Thomas Forrest Cotton
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Thomas Forrest Cotton FRCP (4 November 1884 – 26 July 1965) was a Canadian cardiologist. He introduced
electrocardiography Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of t ...
to Canada and England and was the first to recognise the relationship between
finger clubbing Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe nails associated with a number of diseases, anomalies and defects, some congenital, mostly of the heart and lungs.Freedberg, et al. (2003). ''Fitzpa ...
in adults with acquired structural heart disease and
infective endocarditis Infective endocarditis is an infection of the inner surface of the heart (endocardium), usually the heart valve, valves. Signs and symptoms may include fever, petechia, small areas of bleeding into the skin, heart murmur, feeling tired, and anem ...
. His paper on clubbing in endocarditis is considered by cardiologists as a classic.


Early life and family

Thomas Cotton was born on 4 November 1884 in
Cowansville Cowansville is a town in south-central Quebec, Canada, located on Lac Davignon north of the U.S. border. It is the seat of Brome-Missisquoi, a regional county municipality. The population as of the Canada 2021 Census was 15,234. In recent year ...
, Quebec, to Cedric and Harriet C. Cotton.Thomas Forrest Cotton.
Munk's Roll, Royal College of Physicians. Retrieved 27 February 2018.
Cedric was a small-town physician. After completing his early medical education at
McGill University McGill University (French: Université McGill) is an English-language public research university in Montreal, Quebec, Canada. Founded in 1821 by royal charter,Frost, Stanley Brice. ''McGill University, Vol. I. For the Advancement of Learning, ...
, Cotton travelled to Europe to do house jobs. There, he worked with the big names of the time,
Friedrich Kraus Friedrich Kraus (31 May 18581 March 1936) was an Austrians, Austrian internist. He was born in Bodenbach, Kingdom of Bohemia, Bohemia and died in Berlin. He is remembered for his achievements in the field of electrocardiography and his work in c ...
and Georg Nicolai, co-authors of the first textbook of electrocardiography, and later, with Friedrich von Muller in Munich and Karel Wenckebach in Vienna. He then spent a short time in postgraduate training in the United States before moving to University College Hospital, London, in 1913, where he worked with
Sir Thomas Lewis Sir Thomas Lewis (26 December 1881 – 17 March 1945) was a Welsh cardiologist. He coined the term "clinical science" and is also known for the Lewis P Factor.Biography, ''Oxford Dictionary of National Biography'' Early life and education Lewi ...
. In 1928, Cotton married Dr. Mary (Molly) Marshall, then a clinical assistant at the National Heart Hospital. They had no children.


Cardiology career

Despite the age difference and distance between the two, Sir
William Osler Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first Residency (medicine), residency program for speci ...
supported Cotton's postgraduate activities in England and abroad. Cotton later wrote, "the gates were opened wide for me to enter; a letter to Lewis from William Osler was all that was required to make life seem at its best". Cotton briefly returned to Montreal General Hospital, where, in 1913, with the assistance of Osler's influence and financial contributions, Cotton was able to persuade the hospital to purchase an electrocardiograph. Cotton, as a result, became Canada's first electrocardiographer. At the onset of the First World War, Cotton enlisted in the
Canadian Expeditionary Force The Canadian Expeditionary Force (CEF; French: ''Corps expéditionnaire canadien'') was the expeditionary warfare, expeditionary field force of Canada during the First World War. It was formed on August 15, 1914, following United Kingdom declarat ...
and re-joined Lewis at the Military Hospital, Hampstead, which had been established to carry out research into heart diseases in soldiers. It was at Hampstead that his path crossed with
William Osler Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first Residency (medicine), residency program for speci ...
, Mackenzie,
Clifford Allbutt Sir Thomas Clifford Allbutt KCB, MA, MD, ScD, FRS (20 July 183622 February 1925) was an English physician best known for his role as president of the British Medical Association 1920, for inventing the clinical thermometer, and for supporting ...
, Caler, Meakins, Parkinson and Drury. In 1913 and 1917, he published ten papers in ''Heart'', eight of which were co-authored with Lewis. During his assignment in 1917 at the Sobraon Military Heart Hospital in Colchester, England, Cotton became interested in finger clubbing. He found that clubbing of fingers in adults known to have structural heart disease was a common clinical finding in infective endocarditis. His paper on clubbing in endocarditis is considered by cardiologists as a classic. Following postmortem information on men with "acquired structural heart disease" and clubbing, Cotton stated that although clubbing was not "a conclusive sign of infection, it is nevertheless one of the most valuable signs we possess in coming to a correct diagnosis". As a result, he was the first to recognize clubbing of the fingers as a sign of infective endocarditis. In 1922, he was one of four men who founded the Cardiac Club in London.


Death and legacy

Cotton was an active member of the
Osler Club of London The Osler Club of London, founded in 1928, is a medical society with the purpose of encouraging the study of history of medicine, particularly amongst medical students, and to keep "green the memory of Sir William Osler". Membership in the clu ...
. He had prospered from Canadian investments and following his death at the age of 80 on 26 July 1965, the
Royal College of Physicians The Royal College of Physicians of London, commonly referred to simply as the Royal College of Physicians (RCP), is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of ph ...
received a substantial bequest in his will. His ashes were concealed alongside those of Sir William and Lady Osler in the Osler Library at McGill. His respected chief Osler is remembered in the dining room, named as Cotton had wished, the Osler Room, and in an annual Osler oration. In return, the College honoured Cotton by putting up a plaque in the Osler room and establishing a separate room (known as the "Thomas Cotton Room") to house the library, archives and other possessions of the Osler Club.The Thomas Cotton Room.
Osler Club of London. Retrieved 27 February 2018.
Some of his archives are held at
McGill University McGill University (French: Université McGill) is an English-language public research university in Montreal, Quebec, Canada. Founded in 1821 by royal charter,Frost, Stanley Brice. ''McGill University, Vol. I. For the Advancement of Learning, ...
in the
Osler Library of the History of Medicine The Osler Library, a branch of the McGill University Library and part of ROAAr since 2016, is Canada's foremost scholarly resource for the history of medicine, and one of the most important libraries of its type in North America. It is located ...


References

{{DEFAULTSORT:Cotton, Thomas Canadian cardiologists 1884 births 1965 deaths McGill University alumni People from Cowansville Canadian Army officers Canadian military personnel of World War I Fellows of the Royal College of Physicians Canadian emigrants to the United Kingdom