Basic HTML Version
T
TS
How fardare we go?
W
HILE
the anesthesia
team battled to
keep the patient's
lungs working and his blood
pressure steady, the surgeon
skillfully guided his scalpel.
The patient's punctuated
vital signs hovered between
life and death.
Would his body turn against
the newly transplanted organ?
Medica! advancements-com–
bined with powerful drugs- mean
a human being no longer needs to
die when one of his vital organs
dies.
Today organ transplantation and
artificial "spare parts" have be–
come daily news events. The
human heart, long held as the sym–
bol of life, might now be polyure–
thane or consist of parts from
another species, such as pigs or
monkeys.
These developments in medica!
science highlight new ethical and
economic issues: Who will receive
the new technology? Who will live,
who will die and who will
pay?
The Path of Early Medicine
Replacing diseased or damaged
organs (prosthetics) has long been
10
by
Jeff E. Zhorne
a goal of physicians. The ancient
Greeks and Romans, to repair
faulty waste elimination in ill
humans, used catheters, small tubes
inserted into the urinary tract.
Archaeological specimens of cathe–
ters have been unearthed in Ephe–
sus, Asia Minor and Pompeii.
While the later books of the
Bible were being written, Hindu
surgeons as early as the eighth cen–
tury
B.C.
were performing skin
transplants to replace noses lost
because of syphilis, physical com–
bat or punishment for crimes.
Grafted skin, transplanted from
convenient areas of the body, was
left to regenerate, covered with a
poultice of sappanwood, barberry
and licorice root.
Patients, without the benefits of
modern-day anesthesia, obtained
relief from pain by the application
of pressure on nerves, by freezing
the part to be operated on, inhaling
the fumes of narcotics, or by alco–
holic stupefaction.
Scientífic progress in the West
declined after the Roman Empire
collapsed in
A.D.
476. Smatterings
of preserved truth, mixed with
superstition, were passed from gen–
eration to generation.
Then carne the Renaissance and
medica! research resurged. New
"discoveries" were generally reviv–
als of centuries-old concepts. Draw–
ing from the work of the Hindu
physicians, the Italian surgeon Gas–
pare·Tagliacozzo acquainted West–
ern medicine with nose grafting in
the 16th century.
Once started, scientific advances
were furthered by renowned medica]
schools such as the University of Sa–
lerno in Italy- move–
ments that would even–
tually carry medicine
into the 20th century.
These advances
took place under a
cloud of public cen–
sure. The chief sur–
geon of the U.S .
National Heart Institute
in 1863 hung a plaque on
his wall that read, "Let
no man who hopes to
retain the respect of his
medica! brethren dare to
operate on the human
heart."
At the start of the 1900s
a French surgeon, experi–
menting on cadavers and
animals, learned bow to sew
severed blood vessels end to
end so they would carry blood
as efficiently as they had before
an operation. For this discovery,