Over the centuries, medical science's speed of advance has been breakneck.
Scientific endeavor is rooted in innovation. Without the underlying current of swarming technological advances, medicine would stagnate.
Of course, any list of "top" medical inventions is bound to come up short; the incremental ratcheting of treatments, diagnostics and equipment have formed a wealth of worthy candidates that could never be fully listed.
In order to appreciate how far we have come, it is worth glancing briefly back into the misty realms of prehistory.
One of the earliest innovative medical procedures that we know of was trepanning. This procedure involved drilling or scraping a hole into the skull, possibly to oust evil spirits or to "reduce pressure" on the brain.
At one point in time, this practice was surprisingly widespread, with evidence of its usage cropping up in Europe, Azerbaijan, China, Siberia, North and South America.
In fact, of the thousands of neolithic skulls that archaeologists have unearthed over the years, 5-10% bear the distinctive marks of trepanning.
At the time, this proto-surgery was probably considered a useful and thoroughly modern technique. Thankfully, other procedures have since removed trepanning from common use.
Moving forward in time, another regular addition to such lists is the advent of anesthesia. Anyone who has gone under the surgeon's knife owes a great debt to those innovators who first saw a use for Joseph Priestley's "different sorts of air."
Although not a medical professional, Humphrey Davy was the first to discover the anesthetic properties of nitrous oxide, and it was he who coined the term "laughing gas." However, anesthetics were not commonly used until decades after Davy's death in 1829.
Further forward still, Alexander Fleming's serendipitous discovery of penicillin in 1928 often makes it onto lists of the most historic medical innovations. Fleming's work signaled the birth of modern antibiotics and, over the years, has spared millions of patients from amputations and death by infection.
The list goes on, almost endlessly. For the purposes of this article, we contacted scientists and medical professionals whose work we have covered over recent months. We simply asked them what medical innovation (past, present or future) fascinates them the most, and why they rate it so highly.
Here are the results, in no particular order:
1) Advanced gene editing
Dr. Garry Laverty and his team at the School of Pharmacy, Queen's University in Belfast, Ireland, recently created a peptide gel that shows promise in the fight against so-called superbug infections.
The innovation that he finds most fascinating is a gene editing technique known as CRISPR (clustered regularly-interspaced short palindromic repeats). Before this new technology saw the light of day, engineering a mutation into a gene was incredibly laborious.
Genetic modifications that would have previously taken a great deal of time and money can now be carried out swiftly and cheaply. CRISPR's influence cannot be overstated; an article in Nature says that "CRISPR is causing a major upheaval in biomedical research."
Dr. Laverty told MNT:
"This technique has only come to the forefront of research in the past few years and has the potential to significantly advance gene therapy as it is much faster than conventional methods."
The technology is derived from a mechanism that bacteria use to fight off viral infection and works in conjunction with an enzyme called Cas9.
Cas9 uses a guide RNA molecule to home in on its target DNA. It then edits the DNA to disrupt genes or insert desired sequences. Each run might cost as little as $30, compared with the many thousands of dollars that previous techniques would set laboratories back.
Dr. Laverty holds high hopes for CRISPR's future applications; he hopes that it might eventually allow us to "eradicate genetic disease by eliminating harmful DNA sequences. [...] It has the potential to allow any human genome to be edited by insertion of a tailored genetic sequence or has the ability to destroy harmful segments."
It certainly seems to be a genuine game-changer in molecular genetics. Dr. Laverty goes on:
"With further research, it could treat all kinds of established genetic-based disease, including HIV, cancers and infectious diseases. [...] In future, CRISPR could be utilized to allow our cells to become powerhouses for drugs themselves."
2) Point-of-care sequencing
Point-of-care sequencers could be life-savers on a global scale.
Our next respondent carries on the genetic theme. Ephraim L. Tsalik, assistant professor of medicine at Duke Medicine in Durham, NC, is involved in designing tests that can distinguish between virus-based and bacterial-based illnesses.
Tsalik's chosen medical innovation is point-of-care sequencing. This refers to hand-held devices that can sample tissues and read the DNA in real-time, skipping the necessity of lab-based, time-consuming tests.
These types of devices will eventually find a multitude of uses, from the doctor's office to the jungles of Borneo. Point-of-care sequencers will allow unimagined detail to be gleaned from patients within moments.
The species of bacteria or virus that are causing an infection can easily be derived, removing the chance of unnecessary antibiotic prescriptions.
For diseases such as AIDS (acquired immune deficiency syndrome), the viral load can be ascertained there and then and treatment adjusted accordingly. As Tsalik told MNT:
"The ability to make these measurements in a manner suitable for patient care will be a tremendous asset as we strive for personalized and precision medicine."
On the next page, we look at hearts, ears and the incredibly small.