Charles Saint

Biographical Timeline

• Born August 14, 1886 in Bedlington Station, Northumberland, England, to James Saint (schoolmaster) and Mary Ann Downey Morris.
• 1901 – Achieved First Class Honours in Oxford Junior Examination with distinction in mathematics.
• 1903 – Won Northumberland County Council Major Scholarship and the Durham University Medical Scholarship.
• 1904 – Father James Saint died; family moved from schoolhouse to Choppington.
• 1905 – Awarded Tullock Scholarship for anatomy and physics.
• 1908 – Graduated MBBS with first-class honours, Durham University College of Medicine, Newcastle. Won 15 of 18 possible prizes and 7 scholarships.
• 1910–1912 – Served as house surgeon and registrar under Professor James Rutherford Morison (1853-1939) at Royal Victoria Infirmary.
• 1912–1914 – Appointed lead surgeon at Fleming Memorial Children’s Hospital, Newcastle.
• 1914–1919 – Served in WWI as RAMC officer in forward surgical units; awarded Médaille d’Honneur en Or (Gold) in 1916 and CBE in 1919. Operated on more than 400 cases; met and befriended Marie Curie.
• 1920 – Appointed Foundation Professor of Surgery, University of Cape Town (UCT), South Africa.
• 1927 – Surgical department relocated to new UCT Medical School, Observatory.
• 1935 – Honorary Fellow of the Royal Australasian College of Surgeons
• 1938 – Clinical teaching moved to newly completed Groote Schuur Hospital.
• 1942 – Honorary Fellow of Greek Surgical Society
• 1946 – Retired from UCT after 26 years; trained over 1,300 students including 7 professors.
• 1947 – Official retirement and departure from UCT.
• 1953 – Honary Fellow of Royal Society of Medicine
• 1960 – Retired to Sark, Channel Islands.
• 1968 – Awarded Honorary Fellow of the College of Surgeons of South Africa
• Died on February 15, 1973 on Sark, aged 86. Bequeathed funds to support the medical needs of island residents via the Charles F.M. Saint Trust.

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Medical Eponyms

Saint’s triad (1946)

Saint’s triad refers to the clinical coexistence of three conditions:

• Hiatal hernia
• Cholelithiasis (gallstones)
• Diverticular disease (diverticulosis of colon)

1946 – Charles F. M. Saint (1886–1973), Professor of Surgery at the University of Cape Town, anecdotally highlighted the importance of suspecting multiple coexisting diseases when clinical signs diverged from classic presentations.

…the importance of considering the possibility of multiple separate diseases in a patient whenever his or her history and the results of the physical examination were atypical of any single condition.

Though the triad is uncommon in modern practice, its conceptual legacy endures in surgical thinking and differential diagnosis frameworks.

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Key Medical Contributions

Saint’s Aphorisms

Saint was as revered for his teaching style as he was for his surgical skill. He left behind a number of often-quoted aphorisms that encapsulate his approach to medicine and life. These include:

• “The brain is like a muscle – it atrophies with disuse.”
• “The simpler the procedure, the better the outcome.”
• “Early to bed and early to rise, work like hell and organise!”
• “Always attempt what you are afraid to do – it will be easier next time.”
• “A good assistant does not always become a good chief, but a bad assistant never does. A good chief has always been a good assistant.”

These sayings were regularly passed down among trainees and have become part of his enduring legacy in surgical education.

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Major Publications

• Saint CFM. An introduction to clinical surgery, surgical wherefores and therefores; a reasoned explanation of surgical note-taking. 1949
• Saint CF. The aphorism in the teaching of clinical surgery as illustrated in biliary attacks and jaundice. S Afr Med J. 1954 Jun 5;28(23):471-3
• Saint CF. Some recollections of the early days of the Medical School, Cape Town. S Afr Med J. 1963 Jan 19;37:49-51. 
• Saint CF. Saint’s triad. The origin and story of its recognition. Rev Surg. 1966 Jan-Feb;23(1):1-4.
• Saint CF. Another look around. S Afr Med J. 1967 Jul 29;41(28):687-94.
• Saint CF. The place and status of nature in the ensemble of surgical teaching. S Afr Med J. 1969 Apr 19;43(16):464-9.

References

Biography

• Louw JH. Charles F.M. Saint. S Afr Med J. 1973 Feb 24;47(8):282.
• Haubrich WS. Saint of Saint’s Triad. Gastroenterology, 2007; 132(2): 476
• Rode H, Millar AJ. Our surgical heritage: the role of the Department of Paediatric Surgery in the development of paediatric surgery in Cape Town, in Africa, and around the world. S Afr Med J. 2012 Mar 23;102(6):409-11.
• Krige JEJ, Fieggen G. Charles F M Saint – South Africa’s original surgical pioneer. S Afr Med J. 2021 May 31;111(6):563-566.
• Saint, Charles Frederick Morris (1886 – 1973). Plarr’s Lives of the Fellows

Eponymous Terms

• Muller CJB. Hiatus hernia, diverticula and gall stones* : Saint’s triad. South African Medical Journal 1948; 22(11): 376-382
• Palmer ED. Saint’s triad: hiatus hernia, diverticulosis coli and gall stones. Am J Dig Dis. 1951 Aug;18(8):240-1.