George Lenthal Cheatle
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Sir George Lenthal Cheatle, (13 June 1865 – 2 January 1951) was a British surgeon who made important contributions to the diagnosis and treatment of breast cancer.


Birth and education

George Lenthal Cheatle was born on 13 June 1865 in
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, Kent, England. He was the eldest son of George Cheatle of
Burford Burford () is a town on the River Windrush, in the Cotswolds, Cotswold hills, in the West Oxfordshire district of Oxfordshire, England. It is often referred to as the 'gateway' to the Cotswolds. Burford is located west of Oxford and southeas ...
, Oxfordshire, and Mary Anne Cheatle, daughter of James Allen of Dartford Kent. His father was a solicitor. His younger brother, Arthur Henry Cheatle (4 December 1866 – 11 May 1929), also became a well-known surgeon. Their father died in 1872. George Lenthal Cheatle was educated at Merchant Taylors' School. He began his studies in the Medical department of
King's College London King's College London (informally King's or KCL) is a public research university located in London, England. King's was established by royal charter in 1829 under the patronage of King George IV and the Duke of Wellington. In 1836, King's ...
in 1883. He graduated in 1887.


Career

After graduating from King's College Cheatle's first appointment was Assistant Demonstrator of Anatomy. In 1888 Cheatle was appointed House Surgeon at
King's College Hospital King's College Hospital is a major teaching hospital and major trauma centre in Denmark Hill, Camberwell in the London Borough of Lambeth, referred to locally and by staff simply as "King's" or abbreviated internally to "KCH". It is managed by K ...
, and in 1889 was made House Physician and Sambrooke Surgical Registrar. From 1892 to 1894 he was a Demonstrator of Surgical Pathology, and in 1893 he was appointed Assistant Surgeon to King's College Hospital. He was trained as a surgeon by
Sir Joseph Lister Joseph Lister, 1st Baron Lister, (5 April 182710 February 1912) was a British surgeon, medical scientist, experimental pathologist and a pioneer of antiseptic surgery and preventative medicine. Joseph Lister revolutionised the craft of su ...
, and assisted Lister in his last operation. Cheatle was a Consulting Surgeon to the army in South Africa during the
Second Boer War The Second Boer War ( af, Tweede Vryheidsoorlog, , 11 October 189931 May 1902), also known as the Boer War, the Anglo–Boer War, or the South African War, was a conflict fought between the British Empire and the two Boer Republics (the Sout ...
(1899–1902). In 1900 he was appointed Surgeon and Teacher of Surgical Pathology at King's College Hospital. During
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
, in 1915 he was appointed Surgeon-Rear-Admiral in the Royal Navy. He served at the
Royal Naval Hospital Haslar The Royal Hospital Haslar in Gosport, Hampshire, was one of several hospitals serving the local area. It was converted into retirement flats between 2018 and 2020. The hospital itself is a Grade II listed building. History Formation and ope ...
near Portsmouth and on a hospital ship in the Gallipoli Campaign. In 1919 he was made a Fellow of King's College London. He replaced Frederic Francis Burghard as Senior Surgeon and Lecturer of Surgery in 1923. At a special meeting of the Medical Board of the King's College Hospital Medical School held at Cheatle's house in
Harley Street Harley Street is a street in Marylebone, Central London, which has, since the 19th century housed a large number of private specialists in medicine and surgery. It was named after Edward Harley, 2nd Earl of Oxford and Earl Mortimer.< ...
in February 1928, the Board recorded: Cheatle retired in 1930. He died on 3 January 1951 at his London home. He was aged 85.


Work

Cheatle was deeply influenced by Lord Lister, and this showed up not only in his interest in research and close attention to detail, but also in his dress and physical mannerisms. However, although at first a strong supporter of Lister's
antiseptic An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
approach, he later was the first surgeon to use
asepsis Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deriv ...
at King's. In 1920 Cheatle was the first to repair an inguinofemoral hernia from above the pubis using the posterior preperitoneal space. The innovation received little attention at the time, and was not mentioned in his obituary. It was rediscovered in 1936 by A.K. Henry, but the Cheatle-Henry procedure for femoral and obturator hernias did not become widely used until after World War II. Today it is commonly called the Nyhus procedure after Lloyd Milton Nyhus. Cheatle was interested in
carcinoma Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal ...
s throughout his career, and particularly cancer of the breast. Cheatle designed an exceptionally large
microtome A microtome (from the Greek ''mikros'', meaning "small", and ''temnein'', meaning "to cut") is a cutting tool used to produce extremely thin slices of material known as ''sections''. Important in science, microtomes are used in microscopy, allow ...
that could cut square sections, with which his technician prepared whole-organ sections of the breast. Over a 35-year period he built a huge collection of normal and diseased breast sections. Using them, he was able to prove that
Paget's disease of the breast Paget's disease of the breast is a type of cancer that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast. The condition is an uncommon disease accounting for 1 to 4.3% of all breast cancers and was ...
was the result of an underlying breast cancer, and that the calls that are now called
carcinoma in situ Carcinoma ''in situ'' (CIS) is a group of abnormal cells. While they are a form of neoplasm, there is disagreement over whether CIS should be classified as cancer. This controversy also depends on the exact CIS in question (i.e. cervical, skin, bre ...
was not pre-cancerous or potentially cancerous, but were in fact already malign. He also showed that simple
hyperplasia Hyperplasia (from ancient Greek ὑπέρ ''huper'' 'over' + πλάσις ''plasis'' 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferati ...
and
Papilloma A papilloma (plural papillomas or papillomata) ('' papillo-'' + '' -oma'') is a benign epithelial tumor growing exophytically (outwardly projecting) in nipple-like and often finger-like fronds. In this context, papilla refers to the projection cre ...
s were not malign, as was generally thought, but were in fact benign. Based on his studies of whole-organ sections, Cheatle proposed that epithelial proliferation leading to cancer had lobular rather than ductal origins. In a 1922 article in the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'' Cheatle said that by the time breast cancer became visible it was often too late to be cured by surgery. In 1922 Cheatle proposed that inflamed and cystic breasts should be removed surgically. He coauthored the textbook ''Tumours of the Breast'' (1931) with the American surgeon Max Cutter. This was called "the first modern textbook of mammary pathology". The textbook said that if there was only one "blue dome cyst" in a breast, removal of the cyst was usually sufficient. However, it was safer to remove the whole breast in cases of generalised cystic disease. Cheatle had found that such breasts often contained hidden carcinoma. Cheatle was a contemporary of
Joseph Colt Bloodgood Joseph Colt Bloodgood (November 1, 1867 – October 22, 1935) was a prominent surgeon in the United States based in Johns Hopkins Hospital in Baltimore, Maryland. He was known for insisting on the use of rubber gloves by the entire surgical team, ...
, who was studying the pathology and clinical treatment of prolifierative duct lesions of the breast in
Johns Hopkins Hospital The Johns Hopkins Hospital (JHH) is the teaching hospital and biomedical research facility of the Johns Hopkins School of Medicine, located in Baltimore, Maryland, U.S. It was founded in 1889 using money from a bequest of over $7 million (1873 mo ...
in the United States during the same period. It is not clear how much the influence the two men had on each other, since the published works of both generally do not refer to the work of other researchers, but most likely they reached the same conclusions independently.


Recognition

Cheatle was appointed
Companion of the Order of the Bath Companion may refer to: Relationships Currently * Any of several interpersonal relationships such as friend or acquaintance * A domestic partner, akin to a spouse * Sober companion, an addiction treatment coach * Companion (caregiving), a caregive ...
(CB) in 1901. He was appointed
Commander of the Royal Victorian Order The Royal Victorian Order (french: Ordre royal de Victoria) is a dynastic order of knighthood established in 1896 by Queen Victoria. It recognises distinguished personal service to the British monarch, Monarchy of Canada, Canadian monarch, Mon ...
(CVO) in the 1912 Birthday Honours and knighted as
Knight Commander of the Order of the Bath The Most Honourable Order of the Bath is a British order of chivalry founded by George I of Great Britain, George I on 18 May 1725. The name derives from the elaborate medieval ceremony for appointing a knight, which involved Bathing#Medieval ...
(KCB) in the
1918 New Year Honours The 1918 New Year Honours were appointments by King George V to various orders and honours to reward and highlight good works by citizens of the British Empire. The appointments were published in ''The London Gazette'' and ''The Times'' in Ja ...
. He was made a ''Chevalier'' of the French
Legion of Honour The National Order of the Legion of Honour (french: Ordre national de la Légion d'honneur), formerly the Royal Order of the Legion of Honour ('), is the highest French order of merit, both military and civil. Established in 1802 by Napoleon, ...
and a Knight Grand Cross of the
Order of the Crown of Italy The Order of the Crown of Italy ( it, Ordine della Corona d'Italia, italic=no or OCI) was founded as a national order in 1868 by King Vittorio Emanuele II, to commemorate the unification of Italy in 1861. It was awarded in five degrees for civi ...
. Only American citizens are allowed to lecture at the Edward Hines Jr. VA Hospital in Chicago. He was granted American citizenship for a week so that he could lecture there. In 1931 Cheatle was awarded the Walker Prize by the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations a ...
for work on the Pathology and Therapeutics of Cancer. He was made an Honorary
Fellow of the American College of Surgeons Fellow of the American College of Surgeons (or FACS) is a professional certification for a medical professional who has passed a set of criteria for education, qualification, and ethics required to join the American College of Surgeons. ''FACS'' ...
in 1932.


Family

Cheatle married at the
Savoy Chapel The King's Chapel of St John the Baptist in the Precinct of the Savoy, also known as the King's Chapel of the Savoy, is a church in the City of Westminster, London. Facing it are 111 Strand, the Savoy Hotel, the Institution of Engineering and Te ...
on 2 October 1902 Clara Denman Jobb, daughter of Colonel Keith Jopp, of the Royal Engineers.


References

Citations Sources * * * * * * * * * * * * {{DEFAULTSORT:Cheatle, George Lenthal 1865 births 1951 deaths British surgeons Knights Commander of the Order of the Bath Commanders of the Royal Victorian Order Fellows of the Royal College of Surgeons of England Recipients of the Order of the Crown (Italy)