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The Greatest Medical Advance
Sanitation gets top vote in medical advances from
readers of the Journal BMJ
By Miranda Hitti
WebMD
Medical News |
Sanitation is the greatest medical
advance since 1840, according to voters in a poll on
the medical journal BMJ's web site.
The runners-up: antibiotics and
anesthesia, says BMJ (formerly the British Medical
Journal).
Last year, BMJ invited readers to
submit nominations for the top medical breakthrough
since 1840, the year the journal was launched.
BMJ then posted 15 nominations
and invited people to vote on its web site between
Jan. 5 and Jan. 14, 2007.
Votes poured in from more than 11,000
people (mainly doctors) in countries including
Australia, Bulgaria, Canada, Germany, India, Italy,
Spain, U.K., and the U.S.
Here, in order, are
the results:
1. Sanitation: 1,795 votes.
The importance of clean drinking water and waste
disposal was recognized in the late 1800s, as
diseases began to be linked to impure water.
However, the World Health Organization says there is
still a long way to go. More than 1.1 billion people
now lack access to drinking water from an improved
source; 2.6 billion do not have basic sanitation.
2. Antibiotics: 1,642 votes.
Alexander Fleming, a British bacteriologist,
discovered penicillin in 1928 by accident when he
sloppily left a Petri dish of bacteria unwashed in
his lab. He found a substance (later named
penicillin) growing on it that killed the bugs, and
modern-day antibiotics got its start. Fleming shared
the Nobel Prize in 1945 for the discovery.
3. Anesthesia: 1,574 votes. In
1846, a Boston dentist used ether during surgery,
putting an end to much of the pain of operations.
Since then, general anesthesia has become a
mainstay.
4. Vaccines: 1,337 votes.
Vaccines have helped prevent a variety of diseases
-- including polio, whooping cough, and measles. The
first was Edward Jenner's smallpox vaccine, in 1796.
5. Discovery of DNA structure:
1,000 votes. Scientists James Watson and Francis
Crick presented the structure of the DNA helix, the
molecule responsible for carrying genetic
information from one generation to the next, in
1953. It earned them the Nobel Prize in 1962.
6. Germ theory: 843 votes. In
the late 1800s, Louis Pasteur was the first to
suggest that disease is caused by exposure to
microorganisms. Others furthered the theory, showing
that specific diseases are caused by specific
"bugs."
7. Oral contraceptive pill:
842 votes. The pill arrived on the U.S. market in
1960. For women who use it correctly, oral
contraception can be up to 99% effective at
preventing pregnancy.
8. Evidence-based medicine:
636 votes. As the name suggests, evidence-based
medicine involves making use of the current best
evidence (such as research), combined with a
patient's values and a doctor's clinical experience,
to make decisions about patient care. The term was
coined in the early '90s and the concept has been
evolving ever since.
9. Medical imaging: 471 votes.
The X-ray was accidentally discovered in 1895. Since
then, the field has expanded, giving us computed
tomography (CT scans), positron emission (PET
scans), magnetic resonance imaging (MRIs), and
ultrasound.
10. Computers: 405 votes. From
medical records to insurance, to making sure your
new medication isn't going to clash with an existing
one, computers are now considered as important as
their stethoscopes by some doctors. They've been in
use in medicine since the early 1960s. Doctors can
access information on new drugs and interactions,
new medical studies, and clinical trials, and keep
patient records stored at their fingertips.
11. Oral rehydration therapy:
308 votes. This therapy involves giving fluids by
mouth to replace losses by the body. It was first
reported in 1964; now it's a mainstay of treatment
in patients with cholera, acute diarrhea, and other
conditions.
12. Risks of smoking: 183
votes. The first report of the connection between
smoking and lung cancer was published in BMJ in
1950. Even so, tobacco use still kills an estimated
440,000 Americans each year.
13. Immunology: 182 votes. The
history of immunology is traced to 1798, when Edward
Jenner found that people could be immunized against
the disease smallpox. Numerous other immunology
discoveries followed, leading to a greater
understanding of such things as allergies and
antibodies.
14. Chlorpromazine: 73 votes.
Discovered in 1952, chlorpromazine (Thorazine) was
the first antipsychotic medication. It was used to
treat psychotic disorders and their symptoms, such
as hallucinations, hostility, and delusions. Its
development brought new understanding of the
biological basis for mental illness, and some say it
provided more humane management.
15. Tissue culture: 50 votes.
Tissue culture (keeping tissue alive and growing it
in a culture medium for research or other purposes)
was "discovered" in 1907; but it took until the
1950s for it to become an important tool for
clinical investigation.
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