[From war to priority battle; blood transfusion as a medical innovation during World War I]. / Van oorlog naar prioriteitsstrijd.

The logistics system for blood transfusion was first developed on the Western Front during World War I. This article focuses on the people who played a major role in this development. It discusses the people who came up with the idea of preventing coagulation through addition of citrate and who discovered the stabilisation of blood by adding glucose. The inclusion of citrate can be regarded as having been simultaneously developed in several countries, while the stabilisation of erythrocytes was discovered by American researchers. As regards to the credit for being the first person to apply blood transfusion as a logistics system, this priority development was contested by an American and a Canadian, who coincidentally had the same surname - Robertson. The war induced both of them to start large-scale implementation of their discovery of blood transfusion. The Germans, however, generally continued with the traditional treatment for blood loss and shock by administering saline and gum arabic.

[Snippets of past medical research: worth saving?]. / Snippers uit een medisch onderzoeksverleden.

Medical researchers and physicians are not trained in the care of their written or digital past. Here, a scientific historian and a clinical epidemiologist reflect on possibilities for archiving the records of medical research in order to safeguard scientific legacies. In addition to the use of so-called witness seminars, which may suffer from interpretation by 'hindsight', archival material is necessary to understand and interpret the past. A particular problem is how to establish archives of day-to-day scientific undertakings that rely almost entirely on digital media for measurements, communication and publication. The recently developed conviction that good scientific practice encompasses an obligation to store all relevant information about medical research projects at the time of publication - for future replication or verification - might dovetail with the goals of medical historians, and thus might become a rich source of historical data in the future.

A century of research into the cause of cancer: is the new oncogene paradigm revolutionary?

Contemporary oncological research is predominantly characterised by genetic explanations, a situation which may be briefly denoted as the oncogene paradigm. This essay discusses why the new paradigm was perceived so attractive that it could take over the whole field of oncology within a time-span of less than two decades. It is argued that the revolutionary character of the oncogene paradigm stems from the fact that it transcends a dichotomy which has kept experimental cancer research divided for more than three quarters of a century. This concerns the dichotomy between so-called exogenous and endogenous explanations of cancer causation. This essay mainly focuses on the role of the exogenous/endogenous dichotomy in the reception of research on oncogenic viruses, especially discussing the work of Nobel laureate Peyton Rous on cancer viruses at the Rockefeller Institute. Rous was severely criticised by James Ewing, director of the Memorial Hospital for Cancer and Allied Diseases in New York, who held the idea that the origin of cancer was based in the cell. The twentieth century controversy over oncogenic viruses is placed in the context of the intense discussion over causality in medicine during the first decades of the twentieth century in Germany. It is argued that the oncogene paradigm may be seen as revolutionary because it succeeded in uniting the exogenous and endogenous explanations of cancer in a single paradigm.

A bacteriological paradigm in influenza research in the first half of the twentieth century.

Scholars have argued that the beginning of virology can be dated from the end of the 19th century: the discovery that some infectious agents could pass through ultrafilters produced a criterium to distinguish ultrafilterable viruses from infectious agents that are not filterable, e.g. bacteria. A filterable agent, claimed to be the cause of human influenza, was isolated in 1933. It will be argued in this paper, however, that the influence of a bacteriological paradigm on influenza research in the first half of the twentieth century was very powerful. Until the late 1940s influenza viruses were studied as infectious entities which, although filterable, were conceived of as analogous to bacteria. It was assumed that filterable viruses which infected animals were a kind of ultrabacteria. According to the bacteriological paradigm the assumed dependence of the filterable viruses on living cells was easy to account for. The second half of the 1940s saw the 'modern concept of virus' begin to be applied to the influenza viruses. Influenza vaccinations in 1946 did not appear to provide protection, from which it was concluded that the influenza virus is very variable. Furthermore, in 1946 and 1947 experimental studies were published, which indicated that the influenza virus may go through an eclipse during its multiplication: it disappears as an infectious agent. Viewed from this perspective, it was only by the second half of the 1940s that research on the influenza virus became emancipated from the bacteriological paradigm.