Every theory, invention, and breakthrough discovery had an origin, some from very modest beginnings which paved the way to how modern medicine is practiced today.
The following cases are those of extraordinary discoveries. Some are due to brilliant concepts that are impossible to envision. Others are due to mistakes but nonetheless forever changed the future of medicine.
In medieval Europe, surgery was practiced primarily by barbers (as opposed to surgeons) because surgery was viewed more as a craft than a profession at that time. Barbers carried out the “treatment” of bloodletting (bleeding people) as well as tooth extractions, amputations, enemas, selling medicines, and, of course, a shave and haircut, if desired. In fact, the red-and-white pole that still symbolizes a barbershop also symbolized the white napkins and blood-soaked bandages.
What is so intriguing about the barbers during this time is that they were the first to look inside a human, which paved the way for professional surgeons. The two professions were eventually merged in 1540 by Henry VIII as the United Barber-Surgeons Company.
In time, surgery established itself as a profession, eventually causing King George II to separate the two fields in 1745 by establishing the London College of Surgeons. At that point, a university education was required to perform future operations.
In 1647, English physician Dr. Thomas Willis was the first in modern medical literature to discover that the urine of those who suffered from diabetes tasted sweet, comparing the flavor to that of honey. Yes, you read that correctly. Willis tasted the urine of his diabetic patients.
In fact, Willis described the flavor as “wonderfully sweet as if it were imbued with honey or sugar.” Although such a discovery is off-putting and disgusting to most, it broke down barriers to the understanding of diabetes. Ultimately, it led to the term “mellitus” as in “diabetes mellitus,” a Latin word for “honey” which Willis coined.
A medical chemist of the school of Paracelsus, Willis wrote many books during this time, his last being Rational Therapeutics. His description of the sweet taste of urine in diabetic patients is highly detailed in Section IV, Chapter 3 of the book. Willis was also the first to notice an association between depression and diabetes, an observation that was only rediscovered three centuries later.
Leopold von Auenbrugger
Austrian physician Leopold von Auenbrugger discovered the method of percussion in 1754 during his first years of working in a hospital. Percussion is a method in which the physician taps parts of the body with his fingers to detect the presence of fluid, such as pneumonia in a patient’s lungs. Auenbrugger, the son of an innkeeper who had observed his father tapping on barrels of wine to determine how full they were, created a new method in physical examination and medical diagnosis.
He practiced his theory on cadavers by injecting fluid into the pleural cavity to demonstrate the significance of percussion. In this way, he could determine where the fluid was and what medical efforts should be made for its removal.
Auenbrugger compared the sound of a healthy lung to that of a drum with heavy cloth over it, echoing a hollow sound when tapped. When the lung would fill with fluid, the echo would dissipate, leaving a sound similar to that of the fleshy, hollow part of the thigh.
Auenbrugger’s observations were published in what is now considered to be a medical classic, Inventum Novum. It forever changed the way that examinations would be conducted and remains the cornerstone of a physical exam to this day.
The circulation of blood—as well as the varying pressures—has been studied for centuries, with a broader understanding occurring in 1615 by Dr. William Harvey. In 1628, Dr. Harvey published Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (“On the Movement of the Heart and Blood in Animals”), which was the foundation for work on the circulatory system.
Over 100 years later in 1733, Reverend Stephen Hales recorded the first blood pressure measurement after developing a further understanding of the correlation between the heart and pulse and how it applies to blood pressure and volume. This new knowledge allowed for the invention of the first sphygmomanometer (blood pressure monitor) in 1881 by Samuel Siegfried Karl Ritter von Basch.
However, it wasn’t until 1905 that Dr. Nikolai Korotkoff discovered the difference between systolic and diastolic blood pressures, thus further improving the sphygmomanometer by using a cuff that could be placed around the arm to provide equal pressure to the limb. Korotkoff discovered the varying sounds within the arteries as pressure was applied and released, and this remains the standard of blood pressure measurement to this day.
Rene Theophile Hyacinthe Laennec
French physician Rene Theophile Hyacinthe Laennec, having invented the stethoscope in 1816, is considered the father of clinical auscultation. That year, Laennec had observed two children playing in a courtyard, sending signals to one another using a long piece of solid wood and a pin.
Laennec noted that the children would receive an amplified sound while holding their ears to one end of the wood while scratching the other side with a pin. He later recalled this observation during a physical examination in which he desperately wanted to listen to his patient’s lungs and heartbeat.
Laennec spent the next three years perfecting his design. Ultimately, he created a hollow tube of wood that was the forerunner of the modern-day stethoscope. With his invention, Laennec observed the various sounds of the heart and lungs, ultimately forming various diagnoses based on his observations, which were supported by autopsy findings. As a result, he was the first to write descriptions of cirrhosis, bronchiectasis, and other pulmonary conditions, eventually publishing his work in De L’auscultation Mediate (“On Mediate Auscultation”).
At the University of Vienna, Austrian biologist and physician Dr. Karl Landsteiner took an interest in why some blood transfusions were successful while others proved to be fatal. In 1900, this led to a discovery in which he classified blood into three separate groups: A, B and C. However, C would later become known as O, thus establishing the ABO blood group.
He discovered the different varieties of blood by mixing the red cells and serum from each of his staff and then demonstrating how some of the serum from different individuals agglutinated (stuck together) to the red cells of others. This research led to the publication of his 17th scientific paper in 1901 which broke down the different variations of blood types, thus outlining the importance of individual blood typing.
In 1930, Landsteiner received the Nobel Prize in physiology and medicine, although that would not be the end of his research and discoveries. Ten years later, Landsteiner and Alexander Wiener, an American colleague, discovered Rh, another blood group.
Landsteiner’s research was of paramount importance to the field of medicine. Given that not all blood types are compatible, his discoveries are still in use today and forever will be. For blood transfusions, transplantations, pregnant women, and any form of blood loss, blood typing is essential in preventing incompatibilities which could lead to agglutination, blood clumping, strokes, and death.
Dr. Joseph Bell was a unique medical scholar and surgeon who was obsessed with the power of observation, which he stressed was vital to physical examinations and diagnosis. Bell believed that close observation of an individual could reveal much about the patient before he even spoke a word, thus leading to an accurate diagnosis.
Prior to this, diagnoses were based simply on the symptoms. Bell, who lectured at the medical university in Edinburgh, Scotland, stressed the importance of looking past the obvious and focusing on the once minuscule. Examples of such observations would be sailors’ tattoos (which could tell you where they had traveled), a patient’s hand (which could reveal his profession), and the look of a patient’s face (which could show if he was a drinker among other things).
Bell often tested his students’ concentration to highlight the subtle signs that they had overlooked. On one occasion, he introduced a liquid compound that had a terrible taste to it. He dipped a finger into the solution, licked his finger, and then told his students to do the same.
They complied and were disgusted by the taste. Moments later, they found out that Bell had dipped the wrong finger and licked another, an observation that his students had missed. Bell had a reputation for never being wrong on a single diagnosis. In time, he became a legend at the university.
Bell’s skill was soon sought by detectives who needed his help with criminal investigations. He assisted police with investigating numerous crime scenes, describing the victims and even attempting to create profiles of the culprits. In 1888, he worked on the Jack the Ripper case.
Bell was the model for the Arthur Conan Doyle character Sherlock Holmes. Bell’s powers of observation led to the development of forensic science, forever leaving an imprint on medical and criminal investigations.
In the early 1900s, German chemist Paul Ehrlich focused his attention on immunology as well as combating infectious diseases through the use of drugs. In fact, Ehrlich coined the term “chemotherapy” in what he described as a process of treating diseases with chemicals.
During this time, Ehrlich tested his chemicals on animal models and was the first person to show the potential effect that drugs could have. In 1908, Ehrlich used arsenicals to treat syphilis in a live rabbit, which he cured. In time, he turned his interest to the cure of cancer, ultimately using the first alkylating agents and aniline dyes that proved to be effective.
His pioneering research and the therapies that he discovered—such as using chemicals that combated not only diseases but tumors as well—led to groundbreaking contributions that gave birth to chemotherapy. Prior to this, cancer was treated solely with radiation, surgery, or both. Ehrlich went on to receive the Nobel Prize for his work in immunology, and he will be forever known as the founder of chemotherapy.
On September 3, 1928, Alexander Fleming, a professor of bacteriology at St. Mary’s Hospital in London, was returning from holiday when he noticed something unusual in one of his petri dishes containing the bacteria Staphylococcus. Aside from the dotted colonies containing the bacteria, Fleming observed one clear region in the dish that was free of the Staphylococcus.
This region surrounded an area in the dish where mold had grown, as if the mold had secreted something that inhibited the bacterial growth. This accidental discovery was the dawn of the antibiotic age. Fleming went on to publish his findings in the British Journal of Experimental Pathology in June 1929, keeping the interest in penicillin going with bacteriologists around the world.
It wasn’t until World War II that two scientists from Oxford University enhanced Fleming’s findings. Ernst Chain and Howard Florey began working with penicillin and, in time, produced a powder that kept its antibacterial strength for an extended time as opposed to becoming ineffective in a matter of days.
Mass production of penicillin began, ultimately saving millions of people in the battlefields who would have otherwise succumbed to bacterial infections. Fleming, Chain, and Florey were awarded the 1945 Nobel Prize in physiology and medicine for their outstanding and lifesaving discovery, which gave rise to countless more antibiotics.
Born in Warsaw, Poland, in 1867, Marie Curie had an innate thirst for knowledge, reading and studying whatever she could get her hands on from an early age. Curie moved to Paris in 1891, enrolling at Sorbonne University where she studied physics and mathematics.
There, she met her future husband, Pierre, and the two wed four years later. They went on to investigate radioactivity together, which led to their discovery of polonium in July 1898. Later that year, they discovered yet another new chemical element: radium.
Their research and discoveries paved the way for the development of X-rays. In fact, during World War I, Marie was the head of the radiological service for the Red Cross, teaching medical orderlies and physicians the new techniques of X-rays. She also equipped ambulances with the machines, which she drove to the front lines herself.
Marie and Pierre were awarded the Nobel Prize in 1903, and Marie received a second Nobel Prize in 1911 for her research in chemistry. Her exposure to high-energy radiation during her years of research led to the deterioration of her health, and she succumbed to leukemia on July 4, 1934.