Dr Colin McDougall and LEPRA

Good news for researchers interested in leprosy: I have recently catalogued personal papers of Dr A. Colin McDougall (1924-2006), a leprosy specialist with previous experience in tuberculosis and internal medicine. He worked closely with the British Leprosy Relief Association (now LEPRA Health in Action) whose extensive archive can also be consulted at the Wellcome Library.

Colin McDougall (centre) with S G Browne (left) and Ma Haide (George Hatem) (right) during a visit to China.

McDougall qualified as a medical doctor in Edinburgh in 1946. He worked in the Edinburgh Royal Infirmary, the Radcliffe Infirmary in Oxford and in general practice before taking up a post as chest physician in the Royal Singapore Anti-Tuberculosis Association (SATA) in Singapore 1953-56. Later he was employed as a medical specialist in Sumatra and Aden and worked with refugees in Algeria, before getting appointed as a Leprosy Specialist to the Ministry of Health in Zambia in 1967. In Zambia, McDougall secured funding from LEPRA (then the British Leprosy Relief Association, now LEPRA Health in Action) to buy vehicles to assist in the national leprosy control programme. Some documents from this period can be found in the file PP/MCD/B/1. McDougall returned to the UK in 1970, having previously contacted Dr R J W Rees at the National Institute for Medical Research (NIMR) in Mill Hill, London, about the possibility of working in clinical or experimental research on leprosy in the UK.

From 1970 to 1988, McDougall was Consultant in Clinical Research (Leprosy) to the British Leprosy Relief Association (LEPRA), based at the Slade Hospital, Oxford. He was responsible for the referral and admission of leprosy patients in the UK, working closely with Dr A G M Weddell in the Department of Human Anatomy in the Science Area of the University of Oxford. McDougall was instrumental in setting up a prize essay competition for medical students, supported by LEPRA, on a subject of current importance in leprosy.

In collaboration with Dr Douglas Harman in the Leprosy Study Centre, London, he conducted research on the histology of the disease, the nasal excretion of  Mycobacterium lepra  and on multi-drug therapies (MDT). McDougall championed the idea that the multiple drugs needed for leprosy treatment (either dapsone and rifampicin, or dapsone, rifampicin and clofazimine), both daily and monthly, should be dispensed in appropriate blister calendar packs, similar to the contraceptive pill ones. In association with colleagues in the John Radcliffe Hospital in Oxford, the first designs and proposals for such packs were published in the International Journal of Leprosy in 1983. Surprisingly, the reprints of these articles (or bubble packs designs) are not part of the archive.

To mitigate the tedious and repetitive task of examining thousands of sections for bacillary and cellular changes every day, McDougall undertook numerous visits to leprosy-endemic countries, including Peru, Venezuela, Mexico, Brazil, Africa, India and the Far East. He visited the Indian state of Orissa twice and maintained correspondence with The Damien Institute in Bhubaneswar, established in 1983. File PP/MCD/B/8/1 contains a typed report of the 1985 visit but also a series of colour photographs with McDougall’s hand-written commentary.

Hand-written report of the visit to Orissa in 1985, PP/MCD/B/8/1.

McDougall’s research on experimental animals involved mostly the cultivation of M. leprae in the nine-banded armadillo, one of few species other than homo sapiens that can contract the disease systemically. This is mirrored in the correspondence as well as in the titles of the papers, for example ‘Sudden respiratory collapse in an armadillo (Dasypus novemcinctus, Linn.)’ (1986) (PP/MCD/C/2). No controversy over animal research is recorded in the archive but there is a manuscript of probably unpublished paper (with the intriguing title ‘The armadillo war: a forged map, false figures, and a failed vaccine trial’) by H P Burchfield, who had written on leprosy in wild armadillos before (Wellcome Library MS. 8163), detailing a cover-up by the US Public Health Service of leprosy among wild armadillos in Louisiana and Texas in the 1970s. The USPHS officials denied that it was possible for human leprosy to occur in wild armadillos:

To uphold their viewpoint, they forged a map, published false data, and ignored confirmatory findings of other investigators. Their obduracy caused them to neglect a major zoonosis for 11 years, supply immunologic reagents made from a wild strain of bacilli to endemic countries, and doom a leprosy vaccine trial on 29,000 people.

Burchfield ends his report somehow dramatically:

We fear that the armadillo will be metamorphosed into a scapegoat to protect the reputations of the people who caused this disaster.

More documents relating to McDougall’s work can be found in a major collection held at the Wellcome Library, WTI/LEP, the papers of LEPRA Health in Action (formerly The British Leprosy Relief Association). LEPRA funded both McDougall’s post in Oxford and several of his trips.

LEPRA Health in Action was established in 1924 as the British Empire Leprosy Relief Association, with the aim ‘to rid the Empire of leprosy’ (‘Empire’ was dropped from the name in the 1950s). It was set up as a medical organisation to spearhead outpatient work instead of the traditional segregatory methods (like leprosaria), and to foster research into all aspects of the disease. Fundraising from the general public became a consistent and routine part of the association’s work.

Awareness of leprosy increased dramatically in the 1960s as LEPRA’s work was promoted via television and radio appeals and in 1965 a documentary on LEPRA’s work in India, The Name of the Cloud is Ignorance, was made. As a result, LEPRA’s overseas work expanded greatly throughout the 1970s, supporting projects in a further 11 countries.

Files mentioning McDougall and his activities are strewn throughout WTI/LEP, but the following files are perhaps of biggest relevance:

• In Research and drug regimens section: WTI/LEP/D/1/4 – D/1/8 [‘Dr A.C. McDougall – Consultant at Oxford financed LEPRA’];
• In International projects section: WTI/LEP/C/2/4/5 [‘Dr. Colin McDougall 1976-1977 (Malawi)’], WTI/LEP/C/3/14 [‘Zambia (first files)’], and WTI/LEP/C/5/6 [‘Dr McDougall’s visit report on Guyana’]

Author: Anna Ostrowska, Library Assistant at the Wellcome Library