The early development of intravenous apparatus.

Modern anaesthetists rely on the intravenous route for administration of drugs and fluids. This paper traces the development of intravenous equipment from the first, tentative experiments with the intravenous route through to the first intravenous cannulas.

[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.

From mercury to malaria to penicillin: the history of the treatment of syphilis at the Mayo Clinic--1916-1955.

Between 1916 and 1955 the Mayo Clinic became recognized as one of the premier institutions specializing in the treatment of syphilis. First under the direction of John H. Stokes (1916-1924) and later Paul A. O'Leary (1924-1953), its Department of Dermatology and Syphilology, together with the members of the Clinical Cooperative Study Group, oversaw the establishment of standardized methods for the administration of the existing arsenicals and the introduction of new therapies. Malaria therapy, heat therapy, penicillin, and oxytetracycline each represented important advances in the treatment of syphilis and were extensively evaluated. Two important ancillary benefits of syphilis treatment were the development of routine intravenous techniques, which would later prove invaluable for the administration of antibiotics and cancer drugs, and the establishment of large cooperative clinical trials, the first of their kind. Under the leadership of Stokes and O'Leary the department produced a stream of pivotal clinical research that contributed to the effective management of syphilis in the United States.

[The discovery of Tenebryl, the first French uro-angiographic iodized hydrosoluble product]. / La découverte du Ténébryl, premier produit uro-angiographique hydrosoluble français.

Ténébryl was perfected in 1931 by Marcel and André Guerbet. For the company which bore their name and after the discovery of Lipiodol, this was the opportunity to explore a new area in radiology: intravenous urography. The discovery of this product is exemplary in a greater sense, since it contributed to opening the way to a new class of contrast products of which the majority today are iodized products. All the ingredients of industrial research are present here, from risk-taking to successful commercialization.