Richard Asher
Richard Alan John Asher, FRCP (3 April 1912 – 25 April 1969) was an eminent British endocrinologist and haematologist.[3] As the senior physician responsible for the mental observation ward at the Central Middlesex Hospital[4] he described and named Munchausen syndrome in a 1951 article in The Lancet.[5]
Richard Asher | |
---|---|
Born | Richard Alan John Asher 3 April 1912 |
Died | 25 April 1969 57) | (aged
Cause of death | Suicide[3] |
Occupation | Physician |
Spouse(s) | Margaret Augusta Eliot |
Children | Peter Asher Jane Asher Clare Asher |
Parent(s) | Felix and Louise Asher née Stern |
Personal life
Richard Asher was born to the Reverend Felix Asher and his wife Louise (née Stern). He married Margaret Augusta Eliot at St Pancras' Church, London on 27 July 1943,[6] whereupon his father-in-law gave him a complete set of the Oxford English Dictionary, which doctor and medical ethicist Maurice Pappworth alleged was the source of Asher's "accidental" reputation as a medical etymologist.[7] They had three children: Peter Asher (born 1944), a member of the pop duo Peter & Gordon and later record producer, Jane Asher (born 1946), a film and TV actress and novelist, and Clare Asher (born 1948), a radio actress. Richard Asher's brother Thomas married Margaret's sister, Susan.[8]
The Asher family home above his private consulting rooms at 57 Wimpole Street was briefly notable when Paul McCartney lived there in 1964–66 during his relationship with Jane Asher.[9]
In 1964 Asher suddenly gave up his hospital post and perhaps all medical activities.[4] He suffered from depression in later life and reportedly died by suicide at the age of 57.[3]
Ideas and reputation
Asher was regarded as "one of the foremost medical thinkers of our times",[10] who emphasised the need "to be increasingly critical of our own and other people's thinking".[11] Asher was particularly concerned that "many clinical notions are accepted because they are comforting rather than because there is any evidence to support them".[12]
Asher was hailed as a pioneer[13] in challenging the value of excessive bed rest following treatment,[14] and argued that the Pel–Ebstein fever (a fever characteristic for Hodgkin's disease) was an example of a condition that exists only because it has a name.[15] Asher's 1949 paper "Myxoedematous Madness"[16] alerted a generation of physicians to the interaction between the brain and the thyroid gland. As a result, young and elderly psychiatric patients are now screened for thyroid malfunction.[17] Some of the 'madness' cases are now thought[18] to be the early descriptions of Hashimoto's encephalopathy, a rare neuroendocrine syndrome sometimes presenting with psychosis.
Notable articles
Asher is remembered today mostly for his "refreshingly provoking"[3] articles which "sparkle with sequins--his own aphorisms, imaginary dialogue, fantasies, quotations."[19] He thought that medical writing should provide "useful, understandable, and practical knowledge instead of allotov-words-2-obscure-4-any-1,2-succidin-understanding-them."[20] Anthologies of his articles were well-received,[10][21] with the Talking Sense collection being described as "still the best advice on medical writing."[22] Notable articles include:
- The Dangers of Going to Bed (1947) - "one of the most influential medical papers ever written"[23]
- The Seven Sins of Medicine (1949, in Lancet 1949 Aug 27;2(6574):358-60)
- Myxoedematous Madness (1949)
- Munchausen’s syndrome (1951, in Lancet 1951 Feb 10;1(6650):339-41)
- Respectable Hypnosis (1956)
- Why Are Medical Journals So Dull? (1958)
- The Talking Sense trilogy:
- Clinical Sense (1959) with a rueful correction in The Dog in the Night-time (1960)
- Making Sense (1959, in Lancet, 1959, 2, 359)
- Talking Sense (1959, in Lancet, 1959, 2, 417)
"Seven Sins of Medicine"
The "Seven Sins of Medicine"[3] is a lecture delivered by Asher and later published in The Lancet, describing medical professional behaviour that is considered inappropriate. These sins are often quoted to students:
- Obscurity
- Cruelty
- Bad manners
- Over-specialisation
- Love of the rare
- Common stupidity
- Sloth
Prize in his memory
From 1995–2010 an annual prize (2010 value £1,200) in memory of Asher was awarded by the Royal Society of Medicine and the Society of Authors for the best first edition textbook aimed at undergraduate students.[24] The most recent prize was presented to Hugo Farne, Edward Norris-Cervetto and James Warbrick-Smith for their book "Oxford Cases in Medicine and Surgery" at the Royal Society of Medicine, 27 October 2010.
References
- GRO Register of Births: JUN 1912 2b 394 BRIGHTON - Richard Asher, mmn = Stern
- GRO Register of Deaths: JUN 1969 5d 1959 ST MARYLEBONE - Richard Asher, DoB = 3 Apr 1912
- Rowat, Bruce M.T. (1985). "Richard Asher and the Seven Sins of Medicine". Humane Health Care (Volume 1, Number 2). Archived from the original on 27 September 2007. Retrieved 20 March 2008.
- Anonymous (10 May 1969). "R. A. J. Asher (Obituary notice)". British Medical Journal. 2 (5653): 388. doi:10.1136/bmj.2.665.388. PMC 1983233.
- Asher R (1951). "Munchausen's syndrome". Lancet. 1 (6650): 339–41. doi:10.1016/s0140-6736(51)92313-6. PMID 14805062.
- GRO Register of Marriages: September 1943 1b 4 Pancras - Asher = Eliot
- Lock, Stephen (2003). "The words of medicine, R. Fortuine (book review)". Med Hist. 47 (1): 139. doi:10.1017/S0025727300056623. PMC 1044791.
- Burke's Peerage, Baronetage and Knightage, 107th edition, vol. 3, ed. Charles Mosley, Burke's Peerage Ltd, 2003, p. 3482
- Vickers, Graham (2001). Rock Music Landmarks of London. Omnibus Press. ISBN 978-0-7119-8675-6.
- Drew, Robert (1973). "Richard Asher Talking Sense by Francis Avery Jones (review)". Proc R Soc Med. 66 (5): 488. PMC 1644921.
- Asher, Richard (1954). "Straight and Crooked Thinking". Br Med J. 2 (4885): 460–462. doi:10.1136/bmj.2.4885.460. PMC 2078909. PMID 13182247.
- Talking Sense quoted in Asher R (1999). "Endpiece". Br Medical J. 2 (4885): 1532. doi:10.1136/bmj.318.7197.1532a. PMC 1115904. PMID 10356012.
- Sharpe M, Wessely S (1998). "Putting the rest cure to rest--again". BMJ. 316 (7134): 796–800. doi:10.1136/bmj.316.7134.796. PMC 1112768. PMID 9549447.
- Asher, Richard (1947). "Dangers of Going to Bed". Br Med J. 2 (4536): 967–968. doi:10.1136/bmj.2.4536.967. PMC 2056244. PMID 18897489.
- Hilson AJ, DiNubile MJ (1995). "Pel-Ebstein fever". N Engl J Med. 333 (1): 66–67. doi:10.1056/NEJM199507063330118. PMID 7777006. They cite Asher's lecture Making Sense (Lancet 1959;2:359)
- Asher R (1949). "Myxoedematous madness". Br Med J. 2 (4627): 555–562. doi:10.1136/bmj.2.4627.555. PMC 2051123. PMID 18148089.
- Kiraly, Stephen; Ancill, Raymond; Dimitrova, Gergana (May 1997). "The Relationship of Endogenous Cortisol to Psychiatric Disorder: A Review" (PDF). Canadian Journal of Psychiatry. 42 (4): 415–20. CiteSeerX 10.1.1.507.4164. doi:10.1177/070674379704200409. PMID 9161767. Retrieved 20 March 2008.
- Garrard P, Hodges JR, De Vries PJ, Hunt N, Crawford A, Hodges JR, Balan K (January 2000). "Hashimoto's encephalopathy presenting as "myxodematous madness"". J. Neurol. Neurosurg. Psychiatry. 68 (1): 102–103. doi:10.1136/jnnp.68.1.102. PMC 1760600. PMID 10671115.
- Ruth Holland's introduction to A Sense of Asher, quoted in "From a flea's teeshirt". British Medical Journal. 313 (7072): 1654–1656. 21 December 1999. doi:10.1136/bmj.313.7072.1654. Retrieved 20 March 2008.
- Asher, Richard; Wright, MD (15 November 1947). "All the Vitamins". British Medical Journal. 2 (4532): 788. doi:10.1136/bmj.2.3278.788. PMC 2056092. PMID 20340806.
- Greene, Raymond (4 November 1972). "Wit and Wisdom". British Medical Journal. 4 (5835): 306. doi:10.1136/bmj.4.5835.306-a. PMC 1788854.
- Kay, H.E.M. (1 May 1983). "How to Write and Publish Papers in the Medical Sciences (review)". Journal of Clinical Pathology. 36 (5): 607. doi:10.1136/jcp.36.5.607-a. PMC 498301.
- James Le Fanu (2004). "In sickness and in health". Daily Telegraph. Retrieved 20 March 2008.
- "The Richard Asher Prize Past Winners". The Society of Authors. Retrieved 23 December 2015.