Year : 2021 | Volume
: 8 | Issue : 1 | Page : 82--83
Charles claude guthrie and modern vascular surgery
Consultant Vascular and Endo Vascular Surgeon, Kauvery Hospital, Salem, Tamil Nadu, India
Consultant Vascular and Endo Vascular Surgeon, Kauvery Hospital, Salem, Tamil Nadu
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Sivagnanam K. Charles claude guthrie and modern vascular surgery.Indian J Vasc Endovasc Surg 2021;8:82-83
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Sivagnanam K. Charles claude guthrie and modern vascular surgery. Indian J Vasc Endovasc Surg [serial online] 2021 [cited 2021 Apr 14 ];8:82-83
Available from: https://www.indjvascsurg.org/text.asp?2021/8/1/82/309720
Many of the principles and techniques of modern vascular surgery developed from the meticulous and exhaustive experiments of Charles Claude Guthrie, and in collaboration with Alexis Carrel. Through their conjoint effort, they were able to perfect the technique of vascular anastomosis though they worked together only for a short span of <2 years between 1905–1906. Complete amputation of the thigh with reimplantation was experimentally accomplished in the dog in August 1905 which was reported in the February 1906 issue of the American Journal of Medical Science. However, it was 57 years after which Malt performed the world's first human replantation of a limb. Guthrie was the first to successfully transplant dog kidneys and document subsequent renal function. Later in 1908, he independently performed his famous “two-headed dog” experiments.
Charles Claude Guthrie was born in St. Charles County, Missouri, on May 13, 1880. He grew on the Missouri farmlands where his ancestors had settled from Scotland in the 1700s. Even from his younger days, he had a keen inventive and observational way of thinking when his study of insects was published as notes in the Science. He made his first gun himself and he published studies on preservation of meat and other food stuffs which were born out of the curious nature of his mind. However, he was a shy and reclusive individual which impacted his reputation during his productive days as a scientist.
Charles Claude Guthrie received his M.D. degree from the University of Missouri in 1902. Even during his medical school years, he was interested in surgery of the blood vessels. In 1898–1899, while studying physiology with Dr. John Waldo Connaway, he cut and re-sutured, end-to-end, arteries on the cadaver of a dog that was used for experiments. He had established his own personal laboratory at the University of Chicago where he performed his experiments on surgery of the blood vessels. He was awarded the Ph. D degree from the same university in 1907 where he performed his experiments and the controversially debated work on transplantation of ovaries in chickens.
During this same time, Dr. Alexis Carrel, who had his own experience with vascular anastomotic techniques in Lyon, France had been accepted to the University of Chicago after his interesting presentation at a conference in Montreal, Canada. He was arranged to work with Dr. Guthrie, and they published many articles on vascular anastomosis and other transplantation techniques which laid the foundations of modern vascular surgery. The excerpts from the historical vignettes suggest that though they worked as a team, frequently, they conducted their experiments alone. The copies of the letters written between them were shared by Guthrie's sister, Fannie V. Guthrie who was his long-time laboratory assistant. These letters are now owned by the Yale University and the Missouri State Historical Society.
Though Dr. Alexis Carrel had his own experience with vascular anastomosis for nearly 7 years before starting to work together with Dr. Guthrie including four papers published to his credit, many of his experiments failed due to infections and his blood vessel sutures also failed since he did not include the intima in his anastomotic stitches. It was after they started working together, that many of his experiments thrived. For instance, at Guthrie's insistence, there was strict aseptic technique during their joint experiments and including full-thickness bites with finer needles and sutures, the outcomes were successful.
Dr. Guthrie was an extremely modest personality, and he would spend most of his time focusing on his experiments, publishing papers and shunned publicity. However, Dr. Carrel would be of a different nature where he would like to present his work and discuss politics and philosophy.
After working together only for a brief period between 1905 and 1906, they parted ways and Guthrie accepted the Chair of Physiology and Pharmacology at Washington University in St. Louis while Carrel moved to the Rockefeller Institute on a research scholarship. At Washington, Guthrie published several articles along with Stewart and Pike on resuscitation, which was in continuity to the work begun several years before at Western Reserve University and the University of Chicago. Those studies elaborate the effect of resuscitation on the central nervous system, glands, and muscles. Dr. Guthrie continued his work on ovarian transplantation which he begun in 1904 which led to the controversial genetic-somatic issue of foster-parent influence on offspring.
In 1909, Prof. Guthrie moved to the Chair of Physiology and Pharmacology at the University of Pittsburgh, where he continued his work on the study of shock, physiology of the heart and the nature of red blood cell. His manuscripts and notes establish him as a careful, meticulous, and painstaking man of science who recorded his observations accurately. His notes on experiments were exhaustive and would help avoid duplicative efforts by other researchers on resuscitation.
In 1912, Alexis Carrel received the Nobel Prize in Medicine for his work on anastomosis of blood vessels which would not have been successful without Guthrie's contributions. The combined work done by Dr. Guthrie and Dr. Carrel laid the foundation of modern vascular surgery and transplantation. In the same year, Charles Claude Guthrie, published his study, ''Blood Vessel Surgery and its Applications''. It was a book of two parts which offered an exhaustive review of surgical techniques, histology and also the chronology of his work on the surgery of blood vessels. The second part illustrates the applications of vascular surgery, goitre, and effects of altering thyroid circulation, tissue transplantation and resuscitation. It would take about half a century for his role to be adequately recognized.
Professor Guthrie was passionate in teaching the medical students. He designed experiments and engineered physiologic equipment's which were far better than the ones available in the market. Details of his contributions in this field are included in “Practical Contributions to Physiology and Pharmacology, 1915”. He was also a pioneer in the concept of a medical centre. He laid down a basic plan for a physical plant at Pittsburgh to facilitate integration of clinical sciences with basic sciences.
In 1962, Charles Claude Guthrie was awarded the honorary Doctor of Science degree by his alma mater, the University of Missouri. He had retired and moved to Columbia, Missouri, in 1950, where he lived quietly with his sister and long-time laboratory assistant and collaborator, Fannie Virginia Guthrie, in their family's Columbia home, from which they made pleasant pilgrimages to the ancestral farm near Wentzville. He died on June 16, 1963, in Columbia, Missouri.
Guthrie's persistent focus on scientific accuracy and his modesty are traits worthy of emulating for the physicians and researchers. The Midwestern Vascular Surgical Society has published his correspondences in two volumes. He is considered the historical patron of the society and giving due credence his unfathomable work, the society's logo depicts a photo of Charles Claude Guthrie. The first volume is “America's First Nobel Prize in Medicine or Physiology” and the other volume is “The Evolution of Modern Vascular Surgery.” They give a thorough review of their perspective and the chronology of events during the time including the hand-written letters.
The second volume is more interesting since it also describes the society's history which comprises members who can be invited to the society based on their work in the field of vascular surgery. They should be in a position where they work toward the advancement of vascular surgery as a speciality and represent a regional geographical area in the United States of America. They are one of the largest regional society and play a vital role in the progress of vascular surgery as an independent speciality.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||John R. Pfeifer, MD. Historian of Midwest vascular Surgical society. Boston: Midwestern Vascular Surgery Society; 2001. |
|2||Cooley DA. The evolution of modern vascular surgery. Tex Heart Inst J 2002;29:150-2.|
|3||Friedman SG. Credit where due. J Vasc Surg 2016;64:530-3.|
|4||Available from: https://www.midwestvascular.org/about/.|