Dr. Denis Burkitt



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British surgeon, born February 28, 1911, Enniskillen, now Northern Ireland; died March 23, 1993.

Biography of Denis Parsons Burkitt

The surgeon as a young man

Denis Parsons Burkitt was the son of an engineer. His family were protestants and religion was to play an important part in his life, and had severe consequences already while he was a boy. One day, while on his way through town to the Protestant school, he lost his one eye in a boys’ fight. He attended gymnasium in England and returned to Trinity College, Dublin, at the age of 18, planning to become an engineer like his father. However, he seemed to have no sense of vocation. A tutor wrote a letter to his father in which he expressed grave doubts as to whether Burkitt would ever be able to obtain a degree.

However, wanting to work with a mission, and probably influenced by an uncle who was a missionary physician in Kenya, Burkitt changed to medicine. He received his BA in 1933 and graduated as a physician in 1935. He immediately commenced training as a surgeon, becoming a fellow of Edinburgh’s Royal College of Surgeons in 1938. He applied for a position as physician in the colonies, but his request was turned down, as a one-eyed surgeon did not seem practical. His applications for other posts in the colonies were rejected, but was rejected on the grounds that he was too old – over 30, or that there were no vacancies. He may have been right when he suspected that his religious zeal was to his disadvantage.

One-eyed surgeon goes to war
If God had forsaken him, however, the Evil one was at hand. The opportunities denied him in the colonies, were created for him in Europe by Adolf Hitler. Denis Burkitt became an army physician and in 1943-1945 was posted in Kenya, Somalia and Uganda, obtaining the rank of major. Having proved his cyclopic abilities, he was now accepted for colonial service, and in 1946 he commenced his new service in Uganda.

Into Africa
He first worked primarily as a general practitioner in Lira, where an unusually high incidence of hydrocele aroused his interest in geographical medicine and epidemiology. The cause of the difference in the occurrence of hydrocele later proved to be a mosquito-born worm disease. After about one year he was transferred to the Mulago Hospital, an educational hospital for the Makarere College, situated outside Kampala at the Lake Victoria.

Burkitt’s lymphoma
In 1957 Burkitt was asked to examine a 5 year old boy in the paediatric ward. The boy had tumours in the region of the head and neck, and a few weeks later he saw a girl with the same spread of cancer. The tumours proved to be very fast growing and the children died within weeks. Burkitt recognised that this was possibly a previously undescribed cancer disease. He contacted a large number of Hospitals in Africa and published his results one year later.

Later, Burkitt and two associates, Ted Williams and Cliff Nelson, conducted a 16 000 km research travel visiting some 60 hospitals in East Africa and Southern Africa to study the occurrence of lymphomas, often in places where Livingstone had worked. Burkitt was a great admirer of Livingstone, a larger than life figure enduring cruel hardships, opening up new territory to the white man in Africa. However, considering the fact that David Livingstone’s blatant dishonesty caused the death of dozens of his countrymen – missionaries at that – and that he died after more than thirty years in Africa leaving not one single convert to Christianity – justifies the question of what kind of ideal he was for a religious man like Burkitt. As a ardent atheist says: Livingstone is my favourite missionary!

With his colleagues Edward Williams and Clifford Nelson, Burkitt undertook a geographical survey of the incidence of the disease and found it to be correlated with the same temperature and rainfall zones as malaria. This suggested that the occurrence of the disease may be linked with the distribution of certain insect carriers, as with malaria. Burkitt’s lymphoma survey is regarded as one of the pioneering studies of geographical pathology.

While Burkitt’s first reports, written and in lectures, were met with little interest, the early sixties changed all that, when Burkitt in 1961 published a new compilation on malign lymphoma in African children in the journal Cancer. Attending one of Denis Burkitt’s lectures in England in 1961 was Michael Anthony Epstein (1921–). He suspected a virus and asked Denis Burkitt to furnish him with a sample. In one of these samples he was three years later able to isolate the virus now known as Epstein-Barr’s virus, named for Epstein and his assistant, Australian physician Yvonne M. Barr (1932–).

In 1966 Burkitt left Uganda to take up a position at the Medical Research Council in London

The Fibreman
In Uganda Burkitt had made the important observation that Africans produce several times more faeces than do Westernised people. Moreover, their faeces are soft and is produced with negligible discomfort, again in marked contrast to Westernised people. Burkitt hypothesised that a major cause of Western disease is the consumption of refined carbohydrates with its low contents of dietary fibre. This concept led to the our understanding of the role of dietary fibre in such conditions as type II diabetes, obesity and diverticular disease, and to the realisation f the effectiveness of soluble fibre as a hypocholesterolaemic agent. Of great importance was Burkitt’s hypothesis that dietary fibre plays a major role in protection against colonic cancers.

In his views on the importance of fibres and lifestyle in preventing diseases, Burkitt was strongly supported by his colleague Hugh Trowell, the physician who, in 1957, asked him to investigate the five year old boy with malignant lymphoma.

      Better to build a fence at the top of the cliff than park an ambulance at the bottom.

Diseases can rarely be eliminated through early diagnosis or good treatment, but prevention can eliminate disease.

Western doctors are like poor plumbers. They treat a splashing tube by cleaning up the water. These plumbers are extremely apt at drying up the water, constantly inventing new, expensive, and refined methods of drying up water. Somebody should teach them how to close the tap.

If people are constantly falling off a cliff, you could place ambulances under the cliff og build a fence on the top of the cliff. We are placing all to many ambulances under the cliff.

The frying pan you should give to your enemy. Food should not be prepared in fat. Our bodies are adopted to a stone age diet of roots and vegetables.

America is a constipated nation…. If you pass small stools, you have to have large hospitals.

The only way we are going to reduce disease, is to go backward to the diets and lifestyles of our ancestors.

In Africa, treating people who live largely off the land on vegetables they grow, I hardly ever saw cases of many of the most common diseases in the United States and England — including coronary heart disease, adult-onset diabetes, varicose veins, obesity, diverticulitis, appendicitis, gallstones, dental cavities, haemorrhoids, hiatal hernias and constipation.
Western diets are so low on bulk and so dense in calories, that our intestines just don’t pass enough volume to remain healthy.

In 20 years of surgery in Africa, I had to remove exactly one gallstone.

“Dr Burkitt is one of the best known surgeons today. What has made him famous is his remarkable ability to observe disease patterns around him, to identify their peculiarities and to develop concepts and hypotheses. Like many Surgeons, Dr Burkitt is rarely in doubt about his convictions on medical matters, but unlike the rest of us he consistently turns out to be correct.
Denis Burkitt supported the theory that many of the diseases that are widespread in Western countries but are absent in the Third World, including appendicitis, diverticulitis, diabetes, heart disease and certain cancers, are due to the way we eat. On the basis of his convictions, he has launched a worldwide crusade to increase our consumption of vegetable fibres.
It is impossible to grasp the number of lives that have been improved or saved and will continue to be improved as a result of Dr Burkitt’s epidemiological acumen and his missionary zeal when promoting our health.”
A summarising of his achievements by the Royal College of Physicians and Surgeons in Canada in 1992 when they awarded him an Honorary Fellowship.