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Sent From (Definite): Sydney Price JamesSent To (Definite): Thomas CarnwathDate: 6 May 1935
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Sent from Sydney Price James
6 May 1935
Description:‘Dr. Carnwath,
This report will be considered by the Chemotherapy Committee a ta meeting on 13th July.
From what is said on pages 9 & 15 it will be seen that the continuance of the Ministry’s centre at Horton in something like its present form is regarded as an essential part of the scheme.
With reference to para (2) on page 15 it is probably that I shall be asked at the meeting what period remains during which my services will be available. If I could have any information on that point which I could communicate to the Committee I should be very grateful.
S.P. James, 6/5/35.’
[in separate hand:
‘C.M.O.
Establishment.
You will wish to see this report on the reorganisation of Chemotherapeutic research, as it involves the Horton unit. If does not however affect the present application to the Treasury except to suggest perhaps that we may get what we want for somewhat less than the £500-600 mentioned in my minute. His was Prof Jameson’s figure.
I assume that you will not be in a position to anwer Col. James’ question until you have the Treasury’s decision.
T[?][homas?].C[arnwath?]. 6/VI/35.’]
[attached to above:
‘S.C. 65. Chemotherapy Committee. Report of the Sub-Committee appointed by the Chemotherapy Committee to make recommendations for the organization of Chemotherapeutic work in England.
20th May, 1935.
...
The Chemotherapy Committee since its appointment about eight years ago has been concerned chiefly with making arrangements for preparing new synthetic compounds and for testing their therapeutic value; e.g. –
I. [testing arsenical compounds [on animals?] in Liverpool and Hampstead, generally not on patients, but in case of single compound, that ‘Professor Yorke has been able to make private arrangements for its test on human syphilis in Liverpool and human trypanomiasis in Africa.
II. New compounds, for the most part on the basis of plasmochin and atebrin, are now being produced at various centres, and these are examined as to their therapeutic action on bird malaria in Cambridge. If further testing against human malaria is desirable, it is carried out at the Ministry of Health’s Malaria Therapy Centre at Horton.
...
Existing Chemotherapy Organisations.
Among the existing activities at present associated with the Chemotherapy Committee are:-
1. The Liverpool unit under Professor Yorke.
2. The London unit under Sir Rickard Christophers.
3. The Ministry of Health unit at Horton under Colonel James.
4. The Cambridge unit under Professor Keilin.
Although these various organizations are all working in close association with the Chemotherapy Committee it must be remembered that in one case (Liverpool) the Committee contributes only a fraction of the cost of the work and in another case (Horton) nothing at all, whilst in the remaining instance the units are housed by the London School of Hygiene and the Molteno Institute, respectively...
...[description of testing facilities and beds available at Liverpool School of Tropical Medicine]...
...[ description of testing facilities and beds available at London School of Tropical Medicine]...
The Ministry of Health and London County Council Malaria Therapy Centre.
This centre in something like its present form is essential, not only to chemotherapeutic research and testing, but in connection with malaria research in England as a whole. The exact relations to the scheme would be a matter for consideration, but inclusion need not restrict its other work in connection with malaria. Apart from small annual honoraria paid to Colonel James and Mr. Shute by the Medical Research Council [note: ‘Total £125’] this centre is financed entirely by the Ministry of Health and the London County Council.
...[ description of researchers employed at the Molteno Institute, Cambridge]...
...
Recommendations.
We have now to consider what steps should be taken to remedy the defects of the existing organisation and to put into operation the principles which, in our opinion, are essential for the development of chemotherapy in this country. There appear to us to be two possible lines of action:-
(a) The first plan which presents itself is the establishment of a single large chemotherapeutic organisation or institution. The establishment of such an institution would be an exceedingly costly matter. Not only would it be necessary to provide a building of considerable size and to equip it, but it would be necessary to provide a large and experienced staff familiar with the various infections – malaria, trypanosomiasis, syphilis, etc. – for which it is hoped to discover new methods of treatment. Apart from the financial considerations, this might well prove a difficult matter, as the number of individuals in this country who have interested themselves in chemotherapy is very limited. Furthermore, it is very doubtful whether such a scheme could be brought into operation without considerable delay.
(b) A more practical and economical plan, and one which we recommend, would be to build upon organisations which already exist, and to endeavour to establish two adequately equipped chemotherapeutic centres, one primarily for malaria in London, and the other for trypanosomiasis and syphilis in Liverpool...
...
The London Centre.
The organisation of an adequate malaria centre is obviously a much more difficult matter. In our opinion the first step necessary is the amalgamation of the activities at present going on in Cambridge and London. This we believe to be unavoidable, not only on economic grounds, but because we hold strongly that testing and cognate scientific research should be carried on in the same place and under the same direction. Laboratory testing and chemotherapy research should clearly be combined in one organisation under one roof. Further it is most desirable that it should be located in close association with other laboratory activities particularly those relating to the investigation of the different aspects of malaria. This is only possible in London. With provision of the necessary accommodation and staff the London Unit of experimental malaria could be readily converted into the organisation required. It could either remain as the Unit of Experimental Malaria, its function being those indicated above, but not exclusive of future extension to other aspects of experimental malaria, or be made a purely Chemotherapy Research Centre. A decision on this point should be come to after consideration of the general position in respect to malaria research in London. An important point relevant to the present scheme is that “testing” of anti-malarial compounds could scarcely remain on a purely routine and stereotyped basis, without gravely limiting its scope and usefulness. Testing is, for example, dependent on maintenance of bird malaria; it must use mosquito-induced infection as well as blood-inoculated material and thus must include arrangements for mosquito culture on an adequate scale etc. It should also be in a position to select and cultivate various types or strains of parasite used and to ascertain which of various standards of “cure” etc. are desirable. It is evident also that it could not neglect such an obviously desirable line as testing toxicity and therapeutic effect on monkey malaria. All this means a very considerable amount of the so-called biological type of work. It will be seen, therefore, that a London “testing” centre would be enormously helped by being associated with experimental work on malaria generally. The idea of a Centre for Malaria Research in London has already received a certain amount of consideration and hence there might be considerable advantages when creating a testing and chemotherapy research organisation in leaving the exact limits of future development as open as possible. In this case it might be desirable to retain the designation of Experimental Malaria Unit even though its staff and functions were for the present entirely designed to cover chemotherapy requirements.
Until the location, accommodation and form of such a centre has been decided exact details of staff are probably best left open, but the staff already given as necessary for a Chemotherapy Testing and Research Centre may be taken as a fairly correct guide.
As regards accommodation we attach a sketch [schematic map] of what we think should serve. Existing accommodation at the London School is roughly indicated at A. It could not accommodate, however, any more workers than at present and increased accommodation as roughly indicated at B would be required.
Clinical testing and research for a London Centre would require to be arranged for at the Horton Centre of Malaria Therapy. Certain provisions would be necessary in this respect.
(1) Some recognised working basis would require to be arranged with the Ministry of Health and L.C.C. by which the necessary facilities for testing and research could be made available to the Centre and a proper working association brought about.
(2) Whilst for the present Colonel James’s services would serve to maintain the necessary control and supervision of clinical testing at Horton it would eventually be necessary to ensure continuance of such control and supervision.
(3) It is very desirable that arrangements should be made through the L.C.C. for a centre for the application of malariatherapy in the pre-mental stage of G.P.I. according to the plan which has already been put up officially by Colonel James on several occasions. The malariatherapy work of this centre should be run as a branch of the Horton Centre according to plans already put up. The establishment of the centre would make available an unlimited supply of human material and would obviate the present practice of conducting experimental trials of new drugs in hospitals as far away as Devonshire and other counties.
(4) It is very desirable that more use should be made than at present of clinical material at Horton in connection with the biochemistry of malaria. The appointment of a chemical assistant to work with Colonel James and Dr. Nicol at this Unit is recommended. It is believed that the L.C.C. would provide all accommodation, but the salary of the assistant and all laboratory equipment should be provided by the Chemotherapy Committee. The introduction of malariatherapy in England has led to great advance of knowledge on the biological aspects of malaria and perhaps equal advance on the chemical side may be expected by associating a trained chemist with the official combined clinical and laboratory organisation which already exists.
...’]
-
Sent to Thomas Carnwath
6 May 1935
Description:‘Dr. Carnwath,
This report will be considered by the Chemotherapy Committee a ta meeting on 13th July.
From what is said on pages 9 & 15 it will be seen that the continuance of the Ministry’s centre at Horton in something like its present form is regarded as an essential part of the scheme.
With reference to para (2) on page 15 it is probably that I shall be asked at the meeting what period remains during which my services will be available. If I could have any information on that point which I could communicate to the Committee I should be very grateful.
S.P. James, 6/5/35.’
[in separate hand:
‘C.M.O.
Establishment.
You will wish to see this report on the reorganisation of Chemotherapeutic research, as it involves the Horton unit. If does not however affect the present application to the Treasury except to suggest perhaps that we may get what we want for somewhat less than the £500-600 mentioned in my minute. His was Prof Jameson’s figure.
I assume that you will not be in a position to anwer Col. James’ question until you have the Treasury’s decision.
T[?][homas?].C[arnwath?]. 6/VI/35.’]
[attached to above:
‘S.C. 65. Chemotherapy Committee. Report of the Sub-Committee appointed by the Chemotherapy Committee to make recommendations for the organization of Chemotherapeutic work in England.
20th May, 1935.
...
The Chemotherapy Committee since its appointment about eight years ago has been concerned chiefly with making arrangements for preparing new synthetic compounds and for testing their therapeutic value; e.g. –
I. [testing arsenical compounds [on animals?] in Liverpool and Hampstead, generally not on patients, but in case of single compound, that ‘Professor Yorke has been able to make private arrangements for its test on human syphilis in Liverpool and human trypanomiasis in Africa.
II. New compounds, for the most part on the basis of plasmochin and atebrin, are now being produced at various centres, and these are examined as to their therapeutic action on bird malaria in Cambridge. If further testing against human malaria is desirable, it is carried out at the Ministry of Health’s Malaria Therapy Centre at Horton.
...
Existing Chemotherapy Organisations.
Among the existing activities at present associated with the Chemotherapy Committee are:-
1. The Liverpool unit under Professor Yorke.
2. The London unit under Sir Rickard Christophers.
3. The Ministry of Health unit at Horton under Colonel James.
4. The Cambridge unit under Professor Keilin.
Although these various organizations are all working in close association with the Chemotherapy Committee it must be remembered that in one case (Liverpool) the Committee contributes only a fraction of the cost of the work and in another case (Horton) nothing at all, whilst in the remaining instance the units are housed by the London School of Hygiene and the Molteno Institute, respectively...
...[description of testing facilities and beds available at Liverpool School of Tropical Medicine]...
...[ description of testing facilities and beds available at London School of Tropical Medicine]...
The Ministry of Health and London County Council Malaria Therapy Centre.
This centre in something like its present form is essential, not only to chemotherapeutic research and testing, but in connection with malaria research in England as a whole. The exact relations to the scheme would be a matter for consideration, but inclusion need not restrict its other work in connection with malaria. Apart from small annual honoraria paid to Colonel James and Mr. Shute by the Medical Research Council [note: ‘Total £125’] this centre is financed entirely by the Ministry of Health and the London County Council.
...[ description of researchers employed at the Molteno Institute, Cambridge]...
...
Recommendations.
We have now to consider what steps should be taken to remedy the defects of the existing organisation and to put into operation the principles which, in our opinion, are essential for the development of chemotherapy in this country. There appear to us to be two possible lines of action:-
(a) The first plan which presents itself is the establishment of a single large chemotherapeutic organisation or institution. The establishment of such an institution would be an exceedingly costly matter. Not only would it be necessary to provide a building of considerable size and to equip it, but it would be necessary to provide a large and experienced staff familiar with the various infections – malaria, trypanosomiasis, syphilis, etc. – for which it is hoped to discover new methods of treatment. Apart from the financial considerations, this might well prove a difficult matter, as the number of individuals in this country who have interested themselves in chemotherapy is very limited. Furthermore, it is very doubtful whether such a scheme could be brought into operation without considerable delay.
(b) A more practical and economical plan, and one which we recommend, would be to build upon organisations which already exist, and to endeavour to establish two adequately equipped chemotherapeutic centres, one primarily for malaria in London, and the other for trypanosomiasis and syphilis in Liverpool...
...
The London Centre.
The organisation of an adequate malaria centre is obviously a much more difficult matter. In our opinion the first step necessary is the amalgamation of the activities at present going on in Cambridge and London. This we believe to be unavoidable, not only on economic grounds, but because we hold strongly that testing and cognate scientific research should be carried on in the same place and under the same direction. Laboratory testing and chemotherapy research should clearly be combined in one organisation under one roof. Further it is most desirable that it should be located in close association with other laboratory activities particularly those relating to the investigation of the different aspects of malaria. This is only possible in London. With provision of the necessary accommodation and staff the London Unit of experimental malaria could be readily converted into the organisation required. It could either remain as the Unit of Experimental Malaria, its function being those indicated above, but not exclusive of future extension to other aspects of experimental malaria, or be made a purely Chemotherapy Research Centre. A decision on this point should be come to after consideration of the general position in respect to malaria research in London. An important point relevant to the present scheme is that “testing” of anti-malarial compounds could scarcely remain on a purely routine and stereotyped basis, without gravely limiting its scope and usefulness. Testing is, for example, dependent on maintenance of bird malaria; it must use mosquito-induced infection as well as blood-inoculated material and thus must include arrangements for mosquito culture on an adequate scale etc. It should also be in a position to select and cultivate various types or strains of parasite used and to ascertain which of various standards of “cure” etc. are desirable. It is evident also that it could not neglect such an obviously desirable line as testing toxicity and therapeutic effect on monkey malaria. All this means a very considerable amount of the so-called biological type of work. It will be seen, therefore, that a London “testing” centre would be enormously helped by being associated with experimental work on malaria generally. The idea of a Centre for Malaria Research in London has already received a certain amount of consideration and hence there might be considerable advantages when creating a testing and chemotherapy research organisation in leaving the exact limits of future development as open as possible. In this case it might be desirable to retain the designation of Experimental Malaria Unit even though its staff and functions were for the present entirely designed to cover chemotherapy requirements.
Until the location, accommodation and form of such a centre has been decided exact details of staff are probably best left open, but the staff already given as necessary for a Chemotherapy Testing and Research Centre may be taken as a fairly correct guide.
As regards accommodation we attach a sketch [schematic map] of what we think should serve. Existing accommodation at the London School is roughly indicated at A. It could not accommodate, however, any more workers than at present and increased accommodation as roughly indicated at B would be required.
Clinical testing and research for a London Centre would require to be arranged for at the Horton Centre of Malaria Therapy. Certain provisions would be necessary in this respect.
(1) Some recognised working basis would require to be arranged with the Ministry of Health and L.C.C. by which the necessary facilities for testing and research could be made available to the Centre and a proper working association brought about.
(2) Whilst for the present Colonel James’s services would serve to maintain the necessary control and supervision of clinical testing at Horton it would eventually be necessary to ensure continuance of such control and supervision.
(3) It is very desirable that arrangements should be made through the L.C.C. for a centre for the application of malariatherapy in the pre-mental stage of G.P.I. according to the plan which has already been put up officially by Colonel James on several occasions. The malariatherapy work of this centre should be run as a branch of the Horton Centre according to plans already put up. The establishment of the centre would make available an unlimited supply of human material and would obviate the present practice of conducting experimental trials of new drugs in hospitals as far away as Devonshire and other counties.
(4) It is very desirable that more use should be made than at present of clinical material at Horton in connection with the biochemistry of malaria. The appointment of a chemical assistant to work with Colonel James and Dr. Nicol at this Unit is recommended. It is believed that the L.C.C. would provide all accommodation, but the salary of the assistant and all laboratory equipment should be provided by the Chemotherapy Committee. The introduction of malariatherapy in England has led to great advance of knowledge on the biological aspects of malaria and perhaps equal advance on the chemical side may be expected by associating a trained chemist with the official combined clinical and laboratory organisation which already exists.
...’]