Laboratory Medicine and Its Contribution to Clinical Care; A Historical Perspective

1. Laboratory Medicine and Its Contribution to Clinical Care; A Historical Perspective Laurette Geldenhuys Dalhousie University CDHA, Halifax

2. Declaration of Conflict of Interest • None

3. Objectives • At the end of the presentation participants will have an enhanced understanding of • The historical development of laboratory medicine, including • Surgical Pathology • Cytopathology • Autopsy Pathology • The important role of laboratory medicine in the advancement of clinical care over the last century

4. Egyptian Era • Edwin Smith Papyrus – 17th century BCE • Papyrus Ebers – 1550 BCE • Bone injury • Trachoma • Ulcerating lumps – cancer? • Parasites

5. Greek Era • Hippocrates of Cos – 460 – 370 BCE • Humoural theory of the nature of disease • Crab-like growth of cancer • Inflammation • Haemorrhoids • Malaria • Tuberculosis

6. Roman Era • Cornelius Celsus – 30 BCE – 38 CE • De Re Medicina– 1478 – first medical book ever printed • “Notaeveroinflammationissuntquatuor, rubor et tumor, cum calore et dolore”

7. Roman EraGalen • 129 – 201 CE • Pergamus, Asia Minor • Temple of Asclepius • 500 books • Seats of Disease; Abnormal Tumours • Sarcoma – raw meat • Bloodletting • Fifth sign of inflammation – loss of function/throbbing

8. Humoural theory • Four elements and humours • Fire – yellow bile • Earth – black bile • Water – phlegm • Air – blood • Four qualities • Hot, dry, wet, cold

9. Arab Medicine • Avicenna – 980 – 1037 CE • Canon Medicinae • Influenced by Galen

10. Europe • Monasteries • Italian universities

11. Pathology as a Specialty • Antonio Benivieni – 1443 – 1502 • Florence • Case histories, autopsies • De AbditisNunnullis ac MirandisMorborum et SanctionumCausis– About the Hidden Causes of Disease

12. Terms “Pathology” and Physiology” • Jean Fernel – 1497 – 1558 • Paris • MorbisUniversalibus

13. Blood circulation • William Harvey – 1578 – 1657 • De MotuCordis et Sanguinis • Demise of humoural theory

14. Microscope • Hans and Sacharias Janssen – 1580 – 1638 • Robert Hooke – 1635 – 1703 – cell • Antony van Leeuwenhoek – 1632 – 1723

15. Giovanni Batista Morgagni • 1682 – 1771 • De Sedibus et CausisMorborum per AnatomenIndagatis– About the Seats and Causes of Disease Through Anatomical Investigation • 640 autopsies, clinicopathologic correlation • Colposcopy • Sinus of Morgagni; Columns of Morgagni; Foramina of Morgagni; Hydatid of Morgagni; Morgagni's hernia