Charlotte Anderson died on April 15, 2002, at the age of 87 years. She died in Melbourne, where she was born on March 12, 1915. She was a founding member of the European Society of Pediatric Gastroenterology (now ESPGHAN) at its first meeting in Paris in 1968. She was a member of the first council of ESPGHAN and organized the 1970 annual meeting of the society in Birmingham. She has been described by some as the grandmother of pediatric gastroenterology. It is clear that she was one of the pioneers of the discipline, first of all in the land of her birth, Australia, then in Britain, but also in the European society and beyond in the wider world. The first edition of her book, “Paediatric Gastroenterology” (with Valerie Burke as co-author), was published in 1974. As one of the first such books in the English language, it was an immediate success. It was influential in the dissemination of knowledge of the discipline.
Charlotte Anderson made a notable contribution to the development of pediatrics itself. She had the distinction to be appointed as the first woman professor of Pediatrics in the United Kingdom in 1968. She also made important contributions to the development of clinical research within pediatrics as a whole, in addition to pediatric gastroenterology. Her commitment to research related to the fact that she had graduated first in science as a Bachelor of Science from the University of Melbourne with honors in 1935, followed by a Masters of Science. She then went on to graduate in medicine in 1945. She became a Doctor of Medicine of the University of Melbourne in 1955 with her thesis entitled “Diagnosis, Aetiology and Treatment of Coeliac Disease”, based upon the work she undertook in celiac disease in Birmingham.
In this obituary, first her contribution to the expansion of knowledge concerning gastroenterological problems in children, including cystic fibrosis, will be discussed and second her contribution to the development of the discipline. It is no accident that she was a science graduate, as she always saw the necessity for research as a basis for clinical knowledge of the disease processes in children. She was most proud of her work concerning the malabsorption syndromes. She was particularly proud of her simple ward test for the presence of excess-reducing substances in the stools of infants, described with K. R. Kerry in the Lancet in 1964 and now an internationally used simple diagnostic test for infants with chronic watery diarrhea. There were several important papers with Valerie Burke as first author, describing the clinical syndromes of secondary sugar intolerance as a cause of chronic infantile diarrhea. She also made notable contributions to the knowledge of both celiac disease and cystic fibrosis. Her work on celiac disease was particularly important. Traveling as a ship's doctor, she came to England in 1950 as a research fellow with Sir Wilfrid Sheldon at Great Ormond St., well known for his interest in celiac disease. He subsequently sent her to Birmingham as a research fellow to join the remarkable team of Professor Alistair Frazer and Dr. Jack French who were then studying fat absorption in celiac disease. She gave an account of this period in 1988 when she attended the International Symposium on Celiac Disease: One Hundred Years at St. Bartholomew's Hospital. She presented a paper describing Birmingham's contribution to celiac disease in the early 1950s. This research followed upon the demonstration of the harmful effects of wheat and rye flour on the absorption of fat in children with celiac disease made by Dicke, Weijers, and Van de Kamer in Utrecht. Long-term fat excretion studies in Birmingham demonstrated that the harmful agent was the gluten part of flour. These observations were published in the Lancet in 1952, in fact before the Dutch workers' publication, because of, as Dr. Anderson stated it, “their difficulty in having the paper accepted and published by a journal with an international readership until 1953”. It was this paper that led to her return to Melbourne in 1953 where she continued her research on celiac disease. She also set up Australia's first cystic fibrosis clinic. She developed a technically reliable method of sweat collection in 1958 to enable an accurate diagnosis of cystic fibrosis to be made. She also introduced the technique of small intestinal biopsy to Royal Children's Hospital Melbourne in 1958 following a study tour of Europe and America. Of immense importance was her paper in 1960 from Melbourne that contained the key observation that the abnormal small intestinal mucosa in children with celiac disease normalized on a gluten-free diet. In 1961, she and her colleagues described chylomicron retention disease as an unusual cause of steatorrhea. This has since sometimes been called Anderson's Disease. She formed a Gastroenterological Unit within the Royal Children's Hospital Research Foundation and was appointed its head in 1962.
In 1968 she accepted the Leonard Parsons Chair in Paediatrics and Child Health at the University of Birmingham. Her view was that specialization was essential if pediatrics was to prosper; hence her commitment to the advancement of pediatric gastroenterology. Her interest in cystic fibrosis continued. With Mary Goodchild, in 1976 she wrote an important manual on the diagnosis and management of cystic fibrosis. She also undertook important genetic studies of celiac disease. She made Birmingham a center for pediatric gastroenterology and played an important role in having the discipline recognized nationally and internationally.
She retired in 1980 and was made an Emeritus Professor. She returned to Perth, Australia to write the second edition of “Paediatric Gastroenterology” with her long-term colleagues and friends Valerie Burke and Michael Gracey. Some years later she came back to her roots in Melbourne but continued from time to time to travel back to Britain and Europe.
Amongst her many contributions to pediatric gastroenterology were the young people she trained, inspired, and encouraged to take up a career in the emerging discipline. It is not possible to give a full list, but notably these individuals include Valerie Burke and her husband Michael Gracey, Beat Hadorn, Sandy McNeish, and Martin Brueton. At a wider level she was an inspiration to many internationally, including many women such as Birgitte Strandvik who saw her as a role model. Interestingly Charlo's (as she was affectionately called by her friends) last attendance at an ESPGHAN meeting was in Gothenburg at the meeting hosted by Birgitte Strandvik in 1993.
It is well known that her child patients and their parents, especially those with cystic fibrosis, were devoted to her, both in Australia and Britain. Lasting memories of her in Birmingham include her forceful personality and the presence in her office of a succession of pet poodles. Those of us in ESPGHAN who knew her mourn her passing as one of the pioneers of pediatric gastroenterology and regard it as a privilege to have known her.