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医学史简论 ( 8 ) A Brief History of Medicine. 浙江大学医学院 余 海 Zhejiang University School of Medicine. 人类与传染病的斗争 (2) Battles to Infectious Diseases(2). Infectious disease in Chinese Medicine. 病: disease, illness, more individually 疾病预防 : Disease prevention

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医学史简论 ( 8 ) A Brief History of Medicine

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医学史简论(8)A Brief History of Medicine

浙江大学医学院 余 海

Zhejiang University School of Medicine


Battles to Infectious Diseases(2)

Infectious disease in Chinese Medicine

  • 病:disease, illness, more individually

  • 疾病预防:Disease prevention

  • 疫:Epidemic, communicable disease, more population based (瘟疫 plague)

  • 防疫:Epidemicprevention

  • 免疫:Immunity, Vaccination

  • 疫苗:Vaccine

How did we win the battles

  • Identify the pathogens - Germ Theory

  • Effective therapy – Vaccine and Antibiotics

  • Prevention and control - Public Health System

Establishment of Germ Theory

  • De Contagione et Contagiosis Morbis (On infection and infectious diseases,1546)

  • He proposed that epidemic diseases are caused by transferable tiny particles or "spores" that could transmit infection by direct or indirect contact or even without contact over long  distances.

Girolamo Fracastoro


Establishment of Germ Theory

A Dutch cloth merchant used new method for grinding and polishing tiny lenses of great curvature which gave magnifications up to 270diameters

First to see and describe bacteria asanimalcules,


became the

pioneer of


Antonie van Leeuwenhoek 1632-1723

Establishment of Germ Theory

  • Created germ theory of disease, (germ theory vs miasma theory and spontaneous generation)

  • Created the first vaccine for rabies 

  • Invented Pasteurizaion

  • Is regarded as one of the three main founders of microbiology, together with Ferdinand Cohn and Robert Koch.

巴斯德 1822-1895

Louis Pasteur

Germ Theory vs Spontaneous Generation Theory

"Do not put forward anything that you cannot prove by experimentation"

swan-neck flask experiment

Establishment of Germ Theory

Heinrich Hermann Robert Koch(1843-1910)

  • German physician

  • Isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and the Vibrio cholera (1883)

  • Development of Koch’s postulates

  • He was awarded the Nobel Prize in Physiology or Medicine for his tuberculosis findings in 1905.

Pure culture of bacteria

Koch’s postulates

Koch’s postulates

Koch’s postulates

Discovery of Viruses

tobacco mosaic virus

tulips breaking virus

1619 (a morbid beauty)

Discovery of Viruses

  • The very first virus discovered is credited to the St. Petersburg Academy of Science on the 12th February 1892 by Dmitri Iwanowsky a Russian botanist. While studying mosiac tobacco disease, he found that the agent causing the disease was small enough for pass though ceramic filter that are small enough to trap all bacteria. This is generally accepted as the beginning of Virology.



Discovery of Viruses

  • 1898, Dutch scientist Martinus Beijernick confirmed Iwanowski's results on tobacco mosaic virus.

  • He developed with the term "contagium vivum fluidum" which means “soluble living germ” as first the idea of the virus.

 Martinus Beijernick (1851-1931)

Dimensions of viruses

about 20 nm to about 250nm in diameter

… just for comparison


10 µm

… just for comparison

LeukocyteBacillus subtitlis



10 µm

… just for comparison

LeukocyteBacillus subtitlisHerpesvirus



10 µm

Discovery of Viruses

TYMV (Tomato yellow mosaic virus)

  • 1898 German scientist Loefflerand Froschdiscovered Foot-and-mouth disease virus

  • 1911,Rousdiscovered Rous sarcoma virus

  • 1915-1917,Twortand d’Herellediscovered bacteriophage

TMV(Tobacco mosaic virus)


Shapes of Viruses














of DNA virus )

Influenza Virus

(Replication of RNA virus )


(Replicationof retrovirus)

Invention of Vaccine

In the 10th Century Chinese invented variolation (blow the scab of smallpox skin lesion)

In 1796 English doctor Edward Jenner invented cowpox vaccine against human smallpox

Invention of vaccines

Chicken cholera bacteria


1880,Pasteur first invented chicken cholera live attenuated vaccine

Development of vaccines

1881, Pasteur developed anthrax vaccines, which were based on live-attenuated cultures of Bacillus anthracis and effectively protected livestock from the disease


Live-attenuated anthrax vaccine

Invention of rabies vaccine

Negri body

Rabies virus


Rabies vaccinewas first used on 9-year old Joseph Meister, on July 6, 1885

Invention of vaccines

Diphtheria antitoxin

At that time in Germany alone 50,000 children died from diphtheriaevery year.

1891Von Behring cured first case of diphtheria with antitoxin, thousands of life have been saved since he developed

serum therapy

Diphtheria toxin

and antitoxin

Diphtheria antitoxin

  • Roux andYersini discovered diphtheria toxin which is responsible for the symptoms of the disease

  • Von Behringand his co-worker Kitasato discovered the diphtheria antitoxin which lay foundation of serum therapy

北里柴三郎Kitasato Shibasaburo1852-1931

Emil Adolf von Behring1854-1917

Tetanus antitoxin

  • With the same principle Von Behringand Kitasato developed tetanus antitoxin

  • Von Behring won the first Nobel Prize in Physiology or Medicine in 1901 for developing

    serum therapy against 

    diphtheria and tetanus


dorsal, ventral

Poliomyelitis (infantile paralysis)& Poliovirus


18th Dynasty (1580-1350 BC)

Equinus clubfoot

Three American scientist John Enders, Thomas Weller and Frederick Robbins discovered method to culture polio virus using non-nervous tissue, they won Nobel Prize in 1954

Jonas Salkinvented live polio vaccine in 1954

Franklin Roosevelt

himself was a victim of polio, launched the March of Dimes to raise the National fund for polio prevention in 1938

Albert Sabininvented oral live-attenuated vaccine (pills)

Chemotherapy for Syphilis


A night in the arms of Venus leads to a lifetime on Mercury

风流一夜情 水银伴终生


Chemotherapy for Syphilis

  • PaulEhrich intendedtofindthemagicbulletagainstmicroorganismfromchemicaldyes

  • In 1909 he and his student Hata Sahachiro(秦佐八郎)developeda arsenical compounds Salvarsan (Arsphenamine ,606),which is effective against syphilis

  • Ehrlich received the Nobel Prize for Medicine together with Mechnikov in 1908

Paul Ehrlich(1854-1915)andHataSahachiro

Discovery of antibiotics and the therapeutic revolution

  • Domagk found f red dye Prontosil and its derivant sulfonamide to be effective against streptococcus, and treated his own daughter Alice with it, saving her the amputation of an arm.

  • Prontosil became the first commercially available antibacterial agent

Gerhard Domagk


Discovery of antibiotics and the therapeutic revolution

  • Afterward a series of sulfonamides were synthesized and sulfonamides became a revolutionary weapon at the time, but were later replaced by penicillin

  • Domagk received the 1939 Nobel Prize in Physiology or Medicine

Discovery of antibiotics and the therapeutic revolution

  • Flaming discovered the antibiotic penicillin from the fungus Penicillium notatum in 1928, and published in 1928

Alexander Flaming



Sir Alexander Fleming Twice Saved Churchill's Life

(A false story)

Discovery of antibiotics and the therapeutic revolution

  • 1939, biochemist Ernst Chain (1906-1979)and pathologist Howard Florey (1898-1968)took up researching and mass producing it with funds from the U.S and British governments.

  • They started mass production after the bombing of Pearl Harbor. When D-day arrived they had made enough penicillin to treat all the wounded allied forces.

  • Feb 12,1941, penicilline was first applied clinically

  • Penicillin was referred as one of three major invents during the World War II (Atom bomb, Radar and Penicillin)


Discovery of antibiotics and the therapeutic revolution

  • Waksman performing research in soil bacteriology in Rutgers University

  • Waksman and his team discovered

    several antibiotics, including actinomycin

    clavacin, streptomycin, neomycin and others. 

  • Of these streptomycin was the first

    antibiotic that could be used to cure

    the disease tuberculosis


Selman Waksman


Dispute about discovery

  • The details and credit for the discovery of its use as the antibiotic streptomycin were strongly contested by one of Waksman's graduate students, Albert Schatz, and resulted in litigation. The litigation ended with a substantial settlement for Schatz and the official decision that Waksman and Schatz would be considered co-discoverers of streptomycin. Schatz made the discovery while working in Waksman's basement lab, and using Waksman's equipment

Discovery of antibiotics and the therapeutic revolution

  • After the discovery of penicillin and streptomycin, more antibiotics were isolated from the soil, upon 1960s more than 600 antibiotics were available in practice

  • Thanks of discovery and application of antibiotics severe bacterial infection has no longer a incurable disease and the average life expectancy increased by 10 year leading to the therapeutic revolution.。

Public Health System

  • Early religions attempted to regulate behavior that specifically related to health, from types of food eaten, to regulating certain indulgent behaviors, such as drinking alcohol or sexual relations. 

  • Rome:water supply and sewage system, public bath and public toilet

  • After plague outbreak in Middle Ages: clearance, sanitation, removing bodies of the dead, burning parts of the city and quarantine system

  • 1848passed British Public Health Act

  • 1946 CDCwas founded in US (Communicable Disease Center-1980 Centers of Disease Control)

August 1854 cholera outbreak in London Soho, 140,000 infected and 618 died. John Snow surveyed the cause and transmission of the disease

Public Health System

  • An English social reformer, noted for his work to reform the Poor Laws and improve sanitary conditions and public health

  • 1842, Chadwick proposed 'Report into the Sanitary Conditions of the Labouring Population of Great Britain'

  • 1848 British parliament passed the British Public Health Act

  • People found him rude and dictatorial. Some said that they would rather take their chance with cholera than be told what to do by Chadwick!

Sir Edwin Chadwick


Public Health System

  • Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.” (1920, C. E.A. Winslow)

  • The goal of public health is to improve lives through the prevention and treatment of disease. The WHO defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

Functions of Public Health

  • Prevention of infectious diseases and other diseases through primary, secondary, tertiary prevention

  • Changing health behavior, improving diet and nutrition through health education and health promotion

  • Improving environmentincluding living environment and occupational environment

  • Reproduction health

  • Epidemilogical survey, disease surveillance, statistics, research and education


Leading causes of death in US: comparison of 1990 and 1997 1990年和1997年美国主要死因比较

Public Health System

婴幼儿死亡率 平均期望寿命


The End

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