The Founders of Neurology

Will Pickles of Wensleydale. The Life of a Country Doctor. by JOHN PEMBERTON, London, Geoffrey Bles, 1970, pp. 224, illus., £2-50. Will Pickles (1885-1969) was a country general practitioner of Wensleydale, who made a positive contribution to epidemiology, defining the incubation periods of infectious fevers by a method which he described as 'the short and only possible contact'. He applied a simple practical method to find this elusive information and used his general practice as the medium for research. One wonders why it was not done before, but therein lies the greatness of the man. The essence of a general practitioner is his detective urge to gather all the clues, as he does in making a diagnosis. Dr. Pickles applied this to the epidemic ofjaundice which was to start his researches. He thought 'it great fun when we could exercise Sherlock Holmes tactics and nail the culprits'. To follow personally from a clinical history and examination to a family history, village history and dale history was a special opportunity of his general practice. And this is what he did. Family by family, and village by village he was able to look out for personal information at weddings, christenings, parties and funerals, indeed wherever village people met. In the epidemic of 1928, out of a total estimated population in Wensleydale of 5,700 there were some 250 known cases ofjaundice, of whom Dr. Pickles and his partner attended 118. The story of the research, which established the incubation period as 26 to 35 days, includes the uncovering of a secret romance and reveals the broad human interest that motivates the best medical practitioners. By meticulous and accurate note-taking, in which he was fortunate in having his wife Gerty to transpose his diary records to charts, he extended his work to other infectious diseases that beset his patients. Ten years later, he published his Epidemiology in a Country Practice (1939), a work which was to make his name world famous. Will Pickles was the son of a general practitioner of Camp Road, Leeds, and himself practised medicine in Aysgarth for over fifty years. His thinking was in the tradition of those great G.P.s Edward Jenner, William Budd and James Mackenzie. His valley did not limit his horizons and his influence was more than parochial. He was one of the minority of doctors to welcome the National Health Service Act of 1948 and the possibilities that it brought to medical practice. These he used to the full in the service of his patients and of medicine. It was fitting that he should have become the first President of the College of General Practitioners. Professor John Pemberton's account of his life in the closed society of the dales, portrays a community and its doctor which has already gone for ever. The biography grew out of a series of locums which the author did for Dr. Pickles in the ten years after 1949. The picture of this remarkable G.P.'s daily life, the personal reminiscences, the countryside in all its moods and the anecdotes of the villagers make most agreeable reading. JOHN CULE