John Cosh
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John Cosh (1915–2005) was a British
rheumatologist Rheumatology (Greek ''ῥεῦμα'', ''rheûma'', flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatolog ...
. He is known for his long-term studies of the effects of rheumatoid
arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...
, co-discovery of the genes associated with rheumatoid arthritis, and his work on the benefits of
herbal medicine Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern remed ...
s. In 1973, with R K Jacoby and M I Jayson, he published an 11-year follow-up of 100 patients newly diagnosed as having rheumatoid arthritis and followed them for a further 30 years, showing that rheumatoid arthritis is a progressive disease impairing function for decades after onset. By 2004 eight of the sample were severely disabled with rheumatoid arthritis, three were less disabled, and only five had normal functioning. Of the 84 who died, median survival was reduced by 10 to 11 years, and the leading cause of death was
heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
. In 1986 he published, with other rheumatologists, a study that showed the association of rheumatoid arthritis with several human lymphocyte antigens; the associations were stronger in patients with more advanced disease. John Cosh had originally wanted to be a heart surgeon, but his interests shifted towards cardiology and then to the cardiological aspects of rheumatology. He was born in
Bristol Bristol () is a city, ceremonial county and unitary authority in England. Situated on the River Avon, it is bordered by the ceremonial counties of Gloucestershire to the north and Somerset to the south. Bristol is the most populous city in ...
, the son of a pharmacist. From
Bristol Grammar School Bristol Grammar School (BGS) is a 4–18 mixed, independent day school in Bristol, England. It was founded in 1532 by Royal Charter for the teaching of 'good manners and literature', endowed by wealthy Bristol merchants Robert and Nicholas Thorn ...
he won a scholarship to
St John's College, Cambridge St John's College is a Colleges of the University of Cambridge, constituent college of the University of Cambridge founded by the House of Tudor, Tudor matriarch Lady Margaret Beaufort. In constitutional terms, the college is a charitable corpo ...
, for his pre-clinical studies, and went to
St Thomas's Hospital Medical School St Thomas's Hospital Medical School in London was one of the oldest and most prestigious medical schools in the UK. The school was absorbed to form part of King's College London. History It was part of one of the oldest hospitals in London, ...
,
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 ...
, for his clinical training. He qualified in 1940 and became a house physician at Lambeth Hospital, a satellite hospital of St Thomas's. From there he went to the
Royal Hampshire County Hospital The Royal Hampshire County Hospital in Winchester is a District General Hospital serving much of central Hampshire. It is owned and run by the Hampshire Hospitals NHS Foundation Trust. It is commonly abbreviated to RHCH, or alternatively, Winc ...
in
Winchester Winchester is a City status in the United Kingdom, cathedral city in Hampshire, England. The city lies at the heart of the wider City of Winchester, a local government Districts of England, district, at the western end of the South Downs Nation ...
. He was called up into the
Royal Navy The Royal Navy (RN) is the United Kingdom's naval warfare force. Although warships were used by English and Scottish kings from the early medieval period, the first major maritime engagements were fought in the Hundred Years' War against F ...
Volunteer Reserve in 1942, serving on Arctic convoys to
Murmansk Murmansk (Russian: ''Мурманск'' lit. "Norwegian coast"; Finnish: ''Murmansk'', sometimes ''Muurmanski'', previously ''Muurmanni''; Norwegian: ''Norskekysten;'' Northern Sámi: ''Murmánska;'' Kildin Sámi: ''Мурман ланнҍ'') i ...
and
Archangel Archangels () are the second lowest rank of angel in the hierarchy of angels. The word ''archangel'' itself is usually associated with the Abrahamic religions, but beings that are very similar to archangels are found in a number of other relig ...
, was on the sidelines at the disastrous Dieppe landing, and took part in the landings in
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical re ...
in 1943 and 1944. He was mentioned in dispatches in 1945. After the second world war he went to Bristol to train in
cardiology Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart d ...
and in 1948 was appointed registrar at
Bristol Royal Infirmary The Bristol Royal Infirmary, also known as the BRI, is a large teaching hospital situated in the centre of Bristol, England. It has links with the nearby University of Bristol and the Faculty of Health and Social Care at the University of the Wes ...
, noted for studies in rheumatic heart disease. From 1951 to 1957 he was lecturer in medicine at
Bristol University , mottoeng = earningpromotes one's innate power (from Horace, ''Ode 4.4'') , established = 1595 – Merchant Venturers School1876 – University College, Bristol1909 – received royal charter , type ...
. During this time he published research on vibration sense, patent ductus arteriosus, paroxysmal nodal
tachycardia Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (su ...
, and primordial germ cells. Rheumatic fever was common at the time, and left many patients, most of them young, with damaged
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
s. In the late 1950s his research interest, and publications, shifted towards rheumatic heart disease and to the long term aspects of rheumatoid arthritis. Altogether he published 51 papers, many of major importance. With John Lever, a
pathologist Pathology is the study of the causal, causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when us ...
, he edited Rheumatic Diseases and the Heart (Springer Verlag, 1988). In 1957 he became consultant
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 ...
for the
Bath Bath may refer to: * Bathing, immersion in a fluid ** Bathtub, a large open container for water, in which a person may wash their body ** Public bathing, a public place where people bathe * Thermae, ancient Roman public bathing facilities Plac ...
clinical area, practising cardiology at the Royal United Hospital and general medicine at the Royal National Hospital for Rheumatic Diseases. He felt he lacked expertise in rheumatic diseases and determined to teach himself. He attended ward rounds with the rheumatologist George Kersley, who appointed him, went to
Hammersmith Hospital Hammersmith Hospital, formerly the Military Orthopaedic Hospital, and later the Special Surgical Hospital, is a major teaching hospital in White City, West London. It is part of Imperial College Healthcare NHS Trust in the London Borough of H ...
every week to attend Eric Bywaters' ward rounds, and visited Manchester, which had the United Kingdom's only professorial rheumatology unit. In 1959 he was awarded the Royal College of Physicians' Heberden medal for his research in rheumatology. He retired in 1982. He retired to
Totnes Totnes ( or ) is a market town and civil parishes in England, civil parish at the head of the estuary of the River Dart in Devon, England, within the South Devon Area of Outstanding Natural Beauty. It is about west of Paignton, about west-so ...
, to be near
Dartington Hall Dartington Hall in Dartington, near Totnes, Devon, England, is an historic house and country estate of dating from medieval times. The group of late 14th century buildings are Grade I listed; described in Pevsner's Buildings of England as "on ...
, where he could indulge his love of
music Music is generally defined as the art of arranging sound to create some combination of form, harmony, melody, rhythm or otherwise expressive content. Exact definitions of music vary considerably around the world, though it is an aspect ...
. Predeceased by his wife, Kate Jackson, he left two sons and a daughter.John Cosh's obituary
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References

{{DEFAULTSORT:Cosh, John 1915 births 2005 deaths People educated at Bristol Grammar School Alumni of St John's College, Cambridge