During my professional lifetime there has been a fantastic increase in the number of effective drugs available for treating diseases and as a result the whole spectrum of illness has changed. Antibiotics for example have almost eliminated the once common acute mastoid infestion which left so many subsequently deaf and such serious illness as tuberculosis can now be cured. As a medical student I was taught that the first essential was diagnosis; without specific remedies at least one had to get the diagnosis right. Fortunately the natural defences of the body could sometimes bring about recovery with the doctors and the nurses getting the credit. Within less than half a century discovery has proceeded with great speed and at a pace which is unlikely ever to be matched again in the future. Nevertheless many challenges persist for the rising generation.