James Alison Glover (1874–1963)

Heberden Historical Series/Series Editor: M. I. V. Jayson

G. O. Storey

Pine Grove, Kentsford Road, Grange-Over-Sands, Cumbria, LA11 7BB, UK.

Glover had a most adventurous life. He broke off his medical training at Guys in 1899 to join the army and fight in the Boer War (he was a first-class marksman). After returning to London he qualified MBBCh in 1901 (MD, DPH, MRCP 1927; FRCP 1933; OBE 1919; CBE 1941). He started in general practice but he joined the RAMC in the First World War and served in Malta and on the Western Front at the battle of the Somme. He received an OBE for his war services.

After the War he became a medical officer on the staff of the newly formed Ministry of Health. It was here that he made his major contribution to rheumatology. He wrote three reports for the Ministry of Health. The first, in 1924, dealt with the incidence of ‘rheumatic disease’ (with the help of the statistics of Professor Major Greenwood he showed its importance as a cause of morbidity). The second report in 1927 dealt with acute rheumatism in childhood and its relation to heart disease.

The third, in 1928, dealt with ‘chronic arthritis’, with special reference to the provision of treatment [1]. This report was summarized by George Newman, the Chief Medical Officer at the time, in his prefatory note to the Minister (the Rt Hon Neville Chamberlain). He said that the aim of the report was to ‘marshal the available facts on a complex subject so that a conception of its scope could be appreciated’.

Among the points raised by the report were the following.

(A) The question of classification of non-specific arthritis was difficult when the cause of the disease was unknown. The classification used in the report was (1) rheumatoid arthritis, (2) osteoarthritis, (3) gout and (4) joint changes unclassifiable. Gout was not considered in the report, but the differential diagnosis of the others was discussed.

(B) The history of chronic arthritis was reviewed. He believed it could be traced back to prehistoric dwellers of Nubia and Upper Egypt as well as the Anglo-Saxons of England (osteoarthritis).

(C) Also discussed were some of the aetiological and precipitating factors which at that time were thought to be implicated in the causation of chronic arthritis. These included heredity and diathesis, sex, faulty metabolism, occupational stress, mental strain, senile changes, endocrine imbalance, chill/dampness, pregnancy, menopause, locality, trauma and septic focus. Many of these are no longer regarded as relevant; particularly focal sepsis, which at that time was regarded by many as an important aetiological factor.

(D) Management might involve a search for a septic focus, but vaccines and protein shock were also used in some clinics. Aspirin was in general use but some recommended arsenic or iodine. Physical treatment was likely to be necessary at some stage of the disease, particularly hydrotherapy. Orthopaedic surgery might be necessary.

The report encouraged Newman to put forward his view of a satisfactory rheumatological service. He visualized: (i) out-patient clinics with physical treatment; (ii) arthritis units, preferably related to teaching hospitals for research and orthopaedic liaison; and (iii) spa hospitals for suitable cases.



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FIG. 1. James Alison Glover (1874–1963).

 
Van Breeman had started the recognition of rheumatology on the continent and the importance of Glover's reports was perhaps not so much the contents but the fact that it stimulated The Ministry of Health and the medical professors in England to take seriously the subject of rheumatology, which up to that time had largely been ignored. Kersley has recorded that his decision to take up rheumatology was greeted with disgust by many of his senior colleagues. Glover repeated and extended his views in his three Milroy lectures to the College of Physicians in 1930 and it is noteworthy that at this time progress was being made, for he mentions in his lecture that ‘last week saw the opening by the Queen of the new Regent's Park Physical Treatment Centre for Rheumatic Disease’ (Peto Place) [2].

He addressed the Dutch Committee on Chronic Rheumatism in 1926, represented the Ministry on many of the early rheumatology committees and was secretary of the British Committee on Rheumatism. There is little doubt that his reports stimulated the formation of the International League Against Rheumatism. He was elected an honorary member of the American Rheumatism Association in 1949.

Apart from rheumatology Glover wrote reports on, among others, tonsillitis, malnutrition in schoolchildren, cerebrospinal fever and purification of water in swimming pools. He sat on innumerable committees. He was appointed CBE in 1941.

In the Second World War he served in the Home Guard, but he later developed osteoarthritis of the hips, which limited his activities. He died in 1961 aged 87.


    References
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 References
 

  1. Report to the Minister of Health on Chronic Arthritis by J. Alison Glover with prefatory note by the Chief Medical Officer, 1928.
  2. Milroy lecture on the Incidence of Rheumatic Disease delivered by J. Alison Glover to The Royal College of Physicians, 27th February 1930.




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