1.

1 INTRODUCTION AND HISTORY OF HEMATOLOGY

INTRODUCTION TO HEMATOLOGY
HEMATOLOGY: study of blood
o hema-: blood
o -ology: study of
 It is the scientific study of the structure and
functions of blood in health and in disease
o Structure: basic composition
o Function: emphasize its significance
in health and diseases
 Learn what blood components are and
how much of each component is
normally present in healthy individuals
 Study the pathologic changes that will be
observed in these components in the
presence of diseases
o Kidneys
o Liver
o Heart
 Blood supplies these organs with oxygen and
other essential substances that they may
need for their respective functions.
 Abnormalities in the blood flow within these
organs may also lead to diseases.
 In order to detect the presence of such
diseases, we collect and test blood
samples.
SCOPE OF HEMATOLOGY
1. Origin and development of the various
components of blood.

IMPORTANCE OF BLOOD
 Blood as a tissue is the most studied and
most routinely tested in the clinical
laboratory due to the following reasons:
1. It is easy to collect.
 Compared to other tissues which
will require a more complex
procedure.
1  The collection of samples is Module 1: Introduction and History of Hematology
relatively fast as well.
 May be able to collect large
volumes of this sample if required.
2. It is a tissue that is still “alive”.
 Considered as alive since it is  Where did these blood cells come
capable of surviving outside of the from?
body.  How do they develop from their
 This samples may give us an idea immature form up to their mature
what specifically happens inside forms?
our body.  Throughout the process, what are the
 It tells us about the specific specific changes in terms of their
changes that might have taken morphology?
place which might have caused  Are there changes in their color?
the development of diseases.  Are there changes in terms of the
3. It provides a wide spectrum of different presence or absence of their nucleus?
cells with their own structure, function.
 Through this sample, we may be 2. Structure of the various components of
able to observe any form of blood
abnormality in terms of structure or
function among cells which is 3. Functions of the various components of
important in order to determine the blood to correctly interpret causes of
specific cause of different diseases
conditions.  Any abnormalities in either structure or
4. It forms an integral part of all other function are some of the possible causes
body tissues. of hematologic disorders.
 Normal blood flow within these
tissues or organs is essential for 4. Regulation of levels of the various
them to function properly. components of blood

Capulong. Juangco.quintos.sarmiento.Soliman.
  In the absence of disease, what should be Loss of blood Weakness
their concentration in the blood? o If lost blood has been replenished or
 In the presence of hematologic disorders restored then the overall health and
such as anemia and leukemia, what strength becomes restored as well.
happens to their concentration? Do they Blood loss replenished Health
become elevated or decrease? & Strength
o However, there were instances where loss
5. Normal variations of blood components: of blood is extreme and such cases often
o male vs. female became fatal
 RBC count is normally higher than Excessive blood loss Death
males as compared to females
o old vs. young Because of these interesting properties that
 RBC count is expected to be higher these people observed, then they started to
among newborns as compared to study blood and diseases and there are
adults certain individuals who created their own
o well-fed vs nutritionally deficient theories as to what causes such diseases.
 Example is individuals with iron
(needed in the synthesis of red 1. HIPPOCRATES
blood cells) deficiency, the RBC  Father of Medicine
level of these patients is expected  Four Humors of the
to be lower as compared to those Body: considered by
with sufficient iron. Hippocrates at that
o physiologic vs pathologic conditions time as the major body
fluids
 Patients with pathologic conditions
o Blood
such as malignancies, would have
different blood counts as well as o Phlegm
cellular morphology compared to o Black bile
those who are free of disease. o Yellow bile
2 Module 1:
 Balance and
Introduction = History of Hematology
Health:
 These variations may be quantitative
which means that the difference is balance among all
primarily on the blood levels of the these fluids is
component. responsible for a
person’s good health
6. Understanding the hemostatic mechanism  Imbalance = Diseases:
 Hemostasis: stasis or stoppage of blood imbalance which may be caused by
flow which is needed when vascular injury either excessive or insufficient levels of
or excessive bleeding occurs. any of these four would lead to
 Stoppage of blood flow during bleeding is diseases
achieved through these blood
 Although this are not the exact
components:
concepts that we apply now, this
o Blood vessels
theory of Hippocrates already
o Platelets
acknowledges the fact that
o Plasma proteins
abnormalities in body fluids including
abnormalities in blood would cause
HISTORY OF HEMATOLOGY diseases.
Why did several individuals before began to
study blood? 2. ARISTOTLE
 People became curious about blood  Concept of Concoction or Cooking to
because of its supposedly mysterious explain how blood is formed.
properties. He said that the food we
ingest is cooked in our
MYSTERIOUS PROPERTIES OF BLOOD stomach because of the heat
o Observed that individuals who lost blood inside our body. Then vapors
because of certain injuries developed would be released as this food
weakness. is being cooked inside; such
vapors will travel towards the

Capulong. Juangco.quintos.sarmiento.Soliman.
 heart and in here it will be formed into blood.
This blood will then move into different parts
of the body and the nutrients present in the
blood as this happens.
1. Food in the stomach is “cooked”
This process he referred to is actually
digestion. But this food is not necessarily
cooked inside the body (incorrect notion
about food.)
2. Vapor reaches the heart
3. Vapors are formed into blood
*The first three statements are not accurate.
4. Blood moved and nutrients are
transported
Last statement is actually correct. Blood is
not formed from the vapors of cooked
food but it is circulated throughout the
body and this transports different nutrients
as this occurs. Therefore, his theory is still
accepted.
3. ERASISTRATUS
 His theory also involves food digestion.
 He believed in the concept of
“Plethora”
o Plethora: excessive blood and
this will be produced due to
3 undigested food. Module 1: Introduction and History of Hematology
 This ultimately cause
diseases among humans.
 Starvation: the only way to cure
diseases caused by plethora is by
starving the patients.
o Not recommended form of cure
or treatment during our time.
Although it is true that indigestion may
cause discomfort to us, this is not the
ultimate cause of all diseases as what is
believed by Erasistratus and it does not
necessarily cause the formation of blood
inside the body.
4. CLAUDIUS GALEN
 Description of the
circulatory system
and blood.
 He had his own theory
regarding blood
circulation.
1. According to him the products of
digestion which is actually the nutrients
that we obtain from food inside the
stomach are actually carried by the veins
to the liver.
2. In the liver, these nutrients will be
converted into blood. This blood will then
enter the right side of the heart.
3. Some of the blood inside the heart will be
mixed in the air that is obtained from the
lungs through the pulmonary vein.
4. After mixing with air from the lungs, this
blood will be distributed in the body
through the arteries and these arteries are
also the ones which will transport this
blood back to the heart.
Nutrients: Products of digestion
(from the stomach)
1. v
e
Converted into blood
(in the liver)
2. Enter
s via
right
Mixed with air
Air is from lungs via pulmonary vein
(in the Heart)
4. a 3. a
r r
Distributed to the body
 This one of the first description about
blood circulation. However, this is also
erroneous since:
o Blood is formed in the bone marrow
and not in the liver
o Blood does not necessarily mix with
air in the heart but rather it
undergoes a process called
oxygenation when it reaches the
lungs
o After being circulated in different
tissues, it is the vein which transport
this blood back to the heart and
not the arteries.
5. MARCELLO MALPIGHI
 Description of Capillaries
 He hypothesized that capillaries
connected the arteries with the veins.
Capulong. Juangco.quintos.sarmiento.Soliman.
 6. ANTON VAN LEEUWENHOEK 9. PAUL EHRLICH
 Demonstration of  Invented a staining technique for our
Capillaries cells
o Demonstrates the o allowed him to identify and
circulation inside distinguish the five types of
the capillaries leukocytes since stain emphasize
 He demonstrated how their difference in terms of their
capillaries connected morphology.
the two blood vessels (arteries and  Discovered the different types of white
veins) through his findings based on his blood cells with the use of dyes
study of a small transparent eel with his
microscope. 10. ROMANOWSKY
 Used a stain which combined oxidized
methylene blue (basic dye) and eosin
(acidic dye).
o Used these dyes in order to stain
both the acidic and the basic
components of a cell
 Also developed his own stain which is
called as “Romanowsky stain”
o Routinely used in the clinical
laboratories for staining of cells or
blood smears

 This demonstration was able to further 11. KARL LUDWIG

establish Malpighi’s initial hypothesis. 
 This is considered to be true until now.  Established that oxygen
was absorbed during
4 Module 1: Introduction
breathing andandtaken
Historyinofby
Hematology
DISCOVERY OF BLOOD CELLS
the red coloring matter in
7. JAN SWAMMERDAM the blood to the tissues
 He was the first to o Hemoglobin: red
discover and observe coloring matter
red blood cells under the  However, during this time only few
microscope. information about this protein was
available.
 Leeuwenhoek: He was  He also noted that hemoglobin
the first to describe RBCs. release oxygen as blood passed to
He was able to give a different tissues.
detailed description and  This theory is actually correct.
illustration of RBCs with
regards to their specific 12. MAX PERUTZ
size and specific shape.  He was able to give a detailed
description about the red coloring
8. WILLIAM HEWSON matter observed by Ludwig
 First noted the existence of white  Contributed much to the
blood cells. understanding of the structure and
 He described them as “colorless cells” function of hemoglobin inside the
 He was not able to differentiate the RBCs
different types of white blood cells  Received a Nobel Prize
because stains were not used during
his observations.
o Stains: needed to easily distinguish
the different types of WBCs

Capulong. Juangco.quintos.sarmiento.Soliman.
 SUMMARY OF THE HISTORY OF HEMATOLOGY

Hippocrates Four humors of the body

Related to hematology since
one of the four humors is
blood.
Aristotle Concoction or cooking
Cooking of food  produce
vapors  vapors to blood
Erasistratus Plethora and starvation
Diseases is due to  blood
(plethora) due to indigestion
and starvation is the cure
Galen Circulatory System
Blood is produced in liver 
heart  diff. organs w/n body
He was also able to describe
the function of veins and
arteries which is to transport
blood
Malpighi Discover that capillaries
connect arteries and
veins
Leeuwenhoek Demonstrate that
capillaries connecting
the arteries and veins
Swammerdam First discovery of blood
cells
5 Specifically, RBCs. Module 1: Introduction and History of Hematology
Leeuwenhoek: detailed
description of RBCs
Hewson Existence of WBCs
Ehrlich Different types of WBCs
Discovered his own staining
technique
Romanowsky Mixtures of acidic (eosin)
and basic (methylene
blue) dyes
Established stain that we
currently used for blood
smears staining
Ludwig Oxygen was taken in by
the red coloring matter
in the blood
Hemoglobin: red coloring
matter
Perutz Structure and function of
hemoglobin

Capulong. Juangco.quintos.sarmiento.Soliman.