History of medicine

Greek and Roman taboos had meant that dissection was usually banned in ancient times, but in the Middle Ages it changed: medical teachers and students at Bologna began to open human bodies, and Mondino de Luzzi (c. 1275–1326) produced the first known anatomy textbook based on human dissection.^[77][78]

Wallis identifies a prestige hierarchy with university educated physicians on top, followed by learned surgeons; craft-trained surgeons; barber surgeons; itinerant specialists such as dentist and oculists; empirics; and midwives.^[119]

Institutions

The first medical schools were opened in the 9th century, most notably the Schola Medica Salernitana at Salerno in southern Italy. The cosmopolitan influences from Greek, Latin, Arabic, and Hebrew sources gave it an international reputation as the Hippocratic City. Students from wealthy families came for three years of preliminary studies and five of medical studies. The medicine, following the laws of Federico II, that he founded in 1224 the university and improved the Schola Salernitana, in the period between 1200 and 1400, it had in Sicily (so-called Sicilian Middle Ages) a particular development so much to create a true school of Jewish medicine.^[120]

As a result of which, after a legal examination, was conferred to a Jewish Sicilian woman, Virdimura, wife of another physician Pasquale of Catania, the historical record of before woman officially trained to exercise of the medical profession.^[121]

At the University of Bologna the training of physicians began in 1219. The Italian city attracted students from across Europe. Taddeo Alderotti built a tradition of medical education that established the characteristic features of Italian learned medicine and was copied by medical schools elsewhere.Turisanus (d. 1320) was his student.^[122]

The

By the thirteenth century, the medical school at Montpellier began to eclipse the Salernitan school. In the 12th century, universities were founded in Italy, France, and England, which soon developed schools of medicine. The University of Montpellier in France and Italy's University of Padua and University of Bologna were leading schools. Nearly all the learning was from lectures and readings in Hippocrates, Galen, Avicenna, and Aristotle. In later centuries, the importance of universities founded in the late Middle Ages gradually increased, e.g. Charles University in Prague (established in 1348), Jagiellonian University in Kraków (1364), University of Vienna (1365), Heidelberg University (1386) and University of Greifswald (1456).

• 
  A miniature depicting the Schola Medica Salernitana in Salerno in Italy
• 
  Ruins of St. Giles Hospital (Great Hospital)
• 
  The oldest Polish Collegium Medicum at Jagiellonian University founded in 1364

People

Women

In 1376, in Sicily, it was historically given, in relationship to the laws of Federico II that they foresaw an examination with a regal errand of physicists, the first qualification to the exercise of the medicine to a woman, Virdimura a Jewish woman of Catania, whose document is preserved in Palermo to the Italian national archives.^[125]

Early modern medicine

Places

England

In England, there were but three small hospitals after 1550. Pelling and Webster estimate that in London in the 1580 to 1600 period, out of a population of nearly 200,000 people, there were about 500 medical practitioners. Nurses and midwives are not included. There were about 50 physicians, 100 licensed surgeons, 100 apothecaries, and 250 additional unlicensed practitioners. In the last category about 25% were women.^[126] All across England—and indeed all of the world—the vast majority of the people in city, town or countryside depended for medical care on local amateurs with no professional training but with a reputation as wise healers who could diagnose problems and advise sick people what to do—and perhaps set broken bones, pull a tooth, give some traditional herbs or brews or perform a little magic to cure what ailed them.

People

• 
  Paracelsus (1493–1541). Known as the "father" of toxicology.
• 
  Michael Servetus (1511–1553). Known as the first European to correctly describe pulmonary circulation.
• 
  Andreas Vesalius (1514–1564). Known as the modern founder of human anatomy.

Europe

The Renaissance brought an intense focus on scholarship to Christian Europe. A major effort to translate the Arabic and Greek scientific works into Latin emerged. Europeans gradually became experts not only in the ancient writings of the Romans and Greeks, but in the contemporary writings of Islamic scientists. During the later centuries of the Renaissance came an increase in experimental investigation, particularly in the field of dissection and body examination, thus advancing our knowledge of human anatomy.^[127]

Ideas

• Animalcules: In 1677 Antonie van Leeuwenhoek identified "animalcules", which we now know as microorganisms, within their paper "letter on the protozoa".^[128]
• Blood circulation: In 1628 the English physician
  De Materia Medica, a pharmacopoeia
  .

• Microscopes: Bacteria and protists were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field of microbiology.^[129]

Institutions

At the

Catholic women played large roles in health and healing in medieval and early modern Europe.[132] A life as a nun was a prestigious role; wealthy families provided dowries for their daughters, and these funded the convents, while the nuns provided free nursing care for the poor.^[133]

The Catholic elites provided hospital services because of their theology of salvation that good works were the route to heaven. The Protestant reformers rejected the notion that rich men could gain God's grace through good works—and thereby escape purgatory—by providing cash endowments to charitable institutions. They also rejected the Catholic idea that the poor patients earned grace and salvation through their suffering.^[134] Protestants generally closed all the convents^[135] and most of the hospitals, sending women home to become housewives, often against their will.^[136] On the other hand, local officials recognized the public value of hospitals, and some were continued in Protestant lands, but without monks or nuns and in the control of local governments.^[137]

In London, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials.^[138] The convents were all shut down but Harkness finds that women—some of them former nuns—were part of a new system that delivered essential medical services to people outside their family. They were employed by parishes and hospitals, as well as by private families, and provided nursing care as well as some medical, pharmaceutical, and surgical services.^[139]

Meanwhile, in Catholic lands such as France, rich families continued to fund convents and monasteries, and enrolled their daughters as nuns who provided free health services to the poor. Nursing was a religious role for the nurse, and there was little call for science.^[140]

Asia

China

In the 18th century, during the Qing dynasty, there was a proliferation of popular books as well as more advanced encyclopedias on traditional medicine. Jesuit missionaries introduced Western science and medicine to the royal court, although the Chinese physicians ignored them.^[141]

India

Unani medicine, based on Avicenna's Canon of Medicine (ca. 1025), was developed in India throughout the Medieval and Early Modern periods. Its use continued, especially in Muslim communities, during the Indian Sultanate and Mughal periods. Unani medicine is in some respects close to Ayurveda and to Early Modern European medicine. All share a theory of the presence of the elements (in Unani, as in Europe, they are considered to be fire, water, earth, and air) and humors in the human body. According to Unani physicians, these elements are present in different humoral fluids and their balance leads to health and their imbalance leads to illness.^[142]

Sanskrit medical literature of the Early Modern period included innovative works such as the Compendium of Śārṅgadhara (Skt. Śārṅgadharasaṃhitā, ca. 1350) and especially The Illumination of Bhāva (Bhāvaprakāśa, by Bhāvamiśra, ca. 1550). The latter work also contained an extensive dictionary of materia medica, and became a standard textbook used widely by ayurvedic practitioners in north India up to the present day (2024). Medical innovations of this period included pulse diagnosis, urine diagnosis, the use of mercury and china root to treat syphilis, and the increasing use of metallic ingredients in drugs.^[143]

By the 18th century CE, Ayurvedic medical therapy was still widely used amongst most of the population. Muslim rulers built large hospitals in 1595 in

• 
  Physician taking pulse in Delhi c.1826
• 
  Dar-ul-Shifa, Hyderabad built in 1591

Europe

Events

European Age of Enlightenment

During the Age of Enlightenment, the 18th century, science was held in high esteem and physicians upgraded their social status by becoming more scientific. The health field was crowded with self-trained barber-surgeons, apothecaries, midwives, drug peddlers, and charlatans.

Across Europe medical schools relied primarily on lectures and readings. The final year student would have limited clinical experience by trailing the professor through the wards. Laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. Most schools were small, and only

In the

Medical education instituted at the Royal and Pontifical University of Mexico chiefly served the needs of urban elites. Male and female curanderos or lay practitioners, attended to the ills of the popular classes. The Spanish crown began regulating the medical profession just a few years after the conquest, setting up the Royal Tribunal of the Protomedicato, a board for licensing medical personnel in 1527. Licensing became more systematic after 1646 with physicians, druggists, surgeons, and bleeders requiring a license before they could publicly practice.^[150] Crown regulation of medical practice became more general in the Spanish empire.^[151]

Elites and the popular classes alike called on divine intervention in personal and society-wide health crises, such as the epidemic of 1737. The intervention of the

Botanical medicines also became popular during the 16th, 17th, and 18th Centuries. Spanish pharmaceutical books during this time contain medicinal recipes consisting of spices, herbs, and other botanical products. For example, nutmeg oil was documented for curing stomach ailments and cardamom oil was believed to relieve intestinal ailments.[155] During the rise of the global trade market, spices and herbs, along with many other goods, that were indigenous to different territories began to appear in different locations across the globe. Herbs and spices were especially popular for their utility in cooking and medicines. As a result of this popularity and increased demand for spices, some areas in Asia, like China and Indonesia, became hubs for spice cultivation and trade.^[156] The Spanish Empire also wanted to benefit from the international spice trade, so they looked towards their American colonies.

The Spanish American colonies became an area where the Spanish searched to discover new spices and indigenous American medicinal recipes. The

Francisco de Mendoza recruited the help of Monardez in studying the traditional medicines of the indigenous people living in what was then the Spanish colonies. Monardez researched these medicines and performed experiments to discover the possibilities of spice cultivation and medicine creation in the Spanish colonies. The Spanish transplanted some herbs from Asia, but only a few foreign crops were successfully grown in the Spanish Colonies. One notable crop brought from Asia and successfully grown in the Spanish colonies was ginger, as it was considered Hispaniola's number 1 crop at the end of the 16th Century.[155] The Spanish Empire did profit from cultivating herbs and spices, but they also introduced pre-Columbian American medicinal knowledge to Europe. Other Europeans were inspired by the actions of Spain and decided to try to establish a botanical transplant system in colonies that they controlled, however, these subsequent attempts were not successful.^[156]

United Kingdom and the British Empire

The London Dispensary opened in 1696, the first clinic in the British Empire to dispense medicines to poor sick people. The innovation was slow to catch on, but new dispensaries were open in the 1770s. In the colonies, small hospitals opened in Philadelphia in 1752, New York in 1771, and Boston (Massachusetts General Hospital) in 1811.^[158]

In the 1830s in Italy, Agostino Bassi traced the silkworm disease muscardine to microorganisms. Meanwhile, in Germany, Theodor Schwann led research on alcoholic fermentation by yeast, proposing that living microorganisms were responsible. Leading chemists, such as Justus von Liebig, seeking solely physicochemical explanations, derided this claim and alleged that Schwann was regressing to vitalism.

In 1847 in Vienna,

French scientist

German physician

By the late 19th and early 20th century English statisticians led by Francis Galton, Karl Pearson and Ronald Fisher developed the mathematical tools such as correlations and hypothesis tests that made possible much more sophisticated analysis of statistical data.^[171]

During the U.S. Civil War the Sanitary Commission collected enormous amounts of statistical data, and opened up the problems of storing information for fast access and mechanically searching for data patterns. The pioneer was

Until the nineteenth century, the care of the insane was largely a communal and family responsibility rather than a medical one. The vast majority of the mentally ill were treated in domestic contexts with only the most unmanageable or burdensome likely to be institutionally confined.^[174] This situation was transformed radically from the late eighteenth century as, amid changing cultural conceptions of madness, a new-found optimism in the curability of insanity within the asylum setting emerged.^[175] Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one^[176] to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion.^[177] This new therapeutic sensibility, referred to as moral treatment, was epitomised in French physician Philippe Pinel's quasi-mythological unchaining of the lunatics of the Bicêtre Hospital in Paris^[178] and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.^[47]

From the early nineteenth century, as lay-led lunacy reform movements gained in influence,^[179] ever more state governments in the West extended their authority and responsibility over the mentally ill.^[180] Small-scale asylums, conceived as instruments to reshape both the mind and behaviour of the disturbed,^[181] proliferated across these regions.^[182] By the 1830s, moral treatment, together with the asylum itself, became increasingly medicalised^[183] and asylum doctors began to establish a distinct medical identity with the establishment in the 1840s of associations for their members in France, Germany, the United Kingdom and America, together with the founding of medico-psychological journals.^[47] Medical optimism in the capacity of the asylum to cure insanity soured by the close of the nineteenth century as the growth of the asylum population far outstripped that of the general population.^[a][184] Processes of long-term institutional segregation, allowing for the psychiatric conceptualisation of the natural course of mental illness, supported the perspective that the insane were a distinct population, subject to mental pathologies stemming from specific medical causes.^[181] As degeneration theory grew in influence from the mid-nineteenth century,^[185] heredity was seen as the central causal element in chronic mental illness,^[186] and, with national asylum systems overcrowded and insanity apparently undergoing an inexorable rise, the focus of psychiatric therapeutics shifted from a concern with treating the individual to maintaining the racial and biological health of national populations.^[187]

Because of the social custom that men and women should not be near to one another, the women of China were reluctant to be treated by male doctors. The missionaries sent women doctors such as Dr. Mary Hannah Fulton (1854–1927). Supported by the Foreign Missions Board of the Presbyterian Church (US) she in 1902 founded the first medical college for women in China, the Hackett Medical College for Women, in Guangzhou.^[194]

Japan

European ideas of modern medicine were spread widely through the world by medical missionaries, and the dissemination of textbooks. Japanese elites enthusiastically embraced Western medicine after the Meiji Restoration of the 1860s. However they had been prepared by their knowledge of the Dutch and German medicine, for they had some contact with Europe through the Dutch. Highly influential was the 1765 edition of Hendrik van Deventer's pioneer work Nieuw Ligt ("A New Light") on Japanese obstetrics, especially on Katakura Kakuryo's publication in 1799 of Sanka Hatsumo ("Enlightenment of Obstetrics").^[195][196] A cadre of Japanese physicians began to interact with Dutch doctors, who introduced smallpox vaccinations. By 1820 Japanese ranpô medical practitioners not only translated Dutch medical texts, they integrated their readings with clinical diagnoses. These men became leaders of the modernization of medicine in their country. They broke from Japanese traditions of closed medical fraternities and adopted the European approach of an open community of collaboration based on expertise in the latest scientific methods.^[197]

Kitasato Shibasaburō (1853–1931) studied bacteriology in Germany under Robert Koch. In 1891 he founded the Institute of Infectious Diseases in Tokyo, which introduced the study of bacteriology to Japan. He and French researcher Alexandre Yersin went to Hong Kong in 1894, where; Kitasato confirmed Yersin's discovery that the bacterium Yersinia pestis is the agent of the plague. In 1897 he isolated and described the organism that caused dysentery. He became the first dean of medicine at Keio University, and the first president of the Japan Medical Association.^[198][199]

Japanese physicians immediately recognized the values of X-Rays. They were able to purchase the equipment locally from the Shimadzu Company, which developed, manufactured, marketed, and distributed X-Ray machines after 1900.^[200] Japan not only adopted German methods of public health in the home islands, but implemented them in its colonies, especially Korea and Taiwan, and after 1931 in Manchuria.^[201] A heavy investment in sanitation resulted in a dramatic increase of life expectancy.^[202]

Europe

The practice of medicine changed in the face of rapid advances in science, as well as new approaches by physicians. Hospital doctors began much more systematic analysis of patients' symptoms in diagnosis.^[203] Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres.^[204] Effective cures were developed for certain endemic infectious diseases. However, the decline in many of the most lethal diseases was due more to improvements in public health and nutrition than to advances in medicine.^{[citation needed]}

Medicine was revolutionized in the 19th century and beyond by advances in chemistry, laboratory techniques, and equipment. Old ideas of infectious disease epidemiology were gradually replaced by advances in bacteriology and virology.^[129]

The Russian Orthodox Church sponsored seven orders of nursing sisters in the late 19th century. They ran hospitals, clinics, almshouses, pharmacies, and shelters as well as training schools for nurses. In the Soviet era (1917–1991), with the aristocratic sponsors gone, nursing became a low-prestige occupation based in poorly maintained hospitals.^[205]

Places

France

Paris (France) and Vienna were the two leading medical centers on the Continent in the era 1750–1914.

In the 1770s–1850s Paris became a world center of medical research and teaching. The "Paris School" emphasized that teaching and research should be based in large hospitals and promoted the professionalization of the medical profession and the emphasis on sanitation and public health. A major reformer was Jean-Antoine Chaptal (1756–1832), a physician who was Minister of Internal Affairs. He created the Paris Hospital, health councils, and other bodies.^[206]

The First Viennese School of Medicine, 1750–1800, was led by the Dutchman Gerard van Swieten (1700–1772), who aimed to put medicine on new scientific foundations—promoting unprejudiced clinical observation, botanical and chemical research, and introducing simple but powerful remedies. When the Vienna General Hospital opened in 1784, it at once became the world's largest hospital and physicians acquired a facility that gradually developed into the most important research centre.^[209] Progress ended with the Napoleonic wars and the government shutdown in 1819 of all liberal journals and schools; this caused a general return to traditionalism and eclecticism in medicine.^[210]

Vienna was the capital of a diverse empire and attracted not just Germans but Czechs, Hungarians, Jews, Poles and others to its world-class medical facilities. After 1820 the Second Viennese School of Medicine emerged with the contributions of physicians such as

In the

The hygiene of the training and field camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers. First came epidemics of the childhood diseases of chicken pox, mumps, whooping cough, and, especially, measles. Operations in the South meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria. There were no antibiotics, so the surgeons prescribed coffee, whiskey, and quinine. Harsh weather, bad water, inadequate shelter in winter quarters, poor policing of camps, and dirty camp hospitals took their toll.[216]

This was a common scenario in wars from time immemorial, and conditions faced by the Confederate army were even worse. The Union responded by building army hospitals in every state. What was different in the Union was the emergence of skilled, well-funded medical organizers who took proactive action, especially in the much enlarged United States Army Medical Department,^[217] and the United States Sanitary Commission, a new private agency.^[218] Numerous other new agencies also targeted the medical and morale needs of soldiers, including the United States Christian Commission as well as smaller private agencies.^[219]

The U.S. Army learned many lessons and in August 1886, it established the Hospital Corps.

Institutions

Johns Hopkins Hospital, founded in 1889, originated several modern medical practices, including residency and rounds.

People

• 
  Louis Pasteur, (1822–1895), known for, with Koch, the founding of modern bacteriology, contributions to germ theory, and pasteurization.
• 
  Robert Koch, (1843–1910), known for his founding, with Pasteur, of modern bacteriology, and a father of modern medicine.^[220][221] He provided proofs for the scientific basis of public health.^[222]
• 
  Paul Ehrlich, (1854–1915), known for his discovery of the first antibiotic, arsphenamine. One of the founders of immunology.
• 
  Emil von Behring, (1854–1917), known for his discovery of a diphtheria antitoxin. He was widely known as a "saviour of children".

Cardiovascular

Blood groups

The ABO blood group system was discovered in 1901 by Karl Landsteiner at the University of Vienna. Landsteiner experimented on his staff, mixing their various blood components together, and found that some people's blood agglutinated (clumped together) with other blood, whilst some did not. This then lead him identifying three blood groups, ABC, which would later be renamed to ABO.^[223] The less frequently found blood group AB was discovered later in 1902 by Alfred Von Decastello and Adriano Sturli.^[224] In 1937 Landsteiner and Alexander S. Wiener further discovered the Rh factor (misnamed from early thinking that this blood group was similar to that found in rhesus monkeys) whose antigens further determine blood reaction between people.^[224] This was demonstrated in a 1939 case study by Phillip Levine and Rufus Stetson where a mother who had recently given birth had reacted to their partner's blood, highlighting the Rh factor.^[225]

Blood transfusion

Canadian physician Norman Bethune, M.D. developed a mobile blood-transfusion service for frontline operations in the Spanish Civil War (1936–1939), but ironically, he himself died of sepsis.^[226]

Pacemaker

In 1958, Arne Larsson in Sweden became the first patient to depend on an artificial cardiac pacemaker. He died in 2001 at age 86, having outlived its inventor, the surgeon, and 26 pacemakers.

Cancer

neural prosthetics

emerging in the end of the 20th century.

Diseases

Oral rehydration therapy has been extensively used since the 1970s to treat cholera and other diarrhea-inducing infections.

As infectious diseases have become less lethal, and the most common

tumors and cardiovascular diseases

, these conditions have received increased attention in medical research.

Disease eradication

Malaria eradication

Main article: History of malaria

Starting in World War II,

insect vectors carrying malaria, which was endemic in most tropical regions of the world.^{[227][228][229]} The first goal was to protect soldiers, but it was widely adopted as a public health device. In Liberia, for example, the United States had large military operations during the war and the U.S. Public Health Service began the use of DDT for indoor residual spraying (IRS) and as a larvicide, with the goal of controlling malaria in Monrovia, the Liberian capital. In the early 1950s, the project was expanded to nearby villages. In 1953, the World Health Organization (WHO) launched an antimalaria program in parts of Liberia as a pilot project to determine the feasibility of malaria eradication in tropical Africa. However these projects encountered a spate of difficulties that foreshadowed the general retreat from malaria eradication efforts across tropical Africa by the mid-1960s.^[230]

Pandemics

1918 influenza pandemic (1918-1920)

The 1918 influenza pandemic was a global pandemic in the early 20th century that occurred between 1918 and 1920. Sometimes known as Spanish Flu due to popular opinion at the time thinking the flu originated from Spain, this pandemic caused close to 50 million deaths around the world.^[231] Spreading at the end of World War I.^[232]

Public health

1918 flu pandemic, which killed at least 50 million people around the world.^[233] It became an important case study in epidemiology.^[234]

Bristow shows there was a gendered response of health caregivers to the pandemic in the United States. Male doctors were unable to cure the patients, and they felt like failures. Women nurses also saw their patients die, but they took pride in their success in fulfilling their professional role of caring for, ministering, comforting, and easing the last hours of their patients, and helping the families of the patients cope as well.

Research

Evidence-based medicine is a modern concept, not introduced to literature until the 1990s.

Sexual and reproductive health

antiretroviral

treatments.

Smoking

Tobacco smoking as a cause of lung cancer was first researched in the 1920s, but was not widely supported by publications until the 1950s.

Surgery

Laparoscopic surgery

was broadly introduced in the 1990s. Natural orifice surgery has followed.

War

Mexican Revolution (1910-1920)

During the 19th century, large-scale wars were attended with

mobile hospital units which developed advanced techniques for healing massive injuries and controlling infections rampant in battlefield conditions. During the Mexican Revolution (1910–1920), General Pancho Villa organized hospital trains for wounded soldiers. Boxcars marked Servicio Sanitario ("sanitary service") were re-purposed as surgical operating theaters and areas for recuperation, and staffed by up to 40 Mexican and U.S. physicians. Severely wounded soldiers were shuttled back to base hospitals.^[236]

World War I (1914-1918)

cosmetic surgery and other forms of elective surgery

.

Interwar period (1918-1939)

From 1917 to 1932, the American Red Cross moved into Europe with a battery of long-term child health projects. It built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. A high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. Hundreds of U.S. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of European youth and to reshape European public health and welfare along American lines.^{[237][238][239]}

World War II (1939-1945)

The advances in medicine made a dramatic difference for Allied troops, while the Germans and especially the Japanese and Chinese suffered from a severe lack of newer medicines, techniques and facilities. Harrison finds that the chances of recovery for a badly wounded British infantryman were as much as 25 times better than in the First World War. The reason was that:

"By 1944 most casualties were receiving treatment within hours of wounding, due to the increased mobility of field hospitals and the extensive use of aeroplanes as ambulances. The care of the sick and wounded had also been revolutionized by new medical technologies, such as active immunization against tetanus, sulphonamide drugs, and penicillin."^[240]

During the

germicide which helped prevent gangrene.^[241]

The War spurred the usage of

sulpha

antibiotics.

Nazi and Japanese medical research

Unethical human subject research, and killing of patients with disabilities, peaked during the Nazi era, with Nazi human experimentation and Aktion T4 during the Holocaust as the most significant examples. Many of the details of these and related events were the focus of the Doctors' Trial. Subsequently, principles of medical ethics, such as the Nuremberg Code, were introduced to prevent a recurrence of such atrocities.^[242] After 1937, the Japanese Army established programs of biological warfare in China. In Unit 731, Japanese doctors and research scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese victims.^[243]

Institutions

World Health Organization

Ebola virus epidemic in West Africa

and onwards.

People

• 
  Mary Putnam Jacobi (1842–1906) known for debunking myths around menstruation and female intelligence.
• 
  Florence Nightingale (1820–1910) known for their social action and reforms to nursing.
• 
  Elizabeth Blackwell (1821–1910) known as the first women to gain a medical degree in the United States.
• 
  Susan La Flesche Picotte (1865–1915) known for their activism and as the first indigenous woman to gain a medical degree in the United States.
• 
  Linda Richards (1841–1930) known for their pioneering work in nursing.
• 
  Alexander Fleming (1881–1955) known for the discovery of penicillin and lysozyme.
• 
  Gerty Cori (1896–1957) known for their discovery of the catalytic conversion of glycogen and first woman awarded a Nobel Prize in Physiology or Medicine.
• 
  Virginia Apgar (1909–1974) known for the Apgar score and improving infant mortality.

Contemporary medicine

Antibiotics and antibiotic resistance

The discovery of

cancer treatments, organ transplants, to open heart surgery.^[244] Throughout the 20th century, though, their overprescribed use to humans,^[245] as well as to animals that need them due to the conditions of intensive animal farming,^[246] has led to the development of antibiotic resistant bacteria.^[244]

Robotics

Pandemics

The early 21st century, facilitated by extensive global connections, international travel, and unprecedented human disruption of ecological systems,^[247][248] has been defined by a number of noval as well as continuing global pandemics from the 20th century.^[249]

Past

The SARS 2002 to 2004 outbreak affected a number of countries around the world and killed hundreds. This outbreak gave rise to a number of lessons learnt from viral infection control, including more effective isolation room protocols to better hand washing techniques for medical staff.^[250] A mutated strain of SARS would go on to develop into COVID-19, causing the future COVID-19 pandemic. A significant influenza strain, H1N1, caused a further pandemic between 2009 and 2010. Known as swine flu, due to its indirect source from pigs, it went on to infect over 700 million people.^[251]

Ongoing

The continuing HIV pandemic, starting in 1981, has infected and led to the deaths of millions of people around the world.^[252] Emerging and improved pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) treatments that aim to reduce the spread of the disease have proven effective in limiting the spread of HIV^[253] alongside combined use of safe sex methods, sexual health education, needle exchange programmes, and sexual health screenings.^[254] Efforts to find a HIV vaccine are ongoing whilst health inequities have left certain population groups, like trans women,^[255] as well as resource limited regions, like sub-Saharan Africa, at greater risk of contracting HIV compared with, for example, developed countries.^[256]

The outbreak of COVID-19, starting in 2019, and subsequent declaration of the COVID-19 pandemic by the WHO^[257] is a major pandemic event within the early 21st century. Causing global disruptions, millions of infections and deaths, the pandemic has caused suffering throughout communities. The pandemic has also seen some of the largest logistical organisations of goods, medical equipment, medical professionals, and military personnel since World War II that highlights its far-reaching impact.^[258][259]

Personalised medicine

The rise of personalised medicine in the 21st century has generated the possibility to develop diagnosis and treatments based on the individual characteristics of a person, rather than through generic practices that defined 20th century medicine. Areas like DNA sequencing, genetic mapping, gene therapy, imaging protocols, proteomics, stem cell therapy, and wireless health monitoring devices^[260] are all rising innovations that can help medical professionals fine tune treatment to the individual.^[261][262]

Telemedicine

Remote surgery is another recent development, with the transatlantic Lindbergh operation in 2001 as a groundbreaking example.

Institutions

People

• 
  Patricia Goldman-Rakic (1937–2003) known for research around the prefrontal cortex and working memory.
• 
  Luc Montagnier (1932–2022) known as one of the co-discoverers of HIV.
• 
  屠呦呦 [Tu Youyou] (1930–present) known for discovering malaria treatments.
• 
  Joycelyn Elders (1933–present) known as the first Black American woman to serve as the Surgeon General of the United States.
• 
  Antonia Novello (1944–present) known as the first woman and first Hispanic to serve as the Surgeon General of the United States.
• 
  Françoise Barré-Sinoussi (1947–present) known as one of the co-discoverers of HIV.
• 
  Tedros Adhanom Ghebreyesus (1965–present) first African Director-General of the World Health Organization.

Themes in medical history

Racism in medicine

Racism has a long history in how medicine has evolved and established itself, both in terms of racism experience upon patients, professionals, and wider systematic violence within medical institutions and systems.^[263][264] See: medical racism in the United States, race and health, and scientific racism.

Women in medicine

Main article: Women in medicine

Women have always served as healers and midwives since ancient times. However, the professionalization of medicine forced them increasingly to the sidelines. As hospitals multiplied they relied in Europe on orders of Roman Catholic nun-nurses, and German Protestant and Anglican deaconesses in the early 19th century. They were trained in traditional methods of physical care that involved little knowledge of medicine.

See also

• Health care in the United States
• History of dental treatments
• History of herbalism
• History of hospitals
• History of medicine in Canada
• History of medicine in the United States
• History of nursing
• History of pathology
• History of pharmacy
• History of surgery
• Timeline of nursing history
• Timeline of medicine and medical technology
• History of health care (disambiguation)

Explanatory notes

1. ^ England and Wales had nine county and borough asylums in 1827 with an average capacity of a little over 100 patients, but by 1890 there were 66 such asylums containing on average 800 patients each;^[265] the total number of patients so confined increased from 1,027 in 1827 to 74,004 in 1900.^[266] Similarly, in Germany, between 1852 and 1898 the asylum population increased seven-fold from 11,622 to 74,087 patients during a period when the total population had only grown by ten per cent.^[180] In America the asylum population had risen to almost 250,000 on the eve of the First World War.^[267]

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Further reading

• Bowers BS, ed. (2007). The Medieval Hospital and Medical Practice. Ashgate. p. 258.
  ISBN 978-0-7546-5110-9
  .
• Breslaw EG (2014). Lotions, Potions, Pills, and Magic: Health Care in Early America. NYU Press.
  ISBN 978-1479807048
  .
• Brockliss LW, Jone C (1997). The Medical World of Early Modern France. Oxford: Clarendon Press.
  ISBN 978-0-19-822750-2
  .
• Burnham JC, ed. (2015). Health Care in America: A History. Baltimore: JHU Press.
  ISBN 978-1-4214-1609-0
  .
• Bynum WF, Porter R, eds. (1993). Companion Encyclopedia of the History of Medicine. London: Routledge.
  ISBN 978-1-136-11036-8
  .
• Bynum WF, Hardy A, Jacyna S, Lawrence C, Tansey EM (2006). The Western Medical Tradition. New York, NY: Cambridge University Press.
  ISBN 978-0-521-47565-5
  .
• Conrad LI, Neve M, Nutton V, Porter R, Wear A (1995). The Western Medical Tradition: 800 BC to AD 1800. Cambridge, Eng.: Cambridge University Press.
  ISBN 978-0-521-47564-8
  .
• Cooter R, Pickstone JV, eds. (2003). Companion to Medicine in the 20th Century. Taylor & Francis.
  ISBN 978-0-415-28603-9
  .
• Donahue, M. Patricia (2011). Nursing, the Finest Art: An Illustrated History. Mosby Elsevier.
  ISBN 978-0-323-05305-1
  .
• Jackson M, ed. (2011). The Oxford Handbook of the History of Medicine. Oxford University Press.
  ISBN 978-0-19-954649-7
  .
• Kessel G (2019). "Syriac Medicine". The Syriac World. London: Routledge. pp. 438–59.
  ISBN 978-1-138-89901-8
  .
• Loudon I, ed. (1997). Western Medicine: An Illustrated History. Oxford: Oxford University Press.
  ISBN 978-0-19-924813-1
  .
• Majno G (1991). The Healing Hand: Man and Wound in the Ancient World. Harvard University Press.
  ISBN 978-0674383319
  .
• McGrew RE, McGrew MP (1985). Encyclopedia of Medical History. New York: McGraw-Hill.
  ISBN 978-0-07-045087-5
  .
• ISBN 978-0-393-31980-4
  .
• Nutton V (2012). Ancient Medicine (2nd ed.). London: Routledge.
  ISBN 978-0-415-52094-2
  .
• Porter R (1996). The Cambridge Illustrated History of Medicine. Cambridge: Cambridge University Press.
  ISBN 978-0-521-00252-3
  .
  • Porter R (2006). The Cambridge History of Medicine. Cambridge: Cambridge University Press.
    ISBN 978-0-521-86426-8
    .
• Porter R (2004). Blood and Guts: A Short History of Medicine. WW Norton & Company.
  ISBN 978-0-393-32569-0
  .
• Rosenberg CE, ed. (1992). Framing Disease: Studies in Cultural History. Rutgers University Press.
  ISBN 978-0813517575
  .
• Rousseau GS, Gill M, Haycock D, Herwig M, eds. (2003). Framing and Imagining Disease in Cultural History. Basingstoke: Palgrave Macmillan.
  ISBN 978-1-4039-1292-3
  .
• Singer CJ, Underwood AE (2006). A Short History of Medicine (Rev. ed.). Cambridge: Cambridge University Press.
  ISBN 978-0-521-86426-8
  .
• Siraisi NG (September 2012). "Medicine, 1450-1620, and the history of science". Isis; an International Review Devoted to the History of Science and Its Cultural Influences. 103 (3): 491–514.
  S2CID 6954963
  .
• Siraisi NG (1990). Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice. Chicago: University of Chicago Press.
  ISBN 978-0-226-76130-5
  .
• Watts SJ (2003). Disease and Medicine in World History. Themes in World History. New York: Routledge.
  ISBN 978-0-415-27817-1
  .
• Wear A, ed. (1992). Medicine in Society: Historical Essays. Cambridge University Press.
  ISBN 978-0-521-33639-0
  .
• Weatherall M (1990). In Search of a Cure: A History of Pharmaceutical Discovery. Oxford: Oxford University Press.
  ISBN 978-0-19-261747-7
  .

External links

Wikimedia Commons has media related to History of medicine.

Wikiquote has quotations related to History of medicine.

• Texts on Wikisource:
  • Senfelder L (1911). "History of Medicine". Catholic Encyclopedia. Vol. 10.
• The history of medicine and surgery as portrayed by various artists
• Directory of History of Medicine Collections Archived 2013-09-16 at the Wayback Machine, Index to the major collections in the United States and Canada, selected by the US National Institute of Health