P. C. C. Garnham, CMG, FRS, DSc, MD, FRCP, FRCPE (Hon.), DPH, President 1967–1969

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TRAHSACTKW OF THE ROYAL SKIETY OF TROPICAL MEDICINE AND HYGIENE (1995) 89.129-131

Finally, in collaboration with A. J. Duggan, he produced the Catalogue of the Garnham Collection of Malaria Parasites and other Haemosporidia (1986, Cambridge: Cambridge University Press). The collection itself is now deposited in the Natural History Museum, London.

(Obituary(

J. R. Baker The early years in Kenya

P. C. C. Gamham, CMG? FRS, DSc, MD, FRCPE (Hon.), DPH, President 1967-1969

FRCP,

Percy Cyril Claude Garnham was born in London on 15 January 1901. He graduated in medicine (MB, BS) from St Bartholomew’s Hospital, London, in 1924 and obtained the DPH (London) in the sameyear. He joined the (then) Colonial Medical Service in 1925and remained with it, in Kenya, until 1947. In 1947 he returned to England and was appointed Reader in Medical Parasitology at the London School of Hygiene and Tropical Medicine. When Colonel Shortt retired in 1952, Garnham was appointed to the Chair of Medical Parasitology, which he occupied until his retirement in 1968. He was then made Professor Emeritus, and also Senior Research Fellow at the Silwood Park campus of Imperial College at Ascot in Berkshire. Garnham finally retired from active research in 1980, devoting more time to writing and piano playing. He continued to attend meetings of the Societv until a few months before his death on 25 Decembir 1994. Garnham wrote numerous scientific papers; those published before the end of 1980 are listed in Parasitological Topics (E. U. Canning, editor), which was published by the Society of Protozoologists as Special Publication no. 1, in honour of his 80th birthday in 1981. He also wrote two books-Malaria Parasites and other Haemosporidia (1966, Oxford: Blackwell Scientific Publications) and Progress in Protozoology (1971, London: The Athlone Press), the latter being basedon the Heath Clark lectures which he delivered in the University of London in 1968; he co-edited (with A. E. Pierce and I. Roitt) Immunity to Protozoa (1963, Oxford: Blackwell Scientific Publications) and (with R. Killick-Kendrick) the special volume (3) of the defunct journal Protozoalogy which was published in 1977 in honour of C. A. Hoare’s 85th birthday.

Percy Cyril Claude Garnham joined the Colonial Medical Service in 1925 and went to Kenya, where he remained until 1947. He worked mainly in the Lake Province but also in other areas where he, Esther and the 6 children became well known; he eventually became Provincial Medical Officer of the Lake Province. His work in Kenya showed the breadth of his interests. He co-operated with the Veterinary Department in discovering the viral aetiology of Nairobi sheep disease, which later cameto be known as Rift Valley fever, an important arbovirus infection of East and Central Africa. In Kisumu he told me that he had noticed that fledglings of the weaver birds were falling out of their nests and dying of avian malaria while the adults remained healthv, an obvious parallel with human malaria. He also examined the liver of a monkey from the Kericho forest and noticed small white spots which proved to be stagesof the simian ‘malaria’ parasite Hepatocystis kochi, suggesting to him the liver as a possible site for the exoerythrocytic stagesof human malaria. The late Ronald Heisch placed a bronze plate on the bench of the Medical Research Laboratory in Nairobi to commemorate this finding as the first step in elucidating the full life cycle of the human malaria oarasite. Garnham joined the newly founded Division of InsectBorne Diseases(DIBD). of which he later becamedirector, and which itself became famous in the study of endemic diseasesof Africa. His first achievement was in dealing with a devastating epidemic of louse-borne relapsing fever in the warm and humid Coast Province, which he stopped with the aid of the then new insecticide DDT. Using staff from DIBD whom he had trained he organized the first eradication of Simulium by larviciding a river with DDT and thus eradicated onchocerciasis from the Kodera River system in Kenya. Garnham’s work in East Africa showed what can be done with an enquiring mind and an interest in nature. He was a keen ornithologist and a good naturalist, who demonstrated that epidemiology was essentially a study of the ecology of an area and all its inhabitants, large and small. His example inspired many workers in Kenya and elsewhere, and many of those who had worked under him later becamefamous in the investigation of tropical diseases. P. E. C. Manson-Bahr The middle years at the London and Trobical Medicine

School of Hygiene

It was=myprivilege to have been Professor Garnham’s first PhD student, joining others he inherited on the retirement of his predecessor, Colonel H. E. Shortt, in 1952. Recollections of my interview with the great man were not particularly memorable, and the slip of paper on which he had written some suggested topics, in that almost illegible handwriting we all came to know so well, left me wondering just what he wanted me to do with Toxoplasma, Pneumocystis, Leucocytozoon or Entamoeba invadens. I was soon to learn that Garnham’s policy was to have students formulate their own lines of research, rather than follow a protocol laid down by their supervisor, and that due to his own broad interests it was quite usual for workers on human parasites to be rubbing shoulders with others studying blood parasites of birds, trypanosomes of fish, or even gregarines of locusts. Perplexed members of the medical profession taking the DTM&H course, on asking why they had to attend lectures on such exotica, would be gently admonished ‘Trypanosomeswere first found in frogs, not man, and Ross

130 showed mosquitoes to be the vectors of malaria using the you finish this course, perhaps one of you will go off and discover the nature of Toxoplasma’. Prophetic words: the subsequent demonstration that this parasite was a coccidian, some 13 years later, was largely due to W. M. Hutchison’s veterinary experience in animal parasitology. Some say that Garnham had no senseof humour. He had: somewhat dry, but sometimes quite impish. When due to leave for Belize, to work on leishmaniasis, I commented on what I thought to be a poor Colonial Office salary. ‘Perhaps it is rather modest, Lainson, but you will have plenty of bush-meat. I understand that Iguana tails are particularly good’. It was about this time that Garnham was becoming increasingly irritated by World Health Organization opposition to the use of humans in experimental parasitology, spelling as it did an end to his use of volunteers in his malaria programme. I am sure this was in his mind when, on hearing of our first experimental transmission of a neotropical speciesof Leishmana to humans by the bite of a sandfly, he sent John Strangways-Dixon and me a short but rebellious telegram: ‘Congratulations on your beautiful human experiment’. My last working link with ‘the Prof.’ was in 1969, when he came to Brazil-ostensibly to a scientific meeting, but really to rediscover a malarial parasite of bats found bv Leonidas Deane in 1938. Arriving in Belem, he was lodged in my hot little house and was promptly confined to bed with a mysterious fever which lasted for nearlv 2 weeks. We never did discover the cause of his illness, and I went through a nasty time imagining newspaper headlines like ‘Famous malariologist dies of malaria in student’s house in the Green Hell’. Finally on his feet, but very shaky, Garnham insisted in accompanying us on our trip to capture his bats. Once, on a hectic voyage up a jungle river in pitch darkness, something cold and wet flopped into our tiny skiff. More headlines. ‘Eminent British scientist devoured by giant anaconda’. In fact, a shoal of fish, attracted by our torches, had leapt into the boat. We finally trapped our bats, miraculously found the parasite in one of them, and sent Cyril Garnham back to England a contented man. The reason for his determination to find that parasite is perhaps similar to what was behind Sir Edmund Hillary’s obsession to climb Mount Everest. When asked why it was necessary, he replied simply ‘Becauseit is there’. Plasmodium of sparrows. Who knows-when

R. Lainson The last thirty years

I first met Professor Garnham in 1949 when I joined the Department of Parasitology of the London School of Hygiene and Tropical Medicine as a junior technician. Perhaps ‘met’ is not the right word. To his junior staff and students he was an austere, awe-inspiring figure and we were hardly close to him. From 1955-1963, I worked in Africa and-then returned to the School firstly as his Chief Technician. rising through the ranks to Research Assistant, PhD ‘studem and: finally, colleague and friend. We were in daily contact from 1963 until 1980, after which we still met regularly up to 3 weeks before he died. Having been privileged to work with him for such a long time, this account will be mainly about Garnham the man. His massive contributions to tropical medicine, and narasitoloev in narticular, are so well known that it is unn&essary to”review them -here. A good account was oublished in the ‘Festschrift’ which celebrated his 80th rb&hday (1981: Parasitoloiical Topics, E. U. Canning (editor), Lawrence, Kansas: Society of Protozoologists, Special Publication no. 1). Throughout the 196Os, Garnham’s Department was constantly buzzing with excitement. At least one of his staff, students, or visitors seemedto make a discovery almost every day. Morale was high, and no one worried about time off or overtime pay. Garnham had a mysterious way of persuading people to do as he wished,

without causing offence; even when you knew it was happening, it did not seemto matter. On his retirement from the School in 1968, almost all his team moved away. It was as though an era had passed.Typically, Garnham turned the page and quickly settled with 4 PhD students at Silwood Park, the Imperial College campus in the country at Ascot, where he began to amass type and voucher specimens of malaria parasites of man, monkeys, rodents, birds and reptiles. This involved much travel and considerable charm to persuade workers in all corners of the world to part with their most valuable slides. By 1980, he had completed this task and. with the heln of Dr Tonv Duegan. a catalogue (Garnham, P. C. C. ‘& Duggan, A. JI,“r986: Catalogue of the Garnham Collection of Malaria Parasites and other Haemosporidia. Cambridge: Cambridge University

Press) was published and the collection deposited, firstly at the Wellcome Museum and later at the Natural History Museum, London. While at Silwood Park, Garnham formed a team to work with Dr ‘Al’ Krotowski on relapses in malaria. He had progressively doubted the hvnothesis on relaoses he and Colonel H. E. Shortt had proposed in 1948.‘This illustrates his astonishing determination. He was never satisfied until a problem was solved-even if it took 30 years. It was not until Krotowski discovered the resting stage of the parasite, the socalled hvnnozoite, that he felt the solution to this age-old problem had been found. It was also during this time that Garnham solved another problem which had been in the back of his mind from the time he was writing his magnum opus (1966: Malaria Parasites and other Haemosporidia. Oxford: Blackwell Scientific Publications). The problem was Plasmodium pitheci of the orang-utan. Although it was the first of the malaria parasites of apes to be named (in 1907), the description was so inadequate that it was impossible to assign it to a group or to seewhere it fitted, if at all, in the evolution of the malaria parasites of man. Furthermore, Garnham feared that the host would soon become extinct as its specialized habitat was being destroyed and, with it, the parasite would also be lost. Then, in 1970, he was given some slides prepared recently from orangutans in Sabah, east Malaysia. Some were infected with P. bitheci, but Garnham could not see all the stages necessary to decide to which group it belonged. He decided to go to Sabah with some splenectomized chimpanzees, find an infected orang-utan, inoculate blood into the chimpanzees and elucidate the life-cycle of the parasite. Some may have thought that age was beginning to take its toll. They would have been wrong. He recruited a team consisting of Prof. W. Peters. Dr D. I. Lewis and me and. in 1972. we went. with the chimpanzees, to Borneo.’ Garnham quickly made friends with Stanley da Silva, the Game Warden in charge of the Sepilok Reserveat Sandakan, Sabah, where illegally owned orang-utans were released back to the wild. We were given permission to examine any orangutans we could handle and, later, were allowed to take small amounts of blood from any which were infected. Within a few davs. we had found P. Ditheci and. to our surprise, a second; previously unknown, species which we later named P. silvaticum in honour of Stanley da Silva and to indicate the habitat of the host and its parasite. Mosquitoes were flown in from the colonies maintained by Mr W. H. Cheong at the Medical ResearchInstitute, Kuala Lumpur, and we quickly obtained the sporogony of P. pitheci and showed that it was not infective to man. Blood from infected orangutans was inoculated into 2 chimpanzees, and Garnham, Peters and Lewis then left to attend a malaria meeting in Kuala Lumnur. After the meeting, Peters and Lewis returned to England while Garnhamand I stayed to try to demonstrate the full life cycle of both parasites. It was arranged that, if either of the chimpanzees became infected while Garnham was away,, I would fly them to Kuala Lumpur and we would contmue the work there with the excellent

Professor I’. C. C. Garnham with members of his department at the London School of Hygiene and Tropical Medicine on the occasion of his retirement, 27 September 1968. In the front row, left to right, are J. R. Baker, I’. G. Shute, R. B. Heisch, I’. C. C. Garnham, H. E. Shortt, R. S. Bray, and J. I’. McMahon. Standing behind Professor Garnham are M. Maryon and R. Killick-Kendrick.

mosquito colonies. If they remained negative, Garnham would return to Sabah, and we would decide what to do next. Many rather lonely days after they had left, I saw the first parasite in a thick blood film of the chimpanzee that had been inoculated with P. silvaticum and sent an excited telegram to Garnham announcing the news, ending with ‘You owe me champagne!’ I sent the ammals to Kuala Lumpur and flew there a day later myself. Garnham met me at the airport and took me to our hotel where I joined him for dinner. As the meal began, a waiter came over to serve us champagne. Garnham’s face was expressionless, but he had a twinkle in his eye. We elucidated the whole life cycle of 1’. silvaticum and, except for the tissue schizogony, of P. pitheci. But the mission was not all work and no play. Garnham had an intense interest in so many things, and I have vivid memories of an evening with him in the forest watching flying squirrels, and of a dizzy tree-top walk together along a transect 50 m above the ground. In 1980, Garnham ‘retired’ for the third time-but not to sit in a rocking chair. His life-long fascination with mysticism resulted in a book on Edgar Allen Poe, which he had almost completed before he died. He tackled this task like a piece of research, and visited many places where Poe had lived. Sir Ian McGregor tells of Garnham’s delight when he discovered that his room at a meeting at the University of Virginia had been occupied by Poe when he was a student. He also began to revise a book on life in biomedical research that he had written with his great friend Ronnie Heisch. When Heisch died in 1970, Garnham put the text to one side for more than

20 years. Sadly, our joint attempts to find a publisher met with failure. In spite of failing health, Garnham continued to attend meetings of the Royal Society of Tropical Medicine and Hygiene up to the year of his death. He also continued to play his beloved piano and once told me that music, not parasitology, was his real love. If he had had his way, he would have studied music rather than medicine. Garnham had a wonderful senseof humour and was a master of the ‘deadpan one-liner’. After the discovery of P. silvaticum, we were discussing which journal was going to have the privilege of publishing this remarkable finding. Garnham seemednot to like the one which the rest of us thought would be suitable, and kept suggesting others. I asked him: ‘Professor, why do you never publish in that journal?’ He replied: ‘But I do: I published there in 1928!’ All Garnham’s friends have numerous similar stories to tell, but the abiding memories of this great man, whom so many people loved, will be of his warmth, kindness, wisdom, loyalty, and impeccable behaviour towards others. To foreigners, he was an archetypal Englishman. They were sometimes surprised to find he was, nevertheless, an internationalist with a total disregard for the nationality of his colleagues who inevitably became his friends. Hundreds of doctors and scientists in all parts of the world will remember the support he gave them, and the generous words of encouragement he provided whenever they were needed. He will never be forgotten, but he will be greatly missed. R. Killick-Kendrick