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15 January 2020

Alexander Polycleitos Cawadias / Αλεξανδρος Πολυκλειτος Καββαδιας (1884 – 1971) endocrinologist - Part 1


Cawadias was the son of the noted Greek archeologist, Panagiotis Kavvadias/ Παναγιώτης Καββαδίας (1850 – 1928). Alexander was educated locally in Athens and then at Montpellier University and at the University of Paris where he earned a baccalaureate in 1901, and then studied in Bonn and Heidelberg. From 1906-10 he was a resident physician at a Paris teaching hospital, where he gained a MD. In 1912 he was elected Chef de Clinique in the Paris Faculty.

However the Balkan states having formed the Balkan League fought successfully to complete secession from the Ottoman Empire. This was the First Balkan War 1912-13. Immediately afterwards Bulgaria went to war against Greece and Serbia to settle boundaries. This was the Second Balkan War. Dr Cawadias returned to Greece to help his country, and in particular served during the cholera epidemic in Salonika. In 1914, he married the daughter of a banker, and, on the nomination of Queen Mother Olga, he was appointed Chief of the Medical Clinic in the Evangelismos Hospital in Athens, and he became physician to the new king, her son. During the Great War, Cawadias was the liaison officer to the British Sector, and in 1918 was appointed to the Order of the British Empire (OBE).

Greece attempted to expand into Asia Minor, but was defeated in the Greco-Turkish War 1919-1922. After this chaos and the need to absorb 1.5 million refugees, there was a referendum on the monarchy, and Greece became a republic in 1924. A fervent royalist, Cawadias followed his King Geórgios II (Olga’s grandson) into exile in London two years later. He qualified as a British MD at Durham University. He found a home in the prestigious Wimpole Street, and became a British subject. He quickly established a consulting practice mainly amongst wealthy Greek expatriates. He did not follow his king back to Greece in 1935 after the right-wing coup that restored the monarchy.

Cawadias specialized in endocrinology and established a reputation in the field. He was president of the History of Medicine Society of the Royal Society of Medicine from 1937 to 1939.

The reigning paradigm re intersex persons, or hermaphrodites as they were then called, was that of Theodor Klebs (1834-1913) who in his Handbuch der Pathologischen Anatomie, 1876 codified the already accepted notion that primacy in sex determination should be the gonads: thus a person with a typical female body but also testes would be designated male and a person with a typical male body but with ovarian tissue would be designated female. Klebs distinguished true hermaphroditism (both ovarian and testicular tissue) from what he called pseudo-hermaphroditism.

Cawadias was one of the first to speak out against this paradigm. In December 1941, when the worst of the Blitz was over, he gave the Thomas Vicary lecture at the Royal College of Surgeons: Hermaphroditism: A Historical Approach.
“In all cases of ‘complete’ hermaphroditism described even to-day the testis or the ovary was rudimentary and not functioning. Bisexualism could not be accepted on such slender evidence. Was there a normal woman who did not possess in her ovarian medulla testicular rudiments, or a normal woman who did not secrete testosterone? According to Klebs's criterion all normal women should be considered true hermaphrodites. (1941 p818)” …. “The ovary and testis were not the basis of sex, but merely manifestations or results of the initial genetic sexoformic impulse, which in human beings was either male or female and never bisexual. A female was not the appendage of her ovaries, to use Virchow's phrase, but had ovaries because she was female. A male was not male because he had testes; he had testes because he was male. There was neither absolute male nor absolute female. Every male had more or less latent female features, and vice versa. Intensification of this normal intersexualism characterised the disease hermaphroditism, and all degrees were encountered. (p819)”
Cawadias’ daughter Mary had been a Red Cross nurse during the Italian Invasion of Greece in 1940, and after the Germans also invaded in 1941 she was arrested by the SS and condemned to death for assisting the Allies.

Continued in Part II
52 Wimpole St

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Cawadias was first at 52 Wimpole Street, and then at 50. Number 50 was the residence 1838-46 of poet Elizabeth Barrett, lover of poet Robert Browning. Their courtship was immortalised in the play  The Barretts of Wimpole Street, 1930. It was filmed twice, 1934 and 1957, in both cases directed by Sidney Franklin. It was also remade by the BBC in 1982.

The Royal College of Physicians biography of Cawadias (which does not mention intersex even once) says “In 1914, on the nomination of Queen Olga, he had been appointed Chief of the Medical Clinic in the Evangelismos Hospital”. However her husband Geórgios I had been assassinated in 1913 so she was no longer Queen. Their son Konstantínos ruled 1913-17 but was forced out for being pro-German. His second son, Aléxandros ruled 1920-3 until death from a monkey bite. Following a referendum, Konstantínos returned but abdicated in 1922 after Greece lost a war with Turkey. His first son Geórgios II then reigned 1922-4 until a republic was proclaimed. Geórgios then spent most of his time in Britain, and with his English mistress. He divorced his wife in 1935. After the right-wing coup that year and a rigged referendum, Geórgios returned and ruled during the Metaxas dictatorship, giving his consent to the suspension of the parliament, etc.

The Wikipedia page on Theodor Klebs does not mention his work on hermaphrodites. !!

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