THE ASTONISHING success of chemotherapeutic agents in the treatment of infectious diseases has rendered the management of such cases relatively simple and rewarding thereby shifting emphasis to less common clinical problems in pediatrics. A decade ago, metabolic diseases constituted a mere fraction of the clinical problems encountered; but now make up a large segment of those cases that call for unusual skill and wide knowledge of disease. A clear understanding of metabolic processes has therefore become necessary for the study and management of such cases.
The main factors concerned with the normal function of an organ are its constituent enzymes and the forces that influence enzyme function. The latter are chiefly hormonal and nutritional influences. In recent years, there has been a very rapid advance in our knowledge of the enzyme systems involved in carbohydrate and fat metabolism and the factors that affect the function of those systems.
These advances have placed before the student of metabolism a pattern of stepwise processes that determine the direction and efficiency of metabolism in synthesis or degredation. These orderly processes make it possible to predict more or less accurately, the metabolic picture that may result from a defect in any one particular step. It was with this in mind that a few metabolic diseases were studied and precise biochemical lesions discovered. In some instances these defects were enzymatic and in others essentionally hormonal. This is truly a reversal of the course of events more commonly encountered, because it is often the metabolic disease that furnishes the stimulus for the advances in the physiology of metabolism.
Knowledge for knowledge's sake has characterized this era of rapid physiological advances. The more advanced and orderly this process is, the easier it shall be for the clinician to understand and treat disease.
- Received December 16, 1954.
- Copyright © 1955 by the American Academy of Pediatrics