Noble laureates of public health

1. NOBLE LAUREATES OF
PUBLIC HEALTH
DR. AVINASH BORKAR
Associate Professor
Community Medicine
1

2. Scope of Presentation
❑ Introduction
- How noble prize started
❑ Evolution of medicine / public health
❑ Contributors to public health in ancient era
❑ Contributors to public health era of scientific medicine
❑ Contributors to public health in modern medicine – Noble
Laureates
❑ Medical revolution
❑ Summary
❑ References
2

3. Introduction
• Alfred Nobel
- Born on 21 October 1833 in Stockholm, Sweden
- He was a chemist, engineer - invented dynamite -
he thought this would end all wars
- In 1888, his brother Ludvig died of explosion at his
own factory, a French newspaper called him the
"merchant of death.”
- The article made him apprehensive about how he
would be remembered.
- Died December 10, 1896 after suffering a
cerebral hemorrhage. 3

4. Nobel's last will - establishment of five prizes to
"those who, during the preceding year, shall have conferred the greatest
benefit on mankind."
• Categories –
1. Physics 2. Chemistry 3. Physiology or medicine
4. Literature 5. Peace 6. Economic Sciences – 1969
• Country
Sweden
Norway (Peace Prize only)
• The Nobel Foundation - 1900 - manage the finances and administration
• First awarded - 1901
4

5. Prizes
• Medals
- On one side - image of Alfred, years of birth and death
- Other side - varies according to the institution awarding
the prize
- 175 grams - 18 carat green gold plated with 24 carat
• Diplomas
- A picture and text which states the name of the laureate
and citation of why they received the prize
- From the hands of the King of Sweden or the Chairman of
the Norwegian Nobel Committee
• Award money - (1 Swedish krona = 0.142727 U.S.
dollars)
- 2009 - 10 million SEK (US$1.4 million)
- 2012 - 8 million SEK
5

6. Evolution of medicine/public health
• Ancient Era of Medicine (5000 BC to 1500 AD)
• Dawn of Scientific Medicine (1500 to 1900 AD)
• Modern Medicine (1900 to 2000 AD)
• Medical revolution
6

7. Ancient Era of Medicine(5000 BC – 1500 BC)
1. Primitive medicine (around 5000 BC)
superstition, religion, magic
2. Chinese Medicine (2700 BC )
“World’s 1st organized body of medical knowledge”
• Pioneer of immunization - Variolation against
smallpox
• Hygiene - determinant of health
• Hydrotherapy, massage, accupuncture
7

8. • 3. Indian Medicine
• Dhanvatari
Hindu god of medicine
• Atreya (800BC) – First great indian physician and
teacher
• Ayurvedic medicine
• Classified diseases into curable and incurable
• Causes and treatments of various diseases such as
fevers, diarrheas, dysentery, TB
• Charaka (300 BC) - the Father of Medicine
- Charaka Samhita - 500 drugs
• Susruta (800 BC) - Father of indian Surgery
8

9. 4. Greek Medicine (460 -136 BC)
• Thinking begun as “Why” and “How”
• Aesculapius –
“The god of medicine and healing”
• The rod of Asclepius, a snake-entwined staff - a
symbol of medicine
• Hippocrates -
• “ The father of medicine”
- Rejected supernatural theory of
diseases - product of environmental factors,
diet, and living habits
• Hippocratic medicine - the practice of taking
clinical case-history , family history and
environment
9

10. 5. Roman Medicine ( 1st century AD)
• Romans had keen “Sense of Sanitation”
- Development of Baths, Sewers and aqueducts
(public health born in Rome)
- Pure water supply
- Drainage of sewage
- Establishment of hospitals
- Reporting system in place
• Galen (130-205AD) – Physician
• Comparative anatomy and experimental
physiology
- Disease is due to predisposing, exciting and
environmental factors (Epidemiological Triad)
10

11. Public health in middle ages (500 – 1500 AD)
Dark ages of Medicine
• Deterioration of Roman infrastructure
• Europe -
• Epidemic of plague (black death ), tuberculosis
smallpox and leprosy
• Diseases were widely viewed as inescapable
• No new knowledge was added
• Moved to primitive medicine – superstitions
• During this period – Arab (800 -1300 AD) -
Unani system of medicine
• Greatest contribution in Pharmacology
• Words – Drugs, alcohol, syrup, sugars
11

12. Dawn of Scientific Medicine
(1500 – 1900 AD)
• After 1500 A.D. – revolution – political, industrial, religious and
medical
1. Revival of medicine (1450 – 1830 AD)
2. Era of Public Health (1830 – 1880 AD)
3. Germ theory of disease
4. Birth of preventive medicine
12

13. Revival of medicine
a.1453 – 1600 AD – Age of Individual Scientific Endeavour
b.17th and 18th Centuries – Discoveries
13

14. Girolamo Fracastorius (1478 - 1553)
• An Italian physician
• Theory of contagion - 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
• Syphilis - transmitted from person to person
through sexual relation - suggests using mercury
as a cure
• Gave the first description for typhus
14

15. Theophrastus Paracelsus (1493 -1541)
• Swiss Physician
• Burnt traditional medical books – publically
• Rediscovering ancient Greek theories based on
empirical observation,turned medicine towards
Rational Research
• Illness – Due to attack of outside agent
• Use chemicals and minerals in medicine
“The founder of Epidemiology”
15

16. Andreas Vasalius ( 1514 - 1564)
• A Flemish anatomist , physician
• Demonstrated Galen’s error
“The founder of modern human anatomy”
• Ambroise Paré (1510 -1590)
• French Army surgeon
• Introduced advanced art of surgery - the ligature
of arteries instead
of cauterization during amputation
“The fathers of surgery”
• Royal College of Surgeon - 1540 16

17. • Thomas Sydenham ( 1624 - 1689)
• An English physician
• Set the examples of true clinical methods and
was known as 'The English Hippocrates’
• Differential diagnosis of scarlet fever, malaria,
dysentery and cholera
“First distinguished epidemiologist”
• William Harvey (1578-1657)
• English Physician and Discoverer of the
Circulatory system of Blood (1628)
• Discovered that the heart acts as a pump to
circulate blood through the body via blood
vessels
•
17

18. Antonie Leeuwenhoek (1632 - 1723)
• A Microscopist and Biologist , Netherland
• Discovered - Microscope (1670)
• First to record microscopic observations of muscle
fibers, bacteria, spermatozoa, and blood flow
in capillaries
• Most important tools to identify diseases and their
causes.
18

19. • Bernardino Ramazzini (1633 – 1714)
• An Italian physician
• His book on occupational diseases, outlined the health
hazards of chemicals, dust, metals, motions, odd
postures, and other disease-causative agents
encountered by workers in 52 occupations
• He proposed that physician , history - "What is your
occupation?".
“The father of occupational medicine”
• Christian Hahnemann (1755 -1843)
• A German physician,
• ‘Homeopathy ’ -alternative form of medicine
19

20. 3. SANITARY AWAKENING
ERA OF PUBLIC HEALTH
(1830 – 1880 AD)
• Great Sanitary Awakening – Mid nineteenth in England
• Era of Public Health
• Problems of 18th Century
– Creation of Slums, overcrowding, accumulation of filth, high
sickness and death rates, infectious disease
– Average age – 44 yrs
• Cholera Epidemic of 1832
20

21. Edwin Chadwick(1800-1890)
• An English lawyer
• In 1832, the Prime Minister, Earl Grey - Commission -
• Report ‘The Sanitary Conditions of the Labouring Population
in Great Britain’– Lanmark in history of public health
• Emphasized the need to improve public health
- a constant supply of fresh clean water,
- water closets in every house and a system of carrying sewage
- Improvement in housing & working conditions
• Public Health Act of 1848 – England
Central Board of Health - to oversee street cleansing, refuse
collection, water supply and sewerage systems.
• State has a direct responsible for the health of the people
21

22. “Cholera – The Father of Public Health”
• John Snow (1813 - 1858)
• A British physician
• Cholera outbreak - airborne
• Plotted cases of cholera on a map of the area - how cases
of cholera centered around the water pump and source
of the disease
• Establishing the link between cholera infection and water
as its vector
• Snow’s study - regarded as the founding event of the
science of epidemiology 22

23. William Budd (1811 - 1880)
• An English physician and epidemiologist
• Epidemic of Typhoid fever in North England
(1856) -Spread of Typhoid by polluted water
• 2 discoveries – People demand for clean
physical environment
• Legislation in form of public health act – 1875
– for control of Man’s physical environment
23

24. Sir John Simon (1816-1904)
• An English physician
• First Medical Officer of Health for London in 1848
- Supervision of measures on public sanitation (provision of
clean drinking water and safe sanitary disposal)
- Established the General Medical Council - the licensing body
for medical practitioners in the United Kingdom
24

25. William Farr (1807-1883)
• A British epidemiologist
• He undertook a study of the bills of mortality, tabulating
causes of death according to categories
• In 1838, the Registrar-General Office - registering births,
marriages and deaths
• “Father of modern epidemiological surveillance”
25

26. Lemuel Shattuck(1793-1859)
• A booksellar and publisher
• 1850 survey of sanitary conditions throughout the state –
published - stirred people - help in legisltions
• Outlined a method for the systematic gathering of vital
statistics and a plan for analyzing that data
• Establishment - health offices at the state and local levels in
order to gather statistical information on public health
conditions
“Father of the American vital statistics system”
26

27. • THEORIES – CAUSATION OF DISEASE
• Supernatural theory of disease
• Theory of humors – by Greek and Indians
• Theory of contagion
• The miasmatic theory – noxious air and vapours
27

28. Louis Pasteur ( 1822 - 1895)
• A French chemist and microbiologist
• 1st demonstrated bacteria in air
“The Germ theory of Causation” (1873)
• Created the first vaccines for rabies and anthrax
• Pasteurization – to kill bacteria in milk
28

29. Robert Koch (1843 - 1910)
• A French parasitologist
- Anthrax (1877)- caused by rod shaped bacilli
- Isolated and grown, the tubercle bacillus
- Cause of amoebic dysentery
- Bubonic plague epidemic in Calcutta in 1897 - rats
- vectors of the disease
- Sleeping sickness - by the tsetse fly
• In 1905 Koch won the Nobel Prize for investigation
and discoveries in relation to tuberculosis.
29

30. • Gerhard Hansen (1841 - 1912)
• A Norwegian physician
• Identification of the bacterium Mycobacterium leprae
in 1873 as the causative agent of leprosy.
• Leprosy was regarded as largely hereditary or
otherwise miasmic in origin
30
A specific disease with a specific cause – Shed rags of dogma and
superstitions and step towards prevention of diseases

31. • BIRTH OF PREVENTIVE MEDICINE
• Era of Disease Prevention by Specific Measures
31

32. 18th Century
James Lind (1716-1794)
• Scottish Naval Surgeon
• Lind's studies of scurvy -
- In 1747 , Lind selected 12 men suffering from scurvy and
divided them into six pairs, giving each group different
additions to their basic diet
- Those fed oranges and lemons (citrus fruits) experienced
a remarkable recovery
- Citrus fruits containing Vitamin C - prevent the fatal
illness in scurvy
• Represent the first known controlled clinical medical trial
“ Creator of the Clinical Medical Trial ”
32

33. Edward Jenner (1749 – 1823)
• English Surgeon and physician
• Discoverd the first vaccine against smallpox
(1796), through inoculation with the milder
cowpox virus
• In 1979, the WHO declared smallpox an
eradicated disease.
“The father of immunology"
his work is said to have
"saved more lives than the work of any other man".
33

34. 19th Century
• Emil Behring (1854 – 1917)
• A German physiologist
• Discoverer of diphtheria and tetanus antitoxin in 1894
• First Nobel Prize 1901 for developing a serum
therapy against diphtheria and tetanus
• These diseases were major cause of death
34

35. Sir Ronald Ross (1857 -1932)
• Born in Almora, India
• In 1897, discovered the malarial parasite within a
specific species of mosquito, the Anopheles
• Life cycle of the malarial parasite
• In 1902, Nobel Prize for his remarkable work on
malaria
• Contributions to the epidemiology and methods of its
survey and assessment – help in control of malaria
35

36. • Charles Laveran (1854 -1922)
• A French physician
• In 1880, cause of malaria is a protozoan
• This was the first time that protozoa were shown to be a
cause of disease
• Trypanosomes - sleeping sickness
• For discoveries of protozoan diseases he was awarded
the Nobel Prize in 1907
• Waldmar Haffkine (1860 – 1930)
• A Russian bacteriologist
• Vaccines against cholera (1892) and bubonic plague
(1897)
36

37. Joseph Lister (1827-1912)
• Joseph Lister, a British surgeon
• By the middle of 19th century, post-operative sepsis -death of
almost ½ of the patients undergoing major surgery
• Use - Practice to clean wounds and dress a solution of carbolic
acid
• In 1870 Lister’s antiseptic methods were used, by Germany,
during the Franco-Prussian war saving many Prussian soldier’s
lives
• Thus emphasized the principle of preventive medicine
37

38. MODERN MEDICINE
(1900 – 2000AD)
• Curative Medicine
• Preventive Medicine (Prevention of disease and
promotion of health)
• Social Medicine - Health by the People
• Medical revolution
38

39. • Niels Finsen (1860 – 1904)
• A Danish physician and scientist
• The Nobel Prize in 1903
"in recognition of his contribution to the treatment of
skin diseases, especially lupus vulgaris, with
concentrated light radiation”
• New method for cure of skin diseases – phototherapy
39

40. Paul Ehrlich (1854 – 1915)
• A German scientist
• The syphilis treatment salvarsan - the first drug
targeted against a specific pathogen
• Technique of selectively staining bacteria (the precursor
technique to Gram staining bacteria)
• Nobel Prize in Physiology or Medicine (1908) – with
Mechnikov
40

41. Jules Bordet (1870 - 1961)
• A Belgian immunologist and microbiologist
• Effect of acquired specific antibody is significantly
enhanced in vivo by the presence of innate serum
components which he termed alexine (but which are now
known as complement)
• Basis for complement-fixation testing methods -
enabled the development of serological tests for syphilis
(Wassermann test by August von Wassermann) and
many other diseases
• The Nobel Prize in in 1919 for his discoveries relating to
immunity.
41

42. Willem Einthoven (1860 – 1927)
• A Dutch doctor and physiologist.
• Practical electrocardiogram (ECG or
EKG) in 1903 and received the Nobel
Prize in Medicine in 1924
• Helped in detecting cardiac functioning
by non-invasive method
42

43. Charles Nicolle (1866 – 1936)
• A French bacteriologist
• The discovery
- transmission method of typhus fever and tick
fever
- Vaccine for Malta fever
- Identification of the parasitic
organism Toxoplasma gondii
• Nobel Prize in 1928 for his identification
of lice as the transmitter of epidemic typhus.
43

44. Sir Frederick Hopkins (1861 - 1947)
• An English biochemist
• In 1912 Hopkins demonstrating in a series of animal
feeding experiments that diets consisting of pure
proteins, carbohydrates, fats, minerals, and water
fail to support animal growth.
• These hypothetical substances he called “accessory
food factors”, later renamed vitamins.
• Nobel Prize in 1929, with Christiaan Eijkman, for
the discovery of vitamins.
44

45. Karl Landsteiner (1868 –1943)
• An Austrian biologist and physician
“The father of transfusion medicine”
• He first distinguished the main blood groups (1900),
developed the modern system of classification of blood
groups and the Rhesus factor (1937)
• Enables physicians to transfuse blood without endangering
the patient′s life.
• In 1930 he received the Nobel Prize in Physiology or
Medicine
• With Constantin Levaditi and Erwin Popper, he discovered
the polio virus, in 1909.
45

46. • Albert Szent-Györgyi (1893 – 1986)
• A Hungarian physiologist
• Nobel Prize in 1937 - discovering vitamin C
• Henrik Dam (1895 - 1976)
• A Danish biochemist and physiologist
• Nobel Prize in 1943 for with Edward Doisy -
discovering vitamin K and its role in human
physiology.
• Dam's key experiment involved feeding
a cholesterol free diet to chickens.
• The chickens began hemorrhaging and bleeding
uncontrollably after a few weeks.
46

47. Gerhard Paul Domagk ( 1895 - 1964)
• A German pathologist and bacteriologist
• He found
the sulfonamide Prontosil against streptococcus - 1st
commercially available antibiotic
• Sulfonamides became a revolutionary weapon at the
time, eventually led to the development of the
antituberculosis drugs thiosemicarbazone
and isoniazid
• In 1939, Nobel Prize for this discovery, the first drug
effective against bacterial infections.
47

48. Sir Alexander Fleming (1881 - 1955)
• A Scottish biologist and pharmacologist
• The antibiotic substance penicillin from the
mould Penicillium notatum in 1928,
• The most efficacious life-saving drug in the world
• It altered forever the treatment of bacterial infections
• Penicillin has saved, and is still saving, millions of
people around the world
• Nobel Prize in 1945 with Howard Florey and Ernst
Boris Chain
48

49. • Paul Hermann Müller(1899 -1965)
• A Swiss chemist
• In 1948 he received the Nobel Prize for his 1939
discovery of insecticidal qualities and use of DDT in the
control of vector diseases such as malaria and yellow
fever.
• Max Theiler (1899 -1972)
• A South American virologist
• The Nobel Prize in 1951 - for developing a vaccine
against yellow fever - 1937
• Between 1940 and 1947 the Rockefeller Foundation
produced more than 28 million doses of the vaccine and
finally ended yellow fever as a major disease
49

50. Selman Waksman ( 1888 -1973)
• Ukrainian-American biochemist and microbiologist
• He discovered over twenty antibiotics (a word which
he coined) and introduced procedures that have led to
the development of many others
“The Father of Antibiotics”
• In 1952 ,Nobel Prize "for his discovery of
‘streptomycin’ the first antibiotic active against
tuberculosis”
50

51. John Enders ( 1897 - 1985)
• American scientist
• 1954 Noble – “for their discovery of the ability
of poliomyelitis viruses to grow in cultures of
various types of tissue“
• Jonas Salk used to develop the polio vaccine in 1952
"The Father of Modern Vaccines.”
51

52. John Michael Bishop (born February1936)
• An American immunologist and microbiologist
• Working with Harold E. Varmus in the 1980s, he
discovered the first human oncogene, c-Src.
• Their findings allowed the understanding of how
malignant tumors are formed from changes to the
normal genes of a cell
• These changes can be produced by viruses, by radiation,
or by exposure to some chemical
• 1989, Nobel Prize - for his Nobel-winning work
on retroviral oncogenes.
52

53. Barry James Marshall,(born 30 September 1951)
• An Australian physician , Professor of
Clinical Microbiology
• 2005 Nobel Prize, shared with Robin Warren showed
that the bacterium Helicobacter pylori (H. pylori) is the
cause of most peptic ulcers
• Reversing holding that ulcers were caused by stress,
spicy foods and too much acid.
53

54. Harald zur Hausen (born March 11, 1936)
• A German virologist
• HPV16 and HPV18 in cervical cancers in 1983.
• Discovered the role of papilloma viruses in Ca cervix,
for which with Luc Montagnier and Sinoussi (HIV)
the Nobel Prize in 2008
• This research to development of a vaccine which was
introduced in 2006.
54

55. PREVENTIVE MEDICINE
• Hermann M. Biggs (1859-1923)
• An American physician
• A pioneer in public health education and implementing
disease control measures
• helped apply the science of bacteriology to the
prevention and control of infectious diseases
• He established the world's first municipal diagnostic
laboratory in New York City,
- developed tuberculosis control measures now
considered standard and used worldwide
"The Father of Modern Public Health”
55

56. Charles-Edward Amory Winslow
(1877 – 1957 )
• An American bacteriologist and public health expert
“Science and art of preventing disease, prolonging life
and promoting health and efficiency through
organized community efforts”
- sanitation of the environment
- the control of communicable infections
- the organization of medical and nursing services
- early diagnosis and prevention of disease,
- the education of the individual in personal health
• 1915 - Yale School of Public Health
56

57. Sir Joseph William Bhore (1878-1960)
• Bhore committee - by the Government of India in 1943
to investigate and recommend improvements to the
Indian Public Health system.
• Introduced - Primary health centres in India.
• Though most of the recommendations of the committee
were not implemented at the time, the committee was a
trigger to the reforms that followed.
• He said to be the man responsible for the initial concepts
of comprehensive health care in India
57

58. • Bertrand Edward Dawson (1864 - 1945)
• A British physician
• Advised that Primary Health Centres –
- one or two 16 bed wards (including maternity)
- Clinics - operating room
- radiography - laboratory
- dispensary - public mortuary
- common room for training and clinical records
- ambulances to convey the sick and to provide travelling
clinic
- Provide communal services, such as child welfare, pre-
natal care, medical inspection and treatment of school
children and a service for occupational diseases.
58

59. Social Medicine
“A study of man as a social being in his total environment”
• Rudolph Carl Virchow ( 1821 -1902)
• was a German,biologist and politician
the founders of social medicine
• Man is a social being, and diseases also has
social causes, social consequences and social
therapy
• Alfred Grotjahn (1869 - 1931)
• 1911 – Importance of social factors in the
etiolgy of disease, called - Social Pathology
59

60. Medical revolution
• Modern Medicine – Marvellous Discoveries
• Uncovering of genetic code
• Prenatal diagnosis of sex / genetic diseases
• Cloning
• Organ transplant
60

61. James Dewey Watson (born April 6, 1928)
• Known as a co-discoverer of the structure
of DNA in 1953 with Francis Crick
• 1962 Nobel Prize in Physiology or Medicine
"for their discoveries concerning the
molecular structure of nucleic acids and
its significance for information transfer in
living material"
61

62. Joseph Murray (April 1, 1919)
• An American plastic surgeon
• In December 1954, world's first successful renal
transplant between the identical twins
• In 1959 - world's first successful allograft and
• 1962 - the world's first cadaveric renal
transplant.
• Nobel Prize in 1990 with E. Donnall Thomas for
work on organ and cell transplantation
62

63. Sir Robert Edwards (born 27 September 1925)
• A British physiologist
• Pioneered conception through IVF, which led
to the birth of the first test-tube baby, Louise
Brown, on 25 July 1978.
• 2010 Nobel Prize "for the development of in
vitro fertilization".
• Provide a new way to help infertile couples
who formerly had no possibility of having a
baby.
63

64. Summary
• Noble prize had been started since 1900 AD, in the memory of Alfred
Noble and is given to those whose work make greatest benefit to
mankind.
• In the evolution of public health there were some individuals who did
not get noble prize but their work remain revolutionary like
Aesculapius, Hippocrates, Galen, Paracelsus,John Snow, Edward Jenner
and others
• Among those who got Noble prize were Robert Koch, Ronald Ross,
Alexander Fleming, Emil Ehring and others
• In public health administration Edwin Chadwick, William Farr, Sir John
Simon, Charles Winslow, Sir Joseph William Bhore contributed a lot
• James Dewey Watson ,Sir Robert Edwards, Joseph Murray are some
names which introduced new techniques to bring revolution in modern
medicine
64

65. References
❖ Oxford Textbook of Public Health, Roger Detels, James McEwen,
Robert Beaglehole, Heizo Tanaka, 4th Edition 2002, Oxford University
Press.
❖ Public Health and Preventive Medicine, Wallace/Maxcy-Rosenau-
Last,15th edition,2008, The McGraw-Hill publication.
❖ Textbook of Public Health and Community Medicine,1st edition,2009,
Dept of community medicine AFMC, Pune.
❖ Textbook of Preventive and Social Medicine, K. Park, 21st edition,
2011, Bhanot publication.
65

66. References
❖ Textbook of Community Medicine,J.P.Baride, A.P.Kulkarni ;3rd
edition,2006; Vora medical publication.
❖ Community Medicine With Recent Advances, A.H.Suryakanta; 2nd
edition,2010;Jaypee publication.
❖ Foundation of Community Medicine, G.M.Dhar, I. Robbani; 1st
edition,2006;Elsevier publication.
❖ Deepak Kumar. Probing History of Medicine and Public Health in India,
Indian Historical Review, 2010;37(2),259–273.
❖ htpp://www.nobleprize.org.com
❖ htpp://www. wikipedia.com
66

67. Thank
you