Image Courtesy: Lasker Foundation

Some young men like football, others like politics, and still others prefer the fine arts. John Clements liked chemistry. Attending Cornell on a scholarship, he found its rigorous chemistry program to be “immense fun.” But the events of World War II soon altered the course of his life. Clements volunteered for an accelerated program at Cornell Medical College and earned his medical degree in 1947. Then, in the early 1950s, he again volunteered his services – this time to the Army Chemical Center in Maryland. It was here Clements was thrust into studying the impact of chemical warfare agents, an area that first sparked his interest in the surface tension of the lungs. This experience proved to be critical to his later discovery of surfactant. This is the substance in the lungs’ airspaces that allows them to remain expanded when they exhale. Surfactant is missing in premature babies and this causes respiratory distress syndrome (RDS). Clements’ discovery laid the groundwork for the development of a surfactant replacement therapy for premature infants.

Premature babies, especially those born before 28 weeks gestation, are often unable to produce their own surfactant. Prior to Clements’ discovery, doctors were at a loss as to how to treat these infants, and often watched helplessly as the infants struggled for breath and then died. Clements’ discovery of surfactant led to the development of replacement therapy for premature infants and has been credited with saving over 830,000 lives.

Clements did not choose to study lungs. He was assigned the task of determining the impact of nerve gas on the lungs when he worked for the army. This set the stage. He was fascinated with his work, especially the aspect of the surface tension of the lungs. After the war ended there was still funding in place, and Clements and others enthusiastically pursued their research. Clements set up a rigorous protocol to study the lungs’ surface tension.. He measured the surface tension of the lung both when it was expanded, as in inhalation, and when it was compressed, as in exhalation. Clements, like many scientific pioneers, had to make due. When he wanted to study the dynamic aspects of the lungs’ surface tension, there was no suitable experimental equipment. So he improvised, creating a crude device that was described by one medical historian as being “made from sealing wax, chewing gum, string and other odds and ends.”  It was this ingenious design that led to his discovery of surfactant. Once Clements identified surfactant, other physicians and researchers joined in his enthusiasm. This led to new treatments for RDS, including the development of respiratory ventilation machines that provided support during exhalation as well as inhalation. This allowed the tiny alveoli to remain open. Clements later produced the first synthetic surfactant approved by the U.S. Food and Drug Administration for clinical use. Several other replacement surfactants have been produced thanks to Clements’ discovery, and infant deaths due to respiratory distress syndrome have plummeted.

Table of Contents

Introduction
Links to More Information About the Scientist
Key Insight
Key Experiment or Research
Key Contributors
Quotes by the Scientist
Quotes About the Scientist
Anecdotes
Fun Trivia About The Science
The Science Behind the Discovery
Personal Information
Science Discovery Timeline
Recommended Books About the Science
Books by the Scientist
Books About the Scientist
Awards
Major Academic Papers
Curriculum Vitae
Links to Science and Related Information on the Subject
Sources

Key Insight

Key Experiments or Research

Quotes by the Scientist

Quotes About the Scientist

Anecdotes

Fun Trivia About the Science

Personal Information

Scientific Discovery Timeline

Recommended Books About the Science

Books by the Scientist

Books About the Scientist

Awards

Major Academic Papers Written by the Scientist

Curriculum Vitae

Sources/References