Lives of the fellows

Hugh Roland Butt

b.8 January 1910 d.16 August 2008
MD Virginia(1933) MS(1937) FACP(1940) FRCP(1971)

Hugh Roland Butt was professor of medicine at the Mayo Clinic, Rochester, Minnesota, and a former president of the American College of Physicians. His pioneering studies of the use of vitamin K as a treatment for haemorrhage effectively led the way for the development of transplantation and open-heart surgery. He was born in Belhaven, North Carolina, the son of Harry Frederick Butt, an engineer, and Maybelle Butt née Jarvis, the daughter of a landowner.

He studied medicine at the University of Virginia, graduating in 1933. He then entered the Mayo Graduate School, beginning a more than 50-year association with the institution. In 1938 he was appointed to the staff. In 1943 he became an assistant professor of medicine, becoming a professor of medicine there in 1952.

Butt gained international respect for his discovery that vitamin K could stop bleeding in patients with jaundice, a previously fatal condition. As a 25-year-old resident at Mayo in the 1930s, Butt read a study which noted that a deficiency of vitamin K in laboratory chickens frequently led to the birds’ bleeding internally. He theorised that jaundiced patients, who are prone to internal haemorrhages, might be aided through vitamin K therapy. After a series of clinical experiments, Butt was asked to help a male patient with chronic jaundice who was near death from internal bleeding. He mixed the vitamin with bile salts to aid absorption, and sent the mixture through a tube directly into the patient’s stomach. Within an hour, the internal bleeding had stopped, and the patient eventually recovered.

In 1938 he published his vitamin K study (‘The use of vitamin K and bile in treatment of the hemorrhagic diathesis in cases of jaundice’ Proceedings of the Staff Meetings of the Mayo Clinic 13:74-80,1938). The findings changed the practice of hepatology. Butt later went on to study excess clotting. Building on prior research on the anticoagulant agent dicoumarol, he proposed that it could be used effectively as a reversal of vitamin K. He was able to reduce clotting in a human clinical trial that he conducted in 1941. Both studies have been influential in the development of organ transplantation and other procedures in which either bleeding or clotting needs to be strictly controlled.

At Mayo he devoted more and more time to teaching and administration, and became a nationally recognised advocate for continuing medical education. He was chairman of the American College of Physicians’ committee on educational activities from 1965 to 1970, a time when the internationally-acclaimed medical knowledge self-assessment program was developed, a system of self-testing for doctors to ensure their awareness of advances in medicine. At Mayo he served on the board of governors and on the board of trustees.

Butt was president of the American College of Physicians between 1971 and 1972. He was awarded the prestigious mastership by the College in 1973 and, in 1975, was honoured with the Alfred Stengel memorial award for outstanding service. He also was given a laureate award in 1986 from the Minnesota chapter of the College.

He married Mary Emma Dempwolf in 1939. She died in 1990. They had a son, Charles, who also predeceased him, and three daughters, Lucy, Selby and Frances. Butt died in Rochester, Minnesota, at the age of 98.

Eric Greenberg

[Brit.med.J.,2008 337 2196; The Lancet 2008 372 1144; The New York Times 23 August 2008 www.nytimes.com/2008/08/24/health/research/24butt.html – accessed 10 October 2011; Los Angeles Times 30 August 2008 http://articles.latimes.com/2008/aug/30/local/me-butt30 – accessed 10 October 2011 ]

(Volume XII, page web)

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