Joe Vincent Meigs

Joe Vincent Meigs (1892-1963) portrait

Joe Vincent Meigs (1892-1963) was an American obstetrician and gynecologist

Meigs was a pioneer of gynaecology best known for describing the triad of benign ovarian fibroma, ascites, and pleural effusion known as Meigs syndrome. Through careful observation and post-operative follow-up, he challenged prevailing diagnoses such as tuberculosis and established that these symptoms could resolve completely after tumour removal. This contribution significantly influenced diagnostic criteria in gynaecologic oncology and internal medicine.

Meigs was also a key figure in modernising the Wertheim radical hysterectomy for cervical cancer. His surgical approach and large clinical series helped standardise the procedure and improve outcomes, with his 1955 report on 473 cases marking a milestone in the field. His collaboration with Winifred Liu documented improved survival rates for early-stage disease and highlighted the importance of lymphadenectomy in surgical staging.

Beyond the operating theatre, Meigs played a vital role in validating Papanicolaou smear cytology as a tool for early cancer detection. His joint research with Ruth Graham in 1949 demonstrated the reliability of the Pap smear in detecting cervical cancer before histologic changes were apparent, helping pave the way for widespread cervical cancer screening.

Biographical Timeline
  • Born on October 24, 1892 in Lowell, Massachusetts, USA.
  • 1915 – A.B. degree from Princeton University.
  • 1919 – M.D. from Harvard Medical School.
  • 1920s – Postgraduate training in gynecology at Massachusetts General Hospital; worked under William Phillips Graves at the Free Hospital for Women in Brookline.
  • 1927 – Appointed gynecologist to the Pondville State Cancer Hospital, MA Department of Public Health.
  • 1932–1942 – Instructor in Surgery at Harvard Medical School.
  • 1934 – Published Tumors of the Female Pelvic Organs, introducing what would later be termed Meigs syndrome (ovarian fibroma, ascites, hydrothorax).
  • 1937 – Co-authored seminal paper with John W. Cass detailing 7 cases of the syndrome
  • 1939 – Performed first radical hysterectomy (Wertheim operation variant).
  • 1942 – Promoted to Clinical Professor of Gynecology, Harvard Medical School.
  • 1943–1945 – Published key papers on Wertheim operation and cervical cancer surgery outcomes.
  • 1944 – With Ruth Graham, validated Papanicolaou’s vaginal cytology work; histologically confirmed cervical cancer in patients with negative biopsies but positive smears.
  • 1954 – Edited Surgical Treatment of Cancer of the Cervix; received Honorary Fellowship of the RCOG.
  • 1955 – With Liu, published data on 473 radical hysterectomy cases with a 74% five-year survival rate for Stage I cervical cancer.
  • Died on October 24, 1963 of a coronary occlusion aboard a flight between Rochester and Syracuse, on his 71st birthday.
Medical Eponyms
Meigs syndrome (1934)

Meigs’ syndrome is classically defined as the triad of:

  • Benign ovarian fibroma (or fibroma-like tumour)
  • Ascites
  • Pleural effusion (hydrothorax)

Both fluid accumulations resolve spontaneously after tumour removal. It is a diagnosis of exclusion, requiring histological confirmation of a benign tumour and elimination of metastatic disease.

1934 – In his book Tumors of the Female Pelvic Organ Meigs noted a recurrent pattern of fluid accumulation in association with benign ovarian fibromas.

Three patients with large cellular tumors had been in the medical ward, where because of fluid in the chest a diagnosis of tuberculosis had been made and their chests tapped. Paracentesis had been done more than three times in each case…An abdominal tumor was finally discovered and operation advised. A fibroma was found in each instance with fluid in the abdomen ; the tumor was removed and the patient promptly recovered.

Meigs 1934

1937 – Meigs and John W. Cass published a more detailed clinical series in American Journal of Obstetrics and Gynecology, reporting seven cases of ovarian fibromas accompanied by ascites and hydrothorax. This was the first formal articulation of the syndrome as a distinct clinical entity.

A pelvic tumor, ascites, and hydrothorax occurred together in all seven cases…In each case the operative removal of the ovarian fibroma was followed by prompt and complete disappearance of both the abdominal and the thoracic fluids.

Meigs, Cass 1937

1940s – The eponym “Meigs’ syndrome” came into generalised clinical usage with retrospective attribution to Meigs’ 1937 series. However, earlier related descriptions exist (e.g., Demons and Lemoine in 1902), and some authors distinguish Demons–Meigs syndrome to reflect this broader historical lineage.

Wertheim–Meigs Operation (1944)

The Wertheim–Meigs operation is a radical abdominal hysterectomy combined with extensive pelvic lymphadenectomy, originally developed by Ernst Wertheim (1864-1920) in Austria (1898) for cervical carcinoma. Meigs later modified and popularised the approach in the United States, emphasising more complete lymph node removal and improved perioperative mortality.

1944 – Meigs reintroduced the radical hysterectomy technique to U.S. practice advocating routine removal of pelvic nodes and reporting significantly improved outcomes (operative mortality ~1 %) when performed by specialist gynaecologic oncologists.

It is the purpose of this paper to describe the technic of radical hysterectomy as it is done in the Massachusetts General Hospital… The operation used is a modification of the classic Wertheim operation and involves a wide removal of all pelvic lymph nodes in addition to the uterus, parametria and upper vagina.

Meigs 1944

The eponym “Wertheim–Meigs” gained traction in the 1950s, reflecting Meigs’ modifications and wide dissemination of the technique.

1955 – Meigs and Liu presented a comprehensive surgical series analyzing 473 radical hysterectomies performed between 1941 and 1954 at the Massachusetts General Hospital. Among these, 244 cases were treated for primary invasive cervical carcinoma.

The paper demonstrated a five-year survival rate of 74% for patients with Stage I disease, reinforcing the role of radical surgery in early-stage cervical cancer. They emphasized the importance of pelvic lymphadenectomy and outlined operative refinements that minimized complications.

Key Medical Contributions
Validation of the Vaginal Smear (1949)

Ruth Graham and Joe Vincent Meigs critically assessed the utility of the Papanicolaou smear in the early detection of cervical cancer. Through clinical correlation with histology, they showed that cytologic changes could precede visible lesions or biopsy confirmation, leading to earlier diagnosis. Their work provided early validation of Pap smear screening and advocated for its broader use in routine gynaecological practice.

This study contributed to the eventual global adoption of cervical cytology screening and demonstrated the collaboration between cytologists and surgeons in cancer prevention.

Smear cytology has revealed latent carcinomatous change in otherwise normal-appearing cervices and may indeed precede histologic confirmation

Graham & Meigs, 1949
Major Publications
References

Biography

Eponymous terms

Eponym

the person behind the name

more eponyms…

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |

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