A note from history: the first biochemical test for detection of cancer.

The story of this epoch-making discovery as it unfolded in the 1840s has some similarity to a modern day clinical pathology conference. The place is the St. George’s Hospital in London and the participants are Dr. William MacIntyre (dates unknown), Dr. Henry Bence Jones (1814-1873), and Dr. John Dalrymple (1804-1852). A gravely ill patient of Dr. MacIntyre’s was admitted to the hospital with vague but uninterrupted pain in the chest, back, and pelvis. The patient could not stand or lift his arms without pain. He was afebrile and his pulse was regular. Dr. MacIntyre had no clue as to the nature of the disease, so he called Dr. Henry Bence Jones, a young physician on the hospital staff who had a reputation as a chemist, and asked him to test the patient’s urine. Bence Jones found a substance in the urine that was precipitated by addition of nitric acid. He noted that the precipitate was soluble in boiling water but reprecipitated after the urine was cooled. He informed Dr. MacIntrye about these peculiar findings and stated that the patient had “albumosuria.” Soon after the urine was tested, the patient died. Dr. Dalrymple, the pathologist, performed an autopsy and observed multiple hemorrhagic cavities in bones throughout the body. Reviewing the case, the three physicians realized its unique nature. Soon thereafter, in 1846, Dalrymple summarized the pertinent gross and microscopic postmortem findings [1]. After the publication of the pathologist’s paper, Bence Jones (Fig. 1) reported in 1847 his premortem findings in a short note in the Lancet. A year later, he published a definitive paper on his laboratory findings with a detailed description of the technique he had used to analyze the urine [2]. Following these publications, in 1850, Dr. MacIntyre decided to Address correspondence to: Steven I. Hajdu, M.D., 1759 Drumcliff Court, Westlake Village, CA 91361-1636, USA; tel 805 496 0691; fax 805 496 0620. Fig. 1. The bust of Henry Bence Jones that stands in St. George’s Hospital, London.