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History of Medicine: Personalities

The study of the development of medical science and the role that medicine has played in society.

Ancient Healers

Asclepius, Ἀσκληπιός, was the god of healing in Ancient Greece who was later adopted by the Romans as Aesculapius. The tales about Asclepius may have first referred to a talented physician in Greece, but they developed into legends of a god who could heal all disease and raise people from the dead. His symbol became the asklepian, a physician's walking stick with an entwining snake. Numerous temples of healing dedicated to Asclepius eventually arose in the ancient cities along the Mediterranean including Epidaurus and Cos. Healing practices at these temples included dietary advice and herbal medicines, but also sacrifices to Asclepius and snake rituals.

Hippocrates, Ἱπποκράτης, (ca. 460-ca. 370) came from a family of doctors on the island of Cos. He became a famous healer in the Greek world, practicing medicine in a number of different cities, including Athens, during the Classical Age. Through his writings on medicine, Hippocrates became a leading voice in a rational approach to healing, and he took great care to observe and document symptoms. Hippocratic medicine focused on earthly causes of disease, such as diet and environment, and not religious explanations. Hippocrates believed in the humoral theory of health that was common at the time, so much of his care involved rest and diet to let nature bring the body's humors back in balance. However,  these cures tended to be the best that Greek medical knowledge of the time could provide, since other approaches tended toward dangerous procedures. The followers of Hippocrates expanded his work into the Hippocratic Corpus, including the Hippocratic Oath, which became the starting point for the development of the study of medicine.

Galen (129-200 CE) was born in the Greek Ionian city of Pergamum after it had been taken over by the Romans. He studied at several centers of medicine, including Alexandria, before becoming a doctor for gladiators in Pergamum and then Rome. Eventually, his skill led him to become the personal physician of the emperor, Marcus Aurelius, and other wealthy Romans. Galen wrote widely on a great number of topics but is most remembered today for his influence on medicine. Following a Hippocratic approach to diagnosis and cure, Galen sought to understand human anatomy in order to be able to help his patients. He could not, however, dissect human bodies because of laws against defiling them. So instead Galen relied on the observation of deep wounds, rotting corpses of criminals, and disinterred bodies. Perhaps most influential on his ideas were his dissection and vivesection of apes and pigs. Galen came to understand the function of the kidneys, the contraction of muscles, and the role of the nerves. He thought that the arteries carried both air and blood, instead of just air. Galen's theories on medicine and anatomy shaped the field of medicine for more than one thousand years. Physicians believed in his authority so much, that he can be said to have limited knowledge for that period because few people thought to question his methods or conclusions.

Medieval Physicians

Abū Bakr Muhammad ibn Zakariyā Rāzī, Rhazes, (865-932) was a Persian philosopher, alchemist, and physician who became known as Rhazes in Latin when his books became popular in Western Europe during the Middle Ages. Al-Razi became the director of the teaching hospital in Baghdad. Over 200 books have been attributed to al-Razi, though many of them have been lost. His medical works show a decidedly Hippocratic slant with a focus on careful observation and diagnosis to find the humoural causes of disease. He did, however, make several discoveries of his own. He is most famous for discerning that measles and smallpox were two different diseases to be treated differently. Al-Rhazi's famous book, al-Mansuri, was an encyclopedic review of medicine that became a standard text in the study of medicine in the Christian and Islamic worlds until after the Renaissance.

Ibn Sīnā, Avicenna, (980-1037) was known as Avicenna in Europe, but as Ibn Sīnā in his native Persia. He became the most prominent physician and philosopher of the Muslim world by an early age. He reportedly wrote 450 treatises on a wide variety of topics. More than half of these works have survived, and forty of them focus on medicine, which was his main occupation. The Canon of Medicine was by far the most important of his books and influenced doctors across the world for centuries. It remained a standard text at several French universities until 1650. Presented in five parts, the Canon is an encyclopedia of all medical knowledge that relies heavily on the humour theories of Galen and Hippocrates, as well as some Chinese and Indian influences, but does still include many original insights, such as quarantine, treatments for cancer, and the contagious aspects of tuberculosis.

Guy de Chauliac (c. 1300-1368) served as physician to several popes in Avignon, and was considered the premier surgeon of the European Middle Ages. Most of what we know of his work comes from his Chirurgia Magna from 1363. This book relates the history of medicine up to that time, revealing the continuing importance of Galen, Rhazes, and Avicenna to medical theory. It also shows that while medieval medicine continued to favor bleeding, purging, and other methods of bringing the humours in balance there was also a good understanding of the basic needs of surgery and medicine. In the book, Chauliac describes the bubonic and pneumonic plagues, as well as methods to knock out patients for surgery and to help wounds heal cleanly.

Paracelsus, Philippus Thephrastus Aureolus Bombastus von Hohenheim, (1493-1541) was born in a small mining town in Switzerland, the son of doctor. Paracelsus, as he called himself later, trained in medicine at the University of Ferrara and then traveled across Europe as an itinerant healer. Like many university-trained physicians of the period, Paracelsus practiced medieval astrology and talismanic magic, but he also was a great iconoclast who had harsh criticisms for the medicine of the time, especially its high regard for ancient writers. Paracelsus had a great interest in philosophy and hermetical knowledge which influenced his approach to the study of medicine, so that he used his experience in alchemy to develop innovative chemical theories and medicines for ailments. While Paracelsus had his own theories on the internal balance of humors, he was the first to stress the important role of external forces on the health of the body. He wrote numerous books on a variety of topics but very few of these difficult works were published in his lifetime. After his death, there would be a renewed interest in the medicine of Paracelsus because of his attacks on the old ways of thinking and the promise of his chemical therapies. Paracelsian schools of thought developed over the following years in several European countries, spurred on by the late publication of his work.

Renaissance Revolutionaries

Ambroise Paré (c. 1510–1590) trained as a barber-surgeon but could not afford the fees to join the profession. Instead, he became the house surgeon of the Hôtel-Dieu in Paris, serving three years at the charity hospital before joining the army to serve as a doctor in the field. Paré excelled as a surgeon in many ways, having a great intellect and dextrous hands. Despite the fact that he had no formal medical degree, he became the personal surgeon to the king of France in 1552 and went on to serve in that capacity for four monarchs before his death. Paré wrote numerous handbooks that advised surgeons and physicians. Most famously he argued against cauterization in favor of clean dressings after ambutation or serious wounds. He eventually would develop techniques for the ligature of arteries to help with healing.

Andreas Vesalius (1514-1564) was born into a family of imperial physicians in Brussels. After studying medicine at Louvain and Paris, Vesalius went to Padua to study for his doctorate, where he became an anatomy instructor immediately after completing his degree in 1537. The University of Padua gave him the chair of anatomy and surgery at the age of 25. He became a very vocal proponent of dissectors doing the actual work themselves and comparing what they saw to the ancient anatomies. His early works proved very popular for their detail and his willingness to criticize old theories. In 1543, Vesalius published De fabrica humani corporis in seven volumes with stunning anatomical woodcuts and a lengthy treatise in Latin. This was followed weeks later by a short publication that focused on the images, often called the Epitome. These anatomy books proved to be controversial and very popular, creating a new level of theory and publication on the subject that helped free Renaissance medicine from ancient misconceptions. They also propelled Vesalius into a new position as imperial physician.

 

Matteo Realdo Colombo (c. 1516 - 1559) took over as anatomy professor from Vesalius at Padua in 1543. Five years later he moved to Rome, where he continued to work as an anatomist. Columbo is most significant for arguing that blood, instead of air, traveled in a pulmonary circuit between the lungs and the heart. He also identified contraction as the main function of the heart. 

Georg Bartisch (1535-1607) was born and raised in Saxony, Germany, eventually working as an itinerant barber-surgeon in the region until finally settling in Dresden. He developed a reputation as a skilled eye specialist. Despite his lack of formal education, Bartisch published Ophthalmodouleia, Das ist Augendienst in 1583. Written in the vernacular, the book covers methods of eye surgery and healing; containing some of the finest woodcuts of the 16th century. Bartisch was rewarded for his work five years later when he was named the oculist of the Duke of Saxony.

Medical Reasoning

William Harvey (1578-1657) studied medicine at Cambridge before going to Padua to train under Hieronymus Fabricius, earning a doctorate in medicine there in 1602. Fabricius had described the valves in veins but not their purpose, so Harvey set about understanding the function of veins over the course of his long career as one of the top physicians in England. Already in 1616, Harvey was giving lectures on the circulation of the blood through the lungs to the arteries and back through the veins, but his findings were not complete until 1628, when  he published Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (An Anatomical Exercise on the Motion of the Heart and Blood in Animals). This argued that the heart pumped the blood around the body in a system of two closed loops.  Even though he could not see the exchange taking place in the capillaries, Harvey used several scientific arguments to show that the liver was not creating the blood of every pulse and that veins carried blood in one direction, while arterial blood went the other.  His theories still caused controversies twenty years later, and they did little to immediately change medical practice. However, the eventual acceptance of the Harvey model was a great triumph for the scientific study of medicine.

Thomas Willis (1621-1675) was a founding member of the Royal Society of London and physician to Charles I. He spent most of his career as a doctor and then professor at Oxford, where an active group of experimentalists grew up around him. His own contributions to medicine include a description of diabetes mellitus and significant work on the anatomy and functioning of the brain.

Marcello Malpighi (1628-1694) had a distinquished career as a physician and teacher in Italy. He is best known for his studies of anatomy and histology. Malpighi was the first to use a microscope systematically to investigate anatomical structures and so was able to describe the capillaries that Harvey had never been able to see. Malpighi also identified numerous structures in the kidney, skin, liver, and tongue. He made great advances in the study of embryology. His work was regularly published by the Royal Society of London, who made him a member in 1669.

Richard Lower (1631-1691) had worked as an assistant to Thomas Willis before becoming a physician in London and a member of the Royal Society. Lower's 1669 book on the heart, Tractatas de corde, discusses his successful experiments with transfusion and his studies of the changes in the blood after it has had contact with air in the lungs.

Robert Hooke (1635-1703) served as the curator of the Royal Society of London for 40 years. While studying at Oxford he had worked as a laboratory assistant to Thomas Willis and later Richard Boyle. These associations helped usher him into the circle of great scientists that developed there at the time. Hooke was a genius in his own field of mechanics, which led him to many important developments and discoveries in a variety of fields including architecture and design. He also published Micrographia. This 1665 work, in which he coined the biological term 'cell', described his many observations and helped make the microscope an important tool of medicine. The book also contains a discussion of the the similarities between combustion and respiration, in that both depend on some unseen material in air.

Observation and Investigation

William Cowper (1666-1709) apprenticed as a barber-surgeon in London and was admitted to the company in 1691. Shortly afterwards he was elected to the Royal Society for his anatomy text, Myotomia Reformata, on the muscles. In 1698, he published Anatomy of the Humane Bodies to great renown for its beautiful imagery and clear text. Later, his reputation suffered when it became known that many of the images from the book were Gérard de Lairesse plates that originally had appeared in Govard Bidloo's 1685 Anatomia Humani Corporis, even though Cowper's book made no mention of either of them.

Herman Boerhave (1668-1738) taught botany and medicine at the University of Leiden for many years. His reputation as a lecturer and bedside instructor was legendary. Boerhave helped to make Leiden a famous medical school and encouraged the appreciation of latest clinical practice among contemporary physicians.

Giovanni Battista Morgagni (1682-1771) studied at Bologna and later assisted the famous Valsalva in the anatomical theater and presumably with preparation on the book, Anatomy and Diseases of the Ear. In 1712, Morgagni was elected to the chair of theoretical medicine at the University of Padua. He continued to teach in Padua for another 55 years. While in his eighties, he published De sedibus et causis morborum per anatomen indagatis (The Seats and Causes of Diseases, Investigated by Anatomy). This large book was the first significant work analyzing the diseased body in many decades and essentially created the science of pathology.

William Cheselden (1688-1752) was apprenticed as a barber-surgeon before studying under William Cowper. Respected in London for his surgical skill, Cheselden also became a lecturer in anatomy and published Anatomy of the Human Body and later Osteographia, or the Anatomy of the Bones. He was one of the founding members of the Company of Surgeons.

Bernard Siegried Albinus (1697-1770) studied at the University of Leiden, where his teachers included his father, who had been the chair of medicine, Herman Boerhave, and Nikolaus Bidloo. Albinus went on to become the chair of medicine himself and then rector of the university. He was considered the best teacher of anatomy in Europe by the time he produced the legendary Tabulae sceleti et musculorum corporis humani (The Tables of the Skeleton and Muscles of the Human Body) in 1747. Illustrated by Jan Waandelaar, this work contains stunning images that possess a high standard of accuracy even while surrounded by whimsical embellishments such as flowers, ruins, and a rhinoceros.

Albrecht von Haller (1708-1777) wrote extensively on numerous topics including history and poetry. He earned an MD from the University of Leiden in 1727, and from the age of 27 helped to build the reputation of the new University of Göttingen as the chair of medicine, anatomy, surgery, and botany. His textbooks on medicine and anatomy would have been enough to make a significant contribution to medicine; he is the source of over two dozen anatomical eponyms and he made physiology a respected science. However, Haller also helped advance the field of botany, communicated with scientists all over Europe, edited a major scientific journal, and produced four major bibliographies on different scientific fields.

Percivall Pott (1714-1788) became one of the most fashionable surgeons in London at a time when surgery finally came into its own as a respected medical field separate from the barbers. Pott wrote a small number of works on a variety of medical topics, including a description of leg fractures and one of tuberculosis of the spine. However, Pott is most famous for connecting the work of chimney sweeps with their high incidence of cancer, the first observation of its kind.

William Hunter (1718-1783) became one of the leading obstetricians in Britain. He also established an anatomy school at his home in London where he educated the leading anatomists of his day. In 1774, he published Anatomia uteri umani gravidi (The anatomy of the human gravid uterus) following the highest standards, which helped to forward the scientific standing of obstetrics.

John Hunter (1728-1793) began his studies with his brother William in London. He then went on to study under Cheselden and Potts. Over the course of his legendary career, Hunter showed utmost precision in his work and established experimental surgery as a scientific medical field. He wrote on gunshot wounds, venereal disease, and the lymphatic system, among other topics. Hunter also created a great specimen collection which became the beginnings of the Hunterian Museum of the Royal College of Surgeons, but perhaps his greatest contribution is the technique of outpouching an artery that saved many limbs from amputation.

Antoine-Laurent Lavoisier (1743-1794) continued the work of Scheele and Priestly to isolate oxygen. In the process of doing this, Lavoisier identified what was being separated from the air and thereby overturned traditional thinking on the elements of matter. He was the first to recognized the importance of oxygen to respiration and went on to name 33 separate chemical elements, which laid the groundwork for the new science of chemistry.

Phillipe Pinel (1745-1826) had a modest career until he was appointed the director of the institution for insane men in Paris shortly after the revolution. Pinel's work with the insane turned him into a true reformer of their treatment and also set him on a course to be the first to seriously study, describe, and treat the medical conditions of the mentally ill. He helped initiate the study of modern psychiatry and many consider him the first to release asylum inmates from their chains.

Edward Jenner (1749-1823) studied surgery and anatomy under John Hunter at St. George's Hospital. He returned to Gloucestershire to become a country doctor. In his work with patients, Jenner became aware that people who had contracted cowpox seemed to be immune to the deadly smallpox virus. Jenner innoculated 23 cases with cowpox and then tested each with a smallpox variolation. Though others had noticed the connection between cowpox and smallpox before, Jenner's tests showed that his innoculation had made the recipients immune to smallpox. Variolation had never been wholly accepted because of the dangers of the deadly disease, so Jenner's 1798 paper offered a safe and effective way to protect people from the greatest killer of the age.

Antonio Scarpa (1752-1832) studied under Morgagni at Padua. He began his teaching career at Modena, but then moved to the University of Pavia in his early thirties. He would have a long career teaching surgery. Scarpa himself was a skilled illustrator and he made high demands on the artists who worked on his anatomy books. These included important works on the internal structures of the ears, the nerves of the heart, cancer, and herniae. He helped to establish the field of orthopedic surgery and was the first to describe arteriosclerosis.

Clinical Study

Charles Bell (1774-1842) studied at Edinburgh where he collaborated with his older brother, John, early on in teaching anatomy. Charles began publishing A System of Dissection Explaining the Anatomy of the Human Body before he had even finished his degree. He was elected to the Royal College of Surgeons at the age of 25 but quickly ran into conflict with the staff at the royal infirmary. In 1804, Bell left for London to establish his own private surgery and anatomy school. Over the years, his skill as a teacher and surgeon brought continuing advances to his career, including a professorship at the Royal College and a knighthood. His major contributions stem from his many detailed texts on the anataomy of the nervous system which he illustrated himself. 

René-Théophile-Hyacinthe Laënnec (1781-1826) came up with the name cirrhosis, though others had described the ailment earlier. He also identified melanoma and described how it can metastasize in the lungs. Laennec had been raised by his uncle, a professor of medicine at the University of Nantes, and during the French Revolution, Laennec went to Paris to complete his medical training under some of the greatest medical figures of the age. He showed himself to be a meticulous doctor and a prolific writer, with a special interest in the lungs. At the age of 41, he was appointed to the chair of medicine in Paris. However, his greatest achievement must be the 1819 publication of De l'Auscultation Médiate and its discussion of his invention of the stethoscope in 1816. Laennec had followed the latest developments in ausculation and percussion to determine problems in the thorax. When presented with a very fat woman during his first year as a visiting physician at the Necker Hospital, Laennec thought to listen to her heart with a rolled up tube of paper. Later, he developed a hollow wooden baton to use in his examinations and developed a deep understanding of how the sounds of the chest corresponded to specific diseases. 

Francois Magendie (1783-1855) began his study of medicine in Paris at the age of sixteen despite having almost no education before he was ten. Teachers recognized Magendie's skill early on and he was soon assisting with dissections. He earned his MD in 1808 and immediately began his long career as a teacher and researcher. Magendie showed through experimentation that the same drugs derived from different plant sources had the same physical effects, thus setting pharmacology on a modern, scientific course. He went on to make contributions to almost every field of physiology that people studied at the time, such as discovering the role of the liver in detoxification, understanding the digestive qualities of pancreatic juice, and describing anaphylaxis. He became embroiled in a long controversy with Charles Bell over who first discovered the Bell-Magendie Law which differentiates the motor and sensory nerves of the spinal cord, but Magendie clearly came up with the experimental proof of the concept.

William Beaumont (1785-1853) joined the US army as a surgical assistant during the War of 1812 and then worked as a doctor, both privately and for the army, until he was appointed to be the post surgeon at Fort Mackinac in Michigan in 1820. Two years later, Beaumont was called in to treat a young French Canadian on the island, Alexis St. Martin,  who had been hit with a shotgun blast in the side. The surgeon thought that his patient would soon die, but cleaned and bandaged the wound anyway. Surprisingly, St. Martin healed but a hole remained through the skin and stomach. After eighteen months, a fold in the stomach served to keep the hole closed enough for normal digestion but it could be opened easily with a finger. St. Martin became a handy man for Beaumont and a test subject. In 1825 Beaumont carried out the first in a series of experiments on digestion. He tested the nature of stomach acid and observed different conditions of digestion. This would be followed by later work in 1829 and 1832, each at a different one of Beaumont's posts. He concluded his work with the book, Experiments and Observations on the Gastric Juice and the Physiology of Digestion. Beaumont became famous because of his unique physiological insights and the valuable data he had collected. His work proved that American medicine could meet the same scientific standards of what was being done in Europe at the time. Beaumont moved to St. Louis in 1834, eventually going into private practice and becoming very active in the local medical community.

Pierre-Charles-Alexandre Louis (1787-1872) trained in Rheims and Paris before working as a physician in Russia. Conditions there convinced him to return to France for more study in infectious diseases. Louis was known as prodigious notetaker who followed all of the details of cases from onset to death. Eventually he wrote several famous texts on tuberculosis and yellow fever, as well as a clinical description of typhoid fever. He was most significant because of his development of numerical studies that looked at aggregate patient data to understand the course of diseases. He also had a hand in training in Paris a generation of many of the leading medical men of the United States.

Richard Bright (1789-1858) was one of the three "great men of Guy's" who worked at Guy's Hospital and Medical School in London during the period of a new dawn of modern medicine, all of them educated at Edinburgh. Bright's greatest work involved the study of diseases of the kidneys, and he developed the first investigative ward at a clinical hosptial for the study of a specific ailment.

Robert Liston (1794-1847) served as the first professor of clinical surgery at the University of London Hospital after an early career in Edinburgh. His books, Elements of Surgery and Practical Surgery were well respected. Known as a remarkably fast and confident surgeon in the days before anesthesia, Liston was the first in Europe to perform a major operation in which the patient had been anesthetized with ether in 1846, which changed the nature of surgery for following generations.

Joseph Skoda (1805-1881) developed Laennec's system of ausculation for diagnosis even further. Skoda had little faith in the medicines available at the time and focused generally on correct diagnosis. He was known to prescribe simple therapeutics that often had better results than other options of the time. A popular if pendantic teacher, Skoda was the first professor in Vienna to lecture in German, and he helped to build up the second Vienna School of Medicine into a model of specialization and modern practice.

Samuel D. Gross (1805-1884) graduated from Jefferson Medical College and then taught surgery in Philadelphia, Cincinnati, and Louisville. He became one of the founding members of the AMA and the American Surgical Association. The finest surgeon of his day, Gross is best known for his fourteen books, including System of Surgery (1959) which went through six American editions.

James Young Simpson (1811-1870) joined the Royal Medical Society of Edinburgh in 1833. He gained the chair of midwifery at the university the next year after campaigning agressively for the position. Simpson was quick to explore the reported anesthetic effects of sulfuric ether. In 1847, he reported on a clinical trial that had resulted in bronchial irritation. Seeking a better alternative, Simpson experimented with various compounds on himself until selecting chloroform for trials in the delivery room. He then became an outspoken proponent of chloroform for labor pains, which helped to make anesthesia more common in general. As the Physician in Scotland to Queen Victoria, Simpson used chloroform in the 1853 delivery of Prince Leopold.

Medical Science

John Snow (1813-1858) studied at the University of London before going into private medical practice. He learned of American experiments with ether in surgery in 1846 and mastered the technique, becoming the staff anesthesiologist at St. George's Hospital. He soon started working with chloroform and developed an apparatus for its administration. It was Snow who served as the anesthesiologist when Simpson used chloroform on Queen Victoria during her labor with her eighth child. Snow also wrote the influential book, On Chloroform and Other Anaesthetics. His fame in medicine, however, has much more to do with his work to understand cholera epidemics. As a founding member of the London Epidemiological Society during the epidemic of 1848, he fought against the miasma explanation for the spread of cholera. With the outbreak in 1854, Snow used reasoning, graphs, and maps to explain the spread through contaminated water of a contagion that he could not see. In one study he was able to trace the spread of cholera to one neighborhood pump; in a second study of 1854 he showed that a water company with cleaner water had far few deaths among its customers than another company. Snow is considered one of the pioneers in modern efforts to improve public health.

Claude Bernard (1813-1878) came to work under Magendie at the Hotel Dieu after a mediocre start as a medical student. Magendie recognized Bernard's talent as a researcher and set him to work in the labs of the College of France. Bernard earned his MD in 1843 but continued to focus on laboratory experimentation. He struggled to survive as a researcher until he became a professor of physiology in 1852. His publications covered important work on neurology and digestion. Far more important, however, was the way in which Bernard firmly established the scientific method to explain his clear hypotheses of scientific physiology. Rather than experimenting haphazardly, Bernard set about proving scientific facts with little concern for prevailing theories that might have gotten in the way. Tactics included the use of blind experiments to ensure objectivity. His 1865 An Introduction to the Study of Experimental Medicine, marked a highpoint in his career and helped to set the course of the study of physiology.

James Marion Sims (1813-1883) had a modest family background and general training at the Charleston Medical School and the Jefferson Medical College. He went on to establish a hospital for women in Alabama and in working there discovered his own skill at surgery. As a pioneer in the field of gynecology, Sims developed several important instruments and techniques, some of them through his work on slave women. His insistance on cleanliness and success with healing vesicvaginal fistulae brought him remarkable results and a respected reputation. In 1853, he moved to New York, where he established the Woman's Hospital of the State of New York and continued to write on gynecological issues. During the Civil War he went to Europe to practice and teach. He returned to his practice at the end of the war but continued to return to Europe periodically, cementing his international regard for his work.

Karl Ludwig (1816-1895) worked as a professor at the University of Marburg, then Zurich, then Vienna, until he ended up as the director of the Physological Institute in Leipzig. Ludwig made important contributions to almost every field of physiology, and he developed several important scientific instruments for his work, such as the stromuhr to measure the flow of blood. Throughout his career, Ludwig argued that the chemistry and physics of the body followed the same rules of the rest of the physical universe, not requiring any unique explanations of unseen forces. His well-received Textbook on Human Physiology (1852-56) helped to popularize this view along with the value of scientific experiementation that could get to the facts of physiology. As a teacher and lab supervisor, Ludwig influenced countless researchers, perhaps more than anyone of his generation. Certainly the list of developments that came about directly through his ideas and guidance is much longer than his publications would suggest.

Ignaz Semmelweis (1818-1865) studied medicine at the revolutionary Second Vienna School of Medicine and then became an assistant in obstretics at the school's hospital. The unit was divided into two clinics, one staffed by medical students who took part in postmortems and one by midwives who did not. Troubled by the different rates of puerperal fever in the two clinics, Semmelweis set about collecting huge amounts of data on all of their practices. He determined that medical students were somehow carrying the infection from the cadavers back to the clinic. When he brought in a regimen of hand cleaning with chlorinated lime, he proved something a few others had only suspected: that the contagion could be carried on the hands and that cleanliness helped to prevent infection. Some obstetricians adopted his practices, but almost no one accepted his claim that there was only one explanation for the spread of puerperal fever and one effective method of prevention. His angry rants on the issue did not help matters. Only after his death, when Pasteur had provided an explanation for the spread of biological contagion did Semmelweis earn the respect of the medical community.

Rudolf Virchow (1821-1902) had a respected career as an archaeologist. This was in addition to editing for fifty-six years the most important medical journal in Germany, starting a political party, serving in the imperial diet, teaching pathology to several generations of important scientists and physicians, organizing anthropological societies and museums, instituting a new theoretical model for disease, publishing numerous volumes of his own significant research, and helping to make Germany the leader in medical science during his own lifetime. Virchow's 1858 Cellular Pathology built on the ideas of earlier scientists to create a model of biology that transformed the field by making cells the basic component of tissues and organs, with cells producing other cells and cell structure being at the center of disease. He encouraged researchers to think microscopically and understand development and disease through what was going on in the mechanics and of the cells. In his own work, he made important findings on the subjects of leukemi, spina bifida, neuroglia, and embolism. A vocal critic and great believer in the need for experimental proof of scientific theories, Virchow opposed antisepsis and was slow to accept Koch's work on toxins.

Louis Pasteur (1822-1895) made his career as a brilliant chemist before developing some of the most important underlying theories in modern medicine. His successful studies of fermentation and spoilage led to the technique of killing germs in organic liquid by boiling and also helped to support the notion that life was created from life, though sometimes microscopic, and could not generate spontaneously from nothing. Over the course of his research, he began to argue that diseases were caused by microorganisms similiar to those that caused spoilage. These germs could be spread through the air or through contact. Germ theory became the basis for contemporary arguments for antiseptic or aseptic environments in medicine that helped to save so many. Pasteur built on his knowledge of the behavior of germs to then develop vaccination techniques that weakened deadly organisms before reintroducing them to the body. This greatly improved the understanding of Jenner's ideas and helped Pasteur develop ways to prevent anthrax and rabies, leading the way for the amazing victories over communicable diseases that would come in the 20th century.

Henry Gray (1827-1861) was trained in London and elected a Fellow of the Royal Society at the age of twenty-five. He published his Anatomy in 1858 with the help of his friend the illustrator, Henry Vandyke Carter, a demonstrator at St. George's Hospital, where Gray became a lecturer. New editions Gray's Anatomy soon followed, but Henry Gray was dead by 1861 and did not see the full extent of what would be become one of the most popular medical texts.

Joseph Lister (1827-1912) was present at the first operation performed in England using ether in 1846 while a student at University College London. Upon completing his medical training, he went to Edinburgh to work under James Syme. Lister became a surgeon and professor while pursuing a number of microscopal investigations. In 1860, he took the job of professor of surgery at Glasgow and then a joint appointment as head of surgery at the Royal Infirmary and continued his research in inflammation. Intrigued by Pasteur's work, Lister saw the similarity between the broken atmospheric seal that allowed organisms in to contaminate organic fluids and the compound fractures that were so deadly to his patients; he became convinced that living germs in the air caused sepsis. And so, Lister sought to keep contaminated air from touching open wounds and to kill the germs that might already be there. He experimented with the use of carbolic acid which was then used to deodorize sewers. Other surgeons discussed the benefits of cleanliness at the time, but slowly Lister was able to convince them of the benefits of killing any organisms that might be in contact with wounds through the air or surgical instruments. 

Theodor Billroth (1829-1894) taught in Zurich where he founded the journal for clinical surgery and completed his influential textbook Die Allgemeine Chirurgische Pathologie und Therapie (General Surgical Pathology and Therapy). Billroth became professor of surgery at the University of Vienna in 1867. Though he was slow to accept the new thinking on antisepsis, his surgical innovations developed the total laryngectomy and gastrectomy. He trained a generation of influential surgeons in Central Europe and helped shape modern surgical thinking which included publication of all cases, both successful and unsuccessful.

Adam Politzer (1835-1920) was born near Budapest. He went to Vienna to study medicine under legendary teachers such as Skoda, Oppolzer, and Ludwig. After earning his doctorate in surgery and medicine in 1859, Politzer toured Europe to train further in the anatomy and physiology of the ear at the best clinics available. He took a position in otology at Vienna in 1861 and two years later put together the first private clinic in the world devoted to ear disorders. He would later become a director of the Aural Clinic at the University of Vienna's General Hospital. Politzer's medical innovations had already made him famous by the time he built up a reputation as a world-renowned lecturer who helped to cement Vienna's reputation as a leading medical center and to create the modern science of otology. He was also one of the founders of the leading journal of the field, Archiv für Ohrenheilkunde, and produced the first atlas of the tympanic membrane. His 1878 textbook on the diseases of the ear remained popular for decades and went through numerous editions.

Robert Koch (1843-1910) developed many of the tools and methods of bacteriology through the course of his work to understand public health. He had held a variety of medical positions before taking on the task of microscopically researching anthrax as part of his work as a physician in Wollstein. In 1876, Koch succeeded in describing the full life cycle of the bacillus, including the spore stage, and even reproducing the disease in laboratory animals and proposing measures to prevent future outbreaks. He discovered ways to photograph bacteria soon afterwards and argued strongly that unique species of microorganisms caused specific diseases. From 1880 to 1885, Koch worked at a small lab at the Imperial Health Office in Berlin with a few colleagues studying effective methodologies for bacteriology and establishing Koch as the leading voice of medicine for his generation. The team discovered that steam worked effectively to disinfect surgical tools and that tuberculosis was an infectious disease. After becoming head of the new institute for hygiene at Berlin University in 1885, Koch spent years working on cures for the diseases he had identified, moving to the Institute for Infectious Diseases in 1891.

William Osler (1849-1919) excelled as a bedside and laboratory teacher early in his career at McGill. He then accepted a position at the new Johns Hopkins School of Medicine and wrote numerous influential studies there, as well as a popular medical texbook. At Hopkins, Osler pushed for a residency system that allowed senior students to learn by doing - working as doctors under supervision. As he grew older, Osler continued to be active as a teacher and author but he also began to develop his interest in book collecting, amassing an impressive medical library and writing works on the history of medicine. This became a major focus of his efforts after he became Regius professor of medicine at Oxford in 1905, though he still remained very active in the field of medicine, managing to complete 1,628 publications before his death. Osler clubs honoring his professionalism and humanity have continued to keep his memory alive in the medical community to this day.

Ivan Pavlov (1849-1936) came from Central Russia to start studying science in St. Petersburg at the age of 21. He went on to earn a doctorate in medicine and become a professor of pharmacology there. Years later, while investigating salivation he noticed that the laboratory dogs began to salivate solely in response to noises he was using to test the effects of different conditions on digestion. This led to a new series of experiments on stimuli and reaction. Pavlov's description of the conditioned reflex earned him a Nobel Prize and great respect from the scientific world. He was one of the few Russian scientists who continued to have a long career into the Soviet era.

William Welch (1850-1934) came from a Connecticut family of physicians and had an adequate medical training when he decided to pursue a career in medical science. So, he went to Germany as a young man to train in the best laboratories available. Back in New York, Welch set up the first laboratory course available at an American medical school. More study in Germany convinced him of the importance of germ theory and the need for top-quality scientific education for medical students, which he promoted in his new position as the pathology professor and, soon thereafter, dean at the newly founded Johns Hopkins School of Medicine. In 1901, Welch became president of the board of scientific advisors to the Rockefeller Institute. As both the educator at Hopkins and as an intellectual on the national stage, he worked tirelessly to promote the improvement of medical education, the advancement of science, and the protection of the public health.

Walter Reed (1851-1902) enrolled in the University of Virginia shortly after the end of the Civil War, managing to earn an MD when he was 17. In 1875, he became a medical officer for the army. He worked at various bases around the country, studying physiology at Johns Hopkins during two stints in Baltimore. Reed eventually became a professor at the US Army medical school in Washington DC while also working as a curator at the medical museum. As part of his duties, he was given the task of investigating diseases, eventually heading a commission on typhoid. Reed joined a commission in 1900 that went to Cuba as part of the army's efforts to control Yellow Fever there after the Spanish-American War. His tests on human subjects helped to prove that mosquitoes carried the disease even though no related organism could be seen with the microscopes of the day.

Paul Ehrlich (1854-1915) gained expertise in research chemistry early in his career as a medical student. After earning the MD at the University of Leipzig in 1878, Ehrlich went to work as an assistant to Professor Frerichs in Berlin, where he continued his experiments in dyes and the staining of tissues. In 1890, Koch appointed Ehrlich to the Institute for Infectious Diseases to work on immunology; his work was essential to the development of a diphtheria serum by von Behring, and it also led to Ehrlich's side-chain notion that the body could develop antibodies to specific toxins. He became the director of the Royal Institute of Experimental Therapy in Frankfurt in 1899. His work there continued in a trend that it had developed in his dye experiments in medical school, that compounds could be directed at specific cells, only now he sought a "magic bullet" to kill selected organisms. His greatest successes came with a treatment for sleeping sickness and then the development of Salvarsan and Neosalvarsan which were both effective against human syphilis. In 1908, he shared the Nobel Prize in Medicine with Mechnilkov for his work in immunity.

Subject Guide

20th Century Medicine

Karl Landsteiner (1868-1943) earned a medical degree from the University of Vienna in 1891. Already a published scientist by this time, he spent the next five years studying chemistry at the top laboratories in Switzerland and Germany. Landsteiner then returned to Vienna to begin research in the nature of immunity, which resulted in dozens of significant papers and collaboration with some of the top scientists of Europe over the next twenty years. Injecting monkeys with material from the spinal cords of polio victims, he showed that the disease was contagious. His most important work of the period, however, rested on his research into the immunological responses to transfusion. This work led him to understand the differences between blood types and to his classificaton of the A, B, AB, and O human blood groups. A lack of funding for medical research in Austria after the Great War forced Landsteiner to move to the Hague for three years, where he published further work on blood proteins. In 1922, he went to work for the Rockefeller Institute for Medical Research in New York where he continued to do important research on blood chemistry for another twenty years. Landsteiner was awarded the Nobel Prize in 1930.

Jonas Salk

Washington University

Evarts Graham

WU Nobel Prizes*

* Many more Nobel recipients have spent portions of their careers at Washington University.

1944: Joseph Erlanger (1874-1965) & Herbert Gasser (1888-1963)

1947: Carl F. Cori (1896-1984) & Gerty T. Cori (1896-1957)

1959: Arthur Kornberg & Severo Ochoa [Faculty of Medicine 1940-1942]

1986: Stanley Cohen &  Rita Levi-Montalcini