biographies

Butler, Hildred Mary (1906 - 1975)

DSc ARACI

Born
9 October 1906
Elsternwick, Victoria, Australia
Died
April 1975
Carlton, Victoria, Australia
Occupation
Bacteriologist and Medical Scientist
Summary

Prepared by Ann Westmore PhD, 2006


Hildred Mary Butler was pivotal to studies during the 1930s of infectious agents killing one women in every 360 at the Women’s Hospital after childbirth or abortion. For over four decades she collaborated with, or was a member of, the hospital’s staff, establishing an outstanding Bacteriology Department. Her knowledge of micro-organisms and their effects on human health was exceptional, her career spanning the time before, as well as after, the introduction of antibiotics.

She and Dr Arthur Machen “Bung” Hill undertook detailed studies of infective organisms, growing them in the laboratory to determine what they were and what treatment might curb their spread. Their seminal paper on the diagnosis and management of “clostridium Welchii” infections (now known as “clostridium perfringens”) was of international significance. They combined innovative and astute bacteriology with expert clinical judgment to revolutionise the care of women with these dangerous infections, saving many lives and much illness in the process.

Butler’s breadth of understanding of maternal infections was invaluable in developing better treatments, in teaching and supervising countless doctors, nurses and bacteriologists in a range of beneficial practices, and in advocacy to an international audience over a period of some 25 years.

Details

Hildred Butler was born on 9 October 1906 at Elsternwick in Melbourne, the daughter of a Victorian wheat farmer, Archie Butler, and his wife, Rose Josephine, née Hancock.

A gifted student, she achieved either first or second place in class throughout her secondary schooling at Lauriston Girls School (1918-23). She was equal dux in her final year, studying algebra and geometry, history and English. A fictionalised account of her relationship with the other dux portrayed Butler as a "nerd" (in modern terminology) with her head in a book and a preference for her own company.

A career in science
Butler gained entry to the University of Melbourne where she enrolled in Science. Like many women of her era who pursued successful careers in science and medicine, she never married in contrast to her co-dux whose post-school path, according to Lauriston archivist Jenny Bars, "was typical of upper-middle class girls of her era: a year in Europe, then back to the family home in Toorak to await marriage and family".

Her university Science results improved after a solid but unspectacular start. She passed all subjects in her first year, and then gained first class honours in chemistry and physiology in both 2nd and 3rd years. On graduating with a Bachelor of Science degree in 1928, she immediately gained employment at the newly-established Baker Institute for Medical Research attached to the Alfred Hospital, Melbourne.

While working at the Baker Institute during the following decade she was strongly influenced by the Director, Dr William Penfold, an English-born (1875), University of Edinburgh trained doctor. Having joined the Baker after a stint as foundation Director of the Commonwealth Serum Laboratories, 1916-26, he teamed an international reputation in preventive medicine, blood analysis and anti-toxin work with wide-ranging experience as a clinician, researcher, teacher and practical bacteriologist.

Cultures and Collaboration
Butler learned exceedingly well from Penfold, mastering the techniques and skills he taught her in blood-culture work and characterisation of anaerobic bacteria (that is, bacteria that do not require oxygen to survive). By the early 1930s, she was applying these skills to study infective material provided by a number of hospitals, including the Women’s. According to the hospital’s "Book of Remembrance", she was enlisted to help study a spate of "appallingly frequent severe and fatal infections" among patients in 1931. Comments made subsequently by Dr A. M. "Bung" Hill, then a junior member of the hospital’s staff, indicate that his long-standing collaboration with Butler started at this time.

Max Swan, who joined the Baker Institute in 1934 as a teenager, recalled Butler as "an exacting, awe-inspiring lady whose penetrating blue stare, focused through large-frame spectacles earned her the nickname ‘the Praying Mantis’". Swan, who went on to study medicine, said that he and the other "juniors also held that she conducted human sacrifice at the full moon". Notwithstanding these colourful descriptions which suggest something of Butler’s serious and at times autocratic demeanour, Swan acknowledged her as "an outstanding bacteriologist and serologist".

In 1937 Butler dedicated her book, "Blood Cultures and their Significance", to the inspiring Penfold whose "steadfast devotion to scientific truth and his never-failing help and encouragement" deeply impressed her. In the Preface, Penfold returned the compliment, saying the book gave him "peculiar pleasure". Butler’s was the third monograph from the Baker in a series of publications, but the others had "been written by people who were experienced in their subjects when they associated themselves with the Institute". Butler, on the other hand;
. . . has spent the whole of her bacterial life in the services of the Institute, so that in a very real and complete sense, this is a Baker Institute monograph.

Penfold also voiced his pride in the high standard of Butler’s work. When she joined the Baker Institute, only about 10% of all attempts to isolate bacteria from the bloodstream using culture techniques were positive. Over the years she had made a major difference, doing all the blood cultures the Alfred Hospital required and lifting the percentage of positive results to 25-30%. Because of "her devotion and success in this work", Penfold had suggested she write the book.

In his view, the average clinician underused blood cultures for diagnosis, prognosis or to help in deciding the best course of treatment because they doubted their accuracy, blaming technical defects for this situation. If the methods described in Butler’s book were used, fewer false negative results would occur, he said. A second reason he proffered for why blood cultures were under-used was the absence of a succinct, yet reasonably complete book on the subject, a problem Butler’s book overcame both for bacteriologists doing technical work, and clinicians who interpreted the results.

Triumphs and tributes
In 1938 Butler was appointed the first bacteriologist at the Women’s Hospital where she remained for the next 33 years. As detailed in the "Book of Remembrance", she and Hill continued to work together for decades, developing an international reputation for their insights into infections that complicate childbirth and abortion. Their major contributions were to increase understanding of, and rapid diagnosis and treatment of, anaerobic infections; and to prevent staphylococcal cross infection. They collaborated on numerous articles in the medical literature and Butler herself wrote others on bacteriological and haematological topics which formed the basis of her successful application for a Doctor of Science (DSc) degree from the University of Melbourne in 1946.

Dr Gytha Betheras, a member of the hospital’s medical staff for many years from 1957, found Butler a very committed and competent colleague who was easy to work with, thoughtful and perceptive. She recalled that when suspicions about a possible infection with the dangerous "clostridium Welchii" bacteria arose after hours, Butler would be informed immediately whereupon she would promptly drive into the hospital from her home at distant Ferny Creek and remain until she’d performed the relevant tests on the patient concerned, advised on the most appropriate treatment, and checked on the patient’s progress.

World-renowned research biochemist, Professor James B. Brown, who joined the hospital in 1963 regarded Butler as "quite a force around the hospital". He recalled her taking stands on infection control despite meeting "some resistance" from a sub-section of the medical staff who considered they should have more involvement in the matter. Other sources confirm that she put some noses out of joint by her reluctance to provide details of the organisms involved in particular cases of infections, providing only her recommendations for treatment.

In 1971 she retired from the Royal Women’s Hospital having reached age 65 and having established a Bacteriology Department with a staff of 15. Indefatigable to the end, she promptly announced she had no intention of quitting research, as she had become extremely interested in chronic kidney infections and hoped to work part-time in that field. "So I’m probably giving up work to cart bricks," she told the Melbourne "Herald".

She was soon listed as a Senior Associate in Medicine at the Royal Melbourne Hospital, conducting research into kidney infections in the renal unit with leading kidney physician, Dr Ken Fairley. Dr Fairley’s wife, nephrologist, Professor Priscilla Kincaid-Smith, described Butler as "very definite in her opinions, very intelligent . . . and very impressive as a research worker". She continued with the research until close to her death from cancer in April 1975 despite great physical discomfort.

A few months later Hill used a retirement function for another staff member to reminisce about Butler, "a very wonderful bacteriologist who died recently...I would think that in her class she had no equal in the world. She is among the immortals. She came here in 1938 and found out for Australia what the conditions are...that complicate childbirth and abortion. They are quite different from the conditions that have this effect in other countries. In 1941 she developed a wonderful [smear] test. It used to take in those days with good bacteriology and a first class unit two or more days to culture a germ that was killing a woman. She couldn’t pick these damn things quick enough. These women were dying in a few hours. She sat down and, with a stroke of genius, and with special staining methods...she could decide in 30 minutes what this particular infection was. That’s been the basis of all our success in infection since that day."

Matron Betty Lawson used the occasion of her retirement function in 1976 to praise Butler and Hill, together with Dr Jack Laver, a former Medical Superintendent of the Hospital;
I’d like to pay a tribute to Dr Arthur Hill, Dr Hildred Butler and Dr Laver the members of the hospital’s first Infection Control Committee [in 1957] for their excellent contribution to this hospital and to the world in the control of obstetric infection from 1931 to 1960. In 1936 a management basis was laid down for “clostridium Welchii” infections and now the incidence is very limited. Dr Butler developed a quick smear test which enabled us to diagnose the ladies with this infection very quickly, and so they were well looked after. The active interest of this trio in infection control had a tremendous influence on the practice [of midwifery] in this hospital.

Hildred Butler made a major contribution to the health of countless women. As a tribute to her memory, Hill commissioned a portrait of her by artist Alan Martin in 1967 which he donated to the hospital some years later. In 2003 the hospital recognised her legacy in a formal way by establishing the Hildred Butler Fellowship in Clinical Microbiology and Infectious Diseases worth $40,000.

Archival/Heritage Resources

Royal Women's Hospital Archives

  • Betty Lawson’s farewell function,, 1975, A1993/3/76; Royal Women's Hospital Archives [ Details... ].
  • Book of Remembrance, 1956 - 1975; Royal Women's Hospital Archives [ Details... ].
  • Jean Crameri’s farewell function, 1975, Unaccessioned; Royal Women's Hospital Archives [ Details... ].

Published Resources

Book Sections

  • Attwood, H.D., 'Hildred Mary Butler (1906-1975), Microbiologist', in John Ritchie (ed.), Australian Dictionary of Biography, vol. 13, Melbourne University Press, Melbourne, 1993, p. 320. [ Details... ]
  • Max Swan, 'The Baker Institute Long Since, From Below', in Rod Andrew and Alf Barnett (eds), In Their Day; Memoirs of Alumni [of] The Baker Medical Research Institute, Hyland House, Melbourne, 1992. [ Details... ]
  • Robin, A. deQ, 'William James Penfold (1875-1941), Bacteriologist', in John Ritchie (ed.), Australian Dictionary of Biography, vol. 13, Melbourne University Press, Melbourne, 1993, pp. 197-198. [ Details... ]

Journal Articles

  • Anon, 'A Very Mad Party', The Lauristonian (Melbourne), December 1923, 1923. [ Details... ]

Newspaper Articles

  • Anon, 'Distinguished doctor dies of cancer', The Age (Melbourne), 16 April, 1975. [ Details... ]
  • Pilmer, Ann, 'Leaving the ward', The Herald (Melbourne) (Melbourne), 8 October 1971. [ Details... ]

Prepared by: Robyn Waymouth

Created: 10 November 2006, Last modified: 13 November 2006