Medical Marvels Trivia Quiz

Answer: Drinker & Shaw (1928)

One of the insidious effects of the poliomyelitis virus ('polio') can be the paralysis of the diaphragm, the musculature required for breathing. Although there were earlier versions of instrumentation to assist with breathing, the cylindrical tube device, invented by two Harvard University professors of industrial hygiene, Philip Drinker and Louis Agassiz Shaw Jr, in 1928 became the most common means of treating this aspect of polio during large outbreaks of this contagious disease in the 1940s and 1950s.

Commonly known as the 'Iron Lung', the patient's head protruded from one end of the tube, hence was in the open air, while the air pressure inside the tube was varied to manually force the chest cavity to expand and contract. This manipulation allowed air to be drawn in and then exhaled from the lungs. The design was improved soon after its introduction by Jack Emerson. Drinker sued for patent contravention and lost. Emerson made further improvements over the ensuing years. Mobile versions of the updated iron lung have been used to assist those with severe breathing difficulties during the COVID pandemic.

Answer: Jarvik, DeVries & Kolff (1982)

From the 1940s onward, several devices were created to assist the heart in its operation. These included heart-lung machines that would undertake the functions of those organs during cardiac surgery and a variety of 'pace makers' to assist the heart in maintaining a correct sequence of electrical impulses. South African surgeon, Christiaan Barnard completed the first successful heart transplantation operation in 1967. Fifteen years later, a completely artificial heart, the Jarvik-7, designed by a team including Robert Jarvik, William DeVries and Willem Johann Kolff was given to a Seattle man who was suffering congenital heart failure.

The man survived 112 days. Much earlier (1957), Kolff had successfully implanted an artificial heart into a dog, thereby starting a series of developments that led to the use of the Jarvik-7 in 1982.

Answer: Jenner (1796)

In May 1980, a declaration was made that smallpox had been eradicated. Smallpox was a common and vile disease, caused by exposure to the Variola virus, that killed up to 30% of those affected and leaving many of the survivors horribly scarred for life. English doctor Edward Jenner (1749-1823) noticed that milking maids who had been exposed to the related and much milder cowpox virus seemed to be immune to smallpox.

This led him to take material from a cowpox blister on a milkmaid's arm and then inoculate this into the arm of the 9 year old son of his gardener. Several months later the boy was exposed to the actual smallpox virus but never developed the disease. Jenner published his findings "On the Origin of the Vaccine Inoculation" in 1801; the world's first successful vaccination process. From that point, vaccination quickly gained in acceptance and efficacy.

Answer: Hippocrates of Kos (5th-4th century BC)

Prior to Hippocrates, it was believed that all disease and illness was caused by supernatural factors e.g. the displeasure of a god. Hippocrates and his team believed that disease and subsequent treatments could be made based on rational observations and natural causes. This was a profound change in thinking and stemmed from the Pythagorean school which divided nature into four elements - earth, fire, wind and water.

In an analogous fashion, Hippocrates believed that the body was composed of four 'humors' (fluids) - blood, phlegm, black bile and yellow bile. Disease treatment involved restoring the natural balance of these humors. The ethics and clinical basis for medical treatment today are directly traceable back to Hippocrates. Even in the 21st century, many doctors still take an updated version of the 'Hippocratic Oath' when entering the profession. A key tenet is the concept of 'first, do no harm'.

Answer: Steptoe, Edwards & Purdy (1978)

'In vitro fertilization' is a medical procedure where the egg and sperm are brought together outside the woman's body. This was often performed in a test-tube, followed by the implantation of the fertilized egg back into the uterus of the mother (or sometimes a surrogate) leading to the common term of 'test tube baby'. IVF and related techniques have opened up the possibility of having children to many who were suffering a range of infertility problems. Key steps in the development of IVF began in the middle of the 20th century and included demonstrating that animal eggs fertilized in vitro could be successful implanted back into the animal resulting in a live birth. The first successful in vitro fertilization of a human egg was reported by Carl Wood, John Leeton and Alan Trounson at Monash University (Melbourne, Australia) in 1973. British scientists Patrick Steptoe and Robert Edwards commenced their collaboration on IVF in 1968 and, with the assistance of nurse Jean Purdey, the world's first baby to be conceived using IVF, Louise Brown, was born in Manchester in July 1978. Further successes quickly followed along with the ability to freeze both eggs and sperm for later use.

In 2010, Edwards was awarded the Nobel Prize in Physiology or Medicine "for the development of in vitro fertilization". Steptoe and Purdy unfortunately did not receive this recognition because the Nobel Prize is not awarded posthumously.

Answer: Fleming (1928)

Sometimes great discoveries originate from a lucky event. In 1928, Alexander Fleming, a Professor of Bacteriology at St Mary's Hospital in London went on vacation without cleaning up the cultures of Staphylococcus he was studying. Upon his return he noticed that in one petri dish there was a blob of mold growing and there were no colonies of the Staphylococcus bacteria in that immediate region. His brilliance was in realizing the importance of this singular finding. This mold was a rare strain of Penicillium notatum (now known as P. chrysogenum).

Experimentation showed that this "mold juice" killed a variety of gram positive bacteria, but it was difficult to purify. He published his findings in 1929 and this prompted a team led by Howard Florey and Ernst Chain at Oxford University's School of Pathology to turn this fortuitous discovery into the life saving antibiotic in 1939, just in time to treat large numbers of wounded from World War 2. Infections that would have previously been fatal now were easily treated.

The field of antibiotics has been rapidly developing since that time with many new classes of drugs being discovered. Fleming, Florey and Chain shared the 1945 Nobel Prize in Physiology or Medicine for "for the discovery of penicillin and its curative effect in various infectious diseases".

Answer: Morton (1846) (or Wells or Jackson?)

There is no doubt that the first public demonstration of anaesthesia was at the Massachusetts General Hospital in October 1846 when a surgeon removed a tumor from the neck of a patient. The anaesthetic used was "ether" (diethyl ether) which dentist William Morton demonstrated relieved pain during the operation. Morton is usually therefore credited with discovering anaesthesia. However, the story is not so simple and involved many years of ill-feeling, court action and patent claims, mostly by Morton. The chemist and geologist Charles Jackson was Morton's instructor and claimed it was he who advised Morton to use ether for this purpose and hence should be credited with its discovery. Furthermore, another dentist, Horace Wells from Hartford provided well-substantiated evidence that he'd successfully used nitrous oxide ('laughing gas') as an anaesthetic two years before Morton's use of ether.

Nonetheless, from this time onward, operations were much easier and safer due to the development of anaesthetic procedures.

This I.I. was informed by a 2002 article in the Journal of the Royal Society of Medicine (volume 95(5), pages 266-267).

Answer: Roentgen (1895)

German Physics Professor Wilhelm Roentgen was awarded the first Nobel Prize in Physics in 1901 for his discovery of the rays that were subsequently named in his honor. In English these are referred to as 'X-rays' but in many other languages they are still referred to as Roentgen Rays.

The 'X' came from Roentgen as he recognized it as a new type of unknown radiation. X-rays had undoubtedly been created as early as the late 18th century when electron beams ('cathode rays') were passed through partly evacuated glass tubes by scientists including Humphrey Davey and Michael Faraday. Roentgen was able to investigate this high energy radiation by examining the green glow on a screen around 1 m from the glass tube.

The screen was covered in a fluorescent material - the glow came from the interaction of the X-ray beam and the fluorophore, barium platinocyanide.

The beam passed through many common objects placed in its path including books. In December 1895 he showed a photographic plate containing the image of his wife's hand.

This was the first photograph of an X-ray of a human and Roentgen showed this to the Institute of Physics at the University of Freiburg on New Year's Day in 1896. The use of the technique for body imaging became extremely popular within months. Many laboratories were investigating cathode rays at that time so the equipment was already available. Since that time there has been a continual evolution in medical imaging using X-rays, including a recognition of the physiological dangers of large exposures. X-rays have become a commonplace element in diagnostic medicine throughout much of the world. Imaging techniques using other radiation sources (including positron emission) have also become more frequently used.

Answer: Harvey (1628)

Prior to William Harvey, it was believed that blood was created from food by the liver. This idea, developed by 2nd century CE Greek philosopher and scholar Claudius Galenus of Pergamon (commonly known as Galen), in turn was based on the four humors of Hippocrates and was not challenged for nearly 1500 years! Galen's ideas on the circulatory system also remained unchanged for over 1000 years until the Arab scholar Ibn al-Nafis refined the ideas of Persian polymath Ibn Sina (also known as Avicenna) and described pulmonary circulation - the movement of blood from the heart to the lungs and back again. English physician William Harvey (1578-1657) was the first to describe the full circulation of the blood through the body.

His findings were based on observation and experimentation and developed from noticing the small valves in the heart that prevented two-way blood movement. One of his major areas of research estimated the amount of blood pumped by the heart per minute.

His value of 0.5-1 liter per minute is smaller (by a factor of 4 or more) than current estimates but demonstrated that the body could not produce this volume of blood every minute hence the blood must therefore circulate. Harvey was extremely well regarded and served as King's physician to both James I and Charles I of England.

He published his major work on the heart and circulatory system first in Latin in 1628 and then, much later, in English. It was a seminal work and provided not only the basis for much physiological research but the philosophy of learning through experimentation.

Answer: van Leeuwenhoek (1676)

Dutch-born Antonie van Leeuwenhoek (1632-1723) was a self-taught scientist and business man. As a draper he needed to better see the fine threads of his cloth and therefore he developed a means of making high quality soda glass lenses. He placed a single lens in a metal mount to create a 'microscope'.

A magnification of 275 times has been determined from some of his surviving lenses and it is hypothesized that even higher magnifications were created. He was highly secretive and would not share the method for lens creation, much to the frustration of another microscopy pioneer Robert Hooke (the discoverer of the cell), amongst many others.

Despite that, he was a prolific correspondent with many scientific institutions including the Royal Society. Arguably his most important discovery came from the use of his microscopes to observe rain water droplets.

He was astounded to find very small organisms in the water. These were firstly 'infusoria' - largely a mix of single-cell algae and protists.

Then, using his most powerful lenses he discovered much smaller organisms in the shapes of spirals and 'sticks' - bacteria, which he named 'animalcules' or tiny animals. He wrote about these observations in letters to the Royal Society. Due to the inability of anyone else to produce lenses (or microscopes) of sufficient magnification, no-one else would observe bacteria again for over a century. It wasn't until the pioneering work of Louis Pasteur and Joseph Lister in the mid-19th century that links between bacteria and disease were established.