THE HISTORY OF THE NEONATAL SOCIETY
Foundation and Early Years
Neonatal Society History
Until the end of the war the British Paediatric Association had been the only Paediatric Society of any national standing in Britain. Originally a small club, it had met, as it still does, once a year, usually at Windermere in Cumberland, for the presentation of original papers by its members and guests. When England settled down after the war the numbers in the BPA began to expand, but interest in paediatric care developed even more rapidly, more and more paediatricians were appointed and these bold young men began to claim territory which had long been regarded as that of the obstetricians and gynaecologists. As time went on those paediatricians who were actively interested in one aspect of research or another began to feel that the BPA was not providing the right forum in which they could foregather for discussion, and that they needed some little society of their own.
While all this was going on, and indeed even before it had begun to happen, research had been going on actively in Britain on foetal and neonatal physiology. Some of this had undoubtedly been inspired by Sir Joseph Barcroft's respiratory work at Cambridge, but other centres had, by then, taken this over, notably Professor Huggett's laboratory at St Mary's Hospital, London, and the Nuffield Institute for Medical Research under Geoffrey Dawes at Oxford. Neonatal renal function had been one of Professor McCance's major interests at the Department of Experimental Medicine in Cambridge from about 1938, and since the war LE Mount and others had been getting busy at nearby Babraham about neonatal thermal stability. These groups relied mostly on the Physiological Society for their meeting ground, and the Society was expanding its numbers very rapidly, and the meetings were no longer the intimate little gatherings they had been.
The Neonatal Society can be said to have been conceived on 24 April, 1959. Its womb, if it can be so described, was a rather dismal place, lit only by electric light, somewhere in the pelvis of the Royal Hotel at Scarborough, which had, by that time, become the meeting place of the BPA, now a large society with somewhat divided interests and objectives. Making the most of his opportunities at the Annual Meeting, Douglas Gairdner, who played a more important part in establishing the society than has generally been realised, collected together a number of members he hoped would be interested, among them Tom Stapleton, WW Payne, RA McCance, A Holzel, Peter Tizard, JO Forfar, Hugh Jolly, Beryl Corner, Professor RS Illingworth, Mary Crosse and Otto Wolff, and, last but not least, Geoffrey Dawes, who was there by invitation to give the 'Still Memorial Lecture'. Professor Douglas Hubble and JH Hutchinson were also there, but opted out of becoming active members of a neonatal group as they were more interested in later childhood. Kenneth Cross was not there, but had been discussing such a project with Tom Stapleton shortly before. Gerald Neligan probably would have been had he not been in the United States. RA McCance was persuaded to that the Chair. There was general agreement at one that some active little research society or club was highly desirable in Britain at that time, and a discussion followed on whether its interests should be general paediatrics or neonatal lore. Geoffrey Dawes rather swayed the meeting in favour of a neonatal society pointing out that the physiologists and other scientists outside medicine would be much more likely to be interested in this. It was left to Tom Stapleton, Geoffrey Dawes and RA McCance to organise something as best they could.
These three began without delay, largely by correspondence and personal contacts. They were, as it happened, rather a fortunate choice, for Tom Stapleton seemed to know instinctively all the paediatricians who ought to be members and the other two knew most of the physiologists. RA McCance and Elsie Widdowson, moreover, were already engaged in planning a Ciba Colloquium on steady states in the newly born, and this gave the trio a good start. Towards the end of August a meeting of the emerging society was convened by Tom Stapleton in the following words, and signed with a pen which had been James Gamble's.
27 August, 1959
Dear Professor McCance (or AN other),
At Scarborough earlier this year you said you liked the idea of forming a group to discuss neonatal problems. Professor McCance has enlisted the co-operation of Dr Wolstenholme, who has offered hospitality at Ciba Foundation House, 41 Portland Place, at 4.00pm on Thursday 5 November. if you approve of the idea,
1. please let me know;
2. come to the meeting if you can and let me know whether you are coming or not;
3. give me the names of other people whom you think might be interested.
An agenda for the meeting will be circulated later and if enough people are keen it may be possible to get someone to give us a small paper.
Thirty six people accepted invitations, but not quite all were able to come.
Geoffrey Dawes gave the first paper on 'Changes in the oxygen consumption of monkeys after birth' and he was followed by Kenneth Cross with one on 'Reflex responses of the newborn infant to lung inflation'. These were discussed and then the little group got down to the business of electing an organising committee and talking about a constitution for itself, membership, form of future meetings and the inevitable subscription.
The Committee then elected met on 8 December, 1959 and again on 22 January, 1960. It originally consisted of the following:
- Chairman: RA McCance
- Clinical Secretary: T Stapleton
- Non-Clinical Secretary: LE Mount
- Treasurer: GEW Wolstenholme
- Other members: PM Daniel, TE Oppe
By time the time the second meeting of the Society came to be held on 25 February two modifications had had to be made: Dr Wolstenholme had been replaced by Elsie Widdowson, and Tom Stapleton (destined for a Chair at Sydney) by Tom Oppe. The constitution proposed by the Committee was hurriedly approved and the subscription, hopefully, fixed at 10s per annum. This meeting was a great success. Drs O Celander (Sweden) and Gerald Neligan (Newcastle) gave papers on the determination and meaning of blood pressures in the newly born. Dr Celander, therefore, must be reckoned the Society's first overseas visitor and speaker, and the members drank his and the Society's health with sherry provided by the Ciba Foundation when the meeting closed at 6.00pm.
The third meeting took the form of an organised discussion on placental blood transfer and neonatal blood volume which was opened by Douglas Gairdner and Mavis Gunther.
The Committee met during the summer at Cambridge to discuss the programme for the Annual General Meeting in November and to plan a special Spring meeting to be held the day after the Ciba Colloquium on Somatic Stability in the Newly Born, and at which it was proposed to ask all the foreign visitors to speak and to follow it with a dinner if this could be arranged. By the time the Committee met again just before the Annual Meeting on 3 November, 1960 Dr Oppe had already shown his value as a working secretary, for arrangements were already well in hand for holding the next meeting at the Institute of Child Health, Great Ormond Street, and promising noises had been made by Mr S Sullivan of Oxygenaire Ltd about helping to finance the dinner to be held afterwards. The meeting itself took the form of another discussion, this time on the subject of the metabolic aspects of neonatal surgery, which was opened by Winifred Young, followed by Professor AW Wilkinson, and became very vigorous for a time, even pleasantly acrimonious, and everyone went home feeling that the gathering had been well worthwhile.
The programme of the next meeting, which could hardly have gone better, is given below, and members and their guests left it reluctantly at the end feeling that the Neonatal Society had certainly come to stay.
27-28 January 1961
A meeting of the Neonatal Society will be held at the Hospital for Sick Children, Great Ormond Street, London WC1, on Friday and Saturday, 27-28 January 1961.
The programme will be as follows:-
Friday 27 January
2.30 pm Opening remarks by Professor RA McCance (President)
2.45 pm Dr C Migeon, Department of Paediatrics, Johns Hopkins Hospital, Baltimore, USA. "Transplacental passage of some steroid hormones during pregnancy"
3.30 pm Dr CA Villee, Department of Biological Chemistry, Harvard Medical School, USA. "Alternative pathways of carbohydrate metabolism in foetal tissue"
4.15 pm Tea
4.45 pm Professor R Zetterstrom, Department of Paediatrics, University of Gotheburg, Sweden. "Bilirubin toxicity"
5.30 pm Close of scientific session for the day
5.45 pm Coaches to Apothecaries Hall
7.15 pm Dinner at Apothecaries Hall
Saturday 28 January
9.30 am Opening remarks by Dr GH Newns, Dean, Institute of Child Health
9.45 am Professor S Donhoffer, Department of Pathological Physiology, University of Pecs, Hungary. "Effect of environmental temperature and of hypoxia on body temperature and heat production"
10.30 am Dr RH Usher, Royal Victoria Hospital, Montreal. "The management of "pre-viability" and respiratory distress syndrome of prematurity"
11.15 am Coffee
11.45 am Dr L Stanley James, Department of Anesthesiology, Presbyterian Hospital, New York, USA. "Care of the baby in the delivery room"
Buffet lunch at the Hospital for Sick Children
2.15 pm Professor CA Smith, Department of Pediatrics, Harvard
Medical School, Boston, USA. "Respiratory distress in the newborn - evaluation of current ideas"
3.00 pm Professor E Kerpel-Fronious, Department of Paediatrics, University of Pecs, Hungary. "The bearing of age and nutrition on somatic stability"
3.45 pm Tea
4.15 pm Professor J Jonxis, Department of Paediatrics, State University, Gronigen, Holland. "The detection of Vitamin D deficiency in young infants, especially in prematures"
5.00 pm Meeting closes
The Society now had to face the problem of finding alternative accommodation for its meeting for at least a year while alterations were in progress at the Ciba Foundation, and the last meeting, in fact, to be held there took place on 25 May 1961, for, when the accommodation again became available, the number of members had grown to such an extent that it was no longer large enough. The Second Annual Meeting accordingly was held at the Institute of Orthopaedics and the Winter Meetings continued to be held there for a year or two and the Summer Meetings after that date began to be held at outlying venues. The first of these was at Oxford in 1962 and Geoffrey Dawes and his colleagues, Joan Mott and Heather Shelley, made it a memorable day, which ended with a fork supper at the first's house. During this year 14 papers in all were presented, one long discussion was held and numerous demonstrations were laid on for the Society in Oxford. A feature of the meetings had been that a considerable proportion of the papers dealt with the behaviour and physiology of foetal and newborn animals, and that these had been accepted as palatable and stimulating by the clinical paediatricians.
The young Society was now beginning to find its feet and its fourth year was one of steady progress. The Spring meeting in 1963 was devoted to vasomotor reactions and Dr Karl Bruck (Marburg) was the principal speaker. The Summer gathering was at Babraham, near Cambridge. The afternoon was spent looking over the ten demonstrations which Laurence Mount and others had arranged, papers were given from 4.00 - 6.00 pm, and the dinner afterwards was held at Sidney Sussex College. Laurence Mount completed his term of office as non-clinical secretary at the Annual Meeting in November, and his duties were taken over by Joan Mott. Members were told of the birth of a little sibling, the Australian Neonatal Society, and the meeting itself was devoted to the neonatal aspects of the perinatal mortality survey which had been published not long before. About this time a list of the papers published by members of the Society on neonatal matters was collected by Elsie Widdowson, duplicated and distributed to members.
The Summer Meeting in 1964 which was held on 28 May at the Postgraduate Medical School, Hammersmith Hospital, included both papers and demonstrations and was followed by a dinner. Two other events marked the year 1964. Firstly, the generosity of Mr Sullivan and Oxygenaire Ltd made it possible to arrange for an annual lecture to be given by a distinguished overseas investigator. Professor John Lind gave this lecture at the Annual Meeting in November 1964 to 112 members and guests on "human portal circulation before and after birth". These lectures continued until Oxygenaire Ltd was taken over by the Vickers group of companies in 1966, and the one in 1965 was given by Dr John Clements on "The physiological basis of neonatal respiratory distress" and that in 1966 by Dr (now Professor) HKA Visser on "Some recent developments in foetal and neonatal endocrinology". Secondly, the growth of the Society made it desirable once more to move to more roomy accommodation for the London meetings and the use of the lecture hall in the Wellcome Foundation Building was arranged.
After the Annual Meeting in 1964 Tom Oppe's stint as clinical secretary came to an end and he was replaced by Peter Tizard. The vacancy so created on the Committee was filled by Ross Mitchell, and Leonard Strang joined the Committee in place of Gerald Neligan who had taken over from Professor PM Daniel four years before.
Early in 1965 the Society decided to elect a limited number of foreign members who were "distinguished for their notable contributions to the study of the newborn and who had read a paper before the Society". Those elected were Professors John Lind (Stockholm), JHP Jonxis (Gronigen), E Kerpel-Fronius (Pecs), A Minkowski (Paris) and Dr CA Smith (Boston).
The Summer Meeting at Southmead Hospital, Bristol, organised by Beryl Corner, was an outstanding success. There were 12 communications and 26 demonstrations, and a "clinical" round at the Zoological gardens conducted by Professor Hewer, and sherry afterwards at the invitation of the Director and staff. The day closed with dinner in the Senior Common Room of the University. The President (RA McCance) retired at the Annual Meeting after serving a full term of office and Geoffrey Dawes was elected to succeed him. The subscription by this time had risen to £2 per annum, still collected and handled by Elsie Widdowson, the only member of the original Committee then remaining in office. The Society was no longer in its infancy: it was not even a toddler any more; it had reached school age and was continuing to increase in stature.
- R A McCance (1968)
- Move onto part two - The Years 1966-1980