Rheumatology Advance Access originally published online on August 18, 2006
Rheumatology 2006 45(10):1322; doi:10.1093/rheumatology/kel254
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OBITUARY |
John H. Glyn
1Princess Margaret Hospital, Windsor, SL4 3SJ and 2St Mary's Hospital, London W2 1NY
Corticosteroids have been the backbone of treatment of many rheumatological diseases. Most of us recognize the remarkable beneficial effects of steroids, though mindful of the potential longer-term toxicity. In 1949, Philip Hench had demonstrated the miraculous effect of cortisone at the Mayo Clinic, and he invited Will Copeman and Oswald Savage to participate in the first UK studies. The task of personally administering the first injections of the trial substances and cortisone itself in 1950 and documenting the response was bestowed on John Glyn, then a 28-yr-old ex-RAF (Royal Air Force) doctor who was appointed to the West London Hospital. He developed a clinical assessment protocol, which he later discussed with a Philadelphian physician, who modified them into what became known as the Lansbury index.
Dr Glyn published the preliminary results on the first 10 patients in the Br Med J in 1950, and the results on the next 20 patients in 1952. The results of the first Medical Research Council multicentre, crossover trial of cortisone and aspirin were published in 1954, with the conclusion that there was no discernible difference between the two groups. Dr Glyn criticized the design of the trial, and challenged the conclusion in a long letter to the Br Med J, drawing an immediate and angry riposte from Prof Austin Bradford-Hill, who in later years, in a personal conversation, was gracious enough to admit the errors of trial design. Sixty years on, with our current knowledge and widespread use of steroids, patients and physicians would have to thank Dr Glyn for his temerity as well as intellectual honesty, in challenging the establishment, naively unaware of possible consequences on his future career.
In 1952, he was awarded a combined Fulbright and Masonic Fellowship in New York. He was Morris Ziff's first Fellow, and this resulted in a lifelong friendship. He saw and recognized a phenomenon we abhor today—drug addiction. However, this was addiction to cortisone. Patients abandoned their primary physician, and sought to purchase the drug on the black-market, being finally forced into bankruptcy and destitution. His thesis on his 6 yrs of experience with corticosteroids led to the award of the MD in 1955, and to the first book on the subject ‘Cortisone Therapy Applied to Rheumatic Diseases 1957’.
He saw the great divide between Physical Medicine and Rheumatology. The former attracted Government funding because of the emphasis on rehabilitation. The latter linked the speciality to General Medical training, and the Membership of the Royal College of Physicians. He was one of the first to span this divide, when he became Senior Registrar to Will Tegner at The London Hospital. In 1971, he was President of the section at the Royal Society of Medicine, and during his tenure, he oversaw the amalgamation of the separate sections of Physical Medicine and Rheumatology.
Dr Glyn qualified from Cambridge (via Harrow), having attended the Middlesex Hospital as an undergraduate. He was, therefore, pleased to be appointed to the Arthur Stanley Institute at the Middlesex Hospital as Senior Assistant Physician in 1956. From 1957, he worked for 13 years as Consultant at Prince of Wales’ Hospital, Tottenham, before moving to St Charles’ Hospital in 1970. He retired in 1986.
After retirement, he collaborated with George Kersley to write a treatise entitled ‘A Concise International History of Rheumatology and Rehabilitation—Friends and Foes’. They describe the two decades of separation and the later merger of the two groups within rheumatology, the stormy evolution of our speciality from a Cinderella status to the progressive and integrated speciality we now represent.
John had served on the Council and as Secretary of the Heberden Society, the Council of the British Association of Physical Medicine and the Council and as Section President of the Royal Society of Medicine. John left legacies to the Royal College of Physicians, and the Royal Society for Medicine. He was born in 1921, and died on 1st October 2005. His wife Daphne, a former physiotherapist, son Ian, daughter Gillian and six grandchildren, one of whom is studying medicine at Imperial College, survive him.
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