bacterial infections also made their appearance. A
new class of antibiotics known as fluoroquinolones
were introduced in 1986, the most prominent of
which was ciprofloxacin (Cipro). The name Cipro
would become familiar to the general public as an ef-
fective treatment during the anthrax scare some fif-
teen years later. The first genetically engineered vac-
cine, directed against hepatitis B virus (HBV), was
also introduced in 1986.
An improved rabies vaccine was introduced in
1980, replacing the version that required as many as
twenty-three abdominal injections and that dated to
the time of Louis Pasteur in the 1880’s. The first
statin drug for lowering cholesterol, lovastatin, was
approved in 1987. The antidepressant drug flu-
oxetine hydrochloride received FDA approval in De-
cember that year. Marketed by Eli Lilly under the
name Prozac, the drug would be used by more than
forty million people by the end of the century.
Not all news about pharmaceuticals was upbeat
during the decade. In Chicago in 1982, someone
placed cyanide in capsules of Tylenol, resulting in
seven deaths. In October, 1982, the producer of
Tylenol, Johnson & Johnson, recalled all samples of
the product. The killer was never identified, but in
order to prevent a repeat of the episode, Tylenol
packages were triple-sealed to prevent random tam-
pering.
Advances in Technology New technologies devel-
oped in the previous decade continued to be im-
proved. MRI, the basis for which was discovered
by Nobel laureates Felix Bloch and Edward Mills
Purcell in 1946, was applied to imaging of the body.
In 1980, obtaining a useful image required an expo-
sure time of five minutes; by 1986, exposure time was
reduced to seconds.
Though ultrasonic imaging had been practiced
for nearly a half century, improvements that allowed
for “real-time” imaging were applied in the field of
obstetrics. It became possible to determine details
ranging from the sex of a fetus to observing fetal
malformations; the term “fetal sonography” was
coined, representing a new aspect to the field. An
unexpected result of the procedure was an increase
in abortions of female children in China and India,
countries in which birth of males was considered de-
sirable.
In 1982, the first viable attempt at an artificial
heart transplant, performed by Dr. William DeVries,
took place in December. The patient, Barney Clark,
would live nearly four months with the device before
his death due to multiple organ failure.
Impact The greatest impact of the wide range of
medical advances would be in the area of cost. By the
end of the decade, more than 11 percent of the U.S.
gross national product would go to medical pro-
grams, more than $2,750 per capita, double that at
the beginning of the decade (and a number that
would double again the following decade). By law,
hospitals could not turn away patients who lacked in-
surance coverage, a cost that had to be absorbed
by other agencies. Increased costs associated with
health insurance, both by the individual as well as
corporations, represented a significant portion of
these costs. The issue of medical care for the poor
would be a political issue for the foreseeable future.
The ability to monitor genetic defects also had
unexpected consequences. Development of im-
proved methods of amniocentesis meant a wide
range of birth defects could be monitored early in a
pregnancy. Since it became possible to detect traits
such as Huntington’s disease that would prove fatal,
the question of whether insurance companies would
be required to cover such potential patients had yet
to be addressed.
Further Reading
Allen, Arthur.Vaccine: The Controversial Stor y of Medi-
cine’s Greatest Lifesaver. New York: W. W. Norton,- The story behind the development of most
significant vaccines, beginning with Edward Jen-
ner and smallpox. The hepatitis B vaccine, devel-
oped in the 1980’s, is among those described.
Also addressed is the issue of whether autism is a
possible side effect.
Barlett, Donald L., and James B. Steele.Critical Con-
dition: How Health Care in America Became Big Busi-
ness—and Bad Medicine. New York: Doubleday, - Story behind the development and evolu-
tion of the American health care system. Authors
discuss the balance between coverage by both the
companies and government, and the costs associ-
ated with the business aspects of medicine.
Childs, Barton.Genetic Medicine: A Logic of Disease.
Baltimore: The Johns Hopkins University Press, - Addresses the growing understanding of
the relationship between genetic makeup and the
environment in development of disease. Much of
the writing is historical.
The Eighties in America Medicine 631