When was the last time you had an injection? Perhaps you have the annual flu jab or root canal treatment at the dentist or are planning to holiday in some exotic location where diseases such as Yellow Fever or Typhoid are rampant. Either way, it is likely you have experienced that painful jab as the sharp needle pierces your skin.
But other than the benefit of being able to travel to far flung places with reduced health risks, have you ever wondered about that injection? Who discovered the method of injecting fluid into or for that matter, extracting it out of your body and how was it done prior to the hypodermic needle and syringe?
CORPSES & CHRISTOPHER WREN
The fascination of veins & arteries and the passage of blood being pumped around the body, has gripped the imagination of many for millennia. Syringes were used widely during the 17th & 18th centuries to examine the flow of blood through the vessels of corpses (although I suspect not all of them were completely dead at the start of the experiment!)
Known more for his architectural than medical skills, in 1656 Sir Christopher Wren devised a form of intravenous drip using an animal bladder as the bag and a quill as the cannula that he inserted into the patient’s tied off veins. With liquids being injected including opium, wine and ale, it is little wonder there is little in the way of recorded success!
Wren attempted to carry out his experiment on a human but
“…the victim either really or craftily fell into a swoon and the
experiment had to be discontinued…”
Up to then, his patients had been dogs.
SLICE & DICE
It was generally accepted that the best way of ‘absorbing’ medicine was via the blood stream rather than orally and the early 19th century efforts included blistering or cutting the skin then putting an impregnated poultice over the open wound.
Another method used by Dr Larfargue was to make a hole in the skin with a large needle then push morphine pellets into the hole for slow release of the drug. John Crombie soaked a silk thread with morphine, punctured the skin with the needle then drew the thread through the skin!
However, it was the perfection of the size and design of the hypodermic (‘beneath the skin’) needle that could be attached to a syringe that was the milestone in medical science.
THE SUBCUTANEOUS INJECTION IS BORN.
And this is where it gets tricky because there is more than one contender for the Nobel Prize in Medicine, each one claiming equal rights to the innovation and seemingly, each person coming up with an identical idea simultaneously.
In the right corner we have Scotland’s Dr Alexander Wood who specialised in neuralgia and believed it was essential to inject at the site of pain for the drug to be effective. In 1853 he devised a needle that was not only sharp enough to pierce the skin but was also hollow, allowing the fluid direct and immediate access to the point of pain; Wood used the piston style syringe made by London instrument maker Daniel Ferguson.
(Wood has a slightly less salubrious claim to fame; morphine was a very popular and effective 19th century painkiller often leading to addiction. His wife became the first woman to die from an injected overdose).
Then in the left corner we have Charles Gabriel Pravaz from France who in 1853 also invented the ‘Pravaz syringe’ (the first practical metal syringe) which he used with his hypodermic needle to treat patients suffering from aneurysm.
So with the dawn of a new medical age, the invention of the hypodermic needle changed many medical and therapeutic treatments, removing the need to cut the skin.
There was an additional breakthrough in 1866 when the construction of the syringe was changed from metal to glass, allowing the surgeon to see how much liquid was in the barrel.
However these improvements led to another problem. Needles were reused; the spread of disease was still something of an enigma, however following an outbreak of Tetanus in 1876, the danger of reusing needles began to be recognised.
The next big improvement was the creation of the disposable hypodermic syringe. Glass syringes could be reused up to 20 times and needles were sterilised and sharpened. But with an outbreak of Hepatitis B that was found to have been caused through infected needles the polypropylene disposable syringe was introduced in 1961.
Very little has changed since then, although in 2011 mechanical engineer Seiji Aoyagi of Osaka’s Kansai University created a hypodermic needle that he claimed significantly reduced the pain of that initial ‘jab’. Based on a mosquito proboscis, it has 2 jagged outer shafts with a tube that moves down between them to inject/extract fluid. However, it is a work-in-progress as the after pain is apparently far worse!
So the next time you have an injection, whilst I wouldn’t recommend looking at the procedure, you may want to thank both Wood and Pravaz equally for their joint effort in creating the hypodermic needle.