History of Medical Technology Profession PDF

# History of Medical Technology Profession ## History of Medical Technology in a Global Context - Early medical diagnosis treated disease as a mystery. - Disease was believed to be caused by the negative interaction between the environment and the body. - By around 300 BC to 180 AD, Hippocrates, co...

# History of Medical Technology Profession ## History of Medical Technology in a Global Context - Early medical diagnosis treated disease as a mystery. - Disease was believed to be caused by the negative interaction between the environment and the body. - By around 300 BC to 180 AD, Hippocrates, considered the "father of medicine," and Galen, a Greek physician and philosopher, instigated a rudimentary and qualitative assessment of disorder through measurement of body fluids. - The four humors (blood, phlegm, yellow bile, black bile) were related to the seasons. - The work of these ancient Greek physicians was intended to increase the quality of life of patients. - Urine was one of the body fluids that underwent examination. - Hippocrates advocated the tasting of urine, listening to the lungs, and observing outward appearances in the diagnosis of disease. - He concluded that the appearance of bubbles, blood, and pus in urine indicated kidney disease and chronic illnesses. - Galen described diabetes as "diarrhea of urine" and established the relationship between fluid intake and urine volume. - In medieval Europe, diagnosis by "water casting" (uroscopy) was widely practiced. - Patients submitted their urine specimen in decorative flasks. - Physicians who failed to examine the urine were subjected to public beatings. - By 900 AD, the first book detailing the characteristics of urine (e.g., color, density, quality) was written. - From these early documented works, medicine and medical technology advanced because of the high mortality rate caused by plagues and other diseases. - In the early 11th century, medical practitioners were not allowed to conduct physical examination of the patient's body. - They relied solely on the patient's description of symptoms and their observations. - By the 18th century, mechanical techniques and cadaver dissection were used to provide a more objective and accurate diagnosis and to understand the insides of the body. - In the 19th century, physicians began using machines for diagnosis or therapeutics. - Among these devices were John Hutchinson's spirometer for measuring the vital capacity of the lungs, and Jules Herisson's sphygmomanometer for measuring blood pressure. - Also, the use of chemistry was pivotal in the diagnosis of diabetes, anemia, diphtheria, and syphilis during this period. - The onset of mechanical and chemical devices spurred the turn from general practice to specialization. - This turn was brought about by increasing number of patients and the increasing amount of medical knowledge which generalists could no longer handle. - More complex machinery and equipment used in medical practice required technical expertise, resulting in cooperative arrangement among specialists in different fields. - Consequently, medical service became organized in hospitals. - With this setup, large amounts of data were required in the diagnosis and treatment of patients. - These volumes of patient data prompted the need for information technology. - The need for medical technicians and data specialists also increased. - In 1969, 80 percent of medical professionals were non-physicians. - This growth impelled the need for technicians to be proficient in the use of technology. - Patients were likewise needed to be educated on the tests done on them. ## History of Medical Technology in the United States - In the United States, the establishment of the first clinical laboratories and the development of laboratory practice marked the growth of the medical technology field. - In 1895, the University of Pennsylvania's William Pepper Laboratory of Clinical Medicine was opened to highlight the service role of clinical laboratories. - In 1918, John Kolmer called for the development of a method that would certify medical technologists on a national scale. - Kolmer published "The Demand for and Training of Laboratory Technicians" that included a description of the first formal training course in Medical Technology. - It was also in the same year when the state legislature of Pennsylvania enacted a law requiring all hospitals and institutions to have a fully-equipped laboratory fit for routine testing and to employ a full-time laboratory technician. - In 1920, the administrative units of clinical laboratories in large hospitals were directed by a chief physician. - During this time, clinical laboratories consisted of 4 to 5 divisions including clinical pathology, bacteriology, microbiology, serology, and radiology. - As clinical laboratories held more prominence in the delivery of laboratory tests, the need for technicians and technologists that would assist physicians became greater. - In 1922, the American Society for Clinical Pathology (ASCP) was founded with the objective of encouraging the cooperation between physicians and clinical pathologists as well as maintaining the status of clinical pathologists. - ASCP also established the code of ethics for technicians and technologists stating that these allied health professionals should work under the supervision of a physician and refrain from making oral or written diagnosis and advising physicians on how patients should be treated. - The American Society for Clinical Laboratory Science (formerly the American Society for Medical Technologists), was originally formed as a subgroup of ASCP, helped in the recognition of nonphysician clinical laboratory scientists as autonomous professionals. - In the 1950s, medical technologists in the United States sought professional recognition from the government of their educational qualifications through licensure laws. ## History of Medical Technology in the Philippines - The Spanish Empire established Manila as their capital in late 16th century. - The first hospital the Spaniards established in 1565, Hospital Real in Cebu, was moved to Manila to cater to military patients. - Members of religious orders who came to the country alongside the occupiers established health institutions for the poor and educational institutions for the elite. - In 1578, the Franciscans built the San Lazaro Hospital for the poor and lepers. - In 1596, the Hospital de San Juan de Dios was founded for poor Spaniards. - In 1641, the Hospital de San Jose was founded in Cavite. - The Dominicans founded the University of Santo Tomas in 1611, which in 1871 established the first faculties of pharmacy and medicine. - With the establishment of both health and educational institutions, journals of science and medicine were also published including the Boletin de Medicina de Manila (1886), the Revista Farmaceutica de Filipinas (1893), and Cronicas de Ciencias Medicas (1895) (Anderson, 2006). - The central board of vaccination which started producing and distributing vaccine lymph in 1806 had 122 regular vaccinators (vacunadores) in Manila and other major towns by 1898 (Anderson, 2007; Planta, 2017; Tiglao, 1998). - In 1876, provincial medical officers were appointed to provide health care services throughout the country. - This was followed by the establishment of the Board of Health and Charity in 1883 which was later expanded in 1886. - The Laboratorio Municipal de Manila was established by the Spanish authorities in 1887 for laboratory examinations of food, water, and clinical samples although the laboratory was not adequately used in the study of outbreaks (Anderson, 2007; Cardona et al., 2015). - Philippine war hero, General Antonio Luna, was employed as a chemical expert in this laboratory and pioneered water testing, forensics, and environmental studies (Nakpil, 2008; Vallejo, 2010). - At the end of the Spanish rule, structures of health care and public health were flourishing in major cities of the country. - By the end of the 19th century, the Spaniards who were considered to be authorities in medicine, started exploring the microbial causes of diseases. - However, advancements in medicine and health care during the Spanish colonial rule broke down because of the Philippine-American war which lasted from 1899 to 1902. - In replacement of the Spanish health system, the Americans established public health institutions modeled after military health care systems. - After the fall of Manila, the Spanish Military hospital was converted into the First Reserve Hospital in 1898 by Lt. Col. Henry Lipincott who was a chief surgeon of the Division of the Pacific and Eighth Army Corps. - This hospital had a diagnostic laboratory but was not fully maximized when it first became operational due to its director contracting typhoid fever. - Richard P. Strong, the successor, utilized the laboratory to perform autopsies and to examine blood, feces, and urine along with other laboratory services (Anderson, 2006; Planta, 2017). - By 1901, the US government, through the Philippine Commission, established a Bureau of Government Laboratories under the Philippine Commission Act No. 156 (Anderson, 2006; Planta, 2017). - The Bureau which was located in Calle Herran (Pedro Gil), Ermita, Manila had a science library, chemical section, and serum laboratory for the production of vaccines. - The biology laboratory was designed to address and develop methods in the diagnosis, treatment, and prevention of human and animal diseases. - In the chemical laboratory, food, plant composition, and minerals were investigated. - Paul Freer, the bureau's first director, ensured that the biological laboratory would be equipped with adequate supplies and equipment such as incubators, sterilizers, microscopes, microtomes, stains, glassware, and chemicals. - The main laboratory was composed of two stories and divided into two wings with rooms in the biological wing having microscope tables by the windows. - The rooms had enough space for general laboratory work and processes such as filtering, distilling, and heating. - Each biological room had a chemical worktable with gas, water, and vacuums. - The opposite wall had a hood with a flue extended to the attic. - The biological wing's floors all had incubators heated by Bunsen burners and refrigerating boxes (Anderson, 2006; Freer, 1902). - Unfortunately, the building was destroyed during World War II. - Presently, the National Institutes of Health of University of the Philippines-Manila occupies the area. ## History of Medical Technology in the Philippines - With the reorganization of the Bureau of Government Laboratories 1905, the Bureau of Science was established for medical officers who sought a career in laboratory research (Anderson 2006; Planta, 2017). - The Bureau worked with the Army Board for the Study of the Tropical Diseases until the latter was disbanded in 1914. - The Bureau also focused on pathology while the board was intent on studying white foreigners' physiology in tropical climates. - The Bureau of Science worked closely with the Philippine General Hospital (PGH) and the University of the Philippines. - It then became an active center for scientific research and instruction in the country. - The biological laboratory of the Bureau diligently studied samples coming from across the country. - Every day, scientists would study more than a hundred samples of body fluids to identify the racial bases of diseases through a map of the archipelago's pathological terrain. - In 1909, the laboratory received over 7000 fecal specimens, 900 urine specimens, and 700 blood specimens. - The Bureau's medical research and laboratory investigations were mainly focused on microbiology in connection with the onslaught of different diseases such as cholera, malaria, leprosy, tuberculosis, and dysentery. - At the end of the Philippine-American War, the civilian Board of Health established by the Americans was changed into the Bureau of Health (Planta, 2017). - In 1915, it was reorganized into the Philippine Health Service but later on reverted to the Bureau of Health by 1933. - The University of the Philippines' College of Public Health formally opened its Certificate in Public Health program in June of 1927 with the aim to provide proper training to the Philippine Health Service's medical officers. - On December 8, 1941, Japan attacked the whole of Manila through aerial assault and deployment of troops just ten hours after bombing Pearl Harbor. - It was the beginning of the Second World War that resulted in massive casualties. - Amid this turmoil, the Medical Laboratory unit of the US Army provided medical services with the available laboratory supplies, supplemental laboratory examinations, and epidemiological and sanitary investigations. - It was also tasked to perform routine water analyses, examination of food supplies, distribution of special reagents and solutions, culture media, and investigation of epidemics and epizootics. - The unit also performed special serological, bacteriological, pathological, and chemical examinations, post-mortem examinations, and preservation of pathological specimens of value to the US Army Medical Department (WW2 US Medical Research Centre, 2018). - On June 18, 1942, the 3d Medical Laboratory was the first laboratory unit to be assigned in the South West Pacific Area (SWPA). - Then in 1944, when the US forces landed in Leyte, the laboratories including the 3rd, 5th and 8th Medical Laboratories and the 19th Medical General Laboratory were relocated to the West Pacific Area. - Added to the list were the 26th and 27th Medical Laboratories and the 363rd Medical Composite Detachment. - These medical units were not merged but deployed separately as small detachments or mobile laboratory sections to military bases in different islands. - The 19th Medical General Laboratory, 3rd Medical Laboratory, and the 363rd Medical Composite Detachment operated in Leyte. - The 27th Medical Laboratory operated in Tacloban and the 26th Medical Laboratory operated in Lingayen Gulf (the only laboratory unit in Luzon for six months following the US invasion on January 9, 1945). - The first clinical laboratory in the Philippines was established during World War II by the 6th Infantry Division of the US army at Quiricada St., Sta. Cruz, Manila. - It is now known as the Manila Public Health Laboratory (Cardona et al., 2015; Moraleta, 2012; Rabor, 2016; Suba & Milanez, 2017). - When the US army left in June of 1945, the laboratory was endorsed to the National Department of Health and was non-operational until it was reopened in October of the same year by Dr. Pio de Roda with the help of then Manila City Health Officer Dr. Mariano Icasiano. - After instituting the public health laboratory in Manila, Dr. Pio de Roda along with Dr. Prudencia Sta. Ana, conducted a training program for aspiring laboratory workers. - Later on, Dr. Sta Ana was asked to prepare a six-month formal syllabus for the training program with certificate for the trainees upon completion. - Dr. Tirso Briones joined the two later on (Moraleta, 2012). - The training program ended in 1954 when the Bureau of Private Education approved a four-year course in Bachelor of Science in Medical Technology. - In the same year, the Manila Sanitarium and Hospital (MSH) opened the first School of Medical Technology in the Philippines under the leadership of Mrs. Willa Hedrick, wife of Dr. Elvin Hedrick. - Soon after, MSH started its medical internship and residency training program which was affiliated with Loma Linda University in California. - In 1954, the Philippine Union College (PUC) in Baesa, Caloocan City (now Adventist University of the Philippines) absorbed MSH's School of Medical Technology. - What was left with MSH was the facility for its clinical division. - Dr. Jesse Umali was the first graduate of the medical technology program. - He later graduated as a Doctor of Medicine at the Far Eastern University (FEU) and became a successful OB-gynecologist in the US (Puno, 2014; Rabor, 2016). - University of Santo Tomas initially offered the Medical Technology course as an elective for pharmacy students in 1957. - It was only in 1961 that Medical Technology was recognized as an official program in UST (Cardona et al., 2015). ## Inventions and Innovations in the Field of Medical Laboratory | Inventor | Year | Contribution | |---|---|---| | Antonie van Leeuwenhoek | 1660 | The father of microbiology; known for his work on the improvement of the microscope. | | Edward Jenner | 1796 | Discovered vaccination to establish immunity to small pox; Impact of contribution: Immunology | | Marie Francois Xavier Bichat | 1800 | Identified organs by their types of tissues; Impact of contribution: Histology | | Agostino Bassi | 1835 | Produced disease in worms by injection of organic material - the beginning of bacteriology | | Louis Pasteur | 1857 | Successfully produced immunity to rabies | | Gregor Mendel | 1866 | Enunciated his law of inherited characteristics from studies on plants | | Joseph Lister | 1870 | Demonstrated that surgical infections are cause by airborne organisms | | Robert Koch | 1877 | Presented the first pictures of bacilli (anthrax), and later tubercle bacilli | | Elie Metchnikoff | 1886 | Described phagocytes in blood and their role in fighting infection | | Ernst von Bergmann | 1886 | Introduced steam sterilization in surgery | | Karl Landsteiner | 1902 | Distinguished blood groups through the development of the ABO blood group system | | August von Wassermann | 1902 | Developed immunologic tests for syphilis | | Howard Ricketts | 1906 | Discovered microorganisms whose range lies between bacteria and viruses called rickettsiae | | Hans Fischer | 1929 | Worked out the structure of hemoglobin | | Jonas Salk | 1954 | Developed poliomyelitis vaccine | | James Westgard | 1973 | Introduced the Westgard Rules for quality control in the clinical laboratory | | Baruch Samuel Blumberg | 1980 | Introduced the Hepatitis B vaccine | | Kary Mullis | 1985 | Developed the Polymerase Chain Reaction (PCR) | | Andre van Steirteghem | 1992 | Introduced the intracytoplasmic sperm injection (IVF) | | James Thomson | 1998 | Derived the first human Stem Cell line | ## Key Points - The history of medical technology can be traced back to the ancient times. - In the United States, the establishment of the first clinical laboratories and the development of the laboratory practice marked the growth of the medical technology field. - The history of medical technology in the Philippines can be traced back to the establishment of the country's first clinical laboratory by the 6th infantry Division of the US army.