Samuel Jones Gee (13 September 1839 – 3 August 1911) was an
English
English usually refers to:
* English language
* English people
English may also refer to:
Peoples, culture, and language
* ''English'', an adjective for something of, from, or related to England
** English national ide ...
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
and
paediatrician
Pediatrics (American and British English differences, also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, Adolescence, adolescents, and young adults. In the United King ...
. In 1888, Gee published the first complete modern description of the clinical picture of
coeliac disease
Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barle ...
, and theorised on the importance of diet in its control. His contribution led to the
eponym
An eponym is a person, a place, or a thing after whom or which someone or something is, or is believed to be, named. The adjectives which are derived from the word eponym include ''eponymous'' and ''eponymic''.
Usage of the word
The term ''epon ...
Gee's disease. Gee is also credited with the first English-language description of
cyclic vomiting syndrome
Cyclic vomiting syndrome (CVS) is a chronic functional condition of unknown pathogenesis. CVS is characterized as recurring episodes lasting a single day to multiple weeks. Each episode is divided into four phases: inter-episodic, prodrome, vom ...
.
[ as cited by ]
Life
Samuel Gee was born in
London
London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
, where he spent his medical career. His father, William Gee, was a businessman but the family was not wealthy. He had two years of formal
primary education
Primary education or elementary education is typically the first stage of formal education, coming after preschool/kindergarten and before secondary school. Primary education takes place in ''primary schools'', ''elementary schools'', or first ...
, supplemented by home schooling. His
secondary education
Secondary education or post-primary education covers two phases on the International Standard Classification of Education scale. Level 2 or lower secondary education (less commonly junior secondary education) is considered the second and final pha ...
was at the
University College School
("Slowly but surely")
, established =
, closed =
, type = Public schoolIndependent day school
, religion =
, president =
, head_label = Headmaster
, head = Mark Beard
, r_head_label =
, r_hea ...
, London. He went on to study medicine at the
University College Hospital
University College Hospital (UCH) is a teaching hospital in the Fitzrovia area of the London Borough of Camden, England. The hospital, which was founded as the North London Hospital in 1834, is closely associated with University College London ...
, gaining an
MB in 1861 followed by an
MD in 1865.
Gee initially worked as a house surgeon at the University College Hospital. He moved to the
Hospital for Sick Children, Great Ormond Street in 1865. His career progressed through house surgeon, assistant physician (1866), physician (1875) and finally consulting physician (1904). He worked at both Great Ormond Street Hospital, at
St Bartholomew's Hospital
St Bartholomew's Hospital, commonly known as Barts, is a teaching hospital located in the City of London. It was founded in 1123 and is currently run by Barts Health NHS Trust.
History
Early history
Barts was founded in 1123 by Rahere (died ...
and in private practice. At St Bartholomew's medical school, he was a demonstrator of
morbid anatomy, lecturer on pathological anatomy and lecturer on medicine. He delivered the 1871
Goulstonian, the 1892
Bradshaw and the 1899
Lumleian Lectures
The Lumleian Lectures are a series of annual lectures started in 1582 by the Royal College of Physicians and currently run by the Lumleian Trust. The name commemorates John Lumley, 1st Baron Lumley, who with Richard Caldwell of the College endowe ...
.
Gee was married to Sarah Cooper in 1875 with whom he had two daughters. He died suddenly, of a
coronary occlusion
A coronary occlusion is the partial or complete obstruction of blood flow in a coronary artery. This condition may cause a heart attack.
In some patients coronary occlusion causes only mild pain, tightness or vague discomfort which may be ignored ...
, while on holiday in
Keswick, Cumbria
Keswick ( ) is a market town and civil parishes in England, civil parish in the Allerdale Borough in Cumbria, England. Historic counties of England, Historically, until 1974, it was part of Cumberland. It lies within the Lake District National ...
.
Celiac disease
Samuel Gee gave the first modern-day description of coeliac disease in a lecture at the Hospital for Sick Children, Great Ormond Street in 1887. His interest in the history of medicine, and ability to read
ancient Greek
Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic peri ...
, meant Gee was familiar with the work of
Aretaeus of Cappadocia
Aretaeus ( grc-gre, Ἀρεταῖος) is one of the most celebrated of the ancient Greek physicians. Little is known of his life. He presumably was a native or at least a citizen of Cappadocia (Roman province), Cappadocia, a Roman province in ...
who first wrote of "The Cœliac Affection".
Gee's account is published in the St. Bartholomew's Hospital Reports of 1888 and begins:
There is a kind of chronic indigestion which is met with in persons of all ages, yet is especially apt to affect children between one a five years old. Signs of the disease are yielded by the fæces; being loose, not formed, but not watery; more bulky than the food taken would seem to account for; pale in colour, as if devoid of bile; yeasty, frothy, an appearance probably due to fermentation; stinking, stench often very great, the food having undergone putrefaction rather than concoction.
Gee acknowledges earlier findings and terms for the disease and adopts the same term as Aretaeus. Unlike Aretaeus, he includes children in the scope of the affection, particularly those between one and five years old. He notes that most adults with the cœliac affection have been abroad. Gee finds the cause to be obscure and fails to spot anything abnormal during post-mortem examination. He perceptively states "if the patient can be cured at all, it must be by means of diet." Gee recognises that milk intolerance is a problem with coeliac children and that highly starched foods should be avoided. He forbids rice, sago, fruit and vegetables. Raw meat is recommended as are thin slices of toasted bread. Gee highlights particular success with a child "who was fed upon a quart of the best Dutch
mussel
Mussel () is the common name used for members of several families of bivalve molluscs, from saltwater and Freshwater bivalve, freshwater habitats. These groups have in common a shell whose outline is elongated and asymmetrical compared with other ...
s daily". However, the child cannot bear this diet for more than one season.
The cause of coeliac disease was eventually discovered to be an
autoimmune
In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an "autoimmune disease". P ...
reaction to
gliadin
Gliadin (a type of prolamin) is a class of proteins present in wheat and several other cereals within the grass genus ''Triticum''. Gliadins, which are a component of gluten, are essential for giving bread the ability to rise properly during baki ...
, a
gluten
Gluten is a structural protein naturally found in certain cereal grains. Although "gluten" often only refers to wheat proteins, in medical literature it refers to the combination of prolamin and glutelin proteins naturally occurring in all grain ...
protein found in
wheat
Wheat is a grass widely cultivated for its seed, a cereal grain that is a worldwide staple food. The many species of wheat together make up the genus ''Triticum'' ; the most widely grown is common wheat (''T. aestivum''). The archaeologi ...
, plus Secalin in rye and Hordien in barley.
The lining of the
small bowel
The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pa ...
is flattened, which
interferes with the absorption of nutrients. Gee would not have been able to discover this on
post-mortem
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any dis ...
since this lining quickly deteriorates on death.
The only effective treatment is a lifelong
gluten-free diet
A gluten-free diet (GFD) is a nutritional plan that strictly excludes gluten, which is a mixture of proteins found in wheat (and all of its species and hybrids, such as spelt, kamut, and triticale), as well as barley, rye, and oats. The inclus ...
. The rice, sago, fruit and vegetables that were forbidden by Gee would all have been quite safe to eat; the toasted bread he recommended, however, would not. The disease he describes in adults, affecting those returning from India and other foreign parts, is likely to have been
tropical sprue
Tropical sprue is a malabsorption disease commonly found in tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. It differs significantly from coeliac sprue. It appears to be a mor ...
. For many years this was inadequately distinguished from coeliac disease, which was also known as non-tropical sprue.
Achievements
* 1866: Elected Resident Fellow of the
Royal Medical and Chirurgical Society
The Medical and Chirurgical Society of London was a learned society of physicians and surgeons which was founded in 1805 by 26 personalities in these fields who had left the Medical Society of London (founded 1773) because of disagreement with the ...
. He was the society's librarian from 1877 to 1899.
* 1870: Elected Fellow of the
Royal College of Physicians
The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
. He was the college's censor from 1893 to 1894 and senior censor in 1897.
* 1901: Appointed physician to
George, Prince of Wales.
* The Royal College of Physicians named an annual lecture after him.
Publications
* Articles on
chicken pox
Chickenpox, also known as varicella, is a highly contagious disease caused by the initial infection with varicella zoster virus (VZV). The disease results in a characteristic skin rash that forms small, itchy blisters, which eventually scab ...
,
scarlet fever
Scarlet fever, also known as Scarlatina, is an infectious disease caused by ''Streptococcus pyogenes'' a Group A streptococcus (GAS). The infection is a type of Group A streptococcal infection (Group A strep). It most commonly affects childr ...
and
tubercular meningitis
Tuberculous meningitis, also known as TB meningitis or tubercular meningitis, is a specific type of bacterial meningitis caused by the ''Mycobacterium tuberculosis'' infection of the meninges—the system of membranes which envelop the central nerv ...
in Sir John Russel Reynolds' ''System of Medicine'' (vol. I & II, 1866; 1868).
* ''Auscultation and Percussion together with Other Methods of Physical Examination of the Chest'' by Samuel Jones Gee. London, 1870; 6th edition, 1906.
* Gee, Samuel.
An Address Delivered at the Opening of the Section of Diseases of Children” ''British Medical Journal'' 2.1179 (1883): 236–238. Print.
''Medical lectures and aphorisms''by Samuel Jones Gee. London, 1902; 3rd edition, 1907.
* Forty six papers in St Bartholomew's Hospital Reports.
** Gee, Samuel, Dr. "On the Coeliac Affection." ''St. Bartholomew’s Hospital Reports'' XXIV.B (1888): 17–20. Print.
References
Additional sources
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Further reading
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{{DEFAULTSORT:Gee, Samuel Jones
1839 births
1911 deaths
19th-century English medical doctors
People educated at University College School
Alumni of University College London
Academics of the Medical College of St Bartholomew's Hospital
20th-century English medical doctors
Burials at Kensal Green Cemetery
Physicians of Great Ormond Street Hospital