Mary Broadfoot Walker

Mary Broadfoot Walker (17 April 1888 – 13 September 1974) was a Scottish physician who first demonstrated the effectiveness of physostigmine in the treatment of the condition myasthenia gravis, a disease relating to muscle weakness. She was also the first to recognise the association between familial periodic paralysis and low blood potassium levels.

Mary Broadfoot Walker
Dr Mary Walker in the 1920s
Born	(1888-04-17)17 April 1888 Croft-an-Righ, Wigtown, Scotland
Died	13 September 1974(1974-09-13) (aged 86)
Education	University of Edinburgh Edinburgh College of Medicine for Women
Years active	1913–1974
Known for	Treatment of myasthenia gravis with physostigmine Association of familial periodic paralysis and hypokalaemia
Medical career
Profession	physician
Institutions	St Alfege's Hospital, Greenwich St Leonard's Hospital, Shoreditch St Francis' Hospital, Dulwich St Benedict's Hospital, Tooting Glasgow Royal Maternity and Women's Hospital
Research	Myasthenia gravis Familial periodic paralysis
Awards	Royal College of Physicians Jean Hunter Prize (1962)

Early life and education

Mary Walker was born at Croft-an-Righ, Wigtown, Scotland 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, and like most of the College's students, she received much of her clinical teaching in Glasgow. She graduated MB ChB from the University of Edinburgh in 1913.[1]

Career and research

During the First World War, she served with the Royal Army Medical Corps at the 63rd General Hospital, Malta.[2] In 1920 she became a salaried Assistant Medical Officer in "Poor Law Service" at St Alfege's Hospital, Greenwich, London, where she worked until 1936.[3] In 1932, she was awarded Membership of the Royal College of Physicians. She then worked at St Leonard's Hospital, Shoreditch, St. Francis' Hospital, Dulwich and St Benedict's Hospital, Tooting.

In 1934, while working at St Alfege's Hospital, Walker discovered that the subcutaneous injection of physostigmine could temporarily reverse the muscle weakness found in patients suffering from myasthenia gravis. She had noted that the symptoms and signs of myasthenia were similar to those found in curare poisoning, and physostigmine was used as an antidote to curare poisoning at that time.[4] The first case of myasthenia gravis successfully treated with physostigmine was published in the Lancet in June 1934.[5]

In 1935, Walker was the first to recognise the association between the condition familial periodic paralysis and hypokalaemia (low blood potassium levels).[6] She also described the glucose challenge test used in diagnosing hypokalaemic periodic paralysis and the use of intravenous potassium in its treatment.[7] During 1935, her research on myasthenia was incorporated into her MD thesis which was submitted via the University of Edinburgh,[8] and for which she received a Gold Medal.[9]

After her retirement to Croft-an-Righ in 1954,[1] she continued to work part-time at the Glasgow Royal Maternity and Women's Hospital, and remained active in the field of myasthenia gravis.[lower-alpha 1][10]

Her 1973 article also describes the Mary Walker Effect, a clinical sign found in myasthenia gravis.[10]

She died on 13 September 1974 at the age of 86.[1]

Awards and honours

In 1962, Walker was the first recipient of the Royal College of Physicians 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". [11]

Notes

1. Letter to Miss Sylvia Bates advocating controlled trial of thymectomy to ascertain its role in the management of myasthenia gravis

References

1. "Obituary". Lancet. 304 (7893): 1401. 1974. doi:10.1016/S0140-6736(74)92285-5.
2. Pearce JM (2005). "Mary Broadfoot Walker (1888–1974): a historic discovery in myasthenia gravis". Eur. Neurol. 53 (1): 51–3. doi:10.1159/000084268. PMID 15746548.
3. Johnston JD (September 2007). "Mary Broadfoot Walker (1888–1974)". J. Neurol. 254 (9): 1306–7. doi:10.1007/s00415-007-0663-z. PMID 18000738.
4. "Dr Mary Walker – A Pioneer in the Treatment of Myasthenia Gravis". MG -association UK. Retrieved 23 November 2008.
5. Walker MB (1934). "Treatment of myasthenia gravis with physostigmine". Lancet. 1 (5779): 1200–1201. doi:10.1016/S0140-6736(00)94294-6.
6. Walker MB (1935). "Potassium chloride in myasthenia gravis". Lancet. 2 (5836): 47. doi:10.1016/S0140-6736(01)09382-5.
7. Aitken RS, Allot EN, Gastelden LI, Walker MB (1937). "Observations on a case of familial periodic paralysis". Clin Sci. 3: 47–57.
8. Broadfoot, Walker, Mary (1935). "Contribution to the study of Myasthenia Gravis". Cite journal requires |journal= (help)
9. Edinburgh University Calendar 1937–1938. Edinburgh: James Thin. 1937. p. 581.
10. Walker MB (April 1973). "Some discoveries on myasthenia gravis: the background". Br Med J. 2 (5857): 42–3. doi:10.1136/bmj.2.5857.42. PMC 1588990. PMID 4572033.
11. Encyclopedia of the Neurological Sciences. Academic Press. 29 April 2014. ISBN 9780123851581.

External links

• 1935 video of the effect of prostigmin on myasthenia gravis