© 1999 Robert A. Freitas Jr. All Rights Reserved.

Robert A. Freitas Jr., Nanomedicine, Volume I: Basic Capabilities, Landes Bioscience, Georgetown, TX, 1999

1.4 Background and Brief Overview of This Book

The publication of Nanosystems¹⁰ in 1992 laid a strong technical foundation for the field of molecular manufacturing. Such technology was already known to have major implications for medicine.^8,9 Still lacking, however, was an overview and synthesis of the interactions between molecular machine systems and living systems, particularly human living systems.

With Nanosystems as the intellectual cornerstone, research on Nanomedicine, originally intended to be a single volume, began in 1994. It quickly became clear that the field of nanomedicine would be even more interdisciplinary than molecular manufacturing, in part because of the many essential interfaces between mechanical nanosystems and living systems. This realization prompted ramification of the book into multiple volumes, allowing the field to be defined from diverse technical orientations. Additionally, the need to consider all major aspects of nanomedical device design and operations demanded a substantial increase in the intended length of the work, a regrettable but necessary circumstance for which the author apologizes in advance.

As a result, Nanomedicine has become a three-volume technical work with 31 chapters. Its intended audience is technical and professional people who are seriously interested in the future of medical technology. The three Volumes build upon each other cumulatively. The first Volume, now complete, describes basic capabilities common to all medical nanodevices, and the physical, chemical, thermodynamic, mechanical, and biological limits of such devices. Its primary audience is physical scientists, chemists, biochemists, and biomedical engineers engaged in basic research. The second Volume, still in progress, deals with aspects of device control and configuration, biocompatibility and safety issues, and basic nanomedical components and simple systems. Its primary audience is systems and control engineers, research physiologists, clinical laboratory analysts, biotechnologists, and biomedical engineers doing applied research. The third Volume, also in progress, discusses specific treatments for specific conditions and injuries, using nanomedical technology in the context of clinical (e.g. doctor-patient) situations. Its primary audience is clinical specialists and research physicians, and interested general practitioners.

The first molecular assemblers (Chapter 2) may be able to build only very simple nanomechanical systems, possibly only from very highly ordered substrates with significant rate-limiting intermediate steps, and only in very small numbers, so the earliest functional nanomachines may be laboratory curiosities. As assembler technology slowly improves, progressively more complex and capable nanomachines will be manufactured in vastly larger numbers. This book primarily investigates the rational design and operation of these more complex and capable nanomachines, and assumes that cubic centimeter quantities (e.g. ~10¹² micron-sized nanorobots) will not be unreasonably expensive to manufacture (Section 2.4.2) and thus can be therapeutically deployed routinely by future doctors.

Volume I of Nanomedicine, Basic Capabilities, describes the set of basic capabilities of molecular machine systems that may be required by many, if not most, medical nanorobotic devices. These include the abilities to recognize, sort and transport important molecules (Chapter 3); sense the environment (Chapter 4); alter shape or surface texture (Chapter 5); generate onboard energy to power effective robotic functions (Chapter 6); communicate with doctors, patients, and other nanorobots (Chapter 7); navigate throughout the human body, i.e. determining somatographic or cytographic location within vessels, organs, tissues, or cells (Chapter 8); manipulate microscopic objects and move about inside a human body (Chapter 9); and timekeep, perform computations, disable living cells and viruses, and operate at various pressures and temperatures (Chapter 10).

Volume II of Nanomedicine, Systems and Operations, considers system-level technical requirements in the design and operation of medical nanodevices. Part 1 describes aspects of nanomedical operations and configurations, including scaling factors and general design principles (Chapter 11); control issues including teleoperation and haptic controllers, swarm motions, autogenous control systems, and various operational protocols (Chapter 12); repair, replacement, and reliability issues (Chapter 13); and molecular machine systems design issues such as tradeoffs between special-purpose and general purpose architectures, and deployment configurations such as nano-organs, medical utility fogs, and replicators (Chapter 14). Part 2 deals with a multitude of issues involving clinical safety and performance, specifically medical nanorobot biocompatibility including immunoreactivity and thrombogenicity (Chapter 15); methods of nanorobotic ingress and egress from the human body (Chapter 16); and possible nanodevice failure modes, environmental interactions, side effects of nanomedical treatments, iatrogenic factors, nanodevice software bugs, and other safety issues (Chapter 17). Part 3 summarizes various classes of medical nanosystems, including instruments, tools, and diagnostic systems (Chapter 18); specific medical nanorobot devices (Chapter 19); rapid mechanical reading and editing of chromatin and protein macromolecules (Chapter 20); and various complex nanorobotic systems that will make possible advanced cytopathology and cell repair, tissue and organ manufacturing, and personal defensive systems (Chapter 21).

Volume III of Nanomedicine, Applications, describes the full range of nanomedical applications which employ molecular nanotechnology inside the human body, from the perspective of a future practitioner in an era of widely available nanomedicine. Proof-of-concept designs for whole nanodevices, artificial nano-organs, and nanomedical treatments include rapid cardiovascular repair (Chapter 22); treatments for pathogenic disease and cancer, with epidemiological considerations (Chapter 23); responses to various physical traumas, burns and radiation exposures, and new methods of first aid, surgery, and emergency or critical care (Chapter 24); neurography, spinal restoration and brain repair (Chapter 25); improved nutrition and digestion (Chapter 26); sex, reproduction, and population issues (Chapter 27); cosmetics, recreation, veterinary and space medicine (Chapter 28); the control of aging processes, eliminating most causes of death prevalent in the 20th century, and strategies for biostasis (Chapter 29); and human augmentation systems (Chapter 30). The Volume concludes with a discussion of the sociology of nanomedicine, regulatory issues, nanotechnology implementation timelines, and some speculations on the future of hospitals, pharmaceutical companies, and the medical profession (Chapter 31).

Last updated on 5 February 2003