Mary Broadfoot Walker (17 April 1888 – 13 September 1974) was a Scottish physician who first demonstrated the effectiveness of

physostigmine Physostigmine (also known as eserine from ''éséré'', the West African name for the Calabar bean) is a highly toxic parasympathomimetic alkaloid, specifically, a reversible cholinesterase inhibitor. It occurs naturally in the Calabar bean and ...

in the treatment of the condition

myasthenia gravis Myasthenia gravis (MG) is a long-term neuromuscular junction disease that leads to varying degrees of skeletal muscle weakness. The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, dro ...

, a disease relating to muscle weakness. She was also the first to recognise the association between familial periodic paralysis and low blood potassium levels.

Early life and education

Mary Walker was born at Croft-an-Righ,

Wigtown Wigtown ( (both used locally); gd, Baile na h-Ùige) is a town and former royal burgh in Wigtownshire, of which it is the county town, within the Dumfries and Galloway region in Scotland. It lies east of Stranraer and south of Newton Stewart. I ...

Scotland Scotland (, ) is a country that is part of the United Kingdom. Covering the northern third of the island of Great Britain, mainland Scotland has a border with England to the southeast and is otherwise surrounded by the Atlantic Ocean to the ...

in 1888. The eldest of four children, her father was a solicitor. After school, she trained in medicine at the

Edinburgh College of Medicine for Women The Edinburgh College of Medicine for Women was established by Elsie Inglis and her father John Inglis. Elsie Inglis went on to become a leader in the suffrage movement and found the Scottish Women's Hospital organisation in World War I, but whe ...

, and like most of the college's students, she received much of her clinical teaching in

Glasgow Glasgow ( ; sco, Glesca or ; gd, Glaschu ) is the most populous city in Scotland and the fourth-most populous city in the United Kingdom, as well as being the 27th largest city by population in Europe. In 2020, it had an estimated popul ...

. She graduated

MB ChB Bachelor of Medicine, Bachelor of Surgery ( la, Medicinae Baccalaureus, Baccalaureus Chirurgiae; abbreviated most commonly MBBS), is the primary medical degree awarded by medical schools in countries that follow the tradition of the United King ...

from the

University of Edinburgh The University of Edinburgh ( sco, University o Edinburgh, gd, Oilthigh Dhùn Èideann; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Granted a royal charter by King James VI in 15 ...

in 1913.

Career and research

During the

First World War World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...

, she served with the

Royal Army Medical Corps The Royal Army Medical Corps (RAMC) is a specialist corps in the British Army which provides medical services to all Army personnel and their families, in war and in peace. The RAMC, the Royal Army Veterinary Corps, the Royal Army Dental Corps a ...

at the 63rd General Hospital,

Malta Malta ( , , ), officially the Republic of Malta ( mt, Repubblika ta' Malta ), is an island country in the Mediterranean Sea. It consists of an archipelago, between Italy and Libya, and is often considered a part of Southern Europe. It lies ...

. In 1920 she became a salaried

Assistant Medical Officer A clinical officer (CO) is a gazetted officer who is qualified and licensed to practice medicine. In Kenya the basic training for clinical officers starts after high school and takes four or five years ending on successful completion of a one ...

in "Poor Law Service" at

St Alfege's Hospital St Alfege's Hospital was a hospital that operated in the Maze Hill area of east Greenwich in southeast London. It operated as the Greenwich Union Infirmary from 1874 to 1929. It was briefly known as the Greenwich and Deptford Hospital before beco ...

, Greenwich, London, where she worked until 1936. In 1932, she was awarded

Membership of the Royal College of Physicians Member may refer to: * Military jury, referred to as "Members" in military jargon * Element (mathematics), an object that belongs to a mathematical set * In object-oriented programming, a member of a class ** Field (computer science), entries in ...

. She then worked at

St Leonard's Hospital St Leonard's Hospital may refer to: * St Leonard's Hospital, Ferndown, a community hospital in Dorset * St Leonard's Hospital, Hackney St Leonard's Hospital is a hospital in Hackney, North London. History The hospital was founded as the infir ...

, Shoreditch, St. Francis' Hospital, Dulwich and

St Benedict's Hospital St Benedict's Hospital was a long-stay hospital in Tooting in South London. History The hospital was established in a disused Roman Catholic College building as the Tooting Home for the Aged and Infirm in 1897. During the First World War it ser ...

, Tooting. In 1934, while working at St Alfege's Hospital, Walker discovered that the

subcutaneous injection Subcutaneous administration is the insertion of medications beneath the skin either by injection or infusion. A subcutaneous injection is administered as a bolus into the subcutis, the layer of skin directly below the dermis and epidermis, ...

could temporarily reverse the muscle weakness found in patients with

. She had noted that the symptoms and signs of myasthenia were similar to those found in

curare Curare ( /kʊˈrɑːri/ or /kjʊˈrɑːri/; ''koo-rah-ree'' or ''kyoo-rah-ree'') is a common name for various alkaloid arrow poisons originating from plant extracts. Used as a paralyzing agent by indigenous peoples in Central and South ...

poisoning, and physostigmine was used as an

antidote An antidote is a substance that can counteract a form of poisoning. The term ultimately derives from the Greek term φάρμακον ἀντίδοτον ''(pharmakon) antidoton'', "(medicine) given as a remedy". Antidotes for anticoagulants are s ...

to curare poisoning at that time. The first case of myasthenia gravis successfully treated with physostigmine was published in ''

the Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...

'' in June 1934. In 1935, Walker was the first to recognise the association between the condition familial periodic paralysis and

hypokalaemia Hypokalemia is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abnor ...

(low blood potassium levels). She also described the glucose challenge test used in diagnosing hypokalaemic periodic paralysis and the use of intravenous potassium in its treatment. During 1935, her research on myasthenia was incorporated into her MD thesis which was submitted via the

, and for which she received a gold medal. After her retirement to Croft-an-Righ in 1954, she continued to work part-time at the Glasgow Royal Maternity and Women's Hospital, and remained active in the field of myasthenia gravis. Her 1973 article also describes ''the Mary Walker Effect'', a clinical sign found in myasthenia gravis. She died on 13 September 1974 at the age of 86.

Awards and honours

In 1962, Walker was the first recipient of the

Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...

Jean Hunter Prize "''for the advancement of research into the treatment of nervous exhaustion and for her original contribution to the fundamental knowledge of the nature of myasthenia gravis, made while carrying out the routine duties of a medical officer at a large metropolitan hospital".''

Notes

References

External links

1935 video of the effect of prostigmin on myasthenia gravis
{{DEFAULTSORT:Walker, Mary Broadfoot 20th-century Scottish medical doctors 1888 births 1974 deaths Scottish women medical doctors Alumni of the University of Edinburgh People from Wigton 20th-century women physicians Alumni of the University of Edinburgh Medical School 20th-century Scottish women