3000 bc Dawn of Sumerian, Egyptian, and Minoan cultures—drains, flush toilets
2000 Indus Valley—urban society with sanitation facilities
1700 The Code of Hammurabi—rules governing medical practice
2000 Indus Valley—urban society with sanitation facilities
1500 Mosaic Law—personal, food, and camp hygiene, segregating lepers, overridingduty of saving of life (Pikuah Nefesh)
as religious imperatives
400 Greece—personal hygiene, fitness, nutrition, sanitation, municipal doctors,occupational health; Hippocrates—clinical
and epidemic observation and environmental health
500 bc to ad 500 Rome—aqueducts, baths, sanitation, municipal planning, and sanitation services, public baths,
municipal doctors, military, and occupational health ad 170 Galen—physiology, anatomy, humors dominated
western medicine until ad 1500
500–1000 Europe—destruction of Roman society and the rise of Christianity; sickness as punishment for sin, mortification
of the flesh, prayer, fasting, and faith as therapy; poor nutrition and hygiene, pandemics; antiscience; care of the
sick as religious duty
700–1200 Islam—preservation of ancient health knowledge, schools of medicine, Arab–Jewish medical advances (Ibn
Sinna and Maimonides)
1000_ Universities and hospitals in Middle East and Europe
1000_ Rise of cities, trade, and commerce, craft guilds, municipal hospitals
1096–1272 Crusades—contact with Arabic medicine, hospital orders of knights, leprosy
1268 Roger Bacon publishes treatise on use of eyeglasses to improve vision
1348 Venice—Board of health and quarantine established
1348–1350 Black Death—origins in Asia, spread by armies of Genghis Khan, world pandemic kills 60 million in fourteenth
century, 1/3 to 1/2 of the population of Europe
1300 Pandemics—bubonic plague, smallpox, leprosy, diphtheria, typhoid, measles, influenza, tuberculosis, anthrax,
trachoma, scabies, and others until eighteenth century
1400–1600 Renaissance and enlightenment, decline of feudalism, rise of urban middle class, trade, commerce,
exploration, new technology, arts, science, anatomy, microscopy, physiology, surgery, clinical medicine,
hospitals (religious, municipal, voluntary)
1518 Royal College of Physicians founded in London
1532 Bills of Mortality published
1546 Girolamo Fracastorus publishes De Contagione—the germ theory
1562–1601 Elizabethan Poor Laws—responsibility for the poor on local government
1628 William Harvey publishes findings on circulation of the blood
1629 London Bills of Mortality specify causes of death
1639 Massachusetts law requires recording of births and deaths
1660s Leyden University strengthens anatomical education
1661 John Graunt founds medical statistics
1661 Rene Descartes publishes first treatise on physiology
1662 Royal Society of London founded by Francis Bacon
1665 Great Plague of London
1673 Antony van Leeuwenhoek—microscope, observes sperm and bacteria
1667 Pandemics of smallpox in London; pandemic of malaria in Europe
1687 William Petty publishes Essays in Political Arithmetic
1700 Bernardino Rammazzini publishes compendium of occupational diseases
1701 London—75% of newborns die before fifth birthday
1701 Variolation against smallpox practiced in Constantinople, isolation practiced in Massachusetts
1710 English Quarantine Act
1720_ London—voluntary teaching in hospitals; Guy’s, Westminster
1730_ Science and scientific medicine; Rights of Man, encyclopedias, agricultural and industrial revolutions, population
growth—high birth rates, falling death rates
1733 Obstetrical forceps invented
1733 Stephen Hales measures blood pressure
1747 James Lind—case control study of scurvy in sailors
1750_ British naval hospitals established
1750_ John Hunter establishes modern surgical practice and teaching
1752 William Smellie publishes textbook of midwifery
1762 Jean Jacques Rousseau publishes Social Contract
1775 Percival Pott investigates scrotal cancer in chimney sweeps
1777 John Howard promotes prison and hospital reform in England
1779 Johann Frank promotes Medical police in Germany
1785 William Withering—foxglove (digitalis) treatment of dropsy
1788 British Legislation to protect boys employed as chimney sweepers
1796 Edward Jenner—first vaccination against smallpox
1797 Massachusetts legislation permitting local boards of health
1798 Philippe Pinel removes chains from insane in Bicetre Asylum
1800 Britain and United States—Municipal Boards of Health
1830 Sanitary and social reform, growth of science
1800 Vaccination adopted by British army and navy
1800_ Adam Smith, Jeremy Bentham—economic, social philosophers
1801 Vaccination mandatory in Denmark, local eradication of smallpox
1801 First national census, United Kingdom
1802 U.S. Marine hospitals founded; later U.S. Public Health Service
1804 Modern chemistry established—Humphrey Davey, John Dalton
1807 Abolition Act—mandates eradication of international slave trade by the Royal Navy
1827 Carl von Baer in St. Petersburg establishes embryology
1834 Poor Law Amendment Act documents harsh state of urban working class in U.K.
1837 Pierre Louis—French founder of modern epidemiology
1837 United Kingdom National Vaccination Board
1840s Voluntary societies for reform, boards of health, mines and factory acts—improving work conditions
1842 Edwin Chadwick—Sanitary Commission links poverty and disease
1844 Horace Wells—anesthesia in dentistry then surgery
1848 U.K. Parliament passes Public Health Act establishing the General Board of Health
1850 Massachusetts—Shattuck Report of Sanitary Commission
1852 Adolph Chatin uses iodine for prophylaxis of goiter
1854 John Snow—waterborne cholera in London: the Broad Street pump
1854 Florence Nightingale, modern nursing and hospital reform—Crimean War
1855 London—mandatory filtration of water supplies and consolidation of sanitation authorities
1858 Louis Pasteur proves no spontaneous generation of life
1858 Rudolph Virchow publishes Cellular Pathology; pioneer in political–social health context
1858 Public Health and Local Government Act and Medical Act in United Kingdom—local health authorities and national
licensing of physicians
1859 Charles Darwin publishes On the Origin of Species
1861 Emancipation of the serfs in Russia
1861 Ignaz Semmelweiss publishes The Cause, Concept and Prophylaxis of Puerperal Fever
1862 Louis Pasteur publishes findings on microbial causes of disease
1862 Florence Nightingale founds St. Thomas’ Hospital School of Nursing
1862 Emancipation of slaves in United States
1864 Boston bans use of milk from diseased cows
1864 Russia—rural health as tax-supported local service through Zemstvos
1866 Gregor Johann Mandel, Czech monk, basic laws of heredity, basis of genetics
1867 Joseph Lister describes use of carbolic spray for antisepsis
1869 Dimitri Ivanovitch Mendeleev—periodic tables
1872 American Public Health Association founded and milk stations established in New York
1876 Robert Koch discovers anthrax bacillus
1879 Neisser discovers gonococcus organism
1879 U.S. National Board of Health established
1879 U.S. Food and Drug Administration established
1882 Robert Koch discovers the tuberculosis organism, tubercle bacillus
1880 Typhoid bacillus discovered (Laveran); leprosy organism (Hansen); malaria organism (Laveran)
1883 Otto von Bismarck—workmen’s compensation, national health insurance for workers and their families in Germany
1883 Robert Koch discovers bacillus of cholera
1883 Louis Pasteur vaccinates against anthrax
1884 Diphtheria, staphylococcus, streptococcus, tetanus organisms identified
1885 Pasteur develops rabies vaccine; Escherich discovers coli
1886 Karl Fraenkel discovers pneumococcus organism
1887 Malta fever or brucellosis (Bruce) and chancroid (Ducrey) organisms identified
1887 U.S. National Institutes of Health founded
1890 Anti-tetanus serum (ATS)
1892 Gas gangrene organism discovered by Welch and Nuttal
1894 Plague organism discovered (Yersin, Kitasato); botulism organism (Van Ermengem)
1895 Wilhelm Roentgen—discovers electromagnetic waves (X rays) for diagnostic imaging
1897 London School of Hygiene founded
1897 Felix Hoffman—synthesizes acetylsalicylic acid (aspirin)
1904 Ivan Petrovitch wins Nobel Prize for work in conditioned reflexes, neurophysiology
1905 U.S. Pure Food Act
1905 Abraham Flexner—major report on medical education in U.S.
1905 Workman’s Compensation Acts in Canada
1910 Paul Ehrlich—chemotherapy use of arsenical salvarsan for treatment of syphilis
1911 United Kingdom—compulsory health insurance for workers
1911 Casimir Funk investigates vitamins (vital amines)
1912 Emil Von Behring—diphtheria antitoxin
1912 Health insurance for industrial workers in Russia
1912 U.S. Children’s Bureau established
1914 Joseph Goldberger—investigates cause and prevention of pellagra
1915 Tetanus prophylaxis and antitoxin for gas gangrene
1918 Pandemic of swine flu (influenza) kills some 20 million people
1918 Nikolai Semashko introduces U.S.S.R. national health plan
1921 Frederick Banting and Charles Best discover insulin in Toronto
1923 Health Organization of League of Nations
1924 David Cowie promotes widespread ionization of salt in the United States
1926 Pertussis vaccine developed
1928 Alexander Fleming discovers penicillin
1928 George Papanicolaou—Pap smear for detection of cancer of cervix
1929–1936 The Great Depression—widespread economic collapse, unemployment, poverty, and social distress in
industrialized countries
1935 U.S. Social Security Act and the New Deal in the United States
1940 Charles Drew describes storage and use of blood plasma for transfusion
1941 Normal Gregg publishes on rubella as cause of congenital anomalies
1939–1945 World War II U.K. National Hospital Service—wartime nationalization of hospitals; The Beveridge Report in
the United Kingdom—the “Welfare State” (1942)
U.S. National Centers for Disease Control
U.S. Emergency Maternity and Infant Care for families of servicemen
U.S.S.R. wartime emergency medical structure
1946 World Health Organization founded
1946 National health insurance defeated in U.S. Congress
1946 U.S. Congress passes Hill–Burton Act assisting local hospital construction up to 4.5 beds/1000 population
1946 Tommy Douglas—Saskatchewan provincial hospital insurance plan
1948 United Kingdom establishes National Health Service
1953 James Watson and Francis Crick—structure of DNA
1954 Framingham study of heart disease risk factors
1954 Richard Doll reports on link of smoking and lung cancer
1954 Jonas Salk’s inactivated poliomyelitis vaccine licensed
1956 Gregory Pincus reports on first successful trials of birth control pills
1960 Albert Sabin’s live poliomyelitis vaccine licensed
1962 Francis Crick, Thomas Watson discover DNA, the genetic code
1963 Measles vaccine licensed
1965 U.S. passes Medicare for the elderly, Medicaid for the poor
1966 U.S. National Traffic and Motor Vehicle Safety Act
1966 U.S. Surgeon General’s Report on Smoking
1967 Mumps vaccine licensed
1970 Rubella vaccine licensed
1971 Canada has universal health insurance in all provinces
1974 LaLonde Report—New Perspectives on the Health of Canadians
1977 WHO adopts Health for All by the Year 2000
1978 Alma-Ata Conference on Primary Health Care
1978 Hepatitis B vaccine licensed
1979 Canada adopts mandatory vitamin/mineral enrichment of foods
1979 WHO declares eradication of smallpox achieved
1981 First recognition of cases of acquired immune deficiency syndrome (AIDS)
1985 WHO European Region Health Targets
1985 Luc Montaignier publishes genetic sequence of HIV
1989 WHO targets eradication of polio by the year 2000
1989 Warren and Marshall show Helicobacter pylori as a treatable cause of gastritis and peptic ulcers
1989 International Convention on the Rights of the Child
1990 World Summit on Children, New York
1990 World Conference on Education for All, Jomtien
1990 W.F. Anderson performs first successful gene therapy
1990 Concern for newly emerging, reemerging diseases (HIV, Marburg, Ebola, cholera, mad cow disease, tuberculosis)
and multidrug resistant organisms
1992 United Nations Conference on Environment and Development, Rio de Janiero
1992 International Conference on Nutrition
1993 World Conference on Human Rights, Vienna
1993 World Development Report: Investing in Health published by World Bank
1993 Russian Federation approves compulsory national health insurance
1994 International Conference on Population and Development, Cairo
1994 Clinton National Health Insurance plan defeated in U.S. Congress
1995 World Summit for Social Development, Copenhagen
1995 United Nations Fourth World Conference on Women, Beijing
1996 Second United Nations Conference on Human Settlement (Habitat II), Istanbul
1996 Explosive growth of managed care plan coverage in the United States
1997 Legal suits for damages against tobacco companies for costs of health effects of smoking, 33 states in the United
States and other countries
1998 Clinton proposed legislation on patients rights in managed care
1998 FDA approves rotavirus vaccine
1998 WHO Health for All in the Twenty-first Century adopted
1998 U.S. National Academy of Sciences recommends routine vitamin supplements for adults
1999 U.S. Congress passes legislation regulating patients’ rights in managed care
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