biographies

Hill, Arthur Machen “Bung” (1903 - 1979)

OBE, MD BS DGO FRCS FRCOG FAustCOG FTCS

Born
22 October 1903
Castlemaine, Victoria, Australia
Died
20 January 1979
Mt Eliza, Victoria, Australia
Summary

Prepared by Ann Westmore PhD

Arthur Machen (“Bung”) Hill helped to substantially improve the survival rates of women in Victoria following childbirth and complications associated with miscarriage and abortion. Through collaborative research undertaken in the 1930s with Hildred Butler, a bacteriologist then working at the Baker Medical Research Institute, he helped identify the infectious agents capable of killing women of childbearing age within a couple of hours of causing symptoms of illness.

The collaboration produced findings of international significance and was the springboard for Butler’s transfer from the Baker Institute to the Women’s Hospital in 1938 and her subsequent development of a smear test to identify life-threatening infectious agents within 30 minutes, followed by the introduction of targeted, specific treatment.

After serving as the hospital’s Medical Superintendent, 1933-35, Hill was appointed a member of the honorary gynaecological staff, 1938-63. During this time, he taught medical and nursing staff and students, and contributed to clinical practice through infection control, family planning, artificial insemination, and an influential appraisal of cervical cancer treatment. After retiring in 1965, he was appointed an honorary consulting surgeon, and continued in private practice.

Details

“Bung” Hill was born on 22 October 1903 at Castlemaine, central Victoria, the son of Dr Arthur Machen Hill, at one time a Resident Medical Officer at the Women’s Hospital and, later, Resident Surgeon at the Castlemaine Hospital, and his wife, Emily Maude née Johnson. He was the third of four siblings, and the second of three boys. He was educated at the Castlemaine South State School and Castlemaine High School until 1918 when he was admitted to Wesley College as a day student on a scholarship. From there, he gained admission to the University of Melbourne and studied medicine (graduating 1927).

The origin of the nickname, “Bung”, is uncertain. RWH Honorary Historian, Dr John Nattrass, was told it stemmed from sounds Hill made as a child when playing with a pop-gun in the front garden. A friend for many years (thought to be Dr Bill Cook) suggested it pertained to backyard cricket when a kerosene tin was used as a wicket. (“Bung good at it so tin-arse, bung-arse, and then bung.”) Whatever its origins, the nickname stuck and became so strongly associated with him that it created difficulties for people trying to locate him via the telephone book.

Harvesting riches
Dr Donald Lawson, a contemporary from Castlemaine who, like Hill, became Medical Superintendent at the Women’s Hospital, remembered their childhood amid “the rough, austere terrain of Castlemaine” as one of “rich veins . . . for those who would seek them”. Lawson said that; “One rich vein Bung struck was a spinster schoolteacher - Jessie Robertson – a great lover of, and exponent of the English language, both written and spoken. Bung’s father wrote a book of verse, so there was something in the genes, but Jessie Robertson began a cultivation of it that Bung has carried on to the present day.”

It seems that Robertson contributed to him becoming one of the hospital’s “few superlative speakers” with a style Nattrass characterised as milking the outrageous word, image or action and delivering sentences in a clipped, rapid-fire intonation: “Bung as a lecturer, had the flow that a lecturer must have and the brain to use it and to keep feeding it material. He employed words like vivid, dramatic, colourful and exotic which, if you stop to think about it, applied to what he said, the way he said it, and indeed to him who said it. As well as bravuras [sic], he was capable of meticulous, terse wording [and] economy of expression, which he often rehearsed carefully.” Hill’s ability with words also made an impression on Dr Harold Attwood, who was interviewed by him for the position of RWH Assistant Pathologist in London in 1960. Attwood described Hill as having; “a great personality, widely read and with an ability to write well…He had an enormous vocabulary, but a curious penchant for swear words. To his friends these words added pungency to his talk, but could distress others.”

He was “a character” around the hospital, notorious for his unpunctuality as well as for his quick wittedness and for the value he placed on the same qualities in others. Attwood, having turned up late for his interview in London, subsequently attributed his success in gaining the RWH position to his lack of punctuality. While often running late himself, Hill rarely failed to keep a commitment once made. On one memorable occasion when he missed giving an 11am lecture at the hospital to medical students, he arrived instead at 1am the day after the day after he was supposed to give it. According to Nattrass, “We were hauled down to the labour ward in our pyjamas to be lectured,” the labour ward being the warmest place in the hospital on a cold winter’s night.

The quest of a lifetime
After graduating in medicine, Hill completed a comprehensive resident medical officer training at the Alfred, Children’s and Women’s Hospitals. His successful completion of a Melbourne MD (Doctor of Medicine degree in 1931) suggests a strong interest in clinical research and a desire to gain solid foundations for what became a life-long quest to identify the causes of obstetric infections and to develop ways of controlling them.

In 1933, his first year as Medical Superintendent of the Women’s Hospital and the year in which he obtained his Diploma in Obstetrics and Gynaecology, 15 women died due to infections after giving birth, and 25 after miscarriages or abortions. The following year, the combined death toll was even higher, totalling nearly 50.

Obstetric mortality rates in Victoria were at alarming levels (being 61 per 10,000 deliveries in 1934, 30 times higher than in 1971) and it was a common occurrence in wards to see women having; “sweats and rigors, high fever and tachycardia, pallor and collapse, jaundice and cyanosis, distension and dyspnoea, foul and purulent discharges, anuria, incontinence, delirium, and the muffled movements of the mortuary trolley.” The burdens of nursing and medical care, often without hope, were appalling, he said years later.

Between 1931 and 1937, Hill and Hildred Butler, a young bacteriologist working at the Baker Medical Research Institute, identified four bacteria that were responsible for most of the serious infection complicating childbirth, miscarriage and abortion among women admitted to the hospital. They described the agents – “clostridium Welchii” (now known as “clostridium perfringens”, “haemolytic streptococci”, “anaerobic streptococci” and “staphylococcus pyogenes” - as “the most colourful and dramatic infections in obstetrics”.

The speed with which “clostridium Welchii” could kill (a couple of hours) made swift diagnosis and specific treatment imperative. Between 1931 and 1960, the hospital cared for some 200,000 women who gave birth or who were treated following miscarriage or abortion. A total of 429 died from the four infectious agents with “clostridium Welchii” the most dangerous (accounting for 147 deaths), followed by “haemolytic streptococci” (101 deaths), “anaerobic streptococci” (59) and “staphylococcus pyogenes” (22).

In 1935, addressing the Royal Society of Medicine in London on “Post-abortal and Puerperal Gas Gangrene”, Hill reported on 30 cases diagnosed and treated at the Women’s Hospital during the two years that he was Medical Superintendent. It was the largest personal series published to that time and, in the pre-antibiotic era, it was regarded as a major advance.

In his lecture he described, for the first time, the six chief clinical varieties of “clostridium Welchii” infection in women “each as distinctive as a primary colour in the solar spectrum”. Four of these six types were responsible for deaths in women, which occurred after progressive haemolytic jaundice degenerated into profound collapse, and uterine gangrene accompanied by excruciating pain in the uterus or muscles. The report of his address, published in the “Journal of Obstetrics and Gynaecology of the British Empire” in 1936, won him the British Medical Association’s biennial award, the Katherine Bishop Harman Prize in Obstetrics. While he was overseas he also secured the degrees M(R)COG in 1935 and FRCS(Edinburgh) in 1936.

During the 1940s and 1950s much of the infection control work that Hill and Butler pioneered came to fruition at the Women’s and at other hospitals throughout Australia. Bruce Mayes, Professor of Obstetrics and Gynaecology at the University of Sydney, said that while Sydney had its famous bridge and beautiful harbour, Melbourne had Hill and Butler. Together with Dr Jack Laver, they formed the hospital’s first Infection Control Committee (established 1957) which challenged numerous long-held practices and was a model for similar committees in other hospitals.

Dr Gytha Betheras, a member of the hospital’s medical staff for many years from 1957, said that Hill and Butler formed a remarkable team, combining clinical judgment and expertise with innovative and astute bacteriology. They were totally available to staff whenever a case of “clostridium Welchii” was suspected or diagnosed and, due to their combined efforts, management of the infection was revolutionised. She said they saved many lives and much morbidity firstly by developing faster diagnosis and better treatments, secondly by teaching and supervising countless doctors, nurses and bacteriologists in improved practices, and thirdly by their international advocacy of new approaches to controlling obstetric infection.

Later interests
Apart from obstetric infection, Hill’s other major clinical interests were contraception using the intrauterine device known as the Gräfenberg ring; artificial insemination to treat infertility; and cancer surgery. In work with close friends, Drs Graham Godfrey (cancer surgeon), and Kevin McCaul (anaesthetist) he reappraised the treatment of uterine cancer and, in particular, the acceptability of the Wertheim operation.

In 1966, the year after his retirement from the hospital, he was awarded the degree of Master of Gynaecology and Obstetrics (MGO) and, for many years, he was the senior Fellow of the Royal College of Obstetricians and Gynaecologists in Victoria.

He was short, slim and bald-headed with long sideburns, and was known for his natty dress and unfailingly alert and twinkling eye. His sense of perpetual youthfulness was perpetuated by having a family (a son and a daughter) in his fifties, after marrying Czechoslovakian former ballerina, Mrs Ilona Semark.

As time went on his gregariousness became legendary, with Nattrass praising him for helping develop the dining-together habits of the hospital’s staff. Fittingly, when he retired in 1965, he shared a “wake” with Drs Colin McDonald and Bill (J. R.) Rawlings, during which Lawson gave a memorable homily.

Final years and a lasting legacy
He enjoyed an active retirement, continuing in private practice and dining regularly with colleagues such as Drs Frank Forster and Bryan Gandevia. A regular attendee at hospital functions, he was renowned for removing his hearing aid when bored with a speaker.

He experienced several health crises in the last two decades of his life, and died in his sleep on 20 January 1979 at his Mt Eliza holiday home. Afterwards, his friends gathered annually for the “Bung Hill luncheon” at which some of his provocatively ribald phrases and challenging assessments of colleagues were aired.

As well as a very substantial clinical legacy, his contribution was lasting in other ways as well. Nattrass considered that if the function of a doctor was to cure sometimes, relieve often and comfort always, Bung Hill did this more than most, and not just to his patients but to his friends and colleagues, both figuratively and actually.

Many suggestions were made about how to honour him after his death, and at least one was acted on. In 1980 a plaque was unveiled in Ward 53 which bore the following inscription;

“To commemorate the services to the Royal Women’s Hospital of Arthur Machen Hill (affectionately known as ‘Bung’) c 1903-1979, Member of Honorary Medical Staff 1938-63.
From 1936 a world authority on puerperal and abortal infections, especially those due to clostridium Welchii. He also re-appraised the place of radical surgery in the treatment of carcinoma of the cervix.”

His family also donated to the hospital a portrait of him by artist, Alan Martin.


Sources;

H D Attwood, ‘Recollections of Arthur Machen Hill’ delivered at his funeral on 26 January 1979 (typewritten); RWH archives;

Dr John Nattrass; ‘Dr Arthur Machen Hill – Obituary’, “RWH Bulletin”, 12, 1, 1979, p. 1;

Arthur M. Hill, ‘The R.D. Fetherston Memorial Lecture; Why Be Morbid? Paths of Progress in the Control of Obstetric Infection, 1931 to 1960’, “Medical Journal of Australia”, 1964, I, pp. 101-111;

Drs Donald Lawson and John Nattrass, ‘Reflections on Arthur Machen Hill on the occasion of a meeting held on 31 January 1979 at the College of O&G following his death on 20 January 1979’ (typewritten); Notes from a ‘Bung’ Hill luncheon, archived at the RANZCOG;

Donald Lawson, Speech in 1965 held at a function to honour three retiring doctors, Colin McDonald, Arthur “Bung” Hill, and Bill Rawlings (typewritten); RWH archives

Freda Irving, ‘They planned to be wed secretly’, “The Argus”, 24 October 1951;

Karen Kissane, ‘Top doctor and a top character’, “The Age”, 25 January, 1979;

Death notices, “The Age”, 25 January 1979;

‘Obituary Arthur Machen Hill’, “Medical Journal of Australia”, 1979, II, p. 33;

Anon, ‘Gynaecologist of world repute dies’, “The Age”, 23 January, 1979;

“Victorian Year Book”, 1973, p. 541;

Personal communication, Gytha Betheras, Bryan Gandevia and Prue Forster to Ann Westmore.

Archival/Heritage Resources

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

  • Notes from a ‘Bung’ Hill luncheon, 31 January 1979; Drs Donald Lawson and John Nattrass; Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) [ Details... ].

Royal Women's Hospital Archives

  • Recollections of Arthur Machen Hill, 26 January 1979, A1990/05/24 part; H D Attwood; Royal Women's Hospital Archives [ Details... ].
  • Speech in 1965 held at a function to honour three retiring doctors, Colin McDonald, Arthur “Bung” Hill, and Bill Rawlings, 1 January 1979, A1990/05/24 part; Lawson, Donald; Royal Women's Hospital Archives [ Details... ].

Published Resources

Edited Books

  • Victorian Year Book, Australian Bureau of Statistics, 1973. [ Details... ]

Journal Articles

  • Anon, 'Obituary Arthur Machen Hill', Medical Journal of Australia, II, 1979, p. 33. [ Details... ]
  • Hill, Arthur M., 'The R.D. Fetherston Memorial Lecture; Why Be Morbid? Paths of Progress in the Control of Obstetric Infection, 1931 to 1960', Medical Journal of Australia, I, 1964, pp. pp. 101-111. [ Details... ]

Newspaper Articles

  • Anon, 'Gynaecologist of world repute dies', The Age (Melbourne), 23 January, 1979. [ Details... ]
  • Anon, 'Death notices - Arthur Machen Hill', The Age (Melbourne), 25 January 1979. [ Details... ]
  • Irving, Freda, 'They planned to be wed secretly', The Argus (Melbourne), 24 October 1951, p. 8. [ Details... ]
  • Kissane, Karen, 'Top doctor and a top character', The Age (Melbourne), 25 January, 1979. [ Details... ]

Prepared by: Robyn Waymouth

Created: 15 November 2006, Last modified: 25 November 2006