The
study of the thyroid gland and its diseases had attracted attention
in the United Kingdom before the Second World War. Gull was the
first to treat myxoedema with thyroid extract at the end of the
19th century and the structure of thyroxine was defined by Harington
in 1926 at University College Hospital in London. The phenomenon
of ‘Derbyshire neck’ (non toxic goitre due to iodine
deficiency) was well known. The medical research council had delivered
a report in 1922 concerning iodine status and goitre on a national
basis. Surgery for goitre and hyperthyroidism was being performed
increasingly throughout the land. There were hardly any specialist
societies at this time and physicians relied on The Association
of Physicians of Great Britain and Ireland (founded 1906) and The
Medical Research Society for their continuing professional development.
With this background, a group of 16 London
based clinicians and clinical investigators held a dinner at Canuto’s
restaurant on Wednesday November 16th 1950 to inaugurate the Thyroid
Club. This group included Sir Thomas Dunhill (elected as president),
Dr. (later Lord) Russell Brain (vice president ) and Dr (later
Sir) Eric Pochin (secretary). Notable among other attendees were
Russell Fraser, Raymond Greene and Robert Trotter. It was decided
that no rules should be laid down until the end of the first year
and that the club should meet once before Christmas and twice
in the spring with the option of other meetings to cater for foreign
visitors. At the subsequent meeting Dr Brain was to speak on exophthalmic
ophthalmoplegia and Dr Pochin would speak on radioiodine treatment
of hyperthyroidism at the following meeting. Familiar topics to
all current thyroidologists. Plus ça change! It
was also decided that the speaker should not speak for more than
20 minutes. The membership would be 18, perhaps up to 24 after
1 year and up to 6 guests would be permitted. Exclusivity was
the order of the day.
Meetings continued as scheduled. On July
15th1952 the club was honoured to receive Dr Howard Means (from
Boston) to discuss thyroid facts and fallacies. He was to speak
again in May 1956 on recent travel in search of thyroids (in Argentina
and Japan). The meetings were documented by the secretary. The
attendees were noted (by signature) and the nature of the lecture
and subsequent discussion described for example, on May 22 1952
‘Mr Donald opened a lively and fruitful discussion….’
‘The meeting observed its closing time of 9.30 by ending
at 11 and continuing on the pavement outside till 11.30’.
[And there were only 15 attendees!]. In April 1956 Dr Hamlin described
the method of needle biopsy of the thyroid. ‘A lively discussion
followed, the results receiving much criticism because of the
varied pathology of individual glands.’ Clearly the distinguished
members of the thyroid club had reservations about this technique
and it was another 25 years before it became routine in the UK
The thyroid club was not the province
only of physicians. In November 1953 Mr. (later Sir) Geoffrey
Keynes talked about thymo-thyroid relationships and discussion
was joined by Mr Selwyn Taylor and the noted thyroid pathologist
Dr. Israel Doniach. The venue had changed to Fabbri’s restaurant
which, because of its excellent dinner, was to be the chosen meeting
place for the next year and a half. The price of the dinner had
to be increased from 17/- to 21/- to maintain the dining standard
at this restaurant (around £40 sterling at 2008 prices).
At this meeting too it was decided to increase the number of members
to 25 but any new member had to have been a guest of an existing
member. It is noteworthy that distinguished foreign speakers were
continually invited to the club. In 1954 these included Nafzigger
from California (operation on exophthalmos), Lawson Wilkins the
eminent paediatric endocrinologist from Baltimore and Sam Haines
from the Mayo Clinic in 1955. In 1956 Dr Rosalind Pitt-Rivers
FRS was elected to membership and spoke to the club ‘on
the subject of triiodothyroacetic acid, recently discovered by
her.’ She emphasised the speed of action and the effects
in human myxoedema were described at the same meeting by Trotter.
The 25th meeting of the club was held
in April 1957. By this time the venue had changed to Kettner’s
restaurant. There were 2 important events that night. First, Dr
Raymond Greene proposed that country members (later defined as
outside the Home Counties) should be admitted. The number should
be no more than 5. Unlike the existing members, there would be
no requirement for them to attend at least one meeting per year.
Secondly, Dr. Sidney Ingbar, one of the foremost thyroidologists
in the USA gave a paper. Although 1956 had been the year of the
discovery of T3 by Pitt-Rivers it was also the year of the landmark
paper of Deborah Doniach and Roitt relating to the concept of
autoimmunity as evidenced by the finding of circulating thyroid
antibodies in Hashimoto’s thyroiditis. Deborah’s husband,
Israel, had given a paper to the club the previous year on thyroid
regeneration. Deborah spoke in November 1957. The following year
saw the first election of country members, Professor (later Sir)
Edward Wayne, Dr. Alastair Macgregor and Dr. Douglas Hubble. A
new era of UK inclusivity, albeit small had started. Because of
popular interest in country membership it became necessary to
hold a postal ballot for the 2 vacancies remaining in 1958.
At this meeting Raymond Greene and Selwyn
Taylor reported progress on the arrangements for the 4th International
Goiter Conference to be held in London in 1960. This conference,
the first international conference held after World War II, was
organised by the London Thyroid Club and The American Thyroid
association; it was a great success. At that meeting, the realisation
that there were many Europeans who were working on thyroid physiology
and disease subsequently led to the formation of The European
Thyroid Association in 1965. Indeed, the first secretary of the
ETA (Christian Beckers) had presented a paper at the Goiter conference
in 1960.
The next few meetings saw an increase in numbers attending and
at the 30th meeting in February 1959 (fig 1) it was agreed that
each member would be allowed to invite 1 guest to the meeting.
By the end of the decade the thyroid club was an established entity
and flourishing. Its meetings were convivial the papers good to
excellent and the discussion stimulating as well as illuminating.
Inspection of the list of members and guests reveals some of the
most distinguished British physicians, surgeons, pathologists
and scientists, all with a focus on the thyroid. The breadth of
topics discussed was enhanced by many overseas visitors, mostly
from USA. The high standard and pattern of this foundation decade
provided a platform for the future expansion that was to take
place.
The recording of the meetings by the secretary continued to be
complete until 1965. Between 1951 and May 1965 there were 51 speakers
of whom 20 (39%) were from overseas. At the end of 1965 there
were 43 members including 3 honorary members. Included in the
membership were 3 fellows of the Royal Society and 1 Lord.
Fig 1 Thyroid Club meeting 1959
The minutes of the meetings after 1965 are less complete but did
record the names of the attendees, albeit probably an incomplete
list as not everyone signed. Nevertheless a list of presenters
and topics is available up to 22 October 1980. The 50 papers delivered
between 1965 and 1980 show clearly the depth and range of thyroid
study. A few examples follow (inevitably selective). Medullary
carcinoma of the thyroid (Williams), Iodine metabolism in pregnancy
(Crooks), Studies of the thyroid iodide trap (Alexander) LATS
(Mackenzie), Serum triiodothyronine in health and disease (Sterling),
The neurological type of endemic cretinism (Pharoah), Grades of
Hypothyroidism (Evered), The epidemiology of thyroid disease (Tunbridge)
Cell mediated immunity in thyroid disease (Irvine) and Screening
for neonatal hypothyroidism (Rees, Himsworth and Hoffenberg).
Attendance numbers were increasing and, because of the expanding
interest in thyroidology, it was decided to have an annual scientific
meeting in addition to the dinner meetings held now at Leoni’s
restaurant in Dean Street, Soho. The first annual general meeting
(the 75th meeting of the thyroid club) was held in the Shah lecture
theatre at The Royal Postgraduate medical School, Hammersmith
Hospital on 9th October 1970. It consisted of 4 sessions with
a total of 19 communications . In addition a lecture was given
by Dr Reginald Hall on extra-thyroidal factors influencing the
thyroid. Over the next 10 years these meetings proved very successful,
with attendance numbers around 100 including guests. Although
the thyroid club had a predominance of London members it is interesting
to note that the contribution of papers from Scotland during the
10 years to 1980 was around 30%. Other major centres outside London,
namely Sheffield, Newcastle, Birmingham and Cardiff also contributed
significant numbers of papers. In 1983 the 10th scientific meeting
and AGM was held at the University of York to coincide with the
second annual meeting of the British Endocrine Societies meeting.
The dinner meetings continued to attract the membership. One such
meeting was on 4th December 1975. It was the 97th meeting but
the dinner (at Leoni’s restaurant) celebrated the 25th anniversary
of the founding of the club and was attended by 41 members and
guests. Sir Richard Bayliss, in his typed minutes noted that Mr.
J.E. Piercy (a founding member) reminisced in his inimitable fashion
about those early meetings and those who attended them. Sir Richard
continued ‘His anecdotes, an artful blend of wit and personalities,
vastly entertained his hearers but should not, for the sake of
discretion be recorded in the minutes’.
In 1979 the thyroid club was in the capable
hands of Professor Reg Hall (President) and Dr. David Evered (Secretary).
At the AGM in February a discussion paper entitled The Thyroid
Club- Past, Present and Future was presented. After describing
details of membership, subscription and meetings specific proposals
for discussion were enumerated as follows: 1) the number of members
should remain at 60 2) The number of associate members (ams) should
be unrestricted ; the ams should not vote; they should pay half
the subscription of full members; the duration of an associate
membership should be 5 years. 3) The scientific meeting should
continue 4) Rules governing attendance at dinner meetings should
be enforced and ams should no longer be allowed to introduce guests.
These measures indicate the increasing interest in thyroidology
at that time was placing administrative pressures on the organisation
of the club. During the 1980s the numbers at the dinner meetings
were consistently high (40 to 50). There were many venues including
the zoological gardens at Regents Park and the arts club in Dover
Street as well as a number of hospitals. The venue for the annual
one day scientific meeting also changed. One memorable on was
at The Medical Society of London in Cavendish Square at which
the guest speaker was Dr Paul Ladenson from Johns Hopkins University,
Baltimore. This was held on 26th November 1997 and was also the
occasion of the change in the name of the club to The British
Thyroid Association. The annual scientific meetings have been
held at the Royal Free Hospital since that time and regularly
attract more than 100 participants. At these meetings a guest
speaker from continental Europe is invited. In addition to oral
communications there is a symposium and poster presentations.
Scientific aspects of thyroidology are also well represented at
the annual meeting of The British Endocrine Society of which The
BTA is a constituent member. A highlight is The Pitt-Rivers lecture
which commemorates Rosalind Pitt-Rivers and is partly supported
by The Clinical endocrinology Trust.
The evolution of the thyroid club from
an exclusive dining society restricted to members from London
to a much larger British Thyroid Association with membership drawn
from all grades of the medical profession as well as scientists
has paralleled the changes in medical practice since 1950. On
22nd November 2000 the 50th anniversary dinner of the founding
of the thyroid club was held at Leoni’s restaurant attended
by around 30 members. Sir Richard Bayliss (one of the early members,
now deceased) proposed the health of the club and Anthony Toft,
the president replied (fig 2).
Fig 2 Fiftieth Anniversary Dinner
Menu 2000
Although a subscription is paid by members the funds raised have
never been adequate to support all the activities of the club,
in particular the funding of overseas lecturers at the annual
scientific meetings. It is a pleasure in this account to acknowledge
with gratitude the generous donations from many pharmaceutical
and other companies which have supported the club.
What of the future? Unfortunately it has
become clear that thyroid investigation currently does not seem
to attract large funding from charitable organisations or the
medical research council. However, high quality clinical investigation
and scientific research is still part of the medical scene in
the UK. This has been due in no small part to the enthusiasm of
the founders of the club and their successors.
Prof JH Lazarus
Centre for Endocrine and Diabetes Science
University hospital of Wales, Cardiff , Wales, UK
