[Dissemination of medical information in Europe, the USA and Japan, 1850-1870: focusing on information concerning the hypodermic injection method].

Modern medicine was introduced in Japan in the second half of the nineteenth century. In order to investigate this historical process, this paper focuses on the dissemination of information of a new medical technology developed in the mid-nineteenth century; it does so by making comparisons of the access to medical information between Europe, the USA and Japan. The hypodermic injection method was introduced in the clinical field in Europe and the USA as a newly developed therapeutic method during the 1850s and 1870s. This study analyzed information on the medical assessments of this method by clinicians of these periods. The crucial factor in accumulating this information was to develop a worldwide inter-medical communication circle with the aid of the medical journals. Information on the hypodermic injection method was introduced in Japan almost simultaneously with its introduction in Europe and the USA. However, because of the geographical distance and the language barrier, Japanese clinicians lacked access to this worldwide communication circle, and they accepted this new method without adequate medical technology assessments.

The history of injectable facial fillers.

In an attempt to maintain a youthful appearance or to reconstruct facial deformities, physicians have greeted new technologies with excitement. In the late 1800 s, shortly after the invention of the syringe, chemical agents were used for facial augmentation. Unfortunately, history has taught us that new technologies must be used with care, because complications can occur, sometimes many years after initial treatment. The first injectable filling agent was paraffin, whose use was abandoned after complications of migration, embolization, and granuloma formation were described. More recently, silicone use was banned by the U.S. Food and Drug Administration (FDA) because of similar complications. In 1981, bovine collagen was the first agent to be approved by the FDA for cosmetic injection. Since its approval, dozens of injectable filling agents have been developed, and many are already FDA approved for cosmetic use. This article will review the highlights of the evolution of facial filling agents.

The syringe driver and the subcutaneous route in palliative care: the inventor, the history and the implications.

Since the early 1980s, the syringe driver has become a commonly used technology in British palliative care, used to administer continuous subcutaneous infusions (CSCI) for symptom management. Although the device itself has not been adopted universally, it has stimulated interest in the use of CSCI in palliative care and played a significant role in the modern history of this approach. This historical case study of the syringe driver examines the life and work of its inventor, explores its development for use in childhood thalassemia, and analyzes the circumstances surrounding its adoption in palliative care. We conclude by considering the reasons for the continued popularity of the syringe driver, despite problems in its use, and reflect on the lessons which can be learned about the use of CSCI in palliative care internationally.

[History of injections. Pictures from the history of otorhinolaryngology highlighted by exhibits of the German History of Medicine Museum in Ingolstadt]. / Die Geschichte der Injektionen. Bilder aus der Geschichte der Hals-Nasen-Ohren-Heilkunde, dargestellt an Instrumenten aus der Sammlung im Deutschen Medizinhistorischen Museum in Ingolstadt.

BACKGROUND: Injections are part of the arsenal of all medical disciplines. In addition to this common ground, each specialty has its own particular aspects; the historical development of these are presented here with respect to otorhinolaryngology. INTRAVENOUS INJECTIONS: The first experiments with intravenous injections were carried out in 1642 by a gentleman's hunting servant in eastern Germany. Similar experiments were done in 1656 by Christopher Wren, the astronomer, mathematician, and architect in Oxford, England, and a group of scientists around the physicist Robert Boyle. These experiments were prompted by new knowledge about blood circulation provided by William Harvey in 1628. The first books on the applications of intravenous infusions in humans were published in Germany by Major 1664 (Chirurgia Infusoria) and Elsholtz 1667 (Clysmatica Nova). Bladders of animals or enema syringes were used as instruments. Because of lethal accidents the infusions soon fell from favour. Köhler in Germany in 1776 eliminated a large bolus impacted in a patient's esophagus by an intravenous infusion of tartar emetic thus inducing violent vomiting. After this crucial experiment, foreign bodies in the esophagus were the most important indication for applying intravenous injections until Killian introduced extraction by esophagoscopy in 1990. CALIBRATED SYRINGES AFTER PRAVAZ: The French surgeon C. Pravaz in Lyon in 1853 invented a small syringe, the piston of which could be driven by a screw thus allowing exact dosage. A sharp needle with a pointed trocar could be introduced into the vessel making a dissection unnessessary. Pravaz used his syringe for obliteration of arterial aneurysms by injection of ferric sesquichlorate. Pravaz's syringe initiated the invention of a great number of various calibrated syringes made of glass or metal combined with glass. SUBCUTANEOUS INJECTION AND LOCAL ANAESTHESIA: The calibrated syringes were commonly used in the treatment of syphilis by mercurialization. In otorhinolaryngology, they had and still have their primary application in local anaesthesia, which was introduced by Carl Ludwig Schleich in Berlin in 1892. PARAFFIN-INJECTIONS: Around 1900 the injection of liquid paraffin for closing defects in subcutaneous tissues came into use (Gersuny in Vienna, Delangre in Tournai). This technique was immediately applied to rhinological indications such as a saddle nose (Stein 1901). This gave rise to the invention of special syringes and modifications of paraffin with different hardness and melting points. Around the middle of this century, paraffin was abandoned for this application because of serious complications, and new substances were introduced such like teflon, silicone and collagen. The historical development of these techniques of injections is described in details with many literature citations and figures.