The Patient’s Story
Thomas McKeown, 15 May 1980
As life must be possible before it can be pleasant, human health and its relation to survival and population growth are among the great themes of history. Why did early man, although apparently well-adapted to his environment, have high mortality rates and a short expectation of life? Why did the change from a nomadic to an agricultural existence ten thousand years ago lead to the predominance of infectious diseases as causes of sickness or death? What was the relation between population growth and agricultural and industrial developments? And where, among the nutritional, environmental, behavioural and medical advances of the past three centuries, are we to find the explanation for the decline of the infections and the modern transformation of health?