Arthur C. Guyton

47th APS President (1974-1975)
Arthur C. Guyton

"Sectionalization" has a long history in APS; it extends back at least to the presidency of William F. Hamilton (1955-56). It was, and is, a sort of catchword for attempts to unify the Society by providing publications and membership sections desired by each of the subspecialties of the science. Earlier presidents left office frustrated by their inability to move the Society in this direction. Under the presidency of Guyton, however, both forms of sectionalization were approved and formally announced to the Society in the "Presidents report" (Physiologist 18: 79-82, 1975).

Guyton was born in Oxford, Mississippi, and received his early education there. He was an honor graduate of the University of Mississippi (1939), where he won prizes both for work in physics and in a short story contest. For his medical education he went to Harvard (M.D., 1943) and then became a surgical intern at Massachusetts General Hospital. By 1 January 1944, he was in the U.S. Navy and was assigned first to the National Naval Medical Center in Bethesda (4 months) and then to Camp Detrick in Maryland for research in bacterial warfare (22 months). In 1946 he was able to return to Massachusetts General Hospital to continue his surgical residency, but he contracted poliomyelitis and was obliged to give up these plans. A year later (1947) he joined the faculty of the School of Medicine at the University of Mississippi. The following year, at the age of twenty-nine, he was appointed professor and chairman of the Department of Physiology and Biophysics. He has held these appointments for nearly forty years.

Guyton's loyalty to his home state and to its region extends well outside the university. He is a member of the Southern Society for Clinical Investigation, was president in 1956-57, and received the Founder's Award in 1979. As a member of the Mississippi Heart Association, he was president in 1955-56 and received its Silver Medallion Award for Research in 1961. He was president of the Mississippi Academy of Science in 1967-68; from the academy he received major awards in 1976 and 1980. He is a charter member (1975) of the University of Mississippi Hall of Fame.

For AHA, Guyton served on its Policy Committee (1960-61), Board of Directors (1961-67), and Publications Board (1971-77), as well as on the Advisory Council for the Circulation Section and on the Council for High Blood Pressure Research. He is a member of the International Society for Hypertension. His lifelong interest in the circulation and major research contributions have brought him awards and honors from a remarkable variety of organizations: the Ida B. Gould Award of AAAS in 1959, the Wiggers Award of the Circulation Group of APS in 1972, and the Annual Research Achievement Award of AHA and the Dickinson Richards Award of the Pulmonary Council of AHA in 1975. He has been an honorary fellow of the American College of Cardiology from 1975. At the 400th Anniversary Symposium in honor of William Harvey in London, England, in 1978, Guyton delivered the Harvey Lecture and, in the following year, gave the First Annual Evan Jones Memorial Lecture at St. Thomas' Hospital in London. These honors were followed by the George Griffith Memorial Lectureship of the California Heart Association (1980), the Ciba Award for Research in Hypertension (1980), and the Jenssen Annual Lectureship of the Society of Cardiovascular Anesthesiologists (1982).

Early in his career, Guyton was selected by the U.S. Junior Chamber of Commerce as one of the Ten Outstanding Young Men of America for 1951. In 1956 he received the U.S. Presidential Citation for Development of Aids for Handicapped Persons. Other honors include recognition by the American Society of Anesthesiologists (1967), the Biomedical Engineering Society (1972), and the University of Nebraska (1972). He was given the Leonard and Lillian Ratner Award (1973) and awards by the American College of Chest Physicians (1973), ACDP (1975), the American Surgical Society (1975), and the Albany Medical College (1977). He was honored by the International Anesthesia Research Society (1977) and by the Medical College of Wisconsin (1977) where he gave the Walter E. MacPherson Lecture and received the D.Sc. degree. In 1979 he delivered the Einthoven Lecture and received the medal given biennially by the Einthoven Foundation of Leiden, Holland. The University of Western Ontario invited him to give the James A. F. Stevenson Memorial Lecture in 1980. A year later he received the Mellon Award of the University of Pittsburgh, and in 1982 he received an honorary M.D. degree from the University of Pretoria in South Africa.

Guyton has long been an active member of the Biophysical Society, as well as of the Biomedical Engineering Society. For four years (1957-61; chairman, 1959-61) he was a member of the Physiology Test Committee of the National Board of Medical Examiners. He is a fellow of AAAS and served on the Council of the Society for Experimental Biology and Medicine for six years (1965-71). For the NIH he served on the Cardiovascular Study Section (1954-58), the Physiology Training Grant Committee (1958-64; chairman, 1961-64), and the National Heart and Lung Council (1971-75).

Elected to membership in APS in 1949, like many other former presidents, Guyton began his official service for the Society on its editorial boards (1958-63) and as chairman of the Education Committee (1967-70). He was elected councillor in 1972 and president elect the following year. (Because he was appointed chairman of the Finance Committee in 1977, he continued as an ex officio member of Council for another five years, 1977-82.) He is a member of three sections of APS: Neurophysiology, Circulation, and Respiration. In 1981 he received the Ray G. Daggs Award of the Society. As president of FASEB (1975-76), he steered the Federation Board and the member societies through a reorganization that resulted in a more flexible financial relationship.

Although his formal association with physiology came only after Guyton had all but completed his training as a surgeon, he had been carrying out experiments of one sort or another from the time he was a small boy. He described his research "training" as follows:
"Perhaps the most important aspect of my research training was the lack of any specific formal episode, but instead a continuing self-interest in research beginning rather early in life. Like many other young boys, I had my own shop, which later became more a laboratory especially in the field of electronics. I built devices such as an oscilloscope, code recorder, multiple amateur radio transmitters, multiple radio amateur receivers, an operational amplifier for multiplication in the days before analog computers began to be used, and so forth. This continued through college years. Then during medical school I had also a research fellowship working primarily on physical chemistry projects under Dr. A. Baird Hastings. However, Dr. Hastings was caught up in the war effort, so that most of my work there was likewise without direct supervision. My association with Hastings and with others in the department such as Oliver Lowry and Jack Buchanan provided a high degree of stimulus to continue research. Fortunately, during World War II, I was assigned to bacterial warfare research and immediately entered into a number of different research projects, which led to the first series of electronic and physiological research papers I published."

"During my stint as a surgical intern prior to World War II and as a surgical resident afterwards at the Massachusetts General Hospital, I worked on several projects of a surgical nature, especially projects related to intubation of patients, intermittent suction devices, and so forth. I was allowed to set up a laboratory and was about to get a number of projects underway related to shock and other studies at the time I developed polio in 1946. Thus this was my background for research when I decided to go into academic and research life on a permanent basis beginning in 1947. However, aside from the above experience, probably the one single factor in my training that has been most important through the years was the several summers during my college days when I studied mathematical analysis of electronic circuits. This provided the basis for our subsequent analysis of circulatory, respiratory, renal and body fluid mechanisms, all of which require the same type of mathematical analysis. . . . My principal interest over the years of research has been to provide a working analysis of total circulatory function, with special emphasis on all the important regulatory mechanisms."

In his first paper, published in 1946, Guyton described a method for measuring the size of particles in aerosols (1). By 1948, however, his bibliography begins the long and distinguished series of publications on the circulatory system. A typical paper is the one in 1951 by Guyton and J. W. Harris (2) on what had been regarded as "spontaneous" cycles of oscillation in arterial pressure. They attributed these waves to variations in vasomotion as a result of oscillation in the baroreceptor control system. In the next paper listed here (3), the control of cardiac output was approached via studies on venous return, and the factors that determine both venous return and cardiac output were analyzed here an eventually more fully in a monograph (6). Guyton's research on pulmonary capillary function is typified by the 1959 paper with A. W. Lindsey on pulmonary edema (4). They found that when left atrial pressure is raised, or when plasma protein concentration is lowered, pulmonary edema does not necessarily occur at once, because the system includes "safety factors" that defend the alveoli against fluid accumulation. One of Guyton's best-known discoveries, although he calls it "controversial," is the negative pressure in interstitial fluid surrounding capillaries and lymphatics (5).

Autoregulation of local blood flow is another major theme of Guyton's work. In 1964, with other authors (7), he described the linkage of decreases in oxygen supply with increases in local blood flow that has become a part of every textbook account. Autoregulation of renal glomerular blood flow by feedback control at the juxtaglomerular apparatus was proposed as a result of a theoretical computer analysis in 1964 (8). This has led to intensive investigation of the phenomenon and of the function of the juxtaglomerular apparatus in a number of different laboratories. More extensive but related analyses using computers were published in review articles (9-11) and in a monograph (13) describing regulation of the circulation as it involves body fluid volumes, cardiac output, local blood flow, arterial pressure, and other significant variables. Both the normal circulation and hypertension are included.

Of all the former presidents who have authored or edited textbooks of physiology, Guyton probably has had the broadest influence on students in medical school and college courses. Currently in print are three different textbooks of physiology, one of neurophysiology, and additional volumes he has written or edited. Especially in considering difficult topics, Guyton's style of writing can be paraphrased thus: "We do not know fully how this system operates. But one way it might function is as follows: . . ." Guyton's explanations, although hypothetical, are always reasonable and therefore easy for students to understand and remember. Their teachers appreciate the engaging honesty of his expositions.

Selected Publications

1. Guyton, A. C. Electronic counting and size determination of particles in aerosols. J. Ind. Hyg. 28: 133, 1946.

2. Guyton, A. C., and J. W. Harris. Pressoreceptor-autonomic oscillation: a probable cause of vasomotor waves. Am. J. Physiol. 165: 158, 1951.

3. Guyton, A. C. Determination of cardiac output by equating venous return curves with cardiac response curves. Physiol. Rev. 35: 123, 1955.

4. Guyton, A. C., and A. W. Lindsey. Effect of elevated left atrial pressure and decreased plasma protein concentration on the development of pulmonary edema. Circ. Res. 7: 649, 1959.

5. Guyton, A. C. A concept of negative interstitial pressure based on pressures in implanted perforated capsules. Circ. Res. 12: 399-414, 1963.

6. Guyton, A. C. Circulatory Physiology: Cardiac Output and Its Regulation Philadelphia, PA: Saunders, 1963.

7. Guyton, A. C., J. M. Ross, O. Carrier, Jr., and J. R. Walker. Evidence for tissue oxygen demand as the major factor causing autoregulation. Circ. Res. 14: 60-69, 1964.

8. Guyton, A. C., J. B. Langston, and G. Navar. Theory for renal autoregulation by feedback at the juxtaglomerular apparatus. Circ. Res. 14: 187-197, 1964.

9. Guyton, A. C., and T. G. Coleman. Long-term regulation of the circulation: interrelationships with body fluid volumes. In: Physical Bases of Circulatory Transport Regulation and Exchange. Philadelphia, PA: Saunders, 1967.

10. Guyton, A. C., T. G. Coleman, and H. J. Granger. Circulation: overall regulation. Annu. Rev. Physiol. 34: 13-46, 1972.

11. Guyton, A. C., T. G. Coleman, A. W. Cowley, Jr., R. D. Manning, Jr., R. A. Norman, Jr., and J. D. Ferguson. A systems analysis approach to understanding long-range arterial blood pressure control and hypertension. Circ. Res. 35: 159-176, 1974.

12. Guyton, A. C. Past-president's address. Physiology, a beauty and a philosophy. Physiologist 18: 495-501, 1975.

13. Guyton, A. C. Circulatory Physiology III: Arterial Pressure and Hypertension. Philadelphia, PA: Saunders, 1980.