Samuel Gee
Encyclopedia
Samuel Jones Gee was an English
physician
and paediatrician. In 1888, Gee published the first complete modern description of the clinical picture of coeliac disease
, and theorised on the importance of diet in its control. His contribution led to the eponym
Gee's disease. Gee is also credited with the first English-language description of cyclic vomiting syndrome
.
, 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
, supplemented by home schooling. His secondary education
was at the University College School
, London. He went on to study medicine at the University College Hospital
, 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
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
.
Gee was married to Sarah Cooper in 1875 with whom he had two daughters. He died suddenly, of a coronary occlusion
, while on holiday in Keswick, Cumbria
.
, meant Gee was familiar with the work of Aretaeus of Cappadocia
who first wrote of "The Cœliac Affection". Gee's account is published in the St. Bartholomew's Hospital Reports of 1888 and begins:
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
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
reaction to gliadin
, a gluten
protein found in wheat
, plus Secalin in rye and Hordien in barley.
The lining of the small bowel is flattened, which interferes with the absorption
of nutrients. Gee would not have been able to discover this on post-mortem
since this lining quickly deteriorates on death. The only effective treatment is a lifelong gluten-free diet
. 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
. For many years this was inadequately distinguished from coeliac disease, which was also known as non-tropical sprue.
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
and paediatrician. In 1888, Gee published the first complete modern description of the clinical picture of coeliac disease
Coeliac disease
Coeliac disease , is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward...
, and theorised on the importance of diet in its control. His contribution led to the eponym
Eponym
An eponym is the name of a person or thing, whether real or fictitious, after which a particular place, tribe, era, discovery, or other item is named or thought to be named...
Gee's disease. Gee is also credited with the first English-language description of cyclic vomiting syndrome
Cyclic vomiting syndrome
Cyclic vomiting syndrome or cyclical vomiting syndrome is a condition whose symptoms are recurring attacks of intense nausea, vomiting and sometimes abdominal pain and/or headaches or migraines...
.
Life
Samuel Gee was born in LondonLondon
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
, 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
A primary school is an institution in which children receive the first stage of compulsory education known as primary or elementary education. Primary school is the preferred term in the United Kingdom and many Commonwealth Nations, and in most publications of the United Nations Educational,...
, supplemented by home schooling. His secondary education
Secondary education
Secondary education is the stage of education following primary education. Secondary education includes the final stage of compulsory education and in many countries it is entirely compulsory. The next stage of education is usually college or university...
was at the University College School
University College School
University College School, generally known as UCS, is an Independent school charity situated in Hampstead, north west London, England. The school was founded in 1830 by University College London and inherited many of that institution's progressive and secular views...
, London. He went on to study medicine at the University College Hospital
University College Hospital
University College Hospital is a teaching hospital located in London, United Kingdom. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London ....
, gaining an MB in 1861 followed by an MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
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
Great Ormond Street Hospital
Great Ormond Street Hospital for Children is a children's hospital located in London, United Kingdom...
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
St Bartholomew's Hospital, also known as Barts, is a hospital in Smithfield in the City of London, England.-Early history:It was founded in 1123 by Raherus or Rahere , a favourite courtier of King Henry I...
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
Goulstonian Lectures
The Goulstonian Lectures are an annual lecture series given on behalf of the Royal College of Physicians in London. They began in 1639. The 2009 Goulstonian Lecturer was Geraint Rees. The lectures are named for Theodore Goulston , who founded them with a bequest. Up to the end of the 19th century,...
, the 1892 Bradshaw
Bradshaw Lecture
The Bradshaw Lectures are prestigious lectureships given at the invitation of the Royal College of Physicians and the Royal College of Surgeons of England....
and the 1899 Lumleian Lectures
Lumleian Lectures
The Lumleian Lectures are a series of annual lectures run by the Royal College of Physicians of London, started in 1582 and now run by the Lumleian Trust. The name commemorates John Lumley, 1st Baron Lumley, who with Richard Caldwell of the College endowed the lectures, initially confined to...
.
Gee was married to Sarah Cooper in 1875 with whom he had two daughters. He died suddenly, of a coronary occlusion
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: the myocardium is however damaged....
, while on holiday in Keswick, Cumbria
Keswick, Cumbria
Keswick is a market town and civil parish within the Borough of Allerdale in Cumbria, England. It had a population of 4,984, according to the 2001 census, and is situated just north of Derwent Water, and a short distance from Bassenthwaite Lake, both in the Lake District National Park...
.
Coeliac 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 GreekAncient Greek
Ancient Greek is the stage of the Greek language in the periods spanning the times c. 9th–6th centuries BC, , c. 5th–4th centuries BC , and the c. 3rd century BC – 6th century AD of ancient Greece and the ancient world; being predated in the 2nd millennium BC by Mycenaean Greek...
, meant Gee was familiar with the work of Aretaeus of Cappadocia
Aretaeus of Cappadocia
Aretaeus , is one of the most celebrated of the ancient Greek physicians, of whose life, however, few particulars are known. There is some uncertainty regarding both his age and country, but it seems probable that he practised in the 1st century CE, during the reign of Nero or Vespasian...
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
The common name mussel is used for members of several families of clams or bivalvia mollusca, from saltwater and freshwater habitats. These groups have in common a shell whose outline is elongated and asymmetrical compared with other edible clams, which are often more or less rounded or oval.The...
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
Autoimmunity
Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues. Any disease that results from such an aberrant immune response is termed an autoimmune disease...
reaction to gliadin
Gliadin
Gliadin is a glycoprotein present in wheat and several other cereals within the grass genus Triticum. Gliadins are prolamins and are separated on the basis of electrophoretic mobility and isoelectric focusing.- Types :...
, a gluten
Gluten
Gluten is a protein composite found in foods processed from wheat and related grain species, including barley and rye...
protein found in wheat
Wheat
Wheat is a cereal grain, originally from the Levant region of the Near East, but now cultivated worldwide. In 2007 world production of wheat was 607 million tons, making it the third most-produced cereal after maize and rice...
, plus Secalin in rye and Hordien in barley.
The lining of the small bowel is flattened, which interferes with the absorption
Malabsorption
Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal tract.Impairment can be of single or multiple nutrients depending on the abnormality...
of nutrients. Gee would not have been able to discover this on post-mortem
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
since this lining quickly deteriorates on death. The only effective treatment is a lifelong gluten-free diet
Gluten-free diet
A gluten-free diet is a diet that excludes foods containing gluten. Gluten is a protein found in wheat , barley, rye, malts and triticale. It is used as a food additive in the form of a flavoring, stabilizing or thickening agent, often as "dextrin"...
. 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
Tropical sprue is a malabsorption disease commonly found in the tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine.It differs significantly from coeliac sprue.-Symptoms and signs:...
. 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 SocietyMedical and Chirurgical Society of LondonThe 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 because of disagreement with the autocratic style of its president, James Sims...
. He was the society's librarian from 1877–99. - 1870: Elected Fellow of the Royal College of PhysiciansRoyal College of PhysiciansThe Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...
. He was the College's censor from 1893–94 and senior censor in 1897. - 1901: Appointed physician to George, Prince of WalesGeorge V of the United KingdomGeorge V was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 through the First World War until his death in 1936....
. - The Royal College of Physicians named an annual lecture after him.
Publications
- Articles on chicken pox, scarlet feverScarlet feverScarlet fever is a disease caused by exotoxin released by Streptococcus pyogenes. Once a major cause of death, it is now effectively treated with antibiotics...
and tubercular meningitisTuberculous meningitisTuberculous meningitis is also known as TB meningitis or tubercular meningitis.Tuberculous meningitis is Mycobacterium tuberculosis infection of the meninges—the system of membranes which envelops the central nervous system. It is the most common form of CNS tuberculosis.-Clinical features:Fever...
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.
- Medical lectures and aphorisms by Samuel Jones Gee. London, 1902; 3rd edition, 1907.
- Forty six papers in St Bartholomew's Hospital Reports.