Western Hemisphere and the Etruscans in Europe, were most impressive.