The last quarter century has witnessed tremendous developments in the field of human biology. Some have been accompanied by considerable debate among physicians and, in recent years, have been the cause of added controversy and frustration, with heated discussions involving not only physicians themselves, but also government agencies and "consumers." Perhaps none better exemplifies this than the continual developments in the area of sickle cell disease.
In 1949, Pauling and his colleagues1 demonstrated that the hemoglobin from patients with sickle cell anemia differed from the normal in its electrophoretic mobility. This discovery opened a virtual "Pandora's box;" today, innumerable abnormal hemoglobins are well known in addition to hemoglobin S. About 20 years after their contribution, Nalbandian et al2 reported on the reversal of sickling in vitro, by the addition of urea. Attempts to accomplish reversal of sickling in vivo have been the subject of considerable debate over the
Bemis EL. Optimal vs Optional Testing For Sickle Cell Disease. JAMA. 1975;234(8):855–856. doi:10.1001/jama.1975.03260210063032