In 1950, Philip Showalter Hench shared the Nobel Prize in physiology or medicine with his colleague Edward Calvin Kendall (1886–1972) and Polish-Swiss chemist Tadeus Reichstein (1897–1996) for their “discoveries relating to the hormones of the adrenal cortex, their structure, and biological effects.” Their work resulted in the effective treatment of rheumatoid arthritis and many inflammatory diseases that previously were not treatable. Kendall and Hench performed the chemical and clinical studies at the Mayo Clinic in Rochester, Minn; Reichstein had discovered cortisone independently.
Hench, the son of a classical scholar and educator, was born on February 28, 1896, in Pittsburgh, Pa. His early education was at Shadyside Academy in Pittsburgh. He entered Lafayette College in Eaton, Pa, in 1912 and received a BA degree in 1916, then enrolled in medical school at the University of Pittsburgh. In 1917, he enlisted in the US Medical Corps of the US Army but was transferred to the reserve corps to complete his medical education. He received his MD degree in 1920 from the University of Pittsburgh. From 1920 to 1921, he interned at Saint Francis Hospital in Pittsburgh, and from 1921 to 1923, he was a fellow of the Mayo Foundation in Rochester, Minn.
From 1923 to 1925, Hench was the first assistant in medicine at the Mayo Clinic, and from 1925 to 1926, he was an associate in the division of medicine. He was made a staff consultant in 1926 and became head of the department of rheumatic diseases at Mayo. In 1928 and 1929, Hench studied at Freiburg University in Freiburg, Germany, and with Friedrich von Müller (1858–1941) at the Ludwig Maximilians-Universität in Munich, Germany. He was named an instructor at the Mayo Clinic in 1928 and became an assistant professor in 1932, an associate professor in 1935, and full professor in 1947.
During World War II (1939–1945), COL Hench was chief of the medical services and director of the army's rheumatic center at the Army and Navy General Hospital in Hot Springs, Ark. In 1957, he retired from active practice.
Hench's interest in and study of rheumatoid arthritis began in 1923. While working at Mayo Clinic, he noted that the severe arthritic symptoms of 16 patients with jaundice and rheumatoid arthritis decreased or disappeared during flares of jaundice. He postulated that an unknown substance (which he called “substance X”) caused the decrease in the severity of symptoms and, furthermore, that rheumatoid arthritis was reversible and not caused by germs but was a disorder of metabolism. He published his findings and his theory in 1934. In 1938, he reported a series of 20 women with rheumatoid arthritis whose symptoms remitted during pregnancy. He postulated that a factor circulating in the blood during pregnancy or a jaundice attack accounted for the symptomatic improvement. For years, Hench searched for this unknown factor. Eventually, he found evidence that the adrenal gland was involved. This deduction led to the work with his colleague Edward C. Kendall.
In the mid-1940s, Hench secured enough of Kendall's compound E (isolated by Kendall in 1935 and later called cortisone) to treat patients with rheumatoid arthritis. Their research led to the use of not only cortisone but also ACTH (adrenocorticotropic hormone), a hormone of the pituitary gland, for the alleviation of symptoms of rheumatoid arthritis.
At the Mayo Clinic in September 1948, Dr Charles H. Slocumb (1905–1996) gave compound E to a patient with severe rheumatoid arthritis. This produced dramatic improvement, and in the succeeding 6 months, Drs Hench and Slocumb and another colleague, Dr Howard F. Polley (1913–2001), studied the effects of this hormone in 14 patients who had rheumatoid arthritis. Within a few days, each patient experienced a major reduction in stiffness of the muscles and joints, lessening of articular aching, and increased mobility of the joints. Continued treatment with the hormone, however, produced the distressing effects of hypercortisonism. When treatment was discontinued, the original symptoms recurred. This work proved that rheumatoid arthritis was reversible and that certain adrenal cortex hormones could suppress the joint inflammation associated with the disease.
Hench died on March 30, 1965, while on vacation in Ocho Rios, Jamaica. He was honored on a stamp issued by the Comoro Islands in 1977 and on a postmarked cacheted envelope issued by the United States in 2000 on the 50th anniversary of the Nobel Prize awarded to him, Kendall, and Reichstein.
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© 2001 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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