A brief overview of medicine as it developed worldwide provides a context for the medical history of Utah.

Medicine men and women played, and are still playing, a very important role in primitive tribes throughout the world. Much real knowledge has accumulated, and many drugs now in common use in modern medicine, such as digitalis and quinine, came from this source. Taxol, from yew tree bark, used in treating ovarian carcinoma, is the most recent addition.

Some evidence of early surgery has been found in skeletons of many primitive peoples in the form of trephines--surgical holes in the head--which supposedly allowed evil spirits to escape from the brain. Throughout the Middle Ages, barber-surgeons performed amputations and other emergency procedures. The lack of anesthesia until the mid-nineteenth century (chloroform and ether) prevented the more widespread use of surgery. In general, these early medical experts tried to follow the primary principle of Aristotle: "First, do no harm!"

The beginnings of scientific medicine date to 1796 when Edward Jenner, in England, first vaccinated milkmaids against cow pox. Not until 1840 was it recognized that certain diseases were transmitted by external agents: Ignaz Semmelwis in Vienna demonstrated that childbed fever was transmitted by the dirty hands of physicians; and John Snow in London ascribed an epidemic of cholera to contamination of water.

The science of bacteriology was initiated in the latter part of the nineteenth century by Louis Pasteur in France and by Robert Koch in Germany. Their work led to the identification of the offending organisms that caused pneumococcal pneumonia, typhoid fever, and cholera, among other diseases.

In 1905 Schaudin and Hoffman identified the specific cause of syphilis. Four years later, Paul Ehrlich initiated treatment of the disease with Salvarsan, an arsenic compound--the first application of a specific drug in the successful treatment of an infectious disease.

Despite the development of certain vaccines and the steadily improving hygiene and public health, the average life expectancy did not increase significantly during the nineteenth century. Infectious diseases continued to dominate the practice of medicine and be the primary cause of death until the mid-1930s when sulfonamides, the first of the antibiotics, came into use.