History of Medicine & Surgery

Surgeons in the Code of Hammurabi

The Babylonian law code of King Hammurabi sets fees for surgeons who heal and harsh penalties for those whose operations fail, one of the oldest records of laws about medical practice.

The Code of HammurabiHammurabi

The Edwin Smith Papyrus

An Egyptian scroll copied about this time, now called the Edwin Smith Papyrus, describes 48 cases of injuries, mostly to the head and spine, each with examination, diagnosis and treatment. It is one of the oldest known surgical texts.

The plague of Athens

A deadly epidemic strikes Athens early in its war with Sparta. The historian Thucydides, who caught the disease and recovered, describes its symptoms carefully. The Athenian leader Pericles died of it in 429 BCE.

The History of the Peloponnesian WarPericles

Hippocrates and the Hippocratic writings

Hippocrates of Kos and his followers explain disease by natural causes rather than angry gods and stress careful observation of the patient. The writings collected under his name include the Hippocratic Oath, in which a doctor promises to use treatment to help the sick and never to harm them.

Hippocratic WritingsHippocrates

Dissection at Alexandria

In Alexandria, Egypt, the Greek physicians Herophilus and Erasistratus study human anatomy by dissection. They describe the nerves, the brain and the valves of the heart. Human dissection was then abandoned for many centuries.

Herophilus

Celsus, On Medicine

The Roman writer Aulus Cornelius Celsus writes On Medicine in clear Latin, covering diet, drugs and surgery. He lists the four signs of inflammation: redness, swelling, heat and pain.

On MedicineAulus Cornelius Celsus

Dioscorides, De Materia Medica

Pedanius Dioscorides, a Greek physician, describes about 600 plants and many other substances and their uses as medicines. His book remained the standard guide to drugs for some 1,500 years.

De Materia MedicaPedanius Dioscorides

Galen comes to Rome

Galen of Pergamon, who had treated wounded gladiators, moves to Rome and later becomes physician to emperors. His many books on anatomy (largely from animal dissection), the pulse and the four humors guided European and Islamic medicine for more than 1,300 years.

Galen: Selected WorksGalenMarcus Aurelius

The Antonine Plague

A great epidemic, possibly smallpox, spreads through the Roman Empire in the reign of Marcus Aurelius. Galen describes its fever and rash.

The Fate of Rome: Climate, Disease, and the End of an EmpireGalenMarcus Aurelius

The Plague of Cyprian and Christian nursing

Another epidemic sweeps the empire. Writers of the time, such as Bishop Dionysius of Alexandria, describe Christians staying to nurse the sick and bury the dead, their neighbors as well as their own, when many others fled.

The Fate of Rome: Climate, Disease, and the End of an Empire

Cosmas and Damian, physician saints

Tradition remembers the brothers Cosmas and Damian as Christian physicians in Syria who treated patients without charge and were martyred about 300. They became the patron saints of doctors and surgeons.

Sts. Cosmas and Damian: Physician Saints

Basil the Great's hospital

Basil, bishop of Caesarea in Cappadocia, builds a large charitable settlement outside the city, later called the Basileias, with places to care for the sick, the poor, travelers and people with leprosy. Historians often count it among the first Christian hospitals.

Basil the Great

The Rule of St Benedict and monastic care of the sick

Benedict of Nursia's Rule for monks says that care of the sick comes before everything else, that they are to be served as Christ himself, and that they should have their own room and attendant. Monasteries kept medical books and herb gardens for centuries.

The Rule of St BenedictBenedict of Nursia

The Plague of Justinian

Bubonic plague reaches Constantinople. The historian Procopius describes the swellings, fever and enormous death toll; Emperor Justinian himself caught the disease and recovered.

History of the Wars, Books I-II (The Persian War)The Fate of Rome: Climate, Disease, and the End of an EmpireJustinian I

Al-Razi on smallpox and measles

Abu Bakr al-Razi (Rhazes), a Persian physician who directed hospitals in Rayy and Baghdad, writes one of the earliest clear accounts telling smallpox and measles apart.

A Treatise on the Smallpox and MeaslesAbu Bakr al-Razi (Rhazes)

Al-Zahrawi's surgery

In Córdoba, Spain, the surgeon al-Zahrawi (Abulcasis) completes al-Tasrif, a medical encyclopedia whose surgical section describes and draws some 200 instruments. Translated into Latin, it was used in European medical schools for centuries.

Al-Zahrawi (Abulcasis)

Avicenna's Canon of Medicine

Ibn Sina (Avicenna) completes the Canon of Medicine, a vast, orderly textbook joining Greek medicine with his own observations. In Latin translation it was taught in European universities into the 1600s.

The Canon of Medicine, Book IAvicenna (Ibn Sina)

The Hospital of St John in Jerusalem

Pope Paschal II takes the Hospital of St John in Jerusalem, which cared for sick and poor pilgrims, under papal protection. Its brothers became the Knights Hospitaller, a religious order that ran hospitals and later also fought.

Hildegard of Bingen's medical writings

Hildegard of Bingen, a German abbess, writes Physica, on the healing uses of plants, animals and stones; a second work on the causes and cures of illness is also attributed to her.

Hildegard of Bingen

Maimonides, physician in Cairo

The Jewish rabbi and philosopher Moses Maimonides serves as a court physician in Cairo and writes medical treatises on diet, health and poisons alongside his great works of law and philosophy.

Maimonides

Ibn al-Nafis and the pulmonary circulation

The physician Ibn al-Nafis, born in Damascus and working in Cairo, writes in a commentary on Avicenna that blood passes from the right side of the heart to the left through the lungs, not through the wall between them. Europeans did not describe this until the 1500s.

Avicenna (Ibn Sina)Ibn al-Nafis

The founding of Bethlem

The priory of St Mary of Bethlehem is founded in London. By the early 1400s it was housing people with mental illness, and as Bedlam it became the most famous asylum in England.

St Dymphna and Geel

A Life of St Dymphna, patron saint of people with mental illness, is written for her shrine at Geel in Flanders. Pilgrims seeking healing came to Geel, and townspeople took them into their homes, a tradition of family care that continues today.

St. Dymphna and the Geel Colony

The Black Death

Bubonic plague kills perhaps a third or more of Europe's people. Religious orders and lay brotherhoods nursed the dying and buried the dead, and saints such as Roch and Sebastian were prayed to against plague.

Sts. Roch and Sebastian: Plague Saints

The first quarantine law

The city of Ragusa (today Dubrovnik) orders travelers from plague areas to wait 30 days before entering. Venice and others later used 40 days (quaranta giorni in Italian), which gave us the word quarantine.

A hospital for the mentally ill in Valencia

After defending a mentally ill man being mistreated in the street, the Mercedarian friar Joan Gilabert Jofré preaches for a hospital to shelter such people. Citizens of Valencia fund it, and it opens in 1410, one of the first institutions in Europe built only for people with mental illness.

Paracelsus at Basel

Paracelsus lectures at Basel, rejecting the old authorities and arguing for chemical medicines. His teaching that whether a substance is a poison depends on the dose became a founding idea of toxicology.

Paracelsus

Ambroise Paré and gentler wound care

As a young army surgeon at Turin, Ambroise Paré runs out of the boiling oil then poured into gunshot wounds and uses a soothing dressing instead; the next morning those patients were doing better. His 1545 book on wounds, written in French, spread gentler methods, and he later tied off arteries in amputations instead of searing them.

Journeys in Diverse PlacesAmbroise Paré

John of God's hospital in Granada

After his conversion, John of God opens a house for the sick and poor in Granada, Spain, and nurses them himself. His followers became the Brothers Hospitallers of St John of God, who still run hospitals around the world.

John of God

Vesalius, On the Fabric of the Human Body

Andreas Vesalius, professor at Padua, publishes his great anatomy with detailed woodcut illustrations based on his own dissections. It corrected many of Galen's errors that had come from animal anatomy.

On the Fabric of the Human Body (Preface)Andreas VesaliusGalen

Burton, The Anatomy of Melancholy

Robert Burton, an Oxford clergyman, publishes a huge book on melancholy (depression): its causes, symptoms and cures, drawn from hundreds of authors.

The Anatomy of Melancholy

Harvey and the circulation of the blood

William Harvey publishes On the Motion of the Heart and Blood, showing by experiment and measurement that the heart pumps blood around the body in a circuit.

On the Motion of the Heart and Blood in Animals (De Motu Cordis)William Harvey

Willis, The Anatomy of the Brain

Thomas Willis publishes Cerebri Anatome, a landmark study of the brain and nerves, with drawings by Christopher Wren. Willis is often called a founder of neurology.

Christopher Wren

Leeuwenhoek's tiny animals

Antonie van Leeuwenhoek, a Dutch cloth merchant who made his own microscopes, writes to the Royal Society of London describing tiny living creatures in water, among the first recorded observations of bacteria and other microbes.

Antonie van Leeuwenhoek

Sydenham, the English Hippocrates

Thomas Sydenham publishes Observationes Medicae, describing diseases from careful bedside observation. He promoted laudanum, a tincture of opium, and Peruvian bark (cinchona) for fevers.

Thomas Sydenham

Smallpox inoculation in London and Boston

Inoculation, deliberately giving a mild case of smallpox, comes to England through Lady Mary Wortley Montagu, who saw it in Constantinople, and to Boston, where Cotton Mather, who had learned of it from Onesimus, an enslaved African man in his household, persuades Dr Zabdiel Boylston to try it during an epidemic.

Wesley's Primitive Physick

John Wesley publishes Primitive Physick, an inexpensive book of home remedies for poor families who could not afford doctors. It went through many editions.

Sermons on Several Occasions and Primitive PhysickJohn Wesley

James Lind's scurvy trial

Aboard HMS Salisbury, naval surgeon James Lind gives twelve sailors with scurvy six different treatments; the two given oranges and lemons recover quickly. It is often called one of the first controlled clinical trials.

James Lind

The Pennsylvania Hospital

Benjamin Franklin and Dr Thomas Bond found the Pennsylvania Hospital in Philadelphia, often called the first hospital in the American colonies, to care for the sick poor and people with mental illness.

Autobiography and Poor Richard's AlmanackBenjamin Franklin

Yellow fever in Philadelphia

Yellow fever kills about a tenth of Philadelphia's people. Dr Benjamin Rush stays to treat patients, and Richard Allen and Absalom Jones organize members of the Free African Society to nurse the sick and bury the dead; their 1794 Narrative defends their work.

A Narrative of the Proceedings of the Black People During the Late Awful Calamity in PhiladelphiaBenjamin RushRichard AllenAbsalom Jones

Jenner's smallpox vaccine

Edward Jenner inoculates eight-year-old James Phipps with matter from a cowpox sore, then shows that the boy does not catch smallpox. His 1798 Inquiry launched vaccination, from vacca, Latin for cow.

An Inquiry into the Causes and Effects of the Variolae Vaccinae (with Further Observations and A Continuation of Facts)Edward Jenner

The York Retreat

The Quaker merchant William Tuke opens the Retreat at York, a country house where people with mental illness were treated with kindness, useful work and religious fellowship instead of chains. His grandson Samuel Tuke described it in 1813.

Description of the RetreatSamuel Tuke

Pinel's Treatise on Insanity

Philippe Pinel publishes his Treatise on Insanity, urging humane moral treatment. The famous scene of Pinel striking off patients' chains is partly legend: at the Bicêtre hospital the superintendent Jean-Baptiste Pussin removed chains in 1797, and Pinel followed at the Salpêtrière in 1800.

A Treatise on InsanityPhilippe Pinel

Morphine isolated from opium

Friedrich Sertürner, a young German pharmacist's assistant, isolates morphine from opium, the first drug compound purified from a plant. He named it after Morpheus, the Greek god of dreams.

Rush on diseases of the mind

Benjamin Rush, a signer of the Declaration of Independence, publishes Medical Inquiries and Observations upon the Diseases of the Mind, the first American textbook of psychiatry. Some of his treatments, such as bleeding, are now rejected.

Medical Inquiries and Observations upon the Diseases of the MindBenjamin Rush

Esquirol, Mental Maladies

Jean-Étienne Esquirol, Pinel's student, publishes Mental Maladies, a careful description of mental illnesses based on years of hospital work. In the same year a French law required each department to provide an asylum.

Mental MaladiesJean-Étienne EsquirolPhilippe Pinel

Dorothea Dix's memorial

Dorothea Dix presents a memorial to the Massachusetts legislature describing people with mental illness kept in cages, cellars and jails. Her campaigns helped found or enlarge more than 30 hospitals.

Dorothea Dix

Holmes on childbed fever

Oliver Wendell Holmes Sr., a Boston physician and poet, argues in The Contagiousness of Puerperal Fever that doctors themselves can carry childbed fever from one mother to another.

The Contagiousness of Puerperal Fever

Ether Day: surgery without pain

On 16 October 1846 the dentist William Morton gives ether to a patient at Massachusetts General Hospital while the surgeon John Collins Warren removes a tumor from his neck. Crawford Long had used ether in Georgia in 1842 without publishing, and in 1847 James Young Simpson introduced chloroform in Edinburgh.

Semmelweis and handwashing

At Vienna's maternity clinic, Ignaz Semmelweis has doctors and students wash their hands in a chlorinated lime solution before examining mothers, and deaths from childbed fever fall sharply. Many colleagues rejected his findings during his lifetime.

Ignaz Semmelweis

Elizabeth Blackwell, M.D.

Elizabeth Blackwell graduates from Geneva Medical College in New York, the first woman to receive a medical degree in the United States.

Elizabeth Blackwell

John Snow and the Broad Street pump

During a cholera outbreak in London's Soho, John Snow maps the deaths, traces them to the Broad Street water pump and persuades officials to remove its handle, a founding moment of epidemiology.

On the Mode of Communication of CholeraJohn Snow

Nightingale and Seacole in the Crimean War

Florence Nightingale leads nurses at the army hospital at Scutari, cleaning wards and keeping careful statistics, while Mary Seacole, a Jamaican-born healer, runs her British Hotel near the front for sick and wounded soldiers. Nightingale's Notes on Nursing (1859) and training school (1860) helped found modern nursing.

Wonderful Adventures of Mrs. Seacole in Many LandsNotes on Nursing: What It Is, and What It Is NotFlorence NightingaleMary Seacole

Pasteur and the germ theory

Louis Pasteur shows that fermentation and spoilage are caused by living microbes, not by spontaneous generation, and develops pasteurization, gentle heating to kill germs in wine and milk. In 1885 his experimental rabies vaccine saved nine-year-old Joseph Meister, who had been bitten by a rabid dog.

Germ Theory Papers (Pasteur and Lister)Louis Pasteur

The Red Cross and the first Geneva Convention

Moved by Henry Dunant's account of wounded soldiers left on the battlefield of Solferino, nations sign the first Geneva Convention, protecting the wounded and those who care for them under the sign of a red cross. Clara Barton founded the American Red Cross in 1881.

Clara Barton

Mendel's peas

Gregor Mendel, an Augustinian friar in Brno, publishes his experiments with pea plants, showing that traits are inherited in predictable ratios. Overlooked for 34 years, his work became the foundation of genetics.

Experiments in Plant Hybridisation (in Bateson's Mendel's Principles of Heredity)Gregor Mendel

Lister's antiseptic surgery

Building on Pasteur's work, Joseph Lister in Glasgow uses carbolic acid to clean wounds and dressings and publishes his antiseptic method in The Lancet. Deaths from infection on his surgical wards fell.

Germ Theory Papers (Pasteur and Lister)Joseph ListerLouis Pasteur

Charcot at the Salpêtrière

Jean-Martin Charcot's lectures at the Salpêtrière hospital in Paris describe diseases of the nervous system such as multiple sclerosis, and draw students from across Europe, including the young Sigmund Freud.

Lectures on the Diseases of the Nervous SystemJean-Martin CharcotSigmund Freud

Father Damien at Molokai

Father Damien, a Belgian priest, goes to Kalaupapa on Molokai, Hawaii, where people with leprosy were sent to live apart. He served them for 16 years, until he died of the disease himself in 1889.

Saint Damien of Molokai

Koch finds the tuberculosis germ

On 24 March 1882 Robert Koch announces in Berlin that he has found the bacterium that causes tuberculosis. With his earlier work on anthrax (1876), it showed that particular germs cause particular diseases.

Robert Koch

Johns Hopkins School of Medicine

The Johns Hopkins School of Medicine opens in Baltimore, admitting women on the same terms as men and training doctors in laboratories and on hospital wards. William Osler and William Halsted made its hospital a model for American medicine.

William Osler

Breuer and Freud, Studies on Hysteria

Josef Breuer and Sigmund Freud publish case histories of patients treated by talking through painful memories, the beginning of the talking cure.

Studies on HysteriaJosef BreuerSigmund Freud

Röntgen discovers X-rays

On 8 November 1895 Wilhelm Röntgen discovers X-rays. Within weeks doctors were using them to see broken bones and bullets inside the body.

Wilhelm Röntgen

The Curies discover radium

Marie and Pierre Curie discover polonium and radium. Radium was soon used to treat cancer, and in World War I Marie Curie organized mobile X-ray units for wounded soldiers.

Marie Curie

Kraepelin's classification

In the sixth edition of his textbook, Emil Kraepelin divides the major psychoses into dementia praecox and manic-depressive insanity, a scheme behind modern diagnosis.

Lectures on Clinical PsychiatryEmil Kraepelin

Freud, The Interpretation of Dreams

Sigmund Freud's book on dreams sets out the ideas of psychoanalysis. His theories became enormously influential and have also been sharply criticized.

The Interpretation of DreamsSigmund Freud

Walter Reed and yellow fever

In Cuba a U.S. Army commission led by Walter Reed confirms the Cuban doctor Carlos Finlay's idea that mosquitoes spread yellow fever; volunteers risked their lives in the experiments. Mosquito control later helped make the Panama Canal possible.

Walter Reed

Jacobson v. Massachusetts

The Supreme Court upholds a city's power to require smallpox vaccination during an epidemic, with a fine for refusing.

Jacobson v. Massachusetts

Bleuler, Jung and schizophrenia

At the Burghölzli hospital in Zurich, Carl Jung publishes The Psychology of Dementia Praecox (1907) and Eugen Bleuler introduces the word schizophrenia (1908), describing it fully in his 1911 book.

The Psychology of Dementia PraecoxDementia Praecox or the Group of SchizophreniasEugen BleulerCarl Gustav Jung

The Harrison Narcotics Act

A federal law requires anyone selling or prescribing opium, morphine or cocaine to register and keep records. Supreme Court cases such as Webb (1919) and Linder (1925) argued over how far it limited doctors.

Webb v. United StatesLinder v. United States

The influenza pandemic

An influenza pandemic kills tens of millions of people around the world, more than died in the fighting of World War I.

Insulin

In Toronto, Frederick Banting and Charles Best, with J. J. R. Macleod and James Collip, extract insulin. In January 1922, 14-year-old Leonard Thompson becomes the first person with diabetes treated with it.

The Internal Secretion of the PancreasFrederick Banting

Buck v. Bell and eugenics

The Supreme Court upholds a Virginia law allowing the forced sterilization of people judged unfit, part of the eugenics movement. The decision is now widely condemned, and Virginia's governor apologized in 2002.

Buck v. BellOliver Wendell Holmes Jr.

Penicillin

Alexander Fleming notices that a mold has killed bacteria on a culture plate and names its substance penicillin. In 1940–41 Howard Florey, Ernst Chain and their Oxford team purified it and treated the first patients; mass production saved many lives in World War II.

Alexander Fleming

Electroconvulsive therapy

In Rome, Ugo Cerletti and Lucio Bini give the first electroconvulsive therapy (ECT). Given today under anesthesia, ECT remains a treatment for severe depression.

Frankl, Man's Search for Meaning

Viktor Frankl, a Viennese psychiatrist who survived Auschwitz and other camps, writes about how prisoners could still find meaning in suffering. It became the best-known account of his logotherapy.

Man's Search for MeaningViktor E. Frankl

The Nuremberg Code

At the end of the Doctors' Trial of Nazi physicians, the judges set out ten principles for experiments on human beings, beginning with the voluntary consent of the person.

The Nuremberg Code (Permissible Medical Experiments)

Cade and lithium

Australian psychiatrist John Cade reports that lithium salts calmed patients with mania. After further safety work, especially by Mogens Schou in Denmark, lithium became a mainstay treatment for bipolar disorder.

Founding Papers of Psychopharmacology: Cade on Lithium (1949), Delay, Deniker and Harl on Chlorpromazine (1952), Kuhn on Imipramine (1957)John Cade

Chlorpromazine, the first antipsychotic

After the surgeon Henri Laborit notices that chlorpromazine calms patients before surgery, the psychiatrists Jean Delay and Pierre Deniker in Paris use it for psychosis. As the first antipsychotic drug it changed psychiatry and contributed to shorter stays in mental hospitals.

Founding Papers of Psychopharmacology: Cade on Lithium (1949), Delay, Deniker and Harl on Chlorpromazine (1952), Kuhn on Imipramine (1957)

The double helix

Using X-ray images made in Rosalind Franklin's laboratory, James Watson and Francis Crick propose the double-helix structure of DNA in the journal Nature on 25 April 1953.

Molecular Structure of Nucleic Acids: A Structure for Deoxyribose Nucleic AcidRosalind Franklin

The first successful kidney transplant

Joseph Murray's team in Boston transplants a kidney from Ronald Herrick into his identical twin Richard, the first long-term successful organ transplant.

The polio vaccine

On 12 April 1955 a field trial of Jonas Salk's polio vaccine, given to more than a million children, is announced as safe and effective. Albert Sabin's oral vaccine followed in the early 1960s.

Jonas Salk

The first antidepressants

Roland Kuhn in Switzerland reports in August 1957 that imipramine relieves depression, and in the same year iproniazid, first used for tuberculosis, is reported to lift mood. They began the modern antidepressant drugs.

Founding Papers of Psychopharmacology: Cade on Lithium (1949), Delay, Deniker and Harl on Chlorpromazine (1952), Kuhn on Imipramine (1957)

Librium and Valium

Chlordiazepoxide (Librium), discovered by the chemist Leo Sternbach, is approved as the first benzodiazepine; diazepam (Valium) followed in 1963.

Thalidomide and the Kefauver-Harris Amendments

After the sedative thalidomide caused severe birth defects in thousands of babies, mostly outside the United States, where FDA reviewer Frances Kelsey had refused to approve it, Congress requires drug makers to prove that new drugs work as well as that they are safe.

Robinson v. California

The Supreme Court rules that a state may not make it a crime simply to be addicted to narcotics.

Robinson v. California

The Community Mental Health Act

President Kennedy signs a law to fund local mental health centers as large state hospitals shrank. Many of the planned centers were never built.

John F. Kennedy

The first heart transplant

On 3 December 1967 Christiaan Barnard performs the first human-to-human heart transplant in Cape Town, South Africa.

Cicely Saunders and the hospice movement

Cicely Saunders, a nurse, social worker and physician moved by her Christian faith, opens St Christopher's Hospice in London, beginning the modern hospice movement for care of the dying.

Cicely Saunders

O'Connor v. Donaldson

The Supreme Court rules that a state cannot confine a person with mental illness who is not dangerous and can live safely in freedom.

O'Connor v. Donaldson

The Belmont Report

After the Tuskegee syphilis study came to light, a U.S. national commission sets out three principles for research with human subjects: respect for persons, beneficence and justice. It shaped the rules for informed consent and review boards.

The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research

Smallpox eradicated

The World Health Organization declares smallpox eradicated, the first human disease wiped out worldwide, after a global vaccination campaign. The last natural case was in Somalia in 1977.

Fluoxetine (Prozac)

The U.S. Food and Drug Administration approves fluoxetine, the first selective serotonin reuptake inhibitor (SSRI) antidepressant sold in the United States.

Cruzan and the right to refuse treatment

In Cruzan v. Director, Missouri Department of Health, the Supreme Court accepts that a competent person may refuse life-sustaining treatment, while allowing a state to require clear evidence of a patient's wishes.

Cruzan v. Director, Missouri Department of Health