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Edward H.

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OBITUARY
Edward H. Lambert, MD, PhD:
1915 – 2003
Dr Edward H. Lambert, Professor of Neurology and
Physiology Emeritus at Mayo Medical School and
Mayo Graduate School of Medicine, died in Rochester,
Minnesota in his 88th year on July 27, 2003 at Charter
House, his home for the past 2 years. Recognized as
the “father of electromyography” among his many
trainees and colleagues, he was earlier a pioneer in pulmonary and cardiovascular physiology.
Dr Lambert was born in Minneapolis on August 30,
1915 of a second generation Norwegian mother and a
fourth generation French-Scottish father. He attended
public schools, a talented young man with many musical interests, but with an overriding interest in biology that was apparent already in high school He
moved to Chicago with his family during the depression where he received BS, MS, and MD degrees at the
University of Illinois. These were followed by an internship at Michael Reese Hospital and then a PhD in
Physiology with Dr Ernst Gellhorn, who led him into
his initial career in cardiovascular physiology.
During his post-graduate work at the University of
Illinois, Dr Lambert studied the effects of high protein
and high carbohydrate diets on humans, and their effect on cold tolerance in aircrews for the National Research Council. But it was his PhD thesis work on the
effects of oxygen and carbon dioxide concentrations on
blood flow and blood pressure, and his development of
a method for performing lobectomy in dogs using
bronchial plugs, that caught the attention of Dr C. F.
Code, Head of the Mayo Aero Medical unit. Dr Code
brought him to Mayo Clinic in 1943 to work as a
researcher and instructor in the Mayo Aero Medical
Unit studying acceleration induced loss of consciousness in aviators (G-LOC). Dr Lambert became a key
investigator and research subject of the Mayo human
690
centrifuge program and the in flight-testing in A-24
Douglas Dauntless dive-bombers on loan from the US
Army and US Navy. The latter program was designed
to prove the concepts devised for G-protection on the
human centrifuge in the operational environment of
the actual fighter aircraft. The development of strain
gauge manometry applied to intraarterial blood pressure recording on the rotating centrifuge, the derivation of the absolute reading pulse oximeter applied to
the recording of cerebral perfusion, refinement and
testing of voluntary maneuvers designed to prevent
G-LOC (the anti G-straining “M-1” maneuver, named
for Mayo-1, is still taught to fighter aircrew today) and
ultimately the testing of the single pressure 5 bladder
“G-suit”, were some of the results of this pioneering
work. Dr Lambert lost consciousness 23 times and endured a cumulative 7.7 minutes of lack of perfusion at
head level (estimated by the absence of the ear pulse).
He received the Presidential Certificate of Merit in
1947 for these studies, and was promoted to Professor
of Physiology in Mayo Graduate School in 1958.
When the wartime acceleration work ended in the
late forties, Dr Lambert began his second area of pioneering work, the electrophysiology of neuromuscular
diseases, working with members of the Department of
Neurology, chaired by Dr Lee Eaton. During the transition between these two phases of his career he continued to study cardiovascular physiology, shivering,
pulmonary stretch receptors and gastro-intestinal electrophysiology. His publications in the mid-sixties with
an artificial respiration device and cardiac conduction
block via a vascular catheter were the forerunners of
modern cardiac electrophysiology and the current
Combi-tube for assisted respiration.
Neurologists best know Dr Lambert for his early
studies in 1956 with Drs Lee Eaton and Doug Rooke
that distinguished the myasthenic syndrome sometimes
associated with lung carcinoma from other disorders of
neuromuscular transmission. The disorder has been
called the Lambert-Eaton myasthenic syndrome since
1968 when he and Dr Dan Elmquist demonstrated the
quantal pathophysiology of the neuromuscular transmission defect in a patient’s biopsied intercostal nervemuscle preparation. Dr Lambert and colleagues at
Mayo Clinic and in England elucidated its immunologic basis in a series of human and animal studies over
the next twenty years.
Dr Lambert’s many, less well-known, publications
between 1950 and 1997 covered the pathophysiology,
diagnostic criteria, animal models and therapeutic interventions for the whole range of neuromuscular dis-
© 2003 American Neurological Association
Published by Wiley-Liss, Inc., through Wiley Subscription Services
eases. These early studies led to electromyography and
nerve conduction becoming an integral part of the
evaluation of neuromuscular diseases. Collaborative
studies with Dr Peter Dyck and others defined the nature of the inherited and diabetic neuropathies. His
early animal models of nerve section, thallium toxicity,
and diphtheritic neuropathy distinguished the electrophysiologic differences between Wallerian degeneration
and axonal and inflammatory neuropathies. Work with
his wife, Dr Vanda Lennon, and Dr Andrew Engel defined the pathophysiology of immune-mediated myasthenia gravis, congenital myasthenia and infantile myasthenia. Other studies encompassed generalized
neuropathies, such as metabolic and endocrine, and
mononeuropathies, such as carpal tunnel syndrome
and facial neuropathy. Among the muscle disease electrophysiologic changes that he described were myositis,
the periodic paralyses, dystrophies, endocrine myopathies, botulism, malignant hyperthermia, acid maltase,
myotonias and toxic myopathies. “(Lambert-)Brody”
myopathy is another disorder sometimes associated
with his name. Dr Lambert’s classic reports on the
electrophysiology of amyotrophic lateral sclerosis are
unmatched for their broad description with deep insight. Following his retirement from Mayo Clinic in
1985, he continued his research for another nine years
in the Department of Neurology at the University of
Minnesota. There he concentrated on animal models
of synaptic pathophysiology. In 1996 he, Dr Christopher Gomez and colleagues, reported the first mouse
model of a mutated muscle acetylcholine receptor, the
slow channel syndrome.
His work was widely recognized with a formal invitation to join the American Association of Electromyography and Electrodiagnosis in 1953 and election as
president in 1956. He was on the Advisory Board of
Muscle & Nerve for the first 12 years after its establishment, and he chaired the Medical Advisory Board of
the Myasthenia Gravis Foundation 1973–1975. In
1995 he was awarded the American Association of
Electromyography and Electrodiagnosis Lifetime
Achievement Award, the highest honor bestowed to
members of the association. He was Chair of EMG
Commission and Member of Executive Committee of
International Federation of Societies for Electroencephalography and Clinical Neurophysiology, 1965–1969. He
was elected honorary member of the American Neurological Association in 1984.
Dr Lambert’s many accomplishments in sorting out
the electrophysiology of neuromuscular diseases was
based in large part on his emphasis on careful collection of more quantitative data than others might have
thought necessary, followed by thorough, and painstaking analysis. Such studies over fifty years led to his
determination of the optimal methods and normal values of standard nerve conduction studies from childhood through 90 years of age, the relationship between
the sural nerve action potential and its morphometry,
and the common anomalies of innervation.
Dr Lambert applied the principles learned in his basic science studies to the clinical studies of each patient
he saw. A typical example was his systematic needle
EMG recording of end plate potentials from single
muscle fibers in children with congenital disorders of
neuromuscular transmission. Those who worked with
Dr Lambert were intimately aware of his quiet but determined nature, his dedication to work, and his incomparable stamina that resulted in long hours for Ed,
his fellows, his wife and his patients. As the hours wore
on, Ed was most likely to be heard saying, “Just one
more response”.
Dr Lambert was able to ask discerning questions or
even develop insights into the mechanism of disease
from single patient studies. His clinical-EMG neuromuscular conferences at Mayo Clinic, recorded by
hand from 1953 on, were classic teaching conferences
in which detailed review of individual patients led to
many seminal observations, like the first case of
Lambert-Eaton syndrome in the 1956 conference
book.
Dr Lambert’s major legacies are his many students,
who themselves are now leaders in the field of neuromuscular diseases and EMG. They carried the principles they learned with him into their own clinical and
basic research. Many of those he led into the field are
now renowned for their own work.
Dr Lambert resided in Rochester, Minnesota with
his wife, Vanda Lennon, who survives him. Dr Lennon
and Dr Lambert were an example of a husband and
wife pair who together advanced an entire field of
medical knowledge. Dr Lambert was a man who all
scientists can emulate, as exemplified in one of his
many sayings, “It not as important to be the first, as it
is to be reliable”.
Jasper R. Daube, MD
Annals of Neurology
Vol 54
No 5
November 2003
691
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