Roger Altounyan was born in Aleppo, Syria. He was the third generation of a famous medical family originally based in the Middle East. His grandfather, an American orphan, was born in Turkey, educated by a group of American missionaries, and eventually sent to medical school at Columbia University. After qualifying he returned to Turkey via Europe, where he met his wife, an Irish nurse.
In Turkey, he and his wife travelled from village to village by horseback, conducting surgeries and operations, and eventually settled in Aleppo, Syria, where they established the Altounyan Hospital.
The first Dr Altounyan sent his wife to England to have her children and consequently the Altounyans became British citizens.
Roger Altounyan and his four sisters were educated at boarding school in England and spent many holidays on their own in the family home at Lake Coniston in the Lake District. In the summer of 1927 they were joined by J Arthur Ransome and provided him with the inspiration for his novel Swallows and Amazons.
After completing his school education in England, Roger returned to Syria. His education was interrupted by the outbreak of war, which forced him to flee from Syria to Palestine where he joined the Middle East Command in Jerusalem. He initially trained as a pilot in Bulawayo, Rhodesia, before returning to England. At first he flew bombers and then joined the pilots advanced flying unit, followed by the flying instructors school and the battle school. He was awarded the AFC in 1945.
At the end of the war Roger entered Emmanuel College, Cambridge, to study medicine and went on to Middlesex Hospital, London, to complete his clinical training. It was while at medical school that he developed bronchial asthma for the first time.
After qualifying at the Middlesex he returned to the family hospital in Aleppo, where he worked as assistant physician and surgeon to his father until 1955. As a result of the Suez crisis Roger returned to England in late 1955 where he took up a post in the research department of Benger Laboratories. However, he soon began to miss contact with patients, a situation which was rectified by the late Bill Robinson, a chest physician at Monsall Hospital, who allowed him to conduct an unofficial outpatient clinic in the disused dental department of Monsall Hospital. There - with a spirometer and two chairs - he held three outpatient sessions a week, which rapidly became very busy. Ever mindful of the patients’ requirements, his outpatient sessions were run late in the afternoon and into the evening, so that patients did not have to take time off work. The clinics were carried out without nursing assistance, and the patients themselves were frequently driven to their homes by Roger at the end of the clinic.
While working at Bengers he became interested in a research project looking for smooth muscle relaxants among some synthetic derivatives of Khellin. He suggested that he could use himself as a guinea pig, and he used an extract of guinea pig hair, to which he was sensitive, as a standard challenge. Over the next two years he tested two compounds a week on himself and it became clear that some Khellin derivatives were active in preventing muscle constriction. Despite this he was moved from the project into the laboratory, and the research team was ordered to cease work on the project. But the team were so sure that their work was leading somewhere that they continued with the project in secret, with twice weekly challenge tests being carried out during the outpatient sessions at Monsall Hospital. This work led to the development of di-sodium cromoglycate. Coincident with the identification of this bis-chromone Bengers laboratory was taken over by Fisons, and the project was reinstated. Di-sodium cromoglycate proved to be active only by inhalation, and then in doses of several milligrams. The solution to this problem proved to be the spinhaler, a prototype of which Roger Altounyan had already conceived and manufactured at home. He had noticed after starting work at Monsall Hospital that some asthmatic patients were unable to use pressurised inhalers. He then designed, using metal Tyrozet tubes, a crude inhaler from which patients administered an isoprenaline/lactose combination from gelatin capsules. It was from the principles incorporated in the design of this original inhaler that the spinhaler was developed.
Over the next 20 years Roger continued in active research looking for new compounds which would be more active in the treatment of bronchial asthma.
In 1951 he married Hella Christel, daughter of Reinhold Schumacher, a teacher. They had two sons and three daughters. Throughout his life Roger retained a deep affection for the Lake District, which he visited regularly and could usually be found either sailing on Lake Coniston or char fishing.
His questioning mind was active in all aspects of his life, from his specially ventilated sitting-room fireplace to the oxygen concentrator which he was using during his final illness, to which he added a bag in circuit to increase flow rate during exertion. His friends and colleagues who visited him at home remember with some trepidation his home-made wines produced from a variety of sources ranging from elderberries to tea. This last product was always highly potent but of very variable palatability. He was a quick thinker, and always an excellent conversationalist. Throughout his life he maintained an intense interest in people and would spend hours helping with difficult patients. He was indeed an inspiration to all those with whom he had contact.
CAC Pickering
[The Times, 12 Dec 1987; Lancet, 1988,1,193; Doctor, 10 Nov 1988]