David Paton Cuthbertson (9/5/1900 – 15/4/1989) was born in Kilmarnock and was educated in Kilmarnock Academy. After a spell in the Royal Scots Fusiliers, he went to Glasgow University where he graduated first in Chemistry and then in Medicine. At the age of 26, he was invited to take up a post at Glasgow University, being both the first lecturer In Pathological Biochemistry and the first biochemist based at Glasgow Royal Infirmary.
In his first few weeks a surgeon asked him why fractures of the tibia were slow to heal. The search for the answer to this question ultimately defined his lifetime’s career. By measuring basic chemical constituents – nitrogen, phosphorus, sulphate and calcium – in urine, blood, faeces, tissue and food, and subsequently Basal Metabolic Rate to understand energy expenditure, he developed a basic understanding of how the body’s metabolism responds not only to injury such as broken bones but also to infections and inflammation. He described an early “ebb phase of depressed vitality” when the oxygen utilisation and body temperature decreases. This was followed by what he described as a “flow phase” with increases in metabolic activity, muscle breakdown, temperature, and oxygen utilisation. He recognised that this mobilisation of protein from muscle provided amino acids which would lead to repair and renewal of tissue.
It was clear to Cuthbertson that good nutrition played an important role in recovery of critically traumatised patients and so his interest expanded into this scientific field. Two of his early papers provided the foundation for modern nutritional therapy of seriously ill or injured patients, by attempting to limit loss of body components in early periods and ensuring an adequate supply of nutrients to act as substrates during the recovery phase.
In 1934, he was invited to take up the Grieve lectureship in physiological biochemistry at Glasgow University from 1934-1945, since it offered him access to a wider range of academic colleagues and physiological techniques.
In the late 1930s, Cuthbertson became interested in patients with severe burns since these patients have a large metabolic response to their injury. He applied to the Medical Research Council for a grant to employ a junior colleague to further research his ideas for improved treatment. Because of the importance of improving the treatment of burns in the on-going Second World War, he was offered sufficient funding to establish a team of senior researchers which resulted in a novel therapy – intriguingly named MRC Cream Number 9 – which was successfully employed for the remainder of the war. With the rapid success of this project, Cuthbertson was seconded to the MRC and also to act as an advisor on optimal nutrition in the armed forces.
In 1945 when Lord John Boyd-Orr – famed for overseeing Britain’s food policy during World War II – retired from the directorship of the Rowett Institute, which was established in Aberdeen as the UK’s centre of excellence in nutritional research, Cuthbertson was the obvious choice as successor. Under Cuthbertson’s stewardship the institute expanded enormously. At the time there was perceived to be a post-war threat to food supply because of a potential Russian blockade of supplies and so Cuthbertson’s initial remit was to research animal nutrition with the goal of expanding Britain’s capacity for home food production.
Under his direction, the institute created a farm, and facilities for research in protein and carbohydrate chemistry, microbiology, enzymology, applied biochemistry, physiology, pathology, animal behaviour, applied animal nutrition and statistics. In its jubilee year in 1963, the number of staff had increased fourfold. Aberdeen was not perhaps the most alluring location to attract scientists, but Cuthbertson’s powers of persuasion and his reputation were such that he could still engage the best. One was Dr Richard Synge who in 1952 was awarded the Nobel Prize for Chemistry.
One early report which demonstrated the breadth of his nutritional understanding and gave him much satisfaction was his survey of ‘Nutrition in Newfoundland’ in 1947 with many important public health recommendations.
During his twenty years at the Rowett Institute, his personal reputation and that of the Institute came to be recognised internationally and his involvement in research of animal and human nutrition was set on the world stage. As well as being president of the UK’s Nutrition Society and the British Society of Animal Production he was also president of the International Union of Nutritional Sciences.
He was awarded CBE in 1957 and on his retirement in 1965 he was knighted. He then began the third phase of his career, returning to the Department of Clinical Biochemistry at Glasgow Royal Infirmary to continue his metabolic research. He developed an interest on the effect of elevated environmental temperature in reducing the metabolic response, and had special investigative rooms built to study this.
He was a regular contributor at international meetings and also acted as mentor to other younger scientists and academic clinicians. In 1979 the European Society for Parenteral and Enteral Nutrition was founded to act as a major international forum for the understanding of nutrition in disease, with an emphasis towards artificial nutrition. He was delighted when this new Society chose to name one of the two Plenary lectures after him, this being one of the most prestigious lectures still given annually in the field of Clinical Nutrition. The Society is now known as ESPEN, the European Society for Clinical Nutrition and Metabolism.
Sir David was clearly very bright but other facets of his character were just as important to his success. He was enormously energetic both at work and play. Much of his early research was carried out in the evenings and weekends when he would carry out much of the analytical work himself. Despite his considerable workload he never relaxed from opportunities to expand his research into other areas. When he ‘retired’ at the age of 65, Glasgow Royal Infirmary was only too happy to create an honorary position which enabled him to work right up till his death at the age of 89.
He was an enthusiastic golfer from an early age, his father also being a keen golfer. He was also a skilled painter of water colours which he showed at a number of exhibitions.
Although Cuthbertson could be occasionally be inattentive to administrative matters – for example he forgot to give notice that he was retiring from MRC – when it came to research, his attention to detail was absolute. In his twenties he realised that he could not rely on busy nurses to collect samples and record data and so he convinced medical staff that a separate metabolic ward with a kitchen for preparing tailored meals should be established so that data from his research patients would be meticulously collected. To exclude the possibility that confinement to bed might cause the metabolic changes seen in injured patients, he recruited a control group of students (at a rate of £2 per week) to lie in bed with a leg in splints for up to 2 weeks.
One of Cuthbertson’s greatest contributions to science came from his desire to educate. During his career he regularly contributed at international nutrition conferences, he wrote 5 books and published over 400 scientific papers and reviews and updates on the progression of knowledge regarding the metabolic response to trauma, infection and critical illness.
Perhaps the most important aspect of his success was his personal nature. He was a gentle gentleman – helpful, affable, engaging and enthusiastic – qualities which enabled him to engage positively with all his associates. He acted as a role model and inspiration to many.