Positioned in the posterior abdomen, the pancreas remained little observed until nineteenth century advances in physiology, followed later in the century by abdominal surgery, brought the organ into the clinical domain. The discovery of pancreatic stimulating hormones during the twentieth century culminated in the description of pancreozymin by Harper and Raper in Manchester in 1943. After World War II, Henry T Howat was appointed physician in that city and was able to analyse the results of hormonal stimulation in pancreatic disorders. He became the first doctor in Britain to specialise in pancreatology. His collaboration with colleagues in Britain and in Europe, through the evolution of specialist societies, encouraged the coordination of basic science, medicine, pathology, radiology and surgery, to further research in, and management of, pancreatic disease. Academic recognition by Manchester University resulted in his being appointed its first Professor of Gastroenterology and originator of a gastrointestinal research unit. As he pointed out, continuing scientific and technological advances influenced the concepts of disease, and moved the management of pancreatic disease from the general physician and surgeon to gastroenterologists. Howat’s career illustrates the continuing specialisation witnessed in the latter half of the twentieth century.
