Lives of the fellows

Ralph Wright

b.16 June 1930 d.17 August 1990
MB ChB Cape Town(1954) MD(1960)D Phil Oxon(1965) MA Oxon(1969) *FRCP(1972)

Ralph Wright was born at Paarl, Cape Province, South Africa. His father, Albert Bargmann, was a business man who on marriage to Jamesina Wilhelmina Wright, daughter of a geologist, subsequently adopted his wife’s name, reversing the accepted tradition. Ralph was educated at the University of Cape Town and the Groote Schuur Hospital. While still a medical student he met and married another young medical student, Morag Chisholm, the daughter of a Scottish born composer who held the chair of music at the University of Cape Town. He became resident house physician at his teaching hospital in 1955. In 1956, he and Morag worked for a year at the Charles Johnson Memorial Hospital in the heart of Zululand, near to the site of the Battle of Islandwhana. This was a 300 bed hospital for 40,000 Zulus and for most of this time he and his wife ran the hospital.

In 1957 he became medical registrar, for three years, at the University of Natal which was then the only medical school in South Africa for black students. He was responsible to Barry Adams for the management of many patients with tetanus and, together with Keith Sykes, they set up a new respiratory care unit for artificial ventilation of these patients. He published his experience in this field in The Lancet in 1961 and it was also the subject of his MD thesis.

Ralph came to the United Kingdom for further postgraduate experience and was appointed senior house officer in Leslie Witt’s [Munk’s Roll, Vol.VII, p.618] department at Oxford, where he worked with two other Fellows of the College, Sidney Truelove and Donald Acheson, later Sir Donald, who was then tutor in medicine. In due course he decided not to return to South Africa being much influenced by his abhorrence of the principle and practice of apartheid.

Over the next five years he investigated inflammatory bowel disease and made very important contributions to the understanding of autoimmunity in these disorders. This was also the subject of his D Phil Oxford thesis. In 1967 he was appointed lecturer in medicine at Oxford and, the following year, honorary consultant physician at the United Oxford Hospitals. Later in 1968 he was awarded the James Hudson Brown fellowship in the department of the distinguished hepatologist Gerry Klatskin at Yale University, USA. At that time Blumberg, also a Fellow of the College, had recently described the Australia antigen (subsequently renamed hepatitis B surface antigen) and then noted an association with acute hepatitis. Ralph Wright had the idea that it might also be responsible for chronic liver disease. Ralph, together with virologist Bob McCollum, capitalized on the existence of Klatskin’s bank of sera, stored in the hospital basement, and demonstrated this relationship [The Lancet, ii, 117-121, 1969]. It was this work that established his international reputation.

Before returning to the United Kingdom in August 1969 he was appointed May Reader in medicine at Oxford and in 1970 was elected Fellow of New College. The following year he was appointed professor of medicine with a special interest in clinical immunology at the still embryonic medical school at Southampton. His clinical facilities were at the Royal South Hants Hospital and his laboratories in a converted terrace house on the fringes of the red-light district of the city, a fact he took much delight in relating to colleagues around the world. Subsequently he moved into the new academic buildings and wards at Southampton General Hospital, where he built up a group of gastroenterologists and hepatologists and also, with Wellcome Trust support, a group of endocrine immunologists.

His research work concentrated on immunological aspects of liver disease but he also continued to make significant contributions in the fields of coeliac disease and inflammatory bowel disease. He described high titre antibodies to gut-derived and other common (e.g. measles virus) antigens in chronic liver disease and this initiated his interest in the role of Kupffer cells in the immune response. He also investigated the role of secretory products released by Kupffer cells in liver injury. He made the important observation that heterozygous a1 antitrypsin deficiency is associated with chronic active hepatitis and cryptogenic cirrhosis. Latterly he became interested in the possible significance of persistent measles virus genome in the aetiology of autoimmune chronic active hepatitis.

Perhaps his most widely known achievement was Liver and biliary disease ..., edited with H Millward Sadler, S Karren and G Alberti, London, Saunders, 1979. It was immediately claimed as an outstanding authoritative work and Ralph and Henry Millward Sadler were preparing the third edition at the time of his death. Out of respect, and m his memory, it was decided to rename it Wrights liver and biliary disease. This was published in May 1992 by Baillière.

Ralph always protested his dislike of administration and committee work, yet he clearly enjoyed representing the university on a neighbouring health authority, where his contributions and clarity of thought were greatly appreciated. This enjoyment was surpassed by that of his work for the Royal College of Physicians, where he was censor for the two years before his death.

A tall, commanding figure, Ralph Wright had a florid complexion. He exuded bonhomie. His love of music, particularly that of Mahler, Prokofiev and Copeland, was reflected in the music chosen for his memorial service. He was very much a family man. At his home in Winchester, he and Morag frequently entertained their students, colleagues and visitors. Three of their five daughters have followed their parents into medicine.

Ralph Wright was a big man in every way, possessing boundless energy. Everything he undertook he did with enthusiasm be it research, clinical work, teaching, supporting the local Southampton Football Club, or sailing. It was an irony that it was an accident at his recently acquired holiday cottage on the Medina river in the Isle of Wight that so tragically ended his life.

J B L Howell

* Elected under the special bye-law which provides for the election to the fellowship of "Persons holding a medical qualification, but not Members of the College, who have distinguished themselves in the practice of medicine, or in the pursuit of Medical or General Science or Literature.."

[Brit.med.J., 1990,301,812; The Lancet, 1990,336,998; Daily Telegraph, 31 Aug 1990]

(Volume IX, page 606)

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