Thomas Addison was an English scientist, physician, and medical pioneer. He is best remembered for his discovery of the degenerative disease of the adrenal glands that was later named Addison's Disease in his honor.
Background
Thomas Addison was born in April 1793 at Long Benton near Newcastle-upon-Tyne. The Long Benton church baptismal register has the following entry: “1795, October 11. Thomas s. of Joseph and Sarah Addison, Lg. Benton.” The same register gives 13 April 1794 as the baptismal date of John, the second son of Joseph and Sarah Addison. Since it is unlikely that if Thomas had been born in 1793 his baptism would have been deferred until after that of his younger brother, it is reasonable to believe that in the course of transcription a five has become a three, as Hale-White suggested.
Education
Addison was first sent to school near Long Benton, and then went to a grammar school at Newcastle-on-Tyne. He learned Latin so well that he made notes in that language and spoke it fluently. His father had wished him to become a lawyer, but in 1812 he entered the University of Edinburgh as a medical student. He graduated in 1815, at the age of twenty-two, as a Doctor of Medicine. The title of his thesis was “De syphilide et hydrargyro” (“Concerning Syphilis and Mercury”). Guy’s Medical School book records his entrance: “December 13, 1817, from Edinburgh, T. Addison, M.D., paid £22 to be a perpetual Physician’s Pupil.”
Addison became house surgeon at Lock Hospital in London in 1815, he then held various posts in London hospitals, and in 1819 he was admitted a licentiate of the Royal College of Physicians of London. He was then appointed assistant physician to Guy’s Hospital on 14 January 1824.
In 1829, in collaboration with John Morgan, he published the first work on toxicology in English. Much of his work-including his important observations on pneumonia, pulmonary tuberculosis, and fatty liver-appeared in the Guy's Hospital Reports. He gave the first description of appendicitis in his and Richard Bright's The Elements of the Practice of Medicine, most of which was written by Addison.
He was joint lecturer on medicine with Richard Bright in 1835, and in 1837 he became physician to Guy’s Hospital.
In 1840 Bright retired from the lectureship, and Addison became sole lecturer. He held this position until either 1854 or 1855. He obtained his licentiateship in the Royal College of Physicians on 22 December 1819 and was elected a fellow on 4 July 1838.
Addison’s numerous clinical studies include works on the clinical signs of a fatty liver (1836), appendicitis (1839), pneumonia (1843), phthisis (1845), and xanthoma (1851). In 1849 Addison read to a London medical society a paper on anemia with disease of the suprarenal bodies. In 1849 he described Addison’s anemia before a meeting of the South London Medical Society: “For a long period I had from time to time met with a remarkable form of general anemia. . . .” His clinical findings fit with both Vitamin B12 and folic acid deficiency states. One feature peculiar to Vitamin B,2 deficiency is: “. . . the bulkiness of the general frame and the obesity often present, a most striking contrast.”
In the absence of a separate formal report, it is not surprising that the world overlooked this excellent description of pernicious anemia. That description, good as it was, was quite overshadowed by Addison’s spectacular discovery of the disturbance of the suprarenal capsules. In 1855, in a paper entitled “On the Constitutional and Local Effects of Disease of the Suprarenal Capsules,” he described what is now known as Addison’s disease, a condition characterized by progressive anemia, bronze skin pigmentation, severe weakness, and low blood pressure. It is now known that in Addison’s disease the blood sodium and chloride are lowered, potassium and nitrogen are increased, and there is a diminution in the blood volume. The intravenous administration of a physiologic solution of sodium chloride helps the patient to recover from these conditions. This work laid the foundation for modern endocrinology.
At Guy’s Hospital both conditions became increasingly familiar and were recorded separately from time to time in Guy’s Hospital Reports, but elsewhere Addison’s description of anemia was forgotten until his pupils Samuel Wilks and Thomas Daldy published his collected work and made it clear that Addison had described the disease in 1849, although A. Biermer reported it as a new disease in 1872.
In 1839 Bright and Addison published Elements of Practical Medicine. Only Volume I (two volumes were planned) appeared, and the work is incomplete and very rare.
Although the birth date generally assigned to Thomas Addison is April 1793, the tablet in Guy’s Hospital Chapel in London and that in Lanercost Abbey in Cumberland, where he is buried, state that he died on 29 June 1860, at the age of sixty-eight.
On 7 July 1860 the Medical Times and Gazette published a notice of Addison’s death on 29 June 1860, but neither Lancet nor the British Medical Journal recorded it.
In the late 1850s his health began to decline, and in the hope of effecting an improvement he resigned his hospital posts early in 1860 and moved to Brighton.
Thomas Addison`s major achievement was in the discovery in 1849 of Addisonian anemia or Addison-Biermer disease, now synonymous with pernicious anemia which involves Vitamin B12 deficiency. He described 11 cases, with an autopsy in each. In each he found a lesion in the suprarenal glands, and three-quarters of these lesions were due to tuberculosis. Before Addison wrote, nothing whatever was known about either the function or the diseases of the suprarenal glands, and his book makes clear that one of its main objects was to stimulate others to investigate their function. But important scientific investigations of these glands, leading to the discovery of adrenaline (epinephrine) and cortisone and other steroids, were not begun until the end of the 19th century. By 1855 no disease of any other endocrine gland had been discovered, and Addison was therefore the founder of clinical endocrinology.
Addison was also one of the most respected physicians at Guy's Hospital, he exerted a great deal of influence, devoting himself almost wholly to his students as well as his patients.
Quotations:
He wrote then to his medical students as follows: "A considerable breakdown in my health has scared me from the anxieties, responsibilities and excitement of my profession; whether temporarily or permanently cannot yet be determined but, whatever may be the issue, be assured that nothing was better calculated to soothe me than the kind interest manifested by the pupils of Guy's Hospital during the many trying years devoted to that institution. "
Membership
Addison was a member of the Royal Medical Society.
Personality
Addison was also a superb diagnostician but rather a shy and taciturn man and had a small practice, at a time when physicians of his position usually had large practices.
Quotes from others about the person
Probably the best evaluation of Addison comes from Wilks, who said: “The personal power which he possessed was the secret of his position, much superior to what Bright could ever claim, and equal, if not greater, than that of Sir Astley Cooper.”
Connections
Addison married Elizabeth Catherine Hauxwell at Lanercost Church in September 1847. They were childless, although she had two children by her first marriage.
Father:
Joseph Addison
Mother:
Sarah Addison
Wife:
Elizabeth Catherine Hauxwell
collaborator:
John Morgan
In 1829, in collaboration with John Morgan, he published the first work on toxicology in English.
Addison was described as the type of doctor who is always trying to discover the change in a piece of machinery rather than one who, like his contemporary Benjamin Guy Babington.
