Until the 1840’s, when anaesthetics were invented, a surgical operation was a horrendous experience. The operating theatre was situated as far as possible from the rest of the hospital so that patients would not hear the screams…The use of ether as an anaesthetic put an end to this and permitted more effective surgical techniques to evolve.

Until the early 1800’s, medicine was still governed by the theory of good and bad ‘humours’, which originated in Ancient Greece. These four fluids supposedly present in the human body, and listed as blood, phlegm, choler and black bile, were thought to determine both the physical and the psychological profile of an individual: sanguine, phlegmatic, choleric or melancholy. Illness was explained by an excess of a particular humour and treatment consisted mainly in bleeding with leeches or purging with powerful laxatives… Moving from this to the realization that germs caused disease was evidently a great turning-point in medicine.

Joseph Lister, a British surgeon, pioneered the use of antiseptic surgery in the 1860’s. Strict rules of hygiene were observed for the first time. Surgical clothes were used in the theatre and dressings were soaked in carbolic acid to make them sterile. Death rates from operations fell drastically as a result of these improvements. Much later, in 1928, the discovery of penicillin by Alexander Fleming [Nobel Prize, 1945] complemented Lister’s innovations and gave doctors a powerful new weapon against infection.

Already, at the end of the eighteenth century, Edward Jenner had administered the first vaccine against smallpox, thus bringing into use one of the most important principles of modern medicine and laying the foundations of the science of immunology. Around the same time Marie and Pierre Curie discovered radium, which was to prove invaluable in the treatment of cancer. Another great step forward was the invention of the X-ray by Wilhelm Roentgen in 1895. This was the first stage in the process, which was to lead to modern imaging techniques such as ultra-sound, CAT scans and MRIs, so crucial to modern diagnosis.

Organ transplant surgery became possible as X-ray techniques grew in sophistication. The first successful kidney transplant was carried out in 1950 and is now a routine operation. The South African surgeon Christian Barnard became a worldwide celebrity when he performed the first heart transplant in 1967.

Many medical experts consider the discovery of DNA [Deoxyribonucleic acid] as the single most important discovery of the twentieth century. The genetic code, sometimes called the building blocks of life, was first demonstrated by James Watson and Francis Crick of Cambridge University in 1953. An understanding of the part played by the genes in the development of disease is just now beginning to revolutionise medicine. Future developments in this field are thought to be full of promise.

What does the future hold? Some of the techniques being experimented upon today are extremely controversial, such as the production of stem-cells from human embryos to treat such diseases as Alzheimer’s. What we need now is for the ethics of medicine to keep up with the remarkable technical progress it has made over the last two centuries.