James Scarth Combe

There are many instances in Medicine where the first published account of a previously unknown condition has not resulted in eponymous fame. The clear description by a Glasgow surgeon Kennedy Dalziel of what came to be known as Crohn’s disease preceding Crohn’s description by several years, is a much quoted example.

In the same way the credit for the first description of pernicious anaemia belongs to J. Scarth Combe, a native of Leith, who became a successful Edinburgh surgeon and President of the College in 1851. It was he who clearly described the clinical features and post mortem findings some 27 years before Addison recorded his description.

J. Scarth Combe was born in Leith where his father was a brewer. There is debate about whether his first name was John or James. In the College records and those of the Royal Society of Edinburgh he is styled as “James”, but his biographer Dr David Boyd favours the name “John” He became a licentiate of the College and graduated MD from the University in 1815. Contemporary accounts describe how his viva examination in medicine was interrupted by the sound of the guns of Edinburgh Castle announcing the news of the victory at the Battle of Waterloo. After admission as Fellow of the College in 1823, r he worked for a short time in India, gaining experience of cholera during a stay in Calcutta. This would have proved valuable on his return to Leith where, during the cholera epidemic of 1832, the first therapeutic use of intravenous saline was recorded by Dr. James Latta, a local general practitioner. Combe practised as a surgeon in Edinburgh being elected to The Royal Society of Edinburgh in 1850 and became President of the College the following year.

His presentation to the Edinburgh Medico-Chirurgical Society in 1822 of a case history of anaemia was followed by a published account in the Transactions of the |Society in 1824. In this he describes clinical features and post mortem findings clearly recognisable as pernicious anaemia. This remarkable description was a full 27 years before that of Addison. As so often happens in medicine the first description of the disease does not necessarily ensure an eponym.