FOUNDATION

S OF
CLINICAL LABORATORY
SCIENCE
 ALSO KNOWN AS MEDICAL
TECHNOLOGY
 HEALTHCARE PROFESSION
 PERFORM LABORATORY PROCEDURES
TO HELP DIAGNOSE, MONITOR, AND
TREAT DISEASES, AND TO PROMOTE
HEALTH
 WORK IN EITHER HOSPITAL OR
CLINICAL LABORATORIES
CLINICAL LABORATORY
SCIENCE
 MEDICAL TECHNOLOGY IS DEFINED BY HEINEMANN
AS THE APPLICATION OF THE PRINCIPLES OF
NATURAL, PHYSICAL, AND BIOLOGICAL SCIENCES TO
THE PERFORMANCE OF LABORATORY PROCEDURES
WHICH AID IN THE DIAGNOSIS AND TREATMENT OF
DISEASES
 FAGELSON CONSIDERS MEDICAL TECHNOLOGY TO BE
THAT BRANCH OF MEDICINE CONCERNED WITH THE
PERFORMANCE OF THE LABORATORY
DETERMINATIONS AND ANALYSES USED IN THE
DIAGNOSIS AND TREATMENT OF DISEASE AND IN
THE MAINTENANCE OF HEALTH.
CLINICAL LABORATORY
SCIENCE
 PERFORM SUCH THINGS AS
MICROSCOPIC EXAMINATIONS, OBTAIN
BLOOD SAMPLES, MANIPULATE VARIOUS
LABWARES, OPERATE AUTOMATED AND
SEMIAUTOMATED INSTRUMENTS, AND
MAKE CRITICAL DECISIONS.
AREAS OF THE CLINICAL
LABORATORY SCIENCE
 MICROBIOLOGY
 IMMUNOHEMATOLOGY
 CLINICAL CHEMISTRY
 HEMATOLOGY AND HEMOSTASIS
 URINALYSIS AND BODY FLUIDS
ANALYSIS
 IMMUNOLOGY AND SEROLOGY
 HISTOPATHOLOGY AND CYTOLOGY
AREAS OF THE CLINICAL
LABORATORY SCIENCE
 OPPORTUNITIES:
– BIOMEDICAL RESEARCH
– GENETICS
– TISSUE TYPING
– EDUCATION
– CONSULTING
– LABORATORY MANAGEMENT
– PHARMACEUTICAL AND COSMETICS
– FORENSIC LABORATORIES
 hgg

HISTORY OF CLINICAL
LABORATORY SCIENCE
Ancient and Medieval Times
 The Greek physician, Hippocrates (460 B.C.-
377 B.C.) was called the father of medicine
and is known for the famous Hippocratic
Oath, the code of ethics for practicing
physicians.
 Hippocrates described four "humors" or body
fluids in man.
– Blood
– Phlegm
– Yellow bile
– Black bile
Ancient and Medieval Times
 In ancient times, urine was regarded as a
composite of these humors.  Visual
examination of urine at the bedside could
diagnose illness
 Astrology, superstition and folk-lore often
influenced ancient physicians in making
diagnoses, but they made credible
observations about urine
 Urinalysis, or the study of urine has been
passed down from ancient times and is
regarded as the oldest of laboratory
procedures today
Ancient and Medieval Times
 The polyuria of diabetes was noted in
ancient times.  As early as 600 B.C., a
Hindu physician recorded the sweet
taste of diabetic urine
 Another physician noted in 1674, that
the urine in diabetes had a taste similar
to honey.  These descriptions are still
valid today
Ancient and Medieval Times
 The Earliest Attempts to Conquer
Diabetes
 Folklore has is that Greek physicians had
a primitive but effective way of
diagnosing diabetes. They would pour a
patient's urine on the ground close to an
anthill. Ants swarming to the spot meant
sweetness was present and that the
patient had the "honey-siphoning"
disease, diabetes mellitus.
Ancient and Medieval Times
 Throughout the middle ages, "blood letting"
was a means of curing most afflictions.  A
patient was bled with leeches or by cutting a
blood vessel. In a more enlightened age, this
practice ended and the study of blood and it's
cellular elements began
 Today, we have a better understanding of
how leeches prevent blood from coagulating
and thereby help restore circulation.  Once
again, leeches are used in treatments that aid
the success of reattaching severed limbs.
Progress 1600-1900
Progress 1600-1900
 The development of the microscope was
first described in 1625 with a functional
instrument becoming available in 1673. 
 Following the introduction of the
microscope, great advances were made
in the medical fields of physiology,
bacteriology, chemistry and pathology
 A pioneering course in medical
microscopy was first taught in Paris in
1837
Progress 1600-1900
 The Seminal Period
Jumping ahead to the 1600s, over
"incidental" events like the rise and
fall of Rome, Hun invasions and the
Magna Carta, William Harvey
explained the circulatory system,
and experts determined that the
human body was a chemical system
that could be cured with chemicals.
Progress 1600-1900
 The Seminal Period
Robert Boyle, described by many as the
first modern clinical chemist, who
authored the gas law, was quick to
embrace this philosophy. He was the
first to define chemical elements and
urged the development of analytical
chemistry techniques, as described in his
Memoirs for the Natural History of
Humane Blood.
Institution of clinical chemistry 1800s
Progress 1600-1900
 The science of clinical chemistry evolved by
copying the tools and techniques of analysis
from mercantile manufacturers. Robert Boyle
invented litmus paper to test acidity and
alkalinity of reagents and body fluids by
borrowing from the textile industry. Likewise,
qualitative flame tests to analyze and identify
substances, titimetry analyses, and small
furnaces which allows for uniform and
therefore reproducible test reactions were
borrowed from metallurgists.
Institution of clinical chemistry
1800s
 By the early 1800's linkages between
chemistry and physiology had
tightened. Joseph Louis Gay-Lussac
revolutionized organic analysis by
employing oxidizing agents to trigger
chemical reactions.
 William Prout isolated hydrochloric
acid from gastric juices and divided
foodstuffs into carbohydrates,
proteins and fats.
Institution of clinical chemistry
1800s
 . Prism spectrometers with attached
telescopes were invented to view reaction-
dependent color changes.
 Sir Humphrey Davy demonstrated that
electricity could stimulate color separation,
showing that base solutions move toward
negatively-charged poles: acids toward
positively-charged poles. Using some of these
breakthroughs, Baron Justus von Liebig's
clinical lab was performing six test
determinations per day - more than 400 year
per year.
Institution of clinical chemistry
1800s
 Clinical chemistry became an
academic subject integrated into the
medical school curriculum and
students began to gain practical
knowledge at the bedside as well as
theoretical knowledge in the
classroom.
 In Munich, Hugo von Ziemssen
established the first laboratory
attached to a hospital.
Progress 1600-1900
 By 1848, Fehling had a quantitative test for
urine sugar. 
 Analine dyes used throughout the laboratory
then and today were developed in 1850.
 Early laboratories were established in the last
half of the nineteenth century in the United
States.  Dr. William H. Welsh, considered the
father of American pathology, set up the first
pathology laboratory in America at Bellevue
Hospital in 1878
Progress 1600-1900
 The first recognized clinical
laboratory in the states was located
at Johns Hopkins Hospital in 1896. 
Before the turn of the century,
clinical laboratories were in
operation in hospitals at Boston,
New York and Philadelphia.
Era of technological refinement 1900s

1900-Present
Era of technological refinement
1900s
 Entering into the 20th century, a handful of
American medical centers were establishing
hospital-based laboratories.
 the William Pepper Laboratory at the
University of Pennsylvania was established in
1895,
 the Ayer Laboratory of the Pennsylvania
Hospital was established in 1898 and
 the Rockefeller Institute of New York was
established in 1903.
1900-Present
A census at the turn of the century
indicated that 100 technicians were
employed in the United states, all
men, but not all medical technicians
 WWI (1914-1918) was an important
factor in the growth of the clinical
laboratory with a demand for
medical personnel in the military as
well as civilian hospitals
1900-Present
 In 1915, the state of Pennsylvania passed a
law that required all hospitals be equipped
with adequate laboratories employing
technicians
 By 1920, the census recorded 3500
technicians, 2000 of whom were women.  In
1922, 3000 U.S. hospitals indicated they had
established a clinical laboratory department.
 There was a need for appropriately trained
medical personnel in the field of laboratory
medicine. 
1900-Present
 Practicing physicians trained their assistants,
secretaries and nurses to perform simple
laboratory procedures in their offices
 Trends in the early years indicated the need
for formal and standardized training
programs.  The first formal laboratory course
was established at Woman's Medical School
and Woman's Hospital in Philadelphia in
1921-1922 and is recorded in the files of the
Registry of Medical Technologists.
 1900-Present
 James C. Todd's Clinical Diagnosis, A Manual of
Laboratory Methods 4th edition, published in
1920, provides a "time capsule" view of clinical
pathology. This article consists of edited excerpts
from this book, chosen to illustrate both the thought
processes and methodology of clinical pathology in
the 1920s. Compound microscopes were in wide-
spread use, but other instruments were primitive.
The newest instruments, colorimeters, were read
with the human eye by comparing colors; and the
speed of centrifuges was judged by sound.
1900-Present
 In 1922, the
American Society of Clinical Patholog
ists
, ASCP, was organized.
 The University of Minnesota is
credited with the first degree
program in Medical Technology,
established prior to 1925.  It had
admission requirements equivalent
In summary, this is a quote from
the 19th century Canadian
pathologist William Osler: "That
man can interrogate as well as
observe nature was a lesson
slowly learned in his evolution."
Fortunately for us, our
interrogations have helped
harness a treacherous foe. This
victory in the making is very
sweet.