Lifeblood. The History and Future of Medical Equipment

1543—Looking inside the body: The work published by Andreas Vesalius (1514–64) in 1543 called De Humani Corporis Fabrica Libri Septem (Seven Books on the Fabric of the Human Body) laid the foundations for modern anatomy. In 1537, Vesalius conducted his first public dissection in the Anatomical Theater in Löwen. In this way he gained knowledge about the human skeleton and internal organs that changed medicine fundamentally. Thanks to the printing press and the possibility of producing multiple copies, his writings soon became widely known.

1628—The discovery of blood circulation: In 1628, the scholar William Harvey (1578—1657) revolutionized the medical world with his work called De Motu Cordis (On the Motion of the Heart). His studies disproved the previous belief that new blood was formed in the liver and used up by the body. From the large amount of blood that flowed through an artery in just one hour, Harvey concluded that it was not possible for so much new blood to keep being formed and so there must be a circulatory system.

1796—The beginnings of vaccinations: The country doctor Edward Jenner (1749–1823) had observed that people who had previously fallen sick with the non-fatal cowpox were subsequently immune to smallpox. He therefore conducted a test that was risky and highly unusual for that time: in 1796, he infected a boy with cowpox and, a few weeks later, with true smallpox. The boy remained healthy with no symptoms and the vaccination process was born. In 1874, smallpox vaccination became compulsory in law in the German Reich.

1819—The invention of the stethoscope: A doctor without a stethoscope? Inconceivable. This important medical instrument was invented by the French doctor René Théophile Hyacinthe Laënnec (1781–1826). In order not to have to put his ear directly on the patient's chest during auscultation, he used a roll of paper and established that, in fact, he could hear better with it. And so, in 1819, he developed the wooden listening tube that was the forerunner of the familiar tubing stethoscope that is used today.

1846—The introduction of modern anesthesia: Before the 19th century, the use of anesthetics during surgical interventions was largely unknown. People only knew of certain plants such as the opium poppy, hemp, or mandrake which were supposed to alleviate and dull pain. A general anesthetic was first used successfully by the dentist William Thomas Morton in October 1846 in Boston. The patient had first inhaled ether vapors. In the decades that followed, other anesthetics were developed, along with the first anesthetic masks to which the anesthetic agent was applied.

1850—The discovery of cellular pathology: How does disease happen? What possible course could diseases take? Rudolf Virchow (1821–1902), a doctor at the Charité medical school in Berlin, kept working away at these questions and in 1850 he came up with his revolutionary theory of cellular pathology. Virchow assumed that the whole body was made up of cells performing different tasks. From this he concluded that every illness could be traced back to changes at the level of the cells—a view that is still applicable in some cases today.

1872—Microorganisms have no chance: For a long time, people did not know that microorganisms cause many diseases and infections. In 1872, the microbiologist Ferdinand Julius Cohn (1828–98) published his article entitled Untersuchungen über Bakterien (Research into Bacteria) which launched the study of bacteria. In the end it was thanks to research by Louis Pasteur (1822–95) that the processes of fermentation and decay were attributed to microorganisms. However, it was the British surgeon Joseph Lister (1827–1912) who put the microorganism theory of disease into practice: he developed a device for spraying carbolic acid so as to create a bacteria-free environment for his operations. The operating table and the surgeon's hands would be sprayed with this carbolic acid—an antiseptic agent—during an operation.

1883—The introduction of general social security: Born out of necessity: by introducing health insurance in 1883, the Chancellor of the German Reich Otto von Bismarck wanted to improve the lot of sick workers, not least in the hope that these reforms would keep the workforce loyal to the state. Accident insurance followed in 1884 and then, from 1889, employees could for the first time protect themselves under the law from the effects of old age or invalidity. This social system, the first of its kind in Europe, was extended to white-collar employees in subsequent years.

1895—The discovery of X-rays: Did Wilhelm Conrad Röntgen realize, on the evening of November 8th, 1895, the consequences of his discovery for medical science? It was on that evening that, while using a cathode ray tube, he observed that a fluorescent screen had begun to glow brightly even though the tube was covered. This observation was quickly followed by an X-ray of his wife's hand which was included in his publication, On a New Kind of Ray. In 1901, Röntgen received the Nobel Prize for Physics for his discovery.

Illuminated down to your little toe: When Röntgen discovered X-rays in 1895, he could never have imagined that the rays would even find their way into every shoe shop in the form of the Schucoskop, a shoe-fitting fluoroscope. As so often, this was driven by the military: because a great deal of experience of X-raying soldiers' injured feet had been gathered during the First World War, and well-fitting boots were recognized as being the most important items of clothing, a great deal of energy was invested in developing an instrument that could X-ray feet and show whether a shoe was too tight. In 1920, the first Pedoscope or Schucoskop was introduced to the general public in Boston. A further 10,000 devices were to follow in the USA alone between 1920 and 1950, intended to find out whether a shoe fitted and the toes had enough room to move.

The Schucoskop also became well established in Europe and experienced a boom as shoes began to be mass produced. This was thanks to its medical claims and clever marketing: it promised the right shoe for every shape of foot, on a scientific basis and backed by the latest X-ray technology. Children and their parents were the main target group: for children, the device was a fascinating toy that made the tedious business of trying on shoes more bearable. And it gave parents the comforting feeling that they could find the correct, healthy shoes for their child.

The Schucoskop that can be seen in the TECHNOSEUM was made by Schelmer & Co. AG in Hagen in 1956. To see how well the foot fitted in the shoe that had been chosen, the customer had to stand on a little platform—for children there was a special raised step—and put their feet into the device. There were two handles to hold on to. The X-ray tubes were in the bottom of the device, radiating upwards and therefore through the feet. The customer and sales assistant could assess how well the shoes fitted by looking through slits on the top and sides of the Schucoskop.

The end of the Schucoskop: It was only in the 1950s that tests showed that the devices emitted an extremely high level of radiation. This meant that anyone who checked the fit several times when buying shoes, or shop assistants selling shoes, had been exposed to dangerously high levels of radiation. Finally, in the early 1960s, the devices were banned and disappeared again from shoe shops.

From 1900, poliomyelitis spread around the world. This infectious disease that is caused by the polio virus attacked the nerve cells in the spinal cord that control muscles and resulted in severe muscle weakness, including of the respiratory muscles. Patients were no longer able to breathe for themselves. The polio epidemic in the USA in 1914 cost more than 27,000 people their lives. Until the American immunologist Jonas Salk finally developed a vaccine against polio in 1954, different ways had to be found to fight the disease.

In 1928, engineer Philip Drinker and his colleague Louis Shaw found the answer: Shaw had discovered that an anesthetized cat could be kept alive in an airtight box by alternately generating negative and positive pressure. The two engineers adapted the system for people and invented the breathing machine called the iron lung. It generates negative pressure that substitutes for the diaphragm, lifting the rib cage so that the lungs take in air. The patient lies in an airtight sealed tube with only their head protruding. After the inventors had successfully resuscitated an eight-year-old girl who was sick with polio in their respiratory machine, the tank respirator—the official name of the iron lung—was introduced to the public on September 14, 1929. By 1936 there were already 222 of the devices available worldwide.

Many of the patients who had to use the iron lung for treatment were able to leave it once the inflammation had subsided and all their muscles were working again. However, many other patients spent decades in this life-supporting instrument, taking degrees, writing a doctorate, or even getting married. The Australian June Middleton is believed to be the patient who spent the longest in an iron lung anywhere in the world: she spent 21 hours a day in the machine for 61 years. She died in 2009 at the age of 83.

The Sauerbruch arm, an arm prosthesis that was brilliantly designed both technically and surgically, made it possible for people to use their own muscle power to grip and hold things. It was developed by Ferdinand Sauerbruch (1875–1951) with the help of Swiss mechanical engineering professor Aurel Stodola (1859–1942) during the First World War. This highly sophisticated prosthesis could not be obtained by everyone because it was only available to the higher ranks of the armed forces. Nevertheless, demand was so high that, after 1919, the Deutsche Ersatzglieder-Gesellschaft Sauerbruch G.m.b.H ( D.E.R.S.A - German Sauerbruch Substitute Limb Company) standardized the prostheses and began to mass produce them.

In the early days of laboratory medicine, chemistry and microscopy played a decisive role. Nowadays, the methods of molecular biology, such as genetic diagnosis, are extending the scope of testing that is possible. Most of the analysis is fully automated and is performed very quickly. For a long time, analysis of the cells in a blood sample was laboriously carried out manually. In 1947, the American Wallace H. Coulter and his brother Joseph R. Coulter invented an automatic counting device. The blood sample flows past two electrodes with a constant voltage between them. The cells cause a slight change in the voltage that can be measured. In this way they can be counted accurately.

This system is one of the first manipulators that were used to assist doctors during minimally invasive surgery. Manipulators enable surgical interventions to be far more accurate. Two arms are fitted with surgical instruments and manually controlled by the operator. The system replicates the operator's movements, scales them down, and filters out any trembling of the hands. The third arm is controlled by the voice and gives an insight into the site of the operation via a video endoscope. (The picture shows only the voice-controlled arm of the system)