The SMA celebrates its centennial anniversary.

The practice of medicine has witnessed tremendous progress and dramatic changes during the past 100 years. Although the main goals of medicine as spelled out by Hippocrates to first do no harm, and second to do good, have not changed for the past 3 millennia, the practice of medicine itself has been revolutionized, most notably during the last several decades.

Progress in the medical sciences had been arduous and slow until the twentieth century when it then suddenly exploded. We began to understand the pathophysiology of many diseases, new syndromes were discovered, and the birth of various specialties mushroomed. To commemorate the SMA's anniversary, we intend to publish a series of short papers that will emphasize the impact of various discoveries in the field of medicine. We also intend to publish short essays entitled "Lest We Forget," which will highlight the lives of those who have added the most to the medical community.

In addition, we intend to occasionally use quotes and advertisements from the first year of the Southern Medical Journal as fillers. The purpose is not to minimize or ridicule the efforts of our predecessors but to emphasize how the attitudes and practices of medicine have changed during this past century.

Medicine has applied advances in many of the sciences to enhance its effectiveness at managing diseases. The era of spoonfuls has been replaced by grams and micrograms. Instead of giving a medication 3 or 4 times a day, now many medications can be given once a day, once a week, or even once a month; medications that can be administered once a year are also being tested.

The availability of various diagnostic tools and increasingly sophisticated laboratory tests have revolutionized the diagnostic process, and new discoveries are continuing to be made. Many medical care facilities are often finding it difficult to keep pace with the availability of various new diagnostic tools.

The discovery of anesthesia has ushered in the era of surgery. The ability to transfuse blood safely has emboldened surgeons. Microsurgery gave this specialty a further boost, and the advent of laparoscopic surgery has significantly shortened recovery periods. Same-day surgeries are now the norm rather than the exception, and progress in immunology has allowed surgeons to perform transplants. Cosmetic surgery has added an entirely new dimension to the concept of health as defined by the World Health Organization as being a state of total physical, mental, and social wellbeing, rather than just the absence of disease. Incidentally, it is during this past century that the World Health Organization was founded.

[ILLUSTRATION OMITTED]

Vaccines have also had a tremendous impact. Poliomyelitis has been almost eradicated from the world. Flu shots have saved innumerable numbers of lives and have considerably reduced the associated morbidity. It is also sobering to remember that antibiotics only became available during the past 50 years. Diseases that were associated with high mortality rates are now easily treated. We cannot, however, decrease our vigilance as many microorganisms are finding ways to elude the effect of antibiotics and the duel between microbes and scientists is ongoing.

Life support science has become so refined that a number of ethical issues have been raised. Progress in gene mapping is likely to raise yet more ethical issues when insurers will be tempted to refuse to provide coverage for people with genes predisposing to certain diseases. Will this eventually lead to a universal insurer?

So many advances have been made that it is difficult to imagine what the medical landscape will be at the end of our present century and when the SMA celebrates its 200th anniversary. It is, however, with great anticipation that we witness the continuous progress being made in the various fields of medicine. In the meantime, I would like to wish all our readers a very happy and healthy new year.

As always, we welcome input from our readers. Please contact us at [e-mail] if you are interested in contributing to any of the above-mentioned series, or if you have any ideas on improving the contents of the Journal.

Ronald Hamdy, MD, FRCP, FACP 

Editor-in-chief