OBITUARY
John Richardson
BMJ 2002; 325 doi: 10.1136/bmj.325.7366.716 (Published 28 September 2002)
General practitioner whose records on coxsackie infection won him worldwide fame
The international reputation that John Richardson acquired in the field of myalgic encephalitis (ME) research sprang from the records that he kept for 40 years of enteroviral infections, mostly coxsackie virus. He realised that enteroviral infections were endemic among his practice population on the south bank of the Tyne, spreading from one family to another and from one generation to the next. The public health authorities seemed to be unaware of it and facilities for identification were rarely available locally. The late Dr Eleanor Bell of Glasgow, who had conducted her own researches into the prevalence of enteroviral infections in southwest Scotland, was generous in filling the gap.
The clinical features of these infections varied from Bornholm disease—a common short illness with chest pain—to audible pericarditis, serious myocarditis, and valvulitis with dysfunction. Other features were muscle pain, jitter and weakness, sleep disturbance, hypersensitivity to sound and light, and mild confusion. Many organs in the body could also be affected. In the long term the effects were sometimes serious. While some members of a family would escape with a brief febrile illness only, coxsackie infection could leave one person struggling for years with ME or dilated cardiomyopathy. Worse still, John found that the infection would readily pass from the mother to her unborn child, which would be delivered with fibroelastosis or maldevelopment of the heart, or structural defects of the brain or other organ. He tried to prevent this in early pregnancy by giving the mother intramuscular injections of human immunoglobulin.
Early on John believed that ME was an illness that could follow directly from a coxsackie infection and one that was capable of altering the whole personality and abilities of someone he had known for years. The idea that it was just depression or hysteria, a psychoneurosis or “all in the mind,” he found not only ludicrous and cruel, but also dangerous, and his records contain several examples of suicide. When patients told him that they had grown tired after taking vigorous or progressively “graded” exercise and found that they had to pay for it by being much worse for the next day or so, he believed them and sought other methods of treatment.
The fame of his records led James Mowbray, professor of immunopathology at St Mary's Hospital, London, to offer him unrestricted facilities for identification of the various strains of the coxsackie group of viruses, as well as other viruses less frequently encountered. Leonard Archard, now professor of biochemistry at Imperial College, London, was also helpful in culturing virus in samples of tissue sent to him and both became personal friends. John did not publish these records in the form of his book
Enteroviral and Toxin Mediated Myalgic Encephalitis/Chronic Fatigue Syndrome and Other Organ Pathologies (Haworth Medical Press) until 2001.
John also became acquainted with Dr Melvin Ramsay, who defined benign myalgic encephalomyelitis in 1956 after studying an outbreak of Bornholm disease at the Royal Free Hospital, London. John became a founder member of the ME Association, renamed the Ramsay Research Fund in 1999 after Melvyn Ramsay's death.
John's own international reputation grew rapidly after an international symposium on myalgic encephalitis was held in Cambridge, United Kingdom, in 1989. He was chairman of it and the book that followed in 1992,
The Clinical and Scientific Basis of Myalgic Encephalomyelitis, edited by Dr Byron Hyde, not only contains a chapter written by John, but is dedicated to him.
John gave up all NHS work in 1992 and his appointment as a senior police surgeon. However, he continued to see patients privately. Most came from the United Kingdom, but some also from France, Republic of Ireland, Belgium, and Norway. He refused fees, but suggested instead a contribution to the research fund that he established. This he used partly to finance scientific papers that he wrote and partly as gifts to individuals and university departments where the effects of long term survival of virus in the human body were being studied. His own papers were into what part of the brain was involved in ME. John also used the patient contributions to finance an annual international conference in his local area. The pursuit of these researches did not prevent him playing a full part in the general practice of which he was a partner, including training medical students sent to him by the university.
Outside medicine his main interest was music, especially playing the three manual pipe organ, which with assistance he had built in his own house and for which he composed 28 pieces. Predeceased by a daughter, he leaves a wife, Margaret (Peggy), and three children.
John Richardson, former general practitioner Ryton, Tyne and Wear (b 1915; q Durham 1952), died in the Freeman Hospital, Newcastle, on 18 July 2002.
