Richard Clarke Cabot

Richard Clarke Cabot (1868- 1939)

Richard Clarke Cabot (1868- 1939) was an American physician.

Cabot was known for his work in clinical haematology and pioneering approach to social work and patient-centred approach to patient care and history taking.

He was a maverick in the medical field, favoring socialized medicine and founding a department of medical social work at Massachusetts General Hospital in 1905.

Prolific writer: Early career on blood; serum; physical diagnosis; case histories and differential diagnosis. Towards the end of his career his writing became more philosophical – What Men Live By, The Meaning of Right and Wrong, and Adventures on the Borderland of Ethics.

Ethics and Science Need to Shake Hands


Biography

  • Born May 21, 1868 in Brookline, Massachusetts.
  • 1889 – Bachelor of Arts in Classics and Philosophy, Harvard College
  • 1892 – M.D. Harvard Medical School. Turned down the role of the first bacteriologist at Massachusetts General Hospital, instead choosing to work in the outpatient department where he advocated social work.
  • 1900 – Formalised ‘Case Histories of the Massachusetts General Hospital‘ to be part of the third year training for Harvard Medical School students – the clinicopathological conference (C.P.C.).
  • Harvard teaching career: Lecturer on Philosophy (1902-1903); Instructor in Clinical Medicine (1903-1908); Assistant Professor of Clinical Medicine (1908-1913); Assistant Professor of Medicine (1913-1918); Professor of Clinical Medicine (1918-1933); Professor of Social Ethics (1920-1934)
  • 1939 – died May 7, while working on a philosophical treatise called “Creation”.

Key Medical Attributions

Strong advocate for patient-centered approach to patient care and history taking. In 1905 established the first hospital social service department in the United States at Massachusetts General Hospital. He initiated home visits to gain information to facilitate a more efficient and holistic provision of medical care, his work was not funded by the hospital, so paid for social workers out of his own pocket


Medical Eponyms

  • Cabot Rings (1903) – Described as thin, loop-like strands found in erythrocytes. They indicate an abnormality in the production of erythrocytes and are remnants of the mitotic spindle and stain red- purple with Wrights stain.
  • Cabot- Locke murmur (1903) – Collaborated with E.A (Frank) Locke, and together described cases of a diastolic murmur in patients with severe anaemia. Early diastolic murmur (without the decrescendo usually heard in aortic regurgitation). It resolves with treatment of the anaemia.

Controversies

  • Held the firm belief that clinical diagnosis and laboratory diagnosis should be used in close sequence, rather than treating them as separate entities.
  • Wrote a controversial paper in 1912 in which he stated there were “a goodly number of ‘classic’ time-honoured mistakes in diagnosis” having examined autopsy reports of 3000 cases.

So this is good old Boston. The home of the bean and the cod. Where the Lowells talk only to the Cabots. And the Cabots talk only to God.


Major Publications


References

  • White PD. Richard Clarke Cabot 1868–1939. New Engl J Med. 1939;220(25):1049–52.
  • Cabot, Richard C. (Richard Clarke), 1868-1939. Papers of Richard Clarke Cabot: an inventory. Harvard University Library.
  • Verghese A, Charlton B, Cotter B, Kugler J. A History of Physical Examination Texts and the Conception of Bedside Diagnosis. Trans Am Clin Climatol Assoc. 2011; 122:290-311 [PMC3116347]
  • Ma I, Tierney LM. Name that murmur–eponyms for the astute auscultician. N Engl J Med. 2010 Nov 25;363(22):2164-8.[PMID 21105801]

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Posted by Dr Mike Cadogan

Emergency physician with a passion for medical informatics and medical education/textbooks. Asynchronous learning #FOAMed evangelist | @sandnsurf | + Mike Cadogan | LinkedIn

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