[U2] History of MedTech

Late 19th Century

Century when laboratory tests became essential for diagnosing and treating diseases;

Manual tests performed on blood, urine, and other bodily fluids w/ basic equipment

Traditional Chinese Medicine

Ancient Asian Medicine: China

employed diagnostic techniques w/o use of instruments

Four Pillars of Diagnosis

Employed by Traditional Chinese Medicine

diagnostic technique w/o instruments

Observation

Four Pillars of Diagnosis

assessing patient’s vitality, color, appearance, secretions, excretions

Auscultation and Olfcation

Four Pillars of Diagnosis

listening to sounds e.g. patient’s voice and breathing; detecting specific odors

Interrogation

Four Pillars of Diagnosis

questioning patient on symptoms and medical history

Palpation

Four Pillars of Diagnosis

pulse-taking, involves three specific positions on radial artery

evaluate changes in internal organs

Acupuncture Needles

Ancient Asian Medicine: China

earliest forms of minimally invasive medical devices

made of stone and bone, evolved into bronze, gold, and silver

Herbal Medicine and Pharmacopoeias

Ancient Asian Medicine: China

ancient Chinese texts compiled extensive knowledge on herbs and their medicinal properties

early forms of drug preparation and standardization

Forensic Medicine

Ancient Asian Medicine: China

developed by Sung Tse, advocating hand washing w/ sulfur and vinegar to prevent infection during autopsies

early hygiene in laboratory-like settings

Sung Tse

Ancient Asian Medicine: China

developed forensic medicine

Early Use of Hormones

Ancient Asian Medicine: China

Daoist physicians used androgens and estrogens from therapeutic preparations of palcentas to treat hypogonadism

advanced knowledge of biochemistry

Medical Texts

Mesopotamia (Sumerians, Babylonians, Assyrians); (3rd Millennium BCE)

recorded detailed accounts of drug prescriptions, operations, exorcisms on cuneiform clay tablets

show high degree of knowledge about disease and treatment

Simple Surgical Instruments

Mesopotamia (Sumerians, Babylonians, Assyrians)

early forms of scalpels and needles made of stone/metal; minor surgeries, wound cleaning, suturing

Diagnostic Handbook

Mesopotamia (Sumerians, Babylonians, Assyrians); (11th Century BCE)

Babylonian medical text; demonstrates systematic approach to diagnosis, listing symptoms, prognoses

Early Medical Instruments

Ancient Egypt; (7000 BCE)

archaeological evidence of varied brass surgical instruments, prosthetic devices, splints

Uroscopy (Urine Analysis)

Ancient Egypt

Ancient Egyptian physcians (along w/ Babylonians) practiced urine examination

Observed urine’s color, clarity, sediments, foam and other properties as primary diagnostic tool

Dissection and Anatomy

Ancient Egypt

Understanding of body organs, contributing to anatomical knowledge influencing later Greek medicine

Hippocratic Medicine

Ancient Europe (Ancient Greece)

Medicine found by Hippocrates; emphasized observation and rational diagnosis

Hippocrates

Ancient Europe (Ancient Greece)

Father of Medicine

Humoral Theory

Ancient Europe (Ancient Greece)

Central Hippocratic doctrine of humoral pathology; attributes diseases to imbalances of four bodily fluids (blood, yellow bile, black bile, phlegm); influenced diagnostic approaches for centuries

Pulse as a Diagnostic Tool

Ancient Europe (Ancient Greece)

early Hippocratic practioners (Herophilus in Alexandria); differentiate arteries from veins

Early Diagnostic Tests

Ancient Europe (Ancient Greece)

frothing of urine associated with dropsy (edema); early recognition of diagnostic indicator (now known as nephrotic syndrome)

Sophisticated Surgical Instruments

Ancient Europe (Ancient Rome)

Romans developed more refined surgical instruments, e.g. “Roman scalpel”

Military Medicine

Ancient Europe (Ancient Rome)

Roman military doctors had well-developed methods for setting fractures and treating trauma, comparable to those in ancient China

Galen

Ancient Europe (Ancient Rome); (131-201 AD)

Founder of experimental physiology; expanded upon Hippocrates’ humoral theories

Extensive writings on anatomy and medicine (based on animal dissection) were highly influential and transmitted Greek medical knowledge to the Western world through Arab scholars

Uroscopy

Early MedLabSci Practices

Examining urine (practice from ancient Egypt and Babylonia); earliest form of “laboratory medicine”

Observation and analysis of various properties of urine to make diagnoses

Observation and Sensory Examination

Early MedLabSci Practices

Heavy reliance on senses (sight, smell, touch, taste) to assess patient conditions and bodily excretions

Earliest “tests” of patient samples

Early Documentation

Early MedLabSci Practices

Record-keeping on clay tablets in Mesopotamia

Comprehensive medical texts in China and Greece

Early attempt at systematizing medical knowledge

Core principle of scientific inquiry and laboratory practice

Ancient Ebers Papyrus

Early Parasite Identification

Ancient Record (circa 1550 BC); earliest known documentation of parasites

Dracunculus

Early Parasite Identification

The guinea worm; type of larger ectoparasites

Paleoparasitology

Early Parasite Identification

Study of parasites from the past and interactions with hosts and vectors

Discovery of calcified eggs in Egyptian mummies (Schistosoma haematobium)

Antoine Van Leeuwenhoek

Early Parasite Identification (17th Century onwards)

Father of Microbiology

Onserved Giardia lamlia through his simple microscope

Francesco Redi

Early Parasite Identification (17th Century onwards)

Described both internal and external parasites; e.g. sheep liver fluke, ticks

Modern Parasitology (19th Century)

Early Parasite Identification

Significant advancement: systematic studies and classifications of parasites

Stool and blood samples using wet mounts, staining, concentration methods became essential for enhancing visibility and detection

Galileo Galilei

Development of the Microscope (Early 17th Century)

(after 1609) adapted his telescope for viewing small objects up close, effectively creating a compound microscope

Giovanni Faber of Bamberg

Development of the Microscope (Early 17th Century)

(1625) coined the term “microscope” to describe Galilei’s compound microscope

Robert Hooke

Development of the Microscope (Early 17th Century)

(1665) author of Microphagia, coined the term “cell” while describing cork structure

Microphagia

Development of the Microscope (Early 17th Century)

(1665) Book; detailed illustrations of objects observed through his compound microscope

Antoine van Leeuwenhoek

Development of the Microscope (Early 17th Century)

(1674) improved the simple microscope, achieving magnifications of up to 270x

First to describe and illustrate various microorganisms (“animacules”) e.g. bacteria and protozoa

Joseph Jackson Lister

Development of the Microscope

(1830) developed lenses that corrected spherical and chromatic aberrations, lead to significant improvements in image quality in microscopes, enabling more accurate observations

Carl Zeiss and Ernst Abbe

Development of the Microscope

(Mid-19th Century) Advances in lens manufacturing

Developed the Abbe sine condition, led to mass production of high-quality microscopes and understanding of optical theory

Max Knoll and Ernst Ruska

Development of the Microscope

(1931) Constructes the first transmission electron microscope (TEM), revolutionized ability to visualize ultra-small strucures beyond capability of light microscope

Girolamo Fracastoro

Advent of Bacteriology

(16th Century) Introduced concept of contagion

Contagion

Advent of Bacteriology

(16th Century) Term for an infection that can be transmitted from one entity to another

Ferdinand Cohn

Advent of Bacteriology

(1853-1872) Significant contributions to classification of bacteria, recognized bacteria as distinct plant-like organisms

Louis Pasteur

Advent of Bacteriology

(1850s-1860s) Disproved theory of spontaneous generation, demonstrating that life, including microorganisms, arise only from pre-existing life

Elucidated role of microorganisms in fermentation and spoilage

Developed pasteruization

Biogenesis

Advent of Bacteriology

(1850s-1860s) Term for theory that life arises only from pre-existing life, including microorganisms

Robert Koch

Advent of Bacteriology

(late 19th Century) established systematic approach to studying infectious diseases

Developed critical laboratory techniques e.g. using solid culture media (agar) for isolating pure cultures of bacteria (w/ help of Angelina Fannie Hesse) and staining methods

Identified causative agents of anthrax (1876), tuberulosis (1882), and cholera (1884)

Koch’s Postulates

Advent of Bacteriology

Provided framework for proving that specific microorganisms cause specific diseases

Late 19th Century

Advent of Bacteriology

(1880-1900) “Golden Age of Microbiology”

Students of Pasteur and Koch rapidly discovered a host of pathogenic bacteria responsible for various diseases, leading to significant advancements in immunology and vaccine development

Professionalization and Standardization

MedTech 20th Century

(Early 1900s-1920s) demand for laboratory testing grew, especially after infectious disease outbreaks

Need for trained personnel, “medical technologists”

Americann Society for Clinical Pathology

MedTech 20th Century

ASCP, established the Board of Registry (1928)

Aim to standardize academic requirements and define the scope of practice

Specialization

MedTech 20th Century

(Mid-20th Century) Various disciplines within medical technology began to emerge

hematology, microbiology, clinical chemistry, blood banking, imuunology

American College of Surgeons’ Accreditation Standard of 1919

MedTech 20th Century

Integration into Healthcare

Accreditation required hospitals to have a laboratory, further soldifying role of medical technologists

Clinical Laboratory Improvement Act of 1988

MedTech 20th Century

Increased Complexity and Information (Late 20th Century)

CLIA ‘88 - defined tiers of method complexity and personnel standards, reflecting the growing sophistication and importance of laboratory testing

Improved Culture Media and Identification

MedTech 20th Century: New Lab Techniques

Microbiology

Continued refinement of selective and differential media allowed for better isolation and identification of various microorganisms

Antimicrobial Susceptibility Testing

MedTech 20th Century: New Lab Techniques

Microbiology

As antibiotics were discovered (e.g., penicillin in the 1920s, mass-produced after WWII), techniques to determine bacterial susceptibility to these drugs became crucial

Serological Tests

MedTech 20th Century: New Lab Techniques

Microbiology

Development of tests to detect antibodies or antigens in serum for diagnosing infectious diseases (e.g. Wassermann test for syphilis in 1906, Widal test for typhoid)

Spectrophotometry

MedTech 20th Century: New Lab Techniques

Clinical Chemistry

Accurate measurement of light absorption, precise quantification of substances in blood and urine (e.g., glucose, cholesterol, electrolytes)

Enzymatic Assays

MedTech 20th Century: New Lab Techniques

Clinical Chemistry

Methods to measure enzyme activity in body fluids (e.g., liver enzymes, cardiac enzymes) to measure eznyme activity in bodily fluids

Immunoassays

MedTech 20th Century: New Lab Techniques

Clinical Chemistry

Highly sensitive and specific detection of hormones, drugs, and disease markers

Automated Cell Counters

MedTech 20th Century: New Lab Techniques

Hematology

Rapidly count and differentiate blood ccells, providing comprehensive blood counts

Coagulation Studies

MedTech 20th Century: New Lab Techniques

Hematology

Assess blood clotting function for managing bleeding disorders and anticoagulant therapy

DNA Structure Discovery

MedTech 20th Century: New Lab Techniques

Molecular Diagnostics (Late 20th Century)

Discovered in 1953, laying the groundwork for molecular diagnostics

Polymerase Chain Reaction

MedTech 20th Century: New Lab Techniques

Molecular Diagnostics (Late 20th Century)

(1980s) allowed for the amplification of specific DNA sequences

Detection of pathogens, genetic mutations, and forensic analysis with unprecedented sensitivity)

Electrophoresis

MedTech 20th Century: New Lab Techniques

Molecular Diagnostics (Late 20th Century)\

Technique for separating proteins and nucleic acids based on size and electric charge

Automation

MedTech 20th Century

Use of technology to address the growing volume of tests, need for speed, desire for improved accuracy, and reduction of human error

Next-Generation Sequencing

MedTech 21st Century: New Lab Techniques

Rapid and cost-effective sequencing of entire genomes or specific genes

Diagnose rare genetic disorders, identify cancer mutations, assess pharmacogenomics, tracking infectious disease outbreaks

Liquid Biopsies

MedTech 21st Century: New Lab Techniques

Minimally invasive technique, analyze biomarkers (e.g., circulating tumor DNA, circulating tumor cells) from bodily fluids like blood or urine.

Less invasive alternative to tissue biopsies for cancer detection, monitoring treatment response, assessing recurrence

Mass Spectrometry

MedTech 21st Century: New Lab Techniques

Rapid and accurate identification of proteins, metabolites, microorganisms

Digital Pathology

MedTech 21st Century: New Lab Techniques

Digitizing tissue slides

Viewing, analysis, and consultation, enhancing efficiency, accuracy, and access to expert opinions, particularly in underserved areas

Advanced Immunology and Flow Cytometry

MedTech 21st Century: New Lab Techniques

Techniques, identifying and quantifying different cell populations for complez immunophenotyping

CRISPR-Cas9 Gene Editing

MedTech 21st Century: New Lab Techniques

Primarily a research tool, gene-editing technology for diagnostics and potential future therapies

Allows precise modification of DNA

mRNA Technology

MedTech 21st Century: New Lab Techniques

Rapid development of mRNA vaccines during COVID-19 pandemic

Potential applications in various other diseases and therapies