William John Adie

---

Biography

• Born 31 October 1886, Geelong, Victoria, Australia
• Left school at the age of 13 to support his family after his father passed away in 1899
• Gained university entrance after an employer recognised Adie’s capacity for learning and offered to fund his further education through evening classes
• Dr Arthur South an physician in Geelong inspired Adie to embark on a career in medicine, however the high cost of medical education in Melbourne led Adie to move to the UK at the age of 20 with the aid of his uncle who paid for a £19 one-way ticket to the UK
• Adie obtained his medical degree in 1911 from the University of Edinburgh and was awarded the McCosh Graduates scholarship
• During World War I Adie was a field physician and took part in the retreat from Mons, but luckily for Adie a timely bout of measles kept him from the battle where his regiment was decimated by the enemy
• Adie improvised a mask of clothing soaked in urine during the early gas attacks in World War I saving a number of soldiers lives before taking charge of the 7th General Hospital as a consultant in the management of head injuries
• In 1916 Adie was a medical registrar at Charling Cross Hospital, London and Royal London Ophthalmic Hospital where he alongside Macdonald Critchley described in frontal lobe disease ‘‘a syndrome of forced grasping and groping’’, and lucidly described narcolepsy, with important papers on pituitary tumours and disseminated sclerosis
• Adie earned several honours including the University of Edinburgh gold medal
• Adie was one of the first to nullify the misconstrued association between the Argyll Robertson pupil of syphilis and the tonic pupil
• Most notably, in 1931 Adie in combination with observations from previous colleagues published 6 case reports of his own (44 reports including previous observations) in the British Medical Journal a clinical syndrome involving a tonic pupil with diminished or absent deep tendon reflexes – eventually given the eponym Adie syndrome with the hallmark Adie pupil
• Although controversially named Adie syndrome as previous colleague had reported similar findings, it was Adie’s dogmatic style and tireless dedication to the syndrome including his exemplary essay for the Brain journal that eventually led to the syndrome being recognised as Adie syndrome
• Around the same time in 1931 Gordon Holmes reported 54 cases similar to Adie’s prompting Bramwell in 1936 to propose Holmes-Adie syndrome as a disease synonym
• In 1932 Adie was a co-founder of the Association of British Neurologists; first meeting 28 July at the house of Gordon Morgan Holmes
• Adie resigned from his work 3 years later in 1935 after a recurrent bouts of angina pectoris and died that same year 17 March 1935 from a myocardial infarct

He was honoured in his hometown of Geelong, Australia in a long obituary entitled “Geelong boy who made good in London” published in the Geelong Advertiser

---

Medical Eponyms

Adie Syndrome (1931)

Holmes-Adie syndrome (aka Adie syndrome) affects the autonomic nervous system. Patients present with the pupil of one eye being larger and only slowly constricts in bright light (tonic pupil). There is also absence of deep tendon reflexes, usually the Achilles tendon.

---

Adie-Critchley syndrome (1927)

A phenomenon caused by tumour of the contralateral frontal lobe superior part of area 6. When an object is placed in one hand of a patient, they grasp it and hold it tightly. If attempots are made to withdraw the object, the grip tightens, and the patient is unable to voluntarily relax their grip to release the object.

Adie and MacDonald Critchley (1900-1997) describe three cases of frontal tumours, in each of which there was marked involuntary grasping and groping movements in the contralateral limb caused by a tumour in the upper and posterior part of the frontal lobes. Attention is drawn to the resemblance in the infant of 3-18 months, whose grasping and groping is not under voluntary control. When the parts of the cortex which subserve the conditioned reflexes are damaged then the unconditioned, less controlled reactions appear.

The movements in the flexors and extensors of the forearm and hand are co-ordinated perfectly so long as the movements are gentle and the hand is empty; yet certain movements of the hand cannot be prevented, and once the hand has closed reflexly upon an object, or has been closed voluntarily and firmly, it cannot be opened. The will to open it is there; the extensors are innervated powerfully but the flexors fail to relax. Relaxation is delayed, and the grip tightens when attempts are made to remove an object from the hand passively and when the patient makes voluntary efforts to relax ; partial or complete relaxation occurs when voluntary innervation ceases, and when the palm is no longer stimulated.

Adie, Critchley 1927

Note: In 1926, John Farquhar Fulton (1899-1960) published his doctoral thesis on Muscular Contraction and the Reflex Control of Movement in which he first described the concept of the Adie-Critchley phenomenon.

---

Major Publications

• Adie WJ. Pseudo-Argyll Robertson pupils with absent tendon reflexes. A benign disorder simulating tabes dorsalis. Br Med J. 1931 May 30;1(3673):928-30
• Adie WJ. Argyll Robertson pupils true and false. Br Med J. 1931 Jul 25;2(3681):136-8.
• Adie WJ. Tonic pupils and absent tendon reflexes: a benign disorder sui generis; its complete and incomplete forms. Brain 1932;55:98–113
• Adie WJ. Complete and incomplete forms of the benign disorder characterised by tonic pupils and absent tendon reflexes. Br J Ophthalmol. 1932 Aug;16(8):449-61.
• Adie WJ, Critchley M. Forced grapsing and groping. Brain 1927; 50: 142-70.
• Adie WJ. Idiopathic narcolepsy: a disease sui generis: with remarks on the mechanism of sleep. Brain 1926; 49: 275–306.
• Adie WJ, Wagstaffe WW. A note on a series of 656 cases of gunshot wound of the head, with a statistical consideration of the results obtained. Medical Research Committee Statistical Reports, no. 1. London: Stationery Office, 1918

---

References

Biography

• Obituary: William John Adie. Br Med J. 1935 March 23;1(3872):624-5
• Obituary: William John Adie, M.D. Edin., F.R.C.P. Lond. Lancet 1935; 225:5821; 717.
• Pearce JMS. William John Adie (1886–1935). J Neurol Neurosurg Psychiatry 2004; 75: 1111
• Pearce JMS. William John Adie (1886–1935). Hektoen International
• Siddiqui AA, Clarke JC, Grzybowski A. William John Adie: the man behind the syndrome. Clin Exp Ophthalmol. 2014 Nov;42(8):778-84.

Eponymous terms

• Holmes G. Partial iridoplegia associated with symptoms of other diseases of the nervous system. Transactions of the Ophthalmological Society of the United Kingdom 1931; 51: 209-28
• Brody IA, Wilkins RH. Neurology classics VII – Adie’s Syndrome. Arch Neurol. 1968;18(6):710-715.
• Beighton G, Wiedemann HR. The Person Behind the Syndrome. Springer. 1997 pp 4-6

---