Professor Peter Scheuer

Master of the liver biopsy who established a world centre for liver pathology at the Royal Free
Click to follow
The Independent Online

Peter Joseph Scheuer, hepatopathologist: born Hamburg 15 November 1928; Senior House Officer in Pathology, Royal Free Hospital 1957-59, Lecturer in Morbid Anatomy 1959-64, Senior Lecturer, then Reader 1964-74, Professor of Clinical Histopathology 1974-83, Professor of Pathology 1983-92 (Emeritus); President, British Association for the Study of the Liver 1990-92; married 1960 Dr Louise Withington (two sons); died London 1 March 2006.

The teaming in 1959 of Professor (later Dame) Sheila Sherlock and Peter Scheuer was to result in the establishment of the Royal Free Hospital in London as one of the world's leading centres for diseases of the liver. Scheuer, who was to emerge in his own right as an eminent expert in hepatopathology, collaborated with the liver unit for some 42 years.

From the early 1950s increasingly rapid advances in technology resulted in dramatic changes in most areas of clinical medicine. In hepatology (diseases of the liver) the introduction of liver biopsies contributed most to a greater understanding of liver disease at the clinical practice level. The interpretation of these biopsies, 10 to 15mm in length and some 2mm in diameter, was a major challenge to histopathologists. In the case of diffuse liver disease the biopsy was likely to be representative of the entire liver, whereas with focal lesions the introduction of sophisticated imaging techniques allowed direct biopsies of the lesions.

In all cases it was imperative that there was close collaboration between the histopathologist and the clinician in order that the correct diagnosis could be made. At the Royal Free Scheuer had already developed an interest in hepatopathology and he was appointed Lecturer in Morbid Anatomy there in 1959 at the same time as Sheila Sherlock, who had established a reputation for expertise in hepatology at the Hammersmith Hospital, was appointed to the Royal Free's first Chair of Medicine.

Peter Scheuer was born in Hamburg in 1928, the youngest of four children. His parents were Jewish, from Vienna, and, despite the family's all being members of a Lutheran church, by 1937 both his brothers had been expelled from school and the family returned to Vienna. After the annexation of Austria by the Nazis in March 1938 the situation was worse and they all had, individually, to make good their escape. Peter and his mother joined his father in England in December 1938.

He was sent to a boarding school (to help his English) - "a miserable experience and I cried myself to sleep every night" - but in 1942 he began secondary education at Abbotsholme School in Derbyshire: "a marvellous place". He developed an interest in biology and on leaving school, in 1947, got a post as a laboratory technician at Bromley Cottage Hospital and developed a particular interest in histology. Dr John Keall, the consultant in charge, encouraged him to consider medicine as a career.

In 1949 he gained entry to the Royal Free Hospital School of Medicine, one of 12 males amongst some 80 females in his year. He found himself naturally attracted to the basic sciences and five years later graduated with honours in obstetrics and gynaecology. After house jobs, including one in St John's, Newfoundland, where his parents had emigrated, he was conscripted to the Royal Army Medical Corps. He served two years with the Army in Singapore, rising to the rank of captain.

After National Service Scheuer obtained a post as Senior House Officer in Pathology in Professor Kenneth Hill's department at the Royal Free. Hill encouraged Scheuer to develop a research interest in liver disease. He worked on the laboratory aspects of veno-occlusive disease as a subject for an MD thesis, awarded in 1961. By this time he had met, and in 1960 married, Dr Louise Withington, a post-doctoral fellow in the Department of Anatomy at the Royal Free. Louise later developed interests in juvenile osteology and now continues research as a forensic anthropologist.

In 1962 Scheuer obtained a travelling fellowship from the British Postgraduate Federation and spent a year with Dr Hans Popper at the Mount Sinai Hospital in New York. Popper - another Jewish refugee from Vienna - was already regarded as the world's foremost liver pathologist. He had limitless energy, and a mind that never ceased to enquire and seek knowledge. Scheuer came back from New York with a broader vision. He returned to his post as Lecturer, becoming successively Senior Lecturer (Honorary Consultant), Reader, a (personal) Professor of Clinical Histopathology and, in 1983, Professor of Pathology and head of the Department of Histopathology, a post he held till retirement in 1992. He was the first male graduate of the school to become a consultant to the Royal Free Hospital and the first to hold a chair. His department became a world centre for liver pathology.

In 1968 he published the first edition of Liver Biopsy Interpretation, a brief text, but one which was written concisely and clearly, which was readily assimilated by both histologists and clinicians. It immediately became, if not the bible, then the "new testament" of liver pathology. For the general histopathologist these small liver biopsies became less of a chore and more of a challenge, indeed for many they became of consummate interest. The seventh edition of the book (edited conjointly with Dr Jay Lefkowitch of Columbia University, New York) was published in 2005.

Peter Scheuer was the ideal teacher, both head to head at the microscope and as a lecturer - with elegant, clear presentation; a didactic approach; logical reasoning; comprehensive, yet succinct description; masterful use of English; fleeting moments of silence or suspense; and a sprinkling of humour. His ability to use one slide to illustrate numerous points was unsurpassed.

While he was ready to admit that he was not a practical research worker, he made numerous and seminal original observations of a clinico-pathological nature and his joint articles on various aspects of chronic hepatitis and biliary diseases are classics. In particular, the 1968 Lancet paper "A Classification of Chronic Hepatitis" published by the "Gnomes" owed much to Scheuer's skilled drafting of the deliberation and discussions by this group. The "Gnomes" comprised a group of pathologists and physicians who first met informally at the second meeting of the recently formed European Association of the Study of the Liver (EASL) in Göteborg in 1967; they met again in Zurich in 1968, published the chronic hepatitis paper and gained worldwide recognition. ("Gnomes" was Sheila Sherlock's coinage; she described the group as manipulating the nomenclature of liver disease just as the Gnomes of Zurich, the bankers of Europe, manipulated Europe's finances.)

Scheuer was also an outstanding editor and reviewer, in constant demand for contributions to textbooks and monographs. He was co-editor of Pathology of the Liver (1976), the fifth edition of which appears this year. He was greatly amused when he realised that for all the three editors of that textbook (certainly more the bible than a new testament) English was their second language - Gaelic, Hungarian and German being the native tongues of Roddy MacSween, Peter Anthony and himself respectively.

While he took on some duties at university, national and international level - vice-dean of the Medical School, member of Council of the Royal College of Pathologists, President of the British Association for the Study of the Liver and committee member of the EASL, and on retirement chairman of the medical advisory committee and then vice-chairman of the British Liver Trust, the national charity which helps patients with liver disease - there were other posts which he decided to avoid. His priorities, he said, were "the department, liver pathology and the medical school".

Outside pathology Peter Scheuer's major interest was music. Music from the beginning played an important part in the family: they often went to the opera and conversation at mealtimes was richly laced with quotations from opera. He started violin lessons in 1937; at school he took lessons in violin and piano and while studying medicine he attended classes at the London College of Music. While in Singapore he started cello lessons and he became an accomplished performer, playing in an amateur orchestra and in piano trios and string quartets.

After retirement playing chamber music became a very important part of his life; his wife Louise shared his musical interest and is an accomplished pianist - indeed they first met at the medical school's music society.

Roddy MacSween and Jim McLaughlin