Maryfield Hospital - Combined Department
Initially the Biochemistry Laboratory was in the University Department of Pathology (under Professor Alan C Lendrum). A Lecturer in Pathology (in rotation) was in charge and the other staff member was Margery Patrick, a science graduate on the university staff. On the 2nd May 1946 a note, signed by GH Smith and GR Tudhope from the department of Pathology, Clinical Biochemistry, was circulated and it read:-
It is requested that the undermentioned arrangements be noted and observed in order that the routine work of the department may not be overtaken during the present shortage of technical assistance.Blood Urea(ref: 62)This estimation will be carried out twice weekly. Samples should reach the laboratory before 11 am on the days stated.Blood Sugar
THURSDAYSThis estimation will be carried out three times weekly. Samples should reach the laboratory before 11 am on the days stated.All Other Chemical Estimations
By arrangement with the laboratory.
N.B. Specimens requiring to be examined urgently will be received as heretofore.
H Gemmell Morgan was born into a well-known east coast medical family, (his father, Dr J M Morgan, was Senior Physician to the Royal Infirmary in Dundee) and was educated at Dundee High School and Merchison Castle School. and the University of St Andrews where he graduated BSc in 1943 and MB ChB (with commendation) in 1946. He became MRCP Ed in 1952 and FRCP Ed in 1962.
He was appointed to the Department of Pathology in 1948 as Assistant and then as Lecturer (1949) and Senior Lecturer (1958) and Consultant (1960).In 1941, while he was 18 and a first-year medical student, he got a rare muscle cancer, a desmosarcoma the size of a fist, in his thigh: the standard treatment would have meant hindquarter amputation, so he chose the experimental radiotherapy, for which he had to commute to Edinburgh. The first two courses of treatment were followed by relapse, but the third was successful. After house jobs in Dundee, Morgan had short spells in Paediatrics in Kent and General Practice in the Carse of Gowrie, Perthshire. His intentions had been to train for a Chair in Medicine and spent much time in the wards "linking the laboratory with real life and its excitements". Finding that the study of structural alterations (morbid anatomy) had limitations, he developed clinical chemistry almost as a hobby. He took charge of the Clinical Chemistry Department from 1952 until he moved to Glasgow in 1965. At that time, the department comprised two rooms (25 sq. metres) and a desk in a corridor served as an office. The equipment included: Lovibond Comparitor (for urea, alkaline phosphatase, protein & phosphate) and a spekker which was so sensitive to vibrations that it could only be used in the evenings. The methods included: manual carbon dioxide (pre-Van Slyke), Hagedorn & Jensen ferricyanide titration for sugars, Schales & Schales titration for chloride, permanganate titration for calcium and a urease method for urine urea. The workload was around 2,000 assays per annum. In addition to Morgan, there was one biochemist and one technician. (ref: 148, 185, 187)
Throughout his period in the department, Morgan spent two hours a day in the wards and he held a metabolic clinic. He frequently saw the patient, took the blood specimen, did the assay(s) and returned to discuss the results with the clinician at the bed-side.(ref: 148, 185)
Morgan introduced clinical biochemistry - a series of 10 lectures and 10 practical sessions - into the Final Year Medical Course in 1953. The practical sessions included urine examination and microscopy and assays for urea and sugar. When sodium and potassium by flame photometry became available, blood specimens from the students were assayed and the results plotted on the black board to give an understanding of normal ranges. Repeating this exercise some months later also gave the students an insight into intra-individual variation. (ref: 107, 148)
Morgan's research interests arose from the exploration of practical problems. His first flame photometer was obtained on a research grant to study sodium metabolism. With this instrument, electrolytes became available on a same day basis and much effort was put into finding out what the results meant. Prior to this, sodium was measured by a laborious titration method and was thought to be only useful in the diagnosis of Addison's Disease. Now the need was to make certain that "Addison's" wasn't being diagnosed everytime a low sodium was found. (ref: 148)
Morgan also investigated paraproteins and this led to the wider concepts of protein metabolism. He developed an interest in metabolic balance studies, using methods learned under (Sir) David Cuthbertson in the Rowett Research Institute in Aberdeen, to help elucidate unexplained hypercalcaemia in infants. This was proved to be due to excessive amounts of vitamin D2 which was being added (under Government advice) to milk powder, cereals and even cod liver oil. The doses had been calculated based on work done with chickens - unfortunately, children were substantially more sensitive to the vitamin. Gemmell rushed his findings to The Lancet and the vitamin D2 fortification programme was discontinued. Gemmell included in his lectures on this topic the observation that the fortified milk powder was not withdrawn from use, but that stocks were allowed to be "used up". (ref: 107, 185, 186)
In 1956, he was awarded a Fulbright Fellowship and went to the John Hopkins, Baltimore, Maryland, U.S.A. to study under John Eager Howard. He returned in 1957 and, in his "spare time", built the biochemistry service from one room with two people to a Regional Service which encompassed enzymes, blood gases, co-operation in cardiac surgery and post-operative care and an improved teaching course. He was appointed to the Royal Hospital for Sick Children in Glasgow in 1963 where, in 1965, he was appointed to the Chair of Pathological Biochemistry. He moved to Glasgow Royal Infirmary in 1966 from whence he retired in 1988. He died in 2006. (ref: 107, 185)Katherine M MacKay (1951 - 56) from the Western Infirmary in Glasgow was appointed as the first NHS Biochemist. MacKay was concerned with the chromatography of amino acids, largely from paediatric patients. When two patients, siblings, were found to have phenylketonuria, it was noted that, on the statistics available, this was the number predicted to be found in the population served. Naturally, the thought occurred that the test could be stopped! The chromatography, prior to the acquisition of Ivor Smith's Universal Apparatus, was done on full size 18 x 22 inch sheets of Whatman paper. The tank was a huge wooden box coated with layers of paraffin wax. This had been custom built in the Department of Physiology (whose Head of Department was Professor George H Bell, co-author with Professor J Norman Davidson and Scarbrough of "A Textbook of Physiology and Biochemistry" popularly known as "BDS") and was kindly donated, along with much helpful advice, by Joan Perry.Margaret Brown, a member of Dr RP Cook's University Department of Biochemistry, also helped with interpretation in the early stages. The method involved vast quantities of phenol and had to be carried out in the basement where the chromatographs were hung up to dry in the boiler room. In 1956, MacKay went to Beverley in Yorkshire and in 1960 she moved to Ayrshire where she later became Principal Biochemist. (ref: 60)M Rae Haslock succeeded Margery Patrick in 1951 and moved to Stoke-on-Trent in 1961. (ref: 59,60)Lorna Constable was listed as a member of the ACB in 1959.Annabelle Fitton (later Hayward) was appointed in 1961 and moved to Kent in 1966. She worked at the Middlesex Hospital, London (1972-74) before taking up an appointment at the Kent and Sussex Hospital, Tunbridge Wells. (ref: 59)Anne M Duncan (later Chambers) joined the department in 1960 and moved to Glasgow Royal Infirmary in 1964.
As in other departments, the 1960s was a period of great expansion for the laboratory in D.R.I. It did work for the King's Cross Infectious Diseases Hospital but did not receive specimens from other hospitals nor from general practitioners at that time. The technicians were mostly school leavers and, as there were no senior technicians, the biochemists were involved in their training as well as in working up new methods and doing the more specialised assays such as copper (in liver tissue), muscle enzymes and chromatographic assays. When the hospital started open heart surgery for heart defects, the laboratory provided numerous blood gas analyses at all hours of the day and night.
The department had shared a room with Haematology until it moved into an extension built on the roof. Access to the first phase of this extension was provided, for some time, by a ladder until the stairs were built. There was space for sun bathing in the summer lunch times - this space was soon needed for a further extension, opened ca. 1966. (ref: 59,60)
John Robson, Assistant Lecturer, was appointed as Lecturer and took charge of the laboratory in 1963, when Morgan moved to Glasgow. When Fred Mitchell left the laboratory at Maryfield Hospital in 1964, Robson was appointed as Principal Biochemist there and, by retaining his position as Lecturer at the Royal Infirmary, he became head of both departments until Griffiths was appointed in 1966. About two months after Griffiths took up his appointment, Robson was appointed as Consultant in Stirling (1966 - 71), in Glasgow Western Infirmary/Gartnavel General Hospital (1970 - 75) and Glasgow Royal Infirmary (1975 - 79). He then moved to Perth, Australia in 1979. (ref: 59)
Among the other staff who worked at D.R.I. in the early 1960s were Aileen Cameron, Vi Grieve who had worked in the local Jute Laboratory and whose father and brother were lost in the Broughty Ferry life boat disaster ca. 1959, Margaret McCathie (later Gibb) who was appointed ca. 1962 and who retired from Ninewells Hospital in 1987. (ref: 59)
Dundee Royal Infirmary (D.R.I.) DEPARTMENT OF SURGERY - 1960 - 67
Dundee Royal Infirmary (D.R.I.) 1960s and 70s
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(Last up-dated January 2011)