History of Dialysis in tHe UK: c. 1950–1980 The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 26 February 2008 edited by s M Crowther, l a reynolds and e M tansey Volume 37 2009 ©the trustee of the Wellcome trust, london, 2009 first published by the Wellcome trust Centre for the History of Medicine at UCl, 2009 the Wellcome trust Centre for the History of Medicine at UCl is funded by the Wellcome trust, which is a registered charity, no. 210183. isBn 978 085484 122 6 All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/ Please cite as : Crowther S M, Reynolds L A, Tansey E M. (eds) (2009) History of Dialysis, c.1950-1980. Wellcome Witnesses to Twentieth Century Medicine, vol. 37. London: Wellcome Trust Centre for the History of Medicine at UCL. Contents illustrations and credits v abbreviations vii Witness seminars: Meetings and publications; acknowledgements E M Tansey, L A Reynolds and S M Crowther ix introduction John Pickstone xix transcript Edited by S M Crowther, L A Reynolds and E M Tansey 1 appendix 1 Reminiscences of working with the Kolff rotating drum dialyzer, by Professor Kenneth Lowe 79 appendix 2 From a letter written by Sir Graham Bull, 1979 84 references 87 Biographical notes 103 index 113 illUstrations anD CreDits figure 1 Willem (Pim) Kolff (1911–2009). Provided by Professor Christopher Blagg. 9 figure 2 Belding Scribner (1921–2003). Reproduced by permission of the University of Washington. 10 figure 3 Frank Parsons (1925–1989). Provided by Professor Christopher Blagg. 11 figure 4 Kolff and Berk’s first artifical kidney, 1942. Provided by Professor Christopher Blagg. 13 figure 5 Professor Nils Alwall (1904–1986). Provided by Professor Stanley Shaldon. 14 figure 6 Top: Diagram of the technique of continuous haemodialysis. Adapted from Scribner et al. (1960) Bottom: Arm plate and cannulas in place for long- term cannulation of arteries and veins. Adapted from Quinton et al. (1960). 16 figure 7 Flat plate kidney using Kiil membranes, c. 1965. Provided by and reproduced with permission of Dr Rosemarie Baillod. 21 figure 8 Dr Stanley Shaldon, at the Royal Free Hospital. Provided by Professor Robin Eady, from World Medicine 1 (15 February 1966): 19. 28 figure 9 Dialysis patients at the Royal Free Hospital pictured in the Evening News, c. 1965. Provided by Professor Robin Eady. 31 figure 10 Professor Robin Eady receiving haemodialysis in the ‘side room’ at the Royal Free Hospital renal unit, from the cover of World Medicine 1 (15 February 1966). Provided by Professor Robin Eady. 38 v figure 11 Professor Hugh de Wardener and Dr Anthony Wing from World Medicine 1 (15 February 1966): 23. 48 figure 12 An example of home dialysis equipment c. 1965. Provided by Dr Rosemarie Baillod. 57 figure 13 Mrs Diana Garratt, née Northover in 1969. Provided by Mrs Diana Garratt. 58 figure 14 Pages from the diary of 11-year-old Diana Garratt for 5–8 June 1972. Provided by Mrs Diana Garratt. 63 figure 15 The hand of a patient on dialysis for more than ten years, who had pain, stiffness and age-related carpal tunnel syndrome, c. 1985. Provided by Dr Rosemarie Baillod. 75 vi aBBreViations ASAIO American Society for Artificial Internal Organs AWRE Atomic Weapons Research Establishment CAPD Continuous ambulatory peritoneal dialysis DHSS Department of Health and Social Security EDTA European Dialysis and Transplant Association ESRD End stage renal disease ESRF End stage renal failure MRC Medical Research Council NICE National Institute for Health and Clinical Excellence NIH National Institutes of Health NKC Northwest Kidney Centers NSF National Service Framework SAKC Seattle Artificial Kidney Center SLE systemic lupus erythematosus vii Witness seMinars: MEETINGS AND PUBLICATIONS 1 In 1990 the Wellcome Trust created a History of Twentieth Century Medicine Group, associated with the Academic Unit of the Wellcome Institute for the History of Medicine, to bring together clinicians, scientists, historians and others interested in contemporary medical history. Among a number of other initiatives the format of Witness Seminars, used by the Institute of Contemporary British History to address issues of recent political history, was adopted, to promote interaction between these different groups, to emphasize the potential benefits of working jointly, and to encourage the creation and deposit of archival sources for present and future use. In June 1999 the Governors of the Wellcome Trust decided that it would be appropriate for the Academic Unit to enjoy a more formal academic affiliation and turned the Unit into the Wellcome Trust Centre for the History of Medicine at UCL from 1 October 2000. The Wellcome Trust continues to fund the Witness Seminar programme via its support for the Centre. The Witness Seminar is a particularly specialized form of oral history, where several people associated with a particular set of circumstances or events are invited to come together to discuss, debate, and agree or disagree about their memories. At the time of publication, the History of Twentieth Century Medicine Group has held more than 50 such meetings, most of which have been published, as listed on pages xiii–xvii. Subjects are usually proposed by, or through, members of the Programme Committee of the Group, which includes professional historians of medicine, practising scientists and clinicians, and once an appropriate topic has been agreed, suitable participants are identified and invited. This inevitably leads to further contacts, and more suggestions of people to invite. As the organization of the meeting progresses, a flexible outline plan for the meeting is devised, usually with assistance from the meeting’s chairman, and some participants are invited to ‘set the ball rolling’ on particular themes, by speaking for a short period to initiate and stimulate further discussion. 1 The following is the standard introductory text to the Wellcome Witnesses to Twentieth Century Medicine series. ix Each meeting is fully recorded, the tapes are transcribed and the unedited transcript is sent to every participant. Each is asked to check his or her own contributions and to provide brief biographical details. The editors turn the transcript into readable text, and participants’ minor corrections and comments are incorporated into that text, while biographical and bibliographical details are added as footnotes, as are more substantial comments and additional material provided by participants. The final scripts are then sent to every contributor, accompanied by forms assigning copyright to the Wellcome Trust. Copies of all additional correspondence received during the editorial process are deposited with the records of each meeting in archives and manuscripts, Wellcome Library, London. As with all our meetings, we hope that even if the precise details of some of the technical sections are not clear to the non-specialist, the sense and significance of the events will be understandable. Our aim is for the volumes that emerge from these meetings to inform those with a general interest in the history of modern medicine and medical science; to provide historians with new insights, fresh material for study, and further themes for research; and to emphasize to the participants that events of the recent past, of their own working lives, are of proper and necessary concern to historians. Members of the Programme Committee of the History of twentieth Century Medicine Group, 2009–10 Professor tilli tansey – professor of the history of modern medical sciences, Wellcome Trust Centre for the History of Medicine at UCL (WTCHM) and chair Dr sanjoy Bhattacharya – reader in the history of medicine, WTCHM sir Christopher Booth – former director, Clinical Research Centre, Northwick Park Hospital, London Dr John ford – retired general practitioner, Tonbridge Professor richard Himsworth – former director of the Institute of Health, University of Cambridge Professor Mark Jackson – professor of the history of medicine, Centre for Medical History, Exeter Professor John Pickstone – Wellcome research professor, University of Manchester Mrs lois reynolds – senior research assistant, WTCHM, and organizing secretary Professor lawrence Weaver – professor of child health, University of Glasgow, and consultant paediatrician in the Royal Hospital for Sick Children, Glasgow x