Lives of the fellows

Robert Greenhill Cochrane

b.11 August 1899 d.3 August 1985
CMG(1969) MB ChB Glasg(1924) MRCS LRCP(1924) DTM&H(1924) MRCP(I927) MD(1928) FRCP(1945)

Robert Greenhill Cochrane (‘Bob’ to his many friends) was born in Pei-Tei-Ho, China, of missionary parents. What was to be an eventful career almost ended before it began when, a few months after his birth, the family was captured by Boxers while trying to escape. They were released after a faithful servant had successfully pleaded with their captors. His father Thomas Cochrane, also a physician, was a forceful character who, on returning to China in 1901 after leave in England, founded the Peking Union Medical College and Hospital with money from the Chinese reparations to the great powers and a personal donation from the Empress Dowager herself.

During his early years Robert was taught in China by his mother but his formal education began when, at the age of nine, he was sent to the School for the Sons of Missionaries at Blackheath, England, and then to Eltham when the School moved there. He graduated in medicine in Glasgow in 1924, with commendation. After a few months at St Bartholomew’s Hospital, London, and a short course at the London School of Hygiene and Tropical Medicine, he gained the conjoint diploma and the London diploma in tropical medicine. That same year he sailed for India under the auspices of the Mission to Lepers. He could not have had a better introduction to leprosy, for he sat at the feet of the renowned Ernest Muir in Calcutta for three months. His first term was spent in Purulia and Bankura in West Bengal. He returned to Britain in 1927 and was admitted MRCP. He had also collected enough data on leprosy, and had enough diligence, to prepare a thesis for his MD.

After making a somewhat critical report in his survey of the Mission to Lepers’ homes and hospitals in India, he rather abruptly severed his connexion with the Mission. In 1929 he was appointed medical and general secretary of BELRA (the British Empire Leprosy Relief Association) which, having been formed some four years previously, needed a man of Cochrane’s standing and drive to guide its future course. In 1931 he was invited to a consultation of leading leprologists in Manila, called by the Leonard Wood Memorial Foundation, and the International Leprosy Association was formed. Bob was appointed its first secretary-treasurer. This period set the pattern for his future rather restless activities. He was building up an extensive knowledge of clinical leprosy, and developing a provocative lecture style that never failed to keep his audience alert. After another brief spell in India in 1933, he realized that he was going to achieve his growing ambition to make a significant contribution to leprosy as a world problem, and he needed further field experience. In 1935 he successfully applied for appointment as chief medical officer of the Lady Willingdon Leprosy Sanatorium at Chingleput, Madras. While there, he was asked to become adviser in leprosy to the State of Madras. He used the parent sulphone (dapsone, or DDS) orally to treat leprosy patients - being the first to do so. He had been in touch with the ICI chemists in Britain who were using the compound to treat streptococcal mastitis in cows. However, within a couple of years Cochrane left Chingleput to begin his association with the Vellore Christian Medical College and Hospital. He was responsible for the delicate negotiations which led to the upgrading and government recognition of the College, and the admission of men students. For his exemplary work in India he was awarded the Kaiser-i-Hind medal in gold, first class. He was a friend of Gandhi and other political leaders.

Bob Cochrane returned to England in 1951 and for the next three years he served, once again, as medical secretary of BELRA. Failing to enlist adequate financial sponsorship in Britain for his leprosy activities, he turned to the USA and was appointed technical medical adviser to the American Leprosy Missions Inc., having been assured that he could continue to make his base in Britain. With money from the USA and the Wellcome Trust, he founded the Leprosy Research Fund in London in 1951, as a coordinating and teaching centre, and a histopathological reference centre. This was renamed the Leprosy Study Centre in 1955.

By this time Bob Cochrane had gained a wide reputation as the leading leprologist in the English-speaking world. He was in great demand and travelled in many countries advising governments and missions on their leprosy programmes, and conducting seminars. He was always frank and outspoken in his opinions, qualities that did not endear him to everybody. When leprosy was made a notifiable disease in Britain, Bob Cochrane was the obvious person to be appointed consultant adviser to the Ministry of Health.

In the course of his travels he visited me in the Belgian Congo (now Zaire). In his best pontifical manner he had often declaimed that nowhere could leprosy attack more than 10% of the population. When I showed him some villages where over half the people had diagnosable leprosy lesions he could not believe the evidence of his eyes, but he did afterwards modify his somewhat sweeping generalizations. It was there that Bob advised me to concentrate on leprosy and abandon my interests in general tropical medicine. I next met him in 1960, when in England on my first leave from Nigeria where I had been appointed director of leprosy research. He discussed with me a riminophenazine compound known by its code number B663, which he said was ‘tailor made for leprosy’, being concentrated in macrophages in mice experimentally infected with mycobacterium tuberculosis. He persuaded me to try the compound in cooperative leprosy patients in Uzuakoli, Eastern Nigeria. Under its offical name clofazimine, and its proprietary name Lamprene (Ciba-Geigy), this drug is now generally recognized as an excellent anti-leprotic with anti-inflammatory properties.

Having asked me to succeed him as director of the Leprosy Study Centre, Bob felt free to return to India to resume clinical leprosy work. (He was president of the International Leprosy Association 1965-68, presiding over the Ninth International Leprosy Congress held in London in 1968. He was then made president emeritus.) Shortly after his arrival in India his wife was taken ill and died. Despite his loss, he went to Vadathorasalur in Madras State where he spent two useful years. Meanwhile, a lady doctor who had admired him from afar, and had written sympathizing with him in his loss, invited him to Tanzania. They were married in Kola Ndoto, and worked together under the auspices of the African Inland Mission from 1969-72. The couple then retired to Norristown in Pennsylvania, where Jeanie devotedly nursed her husband through many months of enforced inactivity and increasing weakness. The end came as he was approaching his 86th birthday.

No tribute to Bob Cochrane would be complete without mention of the driving force in his life - his Christian faith. He was a convinced, practising Christian and lost no opportunity of commending and sharing his faith. Some people might have thought him dogmatic and aggressive, but more admired him for his forthrightness and pertinacity. He was actively associated with the World Dominion Trust.

The Cochrane Annex at the Slade Hospital, Oxford, will remind dermatologists of the considerable influence that he wielded during his lifetime; as will the incomparable collection of stained series of histopathological slides - 16.000 of them - of sections of leprosy lesions and related conditions. These are housed at the Hospital for Tropical Diseases, London, and are available for study and research.

‘This one thing I do’ could be Bob’s epitaph, whether the ‘one thing’ was campaigning on behalf of the victims of leprosy worldwide, bludgeoning people in governments or missions to abandon the stigmatizing epithet ‘leper’, or persuading clinicians and medical investigators to interest themselves in the disease called leprosy which to him was of overriding fascination and importance.

Bob Cochrane exercised a far greater influence in the cause of leprosy than any other individual of his generation. He made the study of leprosy ‘respectable’ and constantly advocated its inclusion in medical teaching and practice. He was a clinician to his finger-tips; an accurate observer of clinical signs and an excellent demonstrator of the bewildering variety of clinical manifestations of leprosy. His name will be perpetuated in the Robert Cochrane Fund for Leprosy, administered by the Royal Society of Tropical Medicine and Hygiene, which will provide bursaries to help young scientists in their studies in leprosy.

Bob is survived by his second wife and by three children of his first marriage: two doctor sons and a nurse daughter - all trained at St Bartholomew’s Hospital.

SG Browne

[Brit.med.J., 1985, 291, 608; Lancet, 1985, 2, 457, The Times, 6 Aug 1985]

(Volume VIII, page 97)

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