2011 versus 1911: Many advances made, but old demons remain

December 30, 2010

The lead Editorial in this week's Lancet--the first of 2011--takes a look at the past 100 years in medicine, and examines the journal's first Editorial of 1911, entitled "The Promise of 1911". Many issues that were relevant a century ago remain so today.

The then Lancet editor Squire Sprigge talked of the demon of tuberculosis, and his hopes that "better understanding would one day result in mastery of the disease". Today, tuberculosis continues to blight populations of developing countries worldwide. And nor is it banished even from high-income nations such as the UK, which has seen a steep increase in cases over the past decade.

The social determinants of health, occupational health and workers' compensation all got a mention in the 1911 Editorial, as did the 'quackery' of homoeopathy, echoing modern day sentiments of some people on this issue. Emphasis on syphilis may appear dated, but the 21st century has seen cases on the rise again in high-risk groups in wealthy nations. Cocaine addiction in Canada is highlighted in the 1911 piece, and some leading causes of death in South Africa then--such as tuberculosis, diarrhoea, and respiratory infections--remain so 100 years later.

The importance of modernising medical education doctors was as much in the spotlight then (after a major 1910 report) as it is today, following a recent Lancet Commission into the subject last month. The behaviour of expert medical witnesses and the media was examined by Sprigge. Even medical tourism gets a mention in 1911, and this is extremely relevant in 2011 in light of the media frenzy surrounding the NDM-1 "superbug" and its association with medical tourism (published in Lancet Infectious Diseases this year).

The 2011 Editorial notes how some content in 1911 has been rendered poignant by history. A book review in that issue 100 years ago examined A handbook for medical officers in the field; three years later, World War I would begin. A UK hospital announced plans to acquire an X-ray machine--unaware that, years later, those X-rayed would have a higher risk of developing cancer, in an era before appropriate safeguards were in place. And from Vienna came news about superior health among the city's 180,000 Jewish people, whom a generation later would face lethal persecution.

The 1911 Editorial concludes: "We may in fact, in matters medical, congratulate ourselves upon a hopeful state of affairs and upon the prospect of a sustained forward movement in the year 1911."

The 2011 Editorial concludes: "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 Lancet Press Office. T) +44 (0) 20 7424 4949 E) tony.kirby@lancet.com

For 2011 Editorial see: http://press.thelancet.com/editorials0101.pdf

For 1911 Editorial see: http://press.thelancet.com/editorial1911.pdf


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