Dr. Hugh R. Butt, the Mayo Clinic physician who discovered the role of vitamin K in clotting and developed anti-clotting techniques that paved the way for open-heart surgery and transplants, died Aug. 16 in Rochester, Minn.
He was 98 and died of natural causes after a fall.
A president of the American College of Physicians in the early 1970s, Butt played a key role in establishing that group’s system of self-testing for doctors to ensure their awareness of the most recent advances in medicine.
He was also one of the last assistants to work directly with Dr. William Mayo, one of the founders of the clinic. In his later years, he was a crucial player in efforts to expand it, soliciting large donations from his celebrity patients, including hotel magnate Conrad Hilton and Winn-Dixie co-owner James E. Davis.
“Hugh bridged the gap between the founders and the current leaders of the Mayo Clinic,” said Dr. Robert Waller, chief executive of the clinic from 1988 to 1999. “He never stopped thinking of ways to be helpful to Mayo.”
While Butt was a resident at Mayo in the 1930s, he learned that Danish nutritionist Henrik Dam, who received the 1943 Nobel Prize in Physiology or Medicine for the discovery of vitamin K, had shown that chickens deficient in the vitamin were susceptible to internal bleeding.
He suspected that an inability to absorb the vitamin properly was at the root of the hemorrhaging and confirmed this in chickens. Shortly thereafter, he was confronted with a jaundiced patient who was bleeding to death internally. He administered vitamin K combined with bile salts to increase absorption and, within an hour, the bleeding had ceased.
It was “the first kind of miracle I had ever seen,” he later recalled. After studies in several other jaundiced patients, he published the research in 1938, and the technique is now widely used to control bleeding problems. One benefactor was William Mayo, who was suffering from jaundice after cancer surgery.
Butt later described Mayo calling him into his hospital room. “Now, since you’ve discovered that vitamin K will stop the blood, I know I am not going to bleed to death, and I wanted to thank you,” Mayo told him.
Shortly thereafter, chemist Karl Paul Link of the University of Wisconsin discovered that a bleeding disorder in cattle called “sweet clover disease” was produced by a chemical in the clover called dicumarol. Butt reasoned that its effects were opposite to those of vitamin K and pioneered its use in clinical trials to prevent clotting.
The current anti-clotting drug warfarin is a synthetic relative of dicumarol. Some experts think Butt should have won a Nobel for his work.
Hugh Roland Butt was born Jan. 8, 1910, in Belhaven, N.C. He received his medical degree from the University of Virginia Medical School in 1937 and joined Mayo in 1938, spending the rest of his career there, except for his service as a Navy doctor on a hospital ship in the Pacific during World War II.
During the 1960s, the medical community was undergoing an intense debate about the need for continuing medical education and the recertification of practicing physicians. The Medical Knowledge Self-Assessment Program, which allowed physicians to take the tests in privacy, was the brainchild of Butt and the education committee he headed.
The test is now in its 14th edition.
Butt was chosen by shipping magnate Daniel K. Ludwig to guide the creation of the Ludwig Institute for Cancer Research, heading a drive to collect its $500-million endowment. He was chairman of the institute’s scientific committee from 1971 to 1987.
Upon retirement from Mayo, Butt had more time for his two loves after medicine: winemaking and sculpture. Self-taught, he used farm implements, old tools, wire and other metals to create whimsical figures. His works were displayed at three solo exhibitions in Rochester and exhibited in galleries throughout the country.
His wife, Mary Dempwolf, died in 1990 and a son, Charles, died in 1984.
Butt is survived by daughters Lucy Butsch of Buffalo, N.Y., Selby Beeler of Rochester and Frances Cohn of Telluride, Colo.; seven grandchildren; and 12 great-grandchildren.