Modern medicine, or medicine as it is known, began to emerge after the Industrial Revolution in the 18th century. Meanwhile, a rapid growth has been recorded in economic activities in Western Europe and America. In the 19th century, economic and industrial growth continued to develop, and people made many scientific discoveries and inventions. Scientists have made rapid advances in identifying and preventing diseases and understanding how bacteria and viruses function. But much more work is needed to make progress in the treatment of infectious diseases.
Victorian employees were exposed to new problems and diseases. In the 19th century, ways of living and working changed dramatically. These changes have affected the risk of infectious diseases and other conditions. This way of living is as follows:
• Industry: As more production processes are mechanized, a variety of work-related diseases have become more common. These include lung disease, dermatitis, and phosphorous jaw, a form of jaw necrosis that often affects people who work with phosphorus in the match industry.
• Urban sprawl: Cities have begun to expand rapidly, as a result some health problems such as typhus and cholera have become more common.
• Traveling: People have carried various illnesses, including yellow fever, with them while traveling around the world.
Meanwhile, scientific developments at that time began to make new treatments possible, and these are as follows:
• Scientific breakthroughs: As the theories on microbes emerged, scientists began to test and prove principles on hygiene and antisepsis in preventing infection and treating wounds. The new discoveries included electrocardiography, which records the heart’s electrical activity over time.
• Communication: Medical information spread rapidly as postal services and other communications improved.
• Political changes: Democracy has led people to demand health as a human right.
There were groundbreaking advances in infection control in the 19th and 20th centuries. At the end of the 19th century, 30 percent of deaths were caused by infection, and at the end of the 20th century, this figure dropped below 4 percent.
Louis Pasteur (1822-1895), a chemist and microbiologist from France, was one of the founders of medical microbiology. As a chemistry professor at the University of Lille, he and his team’s job is to find solutions to some of the problems affecting local industries. Pasteur has shown that bacteria cause wine, beer and milk to go rancid. He explained that boiling and cooling a liquid will destroy bacteria. Together with Louis Pasteur and Claude Bernard (1813–1878) he developed a technique for pasteurizing liquids. Claude Bernard was the first scientist to propose the use of blind experiments to make scientific observations more objective. Later, after investigating an epidemic among silkworms in the silk industry in the south of France, Pasteur determined that the parasites were caused. He recommended that only healthy and parasite-free silkworm eggs be used. This action resolved the epidemic and the silk industry recovered.
Pasteur made sure that pathogens attack the body from outside, and this is the germ theory of the disease. However, many scientists did not believe that microscopic beings could harm or even kill humans and other relatively large species. Pasteur said that when microbes from the environment enter the body, many diseases such as tuberculosis (TB), cholera, anthrax and smallpox occur. He believed that vaccines could prevent these types of diseases and continued to develop a vaccine for rabies.
Florence Nightingale has influenced attitudes towards the role of women in hospital hygiene, nursing and health care. Florence Nightingale (1820–1910) was an English nurse, statistician and writer. She did a pioneer nursing job while caring for wounded soldiers during the Crimean War. Nightingale was from a well-connected family and at first was not approved by her family to study nursing. However, his parents finally agreed that he could take a 3-month nursing course in Germany in 1851. In 1853 she became the inspector of a women’s hospital on Harley Street, London. The Crimean War broke out in 1854. Minister of War, Sidney Herbert, the military hospitals in Turkey, Nightingale has asked the nurse to manage a team. 34 nurses trained by 1854, Turkey has come to Scutari. Nightingale was shocked by what she saw. The reason for this was that while the duty officers remained indifferent, the tired medical personnel were treating the injured soldiers, many of whom were dying unnecessarily, with unbearable pain. Lack of medicines and poor hygiene standards led to mass infections.
Nightingale and her team have worked tirelessly to improve hygiene and provide patient services, including cooking facilities and laundry. Under his influence, the death rate fell by two-thirds. She established a training school for nurses in London in 1860. Nurses who were trained here have started working all over the UK. They have applied everything they have learned about sanitation and hygiene, proper hospital planning, and the best ways to achieve health. Nightingale’s work has also been a turning point for women assuming a more important role in medical care. Also, most of its applications are still valid today.
Milestones in Modern Medicine
1800: English chemist and inventor Humphry Davy described the anesthetic properties of nitrous oxide known as laughing gas.
1816: Rene Laennec, a French doctor, invented the stethoscope and pioneered its use in the diagnosis of chest infections.
1818: British obstetrician James Blundell performed the first successful blood transfusion to a patient with bleeding.
1842: Crawford Long, an American pharmacist and surgeon, became the first doctor to give a patient inhaled ether anesthesia for a surgical procedure.
1847: Hungarian doctor Ignaz Semmelweis found that the incidence of fever or birth fever in babies decreased significantly if paramedics disinfected their hands before birth. Childhood fever has been fatal in 25 to 30 percent of sporadic cases and 70 to 80 percent of epidemic cases.
1849: Elizabeth Blackwell, an American, became the first fully qualified female physician in the United States and the first woman to enter the UK Medical Register and encouraged women’s medical education.
1867: English surgeon and pioneer of antiseptic surgery, Joseph Lister, successfully used phenol (later known as carbolic acid) to clean wounds and sterilize surgical instruments, resulting in a reduction in postoperative infections.
1879: Pasteur produced the first laboratory-developed vaccine against chicken cholera.
1881: Pasteur developed an anthrax vaccine by attenuating anthrax bacteria with carbolic acid and demonstrated its effectiveness using 50 sheep in the ring. 25 of the unvaccinated sheep, but only one of the vaccinated sheep died, possibly of unrelated reason.
1882: Pasteur managed to prevent rabies on 9-year-old Joseph Meister using a post-exposure vaccine.
1890: German physiologist Emil von Behring discovered antitoxins and used them to develop diphtheria and tetanus vaccines. He later received the first Nobel Prize in Physiology or Medicine.
1895: German physicist Wilhelm Conrad Röntgen discovered X-rays by generating and detecting electromagnetic radiation in this wavelength range.
1897: Chemists working at the German company Bayer AG produced the first Aspirin. This is a synthetic version of their saline from the plant species Filipendula ulmaria (meadowsweet) and has grown into a global commercial success within 2 years.
1901: Austrian biologist and doctor Karl Landsteiner identified different blood types and classified them into blood groups.
1901: German psychiatrist and neuropathologist Alois Alzheimer described presenile dementia, later known as Alzheimer’s disease.
1903: The Dutch doctor and physiologist named Willem Einthoven invented the first practical electrocardiogram (EKG or EKG).
1906: British biochemist Frederick Hopkins discovered vitamins and suggested that vitamin deficiencies cause scurvy and rickets.
1907: Paul Ehrlich, a German doctor and scientist, developed a chemotherapeutic treatment for sleeping sickness. His laboratory also discovered arsfenamine (Salvarsan), the first effective treatment for syphilis, and these discoveries marked the beginning of chemotherapy.
1921: Canadian medical scientists Sir Frederick Banting and American-Canadian Charles Herbert Best discovered insulin.
1923–1927: Scientists discovered and used the first vaccines for diphtheria, pertussis (pertussis), tuberculosis (TB), and tetanus.
1928: Sir Alexander Fleming, Scottish biologist and pharmacologist, discovered penicillin mold from Penicillium notatum. This discovery changed the course of history and saved millions of lives.
1929: German doctor Hans Berger discovered human electroencephalography and made it the first to record brain waves.
1932: German pathologist and bacteriologist Gerhard Domagk developed a treatment for streptococcal infections and created Prontosil, the first antibiotic on the market.
1935: Max Theiler, a South African microbiologist, developed the first successful vaccine for yellow fever.
1943: Dutch doctor, Willem J. Kolff, built the world’s first dialysis machine and later pioneered artificial organs.
1946: American pharmacologists Alfred G. Gilman and Louis S. Goodman discovered the first effective cancer chemotherapy drug, nitrogen mustard, after realizing that soldiers had abnormally low white blood cells after exposure to nitrogen mustard.
1948: American chemists Julius Axelrod and Bernard Brodie invent acetaminophen (paracetamol, Tylenol).
1949: Daniel Darrow suggested the use of oral and intravenous rehydration solutions to treat diarrhea in infants. With Harold Harrison, he created the first electrolyte-glucose solution for clinical use.
1952: Jonas Salk, an American medical researcher and virologist, invented the first polio vaccine. Salk has been hailed as a miracle worker in the US after World War II, as polio has become a serious public health problem.
1953: Dr. John Heysham Gibbon invented the heart-lung machine. He also performed the first open heart surgery to repair the atrial septal defect, also known as a hole in the heart.
1953: Swedish physicist Inge Edler invented medical ultrasonography (echocardiography).
1954: Joseph Murray performed the first human kidney transplant involving identical twins.
1958: Rune Elmqvist, a doctor and engineer, developed the first implantable pacemaker. He also developed the first inkjet ECG printer.
1959: Min Chueh Chang, a Chinese-American reproductive biologist, later performed an IVF procedure, which led to the formation of the first IVF. The amendment also contributed to the development of the combined oral contraceptive pill approved by the FDA in 1960.
1960: A group of Americans developed the cardiopulmonary resuscitation (CPR) technique. They first successfully tested it on a dog, and the technique soon saved a child’s life.
1962: Sir James W. Black, a Scottish physician and pharmacologist, invented the first beta blocker after investigating how adrenaline affects the functioning of the human heart. The drug Propranolol is a treatment for heart disease, and Black has also developed cimetidine, a treatment for stomach ulcers.
1963: Thomas Starzl, an American physician, performed the first human liver transplant and James Hardy, an American surgeon, performed the first human lung transplant.
1963: Polish chemist Leo H. Sternbach discovered diazepam (Valium). Throughout his career, Sternbach also discovered chlordiazepoxide (Librium), trimetafan (Arfonad), clonazepam (Klonopin), flurazepam (Dalmane), flunitrazepam (Rohypnol), and nitrazepam (Mogadon). John Enders and his colleagues developed the first measles vaccine.
1965: Harry Martin Meyer, an American pediatric virologist, co-developed the rubella vaccine and went on sale in 1970.
1966: American surgeon C. Walton Lillehei performed the first successful human pancreas transplant. Lillehei has also pioneered new equipment, prostheses and techniques for cardiothoracic surgery as well as open heart surgery.
1967: Christiaan Barnard, a South African heart surgeon, performed the first human-to-human heart transplant. Maurice Hilleman, an American microbiologist and vaccine specialist, produced the first mumps vaccine, and Hilleman has developed over 40 vaccines more than anyone else.
1970: Doctors used cyclosporine, the first effective immunosuppressive drug, in organ transplant procedures. In addition, Cyclosporine treats psoriasis and other autoimmune diseases, including severe cases of rheumatoid arthritis.
1971: Armenian-American medical doctor Raymond Vahan Damadian discovered the use of magnetic resonance imaging (MRI) for medical diagnosis. In the same year, British electrical engineer Sir Godfrey Hounsfield presented the computed tomography (CT or CAT) scanning machine he developed.
1978: Doctors recorded the last fatal case of smallpox.
1979: American physician George Hitchings, American biochemist and pharmacologist Gertrude Elion, made significant breakthroughs with antiviral drugs. Their pioneering work led to the development of the HIV drug azidotymidine (AZT).
1980: Dr. Baruch Samuel Blumberg developed the hepatitis B diagnostic test and vaccine.
1981: Bruce Reitz, an American cardiothoracic surgeon, successfully performed the first human heart-lung combined transplant procedure.
1985: American biochemist Kary Banks Mullis made improvements to the polymerase chain reaction (PCR), making it possible to create thousands and possibly millions of copies of a given DNA sequence.
1985: British geneticist Sir Alec John Jeffreys developed DNA fingerprinting and profiling techniques that forensic departments currently use worldwide. These techniques also solve non-criminal problems such as paternity disputes.
1986: Eli Lilly launched fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI) class of antidepressant that doctors prescribe for a variety of mental health problems.
1987: The US Food and Drug Administration (FDA) approved the first statin, lovastatin (Mevacor). Statins can lower LDL cholesterol levels by up to 60 percent, reducing the risk of heart disease and stroke.
1998: James Alexander Thomson, an American developmental biologist, derived the first human embryonic stem cell line. He later found a way to create stem cells from human skin cells.
From 2000 to Present
2000: Scientists completed the Human Genome Project (HGP) draft, and the project includes collaborators from around the world. The purpose of this is as follows:
• Determining the sequence of chemical base pairs that make up DNA
• Identify and map 20,000-30,000 genes of the human genome
The project leads to the development of new drugs and treatments to prevent or cure genetic-based diseases.
2001: Dr. Kenneth Matsumura created the first bio-artificial liver. This leads scientists to create artificial livers for transplantation or to other techniques that allow a damaged liver to regenerate itself.
2005: Jean-Michel Dubernard, a French transplant specialist, performed a partial facial transplant on a woman whose face was disfigured by a dog attack. In 2010, Spanish doctors performed a full face transplant on a man who suffered a shooting accident.
What State of Modern Medicine Today?
Genetic discoveries are revolutionizing medicine today. Research continues to advance medical science, and there are areas that scientists are currently working on and these are:
Targeted cancer therapy: Doctors have started using a new class of drugs called biologicals to treat cancer and other diseases. Unlike traditional chemotherapy, which can destroy fast-growing healthy cells, these drugs target specific proteins in cancer cells and cause less damage to the whole body.
HIV treatment: The effectiveness of HIV treatment is such that people who take the drug regularly will not pass the virus. The amount of virus in their blood, known as viral load, is almost zero.
Stem cell therapy: Scientists are working to produce human tissue and even whole organs from stem cells. This technique helps in a variety of treatments, from wound healing to prostheses and liver replacement.
Gene therapy: A type of genetic engineering known as CRISPR gene editing makes it possible to prevent genetic and inherited conditions such as heart disease, leukemia, cystic fibrosis, and hemophilia.
Robotics: Robotics and remote control tools help surgeons perform certain types of procedures. Surgeons can perform all operations by controlling the movements of the operating robot by looking at the monitor. This can provide greater precision and eliminate some risks of human error.
At a different scale, medical supply companies are already using drones to deliver drugs to remote parts of the world.
Challenges Faced by Modern Medicine Today
As modern medicine continues to make progress, some significant challenges remain. One is that antibiotic resistance is increased, partly as a reaction to the overuse of antibiotics, and also because pathogens or microbes adapt to resist them. Another is the increase in pollution and environmental hazards. While there was a great decrease in deaths due to infection in the 20th century, it is predicted that this number will increase again in the next centuries.