• © 2002 by the Association of Clinical Scientists, Inc.

The First Use of the Microscope in Medicine

• discovery of the microscope
• microscopy in medicine
• history of the microscope

The microscope is undoubtedly one of the greatest inventions that men have ever made. The use of lenses for spectacles (eyeglasses), distant vision (telescopes), and high magnification (microscopes) required early lens makers accurately to grind lenses with different focal lengths. During the 16th and 17th centuries, Holland and Italy were the principal countries for the construction and use of telescopes and microscopes.

The compound microscope (with two convex lenses) was invented in Holland around 1590 by two spectacle makers, Hans Jannsen and his son, Zacharias. During the early 1600’s, Galileo (1564–1642) made several telescopes and microscopes that he called “occhialino.” Also in Italy, James Faber, a physician, coined the word “microscope” in 1625; and the first association of microscopists was formed.

In 1653, Petrus Borellus [1] wrote the first publication on the use of microscope in medicine. He described 100 observations and applications, including how to remove ingrowing eyelashes that are invisible to the naked eye. In 1646, Athanasius Kircher [2] (or “Kirchner, as it is often spelled), a Jesuit priest, wrote that “a number of things might be discovered in the blood of fever patients.” In 1658, in his Scrutinium Pestis, Kirchner [3] described microscopic “worms” in plague victims which he suspected caused the disease that killed millions of people in Europe during the 17th century. Most likely, he was viewing pus cells, or perhaps red blood cells, since he could not possibly see the Bacillus pestis with his 32-power microscope. Another early microscopist was Joseph Campini of Bologna. His microscope was the first that was depicted in clinical use in medicine (Fig. 1⇓) [4].

While there were many botanists and zoologists who used microscope in the 17th century, there were few physicians. The observations of Leeuwenhoek (1632–1723), a Dutch drapery maker, excelled all other microscopists, because of his skill in making high quality lenses. The red blood cell was described in 1667 by Swammerdam (1637–1680) [5] and in 1673 by Malpighi (1628–1694), but it was Leeuwenhoek in 1695 who first illustrated red blood cells in his Arcana [6]. In the 190 letters that he wrote to the Royal Society in London over a period of 50 years, Leeuwenhoek gave descriptions and illustrations of bacteria from the human mouth, protozoa, spermatozoa, striations of skeletal muscles and epithelial cells from a wart on the trunk of an elephant in the Amsterdam Zoo [7–9].

Malpighi (1628–1694) a microscopist, histologist and embryologist, was the first person to see the anastomosis between arterial and venous capillaries [10]. His descriptions of the Malpighian bodies of the kidney, the Malpighian corpuscles of the spleen, and the Malpighian layer of the epidermis are known to every student of medicine [11].

Despite the countless people, including royalty, who paid tribute to early microscopists, the medical world, practicing clinicians, and academic physicians generally ignored or ridiculed them. The microscope was not appreciated as a useful scientific instrument by leaders in morbid anatomy such as Morgagni (1682–1771), John Hunter (1728–1793), and Mettew Baillie (1761–1823). The first atlas of pathology [12], written by Baillie and published in 1799, contains not even one microscopic illustration among more than 100 engravings.

Clinical microscopy had a slow beginning; more than two centuries passed before the value of microscopes began to be appreciated by clinical and laboratory scientists. In 1800, Bichat (1771–1802), a young pathologist, published a book in which, for the first time, morbid anatomic and histopathologic changes of various organs of the body were discussed and illustrated [13]. Soon thereafter the microscope became an indispensable laboratory tool at medical schools all around the world.

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Fig. 1.

This is the first illustration of the microscope in use for clinical examinations in medicine. The microscope designed by Joseph Campani of Bologna is standing on a table (in an enlarged form, left of the picture); and a hand-held microscope is shown in actual use to examine a wound on the leg of the recumbent patient. Note the woman who holds a candle and a mirror for optimal illumination. A second observer with a microscope (standing on the left) seems confused about whether he is using a microscope or a telescope. (Figure from page 372 of Acta Eruditorum, 1686, ref. [4]).