Richard Clarke Cabot

Richard Clarke Cabot (1868-1939), an American physician, pioneered clinical hematology, was an innovator in teaching methods, and introduced the concept of the medical social worker.

Richard Cabot was born in Brookline, Mass., on May 21, 1868. He studied at the Noble and Greenough School before going on to Harvard, from which he graduated with high honors in 1889. He graduated from Harvard Medical School in 1892 and interned there for the next 18 months. In 1894 he married Ella Lyman and settled in Boston.

Cabot's research during 1894 and 1895 indicated that the white blood cell count increases as a result of certain illnesses, like appendicitis; this was therefore a useful diagnostic aid. His first book was A Guide to the Clinical Examination of the Blood for Diagnostic Purposes (1896). He served aboard the U.S. Army hospital ship Bay State during the Spanish-American War. His interest in diagnosis continued, and in 1901 Physical Diagnosis of Diseases of the Chest was published. This book became a standard text.

In 1898 Cabot was appointed physician to outpatients at Massachusetts General Hospital, and in 1912 he became one of two chiefs of staff. It was here that he established medical social service as part of the total effective treatment of the patient when he organized, in 1905, a small group of social workers to attend to cases requiring observation at home. This was perhaps Cabot's greatest contribution to medicine. His ideas about social work are explored in Social Service and the Art of Healing (1909).

As an instructor at Harvard Medical School (1903), assistant professor (1908), and professor (1918), Cabot taught by presenting case histories to his students and asking for a diagnosis, an approach reflected in his Exercises in Differential Diagnosis (1902). These clinical exercises became the clinical pathologic conference, afterward used as a standard teaching method, when Cabot combined them with the results of postmortem examinations. In 1914 he published an important paper, "The Four Common Types of Heart Disease," in the Journal of the American Medical Association, in which he emphasized the etiologic diagnosis of heart disease.

From 1917 to 1919 Cabot served as chief of medicine at U.S. Base Hospital No. 6 in France. In addition to duties at the hospital, he established dispensaries for war refugees and lectured on social work at the Collège de France.

Cabot was appointed professor of social ethics at Harvard in 1919; he retired in 1934. He published essays in this field and held positions in organizations such as the National Conference of Social Work and the American Civil Liberties Union. He died in Boston on May 8, 1939.

Further Reading on Richard Clarke Cabot

There is no full-length study of Cabot. Frequent references to his work are in Frederic A. Washburn, The Massachusetts General Hospital: Its Development, 1900-1935 (1939). Paul Buck, ed., Social Sciences at Harvard, 1860-1920 (1965), describes Cabot's work at Harvard. For general background material see Henry E. Sigerist, American Medicine (1934), and Ida M. Cannon, On the Social Frontier of Medicine: Pioneering in Medical Social Service (1952).

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