Evolution of clinical understanding: paroxysmal nocturnal hemoglobinuria as a paradigm.

In recounting the history of the development of knowledge about PNH, the roles of the clinician, the basic scientist, and the clinician-investigator are apparent. Without the observations of the clinicians, the problem could not be posed. Without the contributions from basic science (the biochemistry of complement, the biology of glycosyl-phosphatidylinositol anchors, etc), the information necessary to the solution of the problem would not be available. Without the synthesis of the clinician-investigator, the two elements would not be fused to result in knowledge about the disease.