Lucy Wills

English girls had few opportunities for education and entry into the professions until towards the end of the nineteenth century. Wills was able to attend Cheltenham Ladies' College, Newnham College Cambridge, and the London School of Medicine for Women.[3]

In September 1903 Wills went to Cheltenham, one of the first British boarding schools to train female students in science and mathematics. Wills's elder sister Edith was in the same house, Glenlee, two years ahead of her. Wills's examination record was good. She passed the 'Oxford Local Senior, Division I' in 1905; the 'University of London, Matriculation, Division II' in 1906; and 'Part I, Class III and Paley, exempt from Part II and additional subjects by matriculation (London).

In September 1907, Wills began her studies at Newnham, a women's college.[4] Wills was strongly influenced by the botanist Albert Charles Seward and by the geologist Herbert Henry Thomas, who worked on carboniferous palaeobotany. Wills finished her course in 1911 and obtained a Class 2 in Part 1 of the Natural Sciences Tripos in 1910 and Class 2 in Part 2 (Botany) in 1911.[4] While she was allowed to sit the University examinations, she was ineligible as a woman to receive a Cambridge degree.

In February 1911, Wills's father died at the age of 53. She had been very close to him, and it is likely that his unexpected death affected her final exam results that summer. In 1913, her elder sister Edith died at the age of 26. Later that year, Wills and her mother travelled to Ceylon, now Sri Lanka, where they visited relatives and friends. In 1914, she and her younger brother Gordon travelled to South Africa. A friend from Newnham, Margaret (Margot) Hume, was lecturing in botany at the South African College, then part of the University of the Cape of Good Hope. She and Wills were both interested in Sigmund Freud's theories. At the outbreak of war in August 1914, Gordon enlisted in the Transvaal Scottish Regiment. Wills spent some weeks doing voluntary nursing in a hospital in Cape Town, before she and Margot Hume returned to England, arriving in Plymouth in December.

In January 1915, Wills enrolled at the London (Royal Free Hospital) School of Medicine for Women, the first school in Britain to train female doctors. The school had strong links with India, and had a number of students from there, including Jerusha Jhirad, who became the first Indian woman to qualify with a degree in obstetrics and gynecology in 1919.[5]

Wills became a legally qualified medical practitioner with the qualification of Licentiate of the Royal College of Physicians London awarded in May 1920 (LRCP Lond 1920), and the University of London degrees of Bachelor of Medicine and Bachelor of Surgery awarded in December 1920 (MB BS Lond), at age 32.

On qualifying, Wills decided to research and teach in the department of Pregnant Pathology at the Royal Free. There she worked with Christine Pillman (who later married Ulysses S. Grant OBE, a doctor on its teaching staff[6]) who had been at Girton at the same time Wills was at Newnham, on metabolic studies of pregnancy.

In 1928 Wills began her seminal research work in India on macrocytic anaemia in pregnancy, a condition where the red blood cells are larger than normal. This was prevalent in a severe form among poorer women with dietary deficiencies, particularly those in the textile industry. Dr Margaret Balfour of the Indian Medical Service had asked her to join the Maternal Mortality Inquiry by the Indian Research Fund Association at the Haffkine Institute in Bombay, now Mumbai.

Wills was in India between 1928 and 1933, mostly based at the Haffkine. From April to October 1929, she moved her work to the Pasteur Institute of India in Coonoor (where Sir Robert McCarrison was Director of Nutrition Research). In early 1931 she was working at the Caste and Gosha Hospital in Madras, now the Government Kasturba Gandhi Hospital for Women and Children of Chennai (see Gosha woman). In each of the summers of 1930–32 she returned to England for a few months and continued her work in the pathology laboratories at the Royal Free. She was back at the Royal Free full-time in 1933, but there was another 10-week working visit to the Haffkine Institute from November 1937 to early January 1938. On this occasion, and for the first time, Wills travelled by air to Karachi and onward by sea.

She travelled to India in October 1937 by air, a five-day journey on Imperial Airways's recently inaugurated route carrying mail and some passengers. The aircraft was a Short 'C' Class Empire flying boat, the Calypso, G AEUA. The route started at Southampton and involved landings on water for refuelling at Marseilles, Bracciano near Rome, Brindisi, Athens, Alexandria, Tiberias, Habbaniyah to the west of Baghdad, Basra, Bahrain, Dubai, Gwadar and Karachi, with overnight stops at Rome, Alexandria, Basra and Sharjah (just outside Dubai). This was the first IA flight to go beyond Alexandria.

In Bombay Wills was on dining terms with the governors and their wives at Government House – Sir Leslie Wilson in 1928 and Sir Frederick Sykes in 1929. In 1929 she visited Mysuru and wrote to her brother that "I was most fortunate to be under the wing of Sir Charles Todhunter, who is a very important person there." Todhunter had been Governor of Madras and in 1929 was the secretary to the Maharaja of Mysuru.

Wills observed a correlation between the dietary habits of different classes of Bombay women and the likelihood of their becoming anaemic during pregnancy. Poor Muslim women were the ones with both the most deficient diets and the greatest susceptibility to anaemia.[7]

This anaemia was then known as 'pernicious anaemia of pregnancy'. However, Wills was able to demonstrate that the anaemia she observed differed from true pernicious anaemia, as the patients did not have achlorhydria, an inability to produce gastric acid. Furthermore, while patients responded to crude liver extracts, they did not respond to the 'pure' liver extracts (vitamin B₁₂) which had been shown to treat true pernicious anaemia. She postulated that there must have been another nutritional factor responsible for this macrocytic anaemia other than vitamin B₁₂ deficiency. For some years this nutritional factor was known as the 'Wills Factor', and it was later shown, in the 1940s, to be folate, of which the synthetic form is folic acid.

Wills decided to investigate possible nutritional treatments by first studying the effects of dietary manipulation on a macrocytic anaemia in albino rats. This work was done at the Nutritional Research Laboratories at the Pasteur Institute of India in Coonoor. Rats fed on the same diet as Bombay Muslim women became anaemic, pregnant ones dying before giving birth. The rat anaemia was prevented by the addition of yeast to synthetic diets which had no vitamin B. This work was later duplicated using rhesus monkeys as the rat results were tainted by a lice infection which may have skewed those results.[1]

Back in Bombay, Wills conducted clinical trials on patients with macrocytic anaemia and established experimentally that this type could be both prevented and cured by yeast extracts, of which the cheapest source was Marmite.[1]

Wills was back again at the Royal Free Hospital in London from 1938 until her retirement in 1947. During the Second World War she was a full-time pathologist in the Emergency Medical Service. Work in the pathology department was disrupted for a few days in July 1944 (and a number of people were killed) when the hospital suffered a direct hit from a V1 flying bomb. By the end of the war, she was in charge of pathology at the Royal Free Hospital and had established the first haematology department there.

After her retirement, Wills travelled extensively, including to Jamaica, Fiji and South Africa, continuing her observations on nutrition and anaemia. In Fiji she, along with New Zealander Dr. Muriel Bell, was responsible for carrying out the first multi-ethnic nutritional survey of women and children in Fiji (1950).[8] They studied the source of anaemias, protein and vitamin deficiencies there. Their work was based on some flawed assumptions about the causes of these issues, while at the same time their recommendations were responsible for the introduction of free iron tablets for anaemic pregnant women and attempts to provide infants and children with increased protein intake through feeding programmes at schools and health centers.[8]