Kaiser: Clinical Chemistry in Austria
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Eur. J. Clin. Chem. Clin. Biochem.
Vol. 32, 1994, pp. 579-582
© 1994 Walter de Gruyter & Co.
Berlin · New York
Clinical Chemistry in Austria
Fast — Present — Future
Reflections on the Occasion of the
25th Anniversary of the Austrian Society for Clinical Chemistry
By E. Kaiser
Medizinisch-Chemisches Institut der Universität Wien, Wien, Austria
(Received November 10, 1993/April 26, 1994)
Twenty-five years ago, on December 12, 1968 the inauguration ceremony of the Austrian Society for Clinical
Chemistry took place in the lecture hall of the Ist Department of Medicine in Vienna. The founding president, Theodor Leipert (1902-1992), explained the
necessity for establishing the society and outlined its
Programme. F. W. Schmidt (Hannover) gave a seminar
on: "Klinische Chemie: Arbeitsrichtung oder Berufsbild" (Clinical Chemistry: a field of activity or a
profession) (1). The 25th anniversary of this historical
event provides an appropriate opportunity to reflect on
the development of clinical chemistry and läboratory
medicine in Austria, to report ön the work of the society
during the past 25 years and to glance at existing problems which have to be solved in the future.
It is generally accepted that clinical chernistry in Austria
originated from the wörk of Johann Florian Heller
(1813-1871) (2-5). He established a läboratory for
chemical analysis of sämples obtained from patients
treated in the General Hospital in Vienna. Heller's merits and his efforts to have his läboratory acknowledged
have been reviewed extensively, Hellem was a highly
motivated chemist whp developed a series of tests for
urine analysis. The best knowji test developed by Heller
was his ring test for the detection of albumin in ürine,
by the addition of nitric acid (6). When Johann Franz
Simon (1807 -1843), the first editor of the German Journal "Archiv für die Physiologie und Pathologische
Chemie und Mikroskopie" died in 1843, Heller became
editor of the Journal, which due to many difficulties was
discontinued in 1854. Vienna's renowned pathologist
Carl v. Rokitansky (1804-1878) emphasized the imEur. J. Clin. Chem. Clin. Biochem. / Vol. 32,1994 / No. 8
portance of chernistry in pathological research (7) and
supported Heller's work. The importance of chemical
analyses for research and diagnostic purpose was generally recognized by several members of the medical faculty in Vienna. As a result, the creation of a separate
Institute of Applied Medical Chemistry (Institut für Angewandte Medizinische Chemie) was discussed extensively. When Heller died in 1871, the famous surgeon,
Theodor Billroth (1829-1894), tried to persuade Felix
Hoppe-Seyler (1825 — 1895) to become professor and
chairman for this Institute. However, Hoppe-Seyler was
not willing to come to Vienna, and Ernst Ludwig
(1842—1915), a chemist, was fmally appointed (8). Ludwig's scientific interest was devoted to the chemical
analysis of mineral waters and to topics related to clinical chernistry. His successors (Julius v. Mauthner (9),
Ernst Fischer (1881-1945), Emil Fromm (10), Otto v.
Fürth (1867-1938), Hermann Karl Barrenscheen
(1887-1958), Fritz Wessely (1897-1967), Franz Seelich (1902—1985)) were also avidly involved in research
in the field of clinical chernistry. In 1972 Erich Kaiser
(1925) was appointed Professor of Clinical Biochemistry. Since 1973 he has been füll professor of Medical
Chemistry and chairman of the Institute. O. v. Fi/ri/i's
mpnograph "Lehrbuch der physiologischen und pathologischen Chemie" (11) and Barrenscheen^ textbook "Laboratoriumsmethoden der Wiener Kliniken" (12) are
good examples of early publications devoted to clinical
chemistry and läboratory medicine.
At the University of Graz, an Institute of Medical Chemistry was established in 1879. Its first chairman, Karl
Berthold Hofmann (1842-1922), is known äs the editor
580
of a "Lehrbuch der Zoochemie" (13) containing Information relevant to clinical chemistry. His successor was
Fritz Pregl (1869-1930) a medical doctor who laid the
foundation of modern clinical chemical analysis by his
pioneering work on microanalysis of organic substances,
for which he was awarded the Nobel Prize in 1923 (14,
15). This research was continued by his successors,
Hans Lieb (1887-1982) and Theodor Leipert (16). At
the Institute of Medical Biochemistry, Anton Holasek
(1921) and his successor Gerhard Kostner (1940) made
substantial contributions to lipoprotein metabolism. Lei*
perfs (1902—1992) early scientific interest was in the
metabolism of iodine and his name is connected with
the first reliable determination of iodine in body fluids.
Together with Piringer and Pilgerstorfer he published
an extensive monograph entitled "Laboratoriumsdiagnostik" in 1953 (17). For more than a decade the book
served äs the Austrian Standard reference textbook in
the field.
In Innsbruck Richard Maly (1839-1891) was active in
the field from 1869 and became famous by editing "Jahresberichte über die Fortschritte in der Thierchemie"
(Maly's Berichte). His successor for the chair of medical
chemistry in Innsbruck was Franz Loebisch (1839-^
1912). He was also interested in clinical chemistry and
wrote a book on urine analysis (18). In more recent
years, Richard Stöhr (1902-1990) and his pupil, Helmut Wächter (1929), äs well äs Hans Grunicke (1935),
together with his collaborator Bernd Puschendorf
(1942), contributed substantially to the field of clinical
chemistry and pathobiochemistry.
In the late forties clinical chemistry and laboratory
medicine became very important in clinical medicine for
the prevention, diagnosis and monitoring of diseases.
The extension and exchange of Information on new techniques and their application in clinical medicine increased rapidly. This initiated intense discussion of the
improvement of the national and international exchange
of Information, since it was realised that clinical chemis^
try and laboratory medicine were inadequately represented in this area. In the late sixties a committee
was founded to prepare the founding of an Austrian Society for Clinical Chemistry. The Austrian clinical ehernists, Franz Gabi (1921), Erich Kaiser, Theodor Leipert
and others, and the prominent clinician Erwin Deutsch
(1917-1992) prepared the necessary background for the
foundation of the society and contacted already existing
Clinical Chemical Societies in other countries, particularly Germany and Switzerland.
One of the main aims of the newly founded society was
the promotion of scientific research. From the very beginning it was clear to the Initiators that research in
clinical chemistry was closely connected to the under-
Kaiser: Clinical Chemistry in Austria
standing of the pathobiochemical basis of diseases and
the Interpretation of analytical results. Therefore particular emphasis was placed on research in the field of pathobiochemistry. In addition it was clear that the goals
of the Society could only be achieved by a close cooperation and continuous discussion rwith clinicians and permanent contact with industry. Scientifie results were
presented by members of the Society at rnany national
meetings. Particular emphasis was placed on supporting
young scientists. In 1993, at its 8th Annual Meeting, the
Society celebrated its 25th anniversary in Gmunden in
collaboration with the German Society for Clinical
Chemistry and the Austrian Society of Laboratory Medicine. This meeting was organized by our colleague G.
Aspöck (Wels).
In order to identify the work of the Society on a federal
basis, local branches of the Society were opened in
Graz, Innsbruck, Linz, Salzburg and Vienna on the initiative of Hans Grunicke (Innsbruck). It is the responsi^
bility of these local branches to organize seminars and
meetings to eriable local members to participate in the
work of the Society. The local branch in Innsbruck has
developed into the most active one.
International contacts were intensified by holding sev*
eral joint meetings with other Eüropean Societies, most
frequently with the German and Swiss societies. In
1981, the 11th 1FCC Congress took place in Vienna. This
meeting was organized by E. Kaiser, F. Gabi, Mathias
M. Müller (1942) and Peter Michael Bayer (1943). It
was generally acknöwledged that the cpngress was Very
successful and contributed to fiirtherifig the international
reputation of the Society. The IFCC Congress in Vienna
was followed by the 3rd International Congress of Clinical Enzymology in Salzburg, organized by Hans Jörg
Gibitz (1927). Recently a close cpoperation with Italian
clinical cherriists was arranged, and so far 3 meetings
have been organized by E. DePalo (Padova) and M. M.
Müller (Vienna). In addition, Conferences in collaboration with the Hungarian Society were organized by K.
Jobst (Pecs) and M. M. Müller (Vienna). Since its
founding, the Austrian Society has participated in the
"Alpe-Adria Meetings"; the 4th Meeting will take place
this year in Hungary (Pecs). All these international congresses and Conferences have substantially increased the
exchange of Information on an international basis, and
helped to promote personal contacts between the members of the participating societies.
The Society strongly supports publicätions of scientific
results in the field. An Austrian Journal (Mitteilungen
der Österreichischen Gesellschaft für Klinische Chemie)
has been published since 1978. Wolfgang Hohenwallner
(Linz), the founder and very .successful editor of this
Journal since its beginning, has devoted rauch work to
Eur. J. Clin. Chern. Clin. Biochem. / Vol. 32,1994/No. 8
Kaiser: Clinical Chemistry in Austria
this important national publication. Publication efforts
have also resulted in close cooperation with the German
Society for Clinical Chemistry and its Journal. Since
1977, the European Journal of Clinical Chemistry and
Clinical Biochemistry has been the official Journal of
the Society. E. Kaiser is acting member of the editorial
board.
581
to the large nurnber of laboratories run by general practitioners in Austria, the number of participants in clinical
chemical surveys increased to more than 2000. Test
samples are circulated 4 times a year. These efforts,
started by the society more than 20 years ago, have contributed substantially to the improvement of laboratory
results in Austria.
In spite of the very successful work of the Society on a
national and international basis and the increasing attention which clinical chemistry and laboratory medicine
find a practical medicine, several issues remain unresolved. Chairs of clinical chemistry have not been set
up in Graz and Innsbruck and Clinical Chemistry and
Laboratory Medicine are not compulsory subjects in the
medical curriculum in Austria. This serious shortcoming
is particularly annoying, since medical doctors increasingly rely on the results of laboratory tests and run their
own laboratories for the care of their patients. They
On the occasion of the 7th IFCC Congress in Geneva in never had a chance to obtain the necessary Information
1969 the Austrian Society became a member of the on specimen collection, analytical interference factors
IFCC. E. Kaiser acted äs a national representative to the and the pathobiochemical background, which are an inIFCC until 1990. At present this position is held by M dispensible basis for the useful application of the tests
M. Müller. The excellent organisational work done by on which they base their medical decisions. Another imMüller on the occasion of the Vienna IFCC Congress portant problem is the fact that many hospital laboraresulted in bis nomination äs an IFCC Secretary for one tories are not supervised and headed by an approved
nomination period and bis present position äs chairman clinical chemist or a specialist in laboratory medicine.
for the IFCC Scientific Committee.
The training of medical doctors in laboratory medicine
and clinical chemistry is regulated by law. However,
In 1978 the first chair of clinical chemistry and laborathere is no officially approved curriculum for non-meditory medicine was established at the University of Vical Professionals such äs biochemists, pharmacy graduenna. Franz Gabi (1921) was appointed äs füll professor
ates or chemists. Recently, an initiative was started by
and chairman of the Department. His nomination was the acting president of the Society to work out guidenot only a personal appreciation of his longlasting scien- lines for the training of non-medical doctors in clinical
tific and organisational engagement in the field but also chemistry. A highly important fact, which has not been
an acknowledgement of the importance of clinical sufficiently acknowledged in the past, is the need for a
chemistry and laboratory medicine in clinical medicine. relevant and permanent dialogue between the clinician
During his term of office he very successfully made the and the clinical chemist in the laboratory. We must keep
necessary preparations for the new eentral laboratory of in mind that the laboratory should never simply offer the
the new University Hospital in Vienna, which became results of chemical analyses to the clinician, but rather
operational in 1990.
medical results for the benefit of our patients. In this
way
the reputation and importance of the laboratory will
In 1969 the Society introdüced the methods of statistical
quality control in Austria in cooperation with the Insti- be further improved, and the results can be regarded äs
tute of Medical Chemistry at the University of Vienna an essential prerequisite for the patient's treatment.
(21). In 1980 the Organisation of national· surveys was The position of clinical chemistry and laboratory meditakeii over by ÖQUASTA (Austrian Society for Quality cine in practical medicine will depend on the realization
Assurance and Standardizätidn of Medical Laboratory of these goäls. However, we are happy that in Austria
Investigation). Since the introduction of external quality a group of young scientists is willing to work towards
control, surveys have been offered in the most important achieving these goals and to pursue the initiatives started
fields of clinical chemistry and laboratory medicine. Due by their mentors.
In addition, proceedings of scientific meetings have
been published. The most extensive were the publication
of the papers presented at the ll th IFCC Congress in
Vienna (19), and the Proceedings of the 3rd International
Congress on Clinical Enzymology (20). Hans Jörg Gibitz (Salzburg) devoted much personal energy to the preparation of a reference guide listing analytes which are
evaluated in laboratories specialising in diiferent aspects
of clinical chemistry and laboratory medicine. This publication is highly esteemed by medical doctors.
References
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Berufsbild? Wien. Klin. Woeheiischr. 82, 437-442.
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2. Mani, N, (1974) Johann Florian Heller und die frühe klinische
Chemie des 19. Jahrhunderts. In: Wien und die Wellmedizin
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582
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Kaiser: Clinical Chermstry in Austria
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18. Loebischj W. F. (1881) Anleitung zur Harn-Analyse flir praktische Ärzte. Studierende und Chemiker mit besonderer Berücksichtigung der klinischen Medizin, Urban u. Schwarzenberg,
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eds.) De Gruyter, Berlin, New York,.
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M., Werner, M., Kaiser, E. & Gibitz, H. J., eds.) Masson, New
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X. & Gabi, F. (1971) Vorläufiger Bericht über den österreichischen Rundversuch 1970. Österr. Ärzteztg. 26, 204-211.
Prof. Dr. E. Kaiser
Medizinisch-Chemisches Institut
der Universität in Wien
Währinger Straße 10
A-1090 Wien
Austria
Eur. J, Clin. Chem. Clin. Biochem. / Vol. 32,1994 /No. 8