Progress in retrospect: Journal compares medical issues heading into 1911 and 2011
By Grant Banks
January 6, 2011
Respected medical journal Lancet has taken a retrospective look at the past century and found that despite incredible advances in the field of medicine, some common issues persist. Problems identified in 1911 that strike a familiar chord today include the quest to understand and eventually cure cancer, an economic depression and it's negative effect on healthcare delivery and the plight of African nations. Challenges faced in first world countries included the impacts of illicit drug addiction, occupational health and workers' compensation issues, the need for better education of doctors, and the continued prevalence of curable and preventable diseases.
The journal's first Editorial of 1911 entitled "The Promise of 1911" by then editor Squire Sprigge marveled at advances in surgery that would have appeared miraculous only decades before. He described “the demon of tuberculosis” and his hopes that "better understanding would one day result in mastery of the disease". Today however, tuberculosis still continues to effect populations of developing countries worldwide. High-income nations such as the UK have also experienced a steep increase in cases of TB over the past decade regardless of advances in vaccination for the disease over the past century. An emphasis on syphilis is also poignant as the 21st century has seen cases on the rise again in high-risk groups in first world nations.
The quest to understand cancer is highlighted in the 1911 piece as was the need for the modernizing of medical education. A recent Lancet Commission into the subject of education found many first world countries lack adequate educational facilitates. A review by Sprigge of an 800-page textbook of paediatric surgery suggests a level of competency in 1911 that makes all the more shocking a recent announcement by the Royal College of Surgeons (UK) highlighting a lack of facilities and staff for emergency surgery on children in England's hospitals.
Social issues such as occupational health and workers' compensation, an economic downturn's impact on health spending, and cocaine addiction were all relevant in 1911 as they are still today. South Africa's battle with diseases such as tuberculosis, diarrhoea, and respiratory infections also remain.
Several points raised gain significance with hindsight including the mention of a handbook for medical officers in the field that would become extremely relevant with the onset of World War I three years later, and news from Vienna about the superior health of the city's 180,000 Jewish people, who a generation later would face genocide at the hands of the Nazis.
A British hospital's plans to acquire an X-ray machine while being blissfully unaware that without safeguards patients and medical staff would have a higher risk of developing cancer also put unchecked medical advances in perspective.
It appears that for all the amazing medical advances made in the past 100 years there are still areas where modern society fall short – particularly when considering the overwhelming gap between the first and third world countries.
"Between 1911 and 2011 there is much for medicine to be proud of – and also be humble about. New years bring new promise and new opportunities, but some old demons remain," the 2011 Lancet Editorial concluded.