IntroductionIn the 1860's, two anatomists, Carl

Thiersch and Wilhelm Waldeyer,proved that epithelial tumors arise onlyfrom epithelial cells. Their findingsnot only disproved Virchow's connective tissue cell theory of the originof cancer but furnished the data fromwhich James Ewing established hishistogenetic classification of tumors in1919. Ewing systematically arrangedtumors into groups. He gathered theinformation provided by previous investigators, sifted it with his own carefulobservations and formulated classifications of tumors based on histogenesis.He asserted that only such a classification would allow a definition of tumortypes and provide understanding of thenatural history of each tumor. Herealized, more than any other earlierobserver,thathuman cancerismanydiseases with differing patterns ofbehavior: his work opened the way totherapy based on tumor type and stageofdisease.The same painstakingattention to detail and clarity of thoughtwhich produced his book, NeoplasticDiseases* is dramatically evident inhis original description of nonosteogenictumor of bone (reprinted below). Thereport was published in 1921 andbrought him sharp criticism. There wasgeneralagreementthatatumorwiththe

clinical and radiographic featuresdescribedbyEwing existed,butsomebelieved that it failed to satisfy thecriteria of a pathological entity. In morerecent years his contention that thetumor was a diffuse endothelioma hasbeen supported.

James Ewing was born on ChristmasDay, 1866 in Pittsburgh, attended Amherst College and the College ofPhysicians and Surgeons of ColumbiaUniversity and interned during the1890's at Roosevelt Hospital in NewYork City with Dr. Francis Delafield.He became the first Professor ofPathology at Cornell University MedicalSchool and at the age of 33 he becamechairman of the newly organized department and occupied that chair until 1932.

Dr. Ewing was convinced that theprogress of cancer research wasinextricably bound with the development of a cancer research hospital,where research could be directly applied to the treatment of human cancer.At the time he was conducting laboratory studies at Cornell he befriendedJames Douglas, a mining engineer andpresident of the Phelps Dodge Corporation. Mr. Douglas' daughter haddied of cancer, and he, in hisdesiretobeofbenefittocancerpatients, became intrigued with thetherapeutic possibilities of radium,which at that time was in shortsupply in the United States. Douglas* Ewing, James: Neoplastic Diseases. Philadel

phia: W. B. SaundersCompany, 1919. 1027pp.

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James Ewing(1866-1943)

wantedexperimentswithradiumtherapyconductedinAmericaandturnedtotheMemorialHospital(originally founded as the New YorkCancer Hospital). He formed anonprofit corporation for the development of American pitchblende deposits,provided funds for research at theMemorial Hospital and built a laboratory. When the Hospital was firstaffiliated with Cornell, Ewing waselected president of the medical board.He became director of research andpathologist at Memorial. Later, uponhis retirement from Cornell, he was madedirector of Memorial Hospital forCancer and Allied Diseases.

While at Memorial, Ewing stressedthe use of radiation therapy to determinethe radiosensitivity of different formsof cancer. His paper on diffuse endothelioma of bone illustrates one ofthese efforts. The work done atMemorial under his direction providedimportant criteria for choosing methodsof cancer therapy —¿�irradiation, surgeryor a combination of both.

Ewing's book, Neoplastic Diseases,first published in 1919, is a classic onthe subject and renewed the interestin the United States of pathologists andclinicians in tumor pathology. He wasesteemed by his colleagues and staff,who referred to him as “¿�TheChief.―His students at Cornell recorded andpublished his last lecture. Even afterhis retirement at the age of 73, hevisited his laboratory daily, and duringhis final illness was engaged in a studyof the medicolegal aspects of cancer.

His influence on those who studiedwith him was profound. Two of hisassociates, Dr. Fred Stewart and Dr.Frank Foote, successively headed thePathology Department of MemorialHospital and are identified among theoutstanding tumor pathologists of theworld not only for their many significant

contributions but also because they, inturn,servedasthementorsofdistinguished tumor pathologists nowchairingpathologydepartmentselsewhere.

In the first chapter of his book,Dr. Ewing gives what is perhaps thebest description of his contribution tomodernoncology:“¿�The20thcenturyopensas...theperiodofspecificetiological investigation whichpromises to widely separate manyneoplastic diseases formerly held to beclosely related. . . [and] may therebyprove to be the era of successfultherapeutics and prophylaxis.―

Dr. Ewingdiedon May 16, 1943 ofcancer. —¿�EDITOR.

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