Lives of the fellows

Douglas McAlpine

b.19 August 1890 d.4 February 1981
MB ChB Glasg(1913) MRCP(1921) MD(1923) FRCP(1932)

Douglas McAlpine was a son of Sir Robert McAlpine. He was educated in Edinburgh and at Kirton College and was a medical student at Glasgow where he qualified with distinction in medicine and midwifery. In April 1914, he was house physician to WR Jack at the Royal Infirmary in Glasgow, and in August 1914 he enlisted as a temporary lieutenant in the RAMC. On his 24th birthday he was posted to the Cambridge Military Hospital at Aldershot, and shortly after this he embarked for France and, in September, joined the 13th Field Ambulance at Colomire and, in November, he became a regimental medical officer to the 2nd Battalion of the Queen’s Own Scottish Borderers. At one stage in the battle at Ypres his unit was moved back behind the lines and a house taken over by fifteen medical officers in a row of houses which was called ‘Harley Street’.

Early in 1915 he was posted to a hospital ship, and in August he resigned his army commission and transferred to the Royal Navy. He was posted to the 3rd Light Cruiser Squadron. He played rugger for the squadron and served in HMS Falmouth at the battle of Jutland in 1916. He was in the ship in August 1916 when she was sunk off Flamborough Head. He then served in Scapa Flow, where he boxed for the squadron and was knocked out in the second round by the chaplain (who later became the lightweight champion of the Mediterranean Fleet).

Douglas married in 1917 Meg Sidebottom, and in March 1918 he was posted to RN Sick Quarters in Plymouth, where he used hypnosis to cure nervous ailments and was mentioned in despatches for this work. He was demobilized in November 1918, and appointed as a clinical clerk to Archibald Garrod at Bart’s. He then decided that neurology was his future career, and in 1920 and 1921 he worked with JG Greenfield at the National Hospital for Nervous Diseases, Queen Square, on post encephalitic parkinsonism. In 1921 he became assistant physician to the Belgrade Hospital for Children, and in 1923 he was attached for six months to Jean l’Hermitte at the Salpetriére in Paris, again working on post encephalitic pathology. In February 1924, he was appointed physician in charge of nervous diseases at the Middlesex Hospital and assistant physician and pathologist at the Maida Vale Hospital.

At the Middlesex he was an outpatient physician with no beds under his own care - not unusual for junior physicians in those hierarchical days. This meant that those referred for inpatient study or treatment were the responsibility of physicians who generally had no special interest in neurology, and it was not until a floor in the older part of the hospital became vacant that an inpatient neurological unit was created in 1930, a handsome gift from the family firm of Sir Robert McAlpine, which turned the deserted and barren group of little rooms into two handsome wards holding 24 patients.

At that time most teaching hospitals had neurology and neurologists as part of a general medical firm; only those students allotted to this firm could clerk inpatient neurological problems. The rest (about three quarters) had to be content with outpatient neurology. Douglas McAlpine arranged for his unit to have all the students in the second clinical year clerking in two months’ groups in the wards, so that all undergraduates at the Middlesex Hospital were able to see neurological inpatients. When space became available neurosurgical beds were added to the unit. In this way he founded a tradition of teaching which has continued until the present day. Even now there are still teaching hospitals that have their neurological unit as part of a general medical firm and thus only a fraction of medical students see inpatient neurology and neurosurgery as a formal part of their teaching. Thus not only were his students given a reasonable exposure to the subject, but the junior hospital doctors, likewise, received a remarkable clinical education in neurology and neurosurgery.

It is trite to say that a clinical unit takes its tone from the top; there is no doubt that Douglas kept the unit on its toes and, as his first house physician, I can vouch for the enthusiasm and gentle discipline that was exercised. It was this enthusiasm that ensured that so many of his juniors continued in neurology. In the second world war Douglas was appointed adviser in neurology, first in the Middle East in 1941, and then to India Command, and finally to South East Asia, and it was here that he met Diana, his second wife. Although he was a brigadier he did not restrict himself to advising from a distance or visiting occasionally. During the El Alamein battle, when the first mobile neurosurgical team received over 200 head injuries in eight days, he joined in the examination, writing up notes and giving intravenous sulphadiazine to all penetrating head wounds. Together we learned how easy it could be for sulphadiazine to block the ureter if the urinary pH was not watched. When the rush of wounded was over he quietly disappeared to his advisory function, his parting words to me being ‘It was nice to be your house physician for a week’.

The major work of Douglas McAlpine’s life was the study of multiple sclerosis. He amassed a vast amount of clinical data and distilled it into his book Multiple Sclerosis first published in 1955. This book has gone through two reappraisals with co-authors, the last edition being in 1965. After retiring from the hospitals in 1955 Douglas continued to follow up his patients, and a new edition of his book was being prepared when he died.

It is wrong, however, to think that all his enthusiasms went into multiple sclerosis. Douglas was eclectic in his interests. When he worked in Japan for the World Health Organization, primarily on the study of demyelinating diseases, he was one of the first (if not the first) to distinguish the effects on man of eating fish that had been poisoned with mercury from industrial effluent. Even in his last years he led an enquiry into the proposal to build a high powered world broadcasting unit in his village, because he was concerned about the possible harmful effects that radiation from such a unit might have on the local community. Protection of the environment was always a major consideration of his.

It was Douglas McAlpine who, in 1951, sponsored the formation of the Multiple Sclerosis Society of Great Britain, and the Society was born in 1953. It was Douglas McAlpine who, at that time, had the vision to see that the medical profession and lay people could work in partnership. He formed the embryo society’s medical panel and its medical advisory research committee, of which he was the first chairman. One of the first decisions this society had to make was whether it should be called the multiple sclerosis or the disseminated sclerosis society. The decision was for multiple sclerosis and it is interesting, and perhaps even entertaining, that this decision so dismayed a leading neurologist of the day that he withdrew from the Society’s affairs.

Douglas was the first and, so far, the only recipient of the Charcot award given by the International Federation of Multiple Sclerosis Societies ‘for significant contributions to and understanding of the cause, mechanisms, treatments and/or cure of multiple sclerosis’. The award was made in Washington in September 1969.

Douglas will always be remembered by his pupils and his patients. He was fundamentally a shy man, which at times made him appear a little brusque, but to get to know him was, indeed, to appreciate his genial and gentle humanity.

M Kremer

[Brit.med.J., 1981, 282, 827, 1244]

(Volume VII, page 349)

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