GLASGOW

Glasgow - Royal Hospital for Sick Children

Glasgow Biochemists' Club

The John King Award

GLASGOW ROYAL INFIRMARY - 1920s to mid 60s

David P Cuthbertson (later Sir David) was appointed in 1926 at the age of 26 as University Lecturer (at £500 per annum) and Clinical Biochemist (at £100 per annum, rising by two increments of £50 to £200). He had been recommended for the post by Professor EP Cathcart. Cathcart thought that the salary (equivalent to that of his Senior Lecturers) was too high and told Cuthbertson that he must tell the Principal of the University, Sir Donald MacAllister, that it should be reduced. The Principal declined this request.

There had been considerable discussion as to where the laboratory should be located. Dr John Cowan, a Physician to the King and an eminent cardiologist, had been anxious that a biochemist be appointed at the Royal Infirmary and had offered his lecture room. However, Professor Walter Hunter (Chair of Medicine) thought that the location should be neutral and in the building mainly occupied by Pathology, where Professor John Teacher was in charge. Bacteriology had already been established there under the immediate charge of Dr Cruickshank (who later became the Professor of Bacteriology, first in St Marys Hospital in London and later at Edinburgh University). Thus the new laboratory was opened on the first floor opposite Bacteriology - "small, but an adequate beginning". Later Cuthbertson acquired a small room next door which he divided into three parts with a book case and a partition to form a tiny office, a bench for gas analysis and a balance room. This brought the total accommodation to around 400 square feet. Accommodation was later found in the basement for a Kuhlmann balance to allow microanalysis and a Pregl micro-combustion train for calorimetry. Cuthbertson obtained a bomb calorimeter which had been designed and built at Professor Darroch's department of mining at the Royal Technical College, as the existing commercial models tended to leak oxygen after a short period of use. (This was also used to check the calorific value of the hospital's coal supply.) Further accommodation was found in the shape of a shed on the roof where there was a steam bath for large scale evaporations such as were required for faecal assays.

During the first six months in which Cuthbertson had to order and assemble his apparatus and to find and train a technician, he acted as a supplementary outdoor resident for one month in each of the six medical wards. He did all the basal metabolic rate measurements (BMRs) himself, collecting the expired air in Douglas bags and analysing it by Haldane gas analyser. This took two hours at the beginning of most mornings. Prior to the laboratory's opening, all the clinical units did their own blood ureas and glucoses. These assays were later absorbed into the routine analyses of the department (although, even in the mid 1950s, the-out-of hours assay of these analytes were still done by the house officers themselves). ref: 124)

The department was given a small metabolic unit on the main ground floor corridor near the medical unit. It consisted of two side rooms capable of containing five beds, a bathroom and a small kitchenette.

Here Cuthbertson performed balance studies to investigate the metabolism of calcium, phosphate, sulphur and nitrogen following fractures. (Later creatine, creatinine, sodium and potassium were also studied.) From these observations he was able to describe the metabolic response to injury as an essentially catabolic phenomenon which reached its peak five to eight days after injury.

Sidney Lionel Tompsett from the Middlesex Hospital, where he had assisted Professor (later Sir) Charles Dodds prepare insulin, was appointed in 1927. He was an adaptable and original analyst and designed methods for trace analysis. In 1940 he was awarded a DSc based on his contribution to the study of trace metals in health and disease. During World War II he was an army bomb disposal expert, serving in the middle east, with the rank of Captain. He was appointed as Senior Lecturer in Edinburgh in 1949. (ref: 11,21)

Alexander Turnbull was appointed as a technician in Cuthbertson's department ca. 1929. Later he obtained a medical degree and became a radiologist.

Andrew P Kenny was appointed as a technician in 1930.

The head master of his school, Provanside School, came into the classroom and announced that there was a job as junior assistant available in the local hospital biochemistry department. Kenny was proxime accessit (i.e. runner-up) to the dux of the school and had an aptitude for science, maths and art. Although he had a Hutcheson's Trust Bursary, he gave this up to start in biochemistry with a pay of eight shillings and ten pence (£0.44)per week. He took evening classes in the old Glasgow Technical College in Chemistry, Physics and Maths prior to taking his Associateship of the Institute of Chemistry in 1938. Kenny was transferred with DB Colquhoun to join Forbes Robertson at Gartnavel (the Neuro-Psychiatric Research Institute) and then, shortly before taking the A.I.C. exam., he was appointed to the biochemistry department at the Victoria Infirmary where he worked until he retired as head of department in 1980. (Ref 5,11)

In 1931, J Shaw Dunn was appointed to the St Mungo-Notman Chair of Pathology on the death of Professor John Teacher. He was very interested in nephritis and experimented with practically every substance that might possibly be a toxic cause of interstitial nephritis. He personally assayed rabbit urine ureas (by the hypobromite method) in the Biochemistry Department. He discovered that alloxan produced diabetes, not nephritis, in his rabbits. Unfortunately, he was not able to follow up his discovery as fast as the Americans did, once he had published his first paper. He transferred to the University Chair at the Western Infirmary in 1936 and was succeeded by John Williams Stewart Blacklock in 1937. (Ref: 11,96)

David Fyfe Anderson, later Muirhead Professor of Obstetrics and Gynaecology, also worked in the department in the 1930s studying pernicious vomiting of pregnancy and its effects on acid base balance. He and Shaw-Dunn were assisted by Eric G Oastler, who had been appointed as an Assistant Physician at Glasgow Royal Infirmary in 1934. Oastler was a senior physician and endocrinologist in the Royal Infirmary in the post-war years until his retiral in 1967. He died in 1990. (Ref: 108)

In 1933 Peter Paterson, Professor of Surgery, asked Cuthbertson's help with a patient with hypercalcaemia. Some parathyroid tissue was removed but the calcium remained elevated. When a further amount of parathyroid tissue was removed, the calcium levels fell.

Cuthbertson was appointed to the Grieve Lectureship in Pathological Biochemistry at Glasgow University in 1934, as Professor Cathcart thought that he needed more experience in teaching than the hospital post could offer. He held that post until 1945 when he was appointed as Director of the Rowett Research Institute in Aberdeen. On his retiral from the Rowett Institute in 1965, he returned to the Royal Infirmary as an Honorary Senior Research Fellow. He finally retired in 1986 and died in 1989. (ref: 11.49)

Alan Bruce Anderson was appointed as Cuthbertson's successor in 1934.

Anderson was an Australian and graduated in biochemistry from Adelaide University in 1923. After a year's postgraduate study on the recently discovered insulin, he came to study carbohydrate metabolism at the Sir William Dunn School of Biochemistry at Cambridge where he graduated PhD in 1928. He studied medicine at Cambridge and at University College Hospital, London, qualifying in 1931. At Glasgow Royal Infirmary he studied lead poisoning and he published work on tetany, hyperthyroidism and obesity. In 1946 he took up an appointment at St Mary's Hospital, Paddington, and later in the North Middlesex Hospital and then in St Bartholomew's Hospital where he was appointed as Chemical Pathologist in charge of the Pathology Department. He was a founder member of the A.C.B. He retired in 1967 and died in 1985. (ref: 11,117)

In the early 1940s, all the routine biochemistry for the hospital was performed by one (only) very efficient young technician - Ronnie McAllister. McAllister took up an appointment as Senior Technician at the Samaritan Hospital in 1948. By 1948, there were 4 technicians (and a maid) and one, Miss S Malcolm, BSc, was appointed to a Lectureship at the Agriculture College. One of these vacancies was filled by Joe Fitzpatrick, BSc, who was appointed as the first Biochemist in Ayrshire in 1949. (ref: 134b)

James C Eaton, from the Victoria Infirmary, Glasgow, was appointed as Consultant in 1947. Eaton developed an interest in the administrative aspects of the profession and the efficient organisation of hospital biochemistry. He travelled widely throughout Europe and in the U.S.A., visiting hospital laboratories to observe and study their organisation and methods. In Glasgow Royal Infirmary, he applied his medical and chemical experience in the study of patients in the metabolic ward. Important studies were performed on sulphaemoglobin, renal failure, calcium metabolism and the effect of surgical trauma on nitrogen metabolism. (ref: 114)

In 1949, Bruce Woodger was appointed as a Junior Registrar in Pathology. This was a training grade for staff leaving military service - Woodger had graduated in 1946 and been in Army Service in Germany from 1946 to 1949. He worked for a year in Biochemistry, followed by a period in Bacteriology and then Pathology. There was no Haematology Department at that time - Alice Marshall did cross-matching on a foot of bench space in Pathology and all other haematological tests were done in the ward side rooms. Tom Symington, who succeeded George Montgomery as Professor of Pathology in the 1950s, ensured that everyone was interested in endocrinology and Woodger returned frequently after his first year in Biochemistry to assay 17 oxogenic and 17 oxo steroids (which were known as 17 hydroxy and 17 keto steroids at that time). As there were no other postgraduate qualifications relevant to laboratory medicine at that time, Woodger took evening classes in the Royal College of Technology (later to become Anderson College, Strathclyde University) and sat the Associateship of the Institute of Chemistry in 1956. Woodger was seconded to the laboratory at Belvidere Hospital in 1951 and to Strathclyde Hospital, Motherwell, Lanarkshire, in 1952. Woodger returned to Glasgow Royal Infirmary Ca. 1954 and was appointed as Consultant Pathologist in Hairmyres Hospital, East Kilbride, Lanarkshire, in 1956.

William Good was a biochemist in the department in the late 1940s. He was appointed in 1951 as Assistant Lecturer at Glasgow Western Infirmary with teaching duties in both the Department of Biochemistry and of Pathological Biochemistry. He left there to take up an industrial appointment in 1954. (ref: 27,85,134b)

The accommodation of Eaton's department in 1947 was virtually unchanged from Cuthbertson's original rooms from the 1920s and remained so until 1951. (EB Hendry, Consultant Biochemist at Glasgow Western Infirmary (1951 to 73), who had been invited to apply for the post, dismissed them as "two small rooms overlooking the necropolis".) By 1951, electrical equipment was common and the single DC electricity plug had several adapters and was "festooned all around with wires". However, when the laboratory caught fire on 21st August 1951, it was the result of an ether spillage and not because of the overloading of the electrical supply (which had been often predicted). Temporary accommodation was provided in the Department of Medicine until space was made available in a row of converted shops in Castle Street in April 1952. During the 50s and 60s the department took over more and more of the row of shops on either side of the archway, including a post office and a bank. (Eaton had his office in the former Bank Manager's Office.) During the various stages of renovations, the department was a bit draughty but it was only considered chilly when the glacial acetic acid froze in the bottles (ca. 16 degrees Celsius). The accommodation north of the arch was used as the Emergency Laboratory. Staff found it eerie working there at night, particularly with the local drunks hammering on the door trying to get in. After several hours in that part of the department, especially in the winter when the heating was on full, staff found that they suffered headaches - it has been suggested that the globules of mercury (from the Van Slyke apparatus) which could be seen in the cracks in the floor boards may have been responsible for this. (ref: 11,111)

Margaret Hartley was appointed as a technician in 1950 and as "a chemist" in 1951, when she moved to set up a small associated laboratory in the Eastern District (Duke Street) Hospital which she ran until 1958 or 59. Hartley later worked in the laboratory at Killearn Hospital and moved with that department to Gartnavel General Hospital in the mid-1970s. (ref: 11,134b)

Mary Gardner was appointed to the department in June 1951. At that time, the staff comprised Eaton, Gardner, a senior technician, three other technicians and Isa Coltart (1951 to 1969 or 70) who was the glassware washer and the brewer of "formidable tea". The work load was around 9,500 tests per annum including 400 electrolytes, 1000 proteins and 4 pHs. When Gardner retired in 1988 this work load was being completed during the first morning of the year. Gardner died in 2016. (ref: 11,134b)

In 1952 James C Eaton was a member of a four man delegation from Scotland who attended the meeting at Market Drayton on 24th May which led to the formation of the Association of Clinical Biochemists in 1953. (Ian A Anderson, Victoria Infirmary, Maurice Jowett, Western Infirmary and J Wilson Chambers, Stobhill General Hospital, were the others. Eaton, Jowett and CP Stewart, from Edinburgh, were members of the interim committee which was set up at Market Drayton and Eaton was a member of A.C.B. Council from 1953 to 1955 and of the Scotland and Northern Ireland Regional Committee from 1953 to 1956.)

A Glasgow Area Hospital Biochemists' Club had been formed on the 4th October 1949 and this was the first such group to be formed in the U.K. (When it visited one of the Edinburgh Hospitals, a carriage was reserved on the train for, according to the notice on its window, "the Comical Chemists".) In June 1952 Eaton and colleagues helped organise a Royal Institute of Chemistry training course; a fore-runner of the A.C.B. Training Courses. Eaton also attended the inaugural meeting of the A.C.B. at the Hammersmith Hospital on 28th March 1953. (Ref: 3,11,16,27,68)

Adam Fleck worked as a locum technician during the summer of 1951 and as a locum biochemist during the summer of 1952. (He was appointed as Consultant in the department from 1966 to 1974 and later, in 1979, as Professor of Chemical Pathology at Charing Cross and Westminster Medical School, London.) At that time, urea estimations (about 30 per day) were by urease-Nesslerisation, blood sugar by Hagendorn-Jensen (a titrimetric method), sodium and potassium by an EEL flame photometer which was manually fed and which required recalibration every second or third measurement and carbon dioxide was expressed as alkali reserve and measured using the Van Slyke volumetric apparatus. Using this apparatus involved raising and lowering a flask filled with about a kilogram of mercury twice per assay and Fleck recalled achieving an all time high result for plasma bicarbonate on the first occasion he was entrusted with it. The only UV-visible spectrophotometer was subject to electrical interference, reputedly from the diathermy equipment the physiotherapists used on the floor above the laboratory. The general working conditions were such that the whole department knew when the feto-steroids were being assayed because of the smell of the initial hydrolysis step which involved boiling the urines with hydrochloric acid. (Ref: 63, 107)

In 1954 Bill ST Thomson was appointed as Principal Biochemist and in 1957 as Senior House Medical Officer (Biochemistry). Thomson had graduated MB ChB in 1945 and, after serving as a Flight Lieutenant in the RAF Medical Service in Agra and Karachi from 1945 to 1948, he graduated BSc Honours Biochemistry (1951) at Glasgow University. He was awarded a Hansen Research fellowship and presented his thesis on the topic "The influence of dietary carbohydrate on the course of protein metabolism" for PhD (1954) at Glasgow University. This laid the basis for his life-long interest in Diabetes Mellitus. During the summer of 1958 he visited hospitals in Canada and the USA and, in Toronto General Hospital, he saw a Technicon AutoAnalyzer for the first time. Slides were shown at an A.C.B. Meeting back in Glasgow. In 1963, he married June Robertson who was an honours graduate member of the scientific staff at Glasgow Royal Infirmary. Thomson was appointed as Consultant Biochemist at the Glasgow Southern General Hospital in 1961 where he worked until his retiral in 1985. (Ref: 94, 191)

Alison J Dinwoodie was appointed in 1954 and studied for a PhD under Eaton and Arthur Jacobs, the Urological Surgeon. She had a grant (£365 per annum - "and I felt rich") from the Scottish Hospitals Endowment Research Trust to investigate "electrolyte disturbances in some urological conditions". This involved manual precipitation methods for sodium and potassium and 10 specimens a day was considered fairly slick work. She undertook an evaluation of the EEL flame photometer which, despite the need for manual dilution of the standards and specimens, was unbelievably quick and easy. Later, Dinwoodie undertook the assay of 17 oxogenic and 17 oxo steroids (which were known as 17 hydroxy and 17 keto steroids in those days). In addition she undertook an FSH assay which involved the addition of four litres of alcohol to each litre of urine in the preparation of an extract which was injected into mice in a bioassay. The weight of the ovaries provided the end point of the assay. She was appointed to the Western Infirmary, Glasgow, in 1968 and retired in 1994. (Ref: 111)

Campbell Scotland, who had been the Senior Technician at Glasgow Southern General Hospital, was appointed as Chief Technician in 1956. He was the Principal M.L.S.O. in the department when he died in 1988.

John (Ian) Leggate was appointed as technician in 1959. Previously he had been a technician in the Royal Maternity Hospital, Rottenrow, Glasgow (from 1951 to 57) and had worked for two years making polio vaccine for Pfizer Ltd. (1957 to 59). He left in 1960 to study for BSc at Glasgow University. He graduated in 1964 and then studied under Harry Holms, graduating PhD in 1967. Later he was appointed as Top Grade Biochemist at Hawkhead Hospital in Paisley from 1975 to 77. After a period in Kuwait, he was appointed as Top Grade Biochemist at Stobhill General Hospital, Glasgow in 1979 and he retired in 1991. He died in 2015. (ref: 35)

Andrew Brown (ex-RAF) was a chief technician in the 1950s and 60s and Alison Dinwoodie recalls his bringing a Geiger counter into the laboratory on one occasion (this was before the department started to use radio isotopes). The staff were surprised to find that, when James Eaton picked up the counter, it registered full-scale deflection - apparently a legacy from Eaton's early work preparing radon needles for radiotherapy in the 1920s. (Eaton died of cancer just before he was due to retire in 1966.) (ref: 111)

Maureen Childs was appointed in the 1950s. She was a Senior Biochemist at Stobhill Hospital in the late 1950s. As Mrs Tennant, she worked at the Glasgow Southern General until 1965. She died tragically in a car accident in 1974. In the 1950s Glasgow's favourite headache powder contained phenacetin which, especially when taken in combination with Andrew's Liver Salts (Magnesium sulphate), gave rise to a high incidence of methaemoglobinaemia. This made the patients breathless in addition to having a headache and led to a doubling of the dose. Blood specimens were screened using a hand spectroscope and Childs was involved in making haemoglobin derivatives in this context. As the production of sulphaemoglobin involved the use of hydrogen sulphide gas, she was banished to a half ruined shack in the courtyard. A paper on this work was presented at the 9th National Meeting of the ACB in Glasgow in 1956. (ref: 111)

Arthur Mollison worked for a year or so in the department after working in Aberdeen and prior to his appointment as Consultant at Hawkhead Hospital in Paisley in 1963. (ref: 78)

While Adam Fleck was a resident in the Royal Infirmary (1959-60) open heart surgery, using cardiopulmonary by-pass, was introduced by Professor WA Mackey and haemodialysis was introduced by Dr AC Kennedy. Prior to this, Bill Thomson had accompanied a patient, who had renal shut down following an abortion, in an ambulance on an overnight transfer (via icy roads) to Leeds for dialysis. Dr Frank Parsons was in charge of a Kolff revolving drum artificial kidney machine which was similar to the one eventually installed in the Royal. The department monitored the composition of the bath dialysate fluid and the patients' electrolytes etc. during dialysis, as the Renal Unit staff became more familiar with the equipment. Large volumes of blood were submitted to the laboratory from these patients for the determination of blood pH. (ref: 63, 94,107,111)

The departments first Technicon AutoAnalyzer was purchased in 1959 and its second in 1961. In 1963 Eaton and GH Lathe from Leeds published a paper in the Lancet expressing concern about the rate of growth of the work load which had increased ten-fold in Glasgow in the ten year period from 1952 to 62 (and ten-fold in Leeds over the fifteen year period from 1947 to 1962). With the advent of the flame photometer for the Technicon analyser (in 1962), it was considered that a daily load of relatively complete electrolyte assays on 100 serum samples could be undertaken by two people. This number could be doubled provided the laboratories were provided with "staff capable of operating the equipment, a large capital outlay (£4000) for automated equipment and provisions for reception and documentation of specimens". In the early 1960s the Biochemistry Department set up an autoanalyser in an operating theatre to provide continuous blood glucose measurements for a patient with an insulinoma and also in a ward to measure ureas in patients on renal dialysis. (ref: 20)

The department moved into further temporary accommodation in McLeod Street in 1964 where it stayed for the next 13 years. The West of Scotland Regional Steroid Laboratory, which had been established under Jim K Grant on the top floor of the new Pathology Block, moved into the vacated premises in Castle Street. James C Eaton continued to cope with the ever increasing workload with minimal equipment and appalling accommodation until his untimely death, just before he was due to retire, in 1966. (ref: 11, 148)

During the 1950s Eaton had four beds in ward 44 where he carried out various metabolic studies. This was closed ca. 1960 and replaced by a new unit in the Out Patient Department consisting of 2 single beds and a double room. The metabolic studies performed included metabolic bone disease and disorders of potassium metabolism and of intestinal absorption. The work continued there with a very high rate of bed occupancy until 1966 when, after Eaton's death, the beds were taken over by the Cardiac Surgery Department. (ref: 11, 148)

Anne Duncan (later Chambers) from Dundee Royal Infirmary was appointed in 1964.

Robert W Logan, from the Glasgow Victoria Infirmary, was appointed as Senior Lecturer in 1964. He supervised the four-bedded metabolic investigation unit until 1965 when he took up an appointment as Consultant Biochemist at Dumfries Royal Infirmary. He was appointed as Senior Lecturer and Honorary Consultant Biochemist in charge of the department at the Glasgow Hospital for Sick Children in 1967. (ref: 82)

Sir David P Cuthbertson returned as Honorary Senior Research Fellow and Honorary Consultant following his retiral as Director of the Rowett Research Institute in 1965. He continued to study the metabolic response to injury and showed the importance of nutritional support. The European Society of Parenteral and Enteral Nutrition founded a "Sir David Cuthbertson Lectureship" in 1979 and elected Sir David as an honorary member in 1981. He was elected an honorary member of the Association of Clinical Biochemists in 1986. Following his second retirement in 1986, a plaque was unveiled at the Royal Infirmary, alongside those of Dr MacIntyre, who set up the first Radiology Department in Britain, Lord Lister and Sir William MacEwan, to commemorate his work, in January 1987. He wrote over 400 publications altogether, 59 during his "retirement". He died, aged 88, in 1989. (ref: 53,54,109)

Frances Neilson (later Dryburgh) was appointed as Registrar in 1965, Senior Registrar in 1966. Following a career break in the early 1970s, she returned to the department and was appointed as Consultant, with additional responsibilities for the Royal Maternity Hospital laboratory, in 1981 and she retired in 2000. (ref: 97)

Adam Fleck was appointed as Consultant in 1966 and, subsequently as Honorary Lecturer in Pathological Biochemistry, having previously been a Lecturer in Biochemistry in Davidson's Department at Glasgow University and Senior Registrar in the Glasgow Victoria Infirmary from 1965 to 1966. He was appointed as Senior Lecturer and Honorary Consultant at the Glasgow Western Infirmary in 1974. (ref: 63)

Glasgow - Royal Infirmary - mid 1960s to present

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Last updated February 2016