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The 19th century in Europe saw the emergence of modern medicine. Vaccination for smallpox was introduced. The stethoscope, clinical thermometer and hypodermic syringe were developed. Morphine and quinine were isolated. Surgical instruments were perfected, antiseptic techniques were developed, and the use of ether as an anaesthetic agent was demonstrated in 1846 at the Massachusetts General Hospital—the single most important contribution of American medicine during the century. Pasteur, Koch, Klebs, Roux and Yersin established the science of bacteriology, and between 1880 and 1900 the microbial origins of numerous diseases were demonstrated. A new interest in nutrition developed.
In 1895 two events took place that would have a profound effect on the progress of American medicine: 1) the discovery of a "new kind of rays" by Roentgen, which led to the development of diagnostic radiology and X-ray therapy; and 2) the development of psychoanalytic psychiatry through the studies of Sigmund Freud. In the same way, the accurate diagnosis of many diseases was virtually impossible before the advent of two major technologies in the early part of the 20th century; 1) the chemistry of blood and bodily fluids, which made easier the study of the body's organ systems; and 2) the use of the X-ray machine and the progressive development of such radiopaque substances as barium and iodine compounds to visualize organ systems. These two advances, together with the expansion of surgery after the introduction of anaesthesia and antiseptic techniques, transformed the hospital. From a passive receptacle for the sick poor, it became a house of hope and an active diagnostic and curative institution for all classes. The use of blood transfusions hastened the transformation.
The new sciences of bacteriology, biostatistics and epidemiology led to development and extensive use of vaccines, pasteurization of milk and measures for the control of disease. These advances led to a marked improvement in public health. So did the development of urban sewage-disposal and water-purification systems, the rapid transportation of fresh food and its storage under refrigeration, state food-control acts and the new concern for woman and child labor, as well as for industrial working conditions. By 1910 average life expectancy at birth had increased to 50 years.
The Progressive Era also profoundly affected health interests. Upton Sinclair's The Jungle, in 1906, exposed abysmal conditions in meat-packing plants. Congress responded by passing the first meat-inspection law. Samuel Hopkins Adams muckraked the patent-medicine industry, and Congress swiftly enacted the Pure Food and Drug Act.