Thomas Hodgkin

Thomas Hodgkin (1798 – 1866)

Thomas Hodgkin (1798 – 1866) was an English physician and pathologist.

Hodgkin contributed to the fields of cardiology, pathology and preventative medicine, and was avidly involved in the public health issues of his time. He trained in the same hospital university as his contemporaries Thomas Addison and Richard Blight, and subsequently became known as one of the ‘three great men of Guy’s’.

Born into a Quaker family, Hodgkin was also an active humanitarian alongside his friend Moses Montefiore, and in his later life, Hodgkin would travel with Montefiore to various countries to advocate for population groups in times of need.

Hodgkin is best known for his account of a form of lymphoma and blood disease (Hodgkin’s disease) in 1832 and the Key-Hodgkin murmur in 1829


Biography
  • Born 17 August 1798
  • 1817 – 1821 – Served as an apprentice to an apothecary Guy’s Hospital, London
  • 1823 – Graduated M.D. from Edinburgh University with his thesis on the functional relationship between lymph nodes and the spleen.
  • 1826 – Appointed anatomical pathology lecturer and museum curator at Guy’s Hospital Medical School
  • 1821 – worked in France with Laennec’s new invention the stethoscope
  • 1836 – Declined fellowship from the Royal College of Physicians, London
  • 1837 – Member of the senate of the University of London
  • 1837 – Resigned from Guy’s Hospital Medical School and abandoned medicine after not being appointed as Assistant Staff Member at Guy’s Hospital.
  • 1838 – Became one of the founders of the Aborigines’ Protector Society, where he advocated for oppressed savages, persecuted Jews, and ill-housed poor.
  • 1857 – Began traveling with Moses Montefiore to various countries as humanitarians, where they advocated for Jews, Christians, and Arabs.
  • Died 5 April 1866 of dysentery whilst visiting Jaffa, Palestine for humanitarian work, where he was also buried.

The little service I have done…

Final words of Thomas Hodgkin

Medical Eponyms
Hodgkin Disease (1832)

The umbrella term for both Hodgkin’s and Non-Hodgkin’s Lymphoma; a group of malignant lymphoid disorders which are distinguished from each other by the presence of Reed-Sternberg cells on biopsy of Hodgkin’s Lymphoma.

Hodgkin described the disease in his 1832 paper on the pathologic relationship between the liver and spleen. In this, he describes seven cases of enlarged lymph nodes and an enlarged spleen not associated with inflammation or other significant pathological findings in post-mortem dissections.

The spleen was large and contained numerous tubercles… A continuous chain of much enlarged indurated absorbent glands of a light colour accompanied the aorta throughout its course, closely adherent to the bodies of the vertebre,- and extended along the sides of the iliac vessels as far as they could be traced in the pelvis…

Hence, we may conclude that if, as I conceive to be the case, there be a close connection between the derangement of the glands and that of the spleen.

Hodgkin 1832; 71, 88

Hodgkin was aware that these were not new findings, however, he wished to garner greater attention to the condition. He noted that Malpighi had described a similar condition in 1666.

Despite his efforts, Hodgkin’s findings were barely recognized during his life, not even being mentioned in his obituary. It was not until 1865, when Dr. Samuel Wilks published a paper with “Hodgkin’s Disease” in the title, detailing the condition in greater depth, that Hodgkin would be recognised for his contributions and his eponym coined.


Key-Hodgkin Murmur (1827)

A diastolic murmur of aortic regurgitation with a raspy quality likened to the sound of ‘a saw cutting through wood‘ (bruit de scie).

Hodgkin correlated the murmur with retroversion of the aortic valve leaflets seen post mortem.

The impulse of the heart was not particularly feeble, but was considerably diffused; the sound very general over the whole left side, and nearly the whole of the right side of the chest, with the exception of the superior part of the chest. Each contraction appeared lengthened, accompanied with a purring, thrilling or sawing kind of noise

In Hodgkin’s 1827 letter, as described by his friend J.H. Pickford.

Key Medical Attributions

Outside the fields of pathology and cardiology, Hodgkin also contributed to the public health issues that plagued his time. He wrote many pamphlets, lectures and papers focussing on the medical needs of the underprivileged, covering the topics of public health care, housing, and sanitation.

One of his major contributions to public health occurred during the London cholera outbreak of 1832, where he wrote letters to the public and the Board of Health which detailed the connection between the deprived living conditions of the poor and cholera, made specific hygiene recommendations, and urged the authorities of the time to observe and record all available data to better understand the outbreak.


Controversies

Is Corrigan sign actually Hodgkin Sign?

Corrigan’s eponymous sign was actually discovered by Hodgkin five years prior, where he noted in his 1829 letter a double murmur associated with carotids that were seen to beat violently on both sides.

Besides the general and inordinately violent arterial action…there was a remarkable thrill in the pulse, and the carotids were seen violently beating on both sides. The contraction of the ventricle were marked by strong impulse, and a constant bruit de scie, which presented this peculiarity…

Hodgkin 1829, pg 438

However, Hodgkin’s disorderly method of presentation and far from exact explanation of the origins of this sign made his contributions overshadowed by Corrigan’s more complete review.

Some medical historians such as Sir Samuel Wilks (1871) and Sir William Hale-White (1924) advocated for Hodgkin’s contribution to be recognised, and this has gone some way to putting Hodgkin’s name on the list of those who have contributed to the knowledge of aortic disease.


Major Publications

References

eponymictionary CTA

eponym

the person behind the name

Lewis is a fourth-year medical student at UWA. He is currently interested in critical care medicine

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