Thomas Hodgkins (1798-1866)

I got curious about the person Hodgkins Lymphoma is named for. I imagined somebody like the guy in the Thomas Eakins painting, The Gross Clinic. You know, some guy in a long black coat with a scalpel.

Thomas Hodgkins was a Quaker and I did find a picture of him. He studied to be an apothacary and then a physician. He was the kind of stiff, religious guy who would refuse to take an oath to tell the truth in court because as a Quaker he always told the truth. He was also the kind of man who would work ten and twelve hour days at a public clinic, treating the poor of London. Principled, outspoken in his Quaker way, and respected as a pathologist.

As a physician he seems to have managed to be a smart guy in the right place at the right time--he spent some time in Paris where he learned how to use the stethescope from Rene Laemec, who invented it, and brought it back to London.

In his first year at Guy's Hospital in London, he had a patient, a nine year old boy, who died. Hodgkins did an autopsy which showed that the lymph nodes were enlarged and hard. They were 'in chains' (which I assume means he found clusters of nodes.) He described what he found, and that's how Hodgkins Lymphoma got its name. He published a paper in 1832 On Some Morbid Appearances of the Absorbent Glands and Spleen. He died in Palestine giving medical aid to Jewish settlers.

Hodgkins Lymphoma (called Hodgkins Disease) was pretty much a death sentence until the 1940s, but trials with irradiation therapy made it one of the first cancers to be treatable. But the strangest treatment may be mustard gas. Apparently after an explosion in a shipyard in Bari, Italy exposed soldiers to mustard gas, doctors noticed that the gas suppressed the immune and lymphatic systems. So in the late 40's and early 50's, clinicians started treating Hodgkins by injecting a form of mustard gas into the patient.

It's a pretty graphic reminder of the way chemo works. You poison the patient and hope that the cancer dies first. There is still a chemo regimen (call MOPP) used for relapsing Hodgkins that uses mustargen, the mustard gas drug. My particular regimen, ABVD, has mostly replaced MOPP because it is less toxic and has fewer longterm effects.

I am always astonished at the chain of observation and serendipity upon which so much science is founded. Soldiers are exposed to mustard gas, their immune and lymphatic systems are supressed, and someone notes that observation and thinks of Hodgkins disease. Makes me feel lucky.