Soma Weiss

Soma Weiss (1898-1942)

Soma Weiss (1898-1942) was a Hungarian-born American physician

Weiss was a physician whose career at Harvard Medical School was marked by brilliance as a clinician, researcher, and teacher. Emigrating to the United States after World War I, he trained at Columbia and Cornell before joining the Thorndike Memorial Laboratory in Boston under Francis Weld Peabody. By his early thirties, Weiss had established himself as a prodigious investigator, publishing widely in pharmacology, cardiovascular physiology, renal disease, vitamin deficiency, and the toxaemias of pregnancy. His laboratory work with Hermann Blumgart in 1925 introduced the first use of radioactive tracers in humans to study circulation, foreshadowing modern nuclear medicine.

Weiss is most widely remembered for eponymous clinical descriptions that remain central to medicine. In collaboration with George Kenneth Mallory in 1929, he identified the Mallory-Weiss Syndrome/lesion/tear causing upper gastrointestinal haemorrhage secondary to mucosal lacerations from vomiting. With James Porter Baker in 1933, he published the first full account of carotid sinus syncope, now termed Weiss–Baker syndrome.

Beyond research, Weiss was revered as a teacher and humanist. Appointed Hersey Professor of the Theory and Practice of Physic at Harvard in 1939 and Physician-in-Chief at the Peter Bent Brigham Hospital, he emphasized attentive listening, psychosocial care, and the patient’s lived experience of illness. His sudden death in 1942, at the age of 43, cut short a career of exceptional promise. His legacy endures not only in syndromes that bear his name but also in the Soma Weiss Student Research Day, a long-running Harvard tradition that continues to inspire generations of young physician-scientists.

Biographical Timeline
  • 1898 – Born January 27 in Bistriţa (Bestercze), Transylvania, Austro-Hungarian Empire
  • 1915–1919 – Studied physiology and biochemistry at the Royal Hungarian University, Budapest; served as demonstrator and research fellow.
  • 1920 – Emigrated to the United States.
  • 1921 – Received B.A. from Columbia University.
  • 1923 – Graduated M.D. from Cornell University Medical College. Early research on pharmacology of digitalis under Robert A. Hatcher.
  • 1925 – Joined Thorndike Memorial Laboratory, Boston City Hospital, under Francis W. Peabody (1881–1927); began long association with Harvard Medical School. With Herrmann Ludwig Blumgart (1895–1977), performed first application of radioactive tracers in humans to measure circulation time.
  • 1929 – With George Kenneth Mallory (1900–1986), described haemorrhagic lacerations at the gastro-esophageal junction from forceful vomiting – later known as Mallory–Weiss syndrome.
  • 1932 – Appointed Director, Second and Fourth Harvard Medical Services, Boston City Hospital; Associate Professor of Medicine, Harvard Medical School.
  • 1933 – With James Porter Baker (1902-1988), published first description of carotid sinus syncope (“Weiss–Baker syndrome”).
  • 1939 – Appointed Hersey Professor of the Theory and Practice of Physic, Harvard Medical School, and Physician-in-Chief, Peter Bent Brigham Hospital (succeeding Henry A. Christian, 1876–1951).
  • 1940 – Founded the Harvard Medical School Undergraduate Research Assembly (later renamed Soma Weiss Student Research Day after his death).
  • 1941 – Co-authored monograph Preeclamptic and Eclamptic Toxemia of Pregnancy with Lewis Dexter.
  • 1942 – Died suddenly January 31 in Cambridge, Massachusetts, of subarachnoid haemorrhage due to ruptured intracranial aneurysm, four days after his 43rd birthday.
Medical Eponyms
Mallory–Weiss Syndrome (1929)

The characteristic of this lesion are longitudinal mucosal lacerations in the distal oesophagus and proximal stomach, which are usually associated with forceful or prolonged vomiting, retching or coughing.

1929 – Soma Weiss and George Kenneth Mallory published their landmark description of 15 patients who developed upper gastrointestinal bleeding after episodes of severe vomiting. They identified a characteristic history of heavy alcohol use followed by persistent nausea, retching and vomiting.

During the past five years we have observed 15 patients, who after a long and intense alcoholic debauch developed massive gastric hemorrhages with hematemesis. … Autopsies in four of them showed fissure-like lesions at the cardiac opening of the stomach.

Mallory, Weiss 1929
Mallory–Weiss Lesion (1929)
Fig. 5.—Cross section of one of the ulcerations from Case II from the lower end of the lesion. Normal mucosa of stomach is present on either side of ulceration. Fissure is narrow and extends down into the submucosa. The floor is composed of fibrin and polymorphonuclear leukocytes. 1929

Mallory and Weiss arrived at the conclusion that these lesions were related to persistent vomiting rather than alcohol due to a case with persistent vomiting in pregnancy. They then went one step further to simulate increased pressure by dilating the stomach against a tied pylorus reproducing the lacerations at the cardia in a cadaveric study.

1932 Weiss and Mallory and Weiss rexpanded their observations with two fatal cases.

  • Case 1: A “classical” presentation: a man with massive haematemesis after heavy alcohol intake; autopsy revealed a deep acute mucosal laceration rupturing an artery.
  • Case 2: More atypical: a man with prior small-volume haematemesis, presenting with an “acute abdomen.” At autopsy, a longitudinal ulcerative lesion at the gastroesophageal junction was found, which had perforated into the mediastinum, causing empyema.

From these cases, Mallory and Weiss proposed a progression: acute laceration → chronic ulcer → perforation, suggesting that repeated vomiting could transform a mucosal tear into a chronic longitudinal ulcer. This concept might now be viewed as overlapping with conditions such as Barrett’s oesophagus.

They also situated their work in historical context:

Charcot-Weiss-Baker syndrome (Carotid Sinus Syncope) (1933)

Transient attacks of syncope with marked slowing in heart rate and lowering of blood pressure, and loss of consciousness, caused by strong pressure on the neck over the bifurcation of the carotid arteries, which cause the excitation of baroreceptors of the carotid sinuses.

First noted by Johann Nepomuk Czermak (1828–1873) in 1866 and later mentioned by Jean-Martin Charcot (1825–1893), the condition was comprehensively described by Weiss and James Porter Baker (1902–1988) in 1933. Their paper in Medicine detailed a syndrome of transient syncope and convulsions provoked by pressure on the carotid sinus.

The syndrome is characterized by:

  • Sudden syncope with marked bradycardia and hypotension
  • Precipitation by pressure at the carotid bifurcation (e.g., turning the head, shaving, tight collars)
  • May be accompanied by focal neurological signs or even cardiac arrest in severe cases
  • Predominantly affects men over 45, often with atherosclerotic or calcified carotid arteries

Transient attacks of unconsciousness may result from pressure on the neck over the bifurcation of the carotid arteries … with profound slowing of the heart and fall in arterial pressure.

Weiss, Baker, 1933

Weiss and Baker emphasized the reflexogenic role of carotid baroreceptors in mediating circulatory collapse. Their work expanded clinical understanding of cardiovascular reflexes and syncope, and the condition remains recognized as Weiss–Baker syndrome or carotid sinus hypersensitivity.

Major Publications
References

Biography

Eponymous terms

Mallory-Weiss syndrome

Charcot-Weiss-Baker syndrome

Eponym

the person behind the name

more eponyms…
Dr William McGalliard LITFL Author

Graduated Medicine in 2020 from Queens University Belfast. Interested in Internal Medicine.

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 | Eponyms | Books |

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