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For most of the 19th century doctors cared for their patients much as they had in prior eras. Most medical tools fit easily into the doctor's little black bag, and diagnoses were based more on instinct than on science. But then in 1895 German physicist Wilhelm C. Roentgen accidentally discovered a form of electromagnetic radiation that could pass through the body and leave an image of its bones or organs on a photographic plate. The birth of the X ray sparked a revolution. Diagnostic tools such as the electrocardiograph, CAT scan, and MRI followed, as did the development of artificial and transplanted organs and joints and myriad other surgical devices and techniques designed to keep the body functioning. These advancements and the discovery of antibiotics and other life-saving drugs contributed to increasing the life span of people throughout the developed world—on average nearly 30 years longer than their ancestors a century ago.


  1903   First electrocardiograph machine

Dutch physician and physiologist Willem Einthoven develops the first electrocardiograph machine, a simple, thin, lightweight quartz "string" galvanometer, suspended in a magnetic field and capable of measuring small changes in electrical potential as the heart contracts and relaxes. After attaching electrodes to both arms and the left leg of his patient, Einthoven is able to record the heart’s wave patterns as the string deflects, obstructing a beam of light whose shadow is then recorded on a photographic plate or paper. In 1924 Einthoven is awarded the Nobel Prize in medicine for his discovery.

  1927   First modern practical respirator

Harvard medical researcher Philip Drinker, assisted by Louis Agassiz Shaw, devises the first modern practical respirator using an iron box and two vacuum cleaners. Dubbed the iron lung, his finished product—nearly the length of a small car—encloses the entire bodies of its first users, polio sufferers with chest paralysis. Pumps raise and lower the pressure within the respirator’s chamber, exerting a pull-push motion on the patients’ chests. Only their heads protrude from the huge cylindrical steel drum.

  1930s   Artificial pacemaker invented

Albert S. Hyman, a practitioner cardiologist in New York City, invents an artificial pacemaker to resuscitate patients whose hearts have stopped. Working with his brother Charles, he constructs a hand-cranked apparatus with a spring motor that turns a magnet to supply an electrical impulse. Hyman tests his device on several small laboratory animals, one large dog, and at least one human patient before receiving a patent, but his invention never receives acceptance from the medical community.

  1933   Kouwenhoven cardiovascular research

Working on rats and dogs at Johns Hopkins University, William B. Kouwenhoven and neurologist Orthello Langworthy discover that while a low-voltage shock can cause ventricular fibrillation, or arrhythmia, a second surge of electricity, or countershock, can restore the heart’s normal rhythm and contraction. Kouwenhoven’s research in electric shock and his study of the effects of electricity on the heart lead to the development of the closed-chest electric defibrillator and the technique of external cardiac massage today known as cardiopulmonary resuscitation, or CPR.

  1945   First kidney dialysis machine

Willem J. Kolff successfully treats a dying patient in his native Holland with an "artificial kidney," the first kidney dialysis machine. Kolff’s creation is made of wooden drums, cellophane tubing, and laundry tubs and is able to draw the woman’s blood, clean it of impurities, and pump it back into her body. Kolff’s invention is the product of many years’ work, and this patient is his first long-term success after 15 failures. In the course of his work with the artificial kidney, Kolff notices that blue, oxygen-poor blood passing through the artificial kidney becomes red, or oxygen-rich, leading to later work on the membrane oxygenator.

  1948   Plastic contact lens developed

Kevin Touhy receives a patent for a plastic contact lens designed to cover only the eye's cornea, a major change from earlier designs. Two years later George Butterfield introduces a lens that is molded to fit the cornea's contours rather than lie flat atop it. As the industry evolves, the diameter of contact lenses gradually shrinks.

  1950s (Late)   First artificial hip replacement

English surgeon John Charnley applies engineering principles to orthopedics and develops the first artificial hip replacement procedure, or arthroplasty. In 1962 he devises a low-friction, high-density polythene suitable for artificial hip joints and pioneers the use of methyl methacrylate cement for holding the metal prosthesis, or implant, to the shaft of the femur. Charnley's principles are subsequently adopted for other joint replacements, including the knee and shoulder.

  1951   Artificial heart valve developed

Charles Hufnagel, a professor of experimental surgery at Georgetown University, develops an artificial heart valve and performs the first artificial valve implantation surgery in a human patient the following year. The valve—a methacrylate ball in a methacrylate aortic—size tube-does not replace the leaky valve but acts as an auxiliary. The first replacement valve surgeries are performed in 1960 by two surgeons who develop their ball-in-cage designs independently. In Boston, Dwight Harken develops a double-cage design in which the outer cage separates the valve struts from the aortic wall. At the University of Oregon, Albert Starr, working with electrical engineer Lowell Edwards, designs a silicone ball inside a cage made of stellite-21, an alloy of cobalt, molybdenum, chromium, and nickel. The Starr-Edwards heart valve is born and is still in use today.

  1952   First successful cardiac pacemaker

Paul M. Zoll of Boston’s Beth Israel Hospital, in conjunction with the Electrodyne Company, develops the first successful cardiac pacemaker. The bulky device, worn externally on the patient’s belt, plugs into an electric wall socket and stimulates the heart through two metal electrodes placed on the patient’s bare chest. Five years later doctors begin implanting electrodes into chests. Around the same time a battery-powered external machine is developed by Earl Bakken and C. Walton Lillehei.

  1953   First successful open-heart bypass surgery

Philadelphia physician John H. Gibbon performs the first successful open-heart bypass surgery on 18-year-old Cecelia Bavolek, whose heart and lung functions are supported by a heart-lung machine developed by Gibbon. The device is the culmination of two decades of research and experimentation and heralds a new era in surgery and medicine. Today coronary bypass surgery is one of the most common operations performed.

  1954   First human kidney transplant

A team of doctors at Boston’s Peter Bent Brigham Hospital successfully performs the first human kidney transplant. Led by Joseph E. Murray, the physicians remove a healthy kidney from the donor, Ronald Herrick, and implant it in his identical twin brother, Richard, who is dying of renal disease. Since the donor and recipient are perfectly matched, the operation proves that in the absence of the body’s rejection response, which is stimulated by foreign tissue, human organ transplants can succeed.

  1960   First totally internal pacemaker

Buffalo, New York, electrical engineer Wilson Greatbatch develops the first totally internal pacemaker using two commercial silicon transistors. Surgeon William Chardack implants the device into 10 fatally ill patients. The first lives for 18 months, another for 30 years.

  1963   Laser treatments to prevent blindness

Francis L’Esperance, of the Columbia-Presbyterian Medical Center, begins working with a ruby laser photo-coagulator to treat diabetic retinopathy, a complication of diabetes and a leading cause of blindness in the United States. In 1965 he begins working with Bell researchers Eugene Gordon and Edward Labuda to design an argon laser for eye surgery. (They learn that the blue-green light of the argon laser is more readily absorbed by blood vessels than the red light of the ruby laser.) In early 1968, after further refinements and careful experiments, L’Esperance begins using the argon-ion laser to treat patients with diabetic retinopathy.

  1970s (Late)   Arthroscope introduced

Advances in fiber-optics technology give surgeons a view into joints and other surgical sites through an arthroscope, an instrument the diameter of a pencil, containing a small lens and light system, with a video camera at the outer end. Used initially as a diagnostic tool prior to open surgery, arthroscopic surgery, with its minimal incisions and generally shorter recovery time, is soon widely used to treat a variety of joint problems.

  1971   First soft contact lens

Bausch & Lomb licenses Softlens, the first soft contact lens. The new product is the result of years of research by Czech scientists Otto Wichterle and Drahoslav Lim and is based on their earlier invention of a "hydrophilic" gel, a polymer material that is compatible with living tissue and therefore suitable for eye implants. Soft contacts allow more oxygen to reach the eye’s cornea than do hard plastic lenses.

  1972   CAT or CT scan is introduced

Computerized axial tomography, popularly known as CAT or CT scan, is introduced as the most important development in medical filming since the X ray some 75 years earlier. (See Imaging)

  1978   First cochlear implant surgery

Graeme Clarke in Australia carries out the first cochlear implant surgery. Advances in integrated circuit technology enable him to design a multiple electrode receiver-stimulator unit about the size of a quarter.

  1980s   Controlled drug delivery technology developed

Robert Langer, professor of chemical and biochemical engineering at MIT, develops the foundation of today’s controlled drug delivery technology. Using pellets of degradable and nondegradable polymers such as polyglycolic acid, he fashions a porous structure that allows the slow diffusion of large molecules. Such structures are turned into a dime-size chemotherapy wafer to treat brain cancer after surgery. Placed at the site where a tumor has been removed, the wafer slowly releases powerful drugs to kill any remaining cancer cells. By confining the drug to the tumor site, the wafer minimizes toxic effects on other organs.

  1981   MRI (magnetic resonance imaging) scanner introduced

The first commercial MRI (magnetic resonance imaging) scanner arrives on the medical market. (See Imaging.)

  1982   First permanent artificial heart implant

Seattle dentist Barney Clark receives the first permanent artificial heart, a silicone and rubber device designed by many collaborators, including Robert Jarvik, Don Olsen, and Willem Kolff. William DeVries of the University of Utah heads the surgical transplant team. Clark survives for 112 days with his pneumatically driven heart.

  1985   Implantable cardioverter defibrillator (ICD) approved

The Food and Drug Administration approves Michel Mirowski’s implantable cardioverter defibrillator (ICD), an electronic device to monitor and correct abnormal heart rhythms, and specifies that patients must have survived two cardiac arrests to qualify for ICD implantation. Inspired by the death from ventricular fibrillation of his friend and mentor Harry Heller, Mirowski has conceived and developed his invention almost single-handedly. It weighs 9 ounces and is roughly the size of a deck of cards.

  1987   Deep-brain electrical stimulation system

France’s Alim-Louis Benabid, chief of neurosurgery at the University of Grenoble, implants a deep-brain electrical stimulation system into a patient with advanced Parkinson’s disease. The experimental treatment is also used for dystonia, a debilitating disorder that causes involuntary and painful muscle contractions and spasms, and is given when oral medications fail.

  1987   First laser surgery on a human cornea

New York City ophthalmologist Steven Trokel performs the first laser surgery on a human cornea, after perfecting his technique on a cow’s eye. Nine years later the first computerized excimer laser—Lasik—designed to correct the refractive error myopia, is approved for use in the United States. The Lasik procedure has evolved from both the Russian-developed radial keratotomy and its laser-based successor photorefractive keratectomy.

  1990   Human Genome Project

Researchers begin the Human Genome Project, coordinated by the U.S. Department of Energy and the National Institutes of Health, with the goal of identifying all of the approximately 30,000 genes in human DNA and determining the sequences of the three billion chemical base pairs that make up human DNA. The project catalyzes the multibillion-dollar U.S. biotechnology industry and fosters the development of new medical applications, including finding genes associated with genetic conditions such as familial breast cancer and inherited colon cancer. A working draft of the genome is announced in June 2000.

  Late 1950s   First artificial hip replacement procedure

English surgeon John Charnley applies engineering principles to orthopedics and develops the first artificial hip replacement procedure, or arthroplasty. In 1962 he devises a low-friction, high-density polythene suitable for artificial hop joints and pioneers the use of methyl methacrylate cement for holding the metal prosthesis, or implant, to the shaft of the femur. Charnley's principles are subsequently adopted for other joint replacements, including the knee and shoulder.

 


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