Graham Steell

Graham Steell (1851- 1942) was a Scottish physician and cardiologist.

Eponymously associated with the Graham Steell murmur (1888) –a high pitched early diastolic murmur of pulmonary incompetence caused by pulmonary hypertension

First to describe the association of oedema and peripheral neuropathy in chronic beer drinkers and in patients with beri-beri, which was later identified as a result of thiamine deficiency. Steell also observed the association between pericarditis and angina pectoris, which was made before coronary occlusion was known

Published extensive research and textbooks on fevers and cardiology

Best remembered for his excellence in correlating clinical signs and physiology, passionate bedside teaching, illegible notes, and brevity of speech.

Biography

Born 27 July 1851, Edinburgh, Scotland
Educated at the Edinburgh Academy. Originally he wanted to be a soldier, but was persuaded into medicine by his brother.
1872– Achieved M.B. from Edinburgh University
1873 –House-physician to George Balfour at the Edinburgh Royal Infirmary, who sparked Steell’s interest in cardiology
1874-77– Practiced at several fever hospitals in Edinburgh, Leeds and London
1877– Awarded M.D. with gold medal for his thesis ‘On scarlatina’ from the University of Edinburgh, which described patients scarlet, enteric and typhus fevers.
1878– Resident medical officer at Manchester Royal Infirmary, where he was constantly on call and lived in the hospital
1883– Honorary assistant physician to the Manchester Royal Infirmary and conducted extensive research into fevers.
1888 – Contracted Tuberculosis, but recovered after several months leave
1889– Fellowship of the Royal College of Physicians
1907– Elected chair of clinical medicine, Manchester Royal Infirmary
1911– Retired from the Royal Infirmary and university chair of clinical medicine
Died 10 January 1942, Streatham Common, England.He was noted to have maintained his passion for medicine right up until his death.

Medical Eponyms

Graham Steell murmur (1888)

Notable Quotables

In regards to the emergence of many new technologies in medicine:

Clinical medicine seems to me at the present moment to be in danger of losing something of its old charm, and in the future of losing much more

In relation to oedema:

Capricious distribution of dropsy is especially apt to occur in cases of the cardiac muscle-failure of beer-drinkers and of the disease known as beri-beri, of both of which diseases, it is curious to note,peripheral neuritis is a clinical feature. . . Curious special localizations of oedema met with, in cases of the kind, have been the scrotum, and together the upper trunk, upper extremities, and scalp and neck, so that the oedema simulates that resulting from mediastinal tumour

This type of heart failure is currently understood to be due to thiamine deficiency

Major Publications

Steell G. Physical Signs of Cardiac Disease. 1881.
Steell G. Thesis “On Scarlatina”. 1887.
Steell G. Murmur of high-pressure in pulmonary artery. The Medical Chronicle (Manchester). 1888;9:182 [Graham Steell murmur]
Steell G. Mitral regurgitation. Practitioner. 1891;47(2).
Steell G. Diastolic murmur in dilatation of the heart without arterial incompetence or auriculo-ventricular constriction. Practitioner. 1895;52(4).
Steell G. The Use of the Sphygmograph in Clinical Medicine. 1889.
Steell G. A Clinical Lecture on Pericarditis: Delivered at the Manchester Royal Infirmary. Br Med J. 1900;27;1(2039):181-183. [PMC2505426]
Steell G. Text-book on diseases of the heart. 1906.

References

Bramwell C. Graham Steell. Br Heart J. 1942 Jul; 4(3): 115–119. [PMC503491] [Graham Steell Portrait]
Fraser AG, Weston CF.The Graham Steell murmur: eponymous serendipity? J R Coll Physicians Lond. 1991;25(1):66-70. [PMID 2023159]
Review: Graham Steell (1851-1942) JAMA. 1965 Feb 22;191:671.
Brockbank,W. The Honorary Medical Staff of the Manchester Royal Infirmary, 1830-1948. Manchester University Press, 1965
Obituary. Graham Steell (1851-1942). British Medical Journal. 1942;1:129-131