So-called Darwinism was originally proposed in 1859 to elucidate the diversity of living organisms. This concept, however, was soon introduced to explain the vicissitudes of other various phenomena in many different fields. In this paper, the developing processes of medical devices have been discussed from the standpoint of Darwinism and concluded as follows. Many important medical devices, e.g. pump-oxygenators for open heart surgery, assist-circulation systems including IABP and ECMO, cardiac assist devices and incubators for prematures have their own progenitors and such devices were all the products of evolution in medicine. On the contrary, artificial pneumothorax apparatuses lost the role as a counter-measure for phthisical lungs and suddenly disappeared about 40 years ago. It was an example of typical extinction resulted from natural selection as a process in evolution. The first shadowless design of surgical lightening was realized in early 20th century and almost at the same time the oil-pressure mechanism was introduced in the surgical tables. These incidents meant the evolution of such devices. But thereafter, any evolution has not occured again in those instruments during past 80 years, although many remarkable improvements have been achieved. From these experiences in this century, it was also pointed out that denying or converting the accepted concepts at present will contribute as the most important driving power to create and develop new medical devices in coming 21st century.
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