When you've been around the block a few times, you start to recognize familiar landmarks. When you are young, perspective is harder, but it's not disabling, either. I am meeting students at Purdue who were not born until after the Gulf War. "Saddam attacked Kuwait? No kidding? Who was Saddam and where is Kuwait?" There is a tendency in science to repackage ideas with new tools and new language, and these new students don't know we seniors have done this and often we don't enlighten them. Fashion is important, but so is history.
How many know that "metabolic profiling" was a very hot topic in the late 1960s and early 1970s? Capillary gas chromatography of lipid profiles was highly advanced and 12-24 hour long ion-exchange chromatograms of human urine stored in low temperature freezers was a topic getting a lot of publicity. Even Oak Ridge National Laboratory and Linus Pauling were into this game. The thought here was that if you are sick, some specific collection of compounds must show up in urine that will hint that you are, in fact, sick. "You are what you pee" is a corollary to "You are what you eat." While capillary gas chromatography proved a wonderful tool, especially coupled with mass spectrometry, to identify inborn errors of metabolism associated with enzyme deficiencies; the urine experiments were hardly compelling.
Today, we have new tools and once more, this same thought drives what we now call proteomics, peptidomics, metabolomics and the like. What we then called clinical chemistry, is now called biomarker research, a more comprehensive term that includes more than chemistry.
Temperature is a biomarker of inflammation. Cortisol is a biomarker of stress. Today we are down orders of magnitude in limits of quantitation, sample volume and speed. We have fabulous informatics tools as well. On the other hand, the thought is exactly the same and the disappointments are similar to 40 years ago.
It's very hard work and how well population statistics can help diagnose a disease in an individual is still very rarely clear. Graduate students have been convinced this is new stuff. No. It is a new name for old stuff approached with new tools.
Another example of old news becoming new is microbes developing resistance to antibiotics. Microbes have been at work on this since the 1930s. We are abuzz with talk on methicillin-resistant staphylococcus aureus (MRSA), for example, a very serious medical problem. We are aware that few drugs today are helpful with sepsis and many die in the hospital as a result.
Early in the development of antibiotics, it was recognized how readily they could lose their effectiveness. The classical example is streptomycin, which in a period of a few years from the late 1940s to the early 1950s transitioned from miracle to disappointment. Combination therapies were then invented (or, more properly, tried in desperation) for tuberculosis. While powerful, these remain unsatisfying given that two million people die each year, some untreated, some under treated and some resistant to the complete armamentarium.
In the mid-1990s, HIV began to be effectively beat down by so-called cocktail therapy. Few today are old enough or aware enough to recognize that this approach was used long ago for bacterial infections. As we've just noted above, cocktails of drugs have long been used against nasty bugs. We should be more cautious about fashion in science and news. For example, tuberculosis never left and is reasserting itself in more virulent forms with HIV and immune suppressing drugs as catalysts. More money is spent on erectile dysfunction and growing hair. Does this make sense? You will agree I could use more hair.
The other day I saw the following quote: "Progress is cumulative in science and engineering, but cyclical in finance," from Money of the Mind by James Grant. With economic cycles, we see them as exceptionally novel and the "ups" as exuberant and the "downs" as a doomsday finally realized. Neither have been true—ever. Science also cycles. Old ideas are approached with new instruments by a new generation. Old publications are left unread and uncited, but progress is cumulative nonetheless. DDN
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