A Century of Growth: A Century of Progress

Chemistry in the service of medical practice was relegated to the periphery of medical science until well into the nineteenth century. Biochemistry took shape near the close of the nineteenth century, when emphasis on living systems shifted from physiology to chemistry. The subsequent emergence of clinical chemistry in the opening years of the twentieth century, as the medical application of analytical biochemistry, was inevitable. During the latter part of the eighteenth and the early part of the nineteenth century, the study of chemistry in Great Britain at the university or hospital medical school was considered a branch of medicine, and the professor of medicine frequently held both chairs. Chemistry was becoming increasingly important in the education of the medical profession. At Guy’s Hospital Medical School in London, chemistry had been the first subject to be given up to a specialist by the clinicians. The crucial separation of chemistry from medicine—in spirit and doctrine—occurred when chemistry moved from the medical faculty to the philosophical faculty as an independent discipline (1).The discoveries of new substances in the healthy and diseased body and the development of organic and physiological chemistry spawned a wave of interest in clinical chemistry in the late 1830s and 1840s. There followed a systematic search for pathologic changes in the chemical composition of body fluids to guide medical diagnosis, follow the course of the disease, and control therapy. A search for chemical explanations for biological phenomena became a major preoccupation of leading scientists during the nineteenth century (1).Noel G. Coley (2) in this issue describes the development of clinical chemistry in Britain and work on the chemical composition of urine, urinary deposits, and calculi by the leading medical investigators there in the last half of the eighteenth century and the first half of the nineteenth …