A Brief History
On October 19, 1943, the antibiotic drug, Streptomycin, was isolated by researchers at the esteemed Rutgers University. Streptomycin, useful for treating many infections, was the first drug to successfully combat tuberculosis. Today we use this medical milestone to take a look at some of the truly great advances in medicine, quite relevant in 2020 while we await the development, approval, and disbursement of a viable vaccine for the Covid-19 pandemic devastating the world. (For that matter, identifying a treatment that defeats this terrible virus would be nice, too!) As always, feel free to nominate extremely important medical advances that you believe should be included on this list. (Our list is not meant to be all inclusive nor listing the order of “most” important medical advances, just some of those advances we find particularly interesting.)
Digging Deeper
Smallpox Vaccine, 1796.
While humans, being observant critters that we are, had noticed that people who had recovered from Smallpox or from a less deadly disease, Cowpox, were not prone to be re-infected by Smallpox, it was no until English physician Edward Jenner made the scientifically published work that established an effective vaccine against the deadly and disfiguring Smallpox. The Jenner vaccine became the first (of many) effective vaccines against previously terrible diseases. By 1977, Smallpox has been virtually eliminated as a viable disease due to the mass inoculation of people by the Smallpox vaccine.
Rabies Vaccine, 1885.
The renowned French physician and researcher Louis Pasteur (the guy that brought us “Pasteurization”) and his French co-researcher Émile Roux gave the world a solution to Rabies, a most horrible disease that invariably results in death, and that death is an agonizing, horrible death! Although not the sort of disease that ravages entire populations such as Plague or Smallpox, Rabies is so awful that having an effective treatment for those bitten by a rabid animal is truly a miracle of modern medicine. Lucky for us, the incubation period of rabies is long enough that if a person is bitten by a rabid animal, the vaccine can be administered, and the person will not develop the disease.
Sterile Surgical Operations, 1867.
English physician Joseph Lister, inspired by the pioneering work of Louis Pasteur regarding microbiology, developed his theory of sterile surgical techniques, using compounds such as phenol and carbolic acid to sterilize surgical instruments and wounds before and during surgery. His work proved that post operation infections could be reduced by an enormous percentage through the use of sterile surgical techniques. Continued development of sterilization procedures and processes have made surgical infections almost rare, where they were once an expected result from any sort of surgery.
Penicillin anti-biotic, 1928/1942.
While other researchers were aware of the mold, Penicillin, and even noticed its antibiotic properties, it was not until Scottish researcher Alexander Fleming made the proper scientifically documented research into the antibiotic properties of Penicillin in 1928 that the scientific world had the information needed to develop this incredibly effective wide-range antibiotic drug. Unfortunately, that same scientific world was a little slow to grasp the importance of Fleming’s work, and not until 1942 was Penicillin widely used as an antibiotic drug. Fleming was recognized for his lifesaving work in 1945 with the awarding of the Nobel Prize for Physiology or Medicine, an award he shared with the researchers from Oxford University (Howard Florey and Ernst Boris Chain) who developed practical applications for the wonder-drug. Although not generally given credit for “inventing” antibiotics, ancient people used crude forms of antibiotics as wound compresses for the past few millennia, and English botanist and herbalist John Parkinson is credited with using moldy bread as a form of antibiotic in the 17th Century. These pre-penicillin attempts at using proto-antibiotics did not reach mainstream medicine or garner widespread scientific notice, hence Fleming getting the credit. Another potential claimant as the first antibiotic could be sulfa drugs, specifically the Prontosil brand drug created in the 1930’s by German scientists at Bayer (the Aspirin company). Sulfa drugs were widely used during World War II, and undoubtedly saved many lives. Today an enormous range of antibiotic drugs and variations of each are available for patients.
Anesthesia, 1799.
Performing surgery on a patient or administering some other sort of painful treatment such as setting broken bones has been a terrible and painful experience over the vast centuries of human medical problems. People tried to mitigate the incredible pain associated with such procedures about as far back as medical surgery first began, perhaps thousands of years ago! Various herbs and plants provided minor relief from pain, and alcohol was a common sedative used for surgical patients. Various narcotic concoctions, such as opium were also used with varying effectiveness. Not until 1772, when Joseph Priestly discovered “laughing gas,” or more properly Nitrous Oxide, was modern anesthesia developed, first by British chemist Humphrey Davy in 1799. Nitrous did not immediately catch on and was used somewhat haphazardly in the decades following Davy’s 1800 report, achieving more widespread use in the mid-19th Century. American physician Crawford W. Long made the next big advance in the field of anesthesiology by publishing his work regarding the use of ether in 1849, although he had first used ether as a surgical anesthetic in 1842. Advances in anesthesia have continued over the years to the point that modern patients fully expect to experience pain free surgery, either from local anesthetic that desensitizes only a limited part of the body or from general anesthetic in which a patient is unconscious during surgery. An intermediate form of anesthesia leaves a patient in a drowsy, dream like state where he/she is not completely unconscious but feels no pain. If you have ever had surgery, even dental work, be sure to thank those researchers that have given us anesthesia!
Polio Vaccine, 1950/1955/1961.
Poliomyelitis a dread disease that could kill or cripple, especially children. One of the most famous victims was US President Franklin Roosevelt. The “iron lung” became a regular part of the American hospital scene in the 20th Century, until an effective polio vaccine was developed, first by Warsaw born Polish virologist Hilary Koprowski in 1950, though his vaccine was not initially accepted in the United States. (Born in Poland, Koprowski and his family fled the German invasion in 1939, first to England, then to Italy and on to the United States where he performed his important research.) Koprowski’s vaccine, using the live form of the polio virus administered orally was later used by Jonas Salk to develop his own injected vaccine in 1955, and again later by Albert Sabin that produced a useful oral vaccine in 1961. Along with the other scientists that worked on the polio project, this dread disease is now virtually eradicated in the industrialized world. Sadly, some backward countries, notably Islamic fundamentalist areas, have strongly resisted the administration of the polio vaccine (among other vaccines) in the mistaken belief that such vaccines contain ingredients that outlawed by the Quran.
Open Heart Surgery, 1925/1947/1960.
Working on a living person’s heart is problematic to say the least. By 1925, sterile procedures, anesthesia and knowledge of anatomy had progressed enough the point where the first successful heart surgery was performed, though in a manner primitive by modern standards. In the 1950’s inventions to circulate the blood and oxygenate the blood as well were produced, so that a patient’s heart could be stopped and worked on by the surgeon. Such surgery was rare at that time, virtually experimental. By 1960, the first coronary bypass surgery was performed and has now become a common and generally safe procedure, saving thousands of lives annually. In 1967, South African surgeon Christian Barnard performed the first human heart transplant, a procedure that has now become fairly common, with notable recipients including former US Vice President Dick Cheney and car guru Carol Shelby. (This author experienced life saving open heart surgery at the Cleveland Clinic in 2012 and 2013.)
Human Organ Transplants, 1954.
While heart transplants get much of the attention, the first successful human organ transplant took place in 1954 and was a kidney. Kidney transplants have become common enough that many people willingly donate a kidney so that another person can live without dialysis. Improvements in surgical techniques and anti-rejection medicines and regimens have allowed doctors to expand the field of transplants to include many organs, such as liver, pancreas, heart, lung and intestinal organs. (Lung, liver and intestinal transplants did not take place until the 1980’s, while the first heart transplant took place in 1967.) There are about 3500 heart transplant operations performed worldwide each year at this time! Other body parts such as corneas, skin, limbs and in the 21st Century even faces are now being transplanted, mostly from dead or nearly dead donors. Doctors have created the ability to make living person to living person transplants of kidneys, lungs (just one at a time!) and portions of livers, which apparently grow back to normal or nearly normal size. Blood transfusion, which has saved millions of lives, can be considered a form of transplant. As equipment, medicine, and knowledge continue to progress, it seems only a matter of time before even more ambitious human transplant operations will take place. (Let your imagination run wild!)
Question for students (and subscribers): What medical advance or achievement do you believe is the most important of all time? Please let us know in the comments section below this article.
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Historical Evidence
For more information, please see…
Nichols, Catherine. Medical Marvels. Turtleback, 2005.
Straus, Eugene and Alex Straus. Medical Marvels: The 100 Greatest Advances in Medicine. Prometheus, 2006.
The featured image in this article, an image by SSamadi15 of streptomycin, is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.