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Home > About the Academy > Biographical memoirs
BIOGRAPHICAL MEMOIRS
Edward Holbrook Derrick 1898-1976
By I.M. Mackerras
This memoir was originally published in Records of the Australian Academy of Science, vol.4, no.1, 1978.
Family and formative years 1898-1923
Edward Holbrook Derrick
was born at Blackwood, Victoria, on 18 September 1898. He was
a fourth-generation Australian, with a solidly Methodist lineage.
Two paternal great-grandparents, Jehu Derrick and his wife, and
their four children (Enoch, Elijah, Joseph, Mary) migrated to
Victoria on three different ships between 1852 and 1855, and a
maternal great-grandfather, Reverend Edward Sweetman, had settled
in Melbourne as a Wesleyan minister in 1840. In addition to Methodism,
or perhaps as an extension of it, was a strong family bent for
teaching. Derrick's paternal grandfather (Joseph Holbrook Derrick),
father (Clement Herbert Derrick, 1864-1945), mother (nee Elizabeth Mary Sweetman, 1871-1946), two uncles (one on each
side), and a maternal aunt were all school teachers, and one of
the uncles (Edward Sweetman, DLitt) became a lecturer in the University
of Melbourne and wrote books on Australian history. Medicine was
represented too, but more peripherally, by a great-great-grandfather,
grandfather, and uncle, all on his mother's side. Derrick wrote
of his lineage, but referring particularly to religion, 'Fortunate
is the child with a goodly heritage'.(1)
In 1895 Clement Derrick brought his bride to Blackwood, a dying
gold-mining town 65km from Melbourne, where he had been appointed
head teacher. Their four children (Herbert, Edward, Edith, Kate)
were born there and spent their early years surrounded by wild
bush-clad hills, and in a more immediate environment of old mullock
heaps, rusty machinery, poor sanitation, and general decay, and
among people who suffered, directly and indirectly, from the effects
of miners' phthisis. The school had about 100 pupils in 1895,
but the numbers had declined considerably by the time the Derrick
children finished their primary education. The young Edward's
most vivid memories of Blackwood (and of Campbell's Creek, where
he spent his holidays after his father was transferred there in
1911) were of the grandeur of the bush scenery; the brilliant
stars at night; learning the constellations from his father; Halley's
comet in 1910; an early fondness for poetry; fossicking for a
few specks of gold; the Cornish miners ('How they could sing!
How triumphantly they prayed!'); and an uncle convalescing from
tuberculosis in their home. His own interest in medicine was excited
at the age of ten or eleven, when he read The Family Physician
(2 vols) from cover to cover while convalescing from typhoid
fever, and his parents concurred in his choice of profession.
He gained an Education Department scholarship and entered Wesley
College, Melbourne, as a day-boy, living with his grandparents.
He was a reserved, rather shy lad who found the headmaster remote
and unapproachable, but he did well at school, gaining four Distinctions
in the Junior Public Examination in 1912 and a Government Exhibition
in the Senior Public in the following year. He loved poetry, but
his best subject was chemistry which he attacked with the same
concentrated energy that he had given to The Family Physician
at Blackwood.
His senior honours year in 1914 was sad and disturbing, for his
brother, who had been a brilliant student two years senior to him at Wesley, died of tuberculosis in May and the Great War began
in August. The school, in common with others of its kind, was
caught up in a fervour of patriotism, and Derrick recorded later
that, of 14 boys in Honour Sixth, 10 enlisted and 3 of them died
in France. In spite of these distractions, he did very well in
the Senior Public Honours Examination, sharing Honours and Exhibitions
with two later fellows of the Academy, T.M. Cherry
and E.J.G. Pitman.
On the advice of the head-master, he repeated the Honours year
as a boarder in 1915, but did not enjoy it, although he added
to his honours list in the Senior.
He matriculated in April 1916 and entered the University of Melbourne
as a resident student in Queen's College, a life he found much
more to his taste than boarding at school. He availed himself
of the wartime provision that those who had obtained Senior Public
Honours in physics and chemistry could commence Medicine in second
year by taking biology as an extra subject. He worked hard, gaining
class honours in each year, and graduated MB, BS in 1920 with
second class honours, fourth in the year to James Brown, Keith
Fairley, and Ernest Chenoweth. He had been a member of the University
Regiment.
Neither at the university, nor in his subsequent year at the Melbourne
Hospital, then in Lonsdale Street, did he feel any attraction
to pathology or microbiology. His basic concern was, and remained
for the rest of his life, with sick people, and he vastly preferred
out-patient clinics and ward rounds to any formal lectures and
demonstrations. He was fortunate in his clinical teachers (especially
Richard Stawell whom he revered), in having two periods of student
residence in the hospital (another wartime emergency), and in
helping to cope with the 1919 pandemic of influenza in an Army
camp hospital with R.H. Fetherstone who was then Medical Officer
of Health in Prahran. In spite of all this vicarious extra experience,
he felt woefully inadequate and was horrified to discover how
many diseases were incurable and how few of the drugs that doctors
prescribed were of any real benefit to their patients. The inevitable
course of lobar pneumonia to crisis or death particularly shocked
him.
When the year ended, the Registrar appointments in the hospital
fell to Brown and Fairley, so Derrick sought and obtained the
Sir John Grice Scholarship in Cancer Research, tenable in the
Walter and Eliza Hall Institute of Medical Research, and carrying
a stipend of £250 per annum, residence in the hospital, and
a share in carrying out the hospital autopsies. His main programme
was a histological study of the tumours of the kidneys and suprarenal
glands, from which he concluded that the common malignant tumour
of the kidneys ('hypernephroma' or 'Grawitz tumour') developed
from renal rather than suprarenal cells. His first scientific
paper was a report of these findings published in The Medical
Journal of Australia on 10 June 1922 (and his last a clinical
account of his own experience with non-exertional angina pectoris,
published posthumously in the same journal on 6 November 1976).
He also visited the Austin Hospital for Incurables and carried
out an experiment on pyrogenic treatment of inoperaable skin cancer,
with some apparent benefit in a few cases. There is no doubt that
the advice and guidance of the director of the Institute, Sydney
Patterson, and successive deputy directors, Neil Hamilton Fairley
and Harold Dew, during his tenure of the scholarship were significant
factors in turning his mind towards a career in medical research.
At that time, the Orient and P & O lines offered three free
passages to England each year through the university, and Derrick
secured one of these at the end of July 1922. Arriving in England
in the summer vacation, he and a friend (a classical scholar on
his way to Oxford) took the opportunity to make a tour of Germany
and Switzerland, which left him with a lasting impression that
'the similarities between people of different countries were much
greater than the differences. A narrow nationalism could never
return.' Back in London at the end of September, he found the employment
he sought difficult to obtain. He made many contacts and Charles
Kellaway, then at University College, was characteristically helpful,
but nothing eventuated until Hugh Cairns, an Adelaide graduate,
introduced him to Hubert Turnbull who was director of the Pathological
Institute in the London Hospital. An appointment of pathological
assistant in the Institute at a salary of £150 per annum
followed. The duties included attending Turnbull's lectures, assisting
in post-mortem examinations, which were carried out with a precision
and attention to detail far surpassing anything he had seen in
Melbourne, and preparing and studying histological sections, again
using techniques of a standard he had not previously encountered.
Turnbull became, with Stawell, one of the two great inspirations
of his medical career.
Derrick became impressed with the frequency of deaths in children
from miliary tuberculosis, due, it was believed, to rupture of
tubercles in the intima of pulmonary veins flooding the body with
tubercle bacilli. He resolved to test this hypothesis, so took
every opportunity to dissect out the pulmonary veins of children
who had died of the disease, search them for internal tubercles,
and cut sections of any that he found. He successfully accomplished
this task, but it was exacting work, and he failed to realize
that snipping the small intimal tubercles off with scissors might
charge the air before his face with live tubercle bacilli.
He had gone to England 'in search of knowledge' and it might be
thought from the foregoing that he was preparing himself for a
life in laboratory medicine. That was not so, for, on the one
hand, he considered that morbid anatomy and experimental pathology
lacked 'the close relation with patients...that gives medicine
its satisfaction and its standing' and, on the other hand, he
had a half-formed intention to become a medical missionary in
China. This was his 'alternative career', and his inclination
for it was no doubt strengthened by his association with Kingsley
Hall, a Methodist mission in the East End to which he devoted
much of his spare time. Proficiency in surgery was an obvious
pre-requisite for a medical missionary, so he began to prepare
himself by reducing his post-mortem work, and attending lectures
and sitting for the primary FRCS examination which he passed in
December 1923.
During the transition period, he visited Paris with Alan Lee (later
a Brisbane surgeon) and one night, when alone in his hotel, he
coughed up some blood, not much but of unequivocal diagnostic
significance. He immediately returned to London, tubercle bacilli
were found in his sputum, the physicians gave him a good prognosis,
and an early passage to Australia was arranged. He arrived in
Melbourne on 13 February 1924, and so, as he put it, 'all my plans
came to a sudden and inglorious end.' He was later convinced that
he had contracted the infection in the post-mortem room, but he
had already had two intimate family contacts with tuberculosis
in his youth, and the strenuous life he led could have activated
a dormant infection.
In search of a curative climate 1924-1934
Thus did Derrick entitle the next ten years of his life. Rest
in bed, which might have shortened his convalescence, was not
then favoured in Victoria and he was treated, with his own full
approval, in the Trudeau tradition of fresh air, sleeping out
of doors, living in the country, and a special reliance on mountain
air. He went to Kyneton, north of the Dividing Range, where he
lived quietly for a few weeks and then took a relieving resident
position in the local hospital. This set the pattern of an odyssey
that was to lead him by devious paths to the far west of New South
Wales and, ultimately, to northern Queensland. It was effective
in that he recovered; but it is an interesting reflection on clinical
attitudes in the twenties that it apparently did not occur, either
to himself or to his advisers, that an itinerant phthisical doctor
might spread the infection wherever he went.
On the advice of Ernest Chenoweth, by now practising in Queensland,
Derrick's first venture further afield was to Brisbane, where
he was well received, saw leprosy for the first time at the Peel
Island lazarette, obtained registration from the Queensland Medical
Board on 10 July 1924, and spent several enjoyable weeks at Bilinga
on the south coast. He was greatly attracted by the northern State,
but his health did not improve and he returned sadly to Melbourne
in October.
He remained quietly in southern Victoria for several months, and
then began again to seek relieving (locum tenens) appointments,
moving progressively into drier and hotter country from Yea in
Victoria (August-September 1925) to Curramukke in South Australia
(September-October), Broken Hill in New South Wales (October-November),
and finally Tibooburra in the northwestern corner of the State
(November 1925 to March 1926). He adapted quickly to the arid
environment, and his health remained good under the stresses of
a busy lodge practice at Broken Hill, a long, tiring, two-day
journey by mail-car to Tibooburra over a rough bush road with
many gates to open on the way (a normal duty for a passenger),
and life in an isolated village about 200m above sea level with
an annual rainfall of about 200mm, annual evaporation of nearly
3m, and December temperatures up to 46.5°C. Medical work
was light at Tibooburra, but he had cases of typhoid fever to
worry him, a woman who died of puerperal septicaemia, and a patient
with delirium tremens to control; he also made two long trips
into South Australia, one to examine an old swagman who had died
in the desert and the other to collect a surgical patient from
an isolated station. One of his patients had a camel team and
enlivened his convalescence by teaching Derrick to ride and manage
the beasts.
When the time came to leave Tibooburra, he did not return south,
but travelled north and east with the overseer of the rabbit-proof
border fence on his tour of inspection and maintenance, crossed
the Paroo River, and entered Queensland at Hungerford, where he
saw his first cases of dengue fever, the 1926 epidemic being then
in full spate. Another fortuitous car trip took him to Cunnamulla
and so by train to Brisbane, where he arrived on 12 March.
A week as locum at Killarney in the border ranges brought
him more experience of dengue fever (including a personal attack
which provided useful serum antibodies for study 30 years later),
but the turning point in his life came in April when he was called
to a relieving appointment at Irvinebank in north Queensland.
It was there that he finally regained his health, married, developed
his great interest in the fevers of the north, and so was led,
almost automatically, into the path that was later to prove so
profitable. But it was still by no means all smooth going.
Irvinebank was a small tin-mining town about 760m above sea level
on the main range 80km west of Innisfail, with an admirably dry
mild winter climate and a monsoonal (summer) rainfall of about
850mm. The duties of the medical officer included regular visits
to Stannary Hills 24km away, but were generally light and Derrick
was able to enjoy the quiet life that he still needed. His health
continued to improve rapidly, so that, when his appointment ended
in June, he decided to spend the next few months visiting other
places, including Ravenshoe, Innot Hot Springs, and Mount Garnet,
in the same general area. Then followed another relieving appointment
at Irvinebank from December 1926 to June 1927, followed by similar
appointments at Mareeba on the tableland and Innisfail on the
coast.
Believing that he was cured, he returned to Melbourne in January
1928 and was appointed resident pathologist at the Austin Hospital,
but he soon relapsed with tubercle bacilli again in his sputum,
a bitter disappointment. Further rest and a trial of private practice
in the Riverina brought little improvement, and he returned to
Melbourne a very worried man.
Relief from this distressing situation came in July 1929, in the
form of a telegram inviting him to take over the position of medical
officer at the Irvinebank Hospital on a permanent basis. He accepted
gratefully and returned at once to the town which held all his
hopes of survival and a productive life. By 1930 he 'pronounced
himself perfectly fit', married Miss Margaret Gina Quadrio, matron
of the hospital, on 11 March, and settled down to what appeared
to promise a quiet life in general practice. But his troubles
had not ended. Mining in the district declined, the Hospital Board
found itself unable to pay his salary, and his appointment was
terminated in May 1931. However, he was able to obtain a similar
appointment at Mount Mulligan and remained there until early in
1934.
Throughout his wanderings, Derrick had been impressed, more than
most, by the weight of responsibility that rests on a doctor who
has to practise all branches of medicine in a remote place where
he cannot discuss his problems with a colleague or call in the
aid of a specialist. This feeling of inadequacy was sharply increased
when he attended a postgraduate course in Brisbane before taking
up the Mount Mulligan appointment, and an attempt to keep up-to-date
thereafter by more intensive reading of the journals he received
did not satisfy him. He believed his cure was complete, so resigned
from Mount Mulligan to begin private practice in Brisbane.
That, indeed, was the end of his wanderings, for he and his wife
remained in or near Brisbane for nearly 42 years, and their two
sons grew up there. The way had been long, arduous, and often
frustrating, but it had brought, too, a wide knowledge of the
harsh interior and the tough north and of the people who lived
in those remote places. Derrick quoted Trudeau's comment as applying
very much to himself:
The struggle with tuberculosis has brought me experiences and
left me recollections which I could not have known otherwise,
and which I would not exchange for the wealth of the Indies.
The rest of this story belongs to his scientific work.
The microbiological laboratory 1935-1947
The practice at Kelvin Grove was short-lived, for Derrick was
appointed director of the Laboratory of Microbiology and Pathology
in the Queensland Health Department on 1 June 1935, a notable
event in Australian medical history (as was J.B. Cleland's
appointment to the equivalent laboratory in Sydney some 20 years
earlier).
The laboratory had had a chequered career (Tonge, 1960). In 1893
a Stock Institute was established in Brisbane with C.J. Pound
in charge for diagnosis and investigation of diseases in the livestock
on which the colony was so dependent for survival and prosperity.
It did good work, especially on the tick fevers of cattle. In
1899 its name was changed to the Bacteriological Institute, Pound
became Government Bacteriologist, and the scope of the Institute
was expanded to include human diseases; it became, in fact; the
first public health laboratory in the colony. Its value in that
capacity was soon demonstrated, notably in the plague epidemic
of 1901-7, its tasks multiplied, and in 1910 it was split into
the Laboratory of Microbiology and Pathology under Dr John Harris,
attached to the Department of Health, and the Stock Institute
under Pound, attached to the Department of Agriculture and Stock
(now Primary Industries). The latter became the flourishing Animal
Research Institute at Yeerongpilly, so the old Institute left
two lusty descendents.
The Microbiological Laboratory had four changes in directorship
(Harris, Burton-Bradley, Arnold Dean, and Harris again) between
1910 and 1923, but then remained without a medical officer for
12 years, during which it was managed, with remarkable efficiency,
by Mr H.E. Brown and a small staff working in cramped, inadequate
quarters. R.W. Cilento,
a noted authority on tropical medicine, became Director-General
of Health and Medical Services in 1934. He immediately perceived
the inadequacy of the laboratory services, secured larger quarters
for them in the new departmental building in William Street, and
pressed strongly for the appointment of a medical director of
the highest quality. This was finally approved by Cabinet on condition
that the laboratory would take over all coronial autopsies from
the private practitioners, thereby saving more in fees than they
intended to pay the director in salary. Cilento's choice of Derrick
proved a remarkably wise one.
It follows that his first task was to establish an efficient autopsy
service, and this he did with his customary thoroughness and meticulous
attention to detail. He based his procedures on the experience
he had gained at the Pathological Institute in London 12 years
earlier and recorded all his findings with such care and completeness
that they now form a unique series for reference and research.
He also published a guide to technique for medico-legal autopsies
and a number of papers on suicide, alcoholism, lead poisoning,
unusual pathological findings, and other subjects in general pathology.
He was one of the first in the world to use blood alcohol estimations
in court evidence.
In the meantime, in August 1935, Cilento was informed of the problem
presented by the occurrence of 'abattoir fever' in the Brisbane
Abattoir, and invited Derrick to investigate it. This was to him
'the opportunity of a lifetime' and he seized it with both hands,
ably assisted by Hubert Brown and D.J.W. Smith whose appointment
in 1937 was the first for full-time medical research in Queensland
since the Commonwealth Institute for Tropical Medicine at Townsville
closed in 1930. The resulting spate of publications has been reviewed
several times, most vividly by Burnet (1967) and Derrick.
Derrick proceeded logically. His first step was to make a careful
clinical study of all the cases available to him, but this revealed
little more than that the disease had some typhoid-like or typhus-like
features. He then used his laboratory resources to discover whether
it was an aberrant form of some febrile disease already known
in Queensland, again with negative results. A search of the veterinary
literature failed to reveal any potential zoonosis derivable from
cattle that would fit the picture. He then turned to the guinea-pig,
the standard experimental animal in his laboratory, as in most
others in Australia at the time. Guinea-pigs inoculated with blood
from febrile patients developed a mild disease, characterized
by fever and enlargement of the spleen, and ending in recovery.
The disease could be passed serially from guinea-pig to guinea-pig
by inoculation of spleen or liver errulsions, but guinea-pigs
which had recovered from a previous attack were refractory to
re-inoculation. Here then was a specific infectious disease caused
by an organism which he could neither detect by microscopic examination
of infected tissues nor grow in any of the culture media available
to him. He thought it was probably a virus and sent infected spleens
to F.M. Burnet at the
Walter and Eliza Hall Institute of Medical Research, Melbourne,
for further study.
Burnet's principal tools were not guinea-pigs but the chorioallantois
of the developing chick and adult mice (the use of infant mice
in rickettsial research came much later). The chorioallantois
proved to be only marginally useful, but the inoculated mice developed
enlarged spleens, sometimes with exudate on the surface. Searching
a section of an infected spleen one day, Burnet came on what appeared
to be a micro-colony of tiny, weakly stained rods, and study of
Castenada-stained smears promptly confirmed their identity as
rickettsiae; the mouse had proved a better animal than the guinea-pig
for this investigation. The immediate problem was solved and Derrick
named the disease Q (for Query) fever, later (January 1939) naming
the organism Rickettsia burneti in honour of Burnet; still
later it was removed from Rickettsia to a new genus Coxiella
by C.B. Philip on account of its distinctive characteristics
within the rickettsial family.
Derrick's guinea-pigs had given him a valuable tool for further
research. Two guinea-pigs, one 'clean', the other recovered from
previous infection, could be inoculated with any suspected material,
and if the first guinea-pig reacted but the other not he was provided
with both a diagnosis and a fresh strain of C. burneti to
study. This method was used extensively, and the laboratory, a
large gloomy room subdivided by island-benches, became congested
with large glass battery jars, each occupied by two guinea-pigs.
It was an awesome sight to the unprepared visitor! At the height
of the work, rectal temperatures of more than 100 guinea-pigs
were being taken daily, and more than 1000 were used in the whole
investigation.
Meanwhile, Burnet and Mavis Freeman went on to provide another
valuable diagnostic tool. 'By a little simple juggling with pH'
(Burnet, 1967) Miss Freeman was able to prepare a stable rickettsial
suspension from infected mouse spleens, which they used to develop
a neat though somewhat tricky micro-agglutination test for specific
antibodies in human and lower animal sera. For much of the work
Derrick simply sent his sera to Melbourne and Burnet and Miss
Freeman returned him prompt and reliable answers. The task was
later transferred to Brisbane, using Freeman mouse spleen antigen,
until Wilbur Smith discovered in 1940 that the abundant multiplication
of rickettsiae in infected female Rhipicephalus sanguineus
(dog ticks) made it possible for him to prepare much larger
volumes of excellent suspensions. The tick antigen was employed
until the complement-fixation test was introduced in 1950.
To return to the main story, recognition of a rickettsia pointed
directly to an arthropod-mammal primary cycle of infection. Local
bandicoots (Isoodon macrourus) were known to harbour a
rich variety of blood-sucking ectoparasites, and here luck favoured
the research, for it led the collectors to Moreton Island where
there were no large mammals, other than a few goats, and abundant
bandicoots carrying only one species of tick, Haemaphysalis
humerosa. Using the guinea-pig technique described above,
Smith soon isolated C. burneti from six batches
of ticks and two bandicoots and a serological survey revealed
a high incidence of infection in the bandicoot population. Bandicoots
and their ticks are widely distributed in eastern Queensland,
so an efficient reservoir cycle had clearly been revealed.
The question remained: how did the infection get from bandicoots
into cattle, and from cattle into workers in widely scattered
departments of the Abattoir, but not at all into the workers in
Swift's and Borthwick's Meatworks which killed only for export
? And, as the work went on, how to account for the laboratory
infections that occurred in both Brisbane and Melbourne? Most
of this looked easy, but it proved most difficult.
Including experimental transmission, the four potential vectors
of C. burneti then known (Haemaphysalis humerosa, H.
bispinosa, Rhipicephalus sangineus, and Ixodes holocyclus)
were also known to attack cattle, at least occasionally, so
it was safe to assume that some transmission from bandicoots to
cattle would occur in nature (another significant cycle involving
sheep is noted later). It was known, too, that infected ticks
had enormous concentrations of rickettsiae in their guts and that
many of the cattle entering the Abattoir were infested with cattle
ticks, Boophilus microplus. But this promising line drew
a complete blank: not a single infection was found in the thousands
of Boophilus and substantial numbers of cattle spleens
from the Abattoir that were tested in guinea-pigs. There had to
be some mechanism other than contamination from the bodies of
infected ticks crushed in the slaughtering operation.
The answer came from the United States. In essence, 'nine-mile
fever' of Montana proved to be a tick-transmitted rickettsiosis,
a chance laboratory infection demonstrated its identity with Q
fever, infection was found to be widespread in California, and
detailed studies showed that rickettsiae were present in large
numbers in the milk of infected dairy cows and in enormous numbers
in the placentas of infected cows and sheep. Analysis of laboratory
infections also supported the conclusion that infection could
be acquired by inhalation of contaminated dust or droplets. C.
burneti, in fact, had the remarkable ability to behave
as a perfectly normal Rickettsia in its reservoir cycle
and as a Brucella in infections of cattle, sheep, and man.
These findings resolved all Derrick's difficulties, including
the absence of Q fever from the export Meatworks which did not
kill pregnant cows. By 1955 the disease had been recognized in
51 different countries.
Derrick's guinea-pigs served him well in another important study.
In 1937, he was asked to investigate cases of fever in dairy farmers,
so he inoculated guinea-pigs in the standard way and isolated
a Leptospira, which he named L. pomona. D.W. Johnson, working in Derrick's laboratory, studied its distribution and
epidemiology in Australia, and it was found later that it was
also the cause of 'swineherd's disease' in Switzerland and mild
leptospirosis in other parts of the world. It was of these two
diseases, Q. fever and Pomona leptospirosis, that Burnet was thinking
when he wrote in his citation for Derrick's election to fellowship
in the Australian Postgraduate Federation in Medicine: 'To have
defined and elucidated the aetiology of two world-wide infectious
diseases is something no other living scientist can claim'.
Other investigations were going on at the same time, some new,
others arising from the steadily increasing volume and range of
routine work that was being undertaken by the laboratory, wedged,
as it were, among the hordes of guinea-pigs in their battery jars.
These included (Doherty, 1967): discovery of a second new leptospira
(L. hyos) by D.W. Johnson; description of generalized
amoebiasis, found at autopsy of a patient from New Guinea and
thought at the time to have been due to Iodamoeba, but
now considered to have been caused by Naegleria; isolation
of the Karp strain of the scrub-typhus rickettsia (also from New
Guinea); recognition of a variety of infections not previously
recorded from Queensland, including classical Weil's disease (L.
icterohaemorrhagiae), rat-bite fever (Spirillum minus),
torula meningitis, chromoblastomycosis, and histoplasmosis;
and surveys of filariasis (including a persistent focus at the
Goodna mental hospital), tick-typhus, and human brucellosis. Finally,
Derrick crowned his labours by developing and carrying through
his plan for the establishment of an institute for medical research
in Brisbane, making this unquestionably the most productive period
in his whole life.
The Queensland Institute of Medical Research 1947-1966
Derrick has recorded the origin and birth of the Institute. During
the later years of the 1939-45 war, the burden of routine forensic
and public health work grew steadily heavier, shortage of staff
was aggravated by enlistments (most notably of Wilbur Smith into
the RAAF), Derrick himself was involved in considerable part-time
teaching in the Medical School (he was a special lecturer in the
Faculty of Medicine from 1939 to 1965), and research in the Microbiological
Laboratory had to be almost completely abandoned. He became seriously
concerned for the future, and therefore included a plea in his
1943-44 annual report for a return to a policy of active research
as soon as the war situation permitted. This was noted by R.H.
Robinson, under-secretary of the department, Derrick's initially
modest proposals were expanded in further discussions and, on
18 April 1945, Cabinet appointed a Medical Research Advisory Committee
of nine members, with Derrick as chairman, to plan an institute
of medical research and advise on how the plan could best be implemented.
As is usual with such committees, the brunt of the work fell on
the chairman (who would not have wished it otherwise), but all
contributed and especially D.H.K. Lee, then Professor of Physiology
in the university and the only member with previous experience
of organized medical research on the scale contemplated. Their
report and a draft Bill for establishment of the Institute were
presented on 13 July, accepted almost in toto, the Bill
was introduced into Parliament on 6 September, and The Queensland
Institute of Medical Research Act was proclaimed on 19 January
1946. It provided for an institute to undertake 'research into
any branch or branches of medical science . . . under the control
and management' of a council of seven members with the director-general
of Health and Medical Services as chairman.
The first meeting of the council, with Sir Raphael Cilento in
the chair, was held on 8 February 1946, and Derrick was appointed
acting deputy-director so that he could implement decisions about
the Institute while continuing to control the Microbiological
Laboratory. He became deputy-director on 27 March 1947, confirming
his intention that someone else should be the first director.
In the meantime, he and the council had done a great deal of work:
gathering the nucleus of a library and essential basic equipment
(including much that had been used by the LHQ Medical Research
Unit at Cairns during the war); obtaining a temporary home for
the Institute in a large, empty US Army hut in Victoria Park near
the Medical School and Brisbane Hospital; providing enough sub-division
and furnishing in the hut to accommodate initial research and
ancillary staff; and securing the services of an experienced librarian
(Mrs Margaret Macgregor, appointed 28 April 1947). When the building
was occupied on 2 June 1947 by the director and the deputy-director,
the librarian, and two ancillary staff (with three more to come
in the following week), it was ready for at least the beginnings
of some active work. It remained a centre of considerable activity
for the next 30 years, for most of which Dr (later Sir) Abraham
Fryberg was chairman of the council. Its successive directors
have been Mackerras to 1961, Derrick to 1966, R.L. Doherty to
1977, and C.S. Kidson from 1978, with J.H. Pope as acting director
in 1977-78.
Doherty (1967, 1978) has given well-balanced accounts of the next
14 years, the second paper bringing Derrick's activities into
perspective with other work that was going on in the Institute
in the same period.
Derrick was unquestionably glad to have a time of relative relaxation
after his strenuous efforts in 1945-47, and he gave most of the
next two years to the pleasant task of clearing up the backlog
of uncompleted papers carried over from the Microbiological Laboratory.
All 11 of his publications from 1948 to 1951 belong to this category.
At the same time, he continued to help in the selection of staff,
in planning the additional laboratories that would be needed within
the building, and especially in establishing adequate stocks of
laboratory animals, principally mice (derived originally from
Hall Institute stock), but also rats, guinea-pigs, and rabbits.
A large section of the area under the hut came to be occupied
by the animal houses, which helped to sustain the rather flimsy
structure of the laboratories above.
He also had two main research projects in mind, both fitting well
into the broad research policy that had been accepted for the
Institute. One was to continue the search for infectious agents
in southern Queensland that had begun in the Microbiological Laboratory,
but using mice rather than guinea-pigs as the primary tool; and
the other was his old favourite, to investigate the many still
undiagnosable fevers of north Queensland. He felt strongly that
an efficient virological unit would be an indispensable component
in the plans for both, so he spent several months in 1951 visiting
relevant overseas laboratories to learn what he could of their
organization and methods.
The first project began as soon as enough resources could be got
together, and it proved (like the study of salmonellosis in infants
that was going on in another section of the Institute at the same
time) an admirable training ground for the young cadets who were
later to become the backbone of the research staff. It went on,
with intermissions, through the whole period, adding to general
knowledge of infectious agents and their hosts, but leading to
only two significant discoveries. One was that toxoplasmosis was
common in Queensland rodents and small marsupials, and serological
surveys showed that it was also common in man, usually in inapparent
infections, but sometimes, as elsewhere, associated with a variety
of syndromes, including congenital brain and eye damage. Its epidemiology
remained obscure for we failed to recognize the domestic cat as
the primary host in which the parasite behaves as an ordinary
coccidian; that discovery came from studies overseas nearly 20
years later. The second discovery was the isolation of an obscure
virus from a house mouse collected in Brisbane and its final identification
by J.H. Pope as a mouse leukaemia virus, which led him directly
into a productive career of research on the tumour viruses of
man.
Derrick's second project began in 1951 after his return from abroad.
A field station was set up in the Innisfail Hospital and manned
successively by two medical research fellows (C.N. Sinnamon for
a year, R.L. Doherty thereafter) and the most experienced of
the available cadets. In essence, the plan was to make a careful
clinical study of all febrile patients, to collect immediate and
convalescent samples of sera for serological investigation, to
make blood cultures for leptospirae, and to inoculate adult mice
for isolation of rickettsiae and other agents. The mice were returned
to the Institute, where they joined the search for infectious
agents described above; sera and positive cultures were sent,
by cooperative arrangement, to the Microbiological Laboratory,
which was now directed by J.I. Tonge and had Hubert Brown and
Wilbur Smith as experts in leptospiral identification. It was
a return to valued old associations for Derrick.
The principal results of this study were the addition of eight
'new' serotypes of leptospirae to those already known in Australia
and the demonstration that mouse-inoculation was much more reliable
than the Weil-Felix serological reaction for the diagnosis of
scrub-typhus. Serology and a broader approach to laboratory diagnosis
in general also reduced the number of more ubiquitous infections
that passed unrecognized, so that by the middle of 1955 it could
fairly be said that the diagnostic problems, and consequently
treatment, of the fevers of north Queensland had been substantially
solved. Work at the field station was turned to a detailed study
of the reservoir hosts, still in collaboration with the Microbiological
Laboratory which had by then became a WHO Reference Centre for
leptospirosis, but that story does not belong here.
Freed from his preoccupation with Innisfail, Derrick was able
to gather in the loose ends and turn his attention to other problems.
He published epidemiological analyses of dengue fever, leptospirosis,
and scrub-typhus, in which he foreshadowed the special concern
with climatic factors that was to influence much of his later
work on asthma; he and Domrow organized a survey of the foci of
scrub-typhus in north Queensland, which provided a basis for later
studies by Domrow, Cook, and Campbell of the host distribution
of Rickettsia tsutsu-gamushi and its transmission by Leptotrombidium
deliense; he joined with Cook in the survey of human toxoplasmosis,
with Pope in an investigation of murine-typhus during a mouse
plague on the Darling Downs; and also with Pope in a final rewarding
study of Q fever arising from an outbreak of the disease among
shearers working on sheep stations in western Queensland. The
investigation revealed a high incidence of infection in local
kangaroos and kangaroo ticks (Amblyomma triguttatum, a
three-host tick with a wide host range), which provided a major
maintenance cycle in the west comparable to that provided by the
bandicoot and its tick in the east. Many of the sheep brought
in for shearing were infested with A. triguttatum, so it seemed probable that the workers in the shed were infected
from the ticks macerated during the shearing operation, a hypothesis
which was supported by the occurrence of Q fever in fellmongers
in Brisbane who handled fleeces from the infected stations.
When Derrick became director on 29 July 1961, the Institute had
teams able to work independently in such fields as arboviruses
(Doherty, with the largest group), tumour viruses (Pope), Acarina
(Domrow), rickettsiae (Pope, Carley, Campbell), bacteriology (Singer),
and a capable deputy-director in R.L. Doherty, and he was therefore
able to concentrate on a study of the epidemiology of asthma in
Queensland, a problem to which he was attracted by the frequency
of the disease, especially in children in the Brisbane area.
He had begun the study in 1960 with a survey of admissions for
asthma in the Brisbane hospitals, which showed that there were
normally two well-defined seasonal peaks, one in autumn and one
in spring. Then he found that similar peaks in admissions occurred
in other hospitals in southeastern Queensland but not in north
Queensland, and that they were much more evident in young people
than in older age groups. These findings suggested seasonally
produced airborne allergens as the probable cause of the epidemics,
so he arranged for the establishment of air-sampling facilities
and secured the appointment of a botanist (J. Moss) and mycologist
(R. Rees) to analyse the samples for plant
pollens and fungal spores respectively. A great mass of quantitative
and qualitative information was collected in the ensuing years,
but no correlations with the frequency of asthmatic attacks were
established either by statistical analysis of the data or by clinical
testing of the potential allergens that had been isolated. Correlations
with growth of grasses and density of smoke were also attempted
without success. In the meantime, he pursued his statistical studies
of weather and climate, still searching for correlations that
might point to the operative allergens. He was able to correlate
the monthly incidence of asthma with mean monthly temperatures
up to 21 degrees C, but no higher, and the annual incidence of
asthma with annual rainfall, but there the work ended. He published
19 papers on asthma, 13 of them after his retirement.
Final years, 1966-1976
When he retired on 28 July 1966, Derrick was appointed honorary
research fellow in the Institute and, a little later, director
of the Research Bureau of the Queensland Asthma Foundation, which
post he held until 1973. He continued his studies much as he had
before his retirement, published 21 papers on a variety of subjects,
including those on asthma already referred to, and prepared a
manuscript (published after his death) recording his own terminal
illness with characteristic detachment and attention to detail.
Though his physical capacity declined, his mental activity did
not, and he was still making notes within a few hours of his death
on 15 June 1976 (Tonge, 1976). It is sad that he did not survive
long enough to enter the Institute's spacious new laboratories
in the grounds of the Brisbane Hospital, which were opened in
February 1977 and will remain his most enduring monument. His
portrait by Graeme Inson hangs in the entrance hall.
Conclusion
This has been the story of an unusual man who came into research
under two diverging influences. On the one side, his family background,
early education, and temperament made him deeply religious, reserved,
intolerant of levity on serious subjects, but still willing to
suffer fools gladly if they were young and teachable. He came
to medicine with the conviction that his task was to relieve human
suffering indeed, to seek it out for relief and there is little
doubt that he would have become a missionary among the heathen
if tuberculosis had not intervened. On the other side, he was
endowed with an analytical mind, a liberal share of scientific
curiosity, an immense respect for the integrity of science, and
an obsession (perhaps acquired in London) with detailed observation
and precise recording. He had gone to England 'in search of knowledge'
and the same tuberculosis that had deprived him of his missionary
ambition led him in the end to the laboratory in Brisbane where
he had ample opportunities to continue the search. This he did,
with results that gave him great satisfaction and brought him
world-wide recognition as a distinguished Australian scientist.
He received many honours. He was awarded a CBE in 1961, was elected
to the Academy in 1955, received The Britannica Australia Award
for Medicine in 1965, admitted DSc (honoris causa) by the
University of Queensland in 1966, and awarded the ANZAAS Medal
in 1969. He was elected a fellow of the Australian and New Zealand
Association for the Advancement of Science (1940), fellow of the
Royal Australasian College of Physicians (1947), foundation member
(later fellow) of the Royal College of Pathologists of Australia
(1956), member of the International Society of Biometeorology
(1966), fellow of the Australian Society of Allergists (1967),
fellow of the Australian Medical Association (1968), fellow of
the Australian Postgraduate Federation in Medicine (1971), and
honorary fellow of the Royal Society of Tropical Medicine and
Hygiene (1975). He also shared the Cilento Medal with F.M. Burnet
in 1939, was Bancroft Orator of the British Medical Association
(Queensland branch) in 1948, and Elkington Orator of the Queensland
Society of Health in 1962. The Medical Journal of Australia
published a Festschrift number in his honour on 9 December
1967.
Acknowledgments
I am grateful to Professor R.L. Doherty, University of Queensland,
to Dr J.H. Pope and other members of the Queensland Institute
of Medical Research, and to Dr J.I. Tonge and Mr D.J.W. Smith
of the Queensland Laboratory of Microbiology and Pathology for
information and suggestions, and to Dr Elizabeth N. Marks and
Mrs E.R. Bailey for help in the preparation of the manuscript.
Notes
(1) Quotations without citation
of reference are from a manuscript autobiography which was completed
only to the end of 1933, now in the Academy's Basser Library.
I.M. Mackerras,
DSc, former Director of The Queensland Institute of Medical
Research, Brisbane (1947-1961). He was elected to the Academy
in 1954 and served on Council 1955-7.
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