Obituary
James Bourne Ayer, MD
1882-1963
Dr. James Bourne Ayer, James Jackson Putnam Professor of Neurology,
Emeritus, died on Oct 25, 1963, at the age of 81. In his long and distinguished career
he was a successful and revered teacher of more than two generations of Harvard
medical students, and in addition he achieved international renown as a neurologist.
JAMES BOURNE AYER
Dr. Ayer was the son, grandson, and
great-grandson of physicians, descending
from Dr. James Ayer (1781-1834) of
Maine. His father, also named Dr. James
Bourne Ayer, was a Boston physician with
an interest in the anatomy of the cerebral
circulation, a subject on which he pub¬
lished a memoir. Professor Ayer was his
third son, the only one to elect a medical
career. He entered Harvard College in
1899, and during his four years at college
he excelled as an oarsman. In 1901 and
1902 he rowed in the Varsity eight against
Yale, and again in 1903 in a four oar
crew. In subsequent years he often rowed
with the Union Boat Club crew of Boston
in regattas in Philadelphia and New York.
When the Union Boat Club in 1914 sent a
particularly successful crew to the Henley
regatta, Dr. Ayer went along as a substitute. Rather than remain inactive when not
needed, he entered at short notice the Diamond Skulls, an international event that
attracted skullers of world renown. He astonished everybody by winning his first
heat, and only narrowly losing the second heat to an Italian oarsman named
Sinagaglia who went on to win the championship with much greater ease from his
other competitors. Dr. Charles Lund remembers well the excitement of the event and
the prodigious physique of the six-foot-five Italian. Ayer's rowing career culminated
in another fantastic feat in 1922 when, at the age of 40, he proposed to his friend
Lothrop Withington, three weeks before the race, that they enter the double skull
event of the Olympic tryouts. Over the long 2,000 meter course they were only very narrowly beaten by Kelly and Costello of Philadelphia, a famous rowing pair.
These activities in rowing were carried on in addition to his studies at Harvard
Medical School, where Ayer graduated with the class of 1907. His closest friend in
school was Francis Weld Peabody, whose early death in 1927 left a mark never fully recovered from. Stimulated by Dr. E. E. Southard, instead of taking the usual
Previously published in Haruard University Gazette (No. 38) 59: (June 6) 1964.
Downloaded from www.archneurol.com on August 2, 2010
internship, Ayer elected to spend the year after graduation in neuropathology, with
Dr. Myrtelle Canavan, then at Danvers State Hospital. His clinical experience began
in 1911 at the Massachusetts General Hospital, where he also kept up a steady
interest in the gross pathology of the nervous system. Having reported cases of brain
abscess, and of subdural cyst in 1908, he became interested in the then new
cytological study of spinal fluid with aniline dyes (then called Alzheimer's method).
With H. A. Cotton he reviewed the more precise information regarding infections of
the nervous system made available by careful cell counts. In 1911 he encountered an
unusual case of the loculation (Froin) syndrome in a tabetic, and in 1916, with Viets,
he further delineated the Froin syndrome. From then onwards he made many
scientific contributions to this field.
During the First World War he served in the U.S. Army Medical Corps, being
transferred to a special group based on Johns Hopkins Hospital, under the direction
of Lewis Weed, to study the severe outbreaks of meningococcal meningitis in
training camps. A number of reports were made by Dr. Ayer in collaboration with a
group of colleagues, including Paul Wegeforth, L. D. Felton, and C. R. Essick.
Among them was a report in 1917 on "The method of obtaining cerebrospinal fluid
by puncture of the cisterna magna (Cistern Puncture)," by Wegeforth, Ayer, and
Essick. The use of cistern puncture in animals in their experimental studies with Dr.
Weed had encouraged the authors to work out a safe technique for human beings
and to use it on two patients.
On his return to the Massachusetts General Hospital in 1919, Dr. Ayer elaborated
his technique of cistern puncture, and by 1921 had, by careful measurements at
combined lumbar and cistern puncture, established the criteria of spinal block of the
subarachnoid space. On one notable occasion Dr. Ayer, with a house pupil named
William B. Castle to hold the nether manometer, successfully demonstrated the
procedure to a large medical audience.
Dr. Ayer had first received an appointment in Harvard Medical School in 1910
and an outpatient staff appointment at the Massachusetts General Hospital in 1911.
Dr. E. Wyllys Taylor, the Putnam Professor, was then head of the outpatient clinic
for neurology at the Massachusetts General Hospital, and had succeeded in obtaining
two beds in the wards, assigned to neurological medicine. After the First World War
Dr. Ayer set up a special cerebrospinal fluid laboratory where normal standards were
established, and the Denis-Ayer method of quantitative estimation of spinal fluid
protein was introduced. By 1923 he could report on over 2,000 cistern punctures, and
in 1925 he defined criteria of pressure measurements for the recognition of lateral
sinus thrombosis (the Ayer-Tobey test). In the laboratory Dr. Frank Fremont-Smith
began the correlation of personally verified fluid and pathological findings in a
thousand cases that he and Dr. Merritt were later to extend to no less than 21,000 at
Boston City Hospital. By 1926, largely due to Dr. Ayer's continued efforts, routine
tests of the spinal fluid became standardized in general hospitals.
In 1926 Dr. E. W. Taylor was retired. Dr. Ayer succeeded him and was
subsequently made James Jackson Putnam Professor of Neurology. In his quiet,
unassuming way he proceeded to strengthen the department at the Massachusetts
General Hospital. He saw the need for neurological medicine to break away from
psychiatry and to become more closely associated with the rapid development of
internal medicine. The number of beds was further increased and a special ward
developed. Dr. Ayer had continued his interest in neuropathology and realized that
clinicopathological correlation was essential to sound clinical teaching. At first Dr.
Downloaded from www.archneurol.com on August 2, 2010
Tracy Putnam carried out the special pathological examinations. In 1927, with the
cooperation of the department of Pathology, a Neuropathology Laboratory was set
up under the direction of Dr. Charles Kubik, then just returned from study in
London.
Dr. Ayer had the gift of going straight to the heart of a clinical problem and of
explaining it in simple terms. The weekly clinical conferences in the Ether Dome,
often with illustrative neuropathological material, became increasingly effective and
popular. The conference case reports, well illustrated and edited by Dr. Ayer, were
bound at his own expense and kept on permanent record. A copy was presented to
each house officer at the end of his year of service.
Neurosurgery under Dr. Jason Mixter and Dr. White, and psychiatry under Dr.
Stanley Cobb, were closely associated and joined hands in the weekly conference.
Joint conferences with ophthalmology and otology were established. Dr. Ayer was
quick to grasp the clinical value of electroencephalography, and in 1936 he had an
EEG laboratory set up in charge of Dr. Robert Schwab, who had trained with
Adrian, Hallowell Davis, and F. Gibbs. Dr. Henry Viets, Dr. Ayer's able chief
clinical assistant for many years, set up the myasthenia gravis clinic, Dr. Edwin Cole
was given charge of speech therapy, and Dr. Watkins began a new era in therapy. With his physical strong and farsighted leadership, neurological medicine at the
Massachusetts General Hospital became an integrated and effective teaching unit.
Dr. Ayer, though genial and kindly, was a diffident and self-effacing man, with a gentle, disarming courtesy that hid from view an observant mind and a penetrating judgment. He was almost apologetic in advancing his ideas before a scientific
audience. Yet the large contribution he had made to the advance of neurology at a critical period was well recognized by his fellow neurologists, who elected him
president of the American Neurological Association in 1931. Because of his own
wide experience, he chose the occasion of his presidential address to plead for the
retention of neurological departments in general hospitals, rather than a segregation in Neurological Institutes, of which two had just been opened at that time.
Dr. Ayer retired in 1946 and was succeeded by Dr. Charles Kubik. In later years, he was the greatly respected "elder statesman" of Boston Neurology. Able to delight in his countless friends and devoted to his family, he was a gracious host at his estate
in Milton. Mrs. Ayer, the former Hannah Palfrey, was also a remarkable and
talented person, prominent in fostering historical societies. Her death earlier in 1963, and that of their youngest daughter soon after, were sad blows to Dr. Ayer, and he did not long survive them. Their son John Palfrey Ayer is a pathologist, continuing the medical tradition of the family.
James Bourne Ayer, MD
1882-1963
Dr. James Bourne Ayer, James Jackson Putnam Professor of Neurology,
Emeritus, died on Oct 25, 1963, at the age of 81. In his long and distinguished career
he was a successful and revered teacher of more than two generations of Harvard
medical students, and in addition he achieved international renown as a neurologist.
JAMES BOURNE AYER
Dr. Ayer was the son, grandson, and
great-grandson of physicians, descending
from Dr. James Ayer (1781-1834) of
Maine. His father, also named Dr. James
Bourne Ayer, was a Boston physician with
an interest in the anatomy of the cerebral
circulation, a subject on which he pub¬
lished a memoir. Professor Ayer was his
third son, the only one to elect a medical
career. He entered Harvard College in
1899, and during his four years at college
he excelled as an oarsman. In 1901 and
1902 he rowed in the Varsity eight against
Yale, and again in 1903 in a four oar
crew. In subsequent years he often rowed
with the Union Boat Club crew of Boston
in regattas in Philadelphia and New York.
When the Union Boat Club in 1914 sent a
particularly successful crew to the Henley
regatta, Dr. Ayer went along as a substitute. Rather than remain inactive when not
needed, he entered at short notice the Diamond Skulls, an international event that
attracted skullers of world renown. He astonished everybody by winning his first
heat, and only narrowly losing the second heat to an Italian oarsman named
Sinagaglia who went on to win the championship with much greater ease from his
other competitors. Dr. Charles Lund remembers well the excitement of the event and
the prodigious physique of the six-foot-five Italian. Ayer's rowing career culminated
in another fantastic feat in 1922 when, at the age of 40, he proposed to his friend
Lothrop Withington, three weeks before the race, that they enter the double skull
event of the Olympic tryouts. Over the long 2,000 meter course they were only very narrowly beaten by Kelly and Costello of Philadelphia, a famous rowing pair.
These activities in rowing were carried on in addition to his studies at Harvard
Medical School, where Ayer graduated with the class of 1907. His closest friend in
school was Francis Weld Peabody, whose early death in 1927 left a mark never fully recovered from. Stimulated by Dr. E. E. Southard, instead of taking the usual
Previously published in Haruard University Gazette (No. 38) 59: (June 6) 1964.
Downloaded from www.archneurol.com on August 2, 2010
internship, Ayer elected to spend the year after graduation in neuropathology, with
Dr. Myrtelle Canavan, then at Danvers State Hospital. His clinical experience began
in 1911 at the Massachusetts General Hospital, where he also kept up a steady
interest in the gross pathology of the nervous system. Having reported cases of brain
abscess, and of subdural cyst in 1908, he became interested in the then new
cytological study of spinal fluid with aniline dyes (then called Alzheimer's method).
With H. A. Cotton he reviewed the more precise information regarding infections of
the nervous system made available by careful cell counts. In 1911 he encountered an
unusual case of the loculation (Froin) syndrome in a tabetic, and in 1916, with Viets,
he further delineated the Froin syndrome. From then onwards he made many
scientific contributions to this field.
During the First World War he served in the U.S. Army Medical Corps, being
transferred to a special group based on Johns Hopkins Hospital, under the direction
of Lewis Weed, to study the severe outbreaks of meningococcal meningitis in
training camps. A number of reports were made by Dr. Ayer in collaboration with a
group of colleagues, including Paul Wegeforth, L. D. Felton, and C. R. Essick.
Among them was a report in 1917 on "The method of obtaining cerebrospinal fluid
by puncture of the cisterna magna (Cistern Puncture)," by Wegeforth, Ayer, and
Essick. The use of cistern puncture in animals in their experimental studies with Dr.
Weed had encouraged the authors to work out a safe technique for human beings
and to use it on two patients.
On his return to the Massachusetts General Hospital in 1919, Dr. Ayer elaborated
his technique of cistern puncture, and by 1921 had, by careful measurements at
combined lumbar and cistern puncture, established the criteria of spinal block of the
subarachnoid space. On one notable occasion Dr. Ayer, with a house pupil named
William B. Castle to hold the nether manometer, successfully demonstrated the
procedure to a large medical audience.
Dr. Ayer had first received an appointment in Harvard Medical School in 1910
and an outpatient staff appointment at the Massachusetts General Hospital in 1911.
Dr. E. Wyllys Taylor, the Putnam Professor, was then head of the outpatient clinic
for neurology at the Massachusetts General Hospital, and had succeeded in obtaining
two beds in the wards, assigned to neurological medicine. After the First World War
Dr. Ayer set up a special cerebrospinal fluid laboratory where normal standards were
established, and the Denis-Ayer method of quantitative estimation of spinal fluid
protein was introduced. By 1923 he could report on over 2,000 cistern punctures, and
in 1925 he defined criteria of pressure measurements for the recognition of lateral
sinus thrombosis (the Ayer-Tobey test). In the laboratory Dr. Frank Fremont-Smith
began the correlation of personally verified fluid and pathological findings in a
thousand cases that he and Dr. Merritt were later to extend to no less than 21,000 at
Boston City Hospital. By 1926, largely due to Dr. Ayer's continued efforts, routine
tests of the spinal fluid became standardized in general hospitals.
In 1926 Dr. E. W. Taylor was retired. Dr. Ayer succeeded him and was
subsequently made James Jackson Putnam Professor of Neurology. In his quiet,
unassuming way he proceeded to strengthen the department at the Massachusetts
General Hospital. He saw the need for neurological medicine to break away from
psychiatry and to become more closely associated with the rapid development of
internal medicine. The number of beds was further increased and a special ward
developed. Dr. Ayer had continued his interest in neuropathology and realized that
clinicopathological correlation was essential to sound clinical teaching. At first Dr.
Downloaded from www.archneurol.com on August 2, 2010
Tracy Putnam carried out the special pathological examinations. In 1927, with the
cooperation of the department of Pathology, a Neuropathology Laboratory was set
up under the direction of Dr. Charles Kubik, then just returned from study in
London.
Dr. Ayer had the gift of going straight to the heart of a clinical problem and of
explaining it in simple terms. The weekly clinical conferences in the Ether Dome,
often with illustrative neuropathological material, became increasingly effective and
popular. The conference case reports, well illustrated and edited by Dr. Ayer, were
bound at his own expense and kept on permanent record. A copy was presented to
each house officer at the end of his year of service.
Neurosurgery under Dr. Jason Mixter and Dr. White, and psychiatry under Dr.
Stanley Cobb, were closely associated and joined hands in the weekly conference.
Joint conferences with ophthalmology and otology were established. Dr. Ayer was
quick to grasp the clinical value of electroencephalography, and in 1936 he had an
EEG laboratory set up in charge of Dr. Robert Schwab, who had trained with
Adrian, Hallowell Davis, and F. Gibbs. Dr. Henry Viets, Dr. Ayer's able chief
clinical assistant for many years, set up the myasthenia gravis clinic, Dr. Edwin Cole
was given charge of speech therapy, and Dr. Watkins began a new era in therapy. With his physical strong and farsighted leadership, neurological medicine at the
Massachusetts General Hospital became an integrated and effective teaching unit.
Dr. Ayer, though genial and kindly, was a diffident and self-effacing man, with a gentle, disarming courtesy that hid from view an observant mind and a penetrating judgment. He was almost apologetic in advancing his ideas before a scientific
audience. Yet the large contribution he had made to the advance of neurology at a critical period was well recognized by his fellow neurologists, who elected him
president of the American Neurological Association in 1931. Because of his own
wide experience, he chose the occasion of his presidential address to plead for the
retention of neurological departments in general hospitals, rather than a segregation in Neurological Institutes, of which two had just been opened at that time.
Dr. Ayer retired in 1946 and was succeeded by Dr. Charles Kubik. In later years, he was the greatly respected "elder statesman" of Boston Neurology. Able to delight in his countless friends and devoted to his family, he was a gracious host at his estate
in Milton. Mrs. Ayer, the former Hannah Palfrey, was also a remarkable and
talented person, prominent in fostering historical societies. Her death earlier in 1963, and that of their youngest daughter soon after, were sad blows to Dr. Ayer, and he did not long survive them. Their son John Palfrey Ayer is a pathologist, continuing the medical tradition of the family.
Obituary
James Bourne Ayer, MD
1882-1963
Dr. James Bourne Ayer, James Jackson Putnam Professor of Neurology,
Emeritus, died on Oct 25, 1963, at the age of 81. In his long and distinguished career
he was a successful and revered teacher of more than two generations of Harvard
medical students, and in addition he achieved international renown as a neurologist.
JAMES BOURNE AYER
Dr. Ayer was the son, grandson, and
great-grandson of physicians, descending
from Dr. James Ayer (1781-1834) of
Maine. His father, also named Dr. James
Bourne Ayer, was a Boston physician with
an interest in the anatomy of the cerebral
circulation, a subject on which he pub¬
lished a memoir. Professor Ayer was his
third son, the only one to elect a medical
career. He entered Harvard College in
1899, and during his four years at college
he excelled as an oarsman. In 1901 and
1902 he rowed in the Varsity eight against
Yale, and again in 1903 in a four oar
crew. In subsequent years he often rowed
with the Union Boat Club crew of Boston
in regattas in Philadelphia and New York.
When the Union Boat Club in 1914 sent a
particularly successful crew to the Henley
regatta, Dr. Ayer went along as a substitute. Rather than remain inactive when not
needed, he entered at short notice the Diamond Skulls, an international event that
attracted skullers of world renown. He astonished everybody by winning his first
heat, and only narrowly losing the second heat to an Italian oarsman named
Sinagaglia who went on to win the championship with much greater ease from his
other competitors. Dr. Charles Lund remembers well the excitement of the event and
the prodigious physique of the six-foot-five Italian. Ayer's rowing career culminated
in another fantastic feat in 1922 when, at the age of 40, he proposed to his friend
Lothrop Withington, three weeks before the race, that they enter the double skull
event of the Olympic tryouts. Over the long 2,000 meter course they were only very narrowly beaten by Kelly and Costello of Philadelphia, a famous rowing pair.
These activities in rowing were carried on in addition to his studies at Harvard
Medical School, where Ayer graduated with the class of 1907. His closest friend in
school was Francis Weld Peabody, whose early death in 1927 left a mark never fully recovered from. Stimulated by Dr. E. E. Southard, instead of taking the usual
Previously published in Haruard University Gazette (No. 38) 59: (June 6) 1964.
Downloaded from www.archneurol.com on August 2, 2010
internship, Ayer elected to spend the year after graduation in neuropathology, with
Dr. Myrtelle Canavan, then at Danvers State Hospital. His clinical experience began
in 1911 at the Massachusetts General Hospital, where he also kept up a steady
interest in the gross pathology of the nervous system. Having reported cases of brain
abscess, and of subdural cyst in 1908, he became interested in the then new
cytological study of spinal fluid with aniline dyes (then called Alzheimer's method).
With H. A. Cotton he reviewed the more precise information regarding infections of
the nervous system made available by careful cell counts. In 1911 he encountered an
unusual case of the loculation (Froin) syndrome in a tabetic, and in 1916, with Viets,
he further delineated the Froin syndrome. From then onwards he made many
scientific contributions to this field.
During the First World War he served in the U.S. Army Medical Corps, being
transferred to a special group based on Johns Hopkins Hospital, under the direction
of Lewis Weed, to study the severe outbreaks of meningococcal meningitis in
training camps. A number of reports were made by Dr. Ayer in collaboration with a
group of colleagues, including Paul Wegeforth, L. D. Felton, and C. R. Essick.
Among them was a report in 1917 on "The method of obtaining cerebrospinal fluid
by puncture of the cisterna magna (Cistern Puncture)," by Wegeforth, Ayer, and
Essick. The use of cistern puncture in animals in their experimental studies with Dr.
Weed had encouraged the authors to work out a safe technique for human beings
and to use it on two patients.
On his return to the Massachusetts General Hospital in 1919, Dr. Ayer elaborated
his technique of cistern puncture, and by 1921 had, by careful measurements at
combined lumbar and cistern puncture, established the criteria of spinal block of the
subarachnoid space. On one notable occasion Dr. Ayer, with a house pupil named
William B. Castle to hold the nether manometer, successfully demonstrated the
procedure to a large medical audience.
Dr. Ayer had first received an appointment in Harvard Medical School in 1910
and an outpatient staff appointment at the Massachusetts General Hospital in 1911.
Dr. E. Wyllys Taylor, the Putnam Professor, was then head of the outpatient clinic
for neurology at the Massachusetts General Hospital, and had succeeded in obtaining
two beds in the wards, assigned to neurological medicine. After the First World War
Dr. Ayer set up a special cerebrospinal fluid laboratory where normal standards were
established, and the Denis-Ayer method of quantitative estimation of spinal fluid
protein was introduced. By 1923 he could report on over 2,000 cistern punctures, and
in 1925 he defined criteria of pressure measurements for the recognition of lateral
sinus thrombosis (the Ayer-Tobey test). In the laboratory Dr. Frank Fremont-Smith
began the correlation of personally verified fluid and pathological findings in a
thousand cases that he and Dr. Merritt were later to extend to no less than 21,000 at
Boston City Hospital. By 1926, largely due to Dr. Ayer's continued efforts, routine
tests of the spinal fluid became standardized in general hospitals.
In 1926 Dr. E. W. Taylor was retired. Dr. Ayer succeeded him and was
subsequently made James Jackson Putnam Professor of Neurology. In his quiet,
unassuming way he proceeded to strengthen the department at the Massachusetts
General Hospital. He saw the need for neurological medicine to break away from
psychiatry and to become more closely associated with the rapid development of
internal medicine. The number of beds was further increased and a special ward
developed. Dr. Ayer had continued his interest in neuropathology and realized that
clinicopathological correlation was essential to sound clinical teaching. At first Dr.
Downloaded from www.archneurol.com on August 2, 2010
Tracy Putnam carried out the special pathological examinations. In 1927, with the
cooperation of the department of Pathology, a Neuropathology Laboratory was set
up under the direction of Dr. Charles Kubik, then just returned from study in
London.
Dr. Ayer had the gift of going straight to the heart of a clinical problem and of
explaining it in simple terms. The weekly clinical conferences in the Ether Dome,
often with illustrative neuropathological material, became increasingly effective and
popular. The conference case reports, well illustrated and edited by Dr. Ayer, were
bound at his own expense and kept on permanent record. A copy was presented to
each house officer at the end of his year of service.
Neurosurgery under Dr. Jason Mixter and Dr. White, and psychiatry under Dr.
Stanley Cobb, were closely associated and joined hands in the weekly conference.
Joint conferences with ophthalmology and otology were established. Dr. Ayer was
quick to grasp the clinical value of electroencephalography, and in 1936 he had an
EEG laboratory set up in charge of Dr. Robert Schwab, who had trained with
Adrian, Hallowell Davis, and F. Gibbs. Dr. Henry Viets, Dr. Ayer's able chief
clinical assistant for many years, set up the myasthenia gravis clinic, Dr. Edwin Cole
was given charge of speech therapy, and Dr. Watkins began a new era in therapy. With his physical strong and farsighted leadership, neurological medicine at the
Massachusetts General Hospital became an integrated and effective teaching unit.
Dr. Ayer, though genial and kindly, was a diffident and self-effacing man, with a gentle, disarming courtesy that hid from view an observant mind and a penetrating judgment. He was almost apologetic in advancing his ideas before a scientific
audience. Yet the large contribution he had made to the advance of neurology at a critical period was well recognized by his fellow neurologists, who elected him
president of the American Neurological Association in 1931. Because of his own
wide experience, he chose the occasion of his presidential address to plead for the
retention of neurological departments in general hospitals, rather than a segregation in Neurological Institutes, of which two had just been opened at that time.
Dr. Ayer retired in 1946 and was succeeded by Dr. Charles Kubik. In later years, he was the greatly respected "elder statesman" of Boston Neurology. Able to delight in his countless friends and devoted to his family, he was a gracious host at his estate
in Milton. Mrs. Ayer, the former Hannah Palfrey, was also a remarkable and
talented person, prominent in fostering historical societies. Her death earlier in 1963, and that of their youngest daughter soon after, were sad blows to Dr. Ayer, and he did not long survive them. Their son John Palfrey Ayer is a pathologist, continuing the medical tradition of the family.
James Bourne Ayer, MD
1882-1963
Dr. James Bourne Ayer, James Jackson Putnam Professor of Neurology,
Emeritus, died on Oct 25, 1963, at the age of 81. In his long and distinguished career
he was a successful and revered teacher of more than two generations of Harvard
medical students, and in addition he achieved international renown as a neurologist.
JAMES BOURNE AYER
Dr. Ayer was the son, grandson, and
great-grandson of physicians, descending
from Dr. James Ayer (1781-1834) of
Maine. His father, also named Dr. James
Bourne Ayer, was a Boston physician with
an interest in the anatomy of the cerebral
circulation, a subject on which he pub¬
lished a memoir. Professor Ayer was his
third son, the only one to elect a medical
career. He entered Harvard College in
1899, and during his four years at college
he excelled as an oarsman. In 1901 and
1902 he rowed in the Varsity eight against
Yale, and again in 1903 in a four oar
crew. In subsequent years he often rowed
with the Union Boat Club crew of Boston
in regattas in Philadelphia and New York.
When the Union Boat Club in 1914 sent a
particularly successful crew to the Henley
regatta, Dr. Ayer went along as a substitute. Rather than remain inactive when not
needed, he entered at short notice the Diamond Skulls, an international event that
attracted skullers of world renown. He astonished everybody by winning his first
heat, and only narrowly losing the second heat to an Italian oarsman named
Sinagaglia who went on to win the championship with much greater ease from his
other competitors. Dr. Charles Lund remembers well the excitement of the event and
the prodigious physique of the six-foot-five Italian. Ayer's rowing career culminated
in another fantastic feat in 1922 when, at the age of 40, he proposed to his friend
Lothrop Withington, three weeks before the race, that they enter the double skull
event of the Olympic tryouts. Over the long 2,000 meter course they were only very narrowly beaten by Kelly and Costello of Philadelphia, a famous rowing pair.
These activities in rowing were carried on in addition to his studies at Harvard
Medical School, where Ayer graduated with the class of 1907. His closest friend in
school was Francis Weld Peabody, whose early death in 1927 left a mark never fully recovered from. Stimulated by Dr. E. E. Southard, instead of taking the usual
Previously published in Haruard University Gazette (No. 38) 59: (June 6) 1964.
Downloaded from www.archneurol.com on August 2, 2010
internship, Ayer elected to spend the year after graduation in neuropathology, with
Dr. Myrtelle Canavan, then at Danvers State Hospital. His clinical experience began
in 1911 at the Massachusetts General Hospital, where he also kept up a steady
interest in the gross pathology of the nervous system. Having reported cases of brain
abscess, and of subdural cyst in 1908, he became interested in the then new
cytological study of spinal fluid with aniline dyes (then called Alzheimer's method).
With H. A. Cotton he reviewed the more precise information regarding infections of
the nervous system made available by careful cell counts. In 1911 he encountered an
unusual case of the loculation (Froin) syndrome in a tabetic, and in 1916, with Viets,
he further delineated the Froin syndrome. From then onwards he made many
scientific contributions to this field.
During the First World War he served in the U.S. Army Medical Corps, being
transferred to a special group based on Johns Hopkins Hospital, under the direction
of Lewis Weed, to study the severe outbreaks of meningococcal meningitis in
training camps. A number of reports were made by Dr. Ayer in collaboration with a
group of colleagues, including Paul Wegeforth, L. D. Felton, and C. R. Essick.
Among them was a report in 1917 on "The method of obtaining cerebrospinal fluid
by puncture of the cisterna magna (Cistern Puncture)," by Wegeforth, Ayer, and
Essick. The use of cistern puncture in animals in their experimental studies with Dr.
Weed had encouraged the authors to work out a safe technique for human beings
and to use it on two patients.
On his return to the Massachusetts General Hospital in 1919, Dr. Ayer elaborated
his technique of cistern puncture, and by 1921 had, by careful measurements at
combined lumbar and cistern puncture, established the criteria of spinal block of the
subarachnoid space. On one notable occasion Dr. Ayer, with a house pupil named
William B. Castle to hold the nether manometer, successfully demonstrated the
procedure to a large medical audience.
Dr. Ayer had first received an appointment in Harvard Medical School in 1910
and an outpatient staff appointment at the Massachusetts General Hospital in 1911.
Dr. E. Wyllys Taylor, the Putnam Professor, was then head of the outpatient clinic
for neurology at the Massachusetts General Hospital, and had succeeded in obtaining
two beds in the wards, assigned to neurological medicine. After the First World War
Dr. Ayer set up a special cerebrospinal fluid laboratory where normal standards were
established, and the Denis-Ayer method of quantitative estimation of spinal fluid
protein was introduced. By 1923 he could report on over 2,000 cistern punctures, and
in 1925 he defined criteria of pressure measurements for the recognition of lateral
sinus thrombosis (the Ayer-Tobey test). In the laboratory Dr. Frank Fremont-Smith
began the correlation of personally verified fluid and pathological findings in a
thousand cases that he and Dr. Merritt were later to extend to no less than 21,000 at
Boston City Hospital. By 1926, largely due to Dr. Ayer's continued efforts, routine
tests of the spinal fluid became standardized in general hospitals.
In 1926 Dr. E. W. Taylor was retired. Dr. Ayer succeeded him and was
subsequently made James Jackson Putnam Professor of Neurology. In his quiet,
unassuming way he proceeded to strengthen the department at the Massachusetts
General Hospital. He saw the need for neurological medicine to break away from
psychiatry and to become more closely associated with the rapid development of
internal medicine. The number of beds was further increased and a special ward
developed. Dr. Ayer had continued his interest in neuropathology and realized that
clinicopathological correlation was essential to sound clinical teaching. At first Dr.
Downloaded from www.archneurol.com on August 2, 2010
Tracy Putnam carried out the special pathological examinations. In 1927, with the
cooperation of the department of Pathology, a Neuropathology Laboratory was set
up under the direction of Dr. Charles Kubik, then just returned from study in
London.
Dr. Ayer had the gift of going straight to the heart of a clinical problem and of
explaining it in simple terms. The weekly clinical conferences in the Ether Dome,
often with illustrative neuropathological material, became increasingly effective and
popular. The conference case reports, well illustrated and edited by Dr. Ayer, were
bound at his own expense and kept on permanent record. A copy was presented to
each house officer at the end of his year of service.
Neurosurgery under Dr. Jason Mixter and Dr. White, and psychiatry under Dr.
Stanley Cobb, were closely associated and joined hands in the weekly conference.
Joint conferences with ophthalmology and otology were established. Dr. Ayer was
quick to grasp the clinical value of electroencephalography, and in 1936 he had an
EEG laboratory set up in charge of Dr. Robert Schwab, who had trained with
Adrian, Hallowell Davis, and F. Gibbs. Dr. Henry Viets, Dr. Ayer's able chief
clinical assistant for many years, set up the myasthenia gravis clinic, Dr. Edwin Cole
was given charge of speech therapy, and Dr. Watkins began a new era in therapy. With his physical strong and farsighted leadership, neurological medicine at the
Massachusetts General Hospital became an integrated and effective teaching unit.
Dr. Ayer, though genial and kindly, was a diffident and self-effacing man, with a gentle, disarming courtesy that hid from view an observant mind and a penetrating judgment. He was almost apologetic in advancing his ideas before a scientific
audience. Yet the large contribution he had made to the advance of neurology at a critical period was well recognized by his fellow neurologists, who elected him
president of the American Neurological Association in 1931. Because of his own
wide experience, he chose the occasion of his presidential address to plead for the
retention of neurological departments in general hospitals, rather than a segregation in Neurological Institutes, of which two had just been opened at that time.
Dr. Ayer retired in 1946 and was succeeded by Dr. Charles Kubik. In later years, he was the greatly respected "elder statesman" of Boston Neurology. Able to delight in his countless friends and devoted to his family, he was a gracious host at his estate
in Milton. Mrs. Ayer, the former Hannah Palfrey, was also a remarkable and
talented person, prominent in fostering historical societies. Her death earlier in 1963, and that of their youngest daughter soon after, were sad blows to Dr. Ayer, and he did not long survive them. Their son John Palfrey Ayer is a pathologist, continuing the medical tradition of the family.
Family Members
Siblings
Sponsored by Ancestry
Advertisement
Explore more
Sponsored by Ancestry
Advertisement
