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Sheila Sherlock

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Professor
Dame Sheila Sherlock
DBE FRS FRCP FRCPE
Professor Dame Sheila Sherlock
Sheila Sherlock
Born
Sheila Patricia Violet Sherlock

(1918-03-31)31 March 1918
Dublin, Ireland
Died30 December 2001(2001-12-30) (aged 83)
London, England
NationalityBritish
Alma materUniversity of Edinburgh
Known forHepatology
Spouse
​
(m. 1951)​
Children2
AwardsDBE (1978)
FRCP (1951)
FRCP Ed
FRS (2001)
Scientific career
FieldsMedicine
InstitutionsRoyal Free Hospital
Thesis The liver in disease: with special reference to aspiration liver biopsy

Dame Sheila Patricia Violet Sherlock (31 March 1918 – 30 December 2001) was a British physician and medical educator who is considered the major 20th-century contributor to the field of hepatology (the study of the liver).

Early life

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Sheila Sherlock was born in Dublin on 31 March 1918, the only daughter of Violet Mary Catherine (née Beckett) and Samuel Philip Sherlock, an army officer then serving as a lieutenant in the 1st Cavalry Reserve.

Her family moved from Ireland to London soon after her birth and she attended private schools in the city until her family moved in 1929 to the village of Sandgate, Kent.[1] In Kent, she was educated at the Folkestone County School for Girls. In the early part of the twentieth-century female applicants to medical schools were at a great disadvantage, and from 1935 to 1936 Sherlock attempted to enter several English medical schools but was rejected. In 1936 she was accepted for a place to study medicine at the University of Edinburgh.[1] Her ability became evident, and she graduated in 1941 finishing top of her year. She was awarded the Ettles Scholarship, being only the second woman to have done so.[1][2]

Career

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She remained in Edinburgh to take up the post of Assistant Lecturer in Surgery offered to her by Professor Sir James Learmonth, and published her first paper with Learmonth in 1942.[3] She later recounted that Learmonth had taught her how to conduct and document research. In the same year she was appointed House Physician to Professor Sir John McMichael at the Royal Postgraduate Medical School, Hammersmith Hospital.[1]

In this post she worked on hepatitis, which she was able to continue from 1943 to 1947 with funding from the Medical Research Council and subsequently with the award of the Beit Memorial Fellowship. She was awarded her MD with a thesis on The Liver in Disease: with special reference to aspiration liver biopsy, receiving a Gold Medal from University of Edinburgh.[4]

She conducted research into portal hypertension, hepatic encephalopathy and ascites at this time. In 1947 she spent a year at Yale University's School of Medicine as a Rockefeller Travelling Fellow, working on carbohydrate metabolism and liver disease.[5] She returned to London and in 1948 was appointed Lecturer in Medicine and Consultant Physician at Hammersmith Hospital. In 1951, aged 33, she was elected as a Fellow of the Royal College of Physicians, making her, at the time, the youngest woman to receive this qualification.[6]

In 1959, she became the United Kingdom's first ever female professor of medicine when she was appointed at the Royal Free Hospital School of Medicine in London. She founded the liver unit which was located in a temporary wooden structure on the roof of the hospital in Gray's Inn Road. Despite its location, the department attracted trainees from around the world, and many current leaders in the field of hepatology spent time there. Research in several different areas of liver disease was undertaken: including; bilirubin metabolism, haemochromatosis, cholestasis, drug-induced liver disease, albumin synthesis, portal hypertension and ascites, autoimmune liver disease and its treatment with corticosteroids, and the use of liver biopsy in the diagnosis of liver disease were all studied. In 1974 the department moved to the new hospital in Hampstead, where it was situated close to the clinical wards, on the 10th floor. Research continued there, with viral hepatitis, liver transplantation and endoscopic treatment of varices all becoming important areas of study. She retired from the Chair of Medicine in 1983, but continued to see patients, conduct research, and write.[citation needed] At the Royal Free, she was succeeded by Neil McIntyre.[7]

Affiliations

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  • Co-founder (with Hans Popper) and president, International Association for the Study of the Liver (1958–1962)
  • Councillor (1964–1968), Censor (1970–72), Senior Censor and Vice President (1976–77) Royal College of Physicians[6] – Sherlock was the first female vice president of the Royal College of Physicians
  • President, British Society of Gastroenterology (1973)
  • Member of Senate, University of London (1976–77)[6]
  • Founder, and later President, British Liver Trust (1988–2001)
  • Founder, American Association for the Study of Liver Disease

She delivered several of the Royal College of Physicians lectures including the Bradshaw Lecture (1961), Humphry Davy Rolleston (1968) and Lumleian Lectures (1978) and Harveian Oration (1985).[8]

Publications

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Sherlock was known as a clear and succinct writer, and she published over 600 papers in scientific journals. Her most widely known book, Diseases of the Liver and Biliary System,[9] was first published in 1955. It was written solely by her until the 9th edition in 1993, and is now in its 13th edition as of 2018. She was also editor of Gut and the Journal of Hepatology.

Awards and honours

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Personal life

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On 15 December 1951, Sherlock married Dr Geraint "Gerry" James, a physician and researcher into sarcoidosis. They had two daughters Amanda and Auriole, and two granddaughters.[1]

Although occasionally referred to as Mrs Sheila James she generally preferred to be known by her maiden name, and was one of the first female professionals to follow this pattern.

On 30 December 2001, Sherlock died in London from pulmonary fibrosis, two weeks after her golden wedding anniversary. Her daughter Amanda, a Baptist minister, conducted her funeral.[13]

Legacy

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When Sherlock started her medical career, little was known about liver disease. Her work helped to establish hepatology as a medical specialty. She pioneered the use of needle liver biopsy,[14] which had been used purely as a research tool, based on the technique of Sir John McMichael. Her approach improved the understanding of the pathology of liver disease and it continues to be used in the diagnosis of liver diseases today. The liver unit that she set up at the Royal Free Hospital became the centre for both research into liver disease and the education of trainees in the specialty.

In 1966, she developed, with Deborah Doniach of the Middlesex Hospital, the standard test for Primary Biliary Cirrhosis[15] and later showed that it was an autoimmune disease. She also demonstrated the efficacy of corticosteroid therapy for autoimmune hepatitis.[16] She also recognised the link between hepatitis B and hepatocellular carcinoma.[17]

In 2006, the Sheila Sherlock Prizes were founded with a donation from her husband, Dr Geraint James. The two prizes are awarded to the highest achieving medical students at the UCL Medical School.[18]

In March 2008, on the 90th anniversary of her birth, the liver unit which she had founded at the Royal Free Hospital, was renamed the Sheila Sherlock Liver Centre in her memory.

Professor Priscilla Kincaid-Smith, nephrologist said of her:—[19]

"She was a superb clinician; we all used to go to Sheila's round. She'd be as rude as anything to you on the round – really pick you out and say, 'That's absolute rubbish,' and walk on to the next patient. But she was tremendous, a really wonderful clinician."

Criticism

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In Human guinea pigs Dr. Maurice Henry Pappworth criticises Prof. Sherlock. He explains he felt she was conducting experiments on patients which she knew to be harmful an example give is that she wrote 'It is dangerous to give amino-acids such as methionine, which are toxic, to patients with liver disease. ... Patients in impending coma are extremely sensitive to sedatives. If the patient is uncontrollable half the usual dose of pentobarbital may be given: morphia is absolutely contraindicated, Drugs known to induce hepatic coma such as ammonium sals, ammonium-exchange resins, methionine, urea and diamond are disallowed'[20] in the British Medical Bulletin in 1957 but then went on to conduct an experiment in which those with liver disease morphine.[21][22]

References

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  1. ^ a b c d e Booth, Christopher C. (2005). "Sherlock, Dame Sheila Patricia Violet". Oxford Dictionary of National Biography (Online ed.). Oxford University Press. doi:10.1093/ref:odnb/76674. Retrieved 26 January 2017. (Subscription or UK public library membership required.)
  2. ^ Obituary, The Guardian, 19 January 2002
  3. ^ Sherlock, S. P. V.; Learmonth, J. R. (1942). "Aneurym of the splenic artery: With an account of an example complicating Gaucher's disease". British Journal of Surgery. 30 (118): 151. doi:10.1002/bjs.18003011809. S2CID 72870958.
  4. ^ Archives Hub Papers and correspondence of Dame Sheila Sherlock, 1918–2001, hepatologist
  5. ^ Williams, R. (2002). "Dame Sheila Sherlock: Mca Patron and Hepatologist Extraordinaire". Alcohol and Alcoholism. 37 (6): 622–623. doi:10.1093/alcalc/37.6.622.
  6. ^ a b c d e f g h i j k l m n "SHERLOCK, Prof. Dame Sheila (Patricia Violet)". Who's who. Oxford University Press. November 2016. Retrieved 25 January 2017.
  7. ^ Campollo, Octavio; McCormick, Aiden (September 2020). "Professor Emeritus Neil McIntyre, BSc, M.D., F.R.C.P. (1934–2020)". Annals of Hepatology. 19 (5): 581–582. doi:10.1016/j.aohep.2020.08.061. PMC 7467658. PMID 33272446.
  8. ^ "Munks Roll – Sheila Patricia Violet Sherlock". Royal College of Physicians. Retrieved 14 October 2010.
  9. ^ Diseases of the Liver and Biliary System, 11th edition. S. Sherlock & J. Dooley (ISBN 978-0-632-05582-1)
  10. ^ "Professor Dame Sheila Sherlock". Universal Medical Center of the Johannes Gutenberg University of Mainz (in German). Archived from the original on 19 July 2011. Retrieved 23 May 2011.
  11. ^ "Library and Archive Catalogue". The Royal Society. Retrieved 14 October 2010.[permanent dead link‍]
  12. ^ Sheila, Sherlock; Rafael, Esteban (1991). "Dame Sheila Sherlock : discurs llegit a la cerimònia d'investidura celebrada a la sala d'actes de l'Hospital de la Vall d'Hebron de Barcelona el dia 31 de maig de l'any 1991". Doctor Honoris Causa (Universitat Autònoma de Barcelona). Doctor honoris causa (in Spanish).
  13. ^ "Correction: Dame Sheila Sherlock". BMJ. 324 (7333): 366i–. 2002. doi:10.1136/bmj.324.7333.366i. PMC 1122299.
  14. ^ Sherlock, S (1945). "Aspiration liver biopsy. Technique and diagnostic application". The Lancet. 2: 397–401. doi:10.1016/s0140-6736(45)91946-5.
  15. ^ D. Doniach, I.M. Roitt, J.G. Walker & S. Sherlock (July 1966). "Tissue antibodies in primary biliary cirrhosis, active chronic (lupoid) hepatitis, cryptogenic cirrhosis and other liver diseases and their clinical implications". Clin. Exp. Immunol. 1 (3): 237–62. PMC 1579190. PMID 5330183.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  16. ^ Cook, G.C., Mulligan, R. & Sherlock, S. (April 1971). "Controlled prospective trial of corticosteroid therapy in active chronic hepatitis". Q. J. Med. 40 (158): 159–85. doi:10.1093/oxfordjournals.qjmed.a067264. PMID 4933363.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ Sherlock, Fox, Niazi & Scheuer (June 1970). "Chronic liver disease and primary liver-cell cancer with hepatitis-associated (Australia) antigen in serum". Lancet. 1 (7659): 1243–7. doi:10.1016/S0140-6736(70)91737-X. PMID 4192492.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  18. ^ UCL Student Handbook Online – The Sheila Sherlock Prizes
  19. ^ Professor Priscilla Kincaid-Smith, nephrologist, Australian Academy of Science, Interview by Dr Max Blythe in 1998.
  20. ^ SHERLOCK, SHEILA (1 May 1957). "LIVER FAILURE". British Medical Bulletin. 13 (2): 136–141. doi:10.1093/oxfordjournals.bmb.a069591. ISSN 0007-1420. PMID 13426541.
  21. ^ Laidlaw, J.; Read, A. E.; Sherlock, S. (March 1961). "Morphine tolerance in hepatic cirrhosis". Gastroenterology. 40 (3): 389–396. doi:10.1016/S0016-5085(61)80071-1. ISSN 0016-5085. PMID 13758327.
  22. ^ Pappworth, MH (1969). Human guinea pigs: experimentation on man. Pelican Books. pp. 160–170.

Bibliography

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