LIONEL SMITH BEALE (1828–1906) AND THE BEGINNINGS OF CLINICAL PATHOLOGY

Abstract

SPECIALTIES arise in medicine by the gradual accumulation of related tech- niques until a body of new methods and new knowledge is built up, which forms a convenient and satisfying occupation to which a man can devote the whole of, or a large part of, his time.It is in this way that the speciality of clinical pathology has arisen.For many years physicians and surgeons made observations on clinical pathology.The fur capped physician of the sixteenth century holding up a flask of urine for inspection has been a favourite subject for the artist.The phlebotomists of the eighteenth century observed their bowls of blood and noted the relative proportions of red clot, 'buffy coat' and serum.The great Richard Bright tested urine for protein by boiling it in a spoon over a candle flame.One instrument, however, more than any other played an important part in stimulating the growth ofclinical pathology-the microscope.Since its improve- ment in the seventeenth century this instrument had, in the hands of pioneer workers, added greatly to knowledge of anatomy and physiology, and with the improvements in optics in the early nineteenth century a great impetus was given to such studies.In the hands of men like Henle and Kolliker knowledge of the microscopic structure of man and animals rapidly advanced, and by the middle of the century the basic micro-anatomy of the body was accurately known.But it is with the use of the microscope in the everyday problems of diagnosis that the beginnings of modern clinical pathology are to be found.It was not until the last decade of the nineteenth century that laboratories for clinical pathology began to be founded even in the London teaching hospitals.However, some forty years before this a pioneer clinical pathologist set up a private laboratory and showed how the microscope could be used with profit in everyday medical practice.His name was Lionel Smith Beale.He was born in I828, the son of a London surgeon and educated at Kings College School.Whilst yet a schoolboy, aged only thirteen, he was apprenticed to a surgeon of Islington.His education appears to have been more liberal than might be supposed, and some six years later he matriculated at London University with honours in chemistry and zoology.Then followed two years' work at anatomy under Acland in Oxford and at the age of twenty-three he qualified and became resident physician to Kings College Hospital, at that time situated in Carey Street just south of Lincoln's Inn Fields.

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