Lives of the fellows

Hugh MacLean

b.23 April 1879 d.18 September 1957
MB ChB Aberd(1903) MD Aberd(1904) MSc Liverp(1910) DSc Lond(1912) MRCP(1922) FRCP(1927)

Hugh MacLean, the eldest son of Hector MacLean, a gamekeeper, and his wife, Barbara (née Fraser), was born at Kincardine, Rossshire. When he was three years old the family moved to Invernessshire where his father became the tenant of the home farm on the Aberarder estate, so that his childhood was passed among the rugged hills of Strathnairn. The latter years of his schooling were spent at the Inverness Academy where his record soon showed that a brilliant academic career might lie ahead. Living in lodgings during the week, he returned to his beloved Aberarder each weekend, making of necessity the fifteen mile journey up to Strathnairn on foot.

On leaving school he became a medical student at Aberdeen University where he worked under T. A. McWilliam, professor of physiology. McWilliam’s teaching made such a profound impression upon him that in 1904 he took the appointment of lecturer in physiological chemistry, and among other subjects began to study the chemistry of the phospholipids. In 1908 he was awarded a Carnegie research fellowship and went to Germany where he continued his work on lecithin in the Institute of Physiology at Berlin University, publishing three papers (Z. physiol. Chem., 1908, 55, 360-70; 1908, 57, 296-303; 1920, 59, 223-9). He returned to continue these and other studies at Liverpool University and obtained the M.Sc, in 1910.

The next move was to London where he became a senior assistant at the Lister Institute; it was here that his work brought him into contact with Dr Ida Smedley, herself an authority upon fat metabolism, whom he was to marry in 1913. She was the daughter of William T. Smedley, of Limpley Stoke, near Bath. After obtaining the D.Sc, in 1912 he was appointed chemical pathologist at St. Thomas’s Hospital and so for the first time had the opportunity of applying his physiological knowledge to the study of disease at first hand. It is hardly surprising that his horizons widened, and that, although his interest in the lecithins continued, the problem of renal function and albuminuria now became his chief concern.

It was therefore natural that when the high incidence of nephritis among our troops in France during the early years of the First World War was causing concern, it was to MacLean that the War Office turned. Commissioned as a captain in the R.A.M.C, he set up a laboratory at Etaples in 1917 and examined many thousands of troops for evidence of renal disease. In this project he was assisted by de Wesselow who was to succeed him as professor of medicine at St. Thomas’s Hospital. Early in 1918 his laboratory at Etaples was severely damaged by bombing, but by then his work had virtually been completed. On his return to London he was appointed consulting physician to the Ministry of Pensions.

At this time St. Thomas’s Hospital decided to inaugurate a medical unit headed by a professor, with the object of co-ordinating undergraduate teaching and of stimulating research. In spite of his relative lack of clinical experience MacLean was chosen as its first director, and in 1920 he became professor of medicine. It soon became apparent that he possessed considerable skill both as a teacher and as a diagnostician, and for the next decade he was swept along on the fast running tide of success.

New accommodation for the unit’s research laboratories was made possible initially by a gift of £10,000 from the Sir William Dunn bequest and later, in 1924, by a donation of £15,000 which he obtained from the Rockefeller Foundation during a visit to America. MacLean was fortunate in his choice of assistants on the unit, for in addition to de Wesselow and Isaac Jones, the deputy director, his team included Harold Gardiner-Hill and Forest Smith. Apart from his continued interest in renal disease, his main line of investigation centred on carbohydrate metabolism on which he gave the Oliver-Sharpey lectures in 1926, and diabetes, and he now devised a new method for estimating blood sugar. Gastric function was another of his special interests and in 1922 he popularised the alkali treatment of peptic ulcer.

During his years as professor of medicine his private practice grew steadily and entailed many visits to see patients in distant parts of the country. Although he never allowed this to interfere with his work at the unit, it meant that he had less and less time for rest and recreation. In the summer of 1929 he visited Australia on a lecture tour, and although he greatly enjoyed the experience he missed the relaxation which his annual holiday in Scotland always brought. During the next twelve months he worked as hard as ever, but it was obvious that the pace of life was taking its toll.

On the first morning of his summer holiday in August 1930 he was suddenly stricken with a severe depressive illness and, although it was not realised at the time, his role as one of the leading figures in medicine was over. In the following year he resigned from St. Thomas’s, but in 1935 recovery was complete. He returned to consulting practice in Harley Street and was appointed by the London County Council as consultant physician to Mile End, New End and Highgate Hospitals. He continued his practice and his hospital appointments during the early years of the War, living at first in London and subsequently in Cambridge, making the journey to town several days weekly.

In 1943 he sustained a fall in the blackout which resulted in a fractured skull and, although he made a rapid physical recovery, a further depression descended upon him during his convalescence from which he never recovered. The death of his wife in the following year may well have weighted the scales against him. He was eventually admitted to St. Andrew’s Hospital, Northampton, where he remained until his death from uraemia at the age of seventy-eight.

Tall in stature, MacLean had an imposing presence. Nevertheless beneath a self confident exterior he was a shy man. His simplicity was one of his greatest assets for he could grasp the essentials of a problem while others were confused by unimportant details, and in his generation he had few equals as a medical writer and teacher. He had great charm and was a good mixer, but he did not make friends easily amongst his medical colleagues at St. Thomas’s and at times was deeply troubled by the considerable tension which existed between the unit and the other physicians. In his later life his intimate friends were almost without exception outside medicine.

Although he retained but little of his Scottish accent, he was a true Highlander and his early upbringing among the Invernessshire hills coloured his whole life. Poetry moved him deeply and he could recite long tracts of Burns and other favourite authors. He was not an openly religious man, but during his depressions he became haunted with ideas of guilt which must have had their origin in the Calvinistic atmosphere of his childhood.

He had a son, Kenneth Smedley MacLean, also a Fellow of the College, and a daughter.

Richard R Trail

[Brit.med.J., 1957, 2, 768; Lancet, 1957, 2, 649 (p); St. Thom. Hosp. Gaz., 1958, 56, 3-6 (p); Times, 20 Sept. 1957.]

(Volume V, page 257)

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