132 



SCIENCE 



[N. S. Vol. LI. No. 1310 



In view of these facts and since there is 

 an increasing mimber of hospitals that are 

 coming to realize that the optimum treat- 

 ment for their patients depends not only in 

 having at hand the means of attaining all 

 possible data, but also that the hospital 

 should be the center for investigation, and 

 are adding to their staffs men specially trained 

 in biochemistry, it seems apropos to discuss 

 briefly some of the points these new alliances 

 are bringing up. 



The average physician dumps all chemists 

 into one class, leaving the biochemists un- 

 differentiated, considers them analysts and 

 mentally determines their status on the hos- 

 pital staff as one a little lower than the plant 

 engineer, but somewhat better than a nurse, 

 although lacking even a nurse's conception of 

 medicine. 



Somewhere, though just where I do not 

 recollect, I have read a discussion in which 

 the distinction was drawn between the types 

 of workers in chemistry. It was there 

 brought out that whereas a chemist is always 

 an analyst, an analyst need not necessarily be 

 a chemist, since a chemist is inherently a 

 thinker in chemistry. On the hospital staff 

 it is the chemist that is needed and it is the 

 chemical specialist, the biochemist, for just 

 as in the medical profession there are special- 

 ists devoted to certain types of disorders, so 

 have we of the chemical profession divided 

 ourselves according as our inclinations and 

 training have fitted us to pursue certain more 

 or less well defined lines of endeavor. The 

 efficient biochemist, however, must be not 

 only well founded in information and ability 

 to think in terms of all branches of chem- 

 istry, but he must also be familiarly ac- 

 quainted with the principles of physics and 

 general biology. This is merely the ground- 

 work and foundation, on it there must be 

 erected the superstructure of a knowledge of 

 morphology, physiology, bacteriology, pathol- 

 ogy and the phenomena of normal and dis- 

 turbed body functions. Only one with such 

 training can be of masimiim service in the 

 field of hospital activities. To a man so 

 equipped the opportunities for usefulness are 

 large, and the full utilization of his services 



can not but resut in benefit to patients and 

 science. 



The question of what and how much 

 routine analytical work should be placed on 

 the shoulders of the biochemist is one of im- 

 portance, and by routine analytical work is 

 meant the regular and systematic chemical 

 examination of every hospital patient. 

 Routine work, it is true, must and should 

 be done, for from such analyses it is possible 

 to follow the progress of disease and the 

 response to treatment. Moreover, it is from 

 the accumulated mass data carefully corre- 

 lated that the conclusions can be drawn lead- 

 ing to the understanding of fundamentals, 

 but routine blood and urine analyses can be 

 made by any skilled technician while it re- 

 quires the cooperative efforts of the clinician 

 and the medically trained biochemist to 

 interpret the results. I^ow the biochemist 

 being primarily trained for and adapted to 

 research should not have his time so taken 

 up with routine that he can give but meager 

 attention to the outlining and carrying on 

 of investigations. In fact I do not believe 

 that this work should be a part of the duties 

 of the biochemist, except in so far as the 

 results are directly applicable to a certain 

 specific problem, but that it should be done 

 by a technician, leaving the biochemist's time 

 for the investigatory cooperation essential for 

 progress. 



The fundamental purpose of the hospital is 

 the cure or relief of the patient, and it shotJd 

 be the aim of the biochemist as an integral 

 part of the institution to plan his work to 

 that end. He has two points of view that are 

 synchronous as to ultimate effect but differ- 

 ent in immediacy. The one line is intended 

 to throw light on the present condition and 

 progress of the patient under treatment; it is 

 individual. Correlated with this is the group 

 study of specific disturbance in various in- 

 dividuals with the aim of acquiring informa- 

 tion as to the general processes occurring in 

 the disorder. These are the immediate ob- 

 jects of study. In addition, he should have 

 in mind and as an object of his attention 

 investigations along the lines of basic phe- 

 nomena not connected with any individual 



