4
Table 1.2 Landmarks in the historical development of personalized medicineEra/year Medical system/concept
10,000 years ago Primitive medicine a mixture of magic, rituals and potions and personal
touch
6000–3000 BC Mesopotamian and Egyptian medicine: Rituals plus medicines from natural
sources, some of which are still in use and some are the basis of
currently used medicines
4000–500 BC Ayurveda, the ancient medical system of India with a blend of
transcendental meditation and herbs, provided the fi rst concept of
individualized healthcare
3000 BC Ancient Chinese medicine used herbs and acupuncture, which are still in use
510 BC The Greek Pythagoras observed that only some individuals (now known to
have defi ciency of G6PD) developed a potentially fatal reaction after
ingesting fava beans
500 BC – 500
AD
Greek medicine separated from rituals and religion. Clinical observations on
diseases but few medicines
500 AD – 1500
AD
Medieval period of medicine. Further development of Greek tradition in
Arabic medicine. Start of hospitals and universities
Sixteenth to
eighteenth
centuries
Important discoveries in anatomy and physiology but no pharmacological
advances in middle ages. Patient care was personalized for lack of
standard treatments
1789 Founding of homeopathy based on “like cures like” by Samuel Hahnemann
in Germany. Homoeopathic prescribing is highly individualized to a
person’s “constitutional picture” rather than to specifi c diseases
Nineteenth
century, late
Start of modern medicine. Claude Bernard’s (1813–1878) introduction of
the scientifi c method into medicine, founded on observation and proved
by experiments, started to endanger personal aspects of treatment
Twentieth century Most of the advances in medicine were made in this century including
imaging techniques, laboratory diagnostics and modern surgical
techniques. Important advances in later decades include discovery of
biotechnology- based products, molecular diagnostics, genomics,
proteomics, biochips, antisense therapy and gene therapy
Twentieth
century
second half
Introduction of randomized, double-blind clinical trials was inconsistent
with the individualized treatment as it leveled out variations of individual
responses to treatment
1908 Introduction of the word ‘gene’ into the German language as ‘Gen’ by
Wilhelm Johannsen and subsequent terms “genotype” and “phenotype”
1920–1950 Scientifi c basis of pharmacology developed with concept of receptors
1931 Publication of a book suggesting that individual differences in responses to
drugs should be anticipated because of the marked individual differences
in each person’s genetic constitution (Garrod^1931 )
1953 Identifi cation of the double-stranded structure of the DNA (Watson and
Crick 1953 )
1955 Observation of a high incidence of hemolysis on exposure to antimalarial
drugs among individuals with glucose-6-phosphate dehydrogenase
defi ciency (Beutler et al. 1955 )
1956–1957 Concept of pharmacogenetics: recognition that adverse reactions to drugs
can be caused by genetically determined variations in enzyme activity
(Kalow 1956 ; Motulsky 1957 )
(continued)
1 Basic Aspects