- Sir Thomas Lewis: Pioneer Cardiologist and Clinical Scientist
Arthur Hollman has written a perceptive and interesting biography that provides useful insight into the development of cardiology and clinical investigation between the two world wars. Exhaustively researched, this book is the result of several decades of active study of the life and contributions of one of the most influential figures in early-twentieth-century Anglo-American medicine. Lewis’s interest in cardiovascular research became apparent shortly after he completed his medical training at University College Hospital, London, in 1906. There, he was exposed to some of Britain’s most productive medical scientists (including Ernest Starling and Arthur Cushny), whose common interest was circulatory physiology.
Lewis took full advantage of this fertile context and brought to it a powerful new physiological tool—the electrocardiograph. In 1909 he was the first person in the English-speaking world to acquire an electrocardiograph for the purpose of clinical research. This machine shaped his early career and gave him an international identity. Lewis’s laboratory at University College Hospital became a [End Page 789] magnet for researchers interested in learning how to use the electrocardiograph as a clinical and research tool. Lewis and several of his ambitious young associates flooded the literature with papers reporting their observations and discoveries. Many of their articles were published in Heart, a journal he launched in 1909 as a forum for research reports on the physiology and pharmacology of the circulatory system.
Although Lewis’s main interest was research, he was also a clinician. He believed that research in the laboratory and at the bedside would provide keys to unlock many of the mysteries that still confronted physicians caring for cardiac patients. Moreover, like James Mackenzie, he was convinced that physicians who framed their patients’ signs and symptoms in terms of disordered function were more likely to interpret their patients’ complaints correctly. Lewis identified two distinct audiences for the new knowledge about the heart that was coming from laboratories and clinics in Europe and the United States. In addition to publishing many scientific papers and a detailed monograph on cardiac electrophysiology, he wrote several clinical articles and two brief books to inform practitioners about the recent advances in the diagnosis of cardiac arrhythmias and the electrocardiograph.
Lewis became a vital link between aspiring American and British heart specialists and clinical scientists interested in cardiovascular physiology. Paul Dudley White, Samuel Levine, Frank Wilson, and several other first-generation American cardiologists worked with him just before or during the First World War, and their experiences with him and his associates played a critical role in establishing cardiology as a discipline in the United States. Although Lewis is remembered mainly for his pioneering work on cardiac arrhythmias and electrocardiography, Hollman provides a detailed summary of his many other clinical and research interests. These included the pathophysiology of pain, the innervation of the skin, and peripheral vascular disease.
Hollman focuses on Lewis and his immediate circle of friends and associates, but he also attempts to place his subject in a larger intellectual context. The text is enriched by many quotations taken from letters to and from Lewis. The book includes interesting information about his personality and his hobbies (notably, photographing birds). Drawing from a vast amount of material collected over several decades and from two dozen oral history interviews with Lewis’s trainees, associates, and family members, Hollman has created a fascinating picture of his subject’s life in words and images. The book includes 145 illustrations, many of them high-quality photographs not published previously. The detailed notes include brief biographical sketches of many of the more important individuals mentioned in the text.