From the first written remedies to gene editing: 526 moments in seven chapters.
Chapter one
Before 500 CE · 19 moments
Physicians in Egypt, Mesopotamia, India, China, Greece and Rome wrote down what they saw, what they tried and what they owed their patients. Some of their ideas were taught for more than a thousand years.
19 moments in 5,500 years, about one every 290 years.
c. 400 BCE: The Hippocratic Corpus. Portrait of Hippocrates of Cos.
In the third millennium BCE the planned cities of the Indus civilization, such as Mohenjo-daro and Harappa, had drains, paved washing areas in houses, wells and soak pits for sewage. At Harappa, skeletons show infection rising after sanitation declined.
Written in Egypt around 1825 BCE, in the reign of Amenemhat III, the Kahun papyrus is the oldest known text on gynaecology and obstetrics. Its 34 cases cover diseases of women, fertility, pregnancy and contraception, most with a diagnosis and a treatment.
Galen of Pergamon tested the workings of the body with experiments on living animals and joined Hippocratic humoral theory to Alexandrian anatomy. His writings were treated as authoritative in Europe and the Middle East for about fifteen centuries, errors included.
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Chapter two
500 to 1499 · 18 moments
Hospitals, medical schools and the first quarantines appeared in these centuries, from Constantinople and Baghdad to Salerno and Venice. The Black Death killed perhaps a third of Europe and changed how cities fought disease.
18 moments in 1,000 years, about one every 60 years.
c. 900 CE: Al-Razi's treatise on smallpox and measles. Portrait of Abu Bakr Muhammad ibn Zakariya al-Razi.
From the 9th century, rulers and viziers in Baghdad, Cairo, Damascus and other cities founded hospitals paid for by endowments. Many were open to men and women, rich and poor, Muslims and non-Muslims, and had free dispensaries and wards for the mentally ill.
The last of the 30 books of al-Zahrawi's medical encyclopedia, written near Cordoba around 1000, covered cautery, incision and bone-setting with drawings of instruments. Translated into Latin in Toledo by Gerard of Cremona, it was read in Europe for centuries.
In 1377 the city-state of Ragusa, now Dubrovnik, ordered people and goods arriving from plague areas to spend 30 days in isolation before entering. The period was later lengthened to 40 days, which gave quarantine its name.
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Chapter three
1500 to 1799 · 44 moments
Anatomists opened bodies and trusted what they found over old books. Microscopes revealed a hidden world, counting began to measure disease, and a ship's surgeon ran one of the first controlled trials.
44 moments in 300 years, about one every 7 years.
c. 1527: Paracelsus and chemical medicine. Portrait of Paracelsus, after Quentin Massys.
Vesalius based a seven-book textbook of human anatomy on his own dissections of human bodies, corrected errors that Galen had carried over from animal dissection, and illustrated it with woodcuts that were copied for centuries.
Harvey showed by calculation and experiment that the heart drives the same blood around the body without end, out through the arteries and back through the veins, replacing Galen's teaching that the liver kept making new blood from food.
Naval surgeon James Lind gave pairs of sailors with scurvy, housed and fed alike, six different remedies and found that oranges and lemons worked best, an early controlled comparison of treatments.
Jenner used cowpox to protect a boy from smallpox in 1796, then documented his cases in 1798. It was the first systematic test of vaccination, and the method eventually drove smallpox to eradication in 1980.
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Chapter four
1800 to 1899 · 87 moments
Stethoscopes, anesthesia and antiseptics changed the bedside. Germ theory explained infection, statisticians mapped where people died, and cities built sewers and clean water supplies.
87 moments in 100 years, about one a year.
1855: Mary Seacole in the Crimea. Portrait of Mary Seacole.
Snow's 1854 Soho investigation tied a cholera outbreak to the Broad Street pump, and his comparison of two London water companies showed cholera spreading through drinking water. Both came decades before the cholera bacterium was accepted as the cause.
Koch identified the tubercle bacillus as the cause of tuberculosis, which then killed one in seven people in Europe and the United States, using a new staining method and pure cultures. He announced the finding in Berlin on March 24, 1882, the date now marked as World TB Day.
In 1890 Emil von Behring and Shibasaburo Kitasato showed that animals given graded doses of diphtheria or tetanus cultures made antitoxins in their blood, and that this serum could protect or cure other animals. Serum treatment of children with diphtheria followed.
Roentgen found a radiation that passed through soft tissue but not bone, letting physicians see inside a living patient without cutting. The work won the first Nobel Prize in Physics in 1901 and started diagnostic radiology.
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Chapter five
1900 to 1959 · 105 moments
Insulin, antibiotics and vaccines turned deadly diseases into treatable ones. After the Second World War, doctors wrote the first international rules for research on people.
105 moments in 60 years, about 2 a year.
1950: McClintock's jumping genes. Portrait of Barbara McClintock.
Before insulin, type 1 diabetes killed within months of diagnosis. Banting and Best's pancreatic extract turned it into a treatable condition; the work won the 1923 Nobel Prize for Banting and Macleod.
Written by American judges into the August 1947 verdict against Nazi doctors, its ten points made voluntary consent the first rule of human research and ranked the subject's welfare above scientific interest.
Doll and Hill compared 709 lung cancer patients with 709 matched hospital controls and found that risk rose with the number of cigarettes smoked, to about 25 times that of non-smokers in the heaviest group. The case-control method they used became a standard tool for studying chronic disease causation.
The first human organ transplant with lasting graft function. Using identical twins sidestepped rejection and showed transplantation could work, opening the clinical field. Murray shared the 1990 Nobel Prize.
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Chapter six
1960 to 1999 · 156 moments
Large trials began to test what really works. Scanners saw inside the living body, transplants became routine, and patients won rights to consent, to refuse and to know.
156 moments in 40 years, about 4 a year.
1971: First clinical CT scanner (EMI head scanner). Portrait of Godfrey Hounsfield, inventor of the EMI CT scanner.
Blumberg's antigen turned out to be the hepatitis B surface protein. It made donor-blood screening possible and led to the first HBV vaccine. He shared the 1976 Nobel Prize for the work.
The Social Security Amendments of 1965 created Medicare, federal health insurance for people 65 and older, and Medicaid, a state and federal program for people with limited income. Nearly 20 million people enrolled in Medicare in its first three years.
A federal study begun in 1932 followed 399 Black men with syphilis, and 201 without, while withholding treatment. Jean Heller's 1972 AP report led to its end and to the National Research Act, institutional review boards and informed consent rules.
On 8 May 1980 the World Health Assembly declared smallpox eradicated, about two and a half years after the last naturally acquired case, in Somalia. It is still the only human infectious disease to have been eradicated, a result of surveillance, containment and ring vaccination.
None of the other moments in this chapter match.
Chapter seven
2000 to today · 97 moments
The human genome was read, new epidemics tested health systems, and medicines arrived that edit genes or teach the body to fight cancer.
97 moments in 27 years, about 4 a year.
2020: BNT162b2 mRNA COVID-19 Vaccine (Pfizer-BioNTech). COVID-19 vaccine vials in a laboratory freezer.
Using a Bayesian model, Ioannidis showed that the odds a published claim is true drop as studies shrink, effects get smaller, and analyses turn flexible. The paper concluded that for most study designs a claimed finding is more likely false than true, and it has been cited more than 5,000 times.
First randomized trial to show a screening test cuts lung cancer death. Across 53,454 heavy smokers, three annual low-dose CT scans lowered lung cancer mortality 20% versus chest x-ray, prompting USPSTF screening guidance.
Connected moments
In April 2014 Flint, Michigan, switched its water supply to the Flint River without corrosion control. Lead leached from old pipes, the share of young children with elevated blood lead roughly doubled, and two outbreaks of Legionnaires' disease killed 12 people.
A new coronavirus identified in Wuhan in January 2020 had reached 114 countries by 11 March, when WHO called COVID-19 a pandemic. WHO later estimated about 14.9 million excess deaths in 2020 and 2021.
None of the other moments in this chapter match.
That is the story so far: 526 moments, 358 of them since 1900. Search for anything above, or see every moment in one list.