Richard Clarke Cabot

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)
• Died May 7, 1939 while working on a philosophical treatise called “Creation”.

Medical Eponyms

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.

In cases of intense anaemia, when the red cells are reduced to or below 1,000,000 per cu. mm, one occasionally hears diastolic murmurs not to be explained by permanent dilatation of the aortic ring nor as “cardio-respiratory murmurs”, and not due to a diastolic accentuation of a venous hum. The cause of these murmurs is obscure

Cabot R, Locke E. 1903: 120

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.

Rings more or less similar to this I have found in three cases of pernicious anemia, three of lead poisoning, and one of lymphatic leukemia. For the most part they are stained red…

Cabot 1903

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

Ethics and Science Need to Shake Hands

Controversies

Cabot held the firm belief that clinical diagnosis and laboratory diagnosis should be used in close sequence, rather than treating them as separate entities.

He 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

• Cabot RC. A Guide to the Clinical Examination of the Blood. 1896. [First English- language haematology textbook]
• Cabot RC. The serum diagnosis of disease. 1899.
• Cabot RC. Physical Diagnosis of Diseases of the Chest. 1901.
• Locke EA, Cabot RC. Iodophilia: A Preliminary Report. J Med Res. 1902 Jan;7(1):25-42.1.
• Cabot RC, Locke EA. On the occurrence of diastolic murmurs without lesions of the aortic or pulmonary valves. Johns Hopkins Hospital Bulletin. 1903;14:115-20
• Cabot RC. Ring Bodies (nuclear Remnants?) in Anemic Blood. J Med Res. 1903; 9(1): 15-18
• Cabot RC. Case teaching in medicine. 1906
• Cabot RC. Physical Diagnosis. 1905
• Cabot RC. Diagnostic pitfalls identified during a study of three thousand autopsies. JAMA. 1912;59:2295–98. [JAMA]
• Cabot RC. Social Work: Essays on the Meeting-ground of Doctor and Social Worker. 1919.
• Cabot RC. Social service and the art of healing. 1909
• Cabot RC. Differential Diagnosis. 1938 [Volume II]

References

Biography

• 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.
• Bibliography. Cabot, Richard C. (Richard Clarke) 1868-1939. WorldCat Identities

Eponymous terms

• 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
• Ma I, Tierney LM. Name that murmur–eponyms for the astute auscultician. N Engl J Med. 2010 Nov 25;363(22):2164-8
• Robbins A, Zhang G, Cadogan M. Name that murmur. LITFL 2022

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