Crofters: the good man who
halted an epidemic
By Chris Holme
It's what every aspiring
doctor dreams of – find a 100% cure for the world's most dreaded disease
and then get on with more important things in life.
This was what the Edinburgh tuberculosis group led by John Crofton
achieved almost 60 years ago. His memoirs, newly-published by his
daughter Alison and son-in-law Dave, shed new light on how they did it.
I first met Crofton at a conference in Aberdeen on Scotland's alcohol
problems. He came up and cheerfully supplied me with a ready splash for
the first edition which ran throughout the day.
Later, with a reporter's cynical eye for a future obituary, I
interviewed him in Edinburgh on his tuberculosis work. He lived for
another 20 years during which we got to know each other well.
He was a wonderful man, who inspired prominent clinicians including Tom
Frieden, current director of the Centers for Disease Control and
Prevention, and many journalists. We affectionately dubbed him
Winding back to 1952 when he took up the chair of tuberculosis at
Edinburgh University, Scotland was in the middle of a rising and
fearsome epidemic of TB. This disease has been with mankind for
millennia, capable of gnawing away at the spine, bones and other organs
or, more commonly, the lungs. It was a death sentence for half of those
The NHS service in Edinburgh was a shambles. Crofton changed all that,
bringing in his own team of consultants, including Jimmy Williamson who
had previously treated George Orwell. Their approach was revolutionary
using all three available drugs from the outset rather than
Rising TB notifications in Edinburgh were halved between 1954 and 1957,
a feat not achieved anywhere before or since. Waiting lists disappeared
and the epidemic was halted in its tracks. Newspaper editors and
broadcasters gave active support to a mass x-ray campaign in 1958 which
rooted out residual TB in the city.
Many did not believe their results. When Williamson presented a paper at
a conference in Istanbul, all the American delegates walked out. An
international trial was arranged, which used the Edinburgh model as a
protocol. It became the international gold standard for TB treatment. By
then, the Edinburgh group had effectively done themselves out of a job
and they moved into other areas of medicine. Williamson became one of
the leaders in the new speciality of geriatrics.
Sir John's memoirs chronicle his later career, including his own
two-year battle with clinical depression. They also hark back to his
early years in Dublin where he played with WB Yeats's children and the
Easter Rising when his nursery was peppered with bullets. He continued
tirelessly campaigning on TB, alcohol and tobacco, co-founding Scottish
ASH with his wife Eileen. They were delighted when Scotland introduced
the smoking ban in 2006. I was later told that Crofters called me his
'spy' in the government which I took as a compliment.
Crofton died in 2009. Williamson, another wonderful man and great
raconteur, was the last survivor of the Edinburgh group. He died in June
this year. Novelist and geriatrician Colin Currie wrote a fitting
obituary in the Scotsman.
As Tom Frieden has pointed out, the Edinburgh group's combination
chemotherapy for TB later became a cornerstone for cancer and HIV
treatments. Their legacy lives on.
Saving Lives and Preventing Misery, by Sir John Crofton (Fast Print
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