September 1, 1916] 



SCIENCE 



299 



has been found not guilty of most of the of- 

 fenses charged in the earlier indictments — 

 and part of the responsibility for gout must 

 be borne by as complete a chemical abstrac- 

 tion as tautomerism. But, by all odds, the 

 greatest progress in the field of pathology is 

 the widening recognition that in the future 

 the important advances must be made by the 

 chemical rather than by the histological route. 



These contributions of chemistry to the 

 science of medicine are for the most part dis- 

 tinctly modern. Far earlier were many of 

 those to the art. Paracelsus gave chemistry 

 a practical object as it emerged from the clouds 

 of alchemy when he declared that " the object 

 of chemistry is not to make gold, but to pre- 

 pare medicines." In England, to-day, the 

 drug store is the " Chemist's Shop," and those 

 are not lacking in this country to whom the 

 term chemist has a similar significance. Both 

 are the spontaneous acknowledgment of the 

 services of the chemist in supplying these tools 

 of the physician. For if Paracelsus, Francis- 

 cus Sylvius and their followers of the iatro- 

 chemical school failed in their effort to de- 

 velop chemistry simply as an adjunct to medi- 

 cine they planted the seed which through many 

 generations have brought forth Liebig's 

 chloral, Ehrlich's salvarsan and the host of 

 other synthetics which make up most of the 

 materia medica of to-day. 



The development in synthetic drugs which 

 has followed the recognition of a connection 

 between chemical structure and pharmacolog- 

 ical action is a fascinating story; less, pos- 

 sibly, on account of actual results than be- 

 cause of the tantalizing probabilities. But 

 with the establishment of the definite effects of 

 at least some configurations and a measure- 

 ment of the mutual influence of different radi- 

 cals have come practical results. Guided by 

 this information, old remedies have been im- 

 proved by blocking the groups responsible for 

 secondary effects or entirely replaced by better 

 ones constructed to specifications. At the 

 same time experimental pharmacology has 

 been stimulated with the result that the mod- 

 ern physician has at command, for producing 

 almost any desired effect, a variety of drugs 

 of great reliability. 



But internal therapy does not exhaust the 

 resources of treatment and if synthetic chem- 

 istry has done much for the former it has done 

 still more for surgery and the surgical special- 

 ties. Anesthesia and asepsis are the pillars of 

 these structures — and the stones of the pillars 

 are the synthetics ether, chloroform, iodoform. 



Strangely enough, diagnosis is the last 

 branch of medicine to which applied chemistry 

 has brought substantial benefit. To be sure 

 we have had for many years an attempt at 

 diagnosis by means of qualitative tests. 2 The 

 urinalysis consisting only of qualitative tests 

 for sugar and albumin is worth just as much 

 as the feel-your-pulse, see-your-tongue, give- 

 you-calomel variety of clinical diagnosis and 

 treatment — just as much and no more. The 

 essentials of progress may be a slow and steady 

 growth, but the results usually appear by spurts 

 and in response to some particular incentive. 

 In this case the impetus was furnished by 

 the new methods of blood. and urine analysis, 

 introduced by Folin and his co-workers-, which 

 in a short time have found such wide applica- 

 tion. Nitrogen partition in the urine and re- 

 tention in the blood ; urobilin index of erythro- 

 cyte destruction ; differentiation and prognosis 

 in renal and cardiac conditions ; sugar and ace- 

 tone elimination in diabetes; hydrogen ion 

 concentration of the blood in other conditions 

 of acidosis — these are but types of the appli- 

 cations of quantitative chemistry to clinical 

 diagnosis. Scarcely a month in which the 

 journals fail to report another. 



In this resume no claim is made to com- 

 pleteness — still less to originality — of data. 

 But it is hoped that from a somewhat pan- 

 oramic view there may be caught a concep- 

 tion of the truly basal relationship of chem- 

 istry to medicine. It is for this collective con- 

 cept that I bespeak the consideration which 

 it has received of few chemists and still fewer 

 physicians. To be sure, chemistry has long 

 occupied a more or less perfunctory position 

 in the curricula of medical colleges — becom- 



a "As long as only qualitative methods are used 

 in a branch of science, this can not rise to a higher 

 stage than the descriptive one. Our knowledge is 

 then very limited, although it may be very useful. ' ' 

 — Arrhenius. 



