will surface-harden t h e metal surface. S h o t peening is also useful t o p r e p a r e a surface for b e t t e r adherence of vitreous e n a m e l s because there is a uniform p a t t e r n of microscopic depressions a n d ridges t o i m p r o v e adherence. I n sand-blast clean ing of buildings recovery of t h e sand is difficult, a n d only c h e a p local sands are u s e d t h a t can be discarded after t h e i r o n e application. Sand-blast nozzles wear a w a y rapidly, a n d a wide v a r i e t y of m a terials is used for t h e i r cons! ruction— h a r d metals, rubber, even fired talc. I n block form talc is v e r y soft a n d can be easily machined and carved i n t o nozzles a n d similar e q u i p m e n t , but after firing a n d d e v e l o p m e n t of enst at ne the product is h a r d a n d abrasion-resistant. Selecting
and
Handling
Although the p r e p a r a t i o n of some a b r a sives comes within t h e realm of science, t h e i r use m a y be described a s a n a r t en t a i l i n g b o t h skill a n d j u d g m e n t . Certain o p e r a t i o n s , such as t h e diamond tooling, r e q u i r e highly trained, experienced workers w h o choose the abrasives with the greatest care a n d use them as t h e y would precision
i n s t r u m e n t s . T o employ a harsh, coarse abrasive for certain types of fine work is a b o u t a s sensible a s attempting to repair a d a i n t y w a t c h w i t h a 6-inch monkey wrench or rinsing a pair of precious nylons in dilute sulfuric a c i d — t h e results are a p t to b e equally disastrous. We can clean build ings or r o u g h stone with a blast of coarse, s h a r p s a n d a n d scour pots and pans with steel wool ; b u t in polishing silver, we m u s t employ s o m e material that will not scratch this relatively soft metal, and for m a i n t a i n ing t h a t dazzling smile, a t o o t h powder o r paste c o n t a i n i n g an even milder abrasive is required. R o u g h metal castings can b e dressed with t h e cheapest, forms of silica abrasives, b u t in cutting a n d polishing gems a n d drilling dies for drawing fine wire, high-priced diamond dust m u s t be used. Our u l t i m a t e victory in the late war w a s h a s t e n e d by a d e q u a t e supplies of m a n y abrasive m a t e r i a l s properly prepared a n d skillfully applied. Now that these faithful artisans h a v e been returned t o civilian i n dustries, t h e y h a v e plenty of j o b s ahead i n m a n u f a c t u r i n g peacetime products a n d helping t o repair t h e damage w r o u g h t d u r ing five y e a r s of systematic destruction.
Literature Cited (1) Beilby, G., "Aggregation a n d Flow of Solids", p. 256, New York, Macmillan Co., 1921. (2) Black, Archibald, Mech. Eng., 67, 192-3 (1945). (3) Bowles, Oliver, Mining Met., 26, 75-SO (1945). (4) Cady, E . L., Materials and Meih&dst 1058-63 (Oct. 1945). (5) Corbett, R. B., and Williams, A. J . , Bur. Mines, Rept. Investigations 3816 (1945). (6) Dasher, John, Fraas, F . , and Gabriel, Alton, Ibid., 3668 (1942). (7) Falconer, S. Α., and Crawford, B . D . , "Froth Flotation of Some Nonsulphide Minerals of Strategic I m portance", A.I.M.M.E., Tvch. Pub. 1754, 1-16 (1944). (Sj Hammond, R. P., Mining Tech., 10, 4, 1-5 (1946). (9) Metcalf, R. W., "Abrasive Materials i n 1945", chapter, of Bureau of Mines Minerals Yearbook, 1946. (10) Metcalf, R. W., Bureau of Mines, Information Circ. 7295 (1944). (11) O'Neill, L. J., Ibid., 7168 (1941). (12) Peters, F . P., Scientific American, S-IO (Jan. 1946). (13) Ralston, 0 . C , Bur. Mines, Rept. Investigations 3397 (1938). (14) Von Bernewitz, M. W., a n d Hess, Frank, Bur. Mines, Information Circ. 7107 (1940).
Some P r o b l e m s of Clinical Chemistry VICTOR C. M Y E R S
Cliainnaii of ACS Committee on Clinical Chemistry, School of Medicine, Western Reserve University, Cleveland 6, Ohio T ^ L I N I C A I , chemistry m a y be defined a s t h a t b r a n c h of b i o c h e m i s t r y which deals with t h e chemical changes occur ring in t h e b o d y in disease, a l t h o u g h p o p u l a r l y it is employed in a s o m e w h a t m o r e restricted sense to cover t h e utiliza t i o n of chemical m e t h o d s in t h e clinical l a b o r a t o r y as a n aid in t h e diagnosis a n d prognosis of disease. iZhemist9
s Part in
Medicine
a n d he w a s appointed professor of physio logical c h e m i s t r y a t Tubingen in 1864. I n 1858 while still a t the P a t h o l o g i c a l I n s t i t u t e he b r o u g h t out the first edition of his h a n d b o o k on physiological a n d pathological chemical analysis which w e n t t h r o u g h m a n y editions and w a s t h e bible of t h e l a b o r a t o r y of clinical biochemistry for 50 y e a r s . Despite the fact t h a t m a n y f u n d a m e n t a l facts had been learned a n d m a n y l a b o r a t o r y methods were available,
In the development of clinical c h e m i s t r y , or pathological c h e m i s t r y a s t h i s s u b j e c t w a s formerly called, individ uals t r a i n e d in both medicine a n d chem i s t r y h a v e played a n i m p o r t a n t role. However, the d e v e l o p m e n t of the labora t o r y m e t h o d s a n d t h e c o n d u c t of m o s t of t h e l a b o r a t o r y work has?· been largely in t h e h a n d s of chemists w i t h o u t formal m e d i c a l training;. Felix Iloppe-Scyler a n d C h r i s t i a n A. H e r t e r a r e two o u t s t a n d i n g exceptions who m i g h t be m e n t i o n e d . Felix Hoppc-Seyier is generally looked u p o n as t h e founder of biochemistry a n d t h e first chair in physiological chemistry in G e r m a n y w a s created for h i m . H e w a s a g r a d u a t e in medicine a n d began his career in 1S56 a s pathological a s s i s t a n t t o R u d o l p h Virchow a t t h e Pathological I n s t i t u t e iri Berlin. H i s interests g r a d u a l l y shifted more a n d more t o w a r d s chemistry, V O L U M E
2 4,
NO.
19
. . OCTOBER
10,
1946
chemical m e t h o d s did not reach t h e stage of being r o u t i n e procedures in t h e clinical laboratory in this c o u n t r y until t h e turn of t h e century. T h e g r o u n d work for the epocli-making a d v a n c e s which were t o occur i n clinical chemistry a p p e a r s t o h a v e b e e n laid in t h e decade 1900-10. T h e m a n who seems to h a v e first visualized t h e great possibilities of t h i s field was C h r i s t i a n A. H e r t e r , t h e n professor of pathological chemistry a t t h e College of Medicine of N e w York U n i v e r s i t y . I n his o w n pri v a t e research laboratory h e e m p h a s i z e d the i m p o r t a n c e of chemistry by securing t h e services of such distinguished bio chemists a s E . E . S m i t h , W a k e m a n , a n d finally D a k i n . Believing t h a t t h e future scientific d e v e l o p m e n t of medicine» rested largely in t h e h a n d s of c h e m i s t r y , H e r t e r , with J o h n J. Abel, f o u n d e d t h e Journal of Biological Chemistry in 1905. T h e critical survey of A m e r ~.an and C a n a d i a n medical schools by .rxoraham Flexner for t h e Carnegie F o u n d a t i o n for the A d v a n c e m e n t of Teaching w h i c h a p peared in 1910 p r o b a b l y f u r t h e r stimu lated t h e d e v e l o p m e n t of biochemistry along with o t h e r preclinical sciences. However, t h e g r e a t e s t s t i m u l u s t o t h e application of biochemical m e t h o d s i n t h e diagnosis a n d prognosis of disease resulted 2615
from the introduction, beginning about 1912, of iiumorous now-mothods for t h e chemical analysis of blood by Folin, S. R. Benedict, a n d D. D . Van Slyke in particular. I t was fortunate t h a t Van Slyke held a hospital post, since he w a s thereby able to carry m a n y of his studies to t h e final practical application in the clinic. Previous to the development of these clinical chemical methods, chemical procedures played a relatively minor role in t h e clinical laboratories of practically all hospitals in t h i s country. However, today no hospital laboratory i n the world can consider itself well equipped if it is unprepared t o do a very largo number of chemical détermina lions.
l e c t u r e a n d laboratory ο mrses in inor g a n i c , organic, analytic, and physical eheiriistiy, followed by a comprehensive c o u r s e in biochemistry a n d a practical c o u r s e in pathological or clinical chemis t r y . One cannot well t a k e these courses without a suitable background of biology, physics,, a n d mathematics. The mini m u m requirement for such work would h e t h e master's degree o r its equivalent. A s curly as 19IS the New York City B o a r d of H e a l t h and the New York S t a t e D e p a r t m e n t of Health began approving or licensing clinical laboratories. With t h e founding of the American oociety of Clinical Pathologists three years later, efforts began t o he made to raise t h e n a t i o n a l s t a n d a r d s of such laboratories. Personal qualifications of pathologists a n d clinical pathologists were still further r a i s e d wit h the organization of the Ameri c a n Board of Pathology i n 1933. While these steps have unquestionably r a i s e d the standards of t h e clinical labo r a t o r y in general, it would not appear that t h e y had improved the chemical work d o n e in these laboratories. As a m a t t e r of fact t h e various actions take'n b y t h e a b o v e groups have placed the chemist in s u b o r d i n a t e positions, and thus h a v e tentled to discourage competent men from entering o r remaining in the field of clini c a l chemistry.
Specialties of Cli η ica I Che mis t T h e clinical eheimst must be an ex pert in numerous chemical determinations on blood a n d u r i n e : he must be able to c a n y out various functional tests on the liver a n d kidney; he must be familiar with hormone assays; he m u s t be able to ap'ply techniques for the measurement of vitamin activities; he must understand the détermination and interpretation of methods for evaluation of acid-base, balance a n d water balance; h e must be sufficiently well informed t o act as a chemical consultant on medical, nutriCompetent tional, a n d toxicological problems; he Uteri S'vetlvd should be able to spot anomalous chemical disturbances a n d conduct both colIt can h a r d l y be denied that the trends laborative a n d independent research. of t h e last 25 t o 30 years will continue t o s h a p e the conduct of t h e chemical work We may inquire how this large volume i n clinical laboratories unless some new of chemical work is being conducted in a n d quite radical steps are taken. T h e t h e hospital laboratory at the present time. A M E R I C A N C H E M I C A L SOCIETY has a l w a y s Who actually does this work a nil who recognized its responsibility in the interest supervises it and what sort of chemical o f public health to see t h a t high s t a n d a r d s training have these individuals had? One o f chemical work were maintained i n clini might e x p e c t ' t h a t with the much higher c a l laboratories. I n J u n e of 1924 it standards in medical education that folentered into a n d a d o p t e d a joint agree lowed the Floxner report, m a n y medical m e n t with the American Medical Associa graduates would have, been prepared for t i o n and t h e American Association of a n d attracted t o the field of clinical Pathologists a n d Bacteriologists. I n prin chemistry. This has been t r u e from t h e c i p l e this agreement stated t h a t whereas standpoint of medical research and a t h e diagnosis and treatment of disease l i r g e number of internists a n d pediatriw e r e the province of t h e licensed physi cians have employed biochemical methods c i a n , no objection should be raised to t h e a s their chief research tools. However, securing of factual laboratory d a t a b y clinical chemistry has, with very few individuals judged competent b y their exceptions, been a means t o an end but o w n profession so long a s such individuals not an end in itself. In other words, these refrained from all diagnostic a n d prog individuals have h a d little t o do with t h e nostic interpretations of the results of such routine practical application of this work laboratory d a t a ; and t h a t a n y effort t o a n d therefore h a v e not m a d e clinical force such individuals t o place themselves chemistry their profession. Unforu n d e r t h e direction of a representative of tunately in m a n y laboratories this work a n y other profession was to be deprecated, would appear to have been left largely in loiter, when this concept was n o longer t h e hands of technicians w i t h o u t either adhered to, t h e Board of Directors of t h e a d e q u a t e chemical training or comAMERICAN C H E M I C A L S O C I E T Y a p p o i n t e d a p e t e n t chemical supervision. special C o m m i t t e e on the Service of Realizing this trend, I commented in 192S in a p a p e r written for a n Α Μ Α - Chemistry t o Medicine, of which Vincent d u Vigneaud was chairman. This com sponsored demonstration o n clinical bio mittee worked long a n d hard a n d w a s chemical m e t h o d s and published in t h e a b l e to o b t a i n agreement with the medical Journal of the American Medical As group o n all except one very crucial point sociation in p a r t a s follows: —namely, t h e direction of clinical labora A biochemist competent t o take charge tories. The American Society of Clinical of hospital work should h a v e taken both 2616
CHEMICAL
Pathologists h a s been unwilling to con cede that a clinical laboratory can bo d i rected by anyone without a medical d e gree. Cooperation
for Higher
Standards
In 1942, du Vigneaud w a s invited to discuss the problem of " T h e Relationship of t h e Chemist to Medicine", and did so in a paper which he presented at t h e Annual Congress on Medical Education and Licensure of the ΑΛΙΑ. H e dis cussed the whole question frankly, point ing out that with full cooperation between the chemical and medical professions much higher technical standards were possible. The chemist felt, however, t h a t there should be no restrictions imposed on a competent clincial chemist's accepting material, doing chemical work, and re porting directly to the physician. Other wise, the medical profession would be u n able to secure the services of competent chemists. So'eondary positions would a t tract only secondary men, i n which case not only medicine but also the patient would suffer. l i e stated further that t h e AMERICAN
CHEMICAL
SOCIETY
was
pre
pared to help by working out a system of certification to be done in full coopera tion with the American Medical Associa tion and related groups. Steps in this direction would no doubt have been taken had not t h e war intervened at this stage of t h e discussions. Certification
by ACS
What steps can the AMERICAN C H E M I
CAL SOCIETY take to bring a b o u t the cer tificat ion of candidates qualified in clini cal chemistry? ACS members w h o are serving a s clinical chemists can be advised that it will be in their own inter est t o prepare themselves for certification, and hospital and other laboratories em ploying clinical chemists c a n be notified that after a certain date t h e individuals responsible for the work in clinical chemistry should be certified by the AMERICAN
(!HK.MJI\\L
SOCIETY,
if
their
laboratory is t o be placed on the approved list of the AMEIUCAN C H E M I C A L SOCIETY.
The fundamental reasons for certifica tion are twofold—namely, to raise the standards of chemical work in t h e clinical laboratory a n d t o elevate the .standing of t h e clinical chemist so t h a t competent men will be a t t r a c t e d t o this field. I t cannot be denied, I think, that eco nomic factors have played a major role in shaping t h e unsatisfactory status of the clinical chemist. It would appear that the medical graduates who have had the requisite chemical training have infre quently been a t t r a c t e d to this field, ap parently because of greater financial op portunities in other specialties of medi cine. Likewise, the financial remunera tion has been inadequate t o attract thor oughly competent chemists to this* field except i n a few of t h e largest hospitals AND
ENGINEERING
NEWS
.•nul clinics. Furthermore, (here arc many hospital laboratories in charge of thor o u g h ^ competent histopnthologists who a d m i t t e d l y know little about clinical chemistry b u t still direct this work with the aid of empirically trained chemical technicians Although the help of tech nicians in a hospital laboratory is almost indispensable, such help is positively dangerous unless t h e work i s done under the direct supervision of some one with competent chemical training, at least equivalent t o . that of a certified asso ciate clinical chemist to b e mentioned pres ently. T h e certification
of clinical chemists
by t h e A M K R I C A X C H E M I C A L SOCIETY will,
I a m confident, receive t h e hearty support of the American Board of Pathology since certification will greatly aid them in the selection of qualified clinical chemists. When this s t e p has been taken and a con siderable n u m b e r of thoroughly competent clinical chemists have been certified, the chemist will be in a much stronger position t o discuss some of t h e vital ques tions dealing with the chemists' welfare in the clinical laboratory. In the p a s t , I believe that the majority of m e m b e r s of the AMERICAN
CHEMICAL
SOCIETY h a v e felt that neither licensing nor certification of the chemist was neces sary. It would appear that the clinical chemist in comparison with the clinical pathologist is handicapped at the present
time in not being certified o r eligible .for certificat ion. Theoret ically , cert ificat ion should improve the status o f t h e clinical chemist if -/c-liemists and laboratories can b e induced t o cooperate* in this step. It should be realized, however, that this objective cannot be attained without con siderable effort. T h e American Board of P a t h o l o g y has been prepared for some time t o certify medical g r a d u a t e s in the fkdd of clinical chemistry, b u t as now constituted cannot certify individuals not holding the M . D . degrreo. Other clinical chem ists would need to b e certified b y an examining; board appointed toy t h e AMERI CAN CmcMicAL· SOCIETY in cooperation with other societies, including t h e medical group. Certification
in Two ilwxtps
T o accomplish the most g o o d il seems desirable to u s that clinical chemists should be certified in two groups: (I) clinical chemists and (2) associate clinical chemists. While it was felt that certi fication should depend o n competence and training it did not seem Unit this could be divorced from degree requirements. T h e following requirements are sug gested: 1. as a hold from have
Clinical Chemist. T o b e certified clinical chemist a n individual should the P h . D . , D . S c , or M . D . degree an approved institution, a n d should had sound training i n analytical,
organic, physical, and I i lo ical chemistry. This should be followed by t w o years' training in an approved hospital labora tory or by association w i t h ' a competent clinical chemist of long experience. 2. Associate Clinical Chemist. T o be certified as a junior clinical chemist an individual should hold t h e degree B.S. or Β.Λ. in chemistry from a n institu tion approved by t h e AMERICAN CHEMICAL
SOCIETY and have had training in ana lytic, organic, physical, a n d liological chemistry, plus one year's training under a competent clinical chemist. Examinations. Written a n d oral exami nations would be held a t t h e time and place of t h e meetings of t h e AMERICAN C H E M I C A L SOCIETY
at
the
discretion of
the examining board. T h e AMERICAN C H E M I C A L SOCIETY has
two prime interests in t h e clinical chemist: (1) t h e maintenance of the highest s t a n d a r d s of chemical work in the clinical laboratory i n t h e interest of the public health, a n d (2) t h e protection of the rights of t h e chemist t o practice his own profession in his special field under satisfactory financial conditions. In t h e foregoing I have endeavored to indicate t h e reasons for a n d probable ad vantages of certification t o t h e clinical chemist. However, I feel certain that the A M E R I C A N C H E M I C A L S O C I E T Y would
not wish to inaugurate such a program unless it would receive t h e approval and loyal support of the chemists who would be involved. I t would be helpful if we could have t h e reaction of clinical chemists on these m a t t e r s .
How Now Chemical Patents? WILLI\Μ
Κ. D \Y, Resident Patent Counsel, Wyandotle Chemicals Corp., Wyandotte, Mich. I T IS a fair statement t o miiko that nearly every modern speaker o r author expound ing the subject of pak'nts and the United States patent systoin prefaces his remarks o n Article I, Suction S of the I n i t o d States Constitution. For the sake of a slight variety, I have searched for a different preface to m j remarks today. T h e import of my text m i g h t not be as revealing as t h e constitutional reference, hut i t should b e paramount i n dignity and jurisdiction. I n brief, my text today is from the Holy Bible, being; taken from Ecclesiastcs, chapter V I I , verse 2 9 : God hath made man upright, b u t they have sought o u t m a n y inventions. Here then is good authority for the proposition t h a t man h a s , from antiquity, been searching for something b e t t e r . It is
V O L U M E
2 4, N O . 1 9 » « O C T O B E R
10, 1 9 4 6
also a fair interpretation of the above Bib lical quotation that, come what may, we are inevitably U e confronted with inven tors a n d inventions. Now, frankly, I d o not profess to know what was attempted to be done a b o u t this situation in those territorial jurisdictions whence o u r Biblical statement must have had i t s origin. J η t h e jurisdiction of the United States, its territories a n d posses sions, we have determined to encourage the inventor through t h e mechanism of our p a t e n t reward system. President Roosevelt's National P a t e n t . Planning Coin mission, after studying t h a t system for about a year and a half, came up with the profound conclusion t h a t it was "the best, in the world ( / ) . Whether i t is mere coincidence or not, I leave u p t o y o u ; b u t man's efforts to change his status of simply 2617
