Nanomedicine, Volume I: Basic Capabilities—A Review
by Robert A. Freitas, Jr.
ISBN 1-57059-645-X, Landes Bioscience: Georgetown,
Texas USA. 1999.
The term nanotechnology describes a variety of
nanoscale technologies. Molecular nanotechnology has been defined as
the three-dimensional positional control of molecular structure to
create materials and devices to molecular precision—the ability to
construct objects with atomic-scale control.
Molecular nanotechnology will usher in an
unprecedented era of dramatic progress in the way medical care is
provided. More than just an extension of "molecular medicine,"
nanomedicine will employ molecular machine systems to address
medical problems and will use molecular knowledge to maintain and
improve human health at the molecular scale. Nanomedicine will have
extraordinary and far-reaching implications for the medical
profession, for the definition of disease, and for the diagnosis and
treatment of medical conditions, including aging.
The hallmark of medicine up to the present time has
been the establishment of a delicate synergy between the tools of
the physician/surgeon and those of nature. In most cases, however,
one is forced to concede that we doctors have had to rely chiefly on
the body’s own self-repair capabilities. The best example, perhaps,
is the recognition that antibiotics will not perform their intended
function in the absence of an intact immune system.
The coming ability to carry out targeted medical
procedures at the molecular level will bring unprecedented power to
the practice of medicine, and promises to dominate medical
technology research in the coming decades as much or more than even
the Human Genome Project.
Nanomedicine, Volume I is the first book-length
technical discussion of the potential medical applications of
molecular nanotechnology and medical nanorobotics. It is meant to
help us to frame the research issues that must be addressed, and to
develop a knowledge base with which to proceed on the path toward
The author, Robert Freitas Jr., has degrees in
physics, psychology, and law, and has written on a diverse set of
scientific, engineering, and legal topics, including a NASA
feasibility analysis of self-replicating space factories. He later
authored the first detailed technical design study of a medical
nanorobot ever published in a refereed biomedical journal.
When completed, Nanomedicine will be a three-volume
technical work with 31 chapters. Its intended audience is technical
and professional people with a serious interest in the future of
medical technology. The three volumes build upon each other
cumulatively. Volume I, the subject of this review, describes basic
capabilities common to all medical nano-devices, and the physical,
chemical, thermo-dynamic, mechanical, and biological limits of such
devices. Its primary audience is physical scientists, chemists,
biochemists, and biomedical engineers engaged in basic research.
Volume II, 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 will
be systems and control engineers, research physiologists, clinical
laboratory analysts, biotechnologists, and biomedical engineers
doing applied research. The third volume will discuss the use of
nanomedical technology in clinical medicine. Its primary audience is
clinical specialists and clinician-scientists.
Volume I of Nanomedicine, Basic
Capabilities, begins with a comprehensive and thoughtful account
of the underpinnings of modern medicine. Chapter 1, The Prospect of
Nanomedicine, defines the field of nanomedicine and its objectives.
Several thought experiments are employed to help the reader develop
an intuitive appreciation of time, space, and mechanics in the
microworld, where nanorobots will be operating. The goals of our
current "molecular medicine" are carefully distinguished from the
goals of nanomedicine. The evolution of the concept of nanomedicine
and cell repair machines is discussed as the natural culmination of
several thousand years of medical discovery and innovation. The
chapter finishes with an overview of the entire three volume
Since nanomachines cannot yet be built, it is
important to establish that such devices are in fact feasible, and
that their design, fabrication, and operation violate no physical
laws and will obey sound engineering principles. Chapter 2, Pathways
to Nanomedicine, begins with a discussion of a number of classical
objections to nanotechnology such as quantum mechanics, which after
careful consideration, are resolved satisfactorily. Next, precursor
technologies to nanotechnology and nanomedicine, such as
micromachines/MEMS, telemicrosurgery, and tissue engineering, are
briefly considered. This is followed by an introduction to the
concept of molecular manufacturing. The chapter concludes with brief
descriptions of molecular machine parts, nanocomponents, and
Surgeons and other clinical specialists should have
little trouble in following the author’s discussion to this point.
These chapters, though, are followed by a necessarily terse and
detailed elaboration of the set of basic capabilities of molecular
machine systems that may be required by medical nanorobotic devices.
These latter chapters will be best appreciated by those in
biomedical engineering or the physical sciences. The capabilities
discussed 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 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
Many of the concepts presented by the author, if
not the underlying premise itself, atomic-scale control, are sure to
engender controversy. The implications for the future of medicine,
would be profound should the technical and theoretical underpinnings
of nanomedicine prove to be correct. Given the current pace of
development in nanotechnologies generally, the future of medicine
really does appear to be nothing short of awesome. Seen in this
context, Nanomedicine by Robert Freitas is a must read. It is the
authoritative roadmap to the future of medicine.