Lives of the fellows

John (Sir) Parkinson

b.10 February 1885 d.5 June 1976
Kt(1948) MRCS LRCP(1907) MB BS Lond(1908) MD(1910) MRCP(1911) FRCP(1923) Hon LLD Glasg(1951) Hon FACP(1951) Hon DSc NUI(1952) Hon FRCPE(1953) Hon FRCPS Glasg(1962) Hon FRCPI(1962) Hon FRSM

John Parkinson was the son of John Parkinson JP, of Thornton-le-Fylde, Lancashire. He received his premedical education at Manchester Grammar School and University College, London. He trained in medicine at the University of Freiburg, and the London Hospital, which he joined in 1903, and later described it as his medical home. There he gained prizes in anatomy and physiology, and the Anderson prize in clinical medicine.

He graduated in 1907, became MD London in 1910, and was elected FRCP in 1923. In 1913 he was first assistant to Sir James Mackenzie in the cardiac department of the London Hospital, and assumed charge of the department in 1919 when Mackenzie moved to St Andrews in Scotland. Parkinson was appointed assistant physician to the London Hospital in 1920, physician in 1927, and physician to the cardiac department in 1933. He also became physician to the National Heart Hospital, and during the years 1931 to 1956 was consulting cardiologist to the Royal Air Force.

In the first world war he served as medical officer to a casualty clearing station in France from 1914 to 1916, divisional officer at the military hospital for research on heart cases at Hampstead in 1916, and as major RAMC in charge of the military heart centre in Rouen from 1917 to 1919.

The excellence and constancy of his work in and for cardiology gained for Parkinson recognition and distinctions from many lands. He was elected president of the association of physicians of Great Britain and Ireland in 1930, president of the British Cardiac Society, 1951 to 1955, and president of the European Society of Cardiology. He was created an honorary member of the Cardiac Societies of France, Italy, Switzerland, Portugal, India, Brazil, Australia and New Zealand.

The Royal College of Physicians appointed him Lumleian lecturer for 1936, and Harveian orator for 1945, and awarded him the Moxon medal in 1957. He received the Fothergill gold medal from the Medical Society of London in 1947, and the gold stethoscope award from the International Cardiology Foundation in 1966. In 1948 he was invested with a knighthood.

Throughout the whole of his professional life, John Parkinson worked untiringly to establish cardiology as an acknowledged specialty within medicine. A notable step towards this ambition took place when the Cardiac Club of 15 members was enlarged to admit 85 members in 1937, and renamed the British Cardiac Society. Parkinson became its first president. The society now has a thriving membership, while its monthly journal, the British Heart Journal, enjoys an international reputation. He had set his heart on achieving for cardiology a premier position in medicine, and before retiring from active practice he had the satisfaction of knowing that this had come to pass.

Parkinson wrote no textbook of cardiology, but he did more, he undertook personal research into most ailments to which the heart is heir, and he conveyed his findings through his many publications. His collected papers, which rest in the library of the College, are literature enough for cardiology. He was no copyist. He cut his lone furrow, and those of us who viewed it from the headlands saw it as a pattern which we wished to follow. In his researches he never allowed his gaze to stray from his avowed object, to improve the diagnosis of heart disease in order to bring it within the compass of practical therapy.

Dealing first with treatment, he and Sir Alun Rowlands tested the effects of strychnine in heart failure at a time when it was standard therapy in such patients. They found that it produced no benefit. They announced their findings at the 17th International Congress of Medicine in London in 1913.

Parkinson was the first to introduce adrenaline in the treatment of Adams-Stokes attacks. In 1917 he wrote on the uselessness of digitalis in the so-called soldier’s heart syndrome, pointing out that the complaint sprang from the nervous system and not the heart. In 1922 he confirmed the benefit produced by quinidine in certain patients with paroxysmal or established auricular arrhythmia. He highlighted the beneficial effect of a mercurial suppository in 1936, some years before the introduction of the modern oral diuretics. In 1939, along with Gavey, he showed that digitalis was always indicated in heart failure, irrespective of the rhythm of the heart. He warned not to accept readily statements on the superiority of new analgesics over morphine, a drug whose universal use through more than a century gave proof of its efficiency, and he told an audience of doctors that some of them were mean in their use of analgesics, adding that their attitude might change when they became ill themselves.

To Parkinson, unfamiliar medicines were suspect, so that when new house physicians reported to him for duty, he warned them not to prescribe any medicine to patients admitted to hospital under his care until he had seen and examined them. We interpreted this caution as an absence of confidence in a new house physician, but we were soon to notice how well patients reacted to rest only, in the absence of any medicinal therapy. From Parkinson we learnt that nature was itself a physician capable of curing illness, and that a knowledge of the natural history of disease along with its lesson of vis medicatrix naturae was being annihilated by overzealous therapeusis.

In 1925, Parkinson supervised a patient with mitral valve disease in whom Sir Henry Souttar undertook digital dilatation of the mitral ring. He had retired from active medical practice when surgical treatment of heart conditions was gaining notable success, a progress he warmly applauded.

In the diagnosis of heart disease Parkinson made significant advances in several sectors. He and Bedford were foremost in correlating the symptoms and electrocardiographic signs of cardiac infarction (coronary thrombosis), especially identifying the changes that take place during the weeks and months which follow the initial attack. With Campbell and Bedford he wrote extensively on the arrythmias, on the heart in emphysema with Clifford Hoyle, and with Harold Cookson on the heart in goitre.

In 1930, Parkinson along with Louis Wolff and Paul White in America, described bundle-branch block associated with a short P-R period in healthy young people prone to paroxysmal tachycardia (the WPW syndrome). The paper in which they described and discussed this anomaly has been quoted in cardiological journals with a frequency probably greater than any other affecting the heart.

Jointly with Bedford and Papp he wrote a comprehensive dissertation on atrial septal defect, which presently led to its more frequent surgical treatment.

Parkinson’s greatest contribution to diagnosis came from his compulsive encouragement to view the heart radiologically. Extolling this method, he pointed out that no organ was so favourably placed for X-ray inspection as the heart, for it was surrounded by translucent lung, while rotation of the patient enabled the heart to be viewed in all its dimensions. In this way, he said, we look at individual chambers of the heart separately and not just its mass.

Parkinson’s wise leadership in clinical cardiology will be remembered as long as hearts keep beating, and an age ahead will rediscover the truths he taught so convincingly at the bedside. He relied on facts. He was never given to imagination, for the truth to him was what he saw. Indeed, he was a tyrant for truth, and through his diligent search for it, he often presaged it.

By nature, John Parkinson was a shy man. He enjoyed the company of close friends, when he was a generous host, but unless obligatory, he preferred not to dwell long in the company of strangers, other than those with a common interest, and especially the young seeking his advice; to them he would devote unlimited time and help. Those whom he had befriended and trained carried a passport to the world’s foremost cardiological centres. Parkinson could converse in both German and French.

His punctuality was proverbial; never late at a consultation, lecture, ward-round, or outpatients’ session.

He did not decry a thorough investigation of a patient’s illness, but he warned sternly against unneeded investigations in a stinging epigram, There is always a moment when curiosity is a sin’.

Parkinson was a plunderer for perfection. Should one of his assistants submit a film of his own recording, expecting to win high praise from the master, it was more likely to draw a terse remark, highlighting a tiny flaw in the far corner of the film. Censure would then carry the injunction that no such exhibit should leave his department for publication. The assistant would retire subdued, but having taken a decided step nearer perfection. Parkinson sought perfection too in the lay-out of his garden, addressing each shrub by its Latin name, and in the choice of furniture and paintings in his home and consulting-rooms; he himself was no mean painter in watercolour.

It is not only what John Parkinson did and said that has so materially benefited our knowlege of the heart in health and in disease, but also the way he said it. His writings and his lectures abound with examples of the apt and happy turns of phrase which fell so naturally from his pen, and so authoritatively from his lips.

In 1917 John Parkinson married Clara Elvina, daughter of Alfred Le Brocq of St Helier, who died in 1974. They had one son who was killed in air combat over the channel in 1942, and four daughters.

W Evans

[Brit.med.J., 1976, 1, 1536; Lancet, 1976, 1, 1359; Times, 8 June 1976]

(Volume VII, page 443)

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