Born 11 November 1864 at Chili, Coshocton County, Ohio, US son of Michael Crile and Margaret Dietz, his wife. He was educated at Ohio Northern University at Ada, Ohio, and Wooster (now the Western Reserve) University, Cleveland, Ohio, where he took his M.D. in 1887 and served as an intern at the Lakeside Hospital. After his travels to the clinics of Vienna, Paris, and London he became demonstrator and lecturer in histology at Western Reserve and then successively professor of physiology 1890, of surgical propaedeutic 1893, of clinical surgery 1900 and of surgery 1911, when he was appointed visiting surgeon to Lakeside Hospital. During the Spanish-American war of 1898 he served in Puerto Rico and Cuba, becoming brigade surgeon. In 1917-18 he served in France as director of the Lakeside unit at base hospital No 4 with the rank of colonel, United States Army Medical Corps, and was decorated by the allies. From 1924 when he retired from his professorial chair he devoted himself as director of research to the service of Cleveland clinic, of which he was one of the founders in 1921, and made one of the best in the world. Crile was elected an honorary Fellow of the College at the last International Medical Congress in London in 1913. He appears in the group of honorary Fellows photographed on the steps of the College, which also includes Harvey Cushing and William Mayo He was president of the American College of Surgeons in 1916. Crile married in 1900 Grace McBride, who survived him with two sons and two daughters. With his wife he was a hospitable host at Cleveland and at the country house, where his chief recreation was riding. He was particular friendly to British surgeons, and his friendships were coloured by the enthusiasm which activated him in all his work. He was a man of dynamic vitality and marked intellectual originality. With Mrs Crile he undertook late in life a game-hunting expedition to Africa to collect a variety of species for comparative study of their endocrine organs. Mrs Crile described the adventure in her book *Skyways to a jungle laboratory*, New York, 1936. He died at the Cleveland clinic on 6 January 1943, aged 78. Crile was one of the outstanding surgeons who, at the turn of the nineteenth and twentieth centuries, put the latest advances of physiological discovery to successful clinical use. He was himself both surgeon and physiologist, and turned his researches in the mechanism of shock and the functions of the endocrines to practical surgical ends. He ranked as a scientific surgeon with Moynihan, who revolutionized the surgery and physiology of digestive dysfunction, and with Cushing, who was outstanding both as surgeon and as neurologist. Crile's prize essay on surgical shock (1897) stated his realization of the patient's unconscious reflex responses to pain stimuli when under anaesthetic. He devised a method of shockless operation, fully developed in the two editions (1914 and 1920) of his famous book *Anoci-association*, allaying the patient's apprehension by preliminary sedative (scopolamine and morphine), securing general anaesthesia with nitrous oxide and oxygen, and cutting off the afferent impulses from the area of operation by local anaesthetics. The field of operation was blocked by infiltration with novocaine, and every division of sensitive tissue was preceded by injection of novocaine. Postoperative discomfort was minimized by injection of quinine and urea hydrochloride solution at distance from the wound. He was a pioneer in the surgery of the thyroid and with a similar purpose elaborated his method of "stealing" the thyroid: placing each patient in a private room, going through the early stages of general anaesthesia ritual on several successive days till on the selected day, unknown to the patient, anaesthesia was completed and the operation performed in the patient's room. On that day Crile would do many such operations consecutively, hurrying from room to room. His work on anoci-association, the blunting of harmful association-impulses, was made in collaboration with W S Lower, and was based on W H Gaskell's researches on the sympathetic nervous system. Crile took a leading part in the revival of blood-transfusion, and devised the practical method of making direct connexion between the arteries of the donor and the veins of the recipient. His book on the subject appeared in 1909. During his service with the American army in France in the first world war he became interested in the study of the suprarenals. Adrenalin had been isolated by Takamine in 1901, and Langley had shown that this secretion of the medullary part of the suprarenal gland had the same effect on the organism as artificial stimulation of the sympathetic. Crile applied Langley's discovery to the direct stimulation of the accelerator nerves of the heart in cases of collapse under anaesthesia. He was essentially a scientist and in American phrase "a savant", closely following the work of the "pure" physiologists and himself experimenting in its application; for instance, he tried to control the peripheral circulation by wearing a rubber suit, and he wrote on the physiology of emotion. At the same time he was a surgeon of ambidextrous facility and the deviser of brilliant and simple operations. He taught the most convenient way of fulfilling Butlin's doctrine that the corresponding lymph-nodes must be removed in operating for malignant disease of the tongue, and Crile's method was universally adopted. In later years he became much interested in the surgical physiology of hypertension, and was the first to advocate sympathectomy for its treatment. His conception of the integration of the endocrines and of their relation as a system to the phenomena of shock was his most original and germinal contribution to medical science. From his studies in nervous and endocrine physiology Crile was led to examine the phenomena of living processes, and elaborated his radioelectric interpretation in several books. He suggested that the acid nucleus of the cell is the positive component of oxidation, the cytoplasm the negative agent, with the cell-membrane as condensor, and the brain and liver as positive and negative poles. Publications:- *An experimental research into surgical shock*, Cartwright prize essay 1897. Philadelphia, 1899. *Experimental research into the surgery of the respiratory system*, Senn prize essay, American Medical Association 1898. Philadelphia, 1899. *An experimental and clinical research into certain problems relating to surgical operations*, Alvarenga prize essay, College of Physicians of Philadelphia, 1901. *Blood pressure in surgery*. Philadelphia, 1903. *Haemorrhage and transfusion*. New York,1909. *Phylogenetic association in relation to certain medical problems*. Boston, 1910. *Anoci-association*, with W. S. Lower. Philadelphia, 1914; 2nd edition: *Surgical shock and the shockless operation through anoci-association* 1920, *Anemia and resuscitation*. New York, 1914. *The origin and nature of the emotions*. Philadelphia, 1915. *A mechanistic view of war and peace*. New York, 1915. *Man an adaptive mechanism*, New York, 1916, *The kinetic drive, its phenomena and control* (Carpenter lecture, New York Academy of Medicine 1915). Philadelphia, 1916. *A physical interpretation of shock, exhaustion, and restoration, an extensional kinetic theory*. London, 1921. *The thyroid gland*. Philadelphia, 1927; two editions in the year, published from the Cleveland clinic, anonymously, *Bipolar theory of living processes*. New York, 1926. *Problems in surgery* (University of Washington graduate medical lectures 1926), Philadelphia, 1926. *Diagnosis and treatment of diseases of the thyroid gland*. Philadelphia, 1932 (portrait). *Diseases peculiar to civilized man; clinical management and surgical treatment* New York, 1934. *The phenomenon of life; a radio-electric interpretation*. New York, 1936. *The surgical treatment of hypertension*. Philadelphia, 1938. *Intelligence, power, and personality*. New York, 1941.