Speaker 1: Welcome to Invention, a production of I Heart Radio. Hey,
Speaker 1: welcome to Invention. My name is Robert Lamb and I'm
Speaker 1: Joe McCormick. And today I thought maybe we could inject
Speaker 1: ourselves into the topic for this episode by the administration
Speaker 1: route of some poetry and Greek myth. Robert, are you
Speaker 1: willing to go that route with me? Let's do it? Okay.
Speaker 1: So this is going to be from Ovid's Metamorphoses. This
Speaker 1: is the section on the transformation of cy rinks into reads.
Speaker 1: And this is the translation of Ovid by John Dryden.
Speaker 1: I'll take it first and then you can pick up.
Speaker 1: You'll know where Robert. All right, So it begins. Then
Speaker 1: Hermie said, thus a nymph of late there was, whose
Speaker 1: heavenly form her fellows did surpass the pride and joy
Speaker 1: of fair Arcadius planes, beloved by deities, adored by Swain's
Speaker 1: cy rinks, her name by Sylvan's oft pursued as off
Speaker 1: she did the lustful God's delude, the rural and woodland
Speaker 1: powers disdained, with Cynthia hunted and her rights maintained like
Speaker 1: Phoebe clad even Phoebe's self. She seems so tall, so straight,
Speaker 1: such well proportioned limbs. The nicest eye did no distinction. No,
Speaker 1: but that the goddess bore a golden bow distinguished thus
Speaker 1: the sight she cheated to. Descending from Lychaeus, Pan admires
Speaker 1: the matchless nymph and burns with new desires. A crown
Speaker 1: of pine upon his head he wore, and thus began
Speaker 1: her pity to implore. But ever he thus began, she
Speaker 1: took her flight so swift she was already out of sight.
Speaker 1: Nor stayed to hear the courtship of the god, but
Speaker 1: bent her course to Leyden's gentle flood. There By the
Speaker 1: river stopped and tired before relief from water, nymphs her
Speaker 1: prayers implore. Now, while the lustful god, with speedy pace,
Speaker 1: just thought to strain her in a strict embrace, he
Speaker 1: feel old his arms with reads new rising on the place,
Speaker 1: And while he sized his ill success to find the
Speaker 1: tender canes were shaken by the wind and breathed a
Speaker 1: mournful air unheard before that much surprising Pan yet pleased
Speaker 1: him more, admiring this new music, Thou, he said, who
Speaker 1: canst not be the partner of my bed? At least
Speaker 1: shall be the comfort of my mind? And often often
Speaker 1: to my lips be joined. He formed the reads proportioned
Speaker 1: as they are unequal in their length, and waxed with care.
Speaker 1: They still retain the name of his ungrateful fair. And
Speaker 1: of course that name is the name of the nymph
Speaker 1: in the story, the name Syrinx, which gives us the
Speaker 1: English word syene. There is, and that's going to be
Speaker 1: our topic for today. The hypodermic needle and the hypodermic syringe,
Speaker 1: I guess too, slightly different things, but very much entwined
Speaker 1: in medical history. Not so much the god's chasing nymphs
Speaker 1: through the reads, right, uh yeah, So this is a
Speaker 1: strange connection. But the next time you are getting ready
Speaker 1: to have blood drawn or to get an injection, get
Speaker 1: a flu vaccine or something, and you're beholding the humble
Speaker 1: medical syringe, know that this word comes from the Greek Syrinx,
Speaker 1: this nymph who is known for her chastity. But then
Speaker 1: the great god Pan, his his eye falls to her,
Speaker 1: and he pursues her, and she defensively praised to be
Speaker 1: transformed into hollow reads, which become the tubes of Pan's flute.
Speaker 1: So a couple of thoughts that this is a weird
Speaker 1: and fascinating myth. Number one, it's the most elaborate myth
Speaker 1: that I could possibly imagine, exploring the concept of tubes.
Speaker 1: And then second, uh so, characters get transformed into a
Speaker 1: lot of different things in these myths. Obviously it's the metamorphoses, right,
Speaker 1: But this is a double metamorphosis, right, because she prays
Speaker 1: to be transformed into hollow reads, and then she is,
Speaker 1: and then those reads get transformed by Pan into a
Speaker 1: musical instrument. I kind of feel like the Smith has
Speaker 1: an unhappy ending, which, of course, of course it does not,
Speaker 1: not out of keeping with tales of God's turning individuals
Speaker 1: into beasts and half beasts, so you know, and they're like,
Speaker 1: uh no, no, the bad guy wins, like I guess
Speaker 1: she she evades Pan, but then he cuts her into
Speaker 1: reads and makes her into a flute. Uh yeah. By
Speaker 1: the way, there's also a great poem by Elizabeth Barrett
Speaker 1: Browning about the Smith called a Musical Instrument. If you've
Speaker 1: never read it, it's worth reading. We're not going to
Speaker 1: read that whole poem, but um, but it's got the
Speaker 1: great lines. What was he doing? The Great God Pan
Speaker 1: down in the reads by the river spreading ruin and
Speaker 1: scattering bands, splashing and paddling with hoofs of a goat,
Speaker 1: and breaking the golden lilies afloat with the dragonfly on
Speaker 1: the river. If you haven't read it, you can look
Speaker 1: it up online and find the full text. It's great.
Speaker 1: But anyway, so we're gonna be talking today about the
Speaker 1: hypodermic syringe and invention that I think we really rarely
Speaker 1: do stop to appreciate, possibly because when most of us
Speaker 1: are encountering it, we're trying to think about it as
Speaker 1: little as possible. Maybe we're hoping our experience with it
Speaker 1: is over very quickly. Uh, And it makes us underappreciate
Speaker 1: how important and and and life saving this invention is.
Speaker 1: It's actually extremely useful. It's deeply underappreciated. For one thing,
Speaker 1: it causes us to ask a question about drugs that
Speaker 1: we rarely ask. Right, yeah, what is the best way
Speaker 1: to get a substance into the body? Not always straightforward, right,
Speaker 1: I mean one of our favorite ways and probably our
Speaker 1: preferred ways, of course, to eat something right now, which
Speaker 1: is simply essentially what we're doing when we have a
Speaker 1: we take a pill, right, um, you know, chewable swallow
Speaker 1: or whatever it happens to be um and then we
Speaker 1: just allow our digestive system to do its job. This
Speaker 1: is oral absorption, just one of the internal routes for
Speaker 1: drug absorption. The other two areas are sublingual and per rectum,
Speaker 1: which is by use of a suppository, So we're talking
Speaker 1: about suppository or something that goes under the tongue um.
Speaker 1: And then there's also inhalation and topical. We'll come back
Speaker 1: to two topical and a little bit too inhalation going on.
Speaker 1: But essentially, any of these methods of bringing a substance
Speaker 1: into your body, bringing a drug into your body, they're
Speaker 1: gonna be pros and cons to each of the methods,
Speaker 1: and some are gonna work better with certain substances than
Speaker 1: others or not at all. It just depends on what
Speaker 1: the substances and and uh, you know, and what its
Speaker 1: properties are and how it is going to be best
Speaker 1: absorbed by the body. Yeah, and well, and a few
Speaker 1: other things about like the circumstances of the administration, like
Speaker 1: how quickly do you want it to take effect, how
Speaker 1: direct like how strong do you want the dose to
Speaker 1: be when it gets absorbed, things like that exactly. But
Speaker 1: there is another way into the human body, and that
Speaker 1: is the parental route, And there are several different varieties
Speaker 1: depending on where you want to stick it, but the
Speaker 1: basic idea is that you inject the substance into the
Speaker 1: body via uh what eventually would become a hypodermic needle
Speaker 1: or via a catheter. Yeah, so I guess to see
Speaker 1: the quick version of why it might be important to
Speaker 1: inject a drug when you could just take a pill.
Speaker 1: For one thing, you can't always just take a pill,
Speaker 1: Like the pharmacology of administration routes is way more complicated
Speaker 1: than that. For one thing, there are obvious practical reasons
Speaker 1: why a pill won't always work. Think about a local
Speaker 1: and aesthetic. Imagine you're you're trying to numb just a
Speaker 1: certain patch of skin or tissue somewhere on the body
Speaker 1: to do a local operation without putting the patient completely
Speaker 1: under right, I mean, yeah, when you go to the dentist,
Speaker 1: and the dentist uses gives you a shot to the
Speaker 1: area of your gums that is about to be worked upon, Like,
Speaker 1: you want a very localized effect because that's where it's
Speaker 1: happening right there, not in your stomach, right there in
Speaker 1: your mouth exactly. But There are also tons of molecular
Speaker 1: and metabolic reasons why a pill isn't always the best
Speaker 1: administration route for a drug. One example is the drug insulin,
Speaker 1: which is used to treat diabetes. Insulin generally needs to
Speaker 1: be injected because it doesn't survive the digestive system. Well,
Speaker 1: if you take an insulin pill, it doesn't survive the
Speaker 1: acids in our stomach. So if you you are to
Speaker 1: take insulin orally, its effectiveness would be compromised. It needs
Speaker 1: to enter the bloodstream directly. Another example would be you
Speaker 1: know mentioned topical. The most popular one or more top
Speaker 1: popular topical um UH systems we have is of course
Speaker 1: the like that patch, like a nicotine patch. But for
Speaker 1: that to work, first of all, you have to be
Speaker 1: very okay with a slow process because you're not going
Speaker 1: to get an instant you know action there. But then
Speaker 1: also the drug molecules have to be small enough to
Speaker 1: pass through skin pores, and that's not always not going
Speaker 1: to be the case. Yeah. Oh, and the size of
Speaker 1: the molecules and the absorption that also comes to be
Speaker 1: a factor within the digestive tract. Right, Like, large molecules
Speaker 1: have a harder time getting absorbed through the walls of
Speaker 1: the intestine or some right. So I want to come
Speaker 1: back to the catheter for a second. So the catheter
Speaker 1: obviously is not a hypodermic needle. It doesn't create an
Speaker 1: opening in the skin. Rather, it makes use of one
Speaker 1: of our smaller orifices, the urethra. So evidence of catheter
Speaker 1: usage actually goes back a long time, Like we're talking
Speaker 1: three thousand b C. With scattered mentions in grease, Syria, India, China.
Speaker 1: The ancient Chinese apparently used onion stalks, The Romans, Indians,
Speaker 1: and Greeks used tubes of wood, sometimes tubes of precious metals.
Speaker 1: The Syrians used wooden reeds, and we wouldn't actually see
Speaker 1: malleable catheters until the eleventh century CE. The most common
Speaker 1: usage and all this was to drain, you know, overfilled bladders.
Speaker 1: And I found this interesting. This is skipping ahead a lot.
Speaker 1: But our old friend Benjamin Franklin comes up. Oh yeah,
Speaker 1: because Benjamin Franklin invented a silver catheter for his brother
Speaker 1: who suffered from kinney's kidney stones and required a daily catheterization.
Speaker 1: He was the original catheter cowboy. Yeah, he's out there,
Speaker 1: he's out there. Electrocuting turkeys, doing catheters, creating catheters for
Speaker 1: his brother, and then Franklin apparently suffered from kidney stones
Speaker 1: later in life, so he likely used his own invention.
Speaker 1: Rubber catheters didn't come along to the eighteenth century latex
Speaker 1: didn't come around to the ninety five uh and the
Speaker 1: you know a technology eventually. Essentially we're dealing with some
Speaker 1: of the same technology that would eventually enter the veins.
Speaker 1: Uh So, in a sense, the catheter is kind of
Speaker 1: the precursor to the hypodermic needle. And of course the
Speaker 1: catheterization also doesn't necessarily involve involved just the urethrow because
Speaker 1: the French physiologist Claude Bernard performed the first cardiac catheorization
Speaker 1: in eighteen forty four on a horse, and this application
Speaker 1: remains in use for neurosurgens and cardiologists. But a catheter
Speaker 1: is somewhat different than than a hypodermic surrent correct, So
Speaker 1: what is a hypodermic syringe, Well, it has two main components.
Speaker 1: This would be the hYP the hypodermic needle and the syringe.
Speaker 1: So the syringe is if you imagine the common sort
Speaker 1: of disposable medical needle you've seen these days. The syringe
Speaker 1: is the plastic part, you know, it's the hollow tube
Speaker 1: with a retractable plunger or piston inside which can be
Speaker 1: used to inject or withdraw liquid. And the hypodermic needle.
Speaker 1: Of course, the word hypodermic means under the skin, so
Speaker 1: a hypodermic needle is a hollow needle made for piercing
Speaker 1: the skin or other outer tissues to inject into or
Speaker 1: withdrawal from what's underneath by way of pressure difference created
Speaker 1: with the plunger inside the syringe. Yeah, Like I remember
Speaker 1: when I was a kid, you know, obviously, you know,
Speaker 1: I think everybody can relate to this. You're you're you're
Speaker 1: getting stuck with hypodermic needles pretty early on, so you
Speaker 1: have a pretty early understanding of what they are. But
Speaker 1: I remember finding a hypodermic needle plunger, a clean one
Speaker 1: because I and my dad was a dentist who worked
Speaker 1: in a hospital, and so he would bring these home
Speaker 1: and you know they're great, Oh boy, one other great
Speaker 1: fun to play with, like in the bathtub, you know,
Speaker 1: because it's actually a little plunger squirter, right, But then
Speaker 1: I was then I found a knitting needle, and I
Speaker 1: was like, oh, I can just put this on the end,
Speaker 1: and I have and I have a hypodermic needle, thankfully,
Speaker 1: you know, I didn't stick it in anything but that.
Speaker 1: Obviously that would not have worked because that is a
Speaker 1: solid needle. It does not have the aperture that is
Speaker 1: necessary for the process to take place, right, the most
Speaker 1: important part of the metal needle being that it is
Speaker 1: the small bore needle that's hollow, right, the liquid can
Speaker 1: pass in and out, so I wouldn't would not have
Speaker 1: been able to inject warm bathwater into my veins even
Speaker 1: if I had wanted to. Well, So, as I was
Speaker 1: saying earlier, I I really do think this has got
Speaker 1: to be one of the most underappreciated inventions, just because
Speaker 1: I mean mostly people don't like them. Like even if you,
Speaker 1: I mean, I'm somebody who I'm very pro vaccine, you know,
Speaker 1: I think, like I don't try not to demonize medical science,
Speaker 1: I still don't enjoy needles. I mean, when I've got
Speaker 1: to get a shot. I get my flu shot every year,
Speaker 1: but I don't like the getting stuck art right, Like
Speaker 1: I I like to give blood when whenever there's a
Speaker 1: blood drive and I, you know, I think to do it.
Speaker 1: I know it more if they've called me and reminded
Speaker 1: me to do it, you know, I'll go and give blood.
Speaker 1: I I don't get faint or freak out or pass
Speaker 1: out at the needle going in. But at the same time,
Speaker 1: I really don't like to look at it, right, I
Speaker 1: really have to look over here, and I don't. I
Speaker 1: don't like the sensation of the needle remaining stuck in
Speaker 1: my arm for you know, the duration of the withdrawal. Right,
Speaker 1: So it's no mystery I think why this is a
Speaker 1: grossly underappreciated medical invention, Like, despite all of the grade
Speaker 1: it does in medical science. It you know, all of
Speaker 1: the lives that saves every year, it's just it's just
Speaker 1: kind of a key to think about. So like people
Speaker 1: don't appreciate it in the same way they might appreciate
Speaker 1: aspirin or something that's not as uh, you know, maybe
Speaker 1: even a lot less life saving, but is less icky
Speaker 1: to think about. Right now, this being said, we realized
Speaker 1: that a lot of people out there, you may have
Speaker 1: more familiarity with needles. Perhaps you you have a self
Speaker 1: administer a shot. Maybe even every day. Uh, you know,
Speaker 1: maybe you've you've gone through treatments sead of required a
Speaker 1: great deal of familarity with hypodermic needles, and you know
Speaker 1: this is the case. We would obviously love to hear
Speaker 1: from you, you know, hear what your thoughts on it like.
Speaker 1: To what extent do you get used to it? Um?
Speaker 1: You know, does it ever feel anything like comforting? I
Speaker 1: don't know. I guess it varies. Well, I mean, I hope,
Speaker 1: I hope. I don't know if we can achieve this,
Speaker 1: But by the end of this episode, maybe we'll give
Speaker 1: you a new appreciation for the great value of the
Speaker 1: hypodermic needle. I mean, such that it even viscerally affects
Speaker 1: your reaction to when you have to get a shot
Speaker 1: or get blood drawn, and maybe you feel a little
Speaker 1: bit better about it. That would be a that'd be
Speaker 1: a good goal to achieve if we can do it.
Speaker 1: Sounds good. Now, before we get to life saving hypodermic
Speaker 1: needles that we should all be thankful for, maybe we
Speaker 1: should think about the hypodermic needles in nature that kill
Speaker 1: well not necessary, Well, okay, I guess most of them
Speaker 1: kill or most of them can kill. Under the rise circumstances,
Speaker 1: because before we lay the mantle of syringe inventor on
Speaker 1: a mere human, we really need to consider some of
Speaker 1: the marvels of hypodermic mastery in the natural world. Let's
Speaker 1: do it alright, So, for instance, just consider a spider
Speaker 1: from uh, you know, a spider's thing is a perfect
Speaker 1: injection tool. It evolved, after all, to pierce the prey
Speaker 1: organisms outer layer and inject venom. We also find biological
Speaker 1: injection needles and other organisms such as bees wasps. Both
Speaker 1: of these are of course examples where they're using an
Speaker 1: ovipositor that you know, as an egg laying organ that
Speaker 1: has evolved to a pierce prey or to pierce an aggressor.
Speaker 1: We've talked about bees and wasp on the show before,
Speaker 1: but then also we have mosquitoes as well, and we're
Speaker 1: talking about several different structures here that have evolved into injectors.
Speaker 1: The ovipositors, mouthparts, teeth, the fang of a venomous serpent,
Speaker 1: for example, is a highly evolved injection tool, and it's
Speaker 1: just a wonderful example. Um In fact, scientists continue to
Speaker 1: look at such bio injectors for possible ideas about how
Speaker 1: to improve upon our injection designs. UH. This includes looking
Speaker 1: at curved spider fangs, such as those of the wandering spider,
Speaker 1: and this was studied by researchers at the Max Planck Institute. Now.
Speaker 1: As amazing as spider fangs are in terms of biological
Speaker 1: hypodermic injection, one thing I do want to make clear,
Speaker 1: because this is one of my favorite distinctions about spiders,
Speaker 1: is that we must remember that the hypodermic needle properties
Speaker 1: of spider fangs only go one way. I remember when
Speaker 1: I was a kid, I always just assumed, I, maybe
Speaker 1: because of exposure to hypodermic needles used to draw blood,
Speaker 1: that spiders would suck the juices out of their prey
Speaker 1: with the needles of their fangs, right like it would
Speaker 1: be like drawing blood or like a or like a mosquito,
Speaker 1: which we can talk about in a minute. But um,
Speaker 1: spiders don't do that. They don't suck the delicious prey
Speaker 1: juices out through the fangs the way you might draw
Speaker 1: blood from a vein with a needle. Spiders do something
Speaker 1: much grosser that it involves often like I mean, different
Speaker 1: spiders have slightly different methods, but it usually involves some
Speaker 1: kind of external digestion, like like spitting or injecting fluid
Speaker 1: that sort of dissolves the prey animal and then like
Speaker 1: slurping parts of it up and chewing it with these
Speaker 1: gross mouth parts. It it's it's much more amazing. Actually, yes,
Speaker 1: And you know, I think next week we're gonna have
Speaker 1: an episode of the show that deals with another creepy
Speaker 1: crawley creature that utilizes a similar feeding strategy. So so
Speaker 1: if you like creatures being hollowed out by digestive juices
Speaker 1: and then uh and then it's slurped like like a
Speaker 1: bubble t, then stay tuned for more stuff to blow
Speaker 1: your mind. Dissolve and slurp. It's what we do now.
Speaker 1: To come back to the mosquito though, Yeah, this is
Speaker 1: this is certainly certainly an interesting species to look at
Speaker 1: because the mosquito is rather skilled at withdrawing blood and
Speaker 1: it does so through its proboscis. Uh so it's not
Speaker 1: you know, it's not an ovipositor. It's it's you know,
Speaker 1: it's it's it's not like an auxiliary mouth part. And
Speaker 1: this is another area where scientists are looking for possible
Speaker 1: bio mimetic solutions, so biommetic that's where we're looking to
Speaker 1: the natural world saying, hey, how here's we have an
Speaker 1: engineering problem. How did evolution solve this engineering problem? And
Speaker 1: then how can we uh, you know, copy off of
Speaker 1: Nature's notes. Actually, bio mimesis goes way back in the
Speaker 1: history of hypodermic metals as well, discuss later in the episode.
Speaker 1: So in this case, researchers at Osaka's Kansai University, we're
Speaker 1: looking into ways to develop a pain free injection device
Speaker 1: based on the the blood drinking functionality of mosquitoes. And
Speaker 1: it's actually rather interesting to think about because sure, bacteria
Speaker 1: in the anticoagulant of ax and that mosquito causes an
Speaker 1: infection that results in itching. But the poke itself, how
Speaker 1: does that feel? I mean, every now and then I'll
Speaker 1: get a mosquito bite where I'll feel it, and I'll
Speaker 1: look down and I'll catch the bugger in action and
Speaker 1: and hopefully smite them. But most of the time you
Speaker 1: do not feel it at all. And the reason, according
Speaker 1: to the Osaka researchers, is that while a hypodermic needle
Speaker 1: is smooth around the edges, the mosquito proboscis is jagged.
Speaker 1: That seems counterintuitive, it does, but but apparently the way
Speaker 1: it works is that the mosquito has two serrated max
Speaker 1: silly that cut into the skin and then they allow
Speaker 1: the labor um to slide in, which I find that
Speaker 1: detail makes being bitten by a mosquito just a little
Speaker 1: creepier to think of, like the mechanics of the first
Speaker 1: skin being parted and then it's other organ entering into
Speaker 1: me um. But at any rate, the reason that we
Speaker 1: we don't see it has everything to do with the serration,
Speaker 1: because the serrated parts result in a minimum amount of
Speaker 1: surface area impacting nerves in the skin, while the human
Speaker 1: needle impacts the maximum amount of surface area. So um.
Speaker 1: They they've apparently been working with this for some time
Speaker 1: and they've they've actually experimented with some prototypes, some prototype
Speaker 1: needles based on the mosquitoes proboscis, and they found that
Speaker 1: in the prototypes they were studying that individuals poked with
Speaker 1: this needle, this mosquito needle, if you will, Uh, they
Speaker 1: didn't really feel the prick of the needle as much,
Speaker 1: but they thought it felt more painful the longer it
Speaker 1: was in there. So Um, I don't know, be interesting
Speaker 1: to see where this goes. I mean, obviously there are
Speaker 1: other factors as well, like the mosquito proboscis is is
Speaker 1: quite small, and uh the needle is going to be
Speaker 1: a by necessity a little larger. Uh, So that could
Speaker 1: be a part of it as well. But it would
Speaker 1: be interesting to see, how you know, to see to
Speaker 1: what extent we can take the the the the the
Speaker 1: the mouth parts of the mosquito. Uh. You know this
Speaker 1: this tremendous enemy of humanity and turn it around to
Speaker 1: improve our healing capabilities. Yeah. Now, we always go out
Speaker 1: of our way not to demonize animals on our shows,
Speaker 1: but if there is any animal that really deserves a
Speaker 1: spot as humanity's enemy, it's like the insects that are
Speaker 1: disease vectors, like mosquitoes and ticks. Right. Though, to be
Speaker 1: fair to the mosquitoes, as always have to point out
Speaker 1: that they are pollinators, uh, and that also mosquito larvae
Speaker 1: are a tremendous food source for a great number of creatures,
Speaker 1: and of course bats eat flying adult mosquitoes. Of course.
Speaker 1: I mean this is not to say they don't play
Speaker 1: a role in nature, but still they are a danger
Speaker 1: to humans, and they actively hunt us and on on
Speaker 1: a on a scale of destruction to humankind that is
Speaker 1: not comparable at all to the types of animals that
Speaker 1: people actually like demonize and go out culling and stuff,
Speaker 1: you know, and uh like large mega fauna predators that
Speaker 1: almost so rarely actually attack humans. Right when you compare
Speaker 1: historic u you know, tiger deaths versus malaria deaths. Yeah,
Speaker 1: clearly the enemies the mosquito. All right, should we take
Speaker 1: a quick break and then come back and talk about humans?
Speaker 1: Sounds good? Alright, we're back. We've talked about how nature
Speaker 1: solved the problem of how to uh squirt stuff into
Speaker 1: or draw things out of a living creature. But now
Speaker 1: it's time for the humans to tics interer stage. Yeah.
Speaker 1: And the question of who should get credit for inventing
Speaker 1: the hypodermic needle or the hypodermic syringe, I would say,
Speaker 1: does not seem fully totally settled, though. I think there's
Speaker 1: there's generally agreement that this medical technology came online around
Speaker 1: the middle of the eighteen hundreds and then was steadily
Speaker 1: adopted more and more throughout the later eighteen hundreds and
Speaker 1: then especially in the twentieth century when the number of
Speaker 1: injectable medications boomed. But which earliest attempt should really get credit,
Speaker 1: I think is kind of disputed, and should also be
Speaker 1: noted that there were various reports of inventions and experiments
Speaker 1: kind of like a hypodermic syringe noted in history before
Speaker 1: the nineteenth century. But to whatever extent they existed, into
Speaker 1: whatever extent they served the purposes of a hypodermic syringe,
Speaker 1: they didn't survive and remain in use or in practice
Speaker 1: across time. But we will do a quick survey of
Speaker 1: a few of these earlier records now. One is that
Speaker 1: forms of syringes existed in medicine before they were equipped
Speaker 1: with fine bore needles for piercing the skin or other tissues.
Speaker 1: Like the first century Roman scholar Aulus Cornelius Kelsus wrote
Speaker 1: in his book Daymondissina about a process for using a
Speaker 1: syringe to wash out a wound or fistula by injecting
Speaker 1: wine or vinegar or a solution of honey. Quote, it
Speaker 1: is not inappropriate when changing the dressings and again before
Speaker 1: inserting fresh medicaments to wash out the fistula using an
Speaker 1: ear syringe with wine. If there is much puss with vinegar,
Speaker 1: if there is hard callous, if it is already clean
Speaker 1: with honey, wine, or a decoction of vetch, to which
Speaker 1: also a little honey should be added. Uh. And I've
Speaker 1: read several himes of Galen also using the mentioning the
Speaker 1: use of a syringe. Now, again, this wouldn't be a
Speaker 1: hypodermic needle, but this we think would be some kind
Speaker 1: of plunger or piston based object that would basically squirt
Speaker 1: liquid into an opening. Right, just a way of squirting
Speaker 1: in the wine, the vinegar or the honey, whatever, the
Speaker 1: delicious food stuff is going into all the good stuff
Speaker 1: they squired into you. Yeah, that's so Uh. These kinds
Speaker 1: of syringes predated the modern hypodermic needle, and you can
Speaker 1: see them being used for things in history like squirting
Speaker 1: liquid into an ear or even to administer enemas. You
Speaker 1: know that that's another thing that predates the needle. There's
Speaker 1: also a record in medieval Egypt by an Arab opthmologist
Speaker 1: and oculus named Amar al Massili, who wrote extensively about
Speaker 1: treatments for eye diseases and the site. Uh. And in
Speaker 1: in one of his works he wrote this I think
Speaker 1: this was around the year nine hundred or so. Quote.
Speaker 1: Then I constructed a hollow needle, but I did not
Speaker 1: operate with it on anybody at all. Before I came
Speaker 1: to Tiberius, there came a man for an operation who
Speaker 1: told me, do as you like with me, only I
Speaker 1: cannot lie on my back. Then I operated on him
Speaker 1: with the hollow needle and extracted the cataract, and he
Speaker 1: saw immediately and did not need to lie, but slept
Speaker 1: as he liked. Only I bandaged his eye for seven
Speaker 1: days with this needle. Nobody preceded me. I have done
Speaker 1: many operations with it in Egypt. So it sounds like
Speaker 1: he's describing some kind of needle attached to a suction device.
Speaker 1: We don't know if it would have been a piston,
Speaker 1: but attached to some kind of suction device or tube
Speaker 1: that can suck cataracts out of the eye. And part
Speaker 1: of what he's saying here is that I think that
Speaker 1: a treatment known to the medicine at the time in
Speaker 1: the area would have been to have patients lie on
Speaker 1: their backs. But this patient was like, no, I can't
Speaker 1: do that, so you've got to do something else. And
Speaker 1: apparently that involved a needle going in uh to suck
Speaker 1: the cataracts out, which uh do not do not try
Speaker 1: at home? Right? Uh? But yeah, it does sound like
Speaker 1: he's describing some kind of early version of a kind
Speaker 1: of hypodermic needle for suction or extraction. There much later, apparently,
Speaker 1: Blaze Pascal experimented with designs for syringes to study pressure
Speaker 1: and fluid dynamics, but it was apparent that these could
Speaker 1: possibly be used for some kind of medical applications. And
Speaker 1: then the seventeenth and eighteenth century English architect and polymaths
Speaker 1: Or Christopher Wren experimented with intravenous injections. He created a
Speaker 1: syringe out of an animal bladder attached to a needle
Speaker 1: made from a goose quill, and he used it to
Speaker 1: inject substances like poppy sap and wine into the veins
Speaker 1: of animals and up building on that kind of thing.
Speaker 1: In the sixteen sixties, the German physicians J. D. Major
Speaker 1: and J. S. L. Schultz experimented with intravenous infusions of
Speaker 1: blood and other liquid substances in humans, but their injection
Speaker 1: methods were dangerous and unsuccessful due to multiple things like
Speaker 1: or lack of knowledge about germs, lack of proper sterilization techniques,
Speaker 1: also lack of knowledge about proper ivy dosage of medicines,
Speaker 1: so their experiments were dangerous. They lead to human deaths,
Speaker 1: and this is often written that it's sort of like
Speaker 1: put a damper on on hypodermic needle technology because it
Speaker 1: went so wrong like that, when we may have developed
Speaker 1: modern hypodermic needle technologies earlier if they hadn't screwed their's up. Yeah,
Speaker 1: you see. You see examples of this in in medical
Speaker 1: history from this time period where you know, clearly they
Speaker 1: were on the right track. But if you're you're getting
Speaker 1: something wrong and it's resulting in like just death after
Speaker 1: death like that, there's only at times it seems like
Speaker 1: it's a dead end. I mean, you saw some of
Speaker 1: this with the history of blood transfusions. Oh yeah, well
Speaker 1: that's sort of what's going on here. Yeah, they were
Speaker 1: doing blood transfusions and transfusions of other things. I mean,
Speaker 1: I didn't read a list of all the stuff, but
Speaker 1: I would not be surprised at all if they were
Speaker 1: just transfusing wine into people's veins. All the kinds of
Speaker 1: stuff people tried back then. What was it about wine
Speaker 1: in medicine throughout history, just always the wine. Well, I mean,
Speaker 1: and it's it's an alcohol. You know, we still use
Speaker 1: alcohol for for medical purposes. And uh, and we've we've
Speaker 1: discussed the you know, the properties of honey on the
Speaker 1: show before or well we discussed it on Stuff to
Speaker 1: Build your Mind, right, um, you know, which has long
Speaker 1: been was was long used in medical practices. The short
Speaker 1: version is that honey, despite having sugar, and it also
Speaker 1: has antimicrobial properties, and vinegar is just delicious. I'm sure
Speaker 1: it was balsamic vinegar. But yeah, So, so there are
Speaker 1: all these precursors to things that would eventually become the
Speaker 1: hypodermic needle. Um. But but it was really around the
Speaker 1: mid eighteen hundreds that the true modern hypodermic syringe was
Speaker 1: really invented. And even once we get to the mid
Speaker 1: eighteen hundreds, it seems like there are a lot of
Speaker 1: people simultaneously doing research and innovation innovation in this area.
Speaker 1: So I think, my necessity, we're not going to be
Speaker 1: able to mention them all. We'll mention several of the
Speaker 1: name aimes that most commonly come up as inventors or
Speaker 1: or sort of inventors of the hypodermic syringe. Now the
Speaker 1: first one in many sources given credit for the invention
Speaker 1: of the hypodermic needle is a nineteenth century Irish surgeon
Speaker 1: named Francis Wrind r y in d I think that
Speaker 1: would be Wrinnd, not Rind. But he lived eighteen o
Speaker 1: one to eighteen sixty one. So Francis Wrind treated the
Speaker 1: public at Meath Hospital, which at the time saw or
Speaker 1: largely saw patients from the southern part of Dublin's inner
Speaker 1: city who tended to be poor at the time, and
Speaker 1: during his education Rind was apprenticed to the Irish surgeon
Speaker 1: Sir Philip Crampton. I was trying to find out things
Speaker 1: about Crampton. The main things I could find about him
Speaker 1: where that he was considered important. He was considered imminent
Speaker 1: uh in early nineteenth century Irish surgery. He helped found
Speaker 1: a hospital for the treatment of poor children in Dublin,
Speaker 1: and that for many years there was there. It was
Speaker 1: like this bizarre looking memorial statue honoring Crampton at a
Speaker 1: street crossing in Dublin. And it looked like first of all,
Speaker 1: it had a fountain and a bust of him, but
Speaker 1: over that it had a huge metal stalk of plant
Speaker 1: matter with leaves peeling off of it, like a giant
Speaker 1: elongated metal artichoke. I don't know what that was supposed
Speaker 1: to represent. I don't think it's there anymore. But Wrind
Speaker 1: was not a hugely significant figure in history apart from
Speaker 1: the hypodermic needle, So it's um. It's hard to come
Speaker 1: across a lot of detailed biographical information about him. According
Speaker 1: to a nineteen seventy article in jama recognizing his achievements,
Speaker 1: Francis Rind was described by his contemporaries as a perfect gentleman,
Speaker 1: passionately fond of hunting, a fashionable dresser, and a favorite
Speaker 1: with the ladies. That that tells us virtually nothing about
Speaker 1: maybe he had syphilis. I don't know what makes me
Speaker 1: wonder so he's a fashionable dresser, a gentleman favorite with
Speaker 1: the ladies. We know our impressions of pain are highly
Speaker 1: variable based on psychological factors. Right, do you think injections
Speaker 1: subjectively freak people out less if the guy doing the
Speaker 1: injection is like a sexy, well dressed gentleman. No, I don't.
Speaker 1: I don't think so. I think based on my experience,
Speaker 1: I think, um, uh, you know, professional equipment and a
Speaker 1: calm demeanor. Demeanor go a long way towards reassuring me
Speaker 1: during an injection or withdrawal. I guess it doesn't say
Speaker 1: whether he was calm or not. Yeah, that's what I want.
Speaker 1: I mean, he can the doc can can be uh
Speaker 1: handsome as I'll get out, but I want him to
Speaker 1: to be you know, to to be calm and efficient. Yeah, alright,
Speaker 1: so let's get to that injection. So in May of
Speaker 1: eighteen forty four, one of Dr Wrenn's patients was a
Speaker 1: fifty nine year old woman named Margaret Cox who was
Speaker 1: experiencing debilitating pain in the face and she couldn't sleep
Speaker 1: as a result of it. And I think it's probably
Speaker 1: pretty agreed now that this this was probably due to
Speaker 1: a condition that we know today is trigeminal neuralgia now.
Speaker 1: Trigeminal neuralgia or t N, is a condition that affects
Speaker 1: the trigeminal nerve, also known as the fifth cranial nerve.
Speaker 1: It's a large nerve that connects the face to the brain,
Speaker 1: and it's the main pathway by which we do facial
Speaker 1: motor functions. Like biting and chewing and by which we
Speaker 1: feel sensations in the face, and people with chronic trigeminal
Speaker 1: neuralgia can repeatedly have bouts of searing pain that just
Speaker 1: shoot across the face or flare up when the face
Speaker 1: is touched or otherwise stimulated, even just by doing something
Speaker 1: like talking or chewing, and this condition can be extremely
Speaker 1: painful and demoralizing. I was reading that there's even evidence
Speaker 1: it might lead to depression, anxiety, and sleep disorders. And
Speaker 1: one of the common causes is when a blood vessel
Speaker 1: is in direct contact with the nerve inside your head,
Speaker 1: and the pressure of the blood vessel on the nerve
Speaker 1: causes false feedback that can be felt in the brain
Speaker 1: as pain. So this patient came to Francis Rand seeking
Speaker 1: help because she had acute pain over the entire left
Speaker 1: side of her face, especially right over her left eye
Speaker 1: and shooting down into the eye and the cheeks and
Speaker 1: the gums, and every time she tried to close her
Speaker 1: mouth or press her teeth together, the pain got worse.
Speaker 1: Apparently she had had this pain for years and doctors
Speaker 1: had tried to treat it by having her drink a
Speaker 1: solution of morphine this did not work, so instead Rind
Speaker 1: created a new surgical tool by combining a couple of
Speaker 1: existing tools called a trocar and a canula, and he
Speaker 1: used it to try treating his patient's pain locally with
Speaker 1: local administration of the morphine or the morphia. And so
Speaker 1: Rinda described his solution in a report to the Dublin
Speaker 1: Medical Press in eighteen forty five that I'm going to
Speaker 1: read from here, so Rind writes, on the third of June,
Speaker 1: a solution of fifteen grains of acetate of morphia dissolved
Speaker 1: in one drachm creosote was introduced to the super orbital
Speaker 1: nerve and along the course of the temporal, melar and
Speaker 1: bucle nerves by four punctures of an instrument made for
Speaker 1: the purpose. In the space of a minute, all pain
Speaker 1: except that caused by the operation, which was very slight,
Speaker 1: had ceased, and she slept better that night than she
Speaker 1: had for months. After the interval of a week, she
Speaker 1: had slight return of pain and the gums of both
Speaker 1: upper and under jaw. The fluid was again introduced by
Speaker 1: two punctures made in the gum of each jaw, and
Speaker 1: the pain disappeared. After this, the pain did not recur,
Speaker 1: and she was detained in hospital for some weeks, during
Speaker 1: which time her health improved, her sleep was restored, and
Speaker 1: she became quite a happy looking person. She left the
Speaker 1: hospital in the first of August and high spirits, and
Speaker 1: promised to return if she ever felt the slightest pain. Again,
Speaker 1: we conclude she continues well, for we have not heard
Speaker 1: from her since now. One very important distinction is that
Speaker 1: Francis Rin's hypodermic needle was not a hypodermic syringe like
Speaker 1: we have today, which would have a tiny hollow need
Speaker 1: or and a plunger or or piston for injecting and
Speaker 1: withdrawing fluid. The hypodermic needle Francis Wrend created was a
Speaker 1: relatively It would create a relatively large puncture wound, and
Speaker 1: it worked by gravity. So the two tools he combined
Speaker 1: to create it were, as I said, a trocar, which
Speaker 1: is a device with kind of a cutting point that
Speaker 1: this is the part that punctures the skin. And then
Speaker 1: a canuloh, which is a hollow tube which the medicinal
Speaker 1: fluid can drain down through. So essentially imagine kind of
Speaker 1: a thin, sharp tipped metal funnel. It punches a hole
Speaker 1: in the skin and you hold it up and let
Speaker 1: the acetate of morphia run down through it, and you
Speaker 1: sort of hope for the best, all right. So yeah,
Speaker 1: basically it makes a hole and then pour stuff into
Speaker 1: the hole. Right. Uh. And after Wrend reported this new
Speaker 1: technique in the medical press, it spread to other doctors
Speaker 1: and innovators and hospitals. Several sources report that the English
Speaker 1: nurse and social reformer Florence Nightingale was treated with this technique,
Speaker 1: and she wrote, quote, nothing did me any good but
Speaker 1: a curious little new fangled operation of putting opium under
Speaker 1: the skin, which relieved one for twenty four hours. This
Speaker 1: is a rather delightful story of medical innovation in the
Speaker 1: nineteenth century, you know. I mean it's it's like there
Speaker 1: was a problem, a solution was introduced and it worked.
Speaker 1: No horrors, horrors. I like that. Um. I mean, so
Speaker 1: the history of hypodermic needles is not without any horrors,
Speaker 1: but we've already explored some in the earlier centuries, right, Um,
Speaker 1: But yeah, this does seem like a really good encounter here,
Speaker 1: and so uh so great for Rind. Now. Wrin died
Speaker 1: in eighteen sixty one, and I think maybe we should
Speaker 1: go on to look at a couple of the other
Speaker 1: people who were commonly cited as early innovators or or
Speaker 1: inventors of the hypodermic needle. Many other sources credit a
Speaker 1: different doctor or pair of doctors with the invention of
Speaker 1: the modern hypodermic syringe, and these doctors are the Scottish
Speaker 1: surgeon Alexander Wood and the French surgeon Charles Gabrielle Pravaz.
Speaker 1: Now Alexander Would lived from eighteen seventeen to eighteen eighty
Speaker 1: four and he was a physician at a few different
Speaker 1: Scottish institutions in medical schools. Think he lived in Edinburgh
Speaker 1: and in the year eighteen fifty three, Would made a
Speaker 1: very important change, and it was pairing a small, hollow
Speaker 1: bore needle with a syringe with a plunger, so the
Speaker 1: drug could be injected rather than drained by the force
Speaker 1: of gravity. So part of this might be just what
Speaker 1: you consider a hypodermic needle. Yeah, this is this is
Speaker 1: more of a true hypodermic needle. We're discussing here, right,
Speaker 1: It's got the it's got a small needle, it's got
Speaker 1: the so a small needle instead of the trocar cutting tip,
Speaker 1: and it's got the piston for injecting. And so I
Speaker 1: want to read a section from the biography of Alexander
Speaker 1: Wood written by the very Reverend Thomas Brown, where where
Speaker 1: he talks about this discovery and some some bio mimesis
Speaker 1: going on here. So Brown rights, it was in the
Speaker 1: year eighteen fifty three that the question became pressing to him.
Speaker 1: He had encountered in his practice certain cases which, while
Speaker 1: there was great suffering, the use of opiates in the
Speaker 1: usual manner was impossible owing to some of the conditions
Speaker 1: we have alluded to, a not at all uncommon state
Speaker 1: of affairs. In one instance, indeed, things were critical, and
Speaker 1: the obtaining of sleep was an absolute necessity were life
Speaker 1: to be prolonged. A certain line of reasoning had led
Speaker 1: doctor Wood to the belief that benefit was to be
Speaker 1: expected from the injection of morphia under the skin. Taking
Speaker 1: as his model the sting of the bee, he had
Speaker 1: constructed a small glass syringe, to which was attached a
Speaker 1: fine perforated needle. Point this needle he passed under the skin,
Speaker 1: and through it he injected a small dose of morphia,
Speaker 1: which he could not give by the mouth. In this manner,
Speaker 1: all derangement of stomach and liver was avoided, an immediate
Speaker 1: absorption of the morphia into the bloodstream took place. The
Speaker 1: strikingly beneficial result which followed this bold experiment made doctor
Speaker 1: Would aware that he now held in his hand a
Speaker 1: new method of treatment which promised far reaching results. Certainly,
Speaker 1: in his most sanguine thoughts, he could little have imagined
Speaker 1: as he stood at that bedside, how in a few
Speaker 1: years every physician would be armed with that syringe, and
Speaker 1: countless patients would have seen cause to bless his skill.
Speaker 1: Interesting and yeah, I like the bit about looking to
Speaker 1: the world of the bee and uh and then trying
Speaker 1: to sort of copy what the bee is doing. Yeah,
Speaker 1: and so another thing we see here that's very true
Speaker 1: about the early days of injections is that this new
Speaker 1: injection method was used almost exclusively for the injection of
Speaker 1: morphia and opium preparations, right, so, primarily in the treatment
Speaker 1: of pain. But Alexander would predicted that other remedies best
Speaker 1: shot directly into the bloodstream and tissues, that they would
Speaker 1: make themselves apparent, and of course he was proven correct.
Speaker 1: It would mainly come later in the twentieth century that
Speaker 1: a lot of these medications would break through. Of course,
Speaker 1: we already mentioned insulin, but you know there would be
Speaker 1: tons of them. But what about this other guy, Charles
Speaker 1: gave Real Provase. Well. Provaz was the French surgeon who's
Speaker 1: also given credit for inventing the hypodermic syringe, and he
Speaker 1: lived to eighteen fifty three. And it appears that without
Speaker 1: any contact, both Provase and would invented versions of the
Speaker 1: hypodermic syringe, something that used a small, fine bore needle
Speaker 1: that could be attached to a syringe with a piston
Speaker 1: or a plunger. Uh And and in truth, the the
Speaker 1: addition of the piston and the plunger to the needle
Speaker 1: had all kinds of benefits. It meant that injections could
Speaker 1: be introduced much more quickly and easily. It also allowed
Speaker 1: intravenous injections, meaning drugs could be inserted directly into the
Speaker 1: blood inside of vein. It also made it easier to
Speaker 1: draw blood, which has all kinds of other uses in medicine. Um.
Speaker 1: But we should stress again that the very beginning of
Speaker 1: this invention, the germ theory of disease was not quite
Speaker 1: yet fully understood or widely accepted, so there was still
Speaker 1: a risk of infection from unsterilized injections. And there's another
Speaker 1: dark twist of the story which does sort of usage
Speaker 1: later associations with hypodermic needles, which is that after experimenting
Speaker 1: with treatments for pain, apparently both Alexander Wood and his
Speaker 1: wife became addicted to injectable morphine. Yeah, and we'll we'll
Speaker 1: definitely return to that theme later on, because I mean,
Speaker 1: part of part of the appeal of of of the
Speaker 1: hypodermic needle is that you can you can get a
Speaker 1: very fast, fast reward on your drug absorption, and uh,
Speaker 1: then you know that becomes a part of the story
Speaker 1: of not only opium, but of course heroin. Yeah. But
Speaker 1: then of course is also, like we say, of of
Speaker 1: great even life saving use in a medical context. If
Speaker 1: you need the medication to take take action now, or
Speaker 1: you needed to take action in a very specific part
Speaker 1: of the human anatomy, then a needle is the best
Speaker 1: way in. I think we should take another quick break
Speaker 1: and when we come back, we can talk more about
Speaker 1: the legacy of the hypodermic syringe. Alright, we're back. So
Speaker 1: I was reading an article that quoted a doctor, Declan
Speaker 1: O'Keefe of the Faculty of Pain Medicine at the Irish
Speaker 1: College of Anesthetists. And this was in the l and
Speaker 1: according to to O'Keefe, there were an estimated twelve to
Speaker 1: thirteen billion subcutaneous injections administered globally every year. That is
Speaker 1: hard to imagine twelve to thirteen billion injections. Now we
Speaker 1: don't know what all of those are, but I mean
Speaker 1: that's billions of doses of medicine, probably a lot of
Speaker 1: that life saving medicine. So in some ways, it's it's
Speaker 1: hard to overstate how important the hypodermic syringe has been
Speaker 1: as a life saving and and quality of life improving
Speaker 1: medical innovation. Yeah, because because again I think back to
Speaker 1: the various ways of getting drugs and vaccines specifically into
Speaker 1: the body. Certain substances just won't work as well if
Speaker 1: they're taken orally, and if you want a fast onset,
Speaker 1: then you want injection. And we mentioned you know, some
Speaker 1: of these substances early. But another great example example is
Speaker 1: if you have an EpiPen, you know, if you're having
Speaker 1: allergic reaction and you need a fast acting uh, you know,
Speaker 1: use of your medication UH. The EpiPen is UH is
Speaker 1: a way to inject it um. And the exact side
Speaker 1: of injection is also key, not only for reasons of
Speaker 1: you know, like dental surgery, you know, when you want
Speaker 1: to target the mouth, but UH, for instance, most vaccines
Speaker 1: have to be injected into the muscle tissue, and the
Speaker 1: aim here is to optimize the immunogenacity of the vaccine
Speaker 1: and to minimize adverse reactions. So and these are just
Speaker 1: two quick examples, you know, that should give you a
Speaker 1: huge idea of how crucial the hypodermic needle is to
Speaker 1: modern medicine. Vaccines alone prevent millions of hospitalizations and hundreds
Speaker 1: of thousands of deaths, and our ability to swiftly administer
Speaker 1: a variety of drugs and to target specific areas of
Speaker 1: the body are of tremendous importance. Where already talking about morphine,
Speaker 1: Another example that came up in research was the morphine
Speaker 1: syrette that was I in during World War two. And
Speaker 1: it was essentially a kind of like if you imagine
Speaker 1: a tiny superglue to like that, you know, the disposable
Speaker 1: little tubes of superglue. It was essentially that, but it
Speaker 1: contained a shot of morphine. And like a bubble and
Speaker 1: then had a little needle on the end. And it
Speaker 1: was a predecessor to auto injectors like the EpiPen. You
Speaker 1: could you know, just have this in the kit and
Speaker 1: then individual needed morphine help treating an injury. That's what
Speaker 1: what you do. You just stick it in, squeeze it,
Speaker 1: and and the morphine is in the body. So it
Speaker 1: sounds to me like part of the benefit there is
Speaker 1: that it could be administered in a situation that was
Speaker 1: not necessarily like maybe if you're not good at giving injections,
Speaker 1: or you don't know what you're doing, or you there's
Speaker 1: like you know, the chaotic environment. It's just a kind
Speaker 1: of stab and go yeah, like like a field medic
Speaker 1: situation exactly. UM and and some of the early advancements
Speaker 1: in UM autoinject or technology were for use in like
Speaker 1: like military scenarios or bioweapons scenarios, et cetera. Now we've
Speaker 1: discussed some of the dark corners of of injection so far,
Speaker 1: but you know, certainly there's there's another huge area that
Speaker 1: we should probably touch on. As with other technological achievements,
Speaker 1: with the ability to greatly improve the human condition, we
Speaker 1: also inevitably turn them into instruments of execution and murder. Uh. So,
Speaker 1: lethal injection remains in use across the United States and
Speaker 1: various other countries as well, and as a primary means
Speaker 1: of state sanctioned murder. It was first proposed by New
Speaker 1: York surgeon Julius mount Blyer in eighty eight as a
Speaker 1: more humane um option uh than hanging. And there's a
Speaker 1: you know, a lot we can discuss on this topic.
Speaker 1: We touched on some of this in our episode and
Speaker 1: the guillotine. You know, much of it comes down to
Speaker 1: the the ethics of capital punishment, but there's also quite
Speaker 1: a bit of strong disagreement on just how humane lethal
Speaker 1: injection really is, not so much because of the needles,
Speaker 1: but because of the drugs used, the differences among recipients, biochemistry,
Speaker 1: and the general lacking of medical medical expertise in the
Speaker 1: administration of these injections. Because, of course, to kill someone
Speaker 1: with an injection for the state is you know, it's
Speaker 1: a violation of the Hipocratic oath, and the American Medical Association,
Speaker 1: for instance, argues that doctors should not participate in lethal injections.
Speaker 1: So you often have people other than medical personnel that
Speaker 1: are injecting these lethal substances. Yeah, and also I would
Speaker 1: think about like the sort of oxymoron implied in the
Speaker 1: idea of researching safe ways to administer lethal injections. And
Speaker 1: then another potential dark side all of this, of course,
Speaker 1: is the use of hypodermic needles in illicit drug use.
Speaker 1: We already touched on morphine and UM and mentioned heroin. UM.
Speaker 1: Heroin is a great example here. Heroin can be taken
Speaker 1: by the mouth, it can be smoked, it can be
Speaker 1: snorted or taken via rectal suppository, but it's most popular
Speaker 1: as an injection for the same reasons that injections are
Speaker 1: handy for medical purposes. And while vein damage is certainly
Speaker 1: an issue, another huge issue is the spread of disease
Speaker 1: via needle sharing, and for this reason, you know, in
Speaker 1: many countries you'll find programs to supply users with clean
Speaker 1: needles and sometimes sterile spoons and filters as well, in
Speaker 1: order to prevent the spread of HIV and other illnesses. Yeah. Um,
Speaker 1: and you could look at that actually, and the idea
Speaker 1: of disposable needles as uh. You know, it might be
Speaker 1: hard for some people to see it this way, but
Speaker 1: that is another life saving technology. If it's preventing the
Speaker 1: spread of disease that would be spread through the unclean
Speaker 1: use of needles. I mean. One of the things that
Speaker 1: it's kind of hard to believe also is that when
Speaker 1: hypodermic needles first came online, when they were first being
Speaker 1: used in the nineteenth century, they were reused. You know,
Speaker 1: they didn't have disposable needles back then, like like we
Speaker 1: have now disposable needles. I think we're they came around
Speaker 1: the mid twentie century. Now there was a long period
Speaker 1: between you know where we were reusing needles, but we
Speaker 1: knew something about germ theory and what was generally happening there.
Speaker 1: Happening there is that they would get autoclaved, you know,
Speaker 1: they get sterilized in between uses. Um. But yeah, that
Speaker 1: clearly the disposable needle is been a really important uh
Speaker 1: development for for sterilization and the preventive spreading of diseases.
Speaker 1: And I would say that needle exchange programs and stuff
Speaker 1: probably fit into the same category, right. Yeah. And then
Speaker 1: part of the argument there too is like if you're
Speaker 1: going to if you're gonna tackle something like like an
Speaker 1: epidemic of heroin abuse, um, like you should be able
Speaker 1: to tackle the thing itself and not all the you know,
Speaker 1: the residual complications of of infectious disease, etcetera. Now I wonder, though,
Speaker 1: you know, how much of that too, you're dealing with
Speaker 1: just the overall stigma stigmatization of needles in general, you know,
Speaker 1: because we've already touched out. We don't want to think
Speaker 1: about needles when we're getting them stuck in our body
Speaker 1: for for you know, completely legal and reasonable purposes. Uh.
Speaker 1: And so maybe we're even less inclined to to look
Speaker 1: favorably upon somebody who's dealing with heroin addiction, uh, you know,
Speaker 1: using needles. Well, I have a I have a suspicion
Speaker 1: that I do not have evidence to back up. So,
Speaker 1: you know, it could be completely wrong about this, But
Speaker 1: I sometimes wonder if a some not insignificant part of
Speaker 1: vaccine opposition has to do with just psychological aversion to needles.
Speaker 1: I know that sounds way oversimplified, but I it kind
Speaker 1: of fits together in my head. I think about the way, um,
Speaker 1: you know I have to go to the vet and
Speaker 1: even just see like a pet get a shot. It
Speaker 1: can be painful, you know, it feels like, oh, that's
Speaker 1: that's not good. And of course I know that this
Speaker 1: this is so important for pets to get their shots,
Speaker 1: and of course even more important for humans to get
Speaker 1: their shots. And it's rough taking a human child to
Speaker 1: get get vaccine shots. Yeah, you know, it's it's it's
Speaker 1: part of it. And so I sometimes wonder if there
Speaker 1: there's like a there's a bleed over and the kind
Speaker 1: of like the visceral emotional psychological reaction you have to
Speaker 1: to seeing a child, uh, feeling unhappiness at getting stuck
Speaker 1: with the needle, even though it's for a life saving vaccine,
Speaker 1: and that could possibly lead you to want to develop
Speaker 1: rational justifications for for saying, well, maybe we shouldn't be
Speaker 1: doing this right, and of course you know we we have.
Speaker 1: It's interesting too when you look to our our fiction
Speaker 1: or horror fiction and you see like all these exaggerations
Speaker 1: of needle anxiety as well. Like I never I don't
Speaker 1: think I ever even watched any of these Nightmine Own
Speaker 1: Street movies, but there's the one where he has hypodermic
Speaker 1: needles for fingers and well, yeah, I mean, so he's
Speaker 1: got knives for fingers normal normally, but and it's funny
Speaker 1: that they like they're like, let's make it even worse
Speaker 1: than nice, Let's make it needles yea. And of course
Speaker 1: there are various other films that play with with needle
Speaker 1: anxiety as well, but uh, you know, you can look
Speaker 1: at those as horror amping us up and making us
Speaker 1: more afraid of the things that we shouldn't be afraid of,
Speaker 1: or just simply being as a sort of a cultural
Speaker 1: expression of how we feel about things, how we feel
Speaker 1: about technologies, and uh, well, the way we feel technologies
Speaker 1: has really has really serious impacts, especially if they're medical
Speaker 1: technologies or their prophylactics of some sort or you know,
Speaker 1: we talked in the episode we did about condoms about
Speaker 1: how you might think, like a project to develop condoms
Speaker 1: that people like using more, you know that they like
Speaker 1: the feel of more something sounds frivolous. But no, if,
Speaker 1: like if it actually affects adoption rates of a technology
Speaker 1: that stops the spread of disease and saves lives, that
Speaker 1: is a really useful thing to research. And I would
Speaker 1: say the same thing could be true of needles. I mean,
Speaker 1: on one hand, I just want to say, like, you know,
Speaker 1: just get your flu shots, get your vaccines, you know,
Speaker 1: get over it. It's not like super exciting to get
Speaker 1: stuck with the needle. But uh, but like it's just
Speaker 1: something we should deal with. But no, I can totally
Speaker 1: see how if you could develop new ways of you know,
Speaker 1: new alternatives for hypodermic needles, or new ways of changing
Speaker 1: the way in injections happen so that people have less
Speaker 1: of an innate psychological version to it, that might increase
Speaker 1: the rates at which people, you know, get the vaccines
Speaker 1: they should be getting, at which people get the flu
Speaker 1: vaccine every year, and stop the spread of flu which
Speaker 1: does actually kill people. Uh, get you know, get the
Speaker 1: other shots they need. Yeah. So, as we've mentioned already,
Speaker 1: scientists are always looking at ways to improve upon the design,
Speaker 1: and there are also efforts to replace the hypodermic needle,
Speaker 1: at least in some context. It seems like there there
Speaker 1: are certain cases where they just there's no getting around
Speaker 1: the effectiveness of a hypodermic needle. But other cases there
Speaker 1: might you know, there's room for some of these other technologies. Um. Also,
Speaker 1: such technology would cut down you know, it would cut
Speaker 1: down a needle anxiety. Anxiety like we're talking about. It
Speaker 1: would cut down on potentially on a needle biomedical waste.
Speaker 1: But also it could cut down on accidental pricks of
Speaker 1: the you know, on the needle. UH. The Centers for
Speaker 1: Disease Control and Prevention have estimated that hospital based healthcare
Speaker 1: workers accidentally pricked themselves with needles three and eighty five
Speaker 1: thousand times per year. Wow, which is a lot um
Speaker 1: So one alternative. We've touched about the on this already.
Speaker 1: But like, you could have a patch, but a patch
Speaker 1: is only going to work if the drug molecules are
Speaker 1: small enough to pass through the skin pores and it
Speaker 1: works very slowly. UH. Jet injectors are another possibility, and
Speaker 1: the several versions are already on the market today. The
Speaker 1: basic idea has been around for a long time, with
Speaker 1: the first demonstration taking place in eighteen sixty six. I
Speaker 1: don't think I know what that is. This is just
Speaker 1: where you like, jet propelled the substance, like directly through
Speaker 1: the skin. Another take on this, studied by M. I.
Speaker 1: T is the Lorentz Force actuator, which is a small,
Speaker 1: powerful magnet surrounded by a coil of wire that's attached
Speaker 1: to a piston inside a drug ampuel and it essentially
Speaker 1: does the same thing as a jet injector, but with
Speaker 1: magnets just forcing this, uh, this blasting the doose of
Speaker 1: drugs directly through the skin. Still, you know, these are
Speaker 1: these are all fine for injections, but not so much withdraws.
Speaker 1: When it comes to drawing blood out of the body.
Speaker 1: They're various other innovations such as I was reading a
Speaker 1: little bit about micro sampler technology that's aimed at drawing
Speaker 1: less blood but making more use of it. But I
Speaker 1: think this still essentially makes use of a hypodermic syringe
Speaker 1: in the same way that an EpiPen, you know, still
Speaker 1: has a hypodermic needle inside of it. Now, there certainly
Speaker 1: are technologies that explore blood withdrawal without needles how at all.
Speaker 1: Though researchers that start up TASSO are working on a
Speaker 1: quote delicate vacuum to suction blood from your microscopic vessels
Speaker 1: called capillaries into an attached container. Uh. This according to
Speaker 1: Jordan Vilinsky, writing for Popular Mechanics. So again, I don't
Speaker 1: think you know these these technologies replace hypodermic needles in
Speaker 1: all situations. But you could see a situation where we're
Speaker 1: looking at medicine, you know, decades from now and the
Speaker 1: hypodermic needle will still be incredibly important, but maybe there
Speaker 1: will be other areas of blood withdrawal or more injection
Speaker 1: that can be left to these less prickly technologies. Yeah. Well,
Speaker 1: I'm all for these technologies, especially if you can show
Speaker 1: that they would probably increase the rates at which people
Speaker 1: get the care they need to get the medications they need.
Speaker 1: If if they might be averse to it otherwise just
Speaker 1: because they don't like needles, but I would say I
Speaker 1: hope a takeaway from today's episode is be thankful for needles,
Speaker 1: even if you don't aesthetically like them, even if it's
Speaker 1: not pleasant. Every time you get a shot, you should
Speaker 1: like stop to think like this is amazing, This is
Speaker 1: actually great, this, this is a wonder Yeah. I almost
Speaker 1: wonder if there's a kind of like campaign we could
Speaker 1: start this, like I don't know what you call it,
Speaker 1: like like needle pride. You know, it's just like whenever
Speaker 1: you get a shot that you need, when or whenever
Speaker 1: you get blood drawn for some important medical reason, you
Speaker 1: can like I don't know, we're we're like a like
Speaker 1: your your pilot wings badge or something. Right, well, you know,
Speaker 1: I think part of it is that we tend to
Speaker 1: fear things we don't completely understand. And you know, I'm
Speaker 1: not saying we don't understand the basics of hypodermic needle,
Speaker 1: because I mean, it's a pretty it's pretty self explanatory.
Speaker 1: But in not wanting to think about it, you know,
Speaker 1: and not wanting to dwell on it, we perhaps give
Speaker 1: it too much, almost like supernatural power, you know. We
Speaker 1: we we we feed into the fear too much by
Speaker 1: not confronting it. So you know, maybe part of it
Speaker 1: is like we should try and look at the needle
Speaker 1: more like I should look at the needle more when
Speaker 1: I'm being given a shot or they're hooking me up
Speaker 1: for a withdrawal for you know, for a blood donation,
Speaker 1: that that ultimately this will help me face my fear,
Speaker 1: you know, and feel better about it. This is a
Speaker 1: crucial part of modern medical science. Be thankful for the needle,
Speaker 1: respect to the needle, get used to it. You're gonna
Speaker 1: get more of You're not done, but we are done
Speaker 1: with this episode of invention. Now. Obviously everyone out there
Speaker 1: has probably had shots, You've you've taken medicine in various forms,
Speaker 1: So we'd love to hear your feedback on this episode
Speaker 1: on the technology itself and how we feel about it.
Speaker 1: If you want to check out more episodes of Invention,
Speaker 1: you can find us at inventin pot dot com. And
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Speaker 1: wherever you have the power to do so, leave a
Speaker 1: nice comment, leave some nice stars, and make sure that
Speaker 1: you have subscribed. Huge thanks as always to our excellent
Speaker 1: audio producer Seth Nicholas Johnson. If you would like to
Speaker 1: get in touch with us with feedback on this episode
Speaker 1: or any other it's agest topic for the future, just
Speaker 1: to say hey, how you doing, you can email us
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