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The Case of Monoclonal Antibodies ______ WELLCOME WITNESSES TO TWENTIETH CENTURY MEDICINE _______________________________________________________________ TECHNOLOGY TRANSFER IN BRITAIN: THE CASE OF MONOCLONAL ANTIBODIES ______________________________________________ SELF AND NON-SELF: A HISTORY OF AUTOIMMUNITY ______________________ ENDOGENOUS OPIATES _____________________________________ THE COMMITTEE ON SAFETY OF DRUGS __________________________________ WITNESS SEMINAR TRANSCRIPTS EDITED BY: E M TANSEY P P CATTERALL D A CHRISTIE S V WILLHOFT L A REYNOLDS Volume One – April 1997 ©The Trustee of the Wellcome Trust, London, 1997 First published by the Wellcome Trust, 1997 Occasional Publication no. 4, 1997 The Wellcome Trust is a registered charity, no. 210183. ISBN 978 186983 579 8 Please cite as : Tansey E M, Catterall P P, Christie D A, Willhoft S V, Reynolds L A. (eds) (1997) Wellcome Witnesses to Twentieth Century Medicine, vol. 1. London: The Wellcome Trust. Key Front cover photographs, L to R: Monoclonal Antibodies: Dr Georges Köhler (1946–95), Sir Christopher Booth, Dr César Milstein (1927–2002) Endogenous Opiates: Dr Derek Smyth Endogenous Opiates: Professor John Hughes Back cover photographs, L to R: Self and Non-Self: Professor Peter Campbell, Professor Richard Batchelor, Sir Christopher Booth Committee on Safety of Drugs: Dr Tilli Tansey, Dr Stephen Lock, Mr Wilfred Turner, Professor Owen Wade (1921–2008) Committee on Safety of Drugs: Dr Josephine Weatherall, Professor Miles Weatherall, Professor David Finney Self and Non-Self: Professor Deborah Doniach (1912–2004), Professor Ivan Roitt Endogenous Opiates: Professor Lesley Rees, Professor Howard Morris CONTENTS WHAT IS A WITNESS SEMINAR? i E M TANSEY TECHNOLOGY TRANSFER IN BRITAIN: THE CASE OF MONOCLONAL ANTIBODIES EDITORS: E M TANSEY AND P P CATTERALL TRANSCRIPT 1 INDEX 33 SELF AND NON-SELF: A HISTORY OF AUTOIMMUNITY EDITORS: E M TANSEY, S V WILLHOFT AND D A CHRISTIE TRANSCRIPT 35 INDEX 65 ENDOGENOUS OPIATES EDITORS: E M TANSEY AND D A CHRISTIE TRANSCRIPT 67 INDEX 100 THE COMMITTEE ON SAFETY OF DRUGS EDITORS: E M TANSEY AND L A REYNOLDS TRANSCRIPT 103 INDEX 133 WHAT IS A WITNESS SEMINAR? Advances in medical science and medical practice throughout the twentieth century, and especially after the Second World War, have proceeded at such a pace, and with such an intensity, that they provide new and genuine challenges to historians. Scientists and clinicians themselves frequently bemoan the rate at which published material proliferates in their disciplines, and the near impossibility of ‘keeping up with the literature’. Pity, then, the poor historian, trying to make sense of this mass of published data, scouring archives for unpublished accounts and illuminating details, and attempting throughout to comprehend, contextualize, reconstruct and convey to others the stories of the recent past and their significance. The extensive published record of modern medicine and medical science raises particular problems for historians: it is often presented in a piecemeal but formal fashion, sometimes seemingly designed to conceal rather than reveal the processes by which scientific medicine is conducted. As Sir Peter Medawar suggested, in his famous article, ‘Is the scientific paper a fraud’, much scientific literature ‘misrepresents the processes of thought that accompanied or gave rise to the work that is described ...’,1 not deliberately intended to deceive, but structured and arranged in a rigid format that allows for little individual expression or amplification. Recourse to unpublished archives for elucidation can introduce additional difficulties. Official archives may have limitations on access: in the UK public records are subject to a restriction that keeps papers hidden for at least 30 years. Equally, specialist archives can present problems: the survival of personal papers can be erratic, many are lost during the lifetime of an individual, as space constraints or relocation demand the jettisoning of material without proper regard for its significance. Probably even more papers are wrongly discarded as worthless and uninteresting by their owners, or by relatives acting immediately after a bereavement.2 Thus historians of contemporary medicine and science are increasingly turning, or returning, to the traditional technique of oral history to supplement, or extend, existing records, and to create new resources.3 Recognizing that many of the principal sources of contemporary medical history are still walking around, although on increasingly elderly and fragile legs, they are attempting to hear, and record, their accounts. A particularly specialized form of oral history is the Witness Seminar, where several people associated with a particular set of circumstances or events are invited to meet together to discuss, debate, and even disagree about their reminiscences. Originally developed by the Institute of Contemporary British History (ICBH), this format attracted the attention of the History of Twentieth 1 Medawar P. (1990) Is the scientific paper a fraud? In Pyke D. (ed.), The Threat and the Glory: Reflections on Science and Scientists. Oxford: Oxford University Press, 228–233. 2 See Booth C C, Sheppard J G, Tansey E M. (1990) Archives of contemporary medicine and science. British Medical Journal 301: 1408. 3 See Tansey E M. (1995) Telling it like it was. New Scientist 148(2008): 49. i What is a Witness Seminar? Century Medicine Group, which was inaugurated by the Wellcome Trust in 1990, to bring together clinicians, scientists, historians and others interested in contemporary medical history. An initial experiment was to organize a meeting with the ICBH on the subject of ‘Monoclonal Antibodies’, which was held in September 1993. The response from those taking part or attending that meeting, and subsequent requests for the transcript, convinced the Steering Committee of the History of Twentieth Century Medicine Group that this forum should be developed. During the following summer a meeting on ‘Renal Transplantation’ was organized, and in the academic year 1994–1995 a number of smaller ‘mini’ Witness Seminars were included as part of the routine programme of the group. Since then Witness Seminars have become a regular feature of the Group’s activities, and subjects are usually proposed by, or through, members of the Steering Committee of the Group. From 1990–1995 this comprised Sir Christopher Booth (Chair), Dr Tilli Tansey (Secretary), Professor Bill Bynum and Dr Stephen Lock. They were joined in 1995 by Dr Lara Marks and Professor Tom Treasure, and in the following year by Dr David Gordon. Meetings already held or planned for the current academic year are listed opposite. Once a suitable subject has been agreed, we try to identify and invite participants, and to plan, in conjunction with the meeting’s chairman, a flexible outline plan for the progress of the meeting. Occasionally we have had to abandon or postpone meetings at this stage if key people are unable to attend. This is a constant problem when many we invite are elderly. Similarly, some meetings can be disrupted at the last minute by accidents or ill-health: sadly the late Professor Charles Fletcher suffered a bad and incapacitating fall just days before he was due to join Dr Philip D’Arcy Hart as one of the two principal witnesses at the ‘Pneumoconiosis’ meeting. Invitations inevitably lead to further contacts, further suggestions of people to invite, and we rely heavily on such recommendations. As the organization of the meeting progresses, we ask some participants to be principal witnesses; to speak for a short period of time to initiate and stimulate further discussion. Again, these arrangements differ from meeting to meeting, although all speakers are asked not to prepare formal presentations or to show slides, as these disrupt informal interchange. Thus by the time each meeting is held, it has already developed its own particular shape determined by the participants. For example, no one could dispute that ‘Endogenous Opiates’ would undoubtedly have been a different kind of seminar, not necessarily better or worse but different, if Hans Kosterlitz had been able to attend; or that ‘Monoclonal Antibodies’ would have been markedly different if the National Research Development Corporation had sent a representative who had been personally involved with the patenting issues that were raised. As each meeting proceeds it also develops its own kinetics, largely dependent on the personalities of the chairman and the participants, and the relationships among those taking part. No two meetings have ever been the same. Each meeting is fully recorded, and the tapes are transcribed. The Steering Committee then decides whether the transcript should be edited for publication. This decision is informed by two main factors – the overall coherence of the meeting, and whether the transcript will contribute new material to the published ii What is a Witness Seminar? History of Twentieth Century Medicine Witness Seminars, 1993–1997 1993 Monoclonal antibodies Organizers: Dr E M Tansey and Dr Peter Catterall 1994 The early history of renal transplantation Organizer: Dr Stephen Lock Pneumoconiosis of coal workers Organizer: Dr E M Tansey 1995 Self and non-self: a history of autoimmunity Organizers: Sir Christopher Booth and Dr E M Tansey Ashes to ashes: the history of smoking and health Organizers: Dr Stephen Lock and Dr E M Tansey Oral contraceptives Organizers: Dr Lara Marks and Dr E M Tansey Endogenous opiates Organizer: Dr E M Tansey 1996 Committee on Safety
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