Mayo Clin Proc, April 1990, Vol 65 Running head 1073

Mayo Clin Proc. 2001;76:1073 © 2001 Mayo Foundation for Medical Education and Research1073

Stamp Vignette on Medical Science

Marc A. Shampo, PhD, and Robert A. Kyle, MD

Philip S. Hench—1950 Nobel Laureate

In 1950, Philip Showalter Hench shared the Nobel Prize inphysiology or medicine with his colleague Edward Calvin

Kendall (1886-1972) and Polish-Swiss chemist TadeusReichstein (1897-1996) for their “discoveries relating to thehormones of the adrenal cortex, their structure, and biologi-cal effects.” Their work resulted in the effective treatmentof rheumatoid arthritis and many inflammatory diseasesthat previously were not treatable. Kendall and Hench per-formed the chemical and clinical studies at the Mayo Clinicin Rochester, Minn; Reichstein had discovered cortisoneindependently.

Hench, the son of a classical scholar and educator, wasborn on February 28, 1896, in Pittsburgh, Pa. His earlyeducation was at Shadyside Academy in Pittsburgh. Heentered Lafayette College in Eaton, Pa, in 1912 and re-ceived a BA degree in 1916, then enrolled in medicalschool at the University of Pittsburgh. In 1917, he enlistedin the US Medical Corps of the US Army but was trans-ferred to the reserve corps to complete his medical educa-tion. He received his MD degree in 1920 from the Uni-versity of Pittsburgh. From 1920 to 1921, he interned atSaint Francis Hospital in Pittsburgh, and from 1921 to1923, he was a fellow of the Mayo Foundation in Roches-ter, Minn.

From 1923 to 1925, Hench was the first assistant inmedicine at the Mayo Clinic, and from 1925 to 1926, he wasan associate in the division of medicine. He was made a staffconsultant in 1926 and became head of the department ofrheumatic diseases at Mayo. In 1928 and 1929, Henchstudied at Freiburg University in Freiburg, Germany, andwith Friedrich von Müller (1858-1941) at the LudwigMaximilians-Universität in Munich, Germany. He was namedan instructor at the Mayo Clinic in 1928 and became anassistant professor in 1932, an associate professor in 1935,and full professor in 1947.

During World War II (1939-1945), COL Hench was chiefof the medical services and director of the army’s rheumaticcenter at the Army and Navy General Hospital in HotSprings, Ark. In 1957, he retired from active practice.

Hench’s interest in and study of rheumatoid arthritisbegan in 1923. While working at Mayo Clinic, he noted thatthe severe arthritic symptoms of 16 patients with jaundiceand rheumatoid arthritis decreased or disappeared duringflares of jaundice. He postulated that an unknown substance(which he called “substance X”) caused the decrease in theseverity of symptoms and, furthermore, that rheumatoidarthritis was reversible and not caused by germs but was adisorder of metabolism. He published his findings and histheory in 1934. In 1938, he reported a series of 20 womenwith rheumatoid arthritis whose symptoms remitted duringpregnancy. He postulated that a factor circulating in theblood during pregnancy or a jaundice attack accounted forthe symptomatic improvement. For years, Hench searchedfor this unknown factor. Eventually, he found evidence thatthe adrenal gland was involved. This deduction led to thework with his colleague Edward C. Kendall.

In the mid-1940s, Hench secured enough of Kendall’scompound E (isolated by Kendall in 1935 and later calledcortisone) to treat patients with rheumatoid arthritis. Theirresearch led to the use of not only cortisone but also ACTH(adrenocorticotropic hormone), a hormone of the pituitarygland, 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 withsevere rheumatoid arthritis. This produced dramatic improve-ment, and in the succeeding 6 months, Drs Hench and Slocumband another colleague, Dr Howard F. Polley (1913-2001),studied the effects of this hormone in 14 patients who hadrheumatoid arthritis. Within a few days, each patient experi-enced a major reduction in stiffness of the muscles and joints,lessening of articular aching, and increased mobility of thejoints. Continued treatment with the hormone, however, pro-duced the distressing effects of hypercortisonism. Whentreatment was discontinued, the original symptoms recurred.This work proved that rheumatoid arthritis was reversible andthat certain adrenal cortex hormones could suppress the jointinflammation associated with the disease.

Hench died on March 30, 1965, while on vacation inOcho Rios, Jamaica. He was honored on a stamp issued bythe Comoro Islands in 1977 and on a postmarked cachetedenvelope issued by the United States in 2000 on the 50thanniversary of the Nobel Prize awarded to him, Kendall, andReichstein.

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