George Mallory

Biography

• Born on February 14, 1900 the son of Frank Burr Mallory (1862-1921) for whom Mallory’s bodies are named
• 1922 – graduated from Harvard College
• 1926 – graduated MD, Harvard Medical School
• 1926-1928 internship in internal medicine at the Boston City Hospital
• 1929 – Along with physician Soma Weiss (1898-1942) described hemorrhagic lacerations of the cardiac orifice of the stomach due to vomiting – Mallory-Weiss syndrome
• 1933 – commenced work in pathology at the Mallory Institute of Pathology under Frederic Parker Jr
• 1949 – Professor of Pathology at Boston University School of Medicine
• 1951 – Chief of Pathology at the Mallory Institute of Pathology at Boston City until retirement in 1965
• Died on April 8, 1986 in Needham, Massachusetts

Medical Eponyms

Mallory–Weiss Lesion (1929)

The characteristic of this lesion are longitudinal mucosal lacerations in the distal esophagus and proximal stomach, which are usually associated with forceful or prolonged vomiting, retching or coughing.

In 1929 George Mallory and Soma Weiss described 15 cases. They identified a characteristic history of heavy alcohol use followed by persistent nausea, retching and vomiting.

It was assumed by the clinicians that the cause of haematemesis was a ruptured varice however there was no underlying liver cirrhosis identified. Of the 15 cases they document, 4 died from the blood loss and in postmortem there were similar lesions. These lesions were described as fissure-like and were located in the mucosa around the cardia of the stomach. In 1 of the 4 patients that died, haematemesis was not a feature however was found to havesame lesion.

Mallory and Weiss arrived at the conclusion that these lesions were related to persistent vomiting rather than alcohol due to a case with persistent vomiting in pregnancy. They then went one step further to simulate increased pressure by dilating the stomach against a tied pylorus reproducing the lacerations at the cardia in a cadaveric study.

In 1932 Mallory and Weiss report on two further cases, one which would be considered classical and the second which might now be viewed differently. The second case was not identified until post mortem when they discovered a lonitudinal ulcer at the oesophageal junction. Based on some infrequent prior episodes of small volume haematemesis, Mallory and Weiss drew the conclusions that acute longitudinal lacerations could lead to chronic longitudinal lacerations and ulcers. Perhaps this would now be more inkeeping with Barrett’s Oesophagus.

In their paper Mallory and Weiss identify – Johann Friedrich Hermann Albers (1833) as the first to document an ulcer in the lower oesophagus. Mallory and Weiss also comment on the work of Heinrich Irenaeus Quincke (1842–1922) and the less common oesophageal ‘peptic’ ulcer. Mallory and Weiss then separated their work from that reported by Georges Dieulafoy (1839-1911) based on histology.

Major Publications

• Mallory GK, Weiss S. Hemorrhages from lacerations of the cardiac orifice of the stomach due to vomiting. American Journal of the Medical Sciences, 1929; 178: 506–15 [Mallory-Weiss syndrome; Mallory-Weiss lesion]
• Weiss S, Mallory GK. Lesions of the cardiac orifice of the stomach produced by vomiting. Journal of the American Medical Association, Chicago, 1932; 98(16): 1353-1355 [Mallory-Weiss syndrome; Mallory-Weiss lesion]

References

Biography

• van den Tweel JG. Mallory, George Kenneth (1900–1986). In: Pioneers in Pathology. 2017: 357-360

Eponymous terms

• Albers JFH. Über stechende Geschwüre der Speiseröhre und der Atemwege. Journal Der Chirurgie Und Augen-heilkunde 1833; 19: 1
• Dieulafoy G. Exulceratio simplex. L’intervention chirurgicale dans les hématémèses foudroyantes consécutives à l’exulcération simple de l’estomac. Bulletin de l’Académie nationale de médecine 1898; 39: 49-84.
• Dieulafoy G. Exulceratio simplex. Clinique médicale de l’Hôtel-Dieu de Paris, 1898: II.
• Quincke H. Ulcus oesophagi ex digestione. Deutsches Archiv für klinische Medicin. 1879; 24: 72-79.
• Carr JC. The Mallory-Weiss Syndrome. Clin Radiol. 1973 Jan;24(1):107-12
• Herbella FA, Matone J, Del Grande JC. Eponyms in esophageal surgery, part 2. Dis Esophagus. 2005;18(1):4-16.