Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

History of Hematology: Intrinsic Factors: William Bosworth Castle and the Development of Hematology and Clinical Investigation at Boston City Hospital Pioneering Hematology: The Research and Treatment of Malignant Blood Disorders—Reflections on a Life's Work

History of Hematology: Intrinsic Factors: William Bosworth Castle and the Development of... The Rare Books and Special Collections Department of Harvard University's Countway Library of Medicine has been responsible for a number of volumes related to the history of medicine in Boston and environs. Latest additions are these biographies of Castle and Moloney, eminent hematologists whose careers intersected yet were worlds apart. First is the story of William B. Castle, his mentors, colleagues, and students during 38 years of remarkable achievement at the Harvard Medical Unit and Thorndike Memorial Laboratory, Boston City Hospital. As son of a Harvard professor of genetics, Castle earned his MD in the mid-1920s from Harvard and spent most of his career affiliated with his alma mater. Mentors included George Minot, Nobel prize winner for the first successful treatment of pernicious anemia, Richard Cabot, originator of the New England Journal of Medicine clinicopathological conferences, and Henry Christian, Hersey Professor of the Theory and Practice of Physic at the Peter Bent Brigham Hospital. Eminent colleagues included Soma Weiss and Maxwell Finland. It was in elucidating pernicious anemia dynamics that Castle made an early and lasting impact on the physiologic approach to clinical investigation. There is an excitement in going from clinical experience to basic questions that haven't been clearly answered, then pursuing the answers with originality and determination. "Castle's law," according to his followers, states, "There is nothing like fact to stop an argument." His studies elucidated the relationship between achylia gastrica and pernicious anemia. He obtained human gastric juice from normal volunteers after a beefsteak meal, then administered it to pernicious anemia patients, observing the reticulocyte response. Variations on these studies led to 15 nascent publications. He made additional contributions in hematology, including advances in iron deficiency and hemolytic anemias. An informal conversation led to Linus Pauling's discovery of the molecular nature of sickle cell anemia. Intrinsic Factors is a well-documented, readable account of Castle's life and times. Many written records, taped sources, and personal interviews were used by Karnad in constructing this account. One gets a feel for typical and changing life on the wards and in the laboratory as the years rolled by. Among photographs is one of the 1951 to 1952 Harvard Medical Service, Boston City Hospital, alongside Castle's faithful mode of transport, his 1932 Model-A Ford coupe, aptly named "Extrinsic Tractor." In tribute both to him and to the significant role of the Veterans Administration (VA) in medical research and teaching, Castle was awarded the VA's first "Distinguished Physician" position on his retirement in 1968. He spent the next four years affiliated with the West Roxbury VA Hospital and interacting with VA physicians and investigators nationwide. He died in 1990 at age 92 years. Moloney, on the other hand, was a scrappy Boston kid of Irish extraction who made his way through Tufts medical school during the height of the depression. Though influenced by William Dameshek, he mainly studied hematology in the school of hard knocks. His is a fascinating autobiography: how he rose through the political machinations of Boston hospitals and medical schools, pioneered the use of several key hematologic tests in Boston, cared for D-day casualties in Britain, spent two years studying leukemia in Hiroshima survivors, later arranged for intensive leukemia chemotherapy facilities at the Brigham, and, all in all, carved out a remarkable academic and practice career. His story is told in a personal, entertaining way, including many great anecdotes. I was fascinated by his account of the dismal laboratory facilities available in most hospitals at the start of his career, of carrying his own basic laboratory tools around with him in a cigar box, and performing certain tests at home in his kitchen. He made a local name for himself by being able to do Quick prothrombin times in the early days of coumadin therapy and of introducing Rh testing early on. Included in his kit was a trusty bone marrow needle. He states, "In those days there were several famous hematologists in Boston, but none would make visits to hospitals other than their own, and certainly not to private homes as I frequently did." He had a number of interesting Army experiences. "The Medical Administrative Corp Colonel said I was to be Chief of the Pathology Laboratory at the 347th Station Hospital, a 350-bed hospital in England. I quietly pointed out that I was a hematologist, not a pathologist. This did not carry much weight; his mind had been made up. He responded, ‘You look through a microscope, don't you?' I had to admit that I did. He then said, ‘Then you are a pathologist. Dismissed!'" And later, "A British pathologist at Radcliffe Infirmary in Oxford was very kind and offered to show me how to do an autopsy." In working to ensure an adequate stocked blood bank in England, he became firm friends with Race and Sanger of the CDE terminology for Rh problems, and with Coombs of the Coombs test. He was chief of laboratories at the Boston City Hospital from 1954 to 1966 and Chief of Hematology and Professor of Medicine at the Peter Bent Brigham from 1966 to 1975. He continued to contribute to the field long after official retirement. He reluctantly acknowledges a historical trend in "hematology bows to oncology." Through it all, both of these physicians come through as consummate clinicians, teachers, and dedicated family men, who retained the common touch and a sense of humor. More than 400 trainees at the Thorndike and a like number on the Harvard medical service fell under Castle's light. Intrinsic Factors will bring back fond memories for them. Many old-timers who did not train there will find it of equal interest. This was the golden era of clinical investigation, and the problems and delights of being a part of it, so well conveyed here, were well known to those working at medical schools and major teaching hospitals elsewhere in the country. We were well aware of Castle and his colleagues at the Thorndike, and they constituted a model to emulate. Pioneering Hematology is also of great interest. Moloney had a fascinating and productive career, leaving his imprimatur on many trainees. He expresses many strong opinions on a variety of topics. I recommend both biographies as entertaining and instructive. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

History of Hematology: Intrinsic Factors: William Bosworth Castle and the Development of Hematology and Clinical Investigation at Boston City Hospital Pioneering Hematology: The Research and Treatment of Malignant Blood Disorders—Reflections on a Life's Work

JAMA , Volume 280 (6) – Aug 12, 1998
Download PDF
5 pages

Loading next page...
 
/lp/american-medical-association/history-of-hematology-intrinsic-factors-william-bosworth-castle-and-H9130CLbaW

References (0)

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
American Medical Association
Copyright
Copyright © 1998 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.280.6.574-JBK0812-3-1
Publisher site
See Article on Publisher Site

Abstract

The Rare Books and Special Collections Department of Harvard University's Countway Library of Medicine has been responsible for a number of volumes related to the history of medicine in Boston and environs. Latest additions are these biographies of Castle and Moloney, eminent hematologists whose careers intersected yet were worlds apart. First is the story of William B. Castle, his mentors, colleagues, and students during 38 years of remarkable achievement at the Harvard Medical Unit and Thorndike Memorial Laboratory, Boston City Hospital. As son of a Harvard professor of genetics, Castle earned his MD in the mid-1920s from Harvard and spent most of his career affiliated with his alma mater. Mentors included George Minot, Nobel prize winner for the first successful treatment of pernicious anemia, Richard Cabot, originator of the New England Journal of Medicine clinicopathological conferences, and Henry Christian, Hersey Professor of the Theory and Practice of Physic at the Peter Bent Brigham Hospital. Eminent colleagues included Soma Weiss and Maxwell Finland. It was in elucidating pernicious anemia dynamics that Castle made an early and lasting impact on the physiologic approach to clinical investigation. There is an excitement in going from clinical experience to basic questions that haven't been clearly answered, then pursuing the answers with originality and determination. "Castle's law," according to his followers, states, "There is nothing like fact to stop an argument." His studies elucidated the relationship between achylia gastrica and pernicious anemia. He obtained human gastric juice from normal volunteers after a beefsteak meal, then administered it to pernicious anemia patients, observing the reticulocyte response. Variations on these studies led to 15 nascent publications. He made additional contributions in hematology, including advances in iron deficiency and hemolytic anemias. An informal conversation led to Linus Pauling's discovery of the molecular nature of sickle cell anemia. Intrinsic Factors is a well-documented, readable account of Castle's life and times. Many written records, taped sources, and personal interviews were used by Karnad in constructing this account. One gets a feel for typical and changing life on the wards and in the laboratory as the years rolled by. Among photographs is one of the 1951 to 1952 Harvard Medical Service, Boston City Hospital, alongside Castle's faithful mode of transport, his 1932 Model-A Ford coupe, aptly named "Extrinsic Tractor." In tribute both to him and to the significant role of the Veterans Administration (VA) in medical research and teaching, Castle was awarded the VA's first "Distinguished Physician" position on his retirement in 1968. He spent the next four years affiliated with the West Roxbury VA Hospital and interacting with VA physicians and investigators nationwide. He died in 1990 at age 92 years. Moloney, on the other hand, was a scrappy Boston kid of Irish extraction who made his way through Tufts medical school during the height of the depression. Though influenced by William Dameshek, he mainly studied hematology in the school of hard knocks. His is a fascinating autobiography: how he rose through the political machinations of Boston hospitals and medical schools, pioneered the use of several key hematologic tests in Boston, cared for D-day casualties in Britain, spent two years studying leukemia in Hiroshima survivors, later arranged for intensive leukemia chemotherapy facilities at the Brigham, and, all in all, carved out a remarkable academic and practice career. His story is told in a personal, entertaining way, including many great anecdotes. I was fascinated by his account of the dismal laboratory facilities available in most hospitals at the start of his career, of carrying his own basic laboratory tools around with him in a cigar box, and performing certain tests at home in his kitchen. He made a local name for himself by being able to do Quick prothrombin times in the early days of coumadin therapy and of introducing Rh testing early on. Included in his kit was a trusty bone marrow needle. He states, "In those days there were several famous hematologists in Boston, but none would make visits to hospitals other than their own, and certainly not to private homes as I frequently did." He had a number of interesting Army experiences. "The Medical Administrative Corp Colonel said I was to be Chief of the Pathology Laboratory at the 347th Station Hospital, a 350-bed hospital in England. I quietly pointed out that I was a hematologist, not a pathologist. This did not carry much weight; his mind had been made up. He responded, ‘You look through a microscope, don't you?' I had to admit that I did. He then said, ‘Then you are a pathologist. Dismissed!'" And later, "A British pathologist at Radcliffe Infirmary in Oxford was very kind and offered to show me how to do an autopsy." In working to ensure an adequate stocked blood bank in England, he became firm friends with Race and Sanger of the CDE terminology for Rh problems, and with Coombs of the Coombs test. He was chief of laboratories at the Boston City Hospital from 1954 to 1966 and Chief of Hematology and Professor of Medicine at the Peter Bent Brigham from 1966 to 1975. He continued to contribute to the field long after official retirement. He reluctantly acknowledges a historical trend in "hematology bows to oncology." Through it all, both of these physicians come through as consummate clinicians, teachers, and dedicated family men, who retained the common touch and a sense of humor. More than 400 trainees at the Thorndike and a like number on the Harvard medical service fell under Castle's light. Intrinsic Factors will bring back fond memories for them. Many old-timers who did not train there will find it of equal interest. This was the golden era of clinical investigation, and the problems and delights of being a part of it, so well conveyed here, were well known to those working at medical schools and major teaching hospitals elsewhere in the country. We were well aware of Castle and his colleagues at the Thorndike, and they constituted a model to emulate. Pioneering Hematology is also of great interest. Moloney had a fascinating and productive career, leaving his imprimatur on many trainees. He expresses many strong opinions on a variety of topics. I recommend both biographies as entertaining and instructive.

Journal

JAMA – American Medical Association

Published: Aug 12, 1998

There are no references for this article.