Medical chemists and the origins of clinical chemistry in Britain (circa 1750-1850).

In this history, I review developments leading toward the establishment of clinical chemistry in Britain. Chemical research by certain physicians occurred in the context of medical traditions founded on vitalism, distillation analysis, and limited chemical knowledge. Urine chemistry figured prominently in this period together with the analysis of kidney and bladder stones. Bright's team studying albuminuria was the first clinical research school in Britain, whereas Prout's survey of physiological chemistry, based on meticulous attention to analysis, was the best summary of human metabolism before Liebig's Animal Chemistry. Liebig's ideas influenced all physicians who were interested in chemistry. Henry Bence Jones based his medical practice on Liebig's theories. His research relating urinary phosphates to diet and exercise revealed the so-called Bence Jones proteins and investigated the distribution and persistence of drugs in the body. J.L.W. Thudichum used analytical skills learned from Liebig in his brain chemistry work. George Owen Rees investigated urine analysis and the relationship between urine and blood, using Liebig's practical methods while condemning an uncritical acceptance of his theories. These and similar studies showed that chemistry could improve clinical medicine, and because it could also reveal the onset of disease even before clinical symptoms developed, it offered valuable support to preventive medicine. However, so many physicians resisted the introduction of chemistry that progress toward the establishment of clinical chemistry in nineteenth-century Britain was slow.