Lives of the fellows

James Purdon Martin

b.11 June 1893 d.7 May 1984
BA Belf( 1915) MA(1918) MB BCh BAO(1920) MD(1922) MRCP(1922) FRCP(1930) Hon DSc Belf(1982)

James Purdon Martin was born at a farm in Jordanstown, County Antrim, and died at the National Hospital, Queen Square, London. He entered Queen’s University, Belfast, in 1912 with a scholarship in modern languages and graduated three years later with first class honours in mathematics. Because of widespread psoriasis he was graded medically unfit for Army service when he attempted to join the Army during the first world war, so he chose to study medicine and qualified in 1920. His first house appointment was in Liverpool, but within a year he had been elected to the staff of the National Hospital for Nervous Diseases and never really left it. He gained his membership of the College in 1922, his fellowship in 1930, and was an examiner from 1939-43. He was appointed to the consultant staff of the National Hospital in 1925, and to the consultant staff of the Royal Postgraduate Hospital, Hammersmith, in 1935. He also had consultant appointments to the Seamen’s Hospital in Greenwich, the Bolingbroke Hospital and Whipps Cross.

From 1940-45 he was neurologist to Eastern Command, for he was still not regarded as fit for military service, and he was also neurologist to the St Mary’s Hospital sector. He was elected dean of the National Hospital, Queen Square, in 1946. In 1948 he became the first dean of the newly constituted Institute of Neurology. There had of course been a postgraduate school of neurology at Queen Square since the days of Hughlings Jackson [Munk’s Roll, Vol.IV, p.l61] but it became officially part of the British Postgraduate Medical Federation in 1948.

Purdon Martin delivered the Lumleian lecture in 1947 on ‘Consciousness and its disturbances...’, and the Arris and Gale lecture of the Royal College of Surgeons in 1963 on ‘Basal Ganglia and locomotion’.

For some years he was joint editor of Neurology, and after he retired he was appointed visiting professor to the University of Colorado. In 1982, to his great delight, he was made an honorary doctor of science at Queen’s University, Belfast. He was a member or the Association of British Neurologists, and of the French and Canadian Societies.

In 1922, while still a resident at Queen Square, he married the resident medical officer, Marjorie Ada Blandy, and there were two sons of the marriage. Sadly, his wife died in 1937. In 1949 he married Janet Smiles Ferguson, née Nichols, who had been a co-student of mathematics at Queen’s University. Janet died in 1978.

At the time of his resident appointment in Liverpool, Purdon Martin came into contact with the first cases of encephalitis lethargica that occurred in the British Isles. The epidemic spread southwards and when Purdon arrived in London, one year later, he had exceptional clinical experience of the sequelae of this disease, which the London neurologists were only just beginning to see. His special interest in basal ganglia was aroused and remained his main concern for the rest of his life.

His first major contribution, in 1927, established the association between hemiballismus and a partial lesion of the corpus luyisii. In 1948 he was the first to report the therapeutic effects of penicillin in neurosyphilis, and he was the first neurologist who had the courage to treat neurosyphilis simply with penicillin. In spite of the spectacular results of penicillin, well into the 1950s many of Purdon Martin’s seniors continued to use methods which had always been inefficient and had never cured the disease; which would no doubt have raised eyebrows among many young neurologists. One of Purdon’s major original contributions was the collation of evidence showing that the basal ganglia had a principal function relating to postural mechanisms.

After retirement, Purdon continued a study that he had commenced in earlier years; of patients with post-encephalitic Parkinsonism, who had been inpatients at the Highlands Hospital, Winchmore Hill, for over 40 years. He had a hut built for him in the grounds for this special study, where he could record their reactions to displacements of posture. He collated all these findings, together with other material, in a book entitled The Basal Ganglia and posture, Philadelphia, Lippincott, 1967, which is a model of English prose. The central idea was novel; such examination and recording methods had not previously been part of the armamentarium of British neurology. His work was increasingly noticed worldwide and a society was set up in Europe for the study of posture. He became the first president at the age of 85. This work brought him recognition among his peers which had not been granted before. He was particularly gratified by the notice his work received in the recent edition of the Handbook of Physiology, Bethesda, American Physiological Society, 1981, and by a request to prepare a second edition of his book. He contributed the section on neurology in Price's Textbook of Medicine, 12th ed.[London] English Language Book Society, 1978, regarded by the majority of postgraduate students as the best textbook in clinical neurology.

These are the bare bones of the remarkable career of a remarkable man. He was a man of strong principles, totally honest, and who expected those who worked with him to have the same high principles and the same devotion to work. Consequently, he was regarded by many as a daunting figure but in fact was a man with a total lack of affectation, great tolerance and an open and enquiring mind which he applied to all his activities - not only to his work, but also to the study of the financial pages of the Stock Exchange and to ballroom dancing. To his patients and those who worked with him he was unvaryingly courteous and kindly. Unthinking colleagues and juniors were inclined to regard him as being slow and ponderous. Admittedly he lacked the charisma of many of his contemporaries on the staff of the National Hospital, but his apparent slowness was merely a manifestation of his determination to think things out before he opened his mouth, so that whenever he did express an opinion it was invariably well formed and to the point. An afternoon spent on a teaching round with Purdon was always a lesson in new ideas, new observations and new challenges. At any hospital, the pathologist always has a much clearer idea of the accuracy of the observations and diagnostic acumen of his clinical colleagues. Godwin Greenfield [Munk's Roll, Vol.V, p.164], when discussing his observations on those patients who had come to post-mortem, always claimed that ‘Purdon’s’ diagnoses were confirmed some 15% more frequently than any of his other colleagues, who included all the giants of the middle quarter of the century.

Purdon Martin retained his active and enquiring mind up to his 90th birthday, in spite of a series of almost catastrophic illnesses. He remained up to date in his knowledge of his favourite subject, the disorders of the basal ganglia, and was able to debate with younger men and women who might be regarded as experts in the field of movement disorders. Future historians will come to regard Purdon Martin as one of the greatest clinical contributors of his day.

Louis Sachs, an American professor of neurology, wrote: ‘Purdon Martin was endlessly thoughtful and ingenious in designing a variety of mechanisms and methods that made it possible for even the most incapacitated patient with Parkinsonism to achieve an artifical normality in gait and posture; lines painted on the floor, counterweights in the belt, loudly ticking pacemakers to set the cadence for walking, and these he always learned from his patients to whom his great book is dedicated. He was indeed a great human pioneer, and understanding and collaboration were central to his medicine. Patient and physician were co-equals, on the same level, each learning from and helping the other and between them arriving at new insights.’

RE Kelly

[Brit.med.J., 1984,288,1698; Lancet, 1984,1,1135-6]

(Volume VIII, page 323)

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