What is the greatest medical breakthrough since 1840? Make your nomination at bmj.com

When the BMJ was first published, in 1840, average life expectancy in the Western world was only about half as long as it is today. Some of the reasons for this are social and political: increasing prosperity and increasing longevity have, for the most part, come hand in hand. But many of the reasons are medical, in the broadest sense of the term. The meticulously recorded observations of epidemiologists; the chance discoveries of pharmacologists; the …