Samuel Gee

Samuel Gee

Samuel Jones Gee (September 13, 1839August 3, 1911) was an English physician and paediatrician. In 1888, Gee published the first complete modern description of the clinical picture of coeliac disease, and theorised on the importance of diet in its control. His contribution led to the eponym Gee's disease. Gee is also credited with the first English-language description of cyclic vomiting syndrome.cite journal
last = Gee
first = SJ
year = 1882
title = On fitful or recurrent vomiting
journal = Saint Bartholomew's Hospital Reports
volume = 18
pages = 1–6
as cited by OMIM|500007]

Life

Samuel Gee was born in London, where he spent his medical career. His father, William Gee, was a businessman but the family was not wealthy. He had two years of formal primary education, supplemented by home schooling. His secondary education was at the University College School, London. He went on to study medicine at the University College Hospital, gaining an MB in 1861 followed by an MD in 1865.

Gee initially worked as a house surgeon at the University College Hospital. He moved to the Hospital for Sick Children, Great Ormond Street in 1865. His career progressed through house surgeon, assistant physician (1866), physician (1875) and finally consulting physician (1904). He worked at both Great Ormond Street Hospital, at St Bartholomew's Hospital and in private practice. At St Bartholomew's medical school, he was a demonstrator of morbid anatomy, lecturer on pathological anatomy and lecturer on medicine. He delivered the 1871 Goulstonian, the 1892 Bradshaw and the 1899 Lumleian Lectures.

Gee was married to Sarah Cooper in 1875 with whom he had two daughters. He died suddenly, of a coronary occlusion, while on holiday in Keswick, Cumbria.

Coeliac disease

Samuel Gee gave the first modern-day description of coeliac disease in a lecture at the Hospital for Sick Children, Great Ormond Street in 1887. His interest in the history of medicine, and ability to read ancient Greek, meant Gee was familiar with the work of Aretaeus of Cappadocia who first wrote of "The Cœliac Affection".cite book |last=Adams F, translator |title=The extant works of Aretaeus, The Cappadocian |url=http://www.chlt.org/sandbox/dh/aretaeusEnglish/index.html |chapter= On The Cœliac Affection |chapterurl=http://www.chlt.org/sandbox/dh/aretaeusEnglish/page.102.a.php |accessdate=2006-09-04 |year=1856 |publisher=Sydenham Society |location=London] Gee's account is published in the St. Bartholomew's Hospital Reports of 1888 and begins:

There is a kind of chronic indigestion which is met with in persons of all ages, yet is especially apt to affect children between one a five years old. Signs of the disease are yielded by the fæces; being loose, not formed, but not watery; more bulky than the food taken would seem to account for; pale in colour, as if devoid of bile; yeasty, frothy, an appearance probably due to fermentation; stinking, stench often very great, the food having undergone putrefaction rather than concoction.

Gee acknowledges earlier findings and terms for the disease and adopts the same term as Aretaeus. Unlike Aretaeus, he includes children in the scope of the affection, particularly those between one and five years old. He notes that most adults with the cœliac affection have been abroad. Gee finds the cause to be obscure and fails to spot anything abnormal during post-mortem examination. He perceptively states "if the patient can be cured at all, it must be by means of diet." Gee recognises that milk intolerance is a problem with coeliac children and that highly starched foods should be avoided. He forbids rice, sago, fruit and vegetables. Raw meat is recommended as are thin slices of toasted bread. Gee highlights particular success with a child "who was fed upon a quart of the best Dutch mussels daily". However, the child cannot bear this diet for more than one season.cite journal
last = Gee
first = SJ
year = 1888
title = On the coeliac affection
journal = St Bartholomew's Hospital Report
volume = 24
pages = 17–20
url = http://web2.bium.univ-paris5.fr/livanc/?cote=epo0466&p=1&do=page
]

The cause of coeliac disease was eventually discovered to be an autoimmune reaction to gliadin, a gluten protein found in wheat. The lining of the small bowel is flattened, which interferes with the absorption of nutrients. Gee would not have been able to discover this on post-mortem since this lining quickly deteriorates on death.cite web
url = http://www.coeliac.co.uk/coeliac_disease/68.asp
title = History of coeliac disease
accessdate = 2007-03-23
last = Holmes
first = Geoff
year = 2006
publisher = Coeliac UK
] The only effective treatment is a lifelong gluten-free diet. The rice, sago, fruit and vegetables that were forbidden by Gee would all have been quite safe to eat; the toasted bread he recommended, however, would not. The disease he describes in adults, affecting those returning from India and other foreign parts, is likely to have been tropical sprue. For many years this was inadequately distinguished from coeliac disease, which was also known as non-tropical sprue.cite journal
author = Lewkonia RM
title = Letter: Samuel Gee, Aretaeus, and the coeliac affection
journal = British Medical Journal
volume = 2
issue = 5916
pages = 442
year = 1974
pmid = 4601230
url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=4601230
]

Achievements

* 1866: Elected Resident Fellow of the Royal Medical and Chirurgical Society. He was the society's librarian from 1877–99.
* 1870: Elected Fellow of the Royal College of Physicians. He was the College's censor from 1893–94 and senior censor in 1897.
* 1901: Appointed physician to George, Prince of Wales.
*The Royal College of Physicians named an annual lecture after him.

Publications

* Articles on chicken pox, scarlet fever and tubercular meningitis in Sir John Russel Reynolds' "System of Medicine" (vol. I & II, 1866; 1868).
* "Auscultation and Percussion together with Other Methods of Physical Examination of the Chest" by Samuel Jones Gee. London, 1870; 6th edition, 1906.
* "Medical lectures and aphorisms" by Samuel Jones Gee. London, 1902; 3rd edition, 1907.
* Forty six papers in St Bartholomew's Hospital Reports.

Notes

References

*cite journal
author = Dowd B, Walker-Smith J
title = Samuel Gee, Aretaeus, and the coeliac affection
journal = British Medical Journal
volume = 2
issue = 5909
pages = 45–7
year = 1974
pmid = 4595183
url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=4595183

*cite web
first = Ole Daniel
last = Enersen
url = http://www.whonamedit.com/doctor.cfm/1312.html
title = Samuel Jones Gee
publisher = Who Named It?
accessdate = 2007-03-23

*cite web
url = http://www.aim25.ac.uk/cgi-bin/search2?coll_id=7101&inst_id=8
title = Royal College of Physicians: GEE, Samuel Jones (1839–1911)
accessdate = 2007-03-23
last = Williams
first = Katharine
year = 2003
month = March
publisher = AIM25

Further reading

* cite book
last = Brown (compiler)
first = GH
title = Munk's Roll (the Lives of the Fellows of the Royal College of Physicians of London) 1826-1925, Vol II
year = 1955
location = London
pages = 183–4

* cite book
last = Lee (ed)
first = Sidney
title = Dictionary of National Biography, Second Supplement, vol. II
year = 1912
location = London
pages = 91–2

* cite journal
last = Garrod
first = Oliver
year = 1938
title = The Life of Samuel Jones Gee, M.D., F.R.C.P. (1839-1911)
journal = Saint Bartholomew's Hospital Reports
volume = 71
location = London


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