George Huntington

George Huntington was the son and grandson of medical practitioners. The family had lived on Long Island since 1797, when his grandfather Dr. Abel Huntington (1778-1858) opened general practice in East Hampton at the Atlantic coast. He married Frances Lee the same year he opened his practice. His son, George Lee Huntington, who was born here in 1811, studied medicine at New York University, and spent the rest of his life continuing the practice established by his father. He married Mary Hogland. His son George, who was to become the third successive general practitioner of the family, was born on April 9, 1850, in East Hampton, a fact that was decisive for his lasting fame in medical history. At an early age George became familiar with his father's practice, and as a child followed him on his rounds and sick calls.

George Huntington qualified in medicine at the University of Columbia, New York, in 1871, at the age of 21. His dissertation at the university's College of Physicians and Surgeons was titled "Opium".

Following graduation Huntington returned to East Hampton, where he worked for some time with his father. In this period he was able to observe further the cases of hereditary chorea, which he had first seen with his grandfather and father.

In a lecture which he gave to the New York Neurological Society in 1909, Huntington said:

"Over 50 years ago, in riding with my father on his rounds I saw my first case of "that disorder", which was the way the natives always referred to the dreaded disease. I recall it as vividly as though it had occurred but yeasterday. It made a most enduring impression upon my boyish mind, an impression which was the very first impulse to my choosing chorea as my virgin contribution to medical lore. Driving with my father through a wooded road leading from East Hampton to Amagansett, we suddenly came upon two women both bowing, twisting, grimacing. I stared in wonderment, almost in fear. What could it mean? My father paused to speak with them and we passed on. Then my Gamaliel-like instruction began; my medical instruction had its inception. From this point on my interest in the disease has never wholly ceased.»

He took advantage of the notes taken by his father and his grandfather on the disease that had attracted his attention in childhood, and he diagnosed several cases. The manuscript for his survey article concerning choreatic hyperkinesias, in which he describes the disease that bears his name, was probably worked out during this time. In an original manuscript that has been preserved his father had made suggestions for alterations and additions. It is probable that Huntington had his unpublished manuscript with him when he left East Hampton

On February 15, 1872 George Huntington gave his classic presentation On Chorea at the Meigs and Mason Academy of Medicine, Middleport, Ohio. He was only twenty-two at the time. His lecture was received with acclaim, so he sent his manuscript to the Medical and Surgical Reporter of Philadelphia, where it appeared on 13 April 1872.

An abstract was published in the German literature by Adolf Kussmaul (1822-1902) and Carl Wilhelm Hermann Nothnagel (1841-1905) in 1872 and thereafter the eponym was increasingly used by European authors. Huntington recognised the hereditary nature of the condition, stating in his original paper "When either or both the parents have shown manifestations of the disease, one or more of the offspring invariably suffer from the condition. It never skips a generation to again manifest itself in another. Once having yielded its claims, it never regains them."

Huntington's chorea can be recognised as the"dancing mania" which occurred on the Continent of Europe in the Middle Ages. Religious persecution following revocation of the Edict of Nantes gave impetus to emigration from the Low Countries and the condition spread to Britain. Thereafter it reached North America and the Commonwealth and it is now widely distributed throughout the world. Huntington's chorea is found in several non-European populations but the prevalence is very low in these groups.

Huntington in his description states that the first symptoms usually occur at an adult age, and he delineates the development of the chorea:

"The movements gradually increase when muscles hitherto unaffected take on the spasmodic action, until every muscle in the body becomes affected (excepting the involuntary ones)..."

On mental symptoms he writes:

"As the disease progresses the mind bcomes more or less impaired, in many accounting to insanity, while in others mind and body gradually fail until death relieves them of their suffering."

In a review article in 1908, Sir William Osler wrote: "In the history of medicine there are few instances in which a disease has been more accurately, more graphically or more briefly described". There is currently a trend to use the designation Huntington's disease rather than Huntington's chorea but the original title is still widely known, accepted and understood.

Jelliffe and Tilney took up the task of tracing the ancestry of the families concerned, a study concluded some years later by Vessie (1932), who found that they stemmed from two brothers and their families who had left Bures (in Essex) for Suffolk, England, and then sailed to Boston Bay in 1630. During the intervening three centuries about 1000 descendents of the original settlers were known to have come down with the disease. Not a few of these unfortunate persons were tried for witchcraft in the Colonial courts, and in other ways too, they were persecuted because their involuntary movements were interpreted as “a derise pantomime of the sufferings of the Saviour during crucifixion.”

Progressive and inheritable chorea had been described before 1872, and the most complete clinical description, even including the component of dementia, had been published in Norway by the district physician in Setesdal, Johan Christian Lund as early as in 1859. This report received no international attention and was certainly unknown to Huntington. It was not translated into English until 1959.

In 1874 he moved to New York, and aside from two years in North Carolina, spent the remainder of his life in the practice of medicine in Duchess County. He retired in 1915.

Huntington married in 1874. He was a humorous modest man who enjoyed hunting, fishing, sketching wildlife and playing the flute. He was kindly and conscientious in his medical practice and much loved by his patients. He had a happy family life and five children, and a great fondness for music, often playing the flute to his wife’s accompaniment. Moreover, he was an ardent student of nature and gun. Drawing was one of his lifetime interests and he often made sketches of game birds during his trips through the woods. Here, then, was a man who enjoyed life to the full, and who, because of his insight and imagination, gained a place in medical history. For periods he suffered from bouts of asthma, but from the turn of the century his health improved and he was practicing up to the age of 64. Huntington died from pneumonia in 1916 at the age of 66 years, in the house of his son, a physician, in Cairo, New York.

We thank Jan Banzer, Halle, Germany; and Patrick Jucker-Kupper, Switzerland, for information submitted.

• C. S. Stevenson:
  A biography of George Huntington, M.D.
  Bulletin of the History of Medicine, Baltimore, 1934, 2: 53.
• R. M. van der Weiden:
  George Huntington and George Sumner Huntington. A tale of doctors.
  Proceedings of the XXXIInd International Congress on the History of Medicine. Edited by Eric Fierens et al. Bruxelles : Societas Belgica Historiae Medicinae, 1991: 615-619
  The authors draws attention to the fact, that some autors were confusing George Huntington (1850-1916) with George Sumner Huntington (1861-1927), an anatomist.
• R. M. van der Weiden:
  George Huntington: the man behind the eponym.
  Journal of Medical Genetics, London, 1993, 30: 1042.
• Douglas J Lanska:
  George Huntington (1850-1916) and Hereditary Chorea.
  Journal of the History of Neurosciences, 2000, 76-89.