James Mourilyan Tanner 1920–2010

James Mourilyan Tanner, co-founder of the Society for the Study of Human Biology, died aged 90 years on August 11^th 2010. During an academic and research career covering seven decades, Jim Tanner became acknowledged as the world's foremost authority on human growth and development. His name has become particularly synonymous with adolescent growth and puberty but his contributions covered all aspects of normal growth and its disorders. He published over 300 articles, and 10 books of which most went in to 2^nd or 3^rd editions and 19 foreign language editions of these books were published in German, Russian, Spanish, Italian, Japanese and Swedish. Jim Tanner was a founding member of the Society for the Study of Human Biology and served as the first editor in chief of the Annals of Human Biology for 20 years from its founding in 1974 until almost 10 years after his retirement in 1994. Jim's contributions to human biology and to the study of human growth and development have been so profound that a simple obituary chronicling his life would not, I think, be appropriate. Having been a student, colleague, and friend of Jim Tanner for almost 40 years I hope my comments create a more complete and perhaps unique perspective on Jim Tanner's contribution to Human Biology.

Jim Tanner was born into a military family in the garrison town of Camberley in the county of Surrey, on 1^st August 1920. His father, Lt. Col. Frederick Courtney Tanner, followed a family tradition of serving his King and country as an officer in the Royal Scots – the oldest regiment of the British Army having been first raised under King Charles I in 1633. The Tanner family was clearly strong on traditions and it was no surprise that, having returned from the regiment's tours of duty in Egypt and China, 13-year-old Jim was sent to further his education as a boarder at Marlborough College, the private school attended by his male ancestors for the previous 180 years. There he excelled at Modern Languages, Mathematics, Engineering, and on the athletics track where he was one of the finest high hurdlers in the country and destined to become the National Junior Hurdles Champion. Jim was intent on following a career in the Royal Army Corps of Engineers but, perhaps due to the premature death of his older brother, his attention turned to medicine. He subsequently reneged against family tradition and left Marlborough in 1937 to take up a place at the University College of the South West (later Exeter University) to study pre-medical courses. His exceptional ability as an athlete gave him the opportunity in 1939 to accept a place at St Mary's Hospital Medical School on an athletic scholarship that covered the fees in exchange for his efforts on the running track. Thus at the outbreak of the Second World War Jim Tanner was studying medicine in London and training for the 1940 games of the XII Olympiad to be held in Tokyo. Like millions of those on the threshold of adulthood in 1939 his life was to change dramatically in the next six years. In response to the outbreak of war the Rockefeller Foundation created 30 scholarships in 1940 to enable London medical students to finish their studies in the USA and thus avoid the interruptions to their studies caused by the hostilities. Following a national competition Jim was shortlisted and interviewed by a panel of University Vice-Chancellors. At that time Jim was thinking of a career in academic physiology and was asked by one of the panel, in a voice that clearly required a negative response, whether he “really intended on being a Physiology Professor?” “No” came the appropriate response, to be followed by, “but, I do want to work at the place where physiology, psychology and sociology meet.” With hindsight Jim Tanner was perhaps already contemplating a science that married an understanding of biology to its social and psychological context. The human was not being viewed in isolation but on a broader canvas and the study of Man was not being viewed as a discipline but, as Sir Peter Medawar was to write 24 years later, “as a certain attitude of mind towards the most interesting and important of animals”. (Medawar 1964)

With this emerging attitude of mind Jim Tanner was chosen to continue his medical studies at the University of Pennsylvania in Philadelphia. He recorded being impressed by the professor in Pathology, Dale Rex Coman (1906–1993), who had started his career in experimental pathology at Penn in 1937. Coman, at 34 years old, was young and dynamic and, like Tanner, something of a polymath being an artist and naturalist in his spare time as well as a clinician, cell biologist, and teacher in his primary occupation. Whilst in Philadelphia Jim met and married Bernice Alture (1917–1991), a medical student at the Women's Medical College of Pennsylvania. Bernice “Bunny” Tanner eventually became a general practitioner in the west of London and was instrumental in reforming general practice in England.

Whilst medical training required long and intensive hours of study Jim Tanner also found the time to embark upon his first recorded research project which he presented on March 21^st 1944 to the Physiological Society of Philadelphia, the abstract being published in the American Journal of Medical Sciences (1944). In 1943 Jim had conducted an experiment in which he assessed the blood pressure of 53 fellow students over a period of 20 minutes and took Ballistocardiograms, to estimate cardiac output, at 14 and 21 minutes. His aim was to study the relationship between “cardiovascular variables” and physique. “The striking thing” he wrote, “was the lack of correlation between blood pressure and heart rate, stroke volume or cardiac output and between cardiac output and surface area or weight”. No explanation for these absent relationships was offered except for the suggestion that “variables in a population at rest may differ entirely from relations between similar variables in a single organism under varying conditions.” This presentation also records Tanner's first foray into body typing and his first exposure to the morphometric methods which were to be such an important part of his future research career: his participants were anthroposcopically somatotyped by CW Dupertuis using Sheldon's method.

In the same year Jim Tanner completed his MD at Penn and undertook a nine-month internship at Johns Hopkins Hospital in Baltimore. He maintained that this time at Johns Hopkins defined him as an adult physician. He returned to England later in the year to finish his English medical degree (MB, BS), and subsequently became a Junior Medical Officer at the Maudesley Hospital in Mill Hill, London. The next year he joined the Psychiatric Unit of Dr. Maxwell Jones in which he was investigating “effort syndrome” in soldiers returning from the War. Maxwell Jones was developing his idea of a “therapeutic community” in which the usual medical hierarchy was overtaken by a democracy in which doctor, nurse and patient had a role in discussing the condition and its treatment. These two years of work led to two publications by Tanner with Maxwell Jones in which they described the clinical characteristics, treatment and rehabilitation of returning prisoners of war with neuroses (1948a) and their response to exercise (1948b). Jim obtained the Diploma in Psychological Medicine (DPM) whilst at the Institute of Psychiatry and, whilst at heart a physiologist and human biologist, he was to maintain an interest in psychiatry throughout his career and held the position of Honorary Secretary to the Research Committee of the Mental Health Research Fund from 1955 to 1977.

In 1946 he was appointed as a demonstrator in Wilfred Le Gros Clarke's Department of Anatomy in Oxford and he joined a group of young scientists who were to fundamentally change the course of British anthropology. The core figures were JS “Joe” Weiner (1915–1982) and Derek Roberts. Le Gros Clarke, with Joe Weiner and Kenneth Oakley (1911–1981), were to prove in 1953 that the Piltdown skull of 1912 was a hoax. Derek Roberts was to become the most important anthropological geneticist of his generation and the triumvirate of Tanner, Weiner, and Roberts must have been a formidable group in Oxford in 1946.

Le Gros Clarke requested Tanner to give a course of lectures on human growth to the medical students. Finding a dearth of information in the UK, he successfully obtained a Viking Trust (now Wenner-Gren Foundation) travelling fellowship in 1948 to visit the American longitudinal child growth studies at Iowa, Colorado, Harvard, Philadelphia, Rochester, Detroit and the Fels longitudinal study in Yellow Springs, Ohio. During this visit he met the leading American researchers in human growth and returned with a desire to initiate the first British longitudinal growth study. He subsequently obtained a lectureship in Physiology at the Sherrington School at St. Thomas' Hospital in 1949 and had the opportunity to present an account of his American travels to a meeting of the Royal Society (subsequently published in the Lancet,- Tanner 1949). He concluded that “The volume of this work and the excellence of a large part of it is an inspiration and a guide to those here who are in a position to emulate and enlarge on it… and a stimulus to all biologists of whatever variety who realise the overwhelming importance of the form [of child growth], and the seemingly overwhelming problems raised by it.” This call for a growth study was the second time that Tanner had promoted the need for a longitudinal study of human growth. In 1947 at the Royal Society of Medicine, at the end of a discourse on the morphological level of personality to the section on psychiatry, he had supported the earlier call by Sir Cyril Burt in Nature (1943) of “the strongest need for the establishment…of a longitudinal, comprehensive and adequately staffed study of the growth of healthy children.” (Tanner 1947). Perhaps as a result of these calls for action he was approached by Dr. E.R. Bransby from the Ministry of Health, who was in the audience at the Royal Society and had spent the war years using a National Children's Home in Harpenden to develop appropriate rationing levels for children. Bransby requested that Jim Tanner join him as he (Bransby) initiated the Harpenden Growth Study. It would appear that Bransby played very little part in the conduct of the study but Tanner, in his PhD thesis of 1953, thanks Bransby for his “administrative support” of the Harpenden Growth Study. As a result of this meeting, the Harpenden Longitudinal Growth Study started in 1949 and was to continue for the next 25 years.

In 1948 Jim was offered a lectureship at the Sherrington School of Physiology at St. Thomas's Hospital in the same year that the famous physiologist Henry Barcroft was appointed to the Chair of Physiology. Tanner, now involved in the Harpenden study, advertised in the Journal of the Royal Army Medical Corps in 1948 in order to recruit the former Regimental Sergeant-Major RH Whitehouse (1911–1987) as his research assistant. They occupied an office in the basement of the school that extended beneath the pavement. In the absence of windows, glass bricks in the pavement created the only source of natural light through to their office which carried an advantage for numerical analysis and graphical work, but also the disadvantage of leaking profusely every time it rained. Whitehouse, dedicated to his work, kept an umbrella next to his desk and continued to work beneath this umbrella through the frequent rainstorms.

The team of “Tanner and Whitehouse” were to become as synonymous to research in child growth as “bacon and eggs” are to an English breakfast. When awarding the James Spence Medal to James Tanner in 1980 “for outstanding contributions to the advancement of paediatric knowledge”, George M Komrower, the President of the British Paediatric Association (later to become the Royal College of Paediatrics and Child Health), commented that he “could find few parallels for this pair in medicine but there was one in industry; Rolls and Royce.”

The Harpenden study became the core research project of Jim Tanner's career: it formed the dataset on which many of his most significant contributions were based and continues to be a model for those wishing to develop a longitudinal study of human growth and development. Tanner indulged his long standing interest in physique and uniquely incorporated anthropometric measurements throughout childhood and adolescence with frequent somatotype photographs to illustrate the changes of physique and eventually of secondary sexual development.

Professor Sir Alan Moncrieff, the first Nuffield Professor of Child Health at London University's Institute of Child Health believed that human growth and development was the basic science of paediatrics and invited Tanner to set up the Department of Growth and Development at the Institute of Child Health in 1956, funded by a grant from the Nuffield Foundation. In the next 15 years this department grew to become one of the most important research centres for child growth in the world. Whilst there were other centres and institutes in both Europe and America that focussed on human growth, few had the breadth and depth of research that was occurring within that department. In 1966 Jim Tanner was appointed as the first Professor of Child Health and Growth and continued to attract many scientists working on a variety of research topics; the ethologist Nick Blurton-Jones researching the development of mother-child interactions, the biochemist Patrick Williams and his group working on the isolation and purification of the somatomedins (insulin-like growth factors), W.A. “Bill” Marshall, famous for his analysis of the variations in pubertal development, Phyllis Eveleth, who collated the global output of the International Biological Programme in terms of worldwide variations in human growth, Harvey Goldstein developing programs to analyse time-series data that would eventually lead to multi-level modelling, and a group of clinicians that included Charles Brook, Mike Preece, Martin Savage, Claire Burns, and Catherine Law, amongst others who saw children with suspected growth disorders in the twice-weekly clinics at the Hospital for Sick Children, Great Ormond Street. James Tanner and the clinicians with whom he worked in these “growth disorder clinics” made fundamental contributions to the clinical assessment and diagnosis of growth disorders and pioneered the treatment of children with growth hormone deficiency using Human Growth Hormone. The growth disorder clinics formed an educational centre for clinicians from throughout the world in which to study the diagnosis and treatment of growth disorders.

The Department attracted a great many visitors, both short- and long-term, from all around the world and from vastly different specialties (physical education, dysmorphology, genetics, paediatric endocrinology, educational psychology, paediatric radiology, anthropology, anatomy). These “fellows” were to take the methods of data collection and analysis that they learned in the department, and the clinical methods of diagnosis, treatment, and growth monitoring that they observed and practiced in the clinics, back to their respective countries and establish centres of excellence in auxology. Tanner's Festschrift volume (Hauspie, Lindgren, Falkner 1995) records many of those colleagues and fellows who wished to celebrate Jim Tanner's scientific contributions. The list of 73 authors reads like a Who's Who of Auxology in the latter part of the 20^th century and included, amongst others, Mashiro Takaishi, Andre Prader, Petter Karlberg, Michael Healy, Harvey Goldstein, R. Darrell Bock, Tim J Cole, Geoffrey A Harrison, William D Ross, John Buckler, Ettore Marubini, Luciano Molinari, Lodovico Benso, Giulio Gilli, Horacio Lejarraga, Jose R Jordan, Roland Hauspie, Robert Fogel, Roberto J Rona, Robert M Malina, Phyllis B Eveleth, Francis E Johnston, William H Mueller, Zef Laron, and Gunilla Lundgren. That volume is truly a testament to Jim Tanner's global influence as a scholar and teacher.

In 1977, Jim Tanner and his Personal Assistant, Jan Baines, inspired the creation of the Child Growth Foundation which, over the last three decades, has established itself as a leading charity in the field of growth disorders. Drawing on the goodwill of parents who had children under the care of the Growth Clinic, they realised that a support group outside medicine could help sustain optimal care for these patients in difficult financial times. The fact that the Foundation did, and is still thriving to-day, is testimony to his foresight.

Jim Tanner's major publications included Growth at Adolescence 1955, Education and Physical Growth 1961, The Physique of the Olympic Athlete 1964, The Assessment of Skeletal Maturity and Prediction of Adult Height (TW2) 1975, Worldwide Variation in Human Growth (with Phyllis B Eveleth) 1976, Fetus into Man 1978, Human growth: a comprehensive treatise (with Frank Falkner) 1978, A History of the Study of Human Growth 1981, and over 300 scientific papers and monographs published between 1944 and 2001.

He was a founding member of the Society for the Study of Human Biology, co-editor (with Gabriel Lasker) of its first official journal Human Biology in the USA from 1963 to 1973, and subsequently founding editor of the Annals of Human Biology from 1974 onwards in the UK. He was the founding member and spirit behind the International Association of Human Auxology, which has met regularly for over 30 years and attracts scientists from throughout the world.

Jim Tanner's contribution to our knowledge of the biology of human growth and development covers virtually the whole of normal growth and its variation, but particularly adolescence and puberty, the development and use of growth charts, the assessment of skeletal maturity and the prediction of adult height. Also, and extremely topical as we approach 2012, Tanner's book, The Physique of the Olympic Athlete, based on the Olympians of the Rome Olympics, is viewed as the classic text in that field.

Jim Tanner's legacy covers not only biological and clinical aspects of human growth but is also significant in all aspects of human development that impact child health and growth. His initial development of growth charts to monitor growth led ultimately to the growth of every child in the UK being routinely monitored during infancy. His analysis of pubertal development led to the universal acceptance of “Tanner Stages” or “Tanner Scaling” as the most appropriate method to assess pubertal development and skeletal maturity is routinely assessed using the “Tanner-Whitehouse” (TW) method. Child growth is assessed and monitored throughout the world partly because of his pioneering research and his ability to inspire biologists and paediatricians on a global scale. It is no exaggeration to state that the work of James Tanner has resulted in a better quality of life for millions of children throughout the world.

James Tanner was the recipient of numerous international honours including the Rosen von Rosenstein Medal of the Swedish Paediatric Association in 1984, the John Alexander Memorial Prize from the Medical School of the University of Pennsylvania in 1986, the Franz Boas award from the Human Biology Association (USA) in 1997, and Honorary Doctorates from the Universities of Madrid (1990), Genoa (1992), and Eötvös Lorand in Budapest (1993). The American Academy of Arts and Sciences granted him Foreign Honorary Membership in 1993. He was also an Honorary Member of the British, French, Swiss, Italian, Cuban and Catalan Paediatric Societies, the Society for Adolescent Medicine, the European Anthropological Association, and the Society for the Study of Human Biology.

Following the death of Bunny Tanner in 1991, James Tanner married Gunilla Lindgren in 1992. Jim had supervised Gunilla's PhD thesis undertaken at Sweden's Karolinska Institute and in their 20 years together they shared an abiding interest in all matters auxological and in the health and wellbeing of their fellows throughout the world.

Jim is survived by Gunilla and his daughter Helen from his first marriage, a step-daughter Katarina, and step-son Fredrik, and three granddaughters Mary, Sarah and Julia. His son, David, from his first marriage, pre-deceased him.

There is no doubt in my mind that association with Jim Tanner profoundly changed my life as it did the academic lives of many others who met Jim in the Institute of Child Health. In my contribution to his Festschrift volume I described Jim as my “academic father” and his loss is therefore felt both personally and professionally. His contribution to my science and perhaps to the science of human biology, was profound not only in our understanding of biology but also in the way in which we approach our science; in the human biologist's unique ability to observe our species on a broader canvas that encompasses all living things.

Noël Cameron

Loughborough University, February 2011