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Sir Robert McCarrison (1878 - 1960):
Physician


Robert McCarrison was born at Edenderry, Portadown, County Armagh, second son in a sibship of the six offspring born to Robert McCarrison (senior), flax merchant of Drumalane, Newry, County Down, and Agnes née McCullagh, who were married in Mullaghglass Parish Church, County Armagh on 21 May 1875. Robert was educated at Lisburn Intermediate School and enrolled at Queen’s College Belfast (QCB) in 1894 to study Arts and Medicine, associated clinical experience being at Richmond Hospital, Dublin, and he graduated MB, BCh, BAO (with First-Class Honours) from the Royal University of Ireland (RUI) in 1900. 

Brought up in a domestic atmosphere of evangelical piety he also showed strict intellectual discipline and a fertile mind, qualities which he was to maintain throughout his life.  Unlike his contemporary fellow-Ulsterman, Sir John Megaw, who was Director-General of the Indian Medical Service (IMS), 1930-1939, McCarrison did not doubt the value of time spent in acquiring further degrees, considering their acquisition to be a natural progression, and he proceeded MD from the new Queen’s University Belfast (QUB) and Membership of the Royal College of Physicians (MRCP, London), both in 1909; and to the Fellowship of the Royal College of Physicians (FRCP) in 1914. He became a Doctor of Science (DSc) of QUB in 1915. His Doctorate of Laws of QUB in 1918 was honorary.

On graduation  in 1900 he decided that his developing interests could best be of service abroad and in 1901 he entered the Indian Medical Service (General Establishment) in the rank of Lieutenant, and “on my twenty-third birthday fresh from the medical schools and but a child in knowledge”, sailed for India and a first posting in the remote and desolate but strategically important region of Chitral and Gilgit at the extreme north-west boundary of  the then Indian Empire (now in Pakistan), first as Regimental Medical Officer to the garrison of Indian troops (1902-1904) and then, by now in the rank of Captain, as the Gilgit Agency Surgeon (1904-1911). As he described the rugged beauty of his surroundings in his own elegant prose: “To the north are the Pamirs with the source of the Oxus; to the west, Chitral; to the east, Baltisan and western Tibet; to the south, the great Himalayan range and the passes to Kashmir”. 

It was here, in Chitral, that he started what was to become his great investigative work which only ceased with his retirement in 1935, and hardly even then. His first study was of the so-called “three-day fever of Chitral” which he attributed, in 1906, to the sand-fly as vector, a finding subsequently confirmed by the German investigator Doerr and his colleagues in 1910.

McCarrison’s fertile mind and investigative energy were now turned to the diseases which were to occupy his researches for the rest of his time in India and which were to form the bulk of his material: nine books, 159 articles and other publications assiduously collected by HM Sinclair and others and published in book form in 1953. These may be classified, broadly chronologically, as endemic goitre, various deficiency diseases (from 1919), dietary problems (from 1921) and stone (mainly in 1927), but with goitre and cretinism pre-eminent as witness his pioneer controlled epidemiological studies especially when, in Gilgit, he was able to show that the endemic goitre and cretinism in the area were due to drinking polluted, untreated water, studies in which he included himself as a “guinea pig”. Though his researches continued until his retirement in 1935, he left Gilgit in 1911 but not without the Kaiser-i-Hind Golf Medal (First Class) for “public service in India”, and promotion to Major (1912). 

Further, in 1913 he delivered he Milroy Lectures before the Royal College of Physicians in London on “The Etiology of Endemic Goitre” and in 1914 received the Prix Amussat of the Academie de Medecin, in Paris.

On leaving Gilgit in 1911 McCarrison was posted (in 1912) to Kasauli in the outer Himalayas and then, on the outbreak of World War I and now in active service, to a large Indian general hospital in Cairo. Here his health broke down and he was transferred to England as officer in charge of the Malaria Investigation Hospital; but in 1918 and now with the rank of Lieutenant-Colonel he was posted as Director of the Pasteur Institute of Southern India at Coonoor in the Nilgiris (“Blue Mountains”), South India, and from 1922 was put in charge of other laboratories as well. 

On arrival at Coonoor, however, all was not well; he found only an empty room and an untrained assistant!  His health soon broke down again and he spent some months recuperating in CS Sherrington’s well-known laboratory in Oxford studying the relationship of fat to the thyroid gland (and was also invited to make a lecture tour in the USA in 1921) and assisted by his faithful Sikh factotum, Mula Singh – who managed also to study histology at McCarrison’s expense! 

On return to better health and active research activity he found that his unit in Coonoor had been suspended on the ground of economy, and after acrimonious correspondence with the authorities he felt forced to resign his charge which he did in 1923.  However, in 1925 he agreed to be re-appointed; but he held on to the ‘empty room’ until it was re-launched now labelled as the Deficiency Disease Enquiry Unit. In 1926 it was visited by the Royal Commission on Agriculture in India (chairman: Lord Linlithgow, who was later to be Viceroy) whose members were impressed by McCarrison and his work and were amenable to his arguments for more support and agreed to “see what they could do”.  This was not a great deal until the Rajah Parlakimedi, who was a member of the Commission, handed across the table to McCarrison a lakh of rupees (that is, 100,000 rupees, worth about £7,000), and the first two research posts were named the Parlakimedi Research Fellowships in consequence.  

From then on the new Nutrition Research Laboratories financed by the Indian Research Fund and with McCarrison as its Director (from 1929) became the leading such Unit in the Far East. McCarrison was now frequently honoured.  He was appointed a Companion of the Order of the Indian Empire (CIE, 1923), Knight Bachelor (1933), Physician to the King (1928-1935); he was presented with many medals and invited to deliver many prestigious lectures including the Stewart Prize (British Medical Association, 1918), the Arnott Memorial Gold Medal from the Irish Medical Schools and Graduates Association (1922), the Arnold Flinker and Julius Wagner-Jauregg Foundation Prize (Vienna, 1934), the first ever to a foreigner, and many others.

McCarrison retired from the IMS in 1935 in the rank of Major-General and settled at 18, Linton Road, Oxford with his wife, Helen Stella (née Johnston, daughter of John Leech Johnston of the Indian civil service) who he had married on 30 July 1906 in All Saints church, Dharwar, Bombay, and who was to outlive her husband by eight year, dying in 1968. They had no surviving children. McCarrison still kept up his pace of publications and professional activities, his favourite text which had always been his inspiration and guide and would remain so until the end of his life, being from Isaiah, chap.55.2: “Harken diligently unto me, and eat ye that which is good”.  

On the outbreak of World War II he became involved as chairman of the local medical war committee, deputy regional adviser in medicine to the Emergency Medical Service (EMS) and chairman of the Oxford section concerning nutrition.  From 1945 until 1955 he was director of postgraduate medical education at the University of Oxford being awarded an MA (in 1945) by the University to give him the requisite status appropriate to the responsibilities. On his seventy-fifth birthday (15 March 1953) he was presented, by the editor, at a Festschrift with a copy of ‘The Work of Sir Robert McCarrison’ (edited by HM Sinclair) which contained his most important papers and which included assessments of his contributions and a bibliography of his work, all at the request of Indian scientists; and he was likewise honoured by the presence at the ceremony of the Minister of Health for India, Rajkumari Amrij Kaur. 

Further honours followed including a bust sculpted by Kathleen Scott (Lady Kennet, widow of Captain Scott RN “of the Antarctic” who had married Lord Kennet in 1922); while along with the honours already mentioned were the Silver Medal  of the Royal Society of Arts; the Stewart Prize of The British Medical Association 1918; the Barclay Memorial Medal of the Royal Asiatic Society of Bengal (1939); the Cantor Lecture (of the Royal Society of Arts, 1936); the Lloyd Roberts  Lecture (of the Medical Society of London, 1936); the Sanderson-Wells Lecture of the Middlesex Hospital Medical School (1939); and other eponymous awards in the names of  Gabrielle Howard, Mellon, Mary Scott Newbold, Hanna, de Lamar, and the Mayo Foundation;  while the Honorary Fellowship of the College of Physicians of Philadelphia completes this list, which is not exhaustive.

McCarrison was highly regarded and respected yet was modest, kind and well-known for his sincerity and integrity.  Until advanced age he was a church- warden at St, Andrews Parish church in Oxford and remained physically and intellectually strong and fit.  He died in his sleep at his Oxford address, 18 Linton Road.

“RP’ wrote in The Lancet: “His work on nutrition ranks with that of Ross, Christopher and Sinton on malaria, of Rogers on cholera, and of Megaw on typhus.”  Sinton, McCarrison and Megaw were all Ulstermen.



Born: 14 March 1878
Died: 18 May 1960
Peter Froggatt
Acknowledgements:

The writer is indebted to his colleague Maud Hamill on the Ulster History Circle for researching the McCarrison pedigree. 

Bibliography:

Obituary: “Sir Robert McCarrison, CIE, MD, DSc, LLD, FRCP”,  British Medical Journal, 1960, vol .i pp 1663-4; Obituary: “Robert McCarrison, Kt, CIE, MA(Oxon), MD (RUI), DSc, LLD, FRCP”, The Lancet, 1960, vol. I, pp.1198-9;   JA Weaver and P Froggatt: “The Wild Geese”, Ulster Medical Journal, 1987, vol. 56  Supplement pp. S33-S34;  Dictionary of Irish Biography, 2009, vol. 5, pp. 770-2;  RSJ Clarke:  A Directory of Ulster Doctors, etc. vol. II, p 643.