Lucy Wills

British physician and hematologist (1888 1964)

Lucy Wills, LRCP (10 May 1888 – 26 April 1964) was an English haematologist and physician researcher. She conducted seminal work in India in the late 1920s and early 1930s on macrocytic anaemia of pregnancy. Her observations led to her discovery of a nutritional factor in yeast which both prevents and cures this disorder. Macrocytic anaemia is characterized by enlarged red blood cells and is life threatening.

Generations of the Wills family had been living in or near Birmingham, a city known as "the workshop of the world" for its many factories and industry. Lucy Wills was born on 10 May 1888 in nearby Sutton Coldfield. Her paternal great grandfather, William Wills, had been a prosperous attorney from a Nonconformist Unitarian family (see Church of the Messiah, Birmingham). One of his sons, Alfred Wills, followed him into the law and became notable both as a judge and a mountaineer. Another son, Lucy's grandfather, bought an edge tool business in Nechells, AW Wills & Son, which manufactured such implements as scythes and sickles. Lucy's father continued to manage the business and the family was comfortably well off. Lucy Wills's father, William Leonard Wills (1858–1911), was a science graduate of Owens College (later part of the Victoria University of Manchester, now part of the University of Manchester). Her mother, Gertrude Annie Wills née Johnston (1855–1939), was the only daughter (with six brothers) of a well known Birmingham doctor, James Johnston. The family had a strong interest in scientific matters. William Wills, the lawyer mentioned above, had been involved with the British Association for the Advancement of Science and wrote papers on meteorology and other scientific observations. Her father was particularly interested in botany, zoology, geology, and natural sciences generally, as well as in the developing science of photography. Her brother, Leonard Johnston Wills, carried this interest in geology and natural sciences into his own career with great success. Lucy Wills was brought up in the country near Birmingham, initially in Sutton Coldfield, and then from 1892 in Barnt Green to the south of the city. She went at first to a local school called Tanglewood, kept by a Miss Ashe, formerly a governess to the Chamberlain family of Birmingham.

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. Wills was strongly influenced by the botanist Albert 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. 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 Ernest Ulysses Williams OBE, a doctor on its teaching staff) 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. 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. 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.

On 10 May 2019, the 131st anniversary of her birth, search engine Google commemorated Wills with a Doodle, shown in North America, parts of South America and Europe, Israel, India, and New Zealand. The accompanying text stated, "Today's Doodle celebrates English haematologist Lucy Wills, the pioneering medical researcher whose analysis of prenatal anemia changed the face of preventive prenatal care for women everywhere."