Lives of the fellows

David Arthur Wright Edwards

b.5 July 1920 d.16 October 2001
BA Cantab(1941) MD Michigan(1943) MB BChir Cantab(1944) MRCS LRCP(1944) MD Cantab(1951) MRCP(1957) FRCP(1967)

Throughout his life, David Edwards was interested in subjects which only later caught the imagination of the medical community. If possible, he would always do the technical and practice work himself.

David was educated at Heckmondwike grammar school in Yorkshire, where his father was headmaster, and at Bootham, from which he won a state scholarship to Christ's College, Cambridge. From there he graduated with a double first and in 1942 was selected with about a dozen other medical students to attend a clinical course, organized by the Rockefeller Foundation, in the USA. The idea was that in the event of British medical training being disrupted by war, the returning students would help to reconstruct it in peacetime. Having graduated with distinction in Michigan he came back to complete his UK qualification at University College Hospital medical school, where he met Joan, his wife.

On completion of medical training he may have considered a career in surgery - one does not lightly take the primary examination of the Royal College of Surgeons - but during National Service at the Farnborough Medical Research Institute his love of research literally took off with a study of the effect on human subjects of air- and structure-borne vibrations of various frequencies. This became his MD thesis in 1951 when the ministry of defence lifted restriction on its publication. An enduring result was his patent for ear defenders.

He became a member of the scientific staff of the MRC in the department of clinical research at University College Hospital medical school and in the MRC gastroenterology unit at Central Middlesex Hospital. He went on to hold consultant posts at both hospitals.

In the early 1950s he was interested in the medical problems of obesity and invented what became a standard technique of estimating body fat by measuring skin-fold thickness. On one occasion he discovered that failure of patients to lose weight was due to relatives lobbing food parcels up to a fifth floor ward balcony! David always maintained that in all circumstances good history taking was the foundation of successful diagnosis.

In the late 1950s he pioneered oesophageal manometry and published a number of classic papers. Oesophageal manometry became fashionable; but David Edwards gradually stopped using it, having concluded that it failed to give information which could be obtained by radiology (which, of course, he did himself and at which he became very skilled). At clinical meetings he argued that much manometric work was flawed because the anatomical basis of pressure tracings was uncertain.

He was a reluctant author, believing that one should only put in print what was original, true and important. His little paper with R Lobello, J W Gummer and M Stekelman (Thorax 1978 33:569-73) is typical because, against the assumption in many books and hundreds of papers, it showed that the lower oesophageal sphincter cannot be the dominant factor in the anti-reflux mechanism because division of the sphincter does not always, or even often, cause pathological gastro-oesophageal reflux, and so it argued that 'the common persistence of an anti-reflux mechanism after cardiomyotomy...is likely to be dependent on a hiatal component'.

Latterly, his international reputation was such that it became almost impossible to hold a conference on the oesophagus without inviting him to participate.

By the 1970s he was intrigued by the fact that some people found clinical diagnosis so difficult, and he wrote a number of papers on decision-making algorithms. He was, himself, a conspicuously able diagnostician; and a kind, modest and utterly unselfish colleague. At a time when others sought prestige in the numbers of their in-patients, David believed that medical diagnosis was an outpatient pursuit, and that ideally the patient should have to attend only once.

With regard to medical administration, David was much ahead of his time in his ideas and as chairman of the then members committee of the Royal College of Physicians he proposed a number of reforms which the President found too revolutionary, but which have all since been accepted.

In addition to his clinical and investigative work, David worked hard for charities. He joined the medical committee of the Family Planning Association at the request of David Pyke and later became chairman. He became the representative to the International Planned Parenthood Federation when the large scale studies were underway on the efficacy and safety of the contraceptive pill. He persuaded the British Standards Institution to create a British standard for condoms. He wrote one of the first booklets for the public on contraception for Which? magazine.

He retired in 1984, but contained a weekly oesophageal clinic until 1990. 'When you retire,' he explained to me, 'your interests change'. This meant that he had joined classes in sculpture. He went on to win prizes at local exhibitions and the Medical Art Society. His living room, when I last saw him, was adorned with beautiful wooden female torsos.

John H Wyllie

[Brit.med.J.,2002,324,117]

(Volume XI, page 176)

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