EMG Homepage - Internet History

For most of us today, it is hard to fathom the fact that the Internet, this network which has irreversibly changed our lives, was born as a Cold War military project. Indeed, it was designed to ensure military communication in a United States devastated by a Soviet nuclear strike. At its inception, the Internet was a post-apocalypse command grid.

For a better understanding of the Internet, we need to go back to the early sixties.

Back in 1964, Robert Sproull, the director of the Defense Advanced Research Projects Agency (DARPA) said to the US Congress:

"One of the next steps (after time-sharing) will be the linking of an individual at MIT through the MIT computer to a computer at Carnegie Tech, Stanford, UCLA, or the Systems Development corporation to permit the researcher at MIT to call forth programs or information stored in these remote computers for use in solving his research program".

This was the ground breaking statement for network research in the early sixties.

By the mid-sixties, The Advanced Research Projects Agency (ARPA) of the US Department of Defense began to sponsor research into the successful linking of remote computers in a way that would allow a remote login access and data and resources sharing. To that end, ARPA had to support packet switching research, research which paved the way for todayÍs computer networks.

Packet switching can be explained as the breaking down of data into individual datagrams, or packets (which are labeled to indicate their origin and destination) and the forwarding of these packets from one computer to another until the information reaches its final destination.

In 1966 Paul Baran of the RAND group proposed a packet switched network which would have no central hub or central control center but instead, lines linking various places together.

Packets would be forwarded from place to place until they arrived at their proper destination. The theory was that if the middle of the country was hit by a nuclear attack, the coasts would still be able to talk to one another by routing traffic around missing links through Canada, satellites, or possibly even by going around the world.

The ARPANET was developed by two dozen engineers and scientists who were funded by the Pentagon with the specific mandate to link distant computers together.

The year 1969 is when it all began. But most people remember 1969 as the year men landed on the moon. That year saw the beginning of ARPANET (the ARPA Network) with the successful linking of four computers which were located at the University of California at Los Angeles, SRI (in Stanford), University of California at Santa Barbara, and the University of Utah.

In 1976 a packet satellite project went into effect and SATNET, the Atlantic packet Satellite network, was born, linking the United States with Europe.

It soon became apparent that a new protocol for network communication was needed since the original addressing scheme did not contain enough information to include other large networks. The TCP/IP, Transmission Control Protocol/ Internet Protocol, was developed in 1973 by Vinton Cerf and his group.

In 1983, an incredible breakthrough in the way the Internet worked was made by the University of Wisconsin. The idea of the domain name server (DNS) was developed. Messages no longer needed to know the exact path (the IP number), to their destination. The domain name server allowed a message to ask for directions along the way to its destination.

For instance if a message needed to be sent to "med.bu.edu" the message would first go to the DNS that served "edu" which would then tell it how to get to "bu" which would tell the message were it could find the "med" machine (the server). This was a vast improvement over the old system in which the user had to send a message to the IP#, which would be something like "128.197.9.173". This made administration of machines and life for the users much easier.

In 1983, the military and civilian functions of the net were separated and in 1988 the ARPANET was officially decommissioned in favor of what was named the Internet

The father of the World Wide Web (WWW) is Tim Berners - Lee. Tim was a founding director of Image Computer Systems and a principal engineer with Plessey Telecommunications in Poole, England. A graduate of Oxford University, he was the driving force behind the development of the WWW. He wrote the first WWW client and the first WWW server while at CERN in Geneva, Switzerland and defined standards such as the Uniform Resource Locator or URL, essentially the address which tells the computer where to look to retrieve the specified document, Hypertext Markup Language or HTML which is the programming language used in web pages and HTTP, the Hypertext Transfer Protocol used to retrieve the web pages by the browser. The current standard of HTML defined by he W3 Consortium at MIT in Cambridge, Massachusetts is HTML 4. Tim stated his dream for the world wide web as follows: "The dream behind the web is of a common information space in which we communicate by sharing information. Its universality is essential: the fact that a hypertext can point to anything, be it personal, local or global, be it draft or highly polished. There was a second part of the dream too, dependent on the web being so generally used that it became a realistic mirror (or in fact the primary embodiment) of the ways in which we work and play and socialize. That was that once the stage of our interactions was on line, we could then use computers to help us analyze it, make sense of what we are doing, where we individually fit in, and how we can better work together" (from Tim Berners-Lee: The World Wide Web: A very short personal history).

It all started with HTML 1.0 which was a very simple and basic standard. But the popularity of the Web started to grow when Mosaic, a web browser, came out. Browsers are programs for displaying HTML-code. They are used for "browsing" these documents. The first browsers, Viola and Midas, were released in January 1993 for X - Windows.

But the first truly popular browser was the National Center for Supercomputer Applications (NCSA) Mosaic browser. It was first released as an ALPHA version in February of 1993, and subsequently, for all common platforms (X, PC/Windows, Macintosh) in September of 1993.

Marc Andreessen was the mastermind behind Mosaic while a student at the University of Illinois. He founded his own company, Mosaic Communications Corporation (now called Netscape), and released a browser, the Netscape Navigator 1.0. He soon controlled 70% of the browser market.

Very quickly, Microsoft saw his gigantic success and soon released its own browser, the MS Internet Explorer, for free.

Today, it is not an exaggeration to say that the Internet has revolutionized communication between scientists. Information is available at the touch of a button on a near infinite number of topics across national and international boundaries, and at a relatively cheap price. Scientists have traditionally been at the vanguard of this technology and have been the major winners in its success. Medicine is being revolutionized every day by the Internet, both for practitioners (who communicate with each other and update themselves) and patients (who obtain information and network through it).

In the beginning of this revolution, we witnessed the development of general medical sites. These were quickly followed by neuroscience sites and lately by exclusive neurophysiology/EMG sites.

In studying the impact of the Internet and TeleEMG on our daily practice, we have to address the following questions:

1) Can web browsing be integrated into the daily research/practice of our specialty and possibly supplant the traditional way of getting information?

2) Can the world wide web become an accepted tool for clinical neurophysiologists to post information, search the medical literature, get updates in their specialty, exchange data with others, and perhaps use for report generation?

3) What are the available resources for clinical neurophysiologists and what are the means by which they can ensure quality; how can they establish guidelines or make recommendations.

As far as publications are concerned, journals, some with full texts, magazines, annual reports, works in progress etc.. have gone on-line. So web browsing, if integrated into our daily research/practice, can actually provide us a great tool to update ourselves and exchange information.

There seems to be an inherent contradiction however in having all this information available for free, when subscription to journals and magazines hard copies could be so expensive! But it seems, that at least for the moment, the publishers/companies have settled on the following as a rationale for making their wares available on the net for free:

1) That the Internet is not available to everybody and therefore they are not significantly cutting into their (hard copy) market.

2) That even when people have access to the free web site on the Internet, they do not tend to discontinue their subscriptions (they still prefer to hang on to the hard copy).

3) That in addition, the web site acts as publicity to the hard copy and the publishers can actually sway their readers to other sites of interest to them easier (and faster) on the net than with the hard copy. Indeed, some additional advertising revenues from pharmaceutical companies and others can be generated by the net to support its cost.

4) That the net is interactive in ways that magazines are not and permits generation of user profiles in ways that magazines do not.

5) And finally, that in this day and age, it is more of an issue to be "absent" from the net (when all the other companies are on it) than whether or not to be present on it. In a great entry into the field, the National Library of Medicine (NLM) has made PubMed and Grateful Med available for free on the Internet.

Can the world wide web become an accepted tool for clinical neurophysiologists? Surely, electronic publications or electronic-magazines (e-zines) have a lot to offer with easy updates, timeliness of publications, update of references, and the ability to cut and paste references (or abstracts, or text) from the journal to one's own database. Another major advantage of electronic text is that it is keyword searchable and some very sophisticated searches can be performed, something which is nearly impossible with hard copy text. So it is fair to say that clinical neurophysiologists stand to gain a great deal by integrating the net into their daily routine.

In fact Pieter Bolman, president of Academic Press, predicted "that eventually all journal articles and books will become a network of interlinked databases, continually updated with new articles linked to other articles..."

Is it little wonder that in this day and age, where magazine articles can take up to 18 months to be published and surface mail delivery to certain parts of the world takes weeks to months, instantaneous publication on the net could become the ultimate goal in this fast paced and rapidly changing scientific world.

As exciting as this seems to be, it is not likely that it will take hold overnight however. Very much in the same fashion, the demise of the mail service and of overnight courier services such as Federal Express or DHL was predicted with the arrival on the scene of the fax machine. It turned out that we still needed to deliver hard copies of documents despite all the improvements in technology and speed and in fact the postal industry prospered and flourished. It is fair to say that the arrival of new technology has so far created novel uses for this technology much more so than supplanted the use of old technology altogether.

What are the available resources for clinical neurophysiologists? The Internet is now replete with on-line journals, textbooks, news forums, continuing medical education sites, practice guidelines, patient information, drug databases, discussion groups, as well image and video/audio clip libraries. Some researchers even go as far as inviting discussions from colleagues around the world for their works in progress posted on their web site.

Another reason the Internet has irreversibly revolutionized our way of communication is e-mail. The first e-mail message was sent in 1972. In 1997, the journal Web Week estimated that 2.7 trillion e-mail messages were exchanged!

E-mail is a rather simple (but getting more complicated by the day) text-based means of immediate, informal communication which virtually knows no boundaries. Its simplicity, unassuming appearance and speed (and low price, if not free) make it an ideal way for scientific communication and exchanges. The ability to send attachments of files (text, graphics, sound) make it an ideal platform for the exchange of scientific papers, graphs or video/audio files at dizzying speeds. E-mail will probably remain the most important means of scientific communication for a long time to come.

Newsgroups are specialized bulletin boards which allow the user to post/read information on the net about an amazing number of specialized topics covering virtually any and everything. Discussion "threads" can be followed to read all of the posted replies to a given question or topic. Medical Newsgroups and mail-lists are found on just about any topic.

Chat "rooms" allow for live discussions by a number of users on a variety of topics in real time.

The language to write web pages is HTML which stands for hypertext markup language. This is a fairly simple programming language which is platform (Unix, PC, Mac) independent and is written and saved in text format.

The language has evolved to become fairly powerful and flexible, and with the addition of JavaScript, VBScript and JAVA applets now allows for more sophisticated interactive programming on the net. The host computer can also find out a great deal about you and your system and can send you "cookies" which store information on your hard disk to keep track of your browsing (or shopping) habits.

Initially, HTML was written using text editors (as it was simple), but today this habit is fast disappearing with the development of sophisticated computer programs (such as Frontpage, Pagemill, etc..) which allow for easy and powerful HTML programming without having to learn the language.

Usually three categories of groups/individuals author medical, or medically related, web pages on the Internet.

These include academic institutions, such as Hospitals, Foundations, Universities... who post web pages as a means to promote their institution, communicate with the inside (and outside) world and provide information on-line about programs they offer to the public. These institutions have web pages which are usually of high quality, uniform, well organized and are very careful (for medico-legal purposes) with their content, so they are likely to have strict guidelines for what goes (and doesn't go) on their sites.

The second group, mostly industry, usually the drug/device manufacturers, book/magazine publishers etc.. use sophisticated, catchy web pages whose purpose is primarily commercial but also educational. Their sites are also useful to gather information about their likely target population and their interests. Again, these pages are uniformly well organized and adhere to strict guidelines for liability issues, but it is important to always remember the underlying commercial interest of the sponsoring entity. Under this group one could also find "fly-by-night" unscrupulous operators who are less reliable and accountable, and their purpose, including the spread of misinformation, is primarily limited to quick commercial profit.

The third group includes individuals who are primarily in academic medicine or research and who have server space allotted to them by their institutions. They use it (programming either with simple text editors or with commercially available programs) to publish relevant information about their activities, works in progress, research scientific ideas etc... There is a wide variation in the content and quality of these web pages. Currently there are web sites which give a comprehensive categorization of clinical neurophysiological sites, including two textbooks of Electromyography on the world wide web.

* This list compiled by Dr. Renzo Bassi, Legnago/Verona, Italy (last checked on September 15, 1998)

A growing number of universities are offering CME credits on the Internet. This presents several advantages. In many instances, CME credits are necessary for physicians to renew their licenses. However, even though these courses may be available at various society meetings, not all physicians can afford the time, travel (or the cost) to attend these meetings. The Internet provides a convenient, and up to date, means to obtain these credits at very low cost. Further, these courses, being sponsored by the same universities, are just as good and written by the same experts. When these credits are not necessary for licensing purposes, physicians from underserved rural areas or remote parts of the world may use them just to get updated in their specialty. CME courses are usually prepared by authorities in the field, regularly updated, and presented in an appealing fashion. A list of relevant questions are given at the end to test the physician's knowledge of the subject after reading the material. If they successfully "pass" the test, a certificate is mailed to them attesting to their successful completion in exchange for a minimum fee.

Hardware, with rapidly changing standards and voracious appetite for speed, memory and disk space, is an important consideration these days when looking into successful access and use of the web. Some of the important issues are the computer platform (PC, Mac or Unix) and browser incompatibilities (Netscape or Explorer) as well as JavaScript, JAVA and HTML standards.

In addition to the computer, the user needs to have access to a phone line and a modem, the faster the better.

To communicate directly through the phone lines, one needs a fast modem with the appropriate browser, TCP/IP and PPP (point to point protocol) software. In general when looking for terminal software, ensure the following: ease of use; the ability to use different protocols to transfer files across platforms; the ability to emulate different terminal protocols; the ability to send attachments; the ability to send and receive files with special European characters; the ability to Compress/Decompress files etc..

To go on line, the user dials a local phone number and logs on to a computer, called a server, at the University or Hospital. This server communicates with the Internet which in turns communicates with other servers all over the world.

E-mail file transmission is accomplished as follows: the user logs on to the server using e-mail software and "attaches" (essentially encodes binary data as text and appends it to a text message) the file(s) to be sent with the e-mail message. The message is sent to the address of the receiver (after having encoded it and compressed it as required). Typical encoding standards are UUencode, MIME and BinHex.

On the receiving end the receiver must decode the file(s) first and then possibly decompress them. Once that is done, the files are loaded on to the computer. There are many e-mail programs (such as Eudora) available on the market some freeware, some shareware and some commercial.

A WORD OF CAUTION: The Internet is too big, its geography too widespread and its accessibility too pervasive for one person, or group of persons or country to own it. Using the words of those who dreamed it, it is designed to survive a "devastating nuclear attack". But this is also what makes people and institutions who come to depend on it more vulnerable because when technology progresses, it does so on more than one front. Parallel to the advancement in communications and transfers has developed a very "healthy" virus industry. As the Internet becomes more and more part of daily life in matters of economy, commerce, education and defense, corrupting such a system may well have devastating consequences on the nation which comes to heavily depend on it. Under those circumstances, one of the biggest threats in the coming millennium, besides the year 2000 problem, El-Niños and nuclear weapons, will come from viruses designed to corrupt such systems and paralyze a country. That's is why, it is likely that countries, and not only individuals (as we are lead to believe) engage in serious virus (and anti-virus) research, to be prepared for such eventualities. Perhaps, like actual biological viruses whose existence became to known to the public only when they accidentally escaped highly guarded government research laboratories, Internet viruses became known to the public only when they somehow managed to "escape" from "computer laboratories" to the outside world.

With free speech flourishing like never before on the web, the issue of censorship (by various government and groups) keeps coming up. Censorship though will prove to be a very hard task. The Internet crosses borders, timezones, networks, etc.. and, after all, it was designed to survive a devastating nuclear attack!

But even though a great deal has to be done to overcome all this, censorship will still be possible! Countries may create a firewall around themselves and download from the world wide web only what they deem appropriate to distribute on their own wide web (such as the China Wide Web or cww).

It is more likely however that we will see the web censor itself. Certainly this trend has taken place successfully in the media, print and electronic, while keeping free speech protections intact. This will be possible when gradually larger and larger corporations, with their self-censorship, become more prevalent on the web and control content and presentation, and distribution.. (such as TV networks). By their mere size and sheer volume these sites will in effect drown out the smaller, resource-poor sites. Users who want visibility will have to come to them to post their material on their web pages and will need to abide by the self-censorship rules and regulations of these networks.

The more resources we will allocate to the Internet, the larger it will become. In fact, in a very short time, humans will no longer be able to understand the routing tables which control the traffic. Nor will they be able to monitor the entire network. The net will be so large that only computers will be able to monitor its activities. Another area of concern is addresses. It is expected that the Internet will quickly run out of addresses to give people. As for cost, web access in the future is more likely to be cheaper than today or even free.

As a medium, albeit a unique one, the Internet is likely to evolve in the same fashion as other media (print and audio-visual) have evolved with large networks getting into the market and controlling large portions of it. A larger, more lucrative side of the web will be devoted to the entertainment industry and electronic commerce (e-commerce) where it is likely that it will merge with cable television and become one medium (recently, Microsoft corporation purchased WebTV, a TV based Internet access company).

This Internet, of which we make so much today -- the network which has helped scholars all over the world and where free speech is flourishing as never before -- is indeed an amazing tool which has changed our lives forever. It will herald new ways in which we will communicate and exchange information in the new millennium.

- INTERNET: The network of interconnected Computers - WWW: World Wide Web The world wide network (looks like a spider's web) of "linked" documents on these Computers - BROWSERS The Computer programs which allow you to browse (display) these documents

- CGI: Common Gateway Interface: Communication between Browser and Server (to send forms for example)

- FTP: File Transfer Protocol: The way files are sent and received over the Internet

- HTTP: HyperText Transfer Protocol: System to transfer pages across the Internet

- JAVA: Just Another Vague Acronym (?): Powerful, text-based, programming language - JAVAScript: Simple Web page programming language

- JPEG: Joint Photographic Expert Group format: Graphic compression format supporting more colors than GIF

- TCP/IP: Transmission Control Protocol/Internet Protocol: The system used by networks to communicate

- VRML: Virtual Reality Modeling Language: Programming language to create 3-D images