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."
3) Cardiac pacemaker
Dr. Thomas Oxley, of the University of Melbourne, Australia, is currently working on a bionic brain implant that helps paralyzed patients control a robotic exoskeleton with the power of thought. His chosen medical innovation is the cardiac pacemaker.
The first pacemaker recipient outlived its inventor and the surgeon who installed it.
In short, the cardiac pacemaker is a medical device that uses electrical stimulation to regulate the rhythm of the beating heart.
These devices are used in cases where the body's natural pacemaker is too slow, or when there is a blockage in the heart's electrical conduction system.
Dr. Oxley describes the cardiac pacemaker as the "archetypal medical device" and "ahead of its time." The first implantable version was designed and installed by Rune Elmqvist and surgeon Åke Senning in 1958 at the Karolinska Institutet in Solna, Sweden.
Arne Larsson was the world's first implantable pacemaker patient; he went on to receive 26 different pacemakers throughout his lifetime. Larsson died in 2001 aged 86, outliving both the inventor and the surgeon.
4) Diagnostic nanosensors
Dr. Thomas J. Webster, of Northeastern University in Boston, MA, is currently working on a number of innovations; one of his projects involves the fascinating future possibilities of synthetic immune cells.
Dr. Webster's chosen medical innovation is the implanted nanosensor - a minute implant that can be inserted into a patient and remain there. It will eventually be able to make diagnoses from within the patient's cells.
The sensors, constructed of carbon nanotubes, could work as early warning systems for potential illnesses. Also, eventually, they will be capable of treating issues as they arise, before the patient is even aware that there is an internal problem. By picking up the tell-tale chemical signals of a variety of diseases, it will raise the alarm before symptoms arrive.
Many illnesses do not present symptoms until the disease is well underway - pancreatic cancer, for instance. The quicker a problem is signaled, the greater chance the patient has of surviving the affront.
Dr. Webster is particularly impressed by technology that makes "big jumps in health." He goes on to say that "too often today, we see small jumps in medicine when we really need revolutionary ideas."
Some of Dr. Webster's work has focused on how nanotechnology can help in the fight against impenetrable biofilms created by bacterial infections that are resilient to many drugs. He told MNT:
"We've been able to develop these nanoparticles that can actually penetrate those biofilms and then kill the biofilm, regenerating healthy tissue in the process."
The nanoscale is difficult to visualize. The diameter of a single-walled carbon nanotube is 100,000 times thinner than a human hair. This minute size allows the nanoparticle to penetrate on a cellular level; it also makes it incredibly difficult to work with and control, hence the furious research within the discipline of nanotechnology.
The future of nanotechnology will, no doubt, be an impressive place.
5) The cochlear implant
Our final innovation comes courtesy of Prof. Michael McAlpine, of the University of Minnesota. He works in the field of 3D printing and its applications in medical science. He recently created a 3D-printed guide that helps regrow sensory and motor functions in nerves following injury.
Prof. McAlpine's chosen medical innovation is the cochlear implant. Invented by Prof. Graeme Clark more than 30 years ago, the technology has changed the lives of thousands of people across the world. Prof. McAlpine says:
"The device is one of the earliest concepts of interweaving electronics directly with the body, and in a surprisingly simple and elegant manner, yet serves the extraordinary function of restoring hearing to people who have gone completely deaf."
To date, more than 350,000 devices have been fitted in deaf or severely hard-of-hearing individuals worldwide. According to the cochlear implant's inventor, Prof. Clark, his device very nearly did not see the light of day. He says:
"I had much criticism and was referred to as 'that clown Clark.' But I was determined to persist and see it through, and I'm so pleased I did. I cannot imagine any technology that has had such a profound effect on transforming so many peoples' lives."
More than 350,000 cochlear implants have been installed to date.
The cochlear implant works differently from a hearing aid, which simply amplifies the sound entering the ear.
The implants bypass damaged portions of the ear and directly stimulate the auditory nerve.
Although the hearing afforded by the cochlear implant is different from natural hearing, it allows users to navigate the world around them with more ease and enjoy natural conversations once again, or even for the first time.
Although the inventions discussed here cover the tiniest corner of the tapestry of historical innovation, their breadth and scope serve as a reminder of how far we have come since trepanning was the brightest surgical idea.
No doubt, as the future rushes in, medical advancements will appear ever more incredible. It seems appropriate to end this article with a quote from the late, great scientific innovator and sci-fi author Arthur C. Clarke:
"Any sufficiently advanced technology is indistinguishable from magic."