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Technology and medicine

Milton Roy kidney machine, United States, 1966

Milton Roy kidney machine, United States, 1966

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Machines became central to medicine in Europe during the 1800s. Medicine had always relied on technology such as scalpels, probes and materia medica. However, by the start of the 20th century new instruments were available to study, diagnose and treat the body. Today, hospitals worldwide use complex, computerised machines to image the body or assist its function.

Developing medical devices in the 1800s

During the 1800s doctors and biomedical scientists developed instruments to examine and understand the body. Devices such as the thermometer, microscope and kymograph revealed how healthy and diseased bodies worked. In 1816, French doctor Rene Laennec invented the stethoscope. This simple wooden tube enabled doctors to hear and diagnose chest diseases. It became an iconic object in biomedicine. Other instruments were developed over the century: the ophthalmoscope saw into specific organs such as the eye and the oesophagus; the sphygmograph provided information about organs deep inside the body such as the heart. Many instruments became routine equipment.

Using electrical machines as therapy in the 1800s

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Electrotherapy machines used electricity to treat patients during the 1800s. Electrostatic machines and galvanic or faradic devices gave brief electric shocks or sustained electric current to patients’ bodies.

Other machines produced light or heat for heliotherapy and diathermy therapies. Doctors initially used such machines to treat conditions such as gout, paralysis and toothache. However, many were ineffective. Others are still useful therapy. They treat pain, spasms and brain conditions such as epilepsy. A distant relative of electrotherapy is electroconvulsive therapy (ECT, sometimes called electroshock). This was invented in the 1930s and is a controversial treatment for mental illness. ECT in a modified form is still used to treat some cases of severe depression.

X‑rays transform diagnosis

German physicist Wilhelm Roentgen discovered X‑rays in 1895. This changed the way doctors diagnosed and treated disease. X‑ray machines became powerful medical tools over the next 30 years, especially during the First World War. Doctors could now see deep inside the body without using exploratory surgery.

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X‑rays were not just used for diagnosis. Cancer could be treated using X‑ray radiation therapy devices. However, unprotected exposure to X‑ray radiation causes burns and cancer. Many patients and radiologists in the early 20th century died from overexposure before the risks were understood. Using proper safety measures, X‑rays were the main imaging technology until the 1970s. Other imaging machines such as the CT, PET and MRI scanner were developed. Unlike traditional X‑ray machines, they gave detailed views of the body’s complex structures, such as the brain.

Developing technology to assist the body

Assistive technologies became central to medicine during the 20th century. Advances in science, engineering and manufacturing were applied to medical problems. Technologies such as hearing aids, artificial limbs and mobility aids became more sophisticated. Ventilators, pacemakers and other machines were developed to support, enhance or replace the body’s organs. Willem Kolff invented the kidney dialysis machine during the 1940s.

The computer revolution in medicine

Using computers was one of the most important technological changes in 20th-century medicine. They became central to medical care from the 1950s. Computerised machines in hospitals monitored patients continuously. They also enabled insurers and state-run health services to track patient records on a massive scale. Imaging techniques such as MRI or PET were possible because faster computers could reconstruct images of the body. More diagnostic tests were developed because automated laboratory machines performed tests quicker and more accurately.

Machines give rise to specialist medical practitioners

Technologies had a major role in medicine becoming more specialised. Many medical technologies allowed specific parts of the body to be studied, diagnosed or treated. This led to doctors who specialised in certain organs. These include ophthalmologists (doctors specialising in eye conditions) and otolaryngologists (ear-nose-throat specialists). Devices such as the X‑ray machine introduced medical professionals such as radiologists and radiographers.

Gradual acceptance of technology

Not all new technologies were readily accepted by the medical community. Many were viewed with suspicion. In the 1930s some doctors doubted an X‑ray image of the chest was as reliable as a physical examination. Devices threatened to replace the diagnostic expertise of traditional doctors. Many doctors valued their clinical experience over machine-produced information. Other technologies failed because doctors or patients found them impractical. ECG was only useful when it became portable and reliable enough to be used at the patient’s bedside.

Limits on the use of technology within medicine

Medical machines also caused practical problems. Safety concerns and cost have limited their use. Technology has changed the relationship between patients and practitioners. Some historians and physicians argued machines made doctors poorer healers by encouraging them to focus only on the sick parts of the body, rather than caring for the patient as a whole. Many question whether excessive use of technology within childbirth or to prolong life can be intrusive and do more harm than good.

Devices causing dilemmas

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Advancing technology has presented physicians and patients with serious ethical dilemmas. Ultrasound screens foetuses for disease before babies are born. However, some parents must decide whether to terminate the pregnancy if the fetus is revealed to have a certain condition. Does medical technology impose on us more than it empowers?

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Bibliography

J Bronzino, V Smith and M Wade, (eds.), Medical technology and society: an interdisciplinary perspective (Massachusetts: MIT press, 1990)

W F Bynum and R Porter, (eds.), Companion Encyclopedia of the History of Medicine (London: Routledge, 1993)

R Cooter and J Pickstone, (eds.), Companion to medicine in the twentieth century (London: Routledge, 2000)

A Gedeon, Science and technology in medicine, (Springer Science, 2006)

B Holtzmann-Kevles, Naked to the bone: medical imaging in the twentieth century (New Jersey: Rutgers University Press, 1997)

J Howell, Technology in the hospital: transforming patient care in the early twentieth century (John Hopkins University Press, 1995)

R Porter, The Greatest Benefit to Mankind': A Medical History of Humanity from Antiquity to the Present (London: Fontana paperback, 1999)

S Reiser, Medicine and the Reign of Technology, (Cambridge: Cambridge University Press, 1978)

A Webster, Health, Technologies & Society: a sociological critique, (London: Palgrave, 2007).

S S Blume, Insight and Industry: On the dynamics of technological change in medicine Cambridge, Mass: MIT Press, 1992)

G Lawrence (ed.), Technologies of Modern Medicine (London: Science Museum, 1994)

R Bud and D J Warner (eds.), Instruments of Science, An Historical Encyclopaedia (London: Science Museum, 1998)

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