98
BRITISH MEDICAL
98
OBITUARY
B.A., M.D., M.S., F.R.C.S.
Sir Zachary Cope, consulting surgeon to St. Mary's Hospital, Paddington, and to the Bolingbroke Hospital, and a vice-president of the B.M.A., -died on 28 December. He was 93. Vincent Zachary Cope, the son of a Methodist minister, was born at Hull on 14 February 1881 and educated at Westminster City School and London University, wh e re he graduated B.A. in 1899. The following year he entered St. Mary's
Hospital, graduating M.B., B.S. with honours in
k-> | ~surgery
11 JANUARY 1975
11 JANUARY 1975~~~~~~~~~~~~~~~~~~-
NOTICES
Sir ZACHARY COPE
; Uw
JOURNAL
BRITISH MEDICAL JOURNAL
and forensic medicine in 1905. He proceeded M.D. in 1907 and took the M.S. and the F.R.C.S. in 1909. After holding posts such as that of demonstrator in anatomy in the school he was appointed surgeon to St. Mary's in 1911 and remained there for the rest of his life, in later years in a consulting capacity. Between 1916 and 1927 he was four times Hunterian professor of the Royal College of Surgeons, and later delivered the Arris and Gale and most of the other lectures associated with that college. He became a member of the board of examiners, a member of the council, and a vicepresident. He was also at various times examiner in surgery to London, Birmingham, and Manchester universities. During the first world war he served in the R.A.M.C. as a captain and temporary major and was attached to the 3rd London General Hospital. He saw active service in the Middle East from 1916 to 1919 and was mentioned in dispatches. His Surgical Aspect of Dysentery, based on his experiences in Mesopotamia, was published in 1921. In the second world war he was a sector officer of the Emergency Medical Service. In 1955 he succeeded Lord Haden-Guest as chairman of the National Medical Manpower Committee. Two clinical volumes of the Official History of the War of 1939-45 were edited by him. Among his contributions to medical literature his Early Diagnosis of the Acute Abdomen, first published in 1922, reached its 14th edition in 1972. Some Principles of Minor Surgery was published in 1939 and A History of the Acute Abdomen in 1965. A member of the Council of the B.M.A. in 1938, he served until 1945. He was a member of the medical Planning Commission set up during the second world war and of the General Practice Review Committee set up in 1950. Other committee work in
which he took part had to do with medical education, proprietary medicines, the British Pharmacopoeia, physical medicine, medical war relief, and many other subjects. Before coming into the central affairs of the B.M.A. he was prominent in the Marylebone Division, of which he was chairm,an from 1940 to 1943. From 1943 to 1945 he and three colleagues were engaged on a regional hospital survey of south-west England. In 1951 he took part in an inauiry into the national registration of medical auxiliaries. He presided over eight committees, each dealing with a different branch of the auxiliary services, and he and his 40 colleagues, the Cope Committee as it was called, carried through a massive piece of work. In 1953, in the first New Year honours list of the Queen's reign, he was designated knight bachelor. For many years he served as honorary librarian of the Royal Society of Medicine and in 1951 was made an honorary Fellow. He was also a familiar figure at the Medical Society of London and was its president for a year. In recognition of his long and distinguished service to the history of medicine he was made in 1961 an honorary Fellow of the faculty of the history of medicine and pharmacology of the Society of Apothecaries. Outside the interests of his profession, his committee work, and his writing he was devoted to music. He was also an enthusiastic motorist and had driven a car from 1916 onwards. His first wife died in 1922 and his second in 1944. He is survived by a daughter of his second marriage.
A.P. writes: As an erstwhile student, registrar, and colleague of Zachary Cope I am proud to be the possessor of a signed copy of the 14th edition of the Early Diagnosis of the Acute Abdomen, published in 1972, just 50 years after the first edition appeared in print. T-he signature is clear and legible, the message above it lucid and warm, though at the time he wrote it he was over 90 years of age, almost blind, very deaf, and not too mobile. Surely no surgical textbook has ever had the active life of this one. Generations of young surgeons all over the world have reason to be eternally grateful for its sound, practical wisdom. In so many ways it reflects the character of its author, not only in its longevity but in its clarity of thought and expression, its basic common sense, and its infallible appreciation of relative values. Zachary was a modest man, with the quiet courtesy and manners of the Victorian era. His unhurried approach to life allowed him to enjoy so many facets of it to the full. He enjoyed company and was himself very good company. Though abstemious, the natural warmth of his personality embraced all those with whom he came in contact. To those who really knew him he showed a rather unexpected sense of quietly sardonic humour. He was a very human person, as his students and his patients soon learnt.
The former flocked to his informatively personal ward rounds; the latter trusted him implicitly-none more so than the children who were his patients, the indelible hallmark of a good doctor. He seemed to have an inexhaustible store of good will towards men, and I would be amazed to learn that Zachary ever had a real enemy. His interest and pride in his trainees was very genuine and very practical and continued throughout life, both his and theirs. Who among those fortunate enough to have received them can have failed to be delighted by the amusing little outpourings of doggerel verse that came at Christmas or at times of recognized success? He was an erudite man, well and widely read, and this ensured two great pleasures in his life: the ability to comprehend and appreciate the dramatic and dynamic changes that science and technology were introducing into modern surgery while himself remaining the essentially humane and clinical exnonent of the art, and the opportunity, particularly in later life, to indulge his undoubted flair for writing. His histories of the Roval College of Surgeons and of St. Mary's Hospital in its centenary year, his biographies of Florence Nightingale and of Cheselden among others, his editorship of two volumes of the official medical history of the second world war-all these will provide lasting memorials to his ability and to his indefatigable industry. Of the major part he played and the deep interest he took in so many of the great medical institutions in the country others will doubtless write more fully, but there is little doubt that in the annals of the Royal College of Surgeons, the B.M.A., the Royal Society of Medicine, and the Medical Society of London the name of Zachary Cope will remain a treasured memory for many a year to come. His frnends, and they are legion, will mourn his passing but will know that their own lives are the richer for his living. He grew older, but neither in mind nor in spirit did he grow old, a man small in stature but big in heart.
G.H.J. writes: Many will pay full and fitting tribute to Sir Zachary Cope and to his outstanding talents as a surgeon. I was merely a locum H.S. of his, but he never forgot anyone who worked for him, however briefly. It was impossible not to be impressed immediately by the humanity, the humility, and the humour of this most friendly little great man. A well-known story about his early days as senior assistant surgeon to the surgical unit at St. Mary's exemplifies his character. Being called to the ward to see an emergency adnission, he imnediately went to the bedside, but was as swiftly ordered, by a very new staff nurse, to go and sit on the bench outside the ward. "Zach" went without demur, and when, as he anticipated, the very senior ward sister soon returned from tea and he was still there gazing at the ground in apparent abstraction.
BRITISH MEDICAL JOURNAL
11 JANUARY 1975
Sister swept on into the ward to inquire "Why is Mr. Cope sitting on the bench, Staff?" Horrified explanation was followed by an order for instant apology, and a quietly smiling surgeon entered the ward saying, "It's quite all right, my dear-we all make mistakes." Quite so, but men like Zachary Cope make fewer than most.
ALECK W. BOURNE M.A., M.B., B.CHIR., F.R.C.S., F.R.C.O.G.
Mr. Aleck Bourne, who will be remembered for courageously inviting prosecution in 1938 after terminating pregnancy in a young girl who had been raped, died on 27 December at the age of 88. Mr. Bourne was consulting gynaecologist and obstetric surgeon to St. Mary's Hospital and Queen Charlotte's Hospital and consulting surgeon to the Samaritan Hospital for Women. Aleck William Bourne was born on 4 June 1886 and educated at Rvdal School, Colwyn Bay, and at Downing College, Cambridge. In 1908 he was placed first class in the natural sciences tripos and the same year became senior university scholar at St. Mary's Hospital, London. He qualified with the Conjoint diploma in 1910 and took the F.R.C.S. the following year. Until the outbreak of the first world war in 1914 he held resident and other appointments at St. Mary's, Queen Charlotte's, and the Samaritan. He then served as a surgical specialist in Egypt and France until 1917 and after the war was appointed to the staffs of the three hospitals. He also settled in consulting practice in London and quickly gained recognition in the field of obstetrics and gynaecology. His Synopsis of Obstetrics and Gynaecology, first published in 1913 as Synopsis of Midwifery, reached its 13th edition in 1965. Recent Advances in Obstetrics and Gvnaecology was first written by Bourne and Leslie Williams in 1926. The 10th edition of the book, still revised and rewritten by the same authors except for a chapter by Dr. L. Steingold, appeared in 1962. That year also was published A Doctor's Creed: The Memoirs of a Gynaecologist, in which Bourne recalled his early days and more than 30 years of practice at St. Mary's. At one time he was examiner in obstetrics and gynaecology for Cambridge University, and from the beginning of the N.H.S. he was a member of the Central Health Services Council. He was a former member of the council of the Royal College of Obstetricians and Gynaecologists. In 1956 he was presented with a Sydney Body gold medal for merit in the field of obstetrics and gynaecology. In 1964, at the age of 77, he reluctantly decided to retire, as the lease of his rooms in Weymouth Streethad come to an end. He moved to Ashtead in Surrey and occupied himself with gardening and writing, his former recreations having been sailing and yacht cruising. Mr. Bourne married Bessie Hayward in 1912 and they had three
daughters. J.P. writes: Aleck Bourne made a great many outstanding contributions to medicine in the wider s,phere and to obstetrics and gynaecology in particular. He was a man of great compassion and understanding, and in
his recognition of the importance of psychological factors in relation to many disorders so frequently encountered in the daily practice of gynaecology he was much ahead of hlis generation. Further, he never lacked the courage to express in public views which he held with great conviction and sincerity. His action in the famous Rex v. Bourne case was typical of the man. In 1938 a girl of 14 was referred to his outpatient clinic at St. Mary's Hospital, having been criminally assaulted and raped by several soldiers from a London barracks. She became pregnant as a result. The girl and her parents were in great distress and the evidence of rape was indisputable. Ever since the Offences Against the Person Act of 1861 the only justification for terminating pregnancy was if its continuance was thought seriously to threaten the life of the pregnant woman. Bourne, though fully aware that a plea of danger to life could not be substantiated, came to the conclusion that termination of the pregnancy was amply justified because of risk to the physical and mental health of the patient. Having operated, he then quite deliberately informed the police because he felt the urgent need for a test case in the courts of law. The trial took place at the Central Criminal Court in July 1938 before Mr. Justice Macnaghten. I think there is no doubt that Bourne's original intention was to let the case stand or fall on his own evidence concerning the risks of permanent psychological trauma to the patient had the pregnancy continued. However, his legal advisers made it plain that under the existing state of the law he would in all probability be convicted unless further evidence of physical risks as well as mental were forthcoming. A number of leading gynaecologists were in consequence called as expert witnesses in his defence. The physical risks of pregnancy and labour in a girl of 14 were then thought to be far greater than would be accepted today in the light of greater experience of the problems of pregnancy in the very young. Bourne was acquitted, and the judge in his summing up made a pronouncement of the greatest possible significance: "If the doctor is of opinion on reasonable grounds and with adequate knowledge, that the probable consequences of the pregnancy will be to make the woman a physical and mental wreck, the jury are quite entitled to take the view that the doctor, who under these circumstances and in that ihonest belief, operates, is operating for the purpose of preserving the life of the mother." This judgement was of great importance to the gynaecologist, because it freed him from the fear of legal action against hbim if he terminated a pregnancy if there was clear evidence of serious risk to health-a genuine medical indication. Nearly 30 years later the Royal College of Obstetricians and Gynaecologists in its report on medical termination of pregnancy before the 1967 Act was able to state that since the Bourne case no gynaecologist had been deterred from terminating pregnancy for a medical indication because of the fear of legal action. Bourne rightly deserves great credit for his determined and courageous action in 1938, based as it was on a deep sense of responsibility and compassionate understanding. It is nevertheless of considerable interest to record that he was strongly opposed to abortion for purely social and
99
trivial indications. During the debates which took place on a great many platforms before the 1967 Act he spoke on many occasions against the proposed legislation, foreseeing the inevitable consequences of total liberalization of the law.
M.L-O. writes: I knew Aleck Bourne since 1930 and was always impressed with his gay personality, kindliness, and friendliness. He was a great sportsman and obtained much pleasure in having his housemen and registrars sailing with him at Burnham. Even at a late age he took part in the annual soccer match between the staff and porters at Mary's. We had many walking, climbing, rowing, and swimming holidays in North Wales, which he loved so much. When I was elected to the staff of Mary's in 1946 he did me the great honour of inviting me to be his anaesthetist. Thhis was an unbelievable act of kindness on his part and I am sure done solely so that I could share in his lucrative practice in the days wuhen being on the staff was an honorary appointment. At one time he had to have a laparotomy for a suspected duodenal ulcer and I was to give him the anaesthetic. Such was his .sense of humour that he said to me, "If the tumour is malignant and I survive the anaesthetic I shall never speak to you again." Luckily it was not, and a fortnight later he was fit enough to climb to the top of Snowdon with me. He was a truly great man, and on his retirement I gave him a silver beer mug with the inscription "To Aleck Bourne on his retirement. Not my best man on my wedding but one of my very best men ever since." I can pay no higher tribute.
ELLA G. F. MACKENZIE M.A., M.D., L.M., D.P.H.
Dr. Ella MacKenzie, who was formerly deputy divisional medical officer of health in the London County Council, died on 4 October. She was 83. Ella Grace Florence MacKenzie was born in Rajputana, India, on 21 January 1891 and graduated M.B., Ch.B. from Edinburgh University in 1919, taking the licentiateship in midwifery of the Rotunda Hospital the same year. She proceeded M.D. in 1927. After working at Birmingham and Blackburn she became senior medical officer to the metropolitan borough of Lewisham in 1931. In 1941 she was designated deputy medical officer of health and senior maternity and child welfare officer. She was responsible for the council's maternity home at Catford, attended many of the clinics throughout the borough, and was in charge of a number of inmmunization campaigns. During the second world war she acted as medical officer of health and was very busy on the first-aid section of civil defence, also working with the health inspectors dealing with conditions in shelters. In 1950 she became deputy divisional medical officer of the London County Council. When she retired Dr. MacKenzie practised chiropody. She also learnt Braille and translated several books. Until a few years ago, when she became ill with arthritis, she travelled extensively. She will be remembered as a kind and helpful friend and an industrious colleague.-M.W., A.J.P.
BRITISH MEDICAL
98
OBITUARY
B.A., M.D., M.S., F.R.C.S.
Sir Zachary Cope, consulting surgeon to St. Mary's Hospital, Paddington, and to the Bolingbroke Hospital, and a vice-president of the B.M.A., -died on 28 December. He was 93. Vincent Zachary Cope, the son of a Methodist minister, was born at Hull on 14 February 1881 and educated at Westminster City School and London University, wh e re he graduated B.A. in 1899. The following year he entered St. Mary's
Hospital, graduating M.B., B.S. with honours in
k-> | ~surgery
11 JANUARY 1975
11 JANUARY 1975~~~~~~~~~~~~~~~~~~-
NOTICES
Sir ZACHARY COPE
; Uw
JOURNAL
BRITISH MEDICAL JOURNAL
and forensic medicine in 1905. He proceeded M.D. in 1907 and took the M.S. and the F.R.C.S. in 1909. After holding posts such as that of demonstrator in anatomy in the school he was appointed surgeon to St. Mary's in 1911 and remained there for the rest of his life, in later years in a consulting capacity. Between 1916 and 1927 he was four times Hunterian professor of the Royal College of Surgeons, and later delivered the Arris and Gale and most of the other lectures associated with that college. He became a member of the board of examiners, a member of the council, and a vicepresident. He was also at various times examiner in surgery to London, Birmingham, and Manchester universities. During the first world war he served in the R.A.M.C. as a captain and temporary major and was attached to the 3rd London General Hospital. He saw active service in the Middle East from 1916 to 1919 and was mentioned in dispatches. His Surgical Aspect of Dysentery, based on his experiences in Mesopotamia, was published in 1921. In the second world war he was a sector officer of the Emergency Medical Service. In 1955 he succeeded Lord Haden-Guest as chairman of the National Medical Manpower Committee. Two clinical volumes of the Official History of the War of 1939-45 were edited by him. Among his contributions to medical literature his Early Diagnosis of the Acute Abdomen, first published in 1922, reached its 14th edition in 1972. Some Principles of Minor Surgery was published in 1939 and A History of the Acute Abdomen in 1965. A member of the Council of the B.M.A. in 1938, he served until 1945. He was a member of the medical Planning Commission set up during the second world war and of the General Practice Review Committee set up in 1950. Other committee work in
which he took part had to do with medical education, proprietary medicines, the British Pharmacopoeia, physical medicine, medical war relief, and many other subjects. Before coming into the central affairs of the B.M.A. he was prominent in the Marylebone Division, of which he was chairm,an from 1940 to 1943. From 1943 to 1945 he and three colleagues were engaged on a regional hospital survey of south-west England. In 1951 he took part in an inauiry into the national registration of medical auxiliaries. He presided over eight committees, each dealing with a different branch of the auxiliary services, and he and his 40 colleagues, the Cope Committee as it was called, carried through a massive piece of work. In 1953, in the first New Year honours list of the Queen's reign, he was designated knight bachelor. For many years he served as honorary librarian of the Royal Society of Medicine and in 1951 was made an honorary Fellow. He was also a familiar figure at the Medical Society of London and was its president for a year. In recognition of his long and distinguished service to the history of medicine he was made in 1961 an honorary Fellow of the faculty of the history of medicine and pharmacology of the Society of Apothecaries. Outside the interests of his profession, his committee work, and his writing he was devoted to music. He was also an enthusiastic motorist and had driven a car from 1916 onwards. His first wife died in 1922 and his second in 1944. He is survived by a daughter of his second marriage.
A.P. writes: As an erstwhile student, registrar, and colleague of Zachary Cope I am proud to be the possessor of a signed copy of the 14th edition of the Early Diagnosis of the Acute Abdomen, published in 1972, just 50 years after the first edition appeared in print. T-he signature is clear and legible, the message above it lucid and warm, though at the time he wrote it he was over 90 years of age, almost blind, very deaf, and not too mobile. Surely no surgical textbook has ever had the active life of this one. Generations of young surgeons all over the world have reason to be eternally grateful for its sound, practical wisdom. In so many ways it reflects the character of its author, not only in its longevity but in its clarity of thought and expression, its basic common sense, and its infallible appreciation of relative values. Zachary was a modest man, with the quiet courtesy and manners of the Victorian era. His unhurried approach to life allowed him to enjoy so many facets of it to the full. He enjoyed company and was himself very good company. Though abstemious, the natural warmth of his personality embraced all those with whom he came in contact. To those who really knew him he showed a rather unexpected sense of quietly sardonic humour. He was a very human person, as his students and his patients soon learnt.
The former flocked to his informatively personal ward rounds; the latter trusted him implicitly-none more so than the children who were his patients, the indelible hallmark of a good doctor. He seemed to have an inexhaustible store of good will towards men, and I would be amazed to learn that Zachary ever had a real enemy. His interest and pride in his trainees was very genuine and very practical and continued throughout life, both his and theirs. Who among those fortunate enough to have received them can have failed to be delighted by the amusing little outpourings of doggerel verse that came at Christmas or at times of recognized success? He was an erudite man, well and widely read, and this ensured two great pleasures in his life: the ability to comprehend and appreciate the dramatic and dynamic changes that science and technology were introducing into modern surgery while himself remaining the essentially humane and clinical exnonent of the art, and the opportunity, particularly in later life, to indulge his undoubted flair for writing. His histories of the Roval College of Surgeons and of St. Mary's Hospital in its centenary year, his biographies of Florence Nightingale and of Cheselden among others, his editorship of two volumes of the official medical history of the second world war-all these will provide lasting memorials to his ability and to his indefatigable industry. Of the major part he played and the deep interest he took in so many of the great medical institutions in the country others will doubtless write more fully, but there is little doubt that in the annals of the Royal College of Surgeons, the B.M.A., the Royal Society of Medicine, and the Medical Society of London the name of Zachary Cope will remain a treasured memory for many a year to come. His frnends, and they are legion, will mourn his passing but will know that their own lives are the richer for his living. He grew older, but neither in mind nor in spirit did he grow old, a man small in stature but big in heart.
G.H.J. writes: Many will pay full and fitting tribute to Sir Zachary Cope and to his outstanding talents as a surgeon. I was merely a locum H.S. of his, but he never forgot anyone who worked for him, however briefly. It was impossible not to be impressed immediately by the humanity, the humility, and the humour of this most friendly little great man. A well-known story about his early days as senior assistant surgeon to the surgical unit at St. Mary's exemplifies his character. Being called to the ward to see an emergency adnission, he imnediately went to the bedside, but was as swiftly ordered, by a very new staff nurse, to go and sit on the bench outside the ward. "Zach" went without demur, and when, as he anticipated, the very senior ward sister soon returned from tea and he was still there gazing at the ground in apparent abstraction.
BRITISH MEDICAL JOURNAL
11 JANUARY 1975
Sister swept on into the ward to inquire "Why is Mr. Cope sitting on the bench, Staff?" Horrified explanation was followed by an order for instant apology, and a quietly smiling surgeon entered the ward saying, "It's quite all right, my dear-we all make mistakes." Quite so, but men like Zachary Cope make fewer than most.
ALECK W. BOURNE M.A., M.B., B.CHIR., F.R.C.S., F.R.C.O.G.
Mr. Aleck Bourne, who will be remembered for courageously inviting prosecution in 1938 after terminating pregnancy in a young girl who had been raped, died on 27 December at the age of 88. Mr. Bourne was consulting gynaecologist and obstetric surgeon to St. Mary's Hospital and Queen Charlotte's Hospital and consulting surgeon to the Samaritan Hospital for Women. Aleck William Bourne was born on 4 June 1886 and educated at Rvdal School, Colwyn Bay, and at Downing College, Cambridge. In 1908 he was placed first class in the natural sciences tripos and the same year became senior university scholar at St. Mary's Hospital, London. He qualified with the Conjoint diploma in 1910 and took the F.R.C.S. the following year. Until the outbreak of the first world war in 1914 he held resident and other appointments at St. Mary's, Queen Charlotte's, and the Samaritan. He then served as a surgical specialist in Egypt and France until 1917 and after the war was appointed to the staffs of the three hospitals. He also settled in consulting practice in London and quickly gained recognition in the field of obstetrics and gynaecology. His Synopsis of Obstetrics and Gynaecology, first published in 1913 as Synopsis of Midwifery, reached its 13th edition in 1965. Recent Advances in Obstetrics and Gvnaecology was first written by Bourne and Leslie Williams in 1926. The 10th edition of the book, still revised and rewritten by the same authors except for a chapter by Dr. L. Steingold, appeared in 1962. That year also was published A Doctor's Creed: The Memoirs of a Gynaecologist, in which Bourne recalled his early days and more than 30 years of practice at St. Mary's. At one time he was examiner in obstetrics and gynaecology for Cambridge University, and from the beginning of the N.H.S. he was a member of the Central Health Services Council. He was a former member of the council of the Royal College of Obstetricians and Gynaecologists. In 1956 he was presented with a Sydney Body gold medal for merit in the field of obstetrics and gynaecology. In 1964, at the age of 77, he reluctantly decided to retire, as the lease of his rooms in Weymouth Streethad come to an end. He moved to Ashtead in Surrey and occupied himself with gardening and writing, his former recreations having been sailing and yacht cruising. Mr. Bourne married Bessie Hayward in 1912 and they had three
daughters. J.P. writes: Aleck Bourne made a great many outstanding contributions to medicine in the wider s,phere and to obstetrics and gynaecology in particular. He was a man of great compassion and understanding, and in
his recognition of the importance of psychological factors in relation to many disorders so frequently encountered in the daily practice of gynaecology he was much ahead of hlis generation. Further, he never lacked the courage to express in public views which he held with great conviction and sincerity. His action in the famous Rex v. Bourne case was typical of the man. In 1938 a girl of 14 was referred to his outpatient clinic at St. Mary's Hospital, having been criminally assaulted and raped by several soldiers from a London barracks. She became pregnant as a result. The girl and her parents were in great distress and the evidence of rape was indisputable. Ever since the Offences Against the Person Act of 1861 the only justification for terminating pregnancy was if its continuance was thought seriously to threaten the life of the pregnant woman. Bourne, though fully aware that a plea of danger to life could not be substantiated, came to the conclusion that termination of the pregnancy was amply justified because of risk to the physical and mental health of the patient. Having operated, he then quite deliberately informed the police because he felt the urgent need for a test case in the courts of law. The trial took place at the Central Criminal Court in July 1938 before Mr. Justice Macnaghten. I think there is no doubt that Bourne's original intention was to let the case stand or fall on his own evidence concerning the risks of permanent psychological trauma to the patient had the pregnancy continued. However, his legal advisers made it plain that under the existing state of the law he would in all probability be convicted unless further evidence of physical risks as well as mental were forthcoming. A number of leading gynaecologists were in consequence called as expert witnesses in his defence. The physical risks of pregnancy and labour in a girl of 14 were then thought to be far greater than would be accepted today in the light of greater experience of the problems of pregnancy in the very young. Bourne was acquitted, and the judge in his summing up made a pronouncement of the greatest possible significance: "If the doctor is of opinion on reasonable grounds and with adequate knowledge, that the probable consequences of the pregnancy will be to make the woman a physical and mental wreck, the jury are quite entitled to take the view that the doctor, who under these circumstances and in that ihonest belief, operates, is operating for the purpose of preserving the life of the mother." This judgement was of great importance to the gynaecologist, because it freed him from the fear of legal action against hbim if he terminated a pregnancy if there was clear evidence of serious risk to health-a genuine medical indication. Nearly 30 years later the Royal College of Obstetricians and Gynaecologists in its report on medical termination of pregnancy before the 1967 Act was able to state that since the Bourne case no gynaecologist had been deterred from terminating pregnancy for a medical indication because of the fear of legal action. Bourne rightly deserves great credit for his determined and courageous action in 1938, based as it was on a deep sense of responsibility and compassionate understanding. It is nevertheless of considerable interest to record that he was strongly opposed to abortion for purely social and
99
trivial indications. During the debates which took place on a great many platforms before the 1967 Act he spoke on many occasions against the proposed legislation, foreseeing the inevitable consequences of total liberalization of the law.
M.L-O. writes: I knew Aleck Bourne since 1930 and was always impressed with his gay personality, kindliness, and friendliness. He was a great sportsman and obtained much pleasure in having his housemen and registrars sailing with him at Burnham. Even at a late age he took part in the annual soccer match between the staff and porters at Mary's. We had many walking, climbing, rowing, and swimming holidays in North Wales, which he loved so much. When I was elected to the staff of Mary's in 1946 he did me the great honour of inviting me to be his anaesthetist. Thhis was an unbelievable act of kindness on his part and I am sure done solely so that I could share in his lucrative practice in the days wuhen being on the staff was an honorary appointment. At one time he had to have a laparotomy for a suspected duodenal ulcer and I was to give him the anaesthetic. Such was his .sense of humour that he said to me, "If the tumour is malignant and I survive the anaesthetic I shall never speak to you again." Luckily it was not, and a fortnight later he was fit enough to climb to the top of Snowdon with me. He was a truly great man, and on his retirement I gave him a silver beer mug with the inscription "To Aleck Bourne on his retirement. Not my best man on my wedding but one of my very best men ever since." I can pay no higher tribute.
ELLA G. F. MACKENZIE M.A., M.D., L.M., D.P.H.
Dr. Ella MacKenzie, who was formerly deputy divisional medical officer of health in the London County Council, died on 4 October. She was 83. Ella Grace Florence MacKenzie was born in Rajputana, India, on 21 January 1891 and graduated M.B., Ch.B. from Edinburgh University in 1919, taking the licentiateship in midwifery of the Rotunda Hospital the same year. She proceeded M.D. in 1927. After working at Birmingham and Blackburn she became senior medical officer to the metropolitan borough of Lewisham in 1931. In 1941 she was designated deputy medical officer of health and senior maternity and child welfare officer. She was responsible for the council's maternity home at Catford, attended many of the clinics throughout the borough, and was in charge of a number of inmmunization campaigns. During the second world war she acted as medical officer of health and was very busy on the first-aid section of civil defence, also working with the health inspectors dealing with conditions in shelters. In 1950 she became deputy divisional medical officer of the London County Council. When she retired Dr. MacKenzie practised chiropody. She also learnt Braille and translated several books. Until a few years ago, when she became ill with arthritis, she travelled extensively. She will be remembered as a kind and helpful friend and an industrious colleague.-M.W., A.J.P.
