anthracis (1877), the tuberculosis bacillus (1882) and vibrio cholerae (1883) and for his development of koch's postulates. he was awarded the nobel prize in physiology or medicine in 1905 for his tuberculosis findings. koch is one of the founders of microbiology, inspiring such major figures as paul ehrlich and gerhard domagk. events american civil war american civil war hospital at gettysburg, 1863 in the american civil war (1861–65), as was typical of the 19th century, more soldiers died of disease than in battle, and even larger numbers were temporarily incapacitated by wounds, disease and accidents. conditions were poor in the confederacy, where doctors and medical supplies were in short supply. the war had a dramatic long-term impact on medicine in the u.s., from surgical technique to hospitals to nursing and to research facilities. weapon development -particularly the appearance of springfield model 1861, mass-produced and much more accurate than muskets led to generals underestimating the risks of long range rifle fire; risks exemplified in the death of john sedgwick and the disastrous pickett's charge. the rifles could shatter bone forcing amputation and longer ranges meant casualties were sometimes not quickly found. evacuation of the wounded from second battle of bull run took a week. as in earlier wars, untreated casualties sometimes survived unexpectedly due to maggots debriding the wound -an observation which led to the surgical use of maggots -still a useful method in the absence of effective antibiotics. the hygiene of the training and field camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers. first came epidemics of the childhood diseases of chicken pox, mumps, whooping cough, and, especially, measles. operations in the south meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria. there were no antibiotics, so the surgeons prescribed coffee, whiskey, and quinine. harsh weather, bad water, inadequate shelter in winter quarters, poor policing of camps, and dirty camp hospitals took their toll. this was a common scenario in wars from time immemorial, and conditions faced by the confederate army were even worse. the union responded by building army hospitals in every state. what was different in the union was the emergence of skilled, well-funded medical organizers who took proactive action, especially in the much enlarged united states army medical department, and the united states sanitary commission, a new private agency. numerous other new agencies also targeted the medical and morale needs of soldiers, including the united states christian commission as well as smaller private agencies. the u.s. army learned many lessons and in august 1886, it established the hospital corps. institutions johns hopkins hospital, founded in 1889, originated several modern medical practices, including residency and rounds. people louis pasteur (1822-1895) known for, with koch, for the founding of modern bacteriology, contributions to germ theory, and pasteurization. robert koch (1843-1910) known for his founding, with pasteur, of modern bacteriology, the father of medical bacteriology., and providing proofs for the scientific basis of public health. rebecca lee crumpler (1831-1895) known as the first african-american woman to become a physician. blood groups the abo blood group system was discovered in 1901 by karl landsteiner at the university of vienna. landsteiner experimented on his staff, mixing their various blood components together, and found that some people's blood agglutinated (clumped together) with other blood, whilst some did not. this then lead him identifying three blood groups, abc, which would later be renamed to abo. the less frequently found blood group ab was discovered later in 1902 by alfred von decastello and adriano sturli. in 1937 landsteiner and alexander s. wiener further discovered the rh factor (misnamed from early thinking that this blood group was similar to that found in rhesus monkies) whose antigens further determine blood reaction between people. this was demonstrated in a 1939 case study by phillip levine and rufus stetson where a mother who had recently given birth had reacted to their partner's blood, highlighting the rh factor. blood transfusion canadian physician norman bethune, m.d. developed a mobile blood-transfusion service for frontline operations in the spanish civil war (1936–1939), but ironically, he himself died of sepsis. pacemaker in 1958, arne larsson in sweden became the first patient to depend on an artificial cardiac pacemaker. he died in 2001 at age 86, having outlived its inventor, the surgeon, and 26 pacemakers. cancer cancer treatment has been developed with radiotherapy, chemotherapy and surgical oncology. diagnosis x-ray imaging was the first kind of medical imaging, and later ultrasonic imaging, ct scanning, mr scanning and other imaging methods became available. disabilities a cochlear implant is a common kind of neural prosthesis, a device replacing part of the human nervous system.prosthetics have improved with lightweight materials as well as neural prosthetics emerging in the end of the 20th century. diseases oral rehydration therapy has been extensively used since the 1970s to treat cholera and other diarrhea-inducing infections. as infectious diseases have become less lethal, and the most common causes of death in developed countries are now tumors and cardiovascular diseases, these conditions have received increased attention in medical research. malaria eradication main article: history of malaria starting in world war ii, ddt was used as insecticide to combat insect vectors carrying malaria, which was endemic in most tropical regions of the world. the first goal was to protect soldiers, but it was widely adopted as a public health device. in liberia, for example, the united states had large military operations during the war and the u.s. public health service began the use of ddt for indoor residual spraying (irs) and as a larvicide, with the goal of controlling malaria in monrovia, the liberian capital. in the early 1950s, the project was expanded to nearby villages. in 1953, the world health organization (who) launched an antimalaria program in parts of liberia as a pilot project to determine the feasibility of malaria eradication in tropical africa. however these projects encountered a spate of difficulties that foreshadowed the general retreat from malaria eradication efforts across tropical africa by the mid-1960s. 1918 influenza pandemic (1918-1920) the 1918 influenza pandemic was a global pandemic in the early 20th century that occurred between 1918 and 1920. sometimes known as spanish flu due to popular opinion at the time thinking the flu originated from spain, this pandemic caused close to 50 million deaths around the world. spreading at the end of world war i. public health public health measures became particularly important during the 1918 flu pandemic, which killed at least 50 million people around the world. it became an important case study in epidemiology. bristow shows there was a gendered response of health caregivers to the pandemic in the united states. male doctors were unable to cure the patients, and they felt like failures. women nurses also saw their patients die, but they took pride in their success in fulfilling their professional role of caring for, ministering, comforting, and easing the last hours of their patients, and helping the families of the patients cope as well. research evidence-based medicine is a modern concept, not introduced to literature until the 1990s. sexual and reproductive health most countries have seen a tremendous increase in life expectancy since 1945. however, in southern africa, the hiv epidemic beginning around 1990 has eroded national health.the sexual revolution included taboo-breaking research in human sexuality such as the 1948 and 1953 kinsey reports, invention of hormonal contraception, and the normalization of abortion and homosexuality in many countries. family planning has promoted a demographic transition in most of the world. with threatening sexually transmitted infections, not least hiv, use of barrier contraception has become imperative. the struggle against hiv has improved antiretroviral treatments. smoking tobacco smoking as a cause of lung cancer was first researched in the 1920s, but was not widely supported by publications until the 1950s. surgery cardiac surgery was revolutionized in 1948 as open-heart surgery was introduced for the first time since 1925. in 1954 joseph murray, j. hartwell harrison and others accomplished the first kidney transplantation. transplantations of other organs, such as heart, liver and pancreas, were also introduced during the later 20th century. the first partial face transplant was performed in 2005, and the first full one in 2010. by the end of the 20th century, microtechnology had been used to create tiny robotic devices to assist microsurgery using micro-video and fiber-optic cameras to view internal tissues during surgery with minimally invasive practices. laparoscopic surgery was broadly introduced in the 1990s. natural orifice surgery has followed. mexican revolution (1910-1920) during the 19th century, large-scale wars were attended with medics and mobile hospital units which developed advanced techniques for healing massive injuries and controlling infections rampant in battlefield conditions. during the mexican revolution (1910–1920), general pancho villa organized hospital trains for wounded soldiers. boxcars marked servicio sanitario ("sanitary service") were re-purposed as surgical operating theaters and areas for recuperation, and staffed by up to 40 mexican and u.s. physicians. severely wounded soldiers were shuttled back to base hospitals. world war i (1914-1918) medicine during the first world war - medical transport.thousands of scarred troops provided the need for improved prosthetic limbs and expanded techniques in plastic surgery or reconstructive surgery. those practices were combined to broaden cosmetic surgery and other forms of elective surgery. interwar period (1918-1939) from 1917 to 1932, the american red cross moved into europe with a battery of long-term child health projects. it built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. a high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. hundreds of u.s. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of european youth and to reshape european public health and welfare along american lines. world war ii (1939-1945) american combat surgery during the pacific war, 1943. major wars showed the need for effective hygiene and medical treatment.the advances in medicine made a dramatic difference for allied troops, while the germans and especially the japanese and chinese suffered from a severe lack of newer medicines, techniques and facilities. harrison finds that the chances of recovery for a badly wounded british infantryman were as much as 25 times better than in the first world war. the reason was that: "by 1944 most casualties were receiving treatment within hours of wounding, due to the increased mobility of field hospitals and the extensive use of aeroplanes as ambulances. the care of the sick and wounded had also been revolutionized by new medical technologies, such as active immunization against tetanus, sulphonamide drugs, and penicillin." during the second world war, alexis carrel and henry dakin developed the carrel-dakin method of treating wounds with an irrigation, dakin's solution, a germicide which helped prevent gangrene. the war spurred the usage of roentgen's x-ray, and the electrocardiograph, for the monitoring of internal bodily functions. this was followed in the inter-war period by the development of the first anti-bacterial agents such as the sulpha antibiotics. nazi and japanese medical research unethical human subject research, and killing of patients with disabilities, peaked during the nazi era, with nazi human experimentation and aktion t4 during the holocaust as the most significant examples. many of the details of these and related events were the focus of the doctors' trial. subsequently, principles of medical ethics, such as the nuremberg code, were introduced to prevent a recurrence of such atrocities. after 1937, the japanese army established programs of biological warfare in china. in unit 731, japanese doctors and research scientists conducted large numbers of vivisections and experiments on human beings, mostly chinese victims. world health organization smallpox vaccination in niger, 1969. a decade later, this was the first infectious disease to be eradicated.the world health organization was founded in 1948 as a united nations agency to improve global health. in most of the world, life expectancy has improved since then, and was about 67 years as of 2010, and well above 80 years in some countries. eradication of infectious diseases is an international effort, and several new vaccines have been developed during the post-war years, against infections such as measles, mumps, several strains of influenza and human papilloma virus. the long-known vaccine against