Interest in the consequences for economic activity of the development of disease, preventive medicine, and of other public health problems is not exactly new. Professor Sigerist, in many ways the doyen of the subject, summarized our background quite well in 1941. “We are”, he wrote, “often inclined to believe that the economic approach to medical problems is new, that we inaugurated it. This is not the case …. Max von Pettenkofer in Munich, reasoned very much along the same lines as we do today” [18:2]. Thus, I have precedent for citing work done in this very city as the logical place to start my discussion. One could, as indeed Sigerist himself did, argue that von Pettenkofer (upon whose work I shall base this analysis) wrote with the knowledge of earlier writers like Chadwick, Simon, Snow, and Budd. But, I am inclined to accept Sigerist's assessment of von Pettenkofer's importance and use his two public lectures as the springboard from which to launch my discussion.