Lives of the fellows

Noel Francis Maclagan

b.25 December 1904 d.16 July 1987
BSc(1925) MSc(1930) MB BS Lond(1932) MD(1935) MRCP(1933) DSc(1946) FRCP(1952) FRCPath(1964) FRSC(1948)

Noel Francis Maclagan was born in north London, the son of Oscar Frederick Maclagan, a company director, and his wife Ada Sarah Nielson. He attended Maidenhead College in his early childhood and later University College School, London, where he was an above average pupil but failed to distinguish himself in games - except at chess, at which he excelled for much of his life. Not until late in his boyhood was it realized that severe myopia accounted for his poor performance in sport; when this was corrected, he greatly enjoyed tennis. At London University he read chemistry, with physics as a subsidiary subject, and graduated with first class honours. At this time jobs in science were not numerous and it was not uncommon for new graduates to accept jobs for which their university careers were inappropriate. It was not until 1926 that Noel was offered, and accepted, a job as a laboratory technician, later as research assistant, in Charles Dodds’ - later Sir Charles [Munk’s Roll, Vol.VI, p.151] - department of biochemistry in the Middlesex Hospital medical school. There were few posts available either in clinical biochemistry or chemical pathology and the department of biochemistry was unique, not in only being concerned with the teaching of medical students during their preclinical studies but also the provision of a proper chemical pathology service to the clinical department of the Middlesex Hospital.

Noel was encouraged to attend the medical school classes while at the same time carrying out his research activities in the biochemistry department - by no means an easy task, as the writer well knows - but in 1930 he gained his MSc and in 1932 his MB BS.

After a post as house physician at the Middlesex, he became research assistant at the Courtauld Institute of the Middlesex Hospital, until 1934. By this time he must have felt rather more secure in his search for a permanent post for he married Annemarie Wilhelmina May Herzog, a union which proved to be a happy and stable one for the rest of his life. During the following year he was a full-time worker for the Medical Research Council, and obtained his MD. He was then appointed biochemist to the Westminster Hospital where he remained until his retirement in 1970.

At the time of Noel’s appointment to the Westminster, complicated biochemical analyses were rarely undertaken and, apart from Charles Dodds’ department at the Middlesex and G A Harrison’s department of chemical pathology at Bart’s, only simple and uncomplicated analyses were carried out by the departments of clinical pathology. Noel immediately began to change this situation. Initially his laboratory in the old medical school in Caxton Street was small and separate from the hospital but with the building of a new medical school attached to the hospital, which was opened by their Majesties the King and Queen in 1939, he gained a new laboratory which he found more acceptable. It was during this period that Noel greatly increased the available analyses and became especially interested in liver function.

When the war began Noel was transferred to Ashford County Hospital, which was part of the Emergency Medical Service. His laboratory work and teaching continued and it was here that the liver function tests, including the well known thymol turbidity test, were developed. In 1945 his work on liver function and other contributions to clinical chemistry were submitted successfully to the University of London for his DSc. In 1948 he was elected a Fellow of the Royal Institute of Chemistry (now the Royal Society of Chemistry).

In 1946 the clinical biochemistry staff returned to London, to the no longer new medical school building, and Dr Pulvertaft, who prior to the war had been clinical pathologist, became professor of clinical pathology. Until that time, heads of pathology departments had always been professors of morbid anatomy and the staff of pathology departments had always been subordinate to the morbid anatomists. Some haematologists had been independent heads of their departments, but most other branches of pathology were under the administrative control of the morbid anatomist. In 1947, Noel Maclagan was appointed the first medically qualified professor of chemical pathology in Britain, but was officially under the administrative control of the professor of clinical pathology. Relationships became somewhat strained and a small pathology committee, with some administrators, was formed which led to the chemical pathology department becoming autonomous and resulted in more harmonious relations.

Noel’s earlier work had been concerned with the relationship between appetite and control of body weight and blood lipids - especially in relation to blood coagulation and atherosclerosis and coronary heart disease. He greatly extended his work on hepatic function, especially in relation to enzymes in blood. In these researches he skilfully guided his junior colleagues and 27 successfully presented theses for their doctorates. His department was a very happy one; medical and scientific staff working harmoniously. Of the 27 successful PhDs, nine ultimately became professors.

The first five years following the end of the war saw biochemistry, both clinical and non-clinical, just beginning to recover from the rigid limitations imposed on theoretical biochemical research, as opposed to the heavy practical demands made on the relatively small number of trained biochemists. Initially, scientific meetings were small and infrequent. The first international meeting of biochemical societies was held in Cambridge in 1949 and was well attended and very fruitful. At that time the fragmentation of biochemistry, due to the enormous extension of knowledge in this subject, had not yet occurred. It was then possible to profit from attending international meetings in Europe and America without experiencing the difficulty of deciding which field of knowledge it was essential to attend. Noel and I, together with our wives, frequently met at these meetings and I rather think our wives were responsible for our subsequent close friendship.

Noel was highly regarded in Westminster Hospital and medical school, by both students and staff. His popularity was apparent in the warmth with which he was greeted on the many social occasions, both formal and informal, to which he was invited both before and after his retirement. For many years he was examiner in pathology for the Conjoint Board and for the University, and was always regarded as an excellent examiner. He was frequently invited to examine postgraduate theses not only for London University but also for other British universities. For several years he was examiner for the medical faculty of the University of Ibadan, Nigeria, and when I followed in his footsteps a year later I was informed that he was much appreciated by the students as a kind, considerate and competent examiner - nevertheless, the examiner was put on his plane before the examination results were published. Noel was always a welcome participant in many clinical chemical pathology meetings in European countries, and he was especially pleased when he was invited to tour most of the major clinical chemical pathology centres in South America. He was asked to postpone a lecture at Caracas University, Venezuela, because a revolution was planned to begin that day - October 24, 1960 - but as he was due in Bogata, Colombia, the following day it was the revolution that had to be postponed: an unusual honour for a British professor.

Noel played an important role in the creation of the Association of Clinical Pathologists and was its first president from 1953-56. He was chairman of the board of studies in biochemistry at London University from 1960-63 and was appointed honorary secretary of an advisory committee on hospital biochemistry set up by the Ministry of Health in 1961. From 1976-79 he was chairman of the Nuffield Project on Clinical Chemistry Laboratories.

After his retirement Noel was for many years a welcome guest at many of the hospital and medical school functions. His marriage was a very happy one and he fully enjoyed the childhood of his children, Andrew and Jennifer. In later years, Andrew lived abroad but frequently visited his parents, together with his daughter, although at irregular intervals. Jennifer obtained an honours degree in physiology from University College London, followed by a doctorate, and was appointed lecturer in pharmacology at the Royal Free Hospital. She married and had four children, three daughters and a son, but her husband died while still a young man. During this sad period, Noel and Anna were able to provide their daughter with wonderful support. They purchased a small country house in Barrowden, Rutland, which they used with their daughter and grandchildren, and which provided an important sheet anchor at that time.

Noel adapted to retirement well, strongly supported by Anna. He enjoyed music and reading, and numerous activities around his home. He also greatly enjoyed driving - especially to Barrowden. About this time Anna had to have a hip replacement, which was highly successful and accepted with fortitude.

This peaceful period came to an end when Noel was found to have a small tumour in the scalp. In the preliminary preparations for its removal he was found to have lymphatic leukaemia which necessitated a long course of various treatments. Noel accepted this philosophically, but after some months became progressively weaker and unable to leave his bed. He was transferred to the Royal Free Hospital where he was found to have a severe osteomalacia - presumably due to his long course of treatment for leukaemia. This was efficiently cured within a few weeks but, just as he was responding well to treatment, he developed herpes zoster of an ophthalmic nerve which persisted for over a year and gave him appalling bursts of pain. During this time he was virtually sightless because of a scotoma in the other eye. After several months the herpes became quiescent, and it was decided that the damaged eye might respond to treatment by laser. This was very successful and within a few more months Noel was able to walk to the local shops, and to read if the print was sufficiently large.

Anna was then obliged to have a second hip replacement, which was also highly successful, but before she had fully recovered from her operation and was still walking around the house with two sticks, Noel suffered a severe cerebral haemorrhage and was admitted to University College Hospital where he died about two weeks later.

Shortly before his death he was made an honorary fellow of the Royal Society of Medicine. As his colleague, J R Hobbs wrote: ‘The world of clinical biochemistry owes a great deal to this modest man, a gentleman not only of science but also in the fullest meaning of the word.’

CH Gray

[, 1987,295,337,385; Lancet, 1987,2,288; Times, 20 July 1987; Festschrift, Feb 1985,Charing X & Westminster Medical School]

(Volume VIII, page 313)

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