John Alfred Ryle

Biography

• Born 1889, Brighton. Third in a family of 10 children, son of Dr RJ Ryle.
• 1913 – Qualified in medicine, Guy’s hospital, London. Won Gold Medal in medicine.
• 1914-1918 RAMC WWI, investigated typhoid and trench fever
• 1924 – Fellow of the Royal College of Physicians (FRCP) and elected physician to Guy’s hospital, London
• 1932-1936 Physician to King George V, his household and then Physician Extraordinary to the King
• 1935 – Regius chair of physic at Cambridge. Surveyed the hospital on the East Coast from Newcastle to London to determine which locations would serve well as Emergency Hospitals in the event of war.
• 1943 – First professor of social medicine (epidemiology) at Oxford studying the environmental factors in the production of disease, and in spite of poor health traveled widely
• Died 1950 of a heart attack

Medical Eponyms

Ryle Tube (1921)

Thin, all rubber nasogastric tube. Ryle made modifications to the brass-tipped nasogastric tube introduced by Max Einhorn (1862–1953) in 1909. It was as a result of his wife’s inability to swallow the larger Einhorn tube that Ryle made his modifications. Ryle recorded experiments performed on himself:

to ascertain (1) the degree of discomfort entailed by swallowing and retaining the gastric tube, and (2) the secretory response to a standard test meal in a healthy subject; on no occasion was any real difficulty experienced in swallowing the tube, and after the first trial no unpleasant symptom of any kind was noted, talking and even mastication not being interfered with.

Ryle 1921; 71: 43

Angor animi (1928)

Ryle coined the phrase to describe “the aura of a nervous storm having its origin in those medullary centres upon which the act of living depends” during his work on vertigo and tumours of the vagus nerve and CNS.  He considered it a ‘medullary aura’, akin to aura’s associated with seizures or migraines. 

What a strange force it is that can stir, and with such intensity, a consciousness of the imminence of an event of which there can never have been any actual experience, and yet is so frequently inoperative when death is at hand.

Ryle JA, 1928; 78: 371-376

Ryle later developed angina in 1942 and described his own experiences of angor animi in 1950, linking the term to a cardiac origin and not only neurogenic phenomena. His son completed the postscript after his death.

• Ryle JA. The sense of dying–a postscript. Guy’s Hospital Report. 1950; 99(4): 204-229.
• Ryle JA. Angor animi, or the sense of dying. Guy’s Hospital Report. 1950; 99(4): 230-235.

Controversies

Firm advocate of the National Health Service and creating less disparity between consultants and other doctors led to incomprehension and hostility from many of his colleagues

Major Publications

• Ryle JA. Studies in Gastric Secretion. Guy’s Hospital Report. 1921; 71: 43.
• Bennett TJ, Ryle JA. Studies in Gastric Secretion. Guy’s Hospital Report. 1921; 71: 286. [gruel test-meal]
• Ryle JA. Discussion on the diagnosis of gastric ulcer. Proc R Soc Med. 1922;15(Med Sect):7-8.
• Ryle JA. Case of Erythraemia (Vaquez-Osler Disease). Proc R Soc Med. 1922;15(Clin Sect):28.
• Ryle JA. On the study of gastric function in health and disease. Goulstonian Lectures. Lancet 1925; 205(5299): (I 583-594) (II 641-650) (III 697-705) (IV 754-759)
• Ryle JA. Angor Animi, or the sense of dying. Guy’s Hospital Report. 1928; 78: 371-376
• Ryle JA. The Aims and Methods of Medical Science. OUP 1935
• Ryle JA. The natural history of disease. OUP. 1936
• Ryle JA. Medicine and eugenics. Eugen Rev. 1938 Apr;30(1):9-19.
• Ryle JA. To-day and To-morrow. Br Med J. 1940 Nov 16;2(4167):657-9
• Ryle JA. The Future of Medical Education as Seen by a Teacher. Br Med J. 1941 Sep 6;2(4209):323-7.
• Ryle JA. Fears may be liars. London, Allen & Unwin. 1941
• Ryle JA. The Science of Health. Br Med J. 1942 Dec 26;2(4277):745-8.
• Ryle JA. Changing disciplines; lectures on the history, method and motives of social pathology. OUP 1948
• Ryle JA. The sense of dying–a postscript. Guy’s Hospital Report. 1950; 99(4): 204-229.
• Ryle JA. Angor animi, or the sense of dying. Guy’s Hospital Report. 1950; 99(4): 230-235.

References

• Obituary: J A Ryle MD FRCP. 1950; 1(4653): 611–613.
• John Alfred Ryle. Munks Roll. Volume IV: 595
• Birch CA. Ryle’s tube. John Ryle (1889-1950). Practitioner. 1974; 213(1276): 581-582.
• Angor animi. The Lancet, 1951; 257(6660): 898
• Ban TA, Lohrenz JJ, Lehmann HE. Observations on the action of Sernyl-a new psychotropic drug. Can Psychiatr Assoc J. 1961; 6(3): 150-157.
• Barker JC. Angor Animi. Br Med J 1964; 2: 688