Robert McCarrison: Life and Career

Robert McCarrison was the son of a County Armagh flax expert who went out to India as a young army doctor in 1901 and came home thirty-four years later as Major-General Sir Robert McCarrison, the man who, in Aykroyd’s judgement, had put nutrition “very firmly on the map” in India — “put on the map in India” being McCarrison’s own phrase. In between he was the only doctor for a garrison and a population on the Himalayan frontier, a goitre specialist whose papers were read in Paris and America, and the founder of the laboratory at Coonoor in the Nilgiri Hills that grew into India’s National Institute of Nutrition.

This page follows the man and his career, year by year: the Ulster family, the Dublin training, the frontier postings in Chitral and Gilgit, the goitre years, the wartime illness that brought him to Coonoor, the one-room laboratory and his remarkable Sikh assistant, the 1921 book and American lecture tour, the gift of a lakh of rupees “across the table”, the knighthood, and the Oxford years that closed his life in 1960. His rat-feeding experiments, his goitre science and the institutions that came after him each have their own page in this wing. The main source for his life is the memoir written in 1960 by W. R. Aykroyd, who followed him at Coonoor, and the stories told here are told as Aykroyd tells them.

Table of Contents

  1. A Linen Family from Portadown
  2. Belfast, Dublin and the Indian Medical Service
  3. The Only Doctor in Chitral and Gilgit
  4. A Goitre Specialist on Special Duty (1913)
  5. War, Illness and Coonoor (1918)
  6. Mula Singh and the One-Room Laboratory
  7. Studies in Deficiency Disease and the American Lectures (1921)
  8. The Royal Commission and the Parlakimedi Gift (1926)
  9. Knighthood, Retirement and the Cantor Lectures
  10. Oxford Years and Last Honours (1945–1960)
  11. Key Research Papers
  12. Connections

1. A Linen Family from Portadown

Robert McCarrison was born on 15 March 1878 at Portadown, in County Armagh in Ulster, the second son of Robert McCarrison and one of a family of five children. At some point the family moved to Lisburn in County Antrim. His father was an expert in the growing of flax, the plant from which linen is spun, and was associated with the Belfast linen industry, which was then one of the great textile trades of the world. The boy grew up, in other words, in a household whose living came out of a field crop and the knowledge of how to grow it well — a background worth remembering in a man who later spent years arguing that the quality of food depends on the soil it is grown in.

Aykroyd records that the McCarrisons were originally from Donegal and belonged to the group the Americans call the “Scotch-Irish”, descended from Scottish settlers established on plantations in Ulster in Elizabethan and later times. The family belonged to the Church of Ireland, and Aykroyd thought it likely the children were brought up in an atmosphere of strict evangelical piety. McCarrison remained a regular churchgoer all his life. In old age he was churchwarden of his parish church in Oxford, St Andrew’s, where, as a colleague recalled in an obituary note quoted by Aykroyd, he “read the lessons beautifully”.

That religious upbringing coloured the way he later talked about his work. Aykroyd describes him as “a preacher with a sense of mission”, and the missionaries who visited his laboratory in South India were sometimes told that he too was a missionary, with a text for his sermons taken from Isaiah 55:2: “Hearken diligently unto me and eat ye that which is good.”

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2. Belfast, Dublin and the Indian Medical Service

McCarrison was educated at Queen’s College, Belfast, and qualified in medicine in 1900. Because the family means were limited, Aykroyd explains, he took his degree through the old Royal University of Ireland rather than through the more expensive Trinity College, Dublin. As a student he worked at the Richmond Hospital, an old and well-known Dublin teaching hospital. He did not see it again for more than thirty years, until he went back to Dublin for the British Medical Association conference in 1933.

Aykroyd is frank that nothing in these years marked him out. He did well in his final examinations, but “he does not appear to have been anything out of the ordinary as a medical student”; at this stage he was “no more than one of the army of young Irishmen who qualify in medicine and seek their fortunes abroad”. A few months after qualifying he passed the stiff competitive examination for the Indian Medical Service (IMS), the medical branch of the Indian Army and civil administration, which then offered an attractive career. His father gave him a small sum of money, in Aykroyd’s words, “in final discharge of parental responsibility”.

Thirty years later McCarrison described his own departure in a passage Aykroyd quotes: “Sailing for India on my twenty-third birthday, fresh from the medical schools and but a child in knowledge, it chanced that the earlier years of my service were spent in the remote regions of Chitral and Gilgit where nature makes large-scale experiments upon man.” His twenty-third birthday fell in March 1901. (One modern biographical dictionary dates his joining the IMS to 1900, the year he qualified; the Wellcome Collection’s archive record gives his IMS service as 1901–1935.)

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3. The Only Doctor in Chitral and Gilgit

McCarrison’s first posting was as regimental medical officer in Chitral, a mountain state on the far north-western frontier of British India; he then became Agency Surgeon at Gilgit, a post the Wellcome archive record dates from 1904, the year he was promoted captain. He later evoked the country in his own words: peaks “robed in perpetual snow” — Rakaposhi, Haramosh, Nanga Parbat — rising above 21,000 feet, “the place of glaciers and glacier-born torrents”, the Bam-i-Dunya, “the roof of the world”. A small garrison of Indian troops held these frontier valleys.

Aykroyd stresses what this meant in practice: McCarrison was the sole doctor responsible for the medical and surgical care of both the troops and the local people, at an age, Aykroyd notes, below that at which doctors qualified in medicine in his own day. He had no training in research, and Aykroyd found no sign of an older colleague in the Service who inspired or encouraged him, yet he began investigating. His first study, described in his 1937 lecture Adventures in Research, was on a fever he called the “three-day fever of Chitral”, which he surmised — correctly, Aykroyd notes — was carried by the sandfly. His equipment, in his own words: “My student’s microscope was sent to me from India as well as some slides, coverslips and stains. Materials for the making of a few simple culture media arrived; an incubator and sterilizer were improvised from kerosine oil tins. Thus equipped I faced the future.”

It was also in these years that he came to know the people of Hunza, the small mountain state beyond Gilgit. In Studies in Deficiency Disease (1921) he wrote of “some seven years spent in their midst”, during which his work for them was confined chiefly to accidents, the removal of senile cataract and operations on the eyelids. Aykroyd called this acquaintance “the key to much of his later work”; what McCarrison wrote about the Hunza diet is set out on the Whole Food, Iodine and Goitre page.

The polo-match story

Aykroyd closed his memoir with what he called a “Kiplingesque story” of Gilgit, “now a little dim in detail through the passage of time”, and it is told here as he told it. The people of Gilgit, it was said, were losing faith in Western medicine and becoming reluctant to accept treatment — perhaps, Aykroyd suggests, because the young doctor’s surgery, learnt in a few months at the Richmond Hospital, was a little rough, and his youthful looks were against him. McCarrison and the Assistant Political Agent decided something had to be done. A high-born local woman had lost a leg to amputation and was crippled. The two men arranged for an artificial limb of the latest type to be sent from England and carried secretly by runner over the mountain passes. It was fitted, and the woman, dressed in traditional finery with long skirts, was suddenly paraded at a polo match — walking. The spectators, in Aykroyd’s telling, were impressed by the miracle and regained their faith in Western medicine and in the doctor.

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4. A Goitre Specialist on Special Duty (1913)

Goitre — a swelling of the thyroid gland in the neck — was enormously common in parts of the Himalayas, and McCarrison began studying it, along with cretinism (the stunted growth and mental disability that can affect children born in severely goitrous districts), soon after he arrived. In some villages, Aykroyd writes, every inhabitant was affected; one was known as “The Abode of Fools”. McCarrison later recalled that when he began, the few textbooks he had told him nothing about the cause.

His frontier observations became a series of papers: “Observations on Endemic Goitre in the Chitral and Gilgit Valleys” in the Medico-Chirurgical Transactions of London in 1906, a long study of endemic cretinism in the same valleys before the Royal Society of Medicine in 1909, a résumé of his goitre researches in the Indian Medical Gazette in 1911, and a paper on “nervous cretinism” in 1914. He was promoted major in 1912. In 1913 he was placed on special duty to investigate goitre and cretinism in India, which allowed him to give the subject his full attention, combining field surveys with animal experiments. He kept working on goitre until he left India in 1935.

His personal life settled in the same years. In 1906 he married Helen Stella Johnson, the daughter of a member of the Indian Civil Service. Aykroyd describes the marriage as “a true partnership” and of great importance in his life; she survived him.

It was the goitre work, Aykroyd writes, that first won McCarrison world-wide recognition, bringing a series of honours in the years just before and after the First World War, among them the Prix Amussat of the Academy of Medicine of Paris in 1914. It drew more attention in countries where goitre was a large public-health problem, the United States among them, than in England. What he concluded about the causes of goitre — iodine, but also water and food factors — is described on the Whole Food, Iodine and Goitre page.

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5. War, Illness and Coonoor (1918)

The First World War took McCarrison away from research to active service. He was promoted lieutenant-colonel in January 1918. Aykroyd records that he fell ill during wartime service in the Near East, and that in 1918 he came to Coonoor, a hill town in the Nilgiri Hills of South India, to convalesce.

“He liked Coonoor, which is indeed a very pleasant place,” Aykroyd writes, “and remained there until he retired from India with the rank of Major-General in 1935.” The convalescent posting turned into seventeen years of work. In the same year, 1918, a small research unit was set up there under the name of the “Beriberi Inquiry” — beriberi being the nerve and heart disease of thiamine (vitamin B1) deficiency that was then a major concern among rice-eating populations. According to the National Institute of Nutrition’s own centenary history, the inquiry began in a single room in the Pasteur Institute at Coonoor.

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6. Mula Singh and the One-Room Laboratory

The Beriberi Inquiry, in Aykroyd’s words, consisted of “McCarrison and a single assistant”. That assistant was Mula Singh, a Sikh who had won the Indian Order of Merit for gallantry in East Africa during the war. Aykroyd calls him “the redoubtable Mula Singh” and “in his own way almost as remarkable a character as McCarrison himself”. Mula Singh was sent to Oxford to learn how to cut and stain tissue sections for the microscope; back in Coonoor he looked after the animals and cut and stained thousands of sections for his chief to examine. His name later appears beside McCarrison’s as co-author of a 1931 paper in the Indian Journal of Medical Research on an anaemia in rats.

Between 1918 and 1921 the two men undertook what Aykroyd calls “the enormous task of studying almost every organ in the body” in animals kept on a range of faulty diets. McCarrison reported the results in a series of papers, among them “The Pathogenesis of Deficiency Disease” in the British Medical Journal in 1919 and “The Effects of Deficient Dietaries on Monkeys” in 1920. Aykroyd singled out his finding that the adrenal glands become enlarged in various deficiency states as of special importance, and noted that McCarrison was among the first to point out that infection and parasites can tip a person into a deficiency state. The experiments themselves are described on the Coonoor Diet Experiments page.

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7. Studies in Deficiency Disease and the American Lectures (1921)

In 1921 McCarrison published the results of the Beriberi Inquiry as a book, Studies in Deficiency Disease, in the Oxford Medical Publications series. It was reviewed that December in the Boston Medical and Surgical Journal (the forerunner of today’s New England Journal of Medicine) and in 1922 in the journal Endocrinology. Aykroyd wrote that there is “little in the literature of nutrition” that parallels the book’s extensive pathological studies, and suggested that researchers on protein malnutrition decades later might still find suggestive material in it.

The same year McCarrison made a lecture tour of the United States that Aykroyd thought “must surely be a unique tour in America for a visiting medical lecturer”. He gave the Mellon lecture in Pittsburgh, the Mary Scott Newbold lecture in Philadelphia, the Hanna lecture in Cleveland, the Mayo Foundation lecture in Rochester and the De Lamar lecture in Baltimore.

Success abroad did not secure his funding at home. The authorities closed the Beriberi Inquiry in the early 1920s — in 1922 according to Aykroyd, in 1923 according to the National Institute of Nutrition’s centenary history — and it was restored in 1925 as the Deficiency Disease Enquiry. Aykroyd, who knew the story well, added his own judgement that “perhaps too much has been made of the obscurantism of the authorities who were reluctant to finance nutrition research in those early days”; nutrition, in McCarrison’s phrase, had simply not yet been “put on the map in India”. In 1923 he was made a Companion of the Order of the Indian Empire (CIE).

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8. The Royal Commission and the Parlakimedi Gift (1926)

Aykroyd calls the 1926 visit to Coonoor of the Royal Commission on Agriculture in India, chaired by Lord Linlithgow (later Viceroy of India), “a turning point”. During the visit one of the commission’s members, the Rajah of Parlakimedi, was so impressed by McCarrison’s account of his work that he handed him a lakh of rupees — one hundred thousand rupees, about £7,000 at the time by Aykroyd’s reckoning — “across the table”. The money created two Parlakimedi Research Fellowships, which Aykroyd describes as the first research fellowships in India supported by private donation. A 2021 study by the historian Malhotra examines how the Coonoor laboratories were established in exactly these years, 1925 to 1927.

McCarrison also gave the commission a written memorandum on malnutrition in India, published in its report in 1927. Aykroyd quotes its central claim: “Malnutrition is the chief among the problems facing those engaged in agricultural research. The ultimate aim of agricultural research is the adequate nutrition of the people.” McCarrison argued that agricultural and nutritional research belonged not “in isolated compartments” but in the closest co-operation. Aykroyd, who later took part in founding the United Nations Food and Agriculture Organization, wrote that these words had a special significance for him.

In 1929 the Coonoor unit became the Nutrition Research Laboratories of the Indian Research Fund Association (now the Indian Council of Medical Research), with McCarrison as its first director. By 1935, according to the institute’s centenary history, the one-room inquiry had grown to six rooms, including a lecture hall and a nutrition museum.

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9. Knighthood, Retirement and the Cantor Lectures

Honours followed through the late 1920s and early 1930s. He was promoted colonel in 1929. The Dictionary of Ulster Biography records him as Honorary Physician to the King from 1928 to 1935 (other sources date the appointment to 1935) and lists the Kaisar-i-Hind Gold Medal for public service in India. He was knighted in 1933 and promoted Major-General the same year. On 19 August 1935 he retired from the Indian Medical Service and left India. The direction of the Coonoor laboratories passed to W. R. Aykroyd.

Retirement did not end his public work. In 1936 he delivered the Cantor Lectures before the Royal Society of Arts in London under the title Nutrition and National Health, setting out the Coonoor results for a British audience; the lectures were republished by Faber and Faber in 1953. In the same year he published papers in the British Medical Journal under the titles “Nutrition and National Health” and “Nutrition in Health and Disease”, and in 1937 he gave the Lloyd Roberts Lecture before the Medical Society of London, Adventures in Research, his own account of his career. During the Second World War, according to the Dictionary of Ulster Biography, he served as an official medical adviser. The message of the Cantor Lectures and its reception are covered on the Legacy page.

Aykroyd’s portrait of the man in these years is of someone with “panache”, “going through life with something of a flourish and a continuing sense of adventure”: an individualist, “remote and rather aloof” from colleagues, but a handsome, dignified and impressive lecturer, “always kind and courteous” to subordinates and the young. He kept to his own teaching at table: “remembering the Hunzas,” Aykroyd writes, “he breakfasted on whole wheat chappatis.”

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10. Oxford Years and Last Honours (1945–1960)

In 1945, in his late sixties, McCarrison became Director of Post-Graduate Medical Education at the University of Oxford — the first holder of the post, according to the Dictionary of Ulster Biography — and held it for ten years. Aykroyd records that a colleague spoke of the “guidance and mothering” he gave to young graduates trying to get a good postgraduate training.

On his seventy-fifth birthday, in March 1953, colleagues presented him with The Work of Sir Robert McCarrison, a volume of his collected work edited by H. M. Sinclair, with introductory essays by Aykroyd and by the American nutrition scientist E. V. McCollum. He received a telegram from India’s Minister of Health, Rajkumari Amrit Kaur, expressing the gratitude of the people of India for his services. The same year The Nutrition Society elected him an Honorary Member. His last indexed paper on nutrition, written with P. Dorolle, appeared in the Proceedings of the Nutrition Society in 1956, on international co-operation in the field of nutrition.

Robert McCarrison died in Oxford on 18 May 1960, at the age of eighty-two. Obituaries appeared in the British Medical Journal, The Lancet and Nature (the last by Sinclair), followed by Aykroyd’s memoir in the British Journal of Nutrition, where he was the seventh member of The Nutrition Society to be commemorated in that way, and a memoir in the Transactions and Studies of the College of Physicians of Philadelphia in 1961. A society bearing his name, the McCarrison Society, was founded in 1966 according to Wikipedia. His papers — including 149 posters of his nutrition observations and experiments from 1913 to about 1947, his speeches and correspondence, and a photograph album of Coonoor — are held by the Wellcome Collection in London.

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Key Research Papers

  1. McCarrison R. Observations on Endemic Goitre in the Chitral and Gilgit Valleys. Med Chir Trans. 1906;89:437-70. PubMed PMID: 20897060
  2. McCarrison R. Observations on Endemic Cretinism in the Chitral and Gilgit Valleys. Proc R Soc Med. 1909;2(Med Sect):1-36. PubMed PMID: 19973738
  3. McCarrison R. A Résumé of Researches on Endemic Goitre. Ind Med Gaz. 1911;46(7):253-260. PubMed PMID: 29005529
  4. McCarrison R. Nervous Cretinism. Proc R Soc Med. 1914;7(Sect Study Dis Child):157-64. PubMed PMID: 19978295
  5. McCarrison R. The Pathogenesis of Deficiency Disease. Br Med J. 1919;1(3033):177-178.1. PubMed PMID: 20769368
  6. McCarrison R. The Effects of Deficient Dietaries on Monkeys. Br Med J. 1920;1(3086):249-53. PubMed PMID: 20769796
  7. Studies in Deficiency Disease. By Robert McCarrison. Oxford Medical Publications, 1921 [book review]. Boston Med Surg J. 1921;185(26):791. DOI: 10.1056/nejm192112291852616
  8. Studies in Deficiency Disease [book review]. Endocrinology. 1922;6(3):414. DOI: 10.1210/endo-6-3-414
  9. McCarrison R. Nutrition and National Health. Br Med J. 1936;1(3921):427-430. DOI: 10.1136/bmj.1.3921.427
  10. McCarrison R. Nutrition in Health and Disease. Br Med J. 1936;2(3951):611-5. PubMed PMID: 20780124
  11. McCarrison R, Dorolle P. International co-operative activities in the field of nutrition. Proc Nutr Soc. 1956;15:1-4. DOI: 10.1079/pns19560003
  12. Aykroyd WR. Major-General Robert McCarrison, Kt, C.I.E., M.A., M.D., D.Sc., LL.D., F.R.C.P. (15 March 1878–18 May 1960). Br J Nutr. 1960;14:413-418. DOI: 10.1079/bjn19600055
  13. Sinclair HM. Sir Robert McCarrison, C.I.E. Nature. 1960;187(4733):195-196. DOI: 10.1038/187195a0
  14. Sir Robert McCarrison. Br Med J. 1960;1(5186):1663-4. PubMed PMID: 13856887
  15. Robert McCarrison. Lancet. 1960;1(7135):1198-9. PubMed PMID: 13857558
  16. Rogers FB. Memoir of Major-General Sir Robert McCarrison (1878-1960). Trans Stud Coll Physicians Phila. 1961;29:39-40. PubMed PMID: 13742754
  17. Gavaravarapu SM, Hemalatha R. National Institute of Nutrition: 100 years of empowering the nation through nutrition. Indian J Med Res. 2018;148(5):477-487. PubMed PMID: 30666974
  18. Malhotra A. Cutting Edge Research in the Contact Zone? The Establishment of the Nutritional Research Laboratories in Coonoor (1925–27). South Asia: Journal of South Asian Studies. 2021;44(1):117-134. DOI: 10.1080/00856401.2021.1863493

PubMed Topic Searches

  1. https://pubmed.ncbi.nlm.nih.gov/?term=McCarrison+R%5Bau%5D
  2. https://pubmed.ncbi.nlm.nih.gov/?term=McCarrison+history
  3. https://pubmed.ncbi.nlm.nih.gov/?term=endemic+goitre+Gilgit
  4. https://pubmed.ncbi.nlm.nih.gov/?term=National+Institute+of+Nutrition+Coonoor+history

Further Reading

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Connections

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