History of medical technology

Technology and the Development of Modern Medicine
The 20th century saw a seismic change in the perception of the human body, and the relationship of patients to physicians and other aspects of modern medicine. With the recent coronavirus pandemic, of course, the focus upon technology and medical developments has become a matter of global importance. Vaccines and innovative drugs were not solely innovations of the past century, but they extent to which they were proven safe and effective is relatively new. The relationship between providers and patients has likewise changed, as well as expectations about treatment.
Vaccination and Immunization Technology
Infectious disease was once an accepted part of modern life. However, the first smallpox vaccines were developed as early as the late 18th century. Safety of vaccines could not always be guaranteed, however. Inactivation of bacteria via heat or chemical treatment to confer immunity status was developed by the very end of the 19th century (Plotkin 12284). But in the 20th century, the generation of technology that would allow widespread, safe transmission of the vaccine became popularized, freeing generations from the fear and threat of illness as a childhood rite of passage.
Purified protein vaccines were developed as early as the 1920s (Plotkin 122285). “By the 1940s, virologists understood that [live] attenuation could be achieved by passage in abnormal hosts,” and both rabies and oral polio vaccines were developed in chicken embryos and mice (Plotkin 12284). Live annotated vaccines for the oral polio vaccine was developed in 1963, with measles, mumps, and rubella shortly after in the 1960s (Plotkin 12284). The 20th century also saw the development of live, inactivated viral vaccines, such as the influenza vaccine (Plotkin 122284). Most influenza vaccines are grown in embryonic eggs. However, “Influenza HA has been produced in insect ells and induces antibodies without the risk of allergy to egg proteins” through the use of genetic engineering and the development of the human papillomavirus (HPV) vaccine was made “because of the properties of the L1 protein of the virus” and “L1 is produced in yeast or in-sect cells, and the VLPs produced there inform the basis of the current vaccines” (Plotkin 122285).
The development of these vaccines has freed modern society, until recently, from the fears of infection in crowded areas. Even as recently as the 1990s, until the development of vaccines, certain illnesses as chickenpox were considered rites of passage. The knowledge that contracting the illness conveyed immunization provided some comfort, although the diseases could cause debilitating effects for the duration of the individual’s lifetime. A good example of this is the polo vaccine, an illness so debilitating and common even President Franklin Delano Roosevelt had suffered the condition when a young man, and was partially paralyzed as a result (Palca).
In the 1950s, when the first polio vaccines were being developed, confidence in science was at a new high, and in contrast to current anxieties about vaccines, there was a widespread call to fuel money and time into developing a disease that was, by the end of World War II, a rite of passage of closing swimming pools and monitoring children in the summers to contain threats of the disease (Palca). In one scandal during the early development of the vaccine, the Cutter Laboratory’s manufacturing did not fully kill the virus, and children actually contracted polio (Palca). During the early vaccine trials on children, a number of children received a placebo in the control group (Palca). Thus, many of the ethical and scientific practices during the development of the vaccine would not be acceptable today.
Fear of polio was so great, however, that when the rollout of the vaccines took place, compliance was widespread. This is in stark contrast to today, where memories of the virulence of infectious diseases is much fainter, and parents often express concerns about impurities or toxins in vaccines, or vaccine side effects, which they fear may be greater than the diseases the vaccines are designed to effect. Whether vaccine resistance and fears in the online age will continue, despite the proven threat of coronavirus in recent months, still remains to be seen as the distribution of the vaccine has only begin.
Development of Sulfonamide Drugs and Penicillin
Along with infectious diseases such as mumps, rubella, polio, chickenpox, and influenza, bacterial diseases such as syphilis had destroyed many lives (famous and non-famous) and was a continual, inhibiting fear in the eyes of many. The development of antibiotics and sulfonamide drugs were likewise groundbreaking. The drugs turned illnesses which could destroy lives and communities, and also generated considerable anxiety in the case of sexually transmitted diseases (STDs) about sexuality in general, into far more benign concerns. “Sulfa antibiotics were first used in the 1930s, and they revolutionized medicine….While antibiotic resistance remains a problem for this class of antibiotics, sulfa drugs are still commonly used to treat a variety of bacterial infections” (Earl).
Concerns about antibiotic resistance, however, has led to the need for innovation for treatment of a variety of types of drugs to address these illnesses. Unlike the highly orchestrated drive to develop sulfa drugs, however, the development of penicillin was initially accidental. “Alexander Fleming…noticed a zone around an invading fungus on an agar plate in which the bacteria did not grow” (Gaynes 859). Fleming isolated the mold, identified it as the Penicillium genus, extracted the mold, and thus penicillin was born (Gaynes).
Penicillin even became a player in World War II, as various Axis powers attempted to secure penicillin from the Allies (Gaynes). Just as germ warfare was long been a factor, treatments for various illnesses have become an issue in wartime. The creator would receive a Nobel Prize, but as seismic an achievement as penicillin was, the generation of new bacterial agents has remained until this day. The fight for new antibacterial agents to keep ahead of antibacterial resistance has likewise continued apace. There are also concerns about over-sanitization regarding antibacterial drugs and cleansers further contributing to antibacterial resistance.
Insulin Development
Finally, another disease which has long plagued humankind is diabetes. Just like measles and syphilis could rob people of their lives, or, at minimum, their productivity and lifetime health, diabetes was often a death sentence before the development of insulin. Before the development of insulin, the only way to control blood sugar was extreme fasting, and this was only a way to delay, not completely postpone the risk of coma and premature death. The discovery of insulin in 1922, following a link to understanding the pancreas’ role in metabolic regulation, was critical, although for many years, potency varied considerably (Quianzon and Cheikh).
Even today, although refinement of insulin treatment and new understanding of the illness has increased, complications in individuals who live longer and longer with the autoimmune disease Type 1 diabetes has increased, and the incidence of Type 2 diabetes (an illness of different origins, but also treated with insulin quite frequently) has likewise increased, due to lifestyle factors that contribute to the illness. Modern medicine once again has made it far easier for people to have their illnesses treated, but new diseases and lifestyle factors continue to be generated.
Works Cited
Earl, Leslie. “How Sulfa Drugs Work.” National Institute of Health. March 12, 2012. Web. December 20, 2020. https://www.nih.gov/news-events/nih-research-matters/how-sulfa- drugs-work
Gaynes, Robert. “The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use.” Emerging Infectious Diseases vol. 23, 5 (2017): 849–853. Web. December 20, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403050/
Palca, Joe. “The Race For A Polio Vaccine Differed From The Quest To Prevent Coronavirus.” NPR. May 22, 2020. Web. December 20, 2020. https://www.npr.org/sections/health- shots/2020/05/22/860789014/the-race-for-a-polio-vaccine-differed-from-the-quest-to- prevent-coronavirus
Plotkin, Stanley. “History of vaccination.” Proceedings of the National Academy of Sciences of the United States of America vol. 111, 34 (2014): 12283-7. December 20, 2020. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151719/pdf/pnas.201400472.pdf
Quianzon, Celeste C, and Issam Cheikh. “History of Insulin.” Journal of Community Hospital Internal Medicine Perspectives, vol. 2, 2 10.3402/jchimp.v2i2.18701. July 16, 2012. Web. December 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714061/