INJECTIONS: First Do No Harm (History of Injections)

Injections are one of the most common, effective, reliable and low cost medical/ health care procedures accepted all around the world. Indeed, there are few medical tools so common and yet so indispensable, as the plastic disposable syringe and needle. However, it took thousands of years for injections to get to where it is today. This review article would trace the evolution of syringe from ancient times to the present and would also highlight about the possible risk of infections related to unsafe disposal of used syringes and needles and injection safety.The word “syringe” is derived from the Greek word syrinx, meaning “tube”. The structure and design of syringe is quite simple and yet effective as a medical tool. A syringe is like a simple pump with a tight plunger that fits into a cylindrical tube. The plunger can be pulled and pushed allowing the syringe to pull in or push out a liquid or gas through the open end of the tube that may be attached with a hypodermic needle.The first syringes were used in Roman times (1st Century AD) and are mentioned in a journal called De Medicina as being used to treat medical complications. Simple piston syringes were used to deliver ointments and creams were described by Galen (129-200 CE). An Egyptian, Ammar bin Ali al-Mawsilli was reported using glass tubes for suction for cataract extraction from about 900 CE. In 1650 Blaise Pascal’s experimental work in hydraulics led him to invent the first modern syringe which allowed the infusion of medicines. By 1660 Esholttz and Drs Major used injections on humans with fatal results due to ignorance of suitable dosage and the need for sterilization and infusion. Hence the disastrous consequences of these experiments delayed the use of injections for around 200 years. An Irish physician named Francis Rynd invented the hollow needle and used it to make the first recorded subcutaneous injections in 1844. In 1853 Charles Pravaz and Alexander Wood developed a medical hypodermic syringe with a needle fine enough to pierce a skin. Alexander Wood injected morphine into humans to treat nerve conditions and his wife subsequently became addicted to morphine and is recorded as the first woman to die of an injected drug overdose.In 1899 Letitia Mumford Geer of New York was granted a patent for a syringe design that permitted the user to operate it one-handed.In 1946 Chance Brothers in England made the first all-glass syringe with an interchangeable barrel and plunge and this was revolutionary as mass-sterilization of different components became possible without needing to match up the individual parts. Then shortly thereafter Australian inventor Charles Rotha user created the world’s first plastic, disposable hypodermic syringe made from polyethylene in 1949. Two years later he produced the first injection-molded syringes made of polypropylene, a plastic that can be heat-sterilized. Then in 1956 a New Zealand pharmacist and inventor Colin Murdoch got patents for disposable plastic syringe followed by Becton Dickinson in 1961 and an African American inventor Phil received a US patent for a “Disposable Syringe”.The basic design has remained unchanged though interchangeable parts and the use of plastic resulted in universal use of disposable syringes and needles since the mid-1950s. The syringe has become an indispensable instrument for many aspects of interventional medicine and everyday practice.