In Dumfries and Galloway, the medical laboratory service developed in three centres; Crichton Royal Hospital, Dumfries and Galloway Royal Infirmary and the Public Health Laboratory of the Municipal Council.
The Crichton Royal Hospital was established in Dumfries in 1839 at the direction of Elizabeth Crichton, widow of Dr James Crichton, with money which had been made mainly by trading in India and China. It became one of Europe's best run and best appointed psychiatric hospitals with active staff who were anxious to keep the the forefront of treatment and research. (ref: 61)
In June 1839, an advertisement published by John W Parker, West Strand, London, said the "the internal arrangements, and the means of restoring the insane to reason - or, if that be impossible, to greater tranquillity and happiness than can be secured to them elsewhere - have been confided to Medical and other Officers, whom the Trustees have selected on account of their high characters and great experience, whose reputation depends upon the amount of benefit they have in their power to confer, and whose interest it is to render the proportion of recoveries as great as possible". There were special reduce fees of £10 per annum for "individuals who - - are to be nominated by Mrs Crichton. Accommodation, diet, etc is given to this class, which consists of persons of respectibility in reduced circumstances, according to what they have been accustomed to". Paupers from Dumfries and Wigtown were charged £15 p.a. and their accommodation was "a public room for 10, a private sleeping room for each; iron bed; no curtains; no carpets, etc"; their diet was "animal soup every day; animal food three times a week; bread, vegetables, etc" and their luxuries were "tea to the females; tobacco and beer to the industrious males". The highest fees of £350 p.a. gave "a parlour and bed-room, Bath-room, etc., elegantly furnished"; the diet was "a separate table, wine, desert every day; game in season; plate given" and the luxuries were "use of a carriage or horse every day". (ref: 182)
In 1908 Dr CC Easterbrook was appointed Medical Superintendent, a post he was to hold until 1937. At that time the hospital had 851 patients In 1909 it was proposed to convert a house into medical and administrative offices and a research laboratory. The directors instituted three fellowships "to be offered to medical men in order that they may devote themselves to original neurological and psychiatrical research at the Institution". One was appointed in Neurology but no suitable candidate was found for "Pathology and Bacteriology" (although an appointment was made in 1911) or for "Pathology and Chemistry". It is interesting to see that these were areas where it was judged that research would be most fruitful. Had an appointment been made, it would have predated by more than a decade the first appointment of a biochemist to a hospital in the United Kingdom. (Miss Hilda Traught was appointed to study the chemistry of eclampsia at the Dudley Road Hospital in Birmingham in 1921 and, in the same year, Charles R Harington was appointed as the first biochemist in a Scottish Hospital.) (ref: 61)
In 1911, John Cruikshank, from the Glasgow School of Pathology and Bacteriology, was appointed to one of these fellowships becoming the first Pathologist in the Dumfries. He did not take up his appointment until 1913, by which time a well equipped laboratory had been fitted out to his specification. In addition to performing autopsies, the histological and serological examination of tissues and the preparation of vaccines, he commenced research on "the nature of chemical and biochemical investigations of the important lecithin and other lipoid constituents of the nervous tissues of the body and interesting pigments and other allied substances in the blood and urine" It is interesting to speculate whether he found any cases of mental disease due to porphyria in his study of pigments. Two research assistants assisted him in the summer of 1914 in work on nitrates in urine but this was not productive. (ref: 61)
The First World War brought problems with staffing and it was difficult to obtain fine chemicals, previously supplied from Germany. In addition, there was an increase in demand for services as patients from other hospitals were moved to the Crichton to made available beds for the treatment of mentally effected soldiers. However, the laboratory work continued with the establishment of the Lange Colloidal Gold Test on cerebrospinal fluid (CSF) for the diagnosis of different types of syphillis and meningitis.
Research was also performed into the proportion of gray and white matter and the amount of water in the brain of patients who died after having different mental illnesses. (ref: 61)
In 1916, Cruikshank joined the army to run a mobile laboratory attached to the British Expeditionary Forces in France. Professor Thomson from Trinity College, Dublin took charge of the laboratory. He investigated blood urea and creatinine in the context of mental illness. The following year (1917) Thomson was appointed as scientific adviser to the Ministry of Food. Most of the work was suspended until the end of the war; a limited number of tests were performed by the medical staff and the pharmacist. (ref: 61)
Cruikshank returned in 1919 and embarked on a comparison between the Lange Colloidal Gold Test and the Wasserman Reaction on samples of CSF in the diagnosis of mental illness. He was appointed to the new Chair of Bacteriology at Aberdeen University in 1921 and was succeeded by Dr JF Kernochan, who in turn was appointed to the Mayo Clinic in New York in 1922. (ref: 61)
Between 1922 and 1925, there were three different appointments as Pathologist/Clinical Pathologist. During this period the post of assistant was established and Miss W Hood, BSc, the first biochemist in Dumfries and Galloway, was appointed to this post. (ref: 61)
In 1925, Dr E Armstrong, from Belfast, was appointed as the first real Clinical Pathologist. He had a large clinical input to the treatment of general paralysis of the insane with arsenic injections and of diabetes with insulin injections. Along with his new assistant , Miss Stewart, BSc, he developed a method for the measurement of serum calcium. Armstrong was appointed as County Bacteriologist for Dumfries-shire in 1927 and Stewart coped with the routine work until his successor was appointed two years later. (ref: 61)
In 1929, Dr AM Wyllie was appointed. He had published work on "the acid-base balance of the body metabolism in dementia". His interest in biochemistry may not have been wholly academic, as he married the biochemist, Marjorie Hamilton Maxwell who had replaced Miss Stewart. While Wyllie was away studying for the Diploma in Psychiatry, Dr Orchard took over the laboratory, arriving just in time to deal with a rush of specimens from a diphtheria outbreak. (ref: 61)
Crichton Royal - 1930s and 40s
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