Medical Science Still Faces Old Century's Challenges
After a century of progress, the issues that medicine must tackle in the coming year aren't that different from the ones that faced doctors at the start of 1911, according to the observations of the medical journal The Lancet.
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The publication's lead editorial for Jan. 1 uses a century-old lens to explore the question, "How much really changes?" by looking back to an editorial called "The Promise of 1911." In the older editorial, The Lancet assessed progress to that point and the challenges ahead.
In his 1911 editorial, Samuel Squire Sprigge, editor of The Lancet from 1909 until 1937, lauded advancements against rabies, diphtheria (a bacterial respiratory infection) and the plague. Prior to the turn of the century, the bacterium that causes the plague had been identified during a pandemic that began in China. The disease, which was blamed for the medieval Black Death, had returned to Europe in 1911, "to be met by science armed with the knowledge of its mode of propagation and of the practical measures to prevent the extension of its ravages," according to the editorial.
The specter of tuberculosis (TB) still loomed, however. "It has seen the continued efforts of science bringing us nearer to that stage of knowledge at which mastery of the disease may be hoped for," Sprigge wrote.
A century later, that demon has not yet vanished. In 2009, an estimated 1.7 million people worldwide died from TB, most of them in Africa, and drug-resistant strains have emerged.
Plague, rabies and diphtheria also remain fatal diseases, most often in developing parts of the world, according to the World Health Organization.
One problem that could easily appear unchanged from the 1911 editorial was "the elucidation of the problem of cancer." Since then, science has shed light on some causes, including tobacco, viruses, exposure to ultraviolet radiation and certain chemicals, and has developed more-complex treatments. However, the disease itself remains an intractable problem. In 2006, American men were diagnosed with cancer at a rate of 539 per 100,000, and 221 per 100,000 died, according to the U.S. Centers for Disease Control and Prevention.
In addition to "The Promise of 1911," the century-old issue of The Lancet covered topics still relevant, its new editorial points out. These include critiques of medical education and a report of the crackdown on the trade in rotten eggs in New York.
"Food safety continues to threaten health, yet new food legislation in the USA seems uncertain because of cost," reads the new editorial, which is the collective product of the journal's senior editors.
Reports in 1911 of cocaine addiction in Montreal, and deaths caused by tuberculosis, measles, diarrhea and respiratory infection in South Africa, would similary feel familiar to readers today, as would discussions about medical tourism and journalism, the senior editors write.
"Between 1911 and 2011 there is much for medicine to be proud of – and also to be humble about. New years bring new promises and new opportunities, but some old demons," it reads.
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