MEDICAL BREAKTHROUGHS IN ALL THEIR GORY

Posted in Modern life, Pills or medicine by carolcooper

Now and again I like to remember how much progress medicine has made in just two centuries or so. Times past were fairly primitive, even if they made for some terrific artwork. Antibiotics hadn’t been discovered, barbers did the blood-letting, and festering sores were common. Nowadays, we have antibiotics galore, barbers are a lot more careful, and most of the festering sores are political.

Diagnostics were rudimentary until quite recently. It was 1816 when French physician René Laennec (1781–1826) invented the stethoscope. The very first version looked like a cylinder of rolled up paper, which is exactly what it was. Binaural stethoscope models came later. Pronounced La Neck, René’s surname was to become an important clue as to where medics should wear their instrument when not in use.

There wasn’t even a clinical thermometer until 1866. X-rays only came along in 1895. Doctors did not always examine their patients closely because it was considered rude, but they did scrutinize their excreta, which was apparently not rude. In 2026, doctors have a vast array of diagnostic tools and no longer have to dabble in their patients’ bodily waste. They despatch it to some hapless lab technician instead.

*A 17^th century medical practitioner examining urine. Oil painting after David Teniers the younger.*

Both boon and bane, the computer only made its impact on medicine this century. In 1826, English mathematician Charles Babbage (1791–1871) published work that was pivotal to computing and actuarial science. Mathematician Ada Lovelace (1815–1852) was only ten at the time, but she later collaborated with Babbage and produced the first algorithm. Today, IT has completely changed the face of medical practice. It is now possible for a doctor to avoid looking at the patient at all, even when they are in the same room, and spend the entire consultation fixated on the screen.

(c) Royal Free Hospital; Supplied by The Public Catalogue Foundation — Elizabeth Garrett Anderson, after John Singer Sargent

Women doctors were non-existent until the 19^th century. In 1865, Elizabeth Garrett Anderson (1836–1917) became the first woman to qualify as a doctor in Britain. However, one James Barry (1789–1865) had qualified in 1812 and practised as a British army surgeon for over 40 years. Only after he died did anyone discover that he had been she all along. So much for the thoroughness of the army medical.

The fairer sex could develop either brains or ovaries, but not both, declared one authority in 1874. On the whole, it was a woman’s job to reproduce, not go to medical school.

*Home birth. Painting by Carl Lemoch (1885)*

Alas, reproduction was not always straightforward. Midwifery was in its infancy, so to speak, and women had unpleasant low-tech births. A mother-to-be preferred to deliver at home, so, while she laboured, the other children could play nearby, and someone would be sent to boil lots and lots of water, possibly to make tea. No woman wanted to deliver in hospital anyway for fear of catching deadly puerperal fever. Nowadays, unpleasant high-tech births are the norm and many women still favour delivering at home. With puerperal fever now a thing of history books, doctors cannot understand why women shun maternity wards, and interested parties still debate whether birth is safer at home than in hospital.

Some of the most dramatic advances have been in surgery. It was a gruesome business until general anaesthesia came along around the mid-19^th century. Those that survived their procedure then faced the risk of deadly infections. Surgeons did not wear rubber gloves until much later that century, and the use of masks did not take off until the 1920s. Bacteria had a field day.

The Gross Clinic (1875) by Thomas Eakins. Dr Samuel Gross operates on a young boy’s leg. A towel soaked in chloroform serves as anaesthetic

However, while human endeavour has advanced healthcare, microorganisms have made progress too, ever adapting and mutating to resist new treatments. French legend Louis Pasteur (1822–1895) did not use the term superbugs or antimicrobial resistance, but he did say “Messieurs, it is microbes that will have the last word.”

The paperback of The History of Medicine in Twelve Objects will be out on August 20. You can pre-order it here, or get the hardback, ebook, or audiobook right now.

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11May2026

WHAT CAN COMPARE TO THE HUMAN HEART?

Posted in Pills or medicine by carolcooper

The heart is unique. Limbs can relax. Even the brain can rest sometimes. The heart cannot. It beats on average once a second, or nearly three billion times in a person’s lifetime. Of course, lungs are vital organs too. Like the heart, their movement is obvious even to a casual observer. But there are two of them, and they hardly carry the same significance. Has any poet ever pledged his lungs to his true love?

Surgery demands a still and bloodless field. But the heart is in continuous motion, pumping 5 litres (one gallon) of blood every minute. Many warned that operating on the heart was impossible.

That didn’t deter everyone. American surgeon Dwight Harken (1910–93) was a larger-than-life military medic from Iowa. Harken arrived in England with the US military in preparation for the D-Day landings. He was thirty-four when he was appointed to manage the 160th US General Hospital, a rambling field hospital in the grounds of Stowell Park, Gloucestershire. It bore more than a passing resemblance to a string of Nissen huts, but it contained all the equipment Harken needed.

Tall, red-haired, and somewhat temperamental, Harken turned out to be just right for the job. In the last year of the war, he busied himself removing bullets and shell fragments from the chests of 134 soldiers. In fifty-six cases, these were inside the heart. Even so, every single one of his patients survived, even Sergeant Leroy Rohrbach. An explosion at the Battle of Normandy had sent a piece of shrapnel flying into Rohrbach’s chest, where it embedded in his heart.

Harken had already tried twice to remove it. At the third attempt, there was a torrential haemorrhage. Harken managed to plug the wound in the heart with one finger. The operation was a success, although Harken had stitched a finger of his glove to the patient’s heart.

If you enjoyed this extract, you might like The History of Medicine in Twelve Objects which contains many more anecdotes of medical firsts. “Sometimes gruesome, frequently fascinating and, on occasions, very funny indeed” ~ Kathryn Hughes, Mail on Sunday

19Dec2024

WHAT’S THE MOST CHRISTMASSY MEDICAL OBJECT?

Posted in Pills or medicine by carolcooper

A lot of readers enjoy seasonal reading this time of year. I know this from the popularity of books such as Sue Moorcroft’s A Skye Full of Stars and Elaine Everest’s A Christmas Wish at Woolworth’s. So perhaps it should not have surprised me to be asked, “What’s the most Christmassy object in your book?”

I scratched my head. My latest book, The History of Medicine in Twelve Objects focuses, as the title suggests, on a dozen iconic objects in medical history. While writing it, I gave hardly a thought to the birth of Jesus. But, with Christmas now less than a week away, I offer this festive tale of the X-ray machine.

Roentgen (1845-1923) with a beard fit for Santa

It was December 1895. For over six weeks, German physicist Wilhelm Conrad Roentgen had been busy in his lab in Würzburg – so busy that he missed meals, slept on a cot by his lab bench, and, it’s safe to say, hadn’t even begun Christmas shopping. What exactly was that radiation coming out of his cathode ray tube? Unlike a beam of light, these rays could go through black cardboard. Roentgen tried blocking the rays with a book, some wood, rubber, a deck of cards, and various metal sheets. Only lead stopped them completely.

Keen to find out what her husband had been doing, Anna Bertha Roentgen visited the lab. She was asked to hold out a photographic plate in front of the beam. This produced an image of her hand, complete with the bones of her fingers and the ring she was wearing. Definitely one for the family album.

Roentgen didn’t know what the rays were, so he called them ‘X’. His publication of his discovery on December 28 made the headlines. Public speculation went wild. Could peeping toms use the rays for peering through women’s knickers? In response to this fear, one London manufacturer began making lead-lined underwear.

As it turned out, there were more serious worries. The first medical X-ray was just weeks later. In January 1896, Birmingham doctor John Hall-Edwards (1858–1926) took an image of a needle stuck in the hand of his assistant. Hall-Edwards had an interest in photography and went on to take many more radiographs during his career.

X-rays weren’t just used for making a diagnosis. Doctors also used them as remedies for a miscellany of conditions, like moles and skin conditions ranging from acne to TB of the skin.

Unfortunately, it soon emerged that prolonged X-ray exposure causes dermatitis, burns, ulceration, hair loss – and worse. Hall-Edwards had to have his left arm amputated below the elbow when he developed cancer. He then lost four fingers from his right hand, leaving him with just one thumb. His left hand can be found in the Chamberlain Museum of Pathology at the University of Birmingham.

Since then, medics have become far more cautious in their use of X-rays and there are plenty of safeguards. What’s more, the concept making the body transparent has led to imaging methods that don’t use X-rays. So that’s a happy ending, although not an ending as such, because as you know inventors love inventing.

Wishing you all a Merry Christmas and a happy, healthy New Year.

23Oct2024

THEY SAID IT COULDN’T BE DONE

Posted in Pills or medicine, Writing by carolcooper

There’s no shortage of great quotes in medicine but this one is among my favourites.

“Once they said it could not be done, it was a sufficient challenge to do it.“

Born on this day in 1918, American heart surgeon Walton Lillehei rose to that challenge and pioneered new ways of doing what couldn’t be done.

Some had said it shouldn’t even be attempted. Operating on the heart was too dangerous. Surgery requires a still and bloodless field. But the heart is in continuous motion, pumping 5 litres of blood every minute. If you stop it, there are dire effects on the brain. It can’t survive more than four minutes without a supply of blood.

In Minnesota, Walt Lillehei came up with the idea of operating on children’s hearts using cross-circulation, where one of the parents does the work of the child’s heart and lungs during the operation. His first patient in 1954 was Gregory Glidden, a thirteen-month-old with a hole in the heart called a ventricular septal defect (VSD). Gregory’s father had the same blood group, so he lay on another operating table next to his child and provided oxygen-rich blood during the surgery.

Gregory’s heart was still beating, but it was bloodless as Lillehei stitched up the hole in the heart. The operation took seventeen minutes. Gregory survived his surgery, though sadly he died of pneumonia a few days later.

Lillehei used cross-circulation on many more occasions to correct congenital heart defects. It was the first series of successful open-heart operations.

Reactions were mixed. Some doctors thought his technique was immoral because it put the donor at risk. That was true. The method had, as Lillehei admitted, a potential mortality rate of 200 per cent.

The popular press, on the other hand, was in rapture, especially when one five-year-old girl was riding her tricycle seven weeks after open-heart surgery. A New Heart for Pamela became headline news, never mind that it was a repaired heart rather than a new one.

The publicity had benefits for the blood bank too. Each operation needed about 7 litres of blood, and local residents soon flocked to become donors and help save young lives.

Plastic didn’t come into use for blood bottles until the 1970s

Of course, cross-circulation wasn’t always feasible. Lillehei also worked with colleagues to refine the heart-lung machine, a new device that could take over the work of the patient’s heart and lungs during surgery.

Walt Lillehei is just one of the many shining lights that made the impossible possible. There are more trailblazers and their iconic inventions in my newest book The History of Medicine in Twelve Objects.