D'Arcy Hart, Dr Phillip, CBE (1900-2006)

Papers of Dr Philip D'Arcy Hart (1900-2006). These papers were received in June 2008 and January 2009 as a deposit on loan from Dr Oliver Hart, son of Philip D'Arcy Hart. They relate primarily to Philip D'Arcy Hart's career in medical research (with particular reference to tuberculosis) with additional material relating to his early career in clinical practice and his personal life, social and political interests. Hart had a long and full career in medical research, specialising in the treatment of tuberculosis with the NIMR's Tuberculosis Research Unit. Most significantly, he directed the clinical trial that demonstrated the efficacy of streptomycin as a treatment for tuberculosis. Before working on tuberculosis he did significant work on pneumoconiosis in coal miners with particular reference to the South Wales coal fields. He was a socialist and peace campaigner, and the papers - both medical and more personal - also reflect these interests, including material on the Socialist Medical Association and the International Brigade Association. This mix of activities is further reflected in the published material within his papers, which ranges from articles in large-circulation scientific journals to input to much smaller-circulation activist journals and bulletins.

1915-2006

12 boxes

The collection is arranged by section as follows:

A. Personal Material, 1915-2006

B. Early Career at University College Hospital, 1926-1940

C. Career with the Medical Research Council, 1942-2002

D. International Visits in Connection with Various Bodies and Organisations, 1946-2000

E. Societies, Committees and Fellowships, 1935-2003

F. Correspondence, 1954-2003

G. Lectures and Broadcasts, 1937-1997

H. Photographs and Slides, 1945-2000

J. Publications and Off-prints, 1929-2005

K. Press-Cuttings, 1928-2005

These papers were received in June 2008 and January 2009 as a deposit on loan from Dr Oliver Hart, son of Philip D'Arcy Hart. Ownership and copyright of this material is retained by the depositor.

Philip D'Arcy Hart was born on 25 June 1900 at 18 Pembridge Gardens, Kensington, London, son of Henry D'Arcy Hart, barrister and his wife Ethel, (née Montagu), daughter of Jewish banking magnate Samuel Montagu, first Baron Swaythling. He was educated at Clifton College, Bristol and Gonville and Caius College, Cambridge, where he completed his basic medical science training. He completed his clinical medical education at University College Medical School, London, qualifying in 1925 and serving as House Officer to Wilfred Trotter. He passed the examination of the Royal College of Physicians of London shortly thereafter and became a member of the University College Hospital Medical Unit. It was here that Hart first started investigating the usefulness of tuberculin testing (the Mantoux test) in detecting tuberculous infection in a large-scale study of school children and later in adults. He showed that it was accurately indicative, with a 98 percent correlation with disease, and provided a valuable indicator for treatment. A report regarding this work was issued by the Medical Research Council (MRC) in 1932. After spending one year at the Rockerfeller Institute, New York, on a research fellowship he returned to University College Hospital, London (UCH) as a consultant physician 1934-1937. Whilst at UCH he came under the influence of Sir Thomas Lewis, who was also a member of the MRC. At Lewis' suggestion Hart was recruited to the MRC in 1937, and left clinical practice to become a full-time researcher. He was to remain associated with the MRC for the rest of his professional life: as scientific staff member of the Pneumoconiosis Research Unit 1937-1948, director of the Tuberculosis Unit 1946-1965, MRC grant holder at the National Institute of Medical Research (NIMR) in the Mycobactrial research Division 1965-1993 and latterly as a Visiting Scientist at NIMR 1993-2002.

Hart was initially recruited to supervise the medical part of an investigation of chronic pulmonary disease among coal miners. In the 1930s, mine workers who excavated the shafts and who developed silicosis were compensated, however those who worked at the coal face and who developed a range of lung diseases widely termed pneumoconiosis were not eligible for compensation. In response to growing discontent amongst coal workers, in 1936 the Home Office and the Mines Department asked the MRC to investigate, with particular reference to South Wales coal fields. Between 1937-1948, as part of the Pneumoconiosis Research Unit, Hart carried out his work from lodgings in Cardiff and travelled the valleys with a portable x-ray van. The Unit's work demonstrated that the disease was occupational, that industrial compensation for pneumoconiosis was warranted, and as a result compensation was subsequently extended.

Hart married Ruth Meyer in 1941.

In 1943, he was appointed secretary of a study to test the efficacy of the antibiotic patulin, an apparently promising treatment for the common cold. Hart and his colleagues designed a trial that alternated the treatment of patients with patulin or a control solution and ensured that neither patients nor medical staff knew which treatment was being administered. No beneficial effect of patulin was discerned. The patulin trial has latterly been recognised as the first well-controlled, multicentre trial conducted under the aegis of the MRC.

In 1946 Hart was asked by the MRC to form the Tuberculosis Research Unit, which was tasked initially with assessing the value and risks of the drug streptomycin in pulmonary tuberculosis. Based in Hampstead, London, Hart and his deputy, Marc Daniels used a system of random allocation designed by statistician Sir Austin Bradford Hill and organised and conducted a controlled trial, the results of which were published in 1948 and showed that streptomycin had a more powerful effect against tubercle bacilli in the living body than any therapeutic agent previously tested. The trial is credited with setting the example for subsequent randomised controlled trials in clinical research. In 1956 Hart was awarded the CBE in recognition of this work.

In the summer of 1945 Hart and his colleague Dr Tom Garland were asked to undertake an investigation on behalf of the Colonial Office, of tuberculosis in Newfoundland, then a British Colony. In war conditions they travelled to the capital, St John's, where they carried out studies among the isolated communities similar to those undertaken in South Wales. In light of his insight into local living conditions Hart made what recommendations he felt he could to the Colonial Office for improvements in these and in medical care. Following the Second World War (1947) Hart and Daniels were sent by the Foreign Office to assess the probable risk of a tuberculosis outbreak in the British occupied zone in Germany. They correctly advised that an outbreak was unlikely to occur.

From 1950 to 1952, under a special MRC committee (chairman Hart, statistician Ian Sutherland), the unit undertook a controlled trial of bacillus Calmette-Guerin (BCG) vaccine against tuberculosis infection in more than 50,000 adolescents in England, which showed it to be about 80 percent effective, with local variation.

Hart retired as director of the MRC's Tuberculosis Unit in 1965 and embarked on a new career as a cell biologist, first as a Grant holder at the National institute of Medical Research (NIMR) 1965-1993, and continued his association with the MRC as an attached worker 1993-2002. Based initially at Hampstead then at Mill Hill, London he conducted laboratory work focused on the cellular interactions of tubercle bacilli within the defence macrophage cells, in collaboration with the electron microscopist John. A. Armstrong, and later with M. R. Young. In 1997 Hart was a keynote speaker at an American Society for Microbiology meeting recognition of the fiftieth anniversary of the streptomycin trial. He also gave the keynote address at the British Medical Association conference in 1998 and in 1999 he was elected as an Honorary Fellow of the Academy of Medical Sciences. He continued to work in the laboratory past his hundredth birthday until his eventual retirement in 2002. His last research paper was published in 2004.

Hart died in London on 30 July 2006.

Hart's papers indicate that he engaged with a number of associations and committees during his lifetime, on both a professional and personal basis. He was a member of World Health Organisation Expert Tuberculosis Committee 1947-1976. He was a long-standing member of the Socialist Medical Association, serving as their refugee secretary during the Second World War and was active in the pro-republican Medical Aid Committee during the Spanish Civil War. In 1939 an informal club called the Committee for the Study of Social Medicine was established, of which Hart was also the secretary. They undertook a number of surveys, however the committee's records were destroyed during a bombing raid in the Second World War and it subsequently disbanded. Between 1953-1955 Hart was chairman of a local residents association, Hampstead Arts and Professions for Peace. Hart engaged with the topic of alien and refugee doctors and scientists and was a member of the Society for Protection of Science and Learning Advisory Sub-Committee for Medical Research (1938-1940). The sub-committee was formed to consider the applications of German and Austrian refugee doctors who applied for assistance in obtaining research positions. According to his records Hart was involved with the Association of Scientific Workers (1942-1964) and with the Labour Research Department Industrial Health Committee (1942-1945).

For additional biographical material see Hart's entry in the Oxford Dictionary of National Biography; Tansey E M, "Philip Montagu D'Arcy Hart, CBE, FRCP, Hon FmedSci", James Lind Library (2004); Tansey E M "Philip Montagu D'Arcy Hart (1900-2006)" Munk's Roll. Obituaries in The Times 16 August 2006; The Independent 24 August 2006; The Guardian 30 August 2006; British Medical Journal, 333:449 (2006); The Lancet 268, 9538 (2006). See also curriculum vitae in file A/3/1 of this archive.

Material was deposited with the Wellcome Trust by Dr Oliver Hart, who retains copyright.

This collection has been catalogued and is available to library members. Some items have access restrictions which are explained in the item-level catalogue records.

Duplicate published material has been removed from Section J of these papers. Duplication may occur elsewhere in the collection where published material has been retained alongside original material within individual files. Duplicate correspondence has been removed only where material obviously represented a copy of a document already present in a file.

The papers represent the personal records of Dr D'Arcy Hart which remained at his home address after his decease in 2006. In 2008 they were surveyed in situ by Wellcome Trust Archive staff and the main body of the records were collected by the Trust on 4 June 2008. A subsequent accession (1 file) of correspondence was transferred to the Trust by the depositor, Dr Oliver Hart, in January 2009.