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1-History-of-MedTech 2

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Overview of Medical

Technology
LESSON’S DESIRED LEARNING
OUTCOMES- To

 discuss the definition of medical technology;


 summarize the contributions leading to the
development of laboratory science/ medical
profession; &
 judge the importance of medical technology/
laboratory science in the society most especially in
this time of health crisis.
What is medical
technology?
 Known as clinical laboratory
science or laboratory
medicine
 Refers to the application of
diagnostic, preventive &
therapeutic medicine to
monitor & improve the
management of health
conditions
Other definitions of med tech

Anna Fagelson Branch of medicine which is concerned with the


(1961) performance of laboratory determinations &
analyses used in the diagnosis & treatment of
disease & the maintenance of health

Walters (1996) A health profession concerned with performing


laboratory analyses in view of obtaining information
necessary in the diagnosis & treatment of diseases
as well as in the maintenance of good health

Ruth Heinemann Application of the principles of natural, physical, &


(1963) biological sciences in laboratory procedures to aid in
the diagnosis & treatment of diseases.
RA 5527

 Known as “ the Philippine Medical Technology Act


of 1969
 Defines MT as an auxiliary branch of medicine
which deals with examinations using various
chemical, microscopic, bacteriologic, & other
medical laboratory procedures or techniques that
will aid the physician in diagnosis, study, &
treatment of disease & in the promotion of health
in general
Med tech--interdisciplinary
 Hematology
 Clinical chemistry
 Medical microbiology
 Clinical microscopy (Urinalysis & other body fluids)
 Medical Parasitology
 Immunology
 Serology
 Immunohematology
 General pathology & Histopathology
 MTLE
HISTORICAL NOTES
Ebers papyrus (1500BC)

 Oldest preserved Egyptian compilation


of medical texts
 110-page, 20 meters long scroll that
contains chapters on contraception,
pregnancy, eye & skin problems,
surgery, burns, & intestinal diseases &
parasites
Hippocrates (300BC to 180 AD)

 “ father of medicine”
 Described 4 humors or body fluids: blood, phlegm,
yellow bile, black bile
 Hippocrates advocated the tasting of urine,
listening to the lungs, & observing outward
appearances in the diagnosis of disease.
 Appearance of bubbles, blood & pus in urine
=kidney disease & chronic illness
 Galen described diabetes as “diarrhea of urine” &
established the relationship between fluid intake &
urine volume
 In medieval Europe, diagnosis is by “water casting”
(uroscopy)
 Patients submitted urine in decorative flask
 Physicians who failed to examine the urine were
subjected to beating
 Rufus of Ephesus(500AD)-First description of
hematuria

Isaac Judaeus (900AD)- A Jewish physician, wrote


Kitab al Baul (book of urine)
 detailed the concepts of urine formation ,
sediments, & urine characteristics in relation to
diseases
 In the early 11th century, medical practitioners were
not allowed to conduct physical examination of the
patient’s body

 They relied solely on patient’s description of


symptoms & in their observations
Greek physicians (1098-1438)

 Made diagnoses by pouring urine on


the ground, observing whether the
urine attracted insects. It if did, patient
has boils
 Anna Fagelson (14th century)- confirmed
beginnings of MT when she correlated the cause of
Alexander Gillani to acquired-laboratory infection
 Inventions & innovators p 6-7, 11-12
Koch’s postulates

Specificity of pathogen can only be


established if:
 It is present in all cases
 Inoculations of its pure culture produce
disease in animals
 From these cultures, it can again be
obtained
 Then it can again be propagated in
pure culture
Koch’s postulates
1. The microorganism must be found in abundance
in all organisms suffering from the disease but
should not be found in healthy organisms.
2. The microorganism must be isolated from a
diseased organism and grown in pure culture.
3. The cultured microorganism should cause
disease when introduced into a healthy
organism.
4. The microorganism must be reisolated from the
inoculated, diseased experimental host and
identified as being identical to the original
specific causative agent.
19 century
th

 John Hutchinson- spirometer for


measuring the vital capacity of the
lungs
 Jules Herisson- sphygmomanometer
for measuring blood pressure

 Use of chemistry was pivotal in the


diagnosis of diabetes, anemia,
diphtheria, & syphilis
 In mid-1900s, technical laboratories regulated by
the Centers for Disease Control & Prevention (CDC)
began to be used for medical diagnostics
 When did medical technicians come into the
picture of healthcare?
 Increasing number of patients that generalists
could not anymore handle

 Training done
 In 1969, 80% of medical professionals were non-
physicians
First laboratories

 In Britain: Guys Hospital ( introduced in


wards)
 USA: most labs were done by
physicians with microscope at home or
office
: first set up lab was at University of
Pennsylvania’s William Pepper

Laboratory of Clinical Medicine


Dr. William Welch - Opened a teaching lab in New York University
Medical School ( Bellevue Medical College)
- 1st physician to teach at John Hopkin’s University;
1st dean of John Hopkin’s University school of
medicine

Dr William Osler - Established ward laboratories at John Hopkin’s


Hospital ( routine tests done by physicians ; complex
procedures done in pathology dept)

James Campbell - Wrote a book clinical diagnosis: A manual of


Todd (1908) laboratory methods

John Bernard - Edit the book of Todd- retitled it as Clinical Diagnosis


Henry & Management by Laboratory Methods
1918

 In 1918, John Kolmer called for the


development of method that would
certify medical technologists on a
national scale

 State legislature of Pennsylvania


enacted a law requiring all hospitals to
have a fully-equipped laboratory &
employ a full time laboratory
technician
1920

 Chief physician directed the


administrative units of clinical
laboratories in large hospitals

 Clinical labs divisions were: clinical


pathology, bacteriology, microbiology,
serology, radiology
1922

 Establishment of American Society for


Clinical Pathology (ASCP)
 Purpose of ASCP
 encourage cooperation between
physicians & clinical pathologists
 Established Code of ethics for
technicians & technologists
1950

 American Society of Medical


Technologists (old name)
 American Society for Clinical
Laboratory Science ( new name)
sought professional recognition of
their educational qualifications
through licensure laws.
MED TECH in the Philippines

 Hospital Real in Cebu : 1st hospital established


(1565) by Spaniards . It was moved to Manila to
cater to military patients
Contribution of Religious orders

 1578: Franciscans built San Lazaro Hospital for the


poor & lepers
 1596: Hospital de San Juan de Dios founded for
poor Spaniards
 1611: Dominicans founded UST, which in 1871
established the first faculty of pharmacy &
medicine
 1641: Hospital de San Jose was founded in Cavite
Science & medicine journals

 Boletin de Medicina de Manila (1886)


 Revista Farmaceutica de Filipinas (1893)
 Cronicas de Ciencias Medicas (1895)
1876

 Provincial medical officers were appointed to


provide health care services throughout the
country
Establishment of

 Board of Health and Charity in 1883 , expanded in


1996
 Laboratorio Municipal de Manila by the Spanish
authorities in 1887 = for lab examinations of food,
water, clinical samples
 General Antonio Luna was employed as chemical
expert who pioneered water testing, forensics,
environmental studies
 At the end of Spanish rule, structures of health care and
public health were flourishing.

 By the end of the 19th century, Spaniards started exploring


the microbial causes of diseases
 The Spanish medicine & health care broke down
because of war in 1899 to 1902.

 The Americans took over


 The Spanish military hospital was converted into
the First Reserve Hospital in 1898 by Lt.Col. Henry
Lipincott- chief surgeon of the Division of the
Pacific & 8th Army Corps
 Frist Reserve hospital had a laboratory but not fully
maximized due to its director having typhoid fever.

 The successor, Richard Strong utilized the lab to


perform autopsies & to examine clinical specimens
In 1901

 The US govt established a Bureau of Government


Laboratories under the Phil Commission Act # 156
 The Bureau was located in Calle Herran, Ermita,
Manila had a science library, chemical section,
serum laboratory (for vaccines)
 Building was destroyed during world war II

 Presently, NIH of UP occupies the area


1905

 Bureau of Science was established


 Bureau functioned to
 Study tropical diseases
 Become an active center for scientific research &
instruction
 In 1927, UP opened College of Public Health
 In 1941, Japan attacked Manila but the Medical
Laboratory unit of the US Army continued to
provide medical services, including laboratory
 In 1942 the 3rd Medical Laboratory was the 1st
laboratory unit to be assigned in the South West
Pacific Area
 In 1944, when US troops landed in Leyte, different
laboratory units were deployed as mobile
laboratory sections in different islands
 First clinical lab was established during world war II
by the 6th Infantry Division of the US Army at
Santa Cruz manila ( now known as Manila Public
Health Laboratory)
 After US army left in 1945, lab was endorsed to the
National Department of Health
 Dr. Alfredo Pio de Roda reorganized the deserted
laboratory.
 Dr. Mariano Icasiano was the 1st City Health
Officer- supported Dr. Roda
 With Dr. Prudencia Sta. Ana & Dr. Tirso Briones a
formal 6-month training program was offered to
HS graduates interested to work as medical
technician in 1947

 In 1954, the Bureau of Private of Education


approved a 4-year course in BSMT
Schools of Phil Med Tech School

 1954- first 4-year BSMT program was offered by


the Manila Sanitarium & Hospital (MSH) (now the
Manila Sanitarium & Hospital ) with the help of an
American physician & missionary, Dr. Willa Hilgert
Hedrick ( founder of medical education in the Phil)
 Medical internship & residency training program
was with Loma Linda University in California
Schools of Phil Med Tech School

 In the same year - the Philippine Union


College ( now the Adventist University
of the Phil) absorbed MSH’s school of
Medical Technology
 What was left with MSH was the
facility of its clinical division
 Dr. Jesse Umali (OB-Gyne) - 1st
graduate in 1956
 1957: UST offered MT elective course in pharmacy
leading to BSMT
 1961: UST offered MT as a 4-year course (3 yrs
academic course & 1-yr internship program)
 : CEU offered MT, first graduates
after 2 years

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