|Year : 2017 | Volume
| Issue : 1 | Page : 123-125
Aldred scott warthin: Pathologist and teacher par excellence
Vineeth G Nair, HV Krishnaprasad
Department of Pathology, Yenepoya Medical College, Mangalore, Karnataka, India
|Date of Web Publication||16-Jun-2017|
Vineeth G Nair
Room No. 412, Gardyenia PG Hostel, Yenepoya University Campus, Deralakatte, Mangalore - 575 018, Karnataka
Source of Support: None, Conflict of Interest: None
Born in 1866, Aldred Scott Warthin was a pathologist and teacher of great repute. Even though many know him from his eponyms, the true value of his achievements, and how far he was ahead of his peers, is known to but a few modern day medical students. It was in fact, based on his work, that Henry Lynch came up with his theories on the genetic nature of cancer. He died in 1931 leaving a lot of work unfinished.
Keywords: Cancer genetics, eponym, family G, warthin, teacher
|How to cite this article:|
Nair VG, Krishnaprasad H V. Aldred scott warthin: Pathologist and teacher par excellence. Arch Med Health Sci 2017;5:123-5
Aldred Scott Warthin [Figure 1] was born on October 21, 1866, in Greensburg, Indiana, to Edward Mason Warthin and Eliza Margaret Warthin neé Weist. Although later in life he would prove his caliber as one of the finest creative scientists of his age, his initial interest was music. To this end, he attained a teacher's diploma in music from the Cincinnati Conservatory at the age of 21. While at the Cincinnati Conservatory, he also attended the Indiana University in Bloomington where he studied Botany. After this, he earned his MD from the University of Michigan in 1890 and then served as an Assistant Professor in Internal Medicine at the same institution.,
A few years later, Warthin shifted his interest to Pathology, and in 1895, he was made an Instructor in Pathology, advancing to Assistant Professor in 1899, to Junior Professor in 1902, and to Professor of Pathology and Director of the Pathological Laboratory in 1903. He remained in that position till his death in 1931.,
During this time, he taught more than 3000 students, and in the editorial to a commemorative volume released on the 35th anniversary of his teaching career, he was described as “the greatest living teacher of Pathology.” His out-of-the-box ideas on teaching methods were legendary. For example, he required that his students learn enough about music to be able to differentiate between the different tones of the local church bells and carillons. This was to prepare them to differentiate between the various sounds heard in the chest on auscultation. His approach to teaching pathology is as, if not more, relevant today as it was more than a 100 years ago. As he wrote in his notes a few weeks before his death, “Pathology is not to my mind a separate subject to be taught academically, but one underlying and intimately connected with all the clinical subjects of the curriculum; the correlation of pathology with the living clinical picture represents to my mind the highest function of medical teaching, and were I starting my career today, I should follow the same ideals and practice initiated in 1895.”
During his professional career, Warthin achieved a great many things. In 1895, he published a paper titled, “Accentuation of the Pulmonary Second Sound: An Important Sign in the Diagnosis of Pericarditis.” This sign was later named “Warthin's sign” in his honor.
He studied syphilis for nearly 20 years and was the world's leading authority on it., He led a public health campaign against tuberculosis and published many articles on what he called the “white plague.”
During the World War 1, he studied the effects of mustard gas on the human body and was the author of the official US Government report on mustard gas.
In 1920, with his colleague Allen Chronister Starry, he introduced the “Warthin–Starry” staining method for the detection of spirochetes. The staining method has also been used to stain Helicobacter pylori, Lawsonia intracellularis, Microsporidia, and Bartonella henselae.
He also worked extensively on the study of diseases affecting the reticuloendothelial system.
In 1929, he published an article describing two cases of a tumor – papillary cystadenoma lymphomatosum – which would later be called “Warthin's tumor” (even though, like many other eponyms, the tumor was first described 19 years earlier by Albrecht and Arzt).
However, his crowning achievement in the field of medical science was a study that started early in his career and lasted until his death. In 1895, at the beginning of his career as a pathologist, Warthin had an encounter with his seamstress that would spark his curiosity. This seamstress told him of the very long line of deaths from cancer in her family (she herself would later go on to die from endometrial cancer). Warthin proceeded to study her family in detail using questionnaires, interviews, and death records. He named this family “Family G” and studied them for decades and, the continued study of the same family by other researchers (including Henry Lynch), has given medical science the longest and most detailed cancer genealogy in the world. This “Family G” was later identified as having Lynch syndrome (previously known as an HNPCC – Hereditary Non-Polyposis Colorectal Cancer). By 1913, Warthin had traced genealogies for 29 similar families. He published his findings in his seminal (1913) article in the Archives of Clinical Medicine (now known as the Journal of the American Medical Association: Internal Medicine). He published a follow-up article on “Family G” in 1925, wherein he concluded that the family had a susceptibility to carcinomas of the gastrointestinal tract and uterus and that these occurred at a younger age., After his death, his colleagues would publish a further follow-up in 1936. However, Warthin's idea would remain largely ignored till the 1960s when Henry Lynch noticed the familial clustering of cancers., It was only decades after his death that Warthin's idea of genetic susceptibility of cancers would be widely accepted. Today, his work as the pioneer in the field has earned him, quite rightly, the title of “Father of Cancer Genetics,” bestowed on him by none other than Henry Lynch himself.
Warthin was a modern-day Renaissance man with interests that were far ranging in their scope and variety. He was an accomplished pianist. He was also an avid collector of death iconography, which he compared and commented on in his monograph “The Physician of the Dance of Death.” Apart from scholarly publications, he wrote two books with a philosophical bent, namely, “Old Age” and “The Creed of a Biologist.” He once discovered a species of snail that was later named in his honor (Welleria Aftonensis Warthin). He was also an avid gardener and golfer.,
On the professional front, he was also at one-time President of the American Association of Pathologists and Bacteriologists, President of the International Association, President of the Medical Museums, President of the Association of American Physicians, President of the American Association for Cancer Research, President of the Association of Experimental Pathology, and Vice-President of the International Medical Historical Society. He was also a member of the International Association for the Study of the Prevention of Tuberculosis, of the American Heart Association, and of the Society of Experimental Biology and Medicine., From 1925 to 1928, he was a delegate to the National Research Council and one of the first members of the Council on Physical Therapy of the American Medical Association. Despite being a pathologist, he was editor of the “Annals of Internal Medicine” from 1924 onward., He was the author of “Practical Pathology” (1897, second edition 1906) and translated Ziegler's “General Pathology” in 1904. He also edited the section on Pathology in the second edition of the “Reference Handbook of the Medical Sciences.” In total, he wrote over 1000 articles in medical journals and textbooks.,,
On the personal front, Warthin married another physician, Katherine Angell, in 1900 and they had four children.
Aldred Scott Warthin passed away at 5 am on May 23, 1931, from a bout of asthma at the age of 64. At the time of his passing, he had left a lot of work unfinished. He had outlined a series of important papers, on cancer, to be published over the course of the next few years. We can only wonder what the outcome would have been if he had the time to finish his work; if he had been able to apply that prodigious intelligence to the problem of cancer. Given all that he accomplished, we can only guess at how far ahead we might have been today if he had been able to continue.
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Boland CR, Lynch HT. The history of Lynch syndrome. Fam Cancer 2013;12:145-57.
Aldred Scott Warthin. Am J Cancer 1931;15:2805-7.