Andrew DouglasBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1663 (Published 10 March 2014) Cite this as: BMJ 2014;348:g1663
- Anne Gulland, London
When Andrew Douglas became a chest physician in Edinburgh in the early 1950s tuberculosis was still a scourge. TB patients were sent to sanatoria, and treatment included bed rest, fresh air, and, in some cases, surgery. Edinburgh had witnessed a TB epidemic, and the city had the ideal conditions to harbour the disease: air quality and housing were poor, rates of smoking were high, and malnutrition was rife.
The antibiotic streptomycin had been developed in the early 1940s, and the world’s first randomised controlled trial was conducted by the Medical Research Council’s TB unit in 1946-47.1 One of the young researchers on that trial was John Crofton, who moved to Edinburgh in 1951.
Although patients had early success on streptomycin, they soon developed resistance, and Crofton and his team, of whom Douglas was a key member, soon concluded that patients needed more than one drug. They tested various combinations and found …