Away with multi-use vials! [editorial]

When the author and physician Conan Doyle created the character of Sherlock Holmes he gave him an opium and cocaine habit. This was not the relatively harmless addiction of early Victorians for laudanum and other forms of opium eating but the fashion new among late Victorian doctors for injecting drugs into their patients and for enabling their more sophisticated patients to inject themselves. The subsequent use (and abuse) of needles and syringes has recently been chronicled in a small exhibition with an excellent catalogue at the Welcome Institute of the History of Medicine London. The benefits that have since come with needles and syringes are to be seen all around us. They have made possible insulin therapy and the successful drug treatment of syphilis tuberculosis and many other diseases. They have allowed vaccines to be given. By providing parenteral access they have shown the way towards intravenous interventions for instance blood transfusion haemodialysis and rapid induction of anaesthesia and muscle relaxation. (excerpt)