WELLCOME WITNESSES TO TWENTIETH CENTURY MEDICINE _____________________________________________________________________________ MAKING THE HUMAN BODY TRANSPARENT: THE IMPACT OF NUCLEAR MAGNETIC RESONANCE AND MAGNETIC RESONANCE IMAGING _________________________________________________ RESEARCH IN GENERAL PRACTICE __________________________________ DRUGS IN PSYCHIATRIC PRACTICE ______________________ THE MRC COMMON COLD UNIT ____________________________________ WITNESS SEMINAR TRANSCRIPTS EDITED BY: E M TANSEY D A CHRISTIE L A REYNOLDS Volume Two – September 1998 ©The Trustee of the Wellcome Trust, London, 1998 First published by the Wellcome Trust, 1998 Occasional Publication no. 6, 1998 The Wellcome Trust is a registered charity, no. 210183. ISBN 978 186983 539 1 All volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/ Please cite as : Tansey E M, Christie D A, Reynolds L A. (eds) (1998) Wellcome Witnesses to Twentieth Century Medicine, vol. 2. London: Wellcome Trust. Key Front cover photographs, L to R from the top: Professor Sir Godfrey Hounsfield, speaking (NMR) Professor Robert Steiner, Professor Sir Martin Wood, Professor Sir Rex Richards (NMR) Dr Alan Broadhurst, Dr David Healy (Psy) Dr James Lovelock, Mrs Betty Porterfield (CCU) Professor Alec Jenner (Psy) Professor David Hannay (GPs) Dr Donna Chaproniere (CCU) Professor Merton Sandler (Psy) Professor George Radda (NMR) Mr Keith (Tom) Thompson (CCU) Back cover photographs, L to R, from the top: Professor Hannah Steinberg, Professor Gerald Curzon (Psy) Dr Tom Flewett, Dr James Lovelock, Dr John Beale (CCU) Professor Sir Peter Mansfield (NMR) row 1: Dr Lise Wilkinson, Dr Ita Askonas; row 2: Professor Miles Weatherall, Dr John Beale (CCU) Dr John Horder, Dr Ian Tait (GPs) Dr James Porterfield, Dr Owen Lidwell, Sir Christopher Booth (CCU) Key to meetings: NMR Nuclear Magnetic Resonance and Magnetic Resonance Imaging GPs Research in General Practice Psy Drugs in Psychiatric Practice CCU MRC Common Cold Unit CONTENTS WITNESS SEMINARS IN THE HISTORY OF TWENTIETH CENTURY MEDICINE E M TANSEY i MAKING THE HUMAN BODY TRANSPARENT: THE IMPACT OF NUCLEAR MAGNETIC RESONANCE AND MAGNETIC RESONANCE IMAGING EDITORS : D A CHRISTIE AND E M TANSEY TRANSCRIPT 1 GLOSSARY 72 RESEARCH IN GENERAL PRACTICE EDITORS : L A REYNOLDS AND E M TANSEY TRANSCRIPT 75 DRUGS IN PSYCHIATRIC PRACTICE EDITORS: E M TANSEY AND D A CHRISTIE TRANSCRIPT 133 GLOSSARY 205 THE MRC COMMON COLD UNIT EDITORS: E M TANSEY AND L A REYNOLDS TRANSCRIPT 209 GLOSSARY 267 INDEX 269 WITNESS SEMINARS IN THE HISTORY OF TWENTIETH CENTURY MEDICINE The past In 1990 the Wellcome Trust’s History of Twentieth Century Medicine Group was established to develop and strengthen links between the biomedical research community and medical historians, and to promote and facilitate the study of twentieth century medical history. Overseen by a Steering Committee,1 the group has endeavoured to satisfy these requirements by initiating a series of seminars and symposia, running an international Summer School meeting, and producing a regular Newsletter.2 Throughout, we have attempted to bring members of these different communities together, to emphasise the potentials of working jointly, and to encourage the creation and deposit of archival sources for present and future use. A particularly effective way, we believe, to meet many of our objectives, has been the development of a programme of Witness Seminars, meetings to which individuals associated with a particular set of circumstances or events are invited, to discuss, debate, agree or disagree about their reminiscences. This format came to our attention in 1993, when we learned that the Institute of Contemporary British History used such meetings to address issues of recent political history, and by way of an experiment we organized a meeting on the subject of Monoclonal Antibodies. Encouraged by the positive responses to that seminar, and to the publication of a detailed report and the transcript,3 we repeated the experiment with a meeting on Renal Transplantation. We subsequently decided to develop such meetings to explore, in particular, aspects of late twentieth century biomedical science, and during the academic year 1994-95 a number of shorter (two hours long) seminars were held, each focusing on a narrowly defined topic. A further meeting, Ashes to Ashes was integrated into a two-day symposium on the history of smoking and health.4 All or parts of most meetings have been published (the exceptions being Renal transplantation and Oral contraceptives), as shown below. From 1996 onwards, meetings were routinely arranged as full afternoon seminars, and it is the transcripts of four of these that are presented in the present Volume. A further five, held from 1997 to 1998 and also listed below, are currently being transcribed and edited. 1 Between 1996 and 1998 the Steering Committee comprised Dr Tilli Tansey (Chairman and Organizing Secretary), Sir Christopher Booth, Dr David Gordon, Dr Stephen Lock, Dr Lara Marks, Professor Vivian Nutton and Professor Tom Treasure. 2 For further details of the Group’s activities, and to receive the Newsletter, please contact Mrs Wendy Kutner at the Wellcome Institute for the History of Medicine, London. 3 Tansey E M, Catterall P. (1994) Monoclonal antibodies: A witness seminar in contemporary medical history. Medical History 38: 322–327; idem (eds) (1995) Technology transfer in Britain: the case of monoclonal antibodies. Contemporary Record 9: 409–444. 4 Lock S P, Reynolds L A, Tansey E M. (eds) (1998) Ashes to Ashes – The history of smoking and health. London: Wellcome Trust, 198-220. i History of Twentieth Century Medicine Witness Seminars, 1993–1998 1993 Monoclonal antibodies6 Organizers: Dr E M Tansey and Dr Peter Catterall 1994 The early history of renal transplantation Organizer: Dr Stephen Lock Pneumoconiosis of coal workers5 Organizer: Dr E M Tansey 1995 Self and non-self: a history of autoimmunity6 Organizers: Sir Christopher Booth and Dr E M Tansey Ashes to ashes: the history of smoking and health4 Organizers: Dr Stephen Lock and Dr E M Tansey Oral contraceptives Organizers: Dr Lara Marks and Dr E M Tansey Endogenous opiates6 Organizer: Dr E M Tansey 1996 Committee on Safety of Drugs6 Organizers: Dr Stephen Lock and Dr E M Tansey Making the body more transparent: the impact of nuclear magnetic resonance and magnetic resonance imaging7 Organizer: Sir Christopher Booth 1997 Research in General Practice7 Organizers: Dr Ian Tait and Dr E M Tansey Drugs in psychiatric practice7 Organizers: Dr E M Tansey and Dr David Healy The MRC Common Cold Unit7 Organizers: Dr David Tyrrell and Dr E M Tansey The first heart transplant in the UK Organizer: Professor Tom Treasure 1998 Haemophilia: aspects of clinical management Organizers: Dr E M Tansey and Professor Christine Lee Obstetric ultrasound: historical perspectives Organizers: Dr Malcolm Nicolson, Mr John Fleming and Dr E M Tansey Post-penicillin antibiotics Organizers: Dr Robert Bud and Dr E M Tansey Clinical research in Britain, 1950–1980 Organizers: Dr David Gordon and Dr E M Tansey ii The present Once a subject has been agreed by the Steering Committee of the Group, a suitable chairman is sought, and we start to discuss the meeting with possible contributors. Inevitably such approaches lead to suggestions for other appropriate participants, and during the months preceding a meeting we compile a detailed database of contacts to invite. It may become apparent at this stage that some topics cannot be included because of the lack of suitable witnesses. An early problem is to ensure that we invite all the appropriate people, and unfortunately we are not regularly able to bring overseas participants to our meetings. Key individuals can be inadvertently omitted simply because they are so ‘obvious’ no one suggests they should be invited. Other proposals may unintentionally reflect bias towards particular labs, Universities or specialities. We consult our scientific colleagues in the Wellcome Trust for advice, and use MEDLINE, SCIENCE CITATION INDEX, and other databases to search for participants. Each meeting’s invitation list is constantly updated and checked for possible omissions. We also search, when appropriate, for the voices that are rarely heard. Although we made the deliberate decision not to invite patients to Drugs in Psychiatric Practice, because of the vast variety of drugs and conditions to be discussed, we did so for Haemophilia, a meeting focused on only one condition. For the Common Cold Unit seminar we were able to locate former volunteers and members of the administrative staff; local Family Planning Association doctors and nurses attended the predominantly scientific seminar on Oral Contraceptives; similarly for Research in General Practice we invited practice nurses involved in specific research projects, although none were able to attend. Throughout we promote informality and flexibility, we neither expect nor encourage participants to arrive with prepared scripts, and we do not usually allow slides or other visual material to be shown, as this may disrupt the flow of the meeting – we suggest that illustrations, graphs or figures are photocopied and placed on every chair, so material can be referred to easily and when appropriate during the course of the meeting. Our further experiences of running Witness Seminars confirm the view expressed in the Introduction to Volume One of these transcripts: that each meeting develops its own unique agenda