James Ewing

James Ewing, was the third of five children of Judge Thomas Ewing and Julia Ewing, née Hufnagel, members of a prominent eastern Pennsylvania family. At age 14 he suffered from osteomyelitis of the femur which confined him to bed for two years. During this time he was tutored by Henry Gibbons who encouraged his academic skills. Whilst bed bound he entered various competitions and won a microscope, the instrument that was to play a strong role in his future interests in cancer. He completed a classical education at Amherst College, from which he received the A.B. degree in 1888 and the M.A. in 1891.

In 1888 he was accepted into the College of Physicians and Surgeons of New York, from which he obtained a medical doctorate in 1891. Ewing’s mentors at the College of Physicians and Surgeons were Francis Delafield (1841-1915) and Theophil Mitchell Prudden (1849-1924). He also served a brief apprenticeship with another eminent pathologist of the era, Alexander Kolisko (1857-1918), at the Vienna Clinic. He worked for a short period of time at the Western Pennsylvania Hospital and interned at the Roosevelt Hospital and Sloane Maternity. In this period he developed a keen interest in pathology, spending much of this time in the hospital laboratory.

He subsequently returned to his alma mater as a tutor in histology (1893-1897), a Clark fellow (1896-1898), and an instructor of clinical pathology (1897-1898).

In 1898 Ewing volunteered as contract surgeon to the US army, treating soldiers evacuated from Cuba and Manila. He published several papers on malaria from which many of the soldiers suffered.

In 1899, Ewing accepted a professorship in clinical pathology at the Medical College of Cornell University in New York, becoming the first person to hold this chair at Cornell. In 1900 he married Catherine Halsted and his son James was born two years later.

His connection with Cornell University allowed him to do research at the Loomis Laboratory for Research in Experimental Pathology, where an experimental cancer was begun in 1902 under the auspices of the New York Memorial Hospital. That year he was instrumental in establishing the P. Huntington Fund for Cancer Research.

In 1906 Ewing and his associates published a significant finding on lymphosarcoma in dogs. This investigations showed that the disease was transmitted from one animal to another during coitus by the transfer of the variable tumor cells. By virtue of this and other important laboratory discoveries, Ewing soon became one of the foremost American spokesmen in experimental oncology. In 1907 he was a co-founder of the American Association for Cancer Research.

His work on cancer brought him into contact with James Douglas who was a mining engineer but with a medical background. Douglas had an interest in the possible therapeutic potential of radium and went on to found the National Radium Institute in 1913. In the same year Ewing co-founded the American Society for the Control of Cancer, now the American Cancer Society. In 1913 he was also elected president of the Medical Board of the General Memorial Hospital for the Treatment of Cancer and Allied Diseases. In this position and later as first director of research and director of Memorial Hospital (from 1931 to 1939), Ewing supervised the creation of a primary cancer facility - the present Memorial Sloan-Kettering Cancer Center in New York City. Under Ewing’s direction Memorial Hospital entered a new era, one especially fruitful for the clinical management of neoplastic disorders through radiation therapy.

Ewing’s scheme for a cancer centre was characterized about 1950 by Leonard Scheele, then surgeon-general of the U. S. Public Health Service, as a plan for «a cancer institute in the modern sense - an institution where scientists of many disciplines combine their efforts and resources in a common mission, cancer research.»

In 1931 he featured on the cover of Time Magazine. In 1932 he assumed the newly created chair in oncology there, which position he occupied until his retirement in 1939.

The early death of his wife and unborn second child, in 1903 evoked reclusive and eccentric tendencies in Ewing’s personality. In later years he suffered the agonizing discomforts of tic douloureux (trigeminal neuralgia), which curtailed his professional activities. He remained an avid sports enthusiast nevertheless, with a marked preference for tennis and baseball, and he possessed a keen artistic temperament.

Ewing’s works include several monographs and textbooks. Clinical Pathology of the Blood is a rich source on haematological disorders, while Neoplastic Diseases is the cornerstone of modern oncology. In the latter work Ewing recorded a number of significant discoveries in tumor morphology and distinguished that form of malignant osteoma now called «Ewing’s sarcoma».

Ewing was founder and charter member of the American Association for Cancer Research (1907) and the American Cancer Society (1913), and an appointee to the first National Advisory Cancer Council (1937). His services to pathology were acknowledge by numerous international tributes and by his election to the National Academy of Sciences. James Ewing died from bladder cancer at the age of 76. Over a thousand people attended his last rites in 1943.

Ewing was the founder of the Journal of Cancer Research.

"It is a growing conviction that to know cancer in man, one must study the disease most carefully in the human subject. Personally, I do not look for any startling advances or sensational discoveries, since it is much more likely that a steady reduction in the mortality from cancer will come chiefly from a large number of separate factors, of which the most significant appear to be increased control of the conditions leading to cancer, more general recognition of the preliminary stages of the disease, early diagnosis, and treatment of the established disease. From the consideration of these various functions of the modern cancer research hospital, I think that it must be evident that such an institution not only can justify its existence, but fills a very urgent need without which, progress of cancer research would be handicapped, and much relief that might early be extended to cancer victims would be unavailable. Nor is there any doubt that the function of supporting such an institution is properly exercised by the State, which support should be continuous and liberal"

• G. A. Luecke:
  Die Lehre von den Geschwülsten in anatomischer und klinischer Beziehung.
  In: Franz Freiherr von Pitha (1810-1875) and Theodor Billroth (1829-1894): Handbuch der allgemeinen und spezielle Chirurgie. Volume II, 1, 1867. James Ewing:
• Clinical pathology of blood: A Treatise on the General Principles and Special Applications of Hematology.
  Philadelphia and New York, 1901.
• Neoplastic diseases: A Textbook on Tumors.
  Philadelphia, W. B. Saunders, and London, 1919. Fourth edition 1940.
• Causation, Diagnosis and Treatment of Cancer. Baltimore, 1931.
  
  In Text-book of legal medicine and toxicology. Philadelphia, 1903.
  
• Identity.
  
• The Signs of Death.
  
• Sudden Death.
• Blood. Philadelphia. 1910. Biographical:
  
• A. R. Zantinga, M. J. Coppes:
  James Ewing (1866-1943): "the chief".
  Medical and Pediatric Oncology, New York, 1993, 21 (7): 505-510.
• A. G. Huvos:
  James Ewing: cancer man.
  Annals of Diagnostic Pathology, April 1998, 2 (2): 146-148.