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PubMed1998

[Laënnec, re-inventor of the stethoscope?].

According to our common medical culture, some facts are simply unquestionable, for instance Laënnec invented the stethoscope. But was he the first one? On a recent trip to Egypt we visited the temple of Kom Ombo, built prior to the roman period and renowned as a medical care center. Today, the tourist is fascinated by the magnificent hieroglyphics on the well-preserved walls testifying to significant advances in various fields of medicine including ophthalmology and gynecology. We were particularly interested by the basreliefs presenting vivid drawings of some of the first medical instruments. We easily identified curettes, scissors, a balance, forceps for dental extraction, and a surgical saw, but were captivated by two other instruments. The first one looked a lot like what Laënnec invented around 1820. The second one was amazingly similar to the instrument we use everyday, with a distal opening and flexible tubes (woven papyrus?) leading to proximal ear pieces. Our Egyptian guide was formal: the stethoscope was invented in Egypt. The scientific impact of our observations leaves something to be desired, but did make us think about the huge gap between the advancement of medical knowledge in ancient Egypt and Laënnec's (re)-invention. Exposed to a similar gap in history, what would our documents stored on CD and video tapes have to say to future touring doctors?

Egypt↗
PubMed2001

Geographic variation in tool use on Neesia fruits in orangutans.

Geographic variation in the presence of skilled behavior may reflect geographic variation in genetic predispositions or ecological conditions (accompanied by reliable expression during development), or it may reflect the vagaries of invention and the appropriate social conditions for persistence. In this study, we compare the feeding techniques and tool-using skills used by orangutans to extract the nutritious seeds from Neesia fruits between Suaq Balimbing on Sumatra and Gunung Palung on Borneo, and map the distribution of Neesia tool use in Sumatran swamps. We show that neither genetics nor ecology is sufficient to explain the distribution of this tool use, confirming earlier findings on chimpanzees. We conclude that the ability to learn to use tools determines the geographic distribution. It is impossible to distinguish between the history of invention and the conditions for social transmission as the causal factors, but the high density and the social tolerance at Suaq Balimbing create propitious conditions for the maintenance of the skill as a tradition once it has been invented. High orangutan densities in the other Sumatran coastal swamps with Neesia tool use support the conclusion that suitable transmission conditions are the critical factor to explain the geographic distribution of skills such as feeding tool use.

Animals↗
PubMed1999

The conditions for tool use in primates: implications for the evolution of material culture.

In order to identify the conditions that favored the flourishing of primate tool use into hominid technology, we examine inter- and intraspecific variation in manufacture and use of tools in extant nonhuman primates, and develop a model to account for their distribution. We focus on tools used in acquiring food, usually by extraction. Any model for the evolution of the use of feeding tools must explain why tool use is found in only a small subset of primate species, why many of these species use tools much more readily in captivity, why routine reliance on feeding tools is found in only two species of ape, and why there is strong geographic variation within these two species. Because ecological factors alone cannot explain the distribution of tool use in the wild, we develop a model that focuses on social and cognitive factors affecting the invention and transmission of tool-using skills. The model posits that tool use in the wild depends on suitable ecological niches (especially extractive foraging) and the manipulative skills that go with them, a measure of intelligence that enables rapid acquisition of complex skills (through both invention and, more importantly, observational learning), and social tolerance in a gregarious setting (which facilitates both invention and transmission). The manipulative skills component explains the distribution across species of the use of feeding tools, intelligence explains why in the wild only apes are known to make and use feeding tools routinely, and social tolerance explains variation across populations of chimpanzees and orangutans. We conclude that strong mutual tolerance was a key factor in the explosive increase in technology among hominids, probably intricately tied to a lifestyle involving food sharing and tool-based processing or the acquisition of large, shareable food packages.

Animals↗
PubMed1997

Scopes of perception: the experimental manipulation of space and time.

Discussions of space and time have been grist to the philosophers' mill for centuries. We argue that the evolution of psychology as an independent discipline was in part a consequence of addressing philosophical questions concerning the perception of space and time by recourse to experiment rather than exposition. Two initially separate factors assisted in establishing this independence. On the one hand, it was driven by the invention of instruments for stimulus control so that the methods of physics could be applied to the study of perceptual phenomena. On the other hand and somewhat later, it was followed by the development of psychophysical methods, which opened the possibility of quantifying the responses to such controlled stimulation. The principal instruments were invented in the first half of the nineteenth century, and they consisted of simple contrivances that manipulated time and space in ways that had not previously been appreciated. This article examines the devices that were invented, like stroboscopes, anorthoscopes, stereoscopes, tachistoscopes, chronoscopes, and more recently oscilloscopes, and the ways in which they influenced the scope of perceptual psychology in the past as well as in the present. In contemporary experimental psychology all these instruments have been replaced by the computer. While it has extended the scope of experiments even further it has introduced a new set of limitations.

History, 18th Century↗
PubMed1981

Patenting of hybridomas and genetically engineered microorganisms.

Many new technologies arrived at through basic research have practical applications. Two recent breakthroughs in microbiology, recombinant DNA techniques and hybridoma techniques, will permit designing cells for specific practical purposes resulting in new products or functions of commercial significance. The unique cell or its usefulness, or both, may satisfy the requirements of a patentable invention, i.e. an inventive act having utility and novelty. Ownership of such patents permits recovery of expenses incurred in the invention process and investment for all concerned in additional research. An integral part of the patenting process is submission of the new cell to an official repository, an outstanding example of which is The American Type Culture Collection.

DNA, Recombinant↗
PubMed1999

The scientific history of hydrocephalus and its treatment.

Hydrocephalus cases were regularly described by Hippocrates, Galen, and early and medieval Arabian physicians, who believed that this disease was caused by an extracerebral accumulation of water. Operative procedures used in ancient times are neither proven by skull findings today nor clearly reported in the literature. Evacuation of superficial intracranial fluid in hydrocephalic children was first described in detail in the tenth century by Abulkassim Al Zahrawi. In 1744, LeCat published findings on a ventricular puncture. Effective therapy required aseptic surgery as well as pathophysiological knowledge--both unavailable before the late nineteenth century. In 1881, a few years after the landmark study of Key and Retzius, Wernicke inaugurated sterile ventricular puncture and external CSF drainage. These were followed in 1891 by serial lumbar punctures (Quincke) and, in 1893, by the first permanent ventriculo-subarachnoid-subgaleal shunt (Mikulicz), which was simultaneously a ventriculostomy and a drainage into an extrathecal low pressure compartment. Between 1898 and 1925, lumboperitoneal, and ventriculoperitoneal, -venous, -pleural, and -ureteral shunts were invented, but these had a high failure rate due to insufficient implant materials in most cases. Ventriculostomy without implants (Anton 1908), with implants, and plexus coagulation initially had a very high operative mortality and were seldom successful in the long term, but gradually improved over the next decades. In 1949, Nulsen and Spitz implanted a shunt successfully into the caval vein with a ball valve. Between 1955 and 1960, four independent groups invented distal slit, proximal slit, and diaphragm valves almost simultaneously. Around 1960, the combined invention of artificial valves and silicone led to a worldwide therapeutic breakthrough. After the first generation of simple differential pressure valves, which are unable to drain physiologically in all body positions, a second generation of adjustable, autoregulating, antisiphon, and gravitational valves was developed, but their use is limited due to economical restrictions and still unsolved technical problems. At the moment, at least 127 different designs are available, with historical models and prototypes bringing the number to 190 valves, but most of these are only clones. In the 1990s, there has been a renaissance of endoscopic ventriculostomy, which is widely accepted as the method of first choice in adult patients with aquired or late-onset, occlusive hydrocephalus; in other cases the preference remains controversial. Both new methods, the second generation of valves as well as ventriculostomy, show massive deficits in evaluation. There is only one randomized study and no long-term evaluation.

Animals↗
PubMed2005

The two ages of the RNA world, and the transition to the DNA world: a story of viruses and cells.

Most evolutionists agree to consider that our present RNA/DNA/protein world has originated from a simpler world in which RNA played both the role of catalyst and genetic material. Recent findings from structural studies and comparative genomics now allow to get a clearer picture of this transition. These data suggest that evolution occurred in several steps, first from an RNA to an RNA/protein world (defining two ages of the RNA world) and finally to the present world based on DNA. The DNA world itself probably originated in two steps, first the U-DNA world, following the invention of ribonucleotide reductase, and later on the T-DNA world, with the independent invention of at least two thymidylate synthases. Recently, several authors have suggested that evolution from the RNA world up to the Last Universal Cellular Ancestor (LUCA) could have occurred before the invention of cells. On the contrary, I argue here that evolution of the RNA world taken place in a framework of competing cells and viruses (preys, predators and symbionts). I focus on the RNA-to-DNA transition and expand my previous hypothesis that viruses played a critical role in the emergence of DNA. The hypothesis that DNA and associated mechanisms (replication, repair, recombination) first evolved and diversified in a world of DNA viruses infecting RNA cells readily explains the existence of viral-encoded DNA transaction proteins without cellular homologues. It also potentially explains puzzling observations from comparative genomic, such as the existence of two non-homologous DNA replication machineries in the cellular world. I suggest here a specific scenario for the transfer of DNA from viruses to cells and briefly explore the intriguing possibility that several independent transfers of this kind produced the two cell types (prokaryote/eukaryote) and the three cellular domains presently known (Archaea, Bacteria and Eukarya).

Archaea↗
PubMed2001

Bioinformatics -- a patenting view.

The use of bioinformatics in the biological sciences has brought about a change in the way that biological inventions can be protected by patent laws. Using approaches developed in the fields of computer science and business, patent applicants now seek to protect certain aspects of their inventions, which include software, methods of doing business and uses of information as well as more traditional biotechnological products and processes. These approaches are useful in resolving some of the difficulties now faced in prosecuting patent applications directed to biological inventions that are claimed in more conventional terms.

Algorithms↗
PubMed1996

The black reaction.

Camillo Golgi (1843-1926) invented the black reaction in 1873, when he was head physician at the hospice for old people in Abbiategrasso, near Milan. Unlike the procedures that were available before its invention, the black reaction was able to reveal neurons in their entirety, i.e., with all their processes. This weighty event at first passed unnoticed. The first stirring of interest in the black reaction outside Italy began in 1885. The reasons the Golgi technique took so long to receive wide international attention are here analyzed. After it became known, the black reaction was widely employed for almost 30 years, during which time it was responsible for bringing about major advances in our knowledge of the microscopic anatomy of the nervous system, as well as in other fields of study. A number of results obtained by other researchers with the black reaction were vitally important for establishing the neuron theory. In the period between the two World Wars, the Golgi technique was almost forgotten, but returned in vogue once more around the middle of the 20th century following the introduction of the electron microscope to neurocytological research. One-hundred and twenty years after its invention, the black reaction is still widely employed, not only in combination with electron microscopy, but also as an autonomous technique for light microscope studies on the organization of the nervous system in normal conditions and after experimental manipulations.

Humans↗
PubMed2004

Exploiting abstract possibilities: a critique of the concept and practice of product patenting.

Developments in biotechnology and genomics have moved the issue of patenting scientific and technological inventions toward the center of interest. In particular, the patentability of genes of plants, animals, or humans and of genetically modified (parts of) living organisms has been discussed, and questioned, from various normative perspectives. This paper aims to contribute to this debate. For this purpose, it first explains a number of relevant aspects of the theory and practice of patenting. The focus is on a special and increasingly significant type of patents, namely product patents. The paper provides three general arguments against the concept and practice of product patenting. The first argument briefly considers the claim that patents are legitimate because they promote socially useful innovation. Against this claim, it is argued that product patents may hamper rather than promote such innovation. The second and main argument concludes that product patents are not adequately based on actual technological inventions, as they should be according to the usual criteria of patentability. The principal moral issue is that product patents tend to reward patentees for inventions they have not really made available. The final argument proposes a method for patenting the heat of the sun. Assuming that granting this patent will be generally considered absurd, the argument exposes a further, fundamental problem of the concept and practice of product patenting.

Animals↗
PubMedDate not supplied

The incubator and the medical discovery of the premature infant.

The invention of the incubator in 1880 ignited a dramatic outpouring of popular and professional excitement over the prospect of reducing premature infant mortality. Yet the technology itself progressed slowly and fitfully over the next 50 years. The story is worth examining not so much from the standpoint of technological progress, but from the perspective of how responsibility for the newborn shifted from mothers to obstetricians and eventually pediatricians. It also illustrates how the history of technology involves more than invention. The invention of the incubator itself was less significant than the development of a system to support the device.

France↗
PubMed2005

Vietnamese children and language-based processing tasks.

PURPOSE: Vietnamese children's performance on language-based processing tasks of fast-mapping (FM) word-learning and dynamic assessment (DA) word- and rule-learning tasks were investigated. METHOD: Twenty-one first- and second-generation Vietnamese preschool children participated in this study. All children were enrolled in 2 Head Start programs in a large city in the Midwest. All children had passed a developmental assessment and routine speech, language, and hearing screenings. All participants were taught 4 invented monosyllabic words in an FM word task, an invented monosyllabic suffix rule (-po) meaning "a part of" in a DA rule task, and 4 invented bisyllabic words in a DA word task. Potential relationships among task performances were investigated. Receptive task performances, expressive task performances, and task totals were added to create receptive total, expressive total, and accumulated performance total (APT) scores. Relationships among receptive total, expressive total, and APT scores were also investigated. RESULTS: Significant correlations were found between FM word, DA rule, and the receptive total. The expressive total correlated with all task total scores, APT, age, and modifiability scores. Modifiability scores correlated with the two DA tasks, expressive total, and the APT. Findings indicate that FM word and the expressive total were positively correlated with most of the other tasks, composite totals, and age. CLINICAL IMPLICATIONS: Performance on language-based processing tasks may provide valuable information for separating typically developing Vietnamese preschool children from their peers with language disorders. Practitioners should consider linguistic characteristics of target stimuli. Comparisons should include task, receptive, expressive, and APT.

Child Language↗
PubMedDate not supplied

Chronic dialysis and dialysis doctors in the United States: a nephrologist-historian's perspective.

In an earlier article in Seminars in Dialysis (9:276-281, 1996), the author described the invention of clinical hemodialysis for acute renal failure and its initially equivocal reception by the emerging specialty of nephrology in the United States. A similar story of blunted enthusiasm played out following the invention of the Quinton-Scribner shunt (whose idea "came in the night"), which allowed maintenance treatment for chronic renal failure. Few centers at first could match Belding Scribner's early successes, and some physiology-oriented university nephrologists envisioned how routine dialysis might swamp other activities. Nonetheless, increasingly complex and successful inventions appeared and prevailed: the chronic dialysis unit, the national dialysis chain. A unique federal entitlement program fostered the spread of maintenance dialysis, but so did the emergence of disposable off-the-shelf supplies and many new nephrologists trained in academia but seeking positions in practice. Indeed, the spread of end-stage renal disease (ESRD) care transformed American nephrology. The essay concludes by considering what nephrologists of the ESRD era share with their patients.

History, 20th Century↗
PubMed2000

[History of injections. Pictures from the history of otorhinolaryngology highlighted by exhibits of the German History of Medicine 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.

Anesthesia, Local↗
PubMed1996

[History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

BACKGROUND. Inspection of or interventions in the external ear canal and the nostrils pose similar technical problems. This is the reason why early instruments devised for otoscopy and rhinoscopy were based on an identical principle. They were shaped like a pair of tongs, comparable to nasal specula of today. A similar type of instrument had been developed earlier by barber surgeons for inspecting narrow wound cavities. TONG-SHAPED SPECULA. The first description and illustration of an aural and nasal speculum was provided by Guy de Chauliac in Montpellier, France in 1363. Sophisticated models were presented by Fabricius Hildanus in Germany in 1646 and J.J. Perret in Paris in 1772, who offered them in his illustrated catalogue of surgical instruments at fixed prices. W. Kramer (1836) in Berlin improved this tong-shaped instrument and devised the ear speculum named after him that was generally favored during the first half of the 19th century. Further variations of this type were presented by Lincke and Schmalz (1846) in Germany. FUNNEL-SHAPED SPECULA. Ignaz Gruber in Vienna in 1838 devised the first tunnel-shaped ear specula made of metal. They had a simple conical shape, were not divided into separate jaws, and could not be spread. Gruber himself did not publish his invention, but he demonstrated his ear specula to W. R. Wilde from Dublin, who had paid a visit to his office in Vienna. Wilde reported on this in 1844, and subsequently systematically refined Gruber's specula. A. v. Tröltsch from Würzburg (Germany) had seen these instruments at Wilde's office and it was Wilde himself and v. Tröltsch who helped this type of ear speculum to gain acceptance on an international scale. A different type of bottle-shaped ear speculum was first used by Schmalz (1846) and Erhard (1859) in Germany, but it was only developed into a commercially available instrument by Josef Gruber in Vienna in 1870. The ear specula most in use today were first presented by A. Hartmann in Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

Endoscopy↗
PubMed1994

[Hermann von Helmholtz (1821-1894). On the 100th anniversary of his death].

In Helmholtz's judgement it was a favourable fate to have been thrown under medical students and into medicine with a sense of geometrics and with knowledge of physics. The result of this favourable combination was the invention of the ophthalmoscope and the Handbook of Physiologic Optics. Those were the foundations of all physiological aspects of ophthalmology, which were taken up and completed by A. v. Graefe and his colleagues. The ophthalmoscope was invented on the occasion of his university-courses, when Helmholtz tried to explain the theory of the red reflex of the pupil. Stimulated by Helmholtz in the following year Ruete developed the method of indirect ophthalmoscopy. This method at once was simplified again by Helmholtz in an extraordinary way. These two publications by Helmholtz contain all further developments involved with the ophthalmoscopy as an anticipation. The Handbook of Physiologic Optics is the first encyclopedic monography of this topic. Many new inventions are extremely valuable for the practical requirements of ophthalmologists. The first chapter about dioptrics contains the description of the Ophthalmometer, a new instrument to measure the astigmatism. In the chapter about visual sensations a clear survey about light- and colour sense is given. The colour deficiencies which were found during the decades before are introduced as the most important arguments for the three-component-theory of human colour vision. The prototype of a telestereoscope is demonstrated in the third chapter about visual perception.(ABSTRACT TRUNCATED AT 250 WORDS)

Germany↗
PubMed1999

Hume's influence on John Gregory and the history of medical ethics.

The concept of medicine as a profession in the English-language literature of medical ethics is of recent vintage, invented by the Scottish physician and medical ethicist, John Gregory (1724-1773). Gregory wrote the first secular, philosophical, clinical, and feminine medical ethics and bioethics in the English language and did so on the basis of Hume's principle of sympathy. This paper provides a brief account of Gregory's invention and the role that Humean sympathy plays in that invention, with reference to key texts in Gregory's work. The paper also considers two interesting and perhaps provocative ways in which Hume can be read through Gregory: first, sympathy as a principle of scientific discovery in Hume's science of man and moral physiology; and sympathy as gendered feminine in Hume's moral philosophy. Hume's principle of sympathy is at the core of Gregory's medical ethics and the histories of Western medical ethics and bioethics pivot on Gregory--and, therefore, on Hume--as it does on few other figures.

Bioethics↗
PubMed1994

Individual and group therapies as constructive continuous experiences.

We began this paper with the conceptualization that individual and group psychotherapies were potentially continuous just as internal and external experiences are co-extensive. We recognized Winnicott's "holding," "regression to dependence," and "The primary maternal preoccupation." In our specific context of individual and group therapies, a state of being, a new construct of one's self can be invented in ways that can overturn the received. Clinician and patient can invent a new state of being and new meaning. For our patient, individual therapy was experienced as impacted space where she could neither be nor invent new meaning with another. "Intimacy" as a problem could not be dealt with in individual work without the risk of decompensation. In group psychotherapy she found no such risks or congestion. Rather, she found space. She was dislodged and group psychotherapy received her by giving her an opportunity to renegotiate who hosts whom. She recognized that group was in the service of the human being and was able to absorb her intolerable conflicts and transfer them without danger to anyone. It was a trusting attitude to the surrounding and was motivated by connectedness toward others. As a result there can be a state of being and the real possibility of thinking as one's own self and for one's self in the midst of others without losing one's newly established self. In a word she could become. Accordingly, our patient was able to work towards amelioration of psychopathological formations and was ready to make appropriate selection for the necessary therapy.

Adult↗