HAROLD JORDAN MALKIN
President of the Nottingham Medico-
Harold Jordan Malkin 26, The Ropewalk, Nottingham. C.B.E., F.R.C.S. (Edinburgh) 1925, M.R.C.S. (England) L.R.C.P. (London) 1923. M.D. London, 1926; M.B., B.S., 1924. F.R.C.O.G., 1938 (University College Hospital, London) Surgeon, Nottingham Womens Hospital Gynaecology and Obstetric Surgeon, City Hospital and Firs Maternity Hospital, Nottingham. Gynaecology Surgeon, Newark Hospital; Consultant Obstetrician Surgeon, Victoria Hospital, Mansfield, Nott's. Obstetric Specialist, Nottinghamshire County Council. Exam Centre, Midwifery Board. Association Exam London, M.B., B.S. Member of the Council of the Royal College of Obstetrics and Gynaecologists. Fellow of the Royal Society of Medicine and Nursing of England Obstetric Society. Late:-
Medical Directory 1948.
Harold Jordan Malkin came to Nottingham in 1928, and was connected with the Old Samaritans' Hospital before it was changed to the Nottingham Women's Hospital. From 1937 he was on the staff of the Nottingham City Hospital, and before that in 1932 the Newark Hospital. Also from that same year, 1932 to 1945 he was linked with Mansfield General Hospital.
In 1956, Mr. Malkin was chosen to be a member of the Government committee set up to inquire into the country's maternity services, a committee that was led by Lord Cranbrook. During his long career with hospitals the many changes he was able to influence were advances in after-
Among his many duties Mr. Malkin held the position of president in the North of England Obstetric Society, and the obstetric section of the Royal Society of Medicine.
For the years 1959 -
In 1963 he retired from the National Health Service but retained his position as chairman of the Obstetric Committee of the Nottingham City and County Health Executive until his retirement in 1969.
Harold Jordan Malkin finally passed away in December 1978, aged 80. In a memorial service held in January 1979 a tribute was paid to him. It was said; "Selfless dedication of his outstanding gifts in teaching and administration. Younger people, it was said, had been ready to respond to the inspiration of his example and the encouragement of his counsel."
Nottingham Local History Library
British Medical Journal,
6th January, 1979.
Mr. Harold Jordan Malkin, formerly consultant obstetrician and gynaecologist at Nottingham died on the 13th December, 1978; he was aged 80. He was survived by his wife Joyce and two daughters.
Harold Jordan Malkin was born on 27th April 1898 and educated at Epworth College and at University College and Hospital. During the first world war his studies were interrupted by service in the Royal Field Artillery. After qualifying in 1923 he held house appointments at University College Hospital and at the Royal Northern Hospital. He took the Fellowship of the Royal College of Surgeons, Edinburgh in 1925 and proceeded MD in 1926. Two years later he became consultant obstetrician and gynaecologist at Nottingham and held the appointment until 1967. From then until 1975 he was director of postgraduate studies at the Royal College of Obstetricians and Gynaecologists, of which he had been a fellow since 1938.
Harold Malkin will be remembered in many places as the kindest and most considerate of friends, as a great obstetrician, a leader in the councils of his specialty, and a broadminded and tolerant seeker after the best outcome for us all and not merely for his own profession. He, and Miss Glen Bott established his specialty in Nottingham at a time when it seemed firmly under the dominance of the surgeons yet contrived to avoid the strife that so often attended such a development. He built up a centre that could compare with any, despite the limitations of hospital resources. He will be remembered for that achievement in the city to which he gave a life’s work far into the future. He taught many who were to look back on their time with him with gratitude and affection for the one who led by unmatched example. He was to play a large part in the establishment of the new medical school, even though he had ceased by then to be an active teacher. His devotion to Nottingham did not prevent him from playing a major part in the college of which he was to be vice-
H. J. MALKIN, Esq.
M.D., F.R.C.S. (Ed.), F.R.C.O.G.
‘THE HEALING ART’
(AN HISTORICAL SURVEY)
Delivered Wednesday, 14th October, 1959.
Ladies and Gentlemen,
That you have made me President of our Society this year is an honour of which I am deeply appreciative and, apart from this evening, I look forward to a programme that I hope will appeal to you. That this is an old and well-
It is, I am afraid, on this occasion of the first meeting that you have to listen to a talk by myself instead of an address, I am proposing to make reference to some personalities who have a bearing on medicine.
In Ariege, in France. there is painted on the wall of a cave, a picture of a very early member of our profession, dressed in animal skins and made to look extremely ferocious. Even today, in the 20th century there are witch doctors who wear quills through their noses to produce the same effect. This fearsome appearance is presumably intended to strike awe into the heart of the patient and doubtless to make up to a large extent for lack of scientific knowledge. Perhaps the black coats and striped trousers used by past, and sometimes present-
The progress of medicine was roughly in three stages -
In the Pre-
In Greece, at Delphi, the palace of the Oracle, is the Temple of Apollo, and inside one may see the actual spot where the Pythia or Pythoness (a girl or women selected by the priests as the mouthpiece of the Oracle) sat over a crevice which excuded intoxicating fumes. These fumes sent her into a trance during which she made her utterances. These were translated by the priests, who were very much the wise men of the day, and the translations were so carefully worded that the hearers were satisfied and the priests uncommitted! Kings, statesmen and great leaders, besides more ordinary folk, came from far and wide to hear wisdom, and gain advice, both medical and otherwise, from the voice of the Oracle. One such visitor was Croesus, who came especially to ask whether it would be wise to involve himself in a certain war. The Oracle replied that “in the case of such a war, a great nation shall fall.” Croesus went off quiet happy with this verdict. There was a war -
Also in Greece, at the temple of Epidaurius, a great deal of healing was done, and I am reminded here of the story of Clio. She was a young woman, who having had no children, went to the Temple to ask that this might be remedied. She duly became pregnant, and grew larger and larger, until, after nearly five years had gone by, and she had not yet come into labour, she returned to the Temple to ask why this was so. She was told hat her wish had been to become pregnant, and this was granted, but she had never mentioned anything about being delivered. However, she was them permitted to come into labour and was delivered a son aged about four-
Even in those days statistics were of some importance, and in order to keep figures of patient survival satisfactory, all the sick who were unlikely to recover were turned out into the hills to die. (On the island of Delos neither births nor deaths were allowed, and all women nearing confinement, and all aged and sick approaching death, were sent away). The Temple at Epidaurus has been destroyed, but the Greek Theatre, with its round orchestra or stage and perfect acoustics, still remains. It seats about 15,000 people at the Festival each year, and from a seat at the top one can distinctly hear the slightest noise -
The first medical school was at Cos, and there, about 400 years before the birth of Christ, we find Hippocrates -
Another great man to whom I must refer was as interested in healing bodies as in saving souls. Some sixty years after the birth of Christ, Paul of Tarsus, moving from place to place, preached to the people and told them that he knew the name of the Unknown God many of them had been worshipping. In Athens, near the Acropolis, and in view of the ancient Parthenon and the Temple of the Wingless Victory, one can see the spot from which he preached. He preached in Corinth, too. When a prisoner on the way to Rome, and travelling in the same ship as St. Luke, he was shipwrecked and landed on what was afterwards known as St. Paul’s Island, where he and St. Luke gained a great reputation for healing, owing to their success in treating the Govenor of the island, who was suffering from enteric fever. Eventually, after continuing the journey through the Straits of Messina and passing between Scylla and Charybdis, Paul reached Rome for his trial. Later, when condemned to death, his judges discovered that although a Jew, he was also a Roman citizen, and therefore his execution must be by beheading and not by crucifixion as in the case of Peter.
The next great character connected with medicine was Soranus (A.D. 60). Born at Ephesus, and later going to Rome, he was the first specialist in obstetrics and gynaecology, and it was he who wrote the textbook De Morbis Mulierum, and it was he who taught version for obstructed labour -
Galen, who lived about seventy years later, was medical officer to the gladiators. With him there was “No phenomenon without a name, and no problem without a solution.” He developed the fire, air, water and earth theory -
The Dark Age was about to begin and Galen’s teaching lasted for nearly 4,000 years -
“There were 1,200 beds. In one bed of moderate size lay four, five or six persons besides each other, the feet of one to the head of another; children besides grey-
During the Dark Ages medicine and obstetrics were crude in the extreme. Women in labour were bounced up and down to encourage delivery or held head downwards and shaken, or frightened by burning faggots placed beneath them. In an era when superstitious beliefs and practices flourished it was perhaps not surprising that an ailment might be considered to come from an evil spirit within, and there are many pictures of devils being cast out -
An event of particular interest took place in 1500. This was the first successful caesarean section in which the mother and baby both lived, and was performed not by a member of the medical profession but by a Swiss peasant on his wife, after the failure of the ‘lithotomists’. There were no sutures, and the patient subsequently delivered herself twins, and later of four other children, she herself living to the age of seventy-
The Renaissance, which we have now reached, is the beginning of the third stage of medicine. The first doctor of repute was Ambroise Pare’ in 1510, who was a Frenchman, and his contribution to medicine was of enormous value. He re-
A compatriot of Pare’, a Hugenot too, named William Chamberlen, also escaped the massacre by fleeing with his family to England. The Chamberlen family consisted of five, of which two, both for some reason named Peter, were Doctors. Both were interested in Obstetrics, and Peter the Elder became physician to James 1st of England and his queen, Anne of Denmark. It was probably Peter the Elder, too, who invented the obstetric forceps -
The 17th century saw the beginning of science as we know it, when William Harvey (physician to Charles 1) discovered circulation. Having found that two ounces of blood flowed from the heart with each beat he did some calculations and realised that this added up to nearly six tons a day. Obviously this enormous quantity of blood had to go somewhere, and he came to the conclusion that it circulated back again; in other words, the heart was just a pump.
The first transfusion was from animal to man; man to man came later, but there were a great many fatalities. These were considerably reduced by the discovery by Lansteiner in 1900, of blood groups, and improved on still by the discovery of the Rhesus factor in 1940.
To go back to the personalities of the 17th century, we must remember William Smellie, whose knowledge of the physiology, mechanics and pathology of obstetrics was detailed and accurate. He trained 900 students, each of whom had to pay 6/-
In the 18th century we have William and John Hunter, to whom we owe amongst other things our knowledge of the foetal and placental circulation. William, in contrast to Smellie, with whom he quarrelled, was an advocate of masterly inactivity and enjoyed showing his forceps, rusty with disuse, and remarking that “it is a thousand pities they have been invented, for where they save one they murder twenty.” He was extremely conservative, and it is likely that his influence on Crofts (who was accoucheur to the Princess Charlotte) may well have been responsible for the decision for non-
Bartholomew Mosse, who founded in Dublin the fifteen-
“Sir Fielding Ould is made a Knight,
He should have been a Lord by right,
For then each Lady’s prayer would be
O Lord, Good Lord, Deliver me.”
In this same century the contagious aspect of infection was recognised first by Burton in 1751, and then by John Leake, and the first treatise was by Alexander Gordon of Aberdeen in 1795. He showed the transmissability of disease and the need to disinfect both doctor and nurse. He had based his theory on seventy-
The 19th century produced men who supplied theories and practices which were of vast importance to the medical profession and to the patient. Charles White of Manchester, who so strongly recommended fresh air and cleanliness in the treatment of illness; Oliver Wendell Holmes, and Ignaz Semmelweiss, the Hungarian who qualified in Vienna and was so struck by the difference in the death-
A useful discovery by Laennec was the value of the stethoscope to help in diagnosis -
Dr. Morton of Massachussetts discovered ether in 1846, and the first operation under it in England was at University College Hospital, performed by Liston, when Lister was still a young man. A year later Simpson discovered chloroform, to which a good deal of publicity was given, and interest in it was enthusiastic. At a dinner party Simpson and some of his friends tried out this new anaesthetic, until gradually, one by one, the guests slid to the floor, or slipped under the table, though one young lady, who was also trying out the new discovery, ran around waving her arms and shouting “I’m an Angel -
Joseph Lister’s introduction of antiseptics in 1851 almost eliminated death from the compound fracture, and medicine was by now advancing steadily. Germs were demonstrated by Myerhofer, and then, in 1897, came Pasteur, with his demonstration of haemolytic streptococci, and his use of vaccines. Lawson Tait of Birmingham introduced asepsis, Rontgen in 1895 discovered X-
Nowadays it is difficult to appreciate that there was no real nursing in this country until Florence Nightingale, who had trained as a nurse in Germany, began her care of the sick and wounded during the Crimean War. The hospital where she and her friends carried out their great and valuable work was at one time called Scutari, on the opposite side of the Bosphorus from Constantinople.
Having now come through the ages to the present day I would like to mention two medical centres in Yugo-
At Zadar too, a lovely old former Italian town on the coast, I found again an attitude to obstetrics very similar to our own, and the members of the medical profession I had the good fortune to meet were, without exception, extremely interested in our methods in this country. What was disconcerting the doctors while I was there, was that they had just been told that in October all private practice would cease. This would mean a drop in income at the top level from about £3,000 a year to just under £1,000. Another point which I thought interesting was their method of dealing with medical cover for villages. Apparently it is quite easy to find doctors for town practices, but the only way of enticing them to the country ones is to pay them at a higher rate, and in fact, allow them to take in several villages, so that their total earnings might well exceed that obtainable in a town by a very considerable amount.
In the Pre-