The night-walkers of Uganda

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Milestones that showed the way to 
modern medicine
Sarah Boseley, health editor
January 5, 2007
Fifteen of the most important milestones in 
modern medicine have been identified today 
by the British Medical Journal. They range 
from vaccines to computers to the pill - and 
the journal is calling for readers to vote on 
which was the most significant. The 15 have 
been chosen from more than 100 nominated 
discoveries since the BMJ began in 1840. 
1. Anaesthesia 
Revolutionised surgery. By the end of the 
19th century, anaesthesia had become a 
symbol for the humanitarian movement. 
2. Antibiotics 
The first ‘wonder drugs’. Alexander Fleming 
reported on penicillin’s potential to kill 
bacteria in 1929. During the second world 
war, cheap mass production in the US 
allowed soldiers to be protected from wound 
infections but also sexually transmitted 
diseases. Antibiotics changed healthcare. 
3. Chlorpromazine 
Breakthrough drug for schizophrenia, which 
helped close the asylums. Pierre Deniker, 
who ran the first trial on psychotic patients,
published in 1952, wrote that conditions 
improved and contact with patients was re-
established. 
4. Computers 
Computers have allowed decoding of the 
genome and permitted doctors to see the 
body and its functions in three dimensions. 
Computers could help us achieve good 
health, whoever or wherever we are. 
5. DNA 
Newborn babies are now tested for genetic 
diseases and all patients for surgery have 
their blood group analysed, after the 
discovery of the structure of DNA by Watson 
and Crick in the 1950s. 
6. Evidence-based medicine 
Evidence-based medicine was described 
in 1991. It recognises that pulling together 
all the information on a topic leads to more 
valid results than a single study and that bias 
exists in many clinical trials. 
7. Germ theory 
In Vienna in 1847 Ignaz Semmelweis 
realised that germs on the hands of doctors 
could transmit lethal infections to women 
while they were giving birth. This led to the 
accepted germ theory of disease. At the end 
of the 19th century, infection caused 30% 
of deaths. By the end of the 20th century it 
caused less than 4%. 
8. Imaging 
Wilhelm Roentgen won the first Nobel prize 
for physics in 1901 for discovering X-rays. 
X-rays became very important for diagnosis 
and soon became therapeutic tools as well. 
9. Magic bullets 
Magic bullets are antibodies which the 
immune system will not reject. Their 
discovery has led to dramatic new 
treatments for disease. They have helped 
reduce organ transplant rejection and 
rheumatoid arthritis. These “magic bullets” 
can also treat cancer. 
10. Oral rehydration 
Children in poor countries have episodes of 
diarrhoea about three times a year. Simple, 
cheap and easily prepared oral rehydration 
therapy, which combines salt and sugar with 
clean water, saves millions of lives. 
11. The pill 
The oral contraceptive brought about a 
social as well as a medical revolution. It had 
huge benefits for women. It was the first