Background

David Linn Edsall was born on July 6, 1869 in Hamburg, New Jersey, United States. He was the sixth of the seven sons of Richard E. Edsall, the proprietor of a large general store and twice a state legislator, and Emma Everett (Linn) Edsall, whose family included a number of physicians. Both parents were descendants of early settlers in New Jersey and were chiefly of English ancestry, the first American Edsall having emigrated in 1648 from England to Boston and then moved on to New Amsterdam.

Education

Edsall entered Princeton to study the classics, but the required courses in biology soon shifted his interests to the laboratory, and after receiving the A. B. degree in 1890 he followed his older brother Frank to the medical school of the University of Pennsylvania.

He graduated, M. D. , in 1893.

He studied in London, Graz, and Vienna.

Career

After interning for a year at Mercy Hospital in Pittsburgh he opened a practice in Pittsburgh. After six months, however, he returned to the University of Pennsylvania Medical School as an assistant. His work attracted the notice of the great teacher and clinician William Pepper, who made Edsall his recording clerk and appointed him an associate in clinical medicine at the newly established Pepper Laboratory for Clinical Research. Edsall's work in Pittsburgh had roused his curiosity about the relation between the illnesses suffered by the steelworkers and conditions in the mills, and his study abroad had convinced him of the value of laboratory research in the understanding of human disease.

At the Pepper Laboratory he used the relatively new techniques of biological chemistry to make fundamental studies of nutritional diseases, metabolic abnormalities of children, and the effects of occupation on health.

Between 1897 and 1910 he and his occasional collaborators produced more than seventy papers, which brought him a national reputation. In 1904 he published the first description of the disease later delineated as "heat cramps, " sometimes called "Edsall's disease, " a severe disorder (caused, so later research revealed, by salt depletion) that attacked workers after exposure to intense heat.

He also studied the role of industrial conditions in producing chronic metallic poisoning.

In 1907 Edsall was appointed professor of therapeutics and pharmacology at Pennsylvania, and in the same year he helped found the American Society for Clinical Investigation, whose members were known as the "Young Turks" because of their revolutionary approach to medicine. He also became president of the Philadelphia Pediatric Society (1908) and of the American Pediatric Society (1909). The famous Flexner report, detailing the poor quality of much of the medical training offered in the United States, led to revolutionary changes in many of the medical schools. Edsall was deeply involved in these movements for change, in three different schools.

Invited in 1909 to head the reforms projected at the Washington University School of Medicine in St. Louis, he formulated far-reaching proposals, and his influence was important in bringing such outstanding men as the pathologist Eugene L. Opie, the physiologist Joseph Erlanger, and the biological chemist Philip A. Shaffer to St. Louis. Edsall was finally persuaded, however, to stay at Pennsylvania, where a radical reorganization raised him to the top chair of professor of medicine in 1910.

At first the university seemed ready to carry out his far-seeing ideas on medical education, which included putting the clinical professors on a salaried basis and requiring them to give at least half time to teaching and research, but what had seemed to be unanimous support for these radical changes evaporated.

Deeply disappointed, Edsall resigned in 1911 and went, after all, to Washington University as professor of preventive medicine. His close friend John Howland came as professor of pediatrics. Both Edsall and Howland, however, were rapidly disillusioned by lack of effective support from the administration for the development of their respective departments, and by the obstructive attitude of a few of their colleagues. With regret they decided to leave.

Thus in 1912 Edsall accepted an invitation to Boston as Jackson Professor of Clinical Medicine at the Harvard Medical School and head of the East Medical Service of the Massachusetts General Hospital. There he led a major development and expansion of research.

He continued studies on nutrition, established an industrial disease clinic, and offered cooperation to manufacturers in determining and eliminating the causes of diseases related to occupational conditions. He had a genius for fostering the careers of promising young men who later became outstanding physicians; among them in those early days were James Gamble, J. Howard Means, Walter Palmer, and Paul Dudley White.

In 1918 Edsall became dean of the Harvard Medical School. In 1922, through funds provided by the Rockefeller Foundation, Harvard's public health departments were amalgamated to form a separate School of Public Health, and as the full-time dean of both schools, Edsall resigned his hospital position and abandoned the practice of medicine.

The seventeen years of Edsall's deanship were a period of remarkable growth and scientific advance. Financial support for medical education and research increased manyfold. As chairs fell vacant and it became possible to support the departments on a modern basis, the school moved gradually (in the flexible Harvard style) toward a system in which teachers of the clinical courses devoted full time to their classes. The curriculum, always under revision, was drastically altered to allow students more freedom of choice and more independence.

The new fourth-year general examination was designed to make students coordinate their knowledge. Edsall never lost sight of the fact that a school meant students and teachers, not buildings or systems. He assembled a great staff, bringing to the Harvard Medical School such leaders as Hans Zinsser in bacteriology, Alice Hamilton in industrial medicine (the first woman appointed to the faculty), Kenneth Blackfan in pediatrics, and Soma Weiss in medicine. Edsall also exerted a wide influence through the Association of American Medical Colleges.

In 1927 he became a trustee of the Rockefeller Foundation, and his reports recommending that the foundation concentrate its medical education funds in support of the best and most promising researchers, and advocating a major shift to support of psychiatry, were of far-reaching importance.

Under Rockefeller auspices in 1926 Edsall spent six very successful months in China, as an adviser on the future development of the department of medicine at the Peking Union Medical College. He retired as dean and Rockefeller trustee in 1935, but in the period preceding World War II took an active part in finding suitable positions for refugee European scientists.

Increasing heart insufficiency made Edsall an invalid in his last two years. He died of congestive heart failure in Cambridge, Massachussets, at the age of seventy-six; his ashes were buried near his summer home in Greensboro, Vermont.

Achievements

• Edsall became widely known as one of the few scientifically trained doctors of his day, men who sought to understand the physiological and biochemical processes of disease in order to find fundamental principles of treatment.

Works

More photos

• book

  • Medicine (Classic Reprint)

    (The editors of MEDICINE regret very much that the followi...)

Religion

Brought up as an Episcopalian, he later became detached from the church.

Membership

In 1905 William Osler chose him as one of the twenty-four original members of the Interurban Clinical Club, a select group of leading physicians of Philadelphia, Boston, New York, and Baltimore.

Personality

His qualities of sound judgment, patience, candor, and intellectual honesty were combined with the kind of courage that led him to say, "The best way to avoid a danger is to run plumb at it. " He liked people and dealt easily with both patients and colleagues.

Edsall was six feet four and generously proportioned, with a deep voice and a deliberate and dignified manner.

Interests

• He enjoyed detective stories, and found relaxation in hiking and mountain climbing.

Connections

Edsall's first wife died in November 1912. In June 1915 he married Elizabeth Pendleton Kennedy; they were divorced in 1929.

On May 3, 1930, he married Louisa Cabot Richardson, his assistant in the dean's office.

Their children were: John Tileston, who became professor of biological chemistry at Harvard; Richard Linn; and Geoffrey, who became professor of applied microbiology at the Harvard School of Public Health and head of the state public health laboratories.

Father:

Richard E. Edsall

proprietor of a large general store and twice a state legislator

Mother:

Emma Everett (Linn) Edsall

Spouse:

Elizabeth Pendleton Kennedy

Spouse:

Louisa Cabot Richardson

Son:

Geoffrey Linn

professor of applied microbiology at the Harvard School of Public Health and head of the state public health laboratories

Son:

Richard Linn

Son:

John Tileston

professor of biological chemistry at Harvard

Friend:

John Howland

Friend:

John Howland

professor of pediatrics

References

• Pioneer in Modern Medicine: David Linn Edsall of Harvard