The London Thyroid Club - a History
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.
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).