Over the next 20 years he served on the attending staff of several hospitals in London: Marylebone General Dispensary, West London Hospital, St. Bartholomew's Hospital, Great Ormond Street Hospital for Children, and Alexandra Hospital for Children with Hip Disease.
Garrod was a proponent of scientific research as the foundation of medical practice, and published on a variety of diseases and topics throughout his career, including ''An Introduction to the Use of the Laryngoscope'' (1886) and ''A Treatise on Rheumatism and Rheumatoid Arthritis'' (1890). He helped found the ''Quarterly Journal of Medicine'' to provide a forum for more fundamental research into the processes of disease. He helped edit a pediatrics textbook, ''Diseases of Children'' (1913), with F.E. Batten and Hugh Thursfield.
Alkaptonuria and Inborn Errors of Metabolism
He developed an increasing interest in chemical pathology, and investigated urine chemistry as a reflection of systemic metabolism and disease. This research, combined with the new understanding of Mendelian inheritance, evolved from an investigation of a few families with an obscure and not very dangerous disease (alkaptonuria) to the realization that a whole territory of mysterious diseases might be understood as inherited disorders of metabolism.Alkaptonuria is a rare familial disease of organic acid metabolism that is best known for the darkening of urine from yellow to brown to black after it is exposed to the air. In later life, individuals with this disease develop arthritis characterized by deposition of brown pigment in joint cartilage and connective tissue. Garrod studied the recurrence patterns in several families, realized it followed an autosomal recessive pattern of inheritance, and postulated that it was caused by a mutation in a gene encoding an enzyme involved in the metabolism of a class of compounds called alkaptans. He published ''The Incidence of Alkaptonuria: a Study in Chemical Individuality'' in 1902.
Over the next decade he developed an understanding of the possible nature of inherited diseases of metabolism. He formulated the "one gene, one enzyme" hypothesis and described the nature of recessive inheritance of most enzyme defects. In 1908, the core of this work was presented as the Croonian Lectures to the Royal College of Physicians, entitled ''Inborn Errors of Metabolism'' and published the following year. Garrod expanded his metabolic studies to cover cystinuria, pentosuria, and albinism.These three inborn errors, along with alkaptonuria are collectively called Garrod's tetrad. In 1923 he summarized these studies in an expanded edition of his best known work, [http://www.esp.org/books/garrod/inborn-errors/facsimile/ Inborn Errors of Metabolism].
Adapted from the Wikipedia article Archibald Garrod, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki
