TABLE 15.1.

Health Care Innovations from the Seventeenth to the Twenty-First Centuries

Period	Selected Highlights of Scientific, Technological, and Organizational Innovations in Health
17th century	Biological basis of disease (Descartes), circulation of blood (Harvey), microscope (Leeuwenhoek)
18th century	Thermometer, lime juice supplements (Lind, 1756), vaccination (Jenner, 1796), surgical anatomy (Hunter), clinical sciences (Sydenham)
19th century	Miasma theory vs germ theory; inventions of stethoscope (1816), blood transfusion (1818), anesthesia (1842), hypodermic syringe (1852), ophthalmoscope (1851), laryngoscope (1855), pasteurization of wine, beer, milk (1860s), cholera vaccine (1879), X-ray (1895), blood pressure cuff (1896); sanitation, municipal health departments, chlorination and filtration of community water supplies, antisepsis, Braille printing, hygiene in obstetrics, nursing, microscopic pathology, pathological chemistry, microbiology, vaccines, X-ray, national health insurance, syringes, well-child care, aspirin (1899), Bismarkian social insurance (1881)
1900–1930	Electrocardiogram (1901), Flexner report on medical education, salvarsan, insulin (1922), blood groups, vitamins, conquest of yellow fever, vitamin B, vaccine for diphtheria (1923), tetanus vaccine (1924), electroencephalogram (1924), iron lung respirator (1927), Social Security Act (1935), cost–benefit analysis, food fortification (iodized salt, flour with vitamin B complex), improved work safety
1931–1945	Mandatory fortification of milk, salt, and flour in USA (1941), Pap test (1942), penicillin (1928), streptomycin, randomized clinical trials, antimalarial drugs, vector controls, dialysis machine (1945)
1946–1960	Contact lens (1948), DNA double helix (1953), heart–lung bypass machine (1953), ultrasound (1955), cardiac pacemaker (1958), Salk polio vaccine (1955), kidney transplant (1959), advances in vaccines, antihypertensives, psychotropic drugs, cancer chemotherapy, prepaid group practice, UK National Health Service (1948), Medicare in Canada (1946–1971)
1961–1980	Oral polio vaccine (Sabin), hip replacement (1962), oral rehydration therapy, measles vaccine (1964), coronary bypass (1964), Medicare, Medicaid (1965), mammography (1965), portable defibrillator (1965), measles–mumps–rubella vaccine, cost-effectiveness analysis, open heart surgery, pacemakers, organ transplantation, computed tomography (CT), eradication of smallpox (1972), health maintenance organizations (HMOs), diagnosis-related groups (DRGs), district health systems
1981–2000	Health promotion (1987), magnetic resonance imaging (MRI), positron emission tomography (PET), endoscopic surgery, Helicobacter pylori and chronic peptic ulcer disease (1982), managed care, Haemophilus influenzae b (Hib) vaccine, statins (1987), poliomyelitis eradication campaign (1982), local eradication of beta-thalassemia, pandemic of HIV (1981 onward), AZT antiretroviral approved (1987), robotic surgery (2000)
2001–2013	Millennium Development Goals (MDGS 2000) with substantial progress achieved, managing emergencies of mass terrorism and natural disasters, new vaccines (HPV), managing epidemics of measles and influenza, new diagnostic technologies, flour fortification to prevent birth defects, HIV still deadly but effective treatment and control measures, new treatments for hepatitis C, robotic surgery, nanotechnology, scientific advances with great potential benefit, Affordable Care Act (2010), Accountable Care Organizations

Source: Adapted from Health United States 2009. Special Feature: Medical technology. Introduction and timeline. 2009. Available at: http://www.ncbi.nlm.nih.gov/books/NBK44737/#specialfeature.sec1 [Accessed 15 December 2012]. See Historical Markers in Chapter 1.