b.21 May 1903 d.12 March 1975
BA Oxon(1924) MRCS LRCP(1927) BM BCh(1927) DM(1932) MRCP(1930) FRCP(1939)
C. L. Cope, emeritus Reader in metabolic medicine at the Royal Postgraduate Medical School and honorary visiting physician to Hammersmith Hospital, died suddenly at the age of 71.
Cuthbert Leslie Cope was born and grew up in the City of Westminster, in a distinguished and versatile medical family. While still at school, he acquired an interest and a love for chemistry, and following his qualification in medicine in 1927, he moved very rapidly into the application of chemical methods to the problems of human illness. He was educated at Oxford and University College Hospital, where he also held his residency appointments.
He began research as a Beit Fellow in 1929 in the biochemistry department at Oxford. His first interest was renal excretion of nonthreshold substances (sulphate, creatinine). During 1931-2 he developed these studies further at the Rockefeller Hospital, New York, where he made important original contributions to the modern analysis of kidney function, working with Donald Van Slyke who remained his intimate friend. He assessed renal function by clearance tests and also studied the excretion of a non-metabolizable sugar, xylose, as an indicator of glomerular filtration. On his return to Britain he continued in the medical units successively at St. Thomas’s Hospital, University College Hospital, and the Radcliffe Infirmary. During this last phase he defined the dangers of kidney and brain damage from over-enthusiastic treatment of stomach ulcers with alkaline powders. He had gradually transferred his interests to the endocrine glands; in the 1930’s he contributed important studies on the anterior pituitary lobe in Graves’ disease and myxoedema, on thyrotrophin assay, on the use of antithyrotrophic serum, and on pregnanediol measurements in pregnancy and in toxaemia. He had to face personal illness in the 1930’s, and also long years of inadequate income due to the slow development of academic opportunities in medicine, but his courage and endurance maintained his devotion to research.
In 1942 he became Lieutenant-Colonel in the RAMC, serving in France and Holland, and, after the armistice, in Norway. From 1947 to 1949 he was director of human problems research in the Coal Board, after which he was appointed to the staff of the Postgraduate Medical School. And so began his most productive period of research, mostly concerned with adrenocortical steroid hormones and their roles in disease — a growing series of successful and satisfying researches. The glint of excitement returned to his eyes as he pondered how these secretions would influence every facet of human medicine. And his work was still in full flood of technical and intellectual precision when the end came so suddenly 25 years after this renewal of his academic career.
He evolved several simple and specific methods for measuring the levels in body fluids of cortisol and aldosterone, and their production rates, mainly by applying chromatography and isotopes. He was especially fruitful in his early development of their measurement in urine, in defining the clinical importance of urinary free cortisol levels as indices of the body’s exposure to cortisol, and in evolving a simple method for measuring the production rate of cortisol — from measurements of a metabolite in a timed sample of urine after an oral dose of C14-cortisol. With Llaurado in 1954 he obtained evidence of excess secretion of aldosterone in a case of potassium-losing nephropathy, and narrowly missed priority in defining a new syndrome described in the following year by Conn. He also defined the significance and limitations of the metopirone and dexamethazone tests of adrenal function, after careful critical appraisals. These fruitful endeavours were slowly appreciated outside this country, and he came to be regarded as one of our most renowned endocrinologists. Towards the end of his career he produced for physicians and experts, an authoritative, popular and balanced book on his subject, Adrenal Steroids and Disease (1972).
"Retirement" at 65 was for him an opportunity for more time for his laboratory work; and he not only revised his Adrenal Steroids and Disease but also crowned his life with another brilliantly perfectionist article in Clinical Science a month before his death. Like his uncle Zachary Cope, he never stopped while he had breath. "Copey", as he was affectionately known, was modest, self-effacing, and shy. He never sought publicity or even the prestige of an academic chair. Avoiding the heavier chores of administration, he concentrated his talents where they were best used.
Unhurried and patiently methodical in his work, he did not publish until he had something worthwhile to say. In 1972 he was awarded the Moxon medal of the Royal College of Physicians as the person "who was deemed to have most distinguished himself by observation and research in clinical medicine".
By his gentle personality, his integrity, and his full responsibility for every detail in his scientific studies he was an inspiration to many and indeed was a most reliable and loved colleague.
His home life with his wife Eileen was ideal, and they had two sons of whom he was justly proud. One of them is in the medical profession and the other was, at the time of his father’s death, the youngest member of the Headmasters’ Conference.
Sir John McMichael
T Russell C Fraser
[Brit.med.J., 1975, 1, 742; Lancet, 1975, 1, 1096]
(Volume VI, page 118)
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