Arthur Guyton
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Arthur Clifton Guyton (September 8, 1919 – April 3, 2003) was an American
physiologist Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and ...
. Guyton is well known for his ''Textbook of Medical Physiology'', which quickly became the standard text on the subject in medical schools. The first edition was published in 1956, the 10th edition in 2000 (the last before Guyton's death), and the 12th edition in 2010. The 14th edition (2020) is the latest version available. It is the world's best-selling medical physiology textbook and has been translated into at least 15 languages.


Textbook of medical physiology

''Textbook of Medical Physiology'' is one of the world's best-selling physiology books and has been translated into at least 13 languages (the textbook memoriam states 13, but the online memoriam states at least 15.) From the ninth edition onwards, John E. Hall co-authored the textbook. However, all prior editions were written entirely by Guyton, with the eighth edition published in 1991. Subsequent editions, including the latest, preserve his legacy within the title, ''Guyton and Hall Textbook of Medical Physiology.''see Table of Contents link
He has also published renowned textbooks on
neurosciences Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions, and its disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, ...
.


Cardiovascular physiology

Guyton is most famous for his experiments in the 1950s which studied the physiology of
cardiac output In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: tha ...
and its relationship with the peripheral circulation (see e.g. chapter 23 of Guyton 1976 edition, or chapter 20 of both Guyton 1991 and Guyton & Hall 2006 edition). It was this work which overturned the conventional wisdom that it was the heart itself that controlled cardiac output. Guyton instead demonstrated that it was the need of the body tissues for oxygen which was the true regulator of cardiac output. The " Guyton Curves" which describe the relationship between right atrial pressure and
cardiac output In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: tha ...
form the basis for understanding the physiology of circulation. This subject is well described in Guyton's textbook (e.g. Guyton 1976; Guyton 1991; Guyton & Hall 2006) which contains references to the original publications.


Guyton model

Guyton's model uses right atrial pressure as an
independent variable A variable is considered dependent if it depends on (or is hypothesized to depend on) an independent variable. Dependent variables are studied under the supposition or demand that they depend, by some law or rule (e.g., by a mathematical function ...
(
causal variable A variable is considered dependent if it depends on (or is hypothesized to depend on) an independent variable. Dependent variables are studied under the supposition or demand that they depend, by some law or rule (e.g., by a mathematical function ...
) but it's incorrect. The
cardiac output In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: tha ...
is the independent variable. In Guyton model's
venous return curve Venous return is the rate of blood flow back to the heart. It normally limits cardiac output. Superposition of the cardiac function curve and venous return curve is used in one hemodynamic model. __TOC__ Physiology Venous return (VR) is the flo ...
, he plotted the right atrial pressure on the x-axis and it can suggest incorrectly that the right atrial pressure was the independent variable in the experiments.


Respiratory Model and Control

'See als
A Mathematical Model of the Human Respiratory Control System


Biography

Arthur Guyton was born in
Oxford, Mississippi Oxford is the List of municipalities in Mississippi, 14th most populous city in Mississippi, United States, and the county seat of Lafayette County, Mississippi, Lafayette County, southeast of Memphis, Tennessee, Memphis. A college town, Oxford ...
, to Dr. Billy S. Guyton, a highly respected eye, ear, nose, and throat specialist, and Kate Smallwood Guyton, a mathematics and physics teacher who had been a missionary in China before marriage. Guyton initially intended to be a cardiovascular surgeon but was partially paralysed after being infected with
polio Poliomyelitis ( ), commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe ...
. He suffered from this infection in 1946 during his final year of residency training. Suffering paralysis in his right leg, left arm, and both shoulders, he spent nine months in Warm Springs, Georgia, recuperating and applying his inventive mind to building the first motorized wheelchair controlled by a "joy stick", a motorized hoist for lifting patients, special leg braces, and other devices to aid the handicapped. For those inventions, he received a Presidential Citation. Despite his disability, he was father to 10 children who all went on to become celebrated physicians, including a professor of ophthalmology, a professor of internal medicine, an endocrinologist, a rheumatologist, two anaesthesiologists, two cardiothoracic surgeons, and two orthopaedic surgeons. Eight of his children attended
Harvard Medical School Harvard Medical School (HMS) is the medical school of Harvard University and is located in the Longwood Medical and Academic Area, Longwood Medical Area in Boston, Massachusetts. Founded in 1782, HMS is the third oldest medical school in the Un ...
, one attended
Duke University School of Medicine The Duke University School of Medicine, commonly known as Duke Med, is the medical school of Duke University. It was established in 1925 by James B. Duke. The School of Medicine, along with the Duke University School of Nursing, Duke Universi ...
, and one attended the
University of Miami The University of Miami (UM, UMiami, Miami, U of M, and The U) is a private university, private research university in Coral Gables, Florida, United States. , the university enrolled 19,852 students in two colleges and ten schools across over ...
's medical school after obtaining a PhD from Harvard. Due to his disability, he had to abandon his plan to become a surgeon. Instead he concentrated on physiology research and teaching, and became the head of the
University of Mississippi The University of Mississippi (Epithet, byname Ole Miss) is a Public university, public research university in University, near Oxford, Mississippi, United States, with a University of Mississippi Medical Center, medical center in Jackson, Miss ...
Dept. of Physiology and Biophysics. He retired as department chair in 1989 but continued as
emeritus ''Emeritus/Emerita'' () is an honorary title granted to someone who retires from a position of distinction, most commonly an academic faculty position, but is allowed to continue using the previous title, as in "professor emeritus". In some c ...
professor Professor (commonly abbreviated as Prof.) is an Academy, academic rank at university, universities and other tertiary education, post-secondary education and research institutions in most countries. Literally, ''professor'' derives from Latin ...
up until his death on April 3, 2003, in a
car accident A traffic collision, also known as a motor vehicle collision, or car crash, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other moving or stationary obstruction, such as a tree, pole or building. T ...
, less than one month after his first great-grandchild was born.


Obituary

Guyton died on April 3, 2003 in a car accident in Pocahontas, Mississippi. His obituary states "unlike most major textbooks, which often have as many as 10-20 authors", the first eight editions "were written entirely by Guyton with a new edition always arriving on schedule for nearly 40 years. This feat is unprecedented for any physiology or medical text. His textbook is unique in the history of medical publishing".Guyton, Arthur C., & Hall, John E (2006) p.ix (the textbook memoriam is almost verbatim of the online citation, with only minor variations) His obituary notes that he triumphed over polio:
He had a special ability to inspire people through his indomitable spirit", and "his courage in the face of adversity humbled us. He would not succumb to the crippling effects of polio. It is very unlikely that a repairman ever crossed his doorstep, except perhaps for a social visit. He and his children not only built their home, but also repaired each and every malfunctioning appliance and home device no matter the difficulty or the physical challenge. He built a hoist to lower himself into the "hole" beneath their house to repair the furnace and septic lines when calling a repairman seemed to be the only option to those who did not know him well. On trips to meetings, he walked long distances across airport terminals when using a wheelchair would have been much easier. His struggle to rise from his chair and walk to the podium for a lecture was moving, but the audience was always more impressed when he forcefully articulated his brilliant concepts.
His obituary in The Physiologist journal, and Memoriam in the 11th edition of his book, are largely verbatim of each other, including as below:
Arthur Guyton's research contributions, which include more than 600 papers and 40 books, are legendary and place him among the greatest figures in the history of cardiovascular physiology. His research covered virtually all areas of cardiovascular regulation and led to many seminal concepts that are now an integral part of the understanding of cardiovascular disorders such as hypertension, heart failure, and edema. It is difficult to discuss cardiovascular regulation without including his concepts of
cardiac output In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: tha ...
and
venous return Venous return is the rate of blood flow back to the heart. It normally limits cardiac output. Superposition of the cardiac function curve and venous return curve is used in one hemodynamic model. __TOC__ Physiology Venous return (VR) is the flow ...
, negative
interstitial fluid In cell biology, extracellular fluid (ECF) denotes all body fluid outside the Cell (biology), cells of any multicellular organism. Body water, Total body water in healthy adults is about 50–60% (range 45 to 75%) of total body weight; women ...
pressure and regulation of tissue fluid volume and edema, regulation of tissue blood flow and whole body blood flow auto-regulation, renal-pressure natriuresis, and long-term blood pressure regulation.Guyton, Arthur C., & Hall, John E (2006) p.vii
The ''Textbook'' Memoriam continues: "Indeed, his concepts of cardiovascular regulation are found in virtually every major textbook of physiology. They have become so familiar that their origin is sometimes forgotten".


Notes


References

*Reference to Guyton's biographical details in the above text comes primarily from the obituary published in ''Physiologist'' magazine, and John E. Hall's memoriam and preface to the 11th edition of ''Textbook of Medical Physiology'' both of which contain overlapping statements, sometimes verbatim, sometimes almost verbatim.


Further reading


The pioneering use of systems analysis to study cardiac output regulation, John E. Hall
* Brinson C, Quinn J. ''Arthur C. Guyton—His Life, His Family, His Achievements''. Jackson, MS, Hederman Brothers Press, 1989. * Bode R. "A Doctor Who's Dad to Seven Doctors—So Far!" ''Reader's Digest'', December, 1982, pp. 141–145. {{DEFAULTSORT:Guyton, Arthur C. 1919 births 2003 deaths University of Mississippi faculty American physiologists Road incident deaths in Mississippi University of Mississippi alumni Harvard Medical School alumni