January 14, 2000

The basic principles of modern medicine were developed during the 19th century. Understanding the concepts of sanitation and infection and acceptance of the germ theory made a significant difference in the course of disease. The discovery of anesthesia and the demonstration at the MGH of its use for the relief of surgical pain — among the first of the hospital's many scientific milestones — allowed surgery to evolve from a brutal last resort to a careful discipline. Toward the century's end, open-minded physicians were investigating the physiologic basis of illness and starting to understand how a healthy body functions.

Organized research efforts of the type that are now so familiar began appearing around the turn of the century. The MGH's first pathology laboratory was established in 1898, expanding knowledge of the mechanisms behind several diseases. Dedicated clinical research facilities first appeared in 1917 for the medical service and in 1922 for the surgical service. In 1925, the famous Ward 4 opened in the Bulfinch Building, dedicated to the study of metabolic disease, and during that same year the hospital opened one of the first multidisciplinary clinics for the treatment and study of cancer. From those early beginnings, research at the MGH has grown to the point where the hospital is the largest research institute of its kind in the country.

Medical education also saw a revolution of sorts in the late 19th and early 20th century. Harvard Medical School's curriculum underwent a complete change, resulting in a more rigorous, scientifically based course of study. At the MGH, the position of "house pupil" evolved from one filled by medical students under close supervision to the familiar residency system of today. Now graduates of MGH training programs are leaders in every medical field at institutions around the world. The hospital also led the way in educating nurses and other health professionals, a legacy that continues in today's Institute of Health Professions.

The explosion of medical and scientific knowledge in the 20th century was unprecedented. Few of the past century's discoveries could have been predicted in 1900. Physicians may have dreamed that such scourges as smallpox, polio and tuberculosis might be controlled or eradicated, but few likely expected such accomplishments within their children's lifetimes.

The molecular and genetic discoveries that are the basis of today's medical research were not imagined 100 years ago. Conversely, the mid-century's confidence that infectious diseases had been conquered by antibiotics and vaccines proved premature with the development of resistance and the emergence of AIDS.

No matter what accomplishments and challenges the 21st century may bring, the dedicated people of the MGH — physicians, researchers, students, residents, health professionals and others — are sure to continue the hospital's record of leadership, taking medicine and science across frontiers unimaginable at the dawn of this new millennium.