Clarence Merskey was born in Alberton, Transvaal, where his father, Bernard Merskey, was an accountant, and he was educated with his brother at Sea Point Boys’ High School when the family settled in Cape Town. After graduating in medicine from the University of Cape Town in 1937, he served as house physician to JF Brock (q.v.) in the newly built Groote Schuur Hospital, and from 1940 to 1946 as a captain in the South African Medical Corps in the East and North African campaigns of World War II.
On demobilization he became first assistant in the University of Cape Town’s medicine department under Frank Forman (q.v.). In addition to complementing the latter’s renowned bedside and teaching skills, he immediately brought to the wards and the nascent clinical laboratory a lively dimension of active investigation and effervescent enquiry, which characterized his whole career. He proceeded MD in 1947 with his thesis The Erythron in Polycythaemia Vera, and the following year he was awarded the Cecil John Adams fellowship which brought him to London and the MRCP in 1949. He spent two rewarding years working with Rosemary Biggs and Gwyn Macfarlane at the Radcliffe Infirmary, Oxford, where he developed his coagulation expertise and made valuable contributions to the study of haemophilia.
He returned for most of the 50s to an intensely productive programme of clinical, teaching and laboratory activities at Groote Schuur Hospital, and was elected a fellow of the University in recognition of his researches in haemostasis. The winds of change in South Africa were already in evidence, and Clarence was steadily drawn to the intellectual stimulus and scientific opportunity of the great centres. In 1958 he lectured in the USA as a Rockefeller foundation travelling fellow, and was invited by Irving London to join the Albert Einstein College of Medicine in New York’s Yeshiva University. He became associate professor of medicine in 1966 and full professor in 1972, with added recognition as professor of laboratory medicine in 1974. In 1982 he became emeritus professor, but continued to work full-time in the laboratory.
Clarence Merskey’s considerable contributions to medicine and haemostasis were expressed with a sustained vitality on three continents. In the land of his birth and early medical training he explored the then prevalent hypothesis that arterial thrombotic disease was a consequence of a ‘hypercoagulable’ state, and concluded that there was inadequate evidence to support that view. In Oxford he systematized the laboratory diagnosis of haemophilia, published the first scientific account of its presence in the human female, and was co-author of the initial account of Christmas disease by Biggs and her colleagues in 1952.
At the Albert Einstein College of Medicine in New York he ran a small research laboratory from which significant findings flowed in a steady stream. These data were often the product of collaborative studies, particularly with Alan Johnson at the New York University College of Medicine, with whom in 1966 he devised the definitive test for measuring fibrin degradation products by a tanned red cell haemagglutination inhibition immunoassay. This technique and modifications of it gained him worldwide acceptance in the diagnosis of disseminated intravascular coagulation, and made Merskey’s name a byword in that field.
He was an instinctively friendly man with an infectious sense of humour, totally lacking in pretentiousness. These qualities blended happily with an exceptionally critical approach to new data or clinical findings, leading his colleagues to recognize three levels of proof: one that satisfied the investigator himself; a second that was sufficient for reviewing editors; and finally the proof that Clarence Merskey accepted. For all his great authority and sharp intellect, he was often diffident in his opinions and might startle a newcomer slow to perceive his talents, by revealing his true stature in the appropriate forum. The circumstances of his life and work, in addition to his personal warmth, led him continually to make new and enduring friends. When he died, large numbers of them set about creating a memorial to his achievements in medicine and haemostasis by endowing a research appointment in his name.
In 1939 in South Africa he married Marie, daughter of Herman Fine of Dublin. She became a professional librarian and survived him with three married daughters and four grandchildren.
RS Mibashan
[Lancet, 1983, 1, 254]