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ABSTRACT This essay aims to stimulate a reawakening of interest in the wr itings of the physician Richard Asher (1912-1969), who is now best known for coining the ter m "Munchausen's syndrome." Asher's essays are as relevant now as when first published. His articles were a model of clar ity, wit and elegance: he argued consistently for precision in thought and expression, for logic in clinical thinking, and for evidence in treatment.
Richard asher (1912-1969) was an English physician and writer. Born in Brighton, the son of a clergyman, he was educated at Lancing College and studied medicine at the London Hospital, qualifying in 1934. After various junior posts at the London and West Middlesex Hospitals, he was appointed physician at the Central Middlesex Hospital in 1943 (Royal College of Physicians 2009). The Central Middlesex was a former municipal hospital, and Asher was among a group of young consultants (including Sir Francis Avery Jones, one of the pioneers of British gastroenterology) who transformed this medical backwater into a center with a high reputation for its clinical work, research, and teaching. Asher was a general physician, but he had interests in hematology, endocrinology, hypnosis, and the physical basis of mental illness. He argued passionately in favor of generalism, and against what he saw as over-specialization.
Asher began writing articles for the medical journals in the early 1940s, and he gradually developed a unique, aphoristic literary style. His articles were easy to read, witty, and often challenged the medical consensus. He had a passion for clear, elegant English, but he acknowledged that his prose style did not come easily. He wrote not only for the medical journals, but also for the popular press, and his articles ranged from the purely clinical to the speculative and philosophical. He was also an inspiring bedside teacher and an accomplished public speaker.
One of Asher's clinical commitments was as consultant in charge of the Mental Observation Unit at the Central Middlesex, where he saw an average of 700 patients a year over a 10-year period (Asher 1954a). This experience provided him with the clinical material for such articles as "Myxoedematous Madness" (1949b), "The Physical Basis of Mental Illness"(1954a), and, of course, "Munchausen's Syndrome" (1951). In 1964, the hospital authorities decided...