Lady Doctors
Of the Malta Garrison
Elizabeth Herdman Lepper
1883 –1971

14 Elizabeth Herdman Lepper

CBE MB BS (Lond 1907)

3 July 1883 – 23 Dec 1971 [Falmouth]

In May 1916, Dr Louisa Aldrich-Blake, Surgeon at the Elizabeth Garrett Anderson Hospital and Dean of the London School of Medicine for Women, approached all the women on the Medical Register asking them to say if they would be willing to serve with the Royal Army Medical Corps. From the replies received, 48 lady doctors were enrolled. The first 22 medical women embarked for Malta on 2 August 1916; another 16 lady doctors embarked on the Hospital Ship (H.S.) Gloucester Castle on 12 August 1916.

The Director General Army Medical Services, Sir Alfred Keogh, was responsible for employing medical women and for dealing with illnesses among them. Women doctors, also referred to as lady doctors, were classed as civilian surgeons attached to the RAMC. Women serving as full time doctors in the Army and doing precisely the same work as their male colleagues had neither military rank nor status, but received the same pay, rations, travelling allowances and gratuity as temporary commissioned male officers of the Royal Army Medical Corps. A uniform was not introduced until after April 1918. This was similar in appearance to that worn by the Queen Mary's Auxiliary Army Corps (QMAAC) but with an RAMC badge on both lapels.

In October 1916, on hearing from the War Office that fifty more medical women were needed for service with the RAMC in English hospitals, Aldrich-Blake again negotiated with all the women who had qualified in the preceding ten years, and secured the requisite number in a very short time. On 20 October 1916, eleven medical women embarked on H.S. Britannic for Malta.

The casualties from operations in Gallipoli (25 April 1915 – 9 January 1916), and Salonica (October 1915 – 30 September 1918), were initially treated in Malta and Egypt, but in 1917, submarine attacks on hospital ships made it unsafe to evacuate from Salonica and five General Hospitals, Nos 61, 62, 63, 64 and 65, mobilized in Malta for service in Salonica to which the medical women were attached.

Between August 1916 and July 1917, eighty two lady doctors served in war hospitals in Malta. They worked alongside their RAMC colleagues and carried out all but administrative duties. Their assistance was very highly appreciated. Their work was recognized in the King's Birthday Honours list of June 1918 when Dr Barbara Martin Cunningham MB ChB, Military Hospital Mtarfa, Mrs Katharine Rosebery Drinkwater MB BS, in charge of Military Families Staff and Department Malta and Miss May Thorne MD, in charge of Sisters' Hospital and Staff Department Malta, were awarded the Order of the British Empire for services rendered during the war.

Service Record

Dr Elizabeth Herdman Lepper trained at the London School of Medicine for Women, graduating in 1907. She held the posts of House Physician and House Surgeon and Pathologist to the New Hospital for Women, Euston Road, Physician to outpatients at the South London Hospital and Assistant to the clinical pathologist Royal Free Hospital. In 1920, she became Pathologist to the Elizabeth Garrett Anderson Hospital, London.

Dr E. H. Lepper became a Richard Hollins Research Scholar in the cancer research department of the Middlesex Hospital and a Beit Memorial Fellow in medical research. She was a member of the Association of Registered Medical Women (later to become the Medical Women's Federation) and of the Pathological Society. Her experience in pathology embraced all branches, and she wrote papers on biochemistry, bacteriology, and morbid anatomy. Her later work included a report on granulosa cell tumours of the ovary at a time when little had been written on this subject.

July 1910 Resident at No 14 Gower Street, London W.C. Elected a member of the British Medical Association (Metropolitan Counties Branch). The Medical Directory of 1917 lists her address as No 42 Manor House, Marylebone Road, London N.W.

July 1916 Dr E. H. Lepper was in the first group of women doctors to join the RAMC. She was contracted to work for 12 months as a Civilian Surgeon attached to the RAMC. Her salary was 24 shillings a day, including allowances, but excluding duty transport. A gratuity of £60 was awarded at the end of the contract, provided employment had not been terminated for misconduct. Most of the medical women were invited to renew their contracts at the expiry of their first year's work.

Malta 2 Aug 1916 Embarked for Malta as part of the Women's Medical Unit RAMC.

Malta 1916 Together with J. A. Arkwright RAMC treated 16 patients with Blackwater Fever who had been invalided to St David's Hospital. They had contracted malaria in Macedonia between October 1916 and April 1917. Three patients died, the first on 14 March 1917, and the other two on 8 April 1917.

Malta 20 June 1917 Attached to No 65 General for duty with the British Salonica Force.

2 July 1917 – 25 July 1919 On duty at Salonica.

4 July 1917 Major E. W. Skinner (O/IC), 7 officers, 57 NCOs and men, 8 Lady Doctors, 1 Matron and 16 nurses left Malta on HMT ship Abbassieh. The transport was escorted by HMS Aster and HMS Azalea. HMS Aster struck a mine and sunk eleven miles off Malta with the loss of ten lives. HMS Azalea also struck a mine as she went to the aid of the stricken ship. The convoy returned to Malta and anchored in Marsaxlokk Harbour.

6 July 1917 HMT Ship Abbassieh sailed out of Marsaxlokk Harbour. She arrived at Suda Bay, Crete on 9 July and in Salonica, (Thessalonika) Harbour, on 11 July. No 65 General Hospital was erected at Hortiach which had been occupied by No 50 General Hospital. Seven medical women reported for duty at Hortiach on 30 July; Dr Blair and four nurses joined them on 2 August. The medical women were:

No 65 General Hospital became operational on 30 July 1917, when 200 patients were transferred from No 43 General Hospital. No 292 Pte Carrell was the first recorded death. He died on 17 August from cerebral malaria; the second and third deaths were from Bacillary Dysentery (Shiga group) on 26 and 27 August 1917 respectively.

3 June 1919 In the King's Birthday Honours list, was appointed Commander of the Most Excellent Order of the British Empire, (CBE), for valuable services rendered in connection with military operations in the Balkans.

1 Aug 1919 Contract expired.

4 Nov 1919 A meeting of the London Association of the Medical Women's Federation, held at 11 Chandos Street London, discussed the Medical work in the Mediterranean area during the Great War. Several lady doctors, who had been attached to the RAMC gave an account of some of their experiences. Dr Lepper presented particulars of a fulminating case of cerebral malaria in which the symptoms began four hours before death, and showed microscopical preparations from the post-mortem material. In addition, she illustrated with slides two further cases, one of black water fever, and another of liver abscess secondary to amoebic dysentery.

Dec 1919 Awarded a three year Beit Fellowship for medical research at the Department of Experimental Pathology, Lister Institute, London, where she investigated infections of the urinary passages with B. coli. The annual value of the fellowship was £300.

1920 – 1937 Appointed Pathologist to the Elizabeth Garrett Anderson Hospital London and held the post until her retirement in 1937, working also at the Lister Institute during part of this time. Dr. Lepper was skilful at improvisation. It was a saying in the department that should she be stranded on a desert island she would establish a working laboratory within weeks. She published a number of articles on biochemistry, pathology and bacteriology. Her publications included:

In 1937, Dr Elizabeth Lepper, had been examining gonadotropic substances of the urine in certain cases of carcinoma of the ovary, correlating the hormonal findings with the microscopical appearances of the growths. She had also been investigating the oestrin contents of ovarian tumours and cysts. This work had been conducted partly in the pathology department of the Royal Free Hospital, where assistance has been given by Dr Dorothy Vaux and partly in the laboratory at the Elizabeth Garrett Anderson Hospital.

Evidence of the presence of a small amount of folliculin was found in two germinal cysts of the ovary, and the frequent association of small follicular cysts with germinal cysts was considered to suggest the possibility that the folliculin may have reached the germinal cyst by the blood stream. The examination of folliculin cysts for folliculin had confirmed the findings of other observers.

The association of cystic ovaries with irregular uterine haemorrhages had been reached from the opposite angle; the changes described in the muscular coat and mucosa had been present. The main interest of Dr Lepper's results lay in the association found between the presence of these cysts containing high concentrations of oestrin and symptoms of metropathia haemorrhagica. 1

1937 On retirement she travelled the world for two years. She returned to England just before the outbreak of war in 1939 and settled in Falmouth, with her life-long friend Dorothy Christian Hare who was also a distinguished physician. She took an active interest in local artistic events, particularly those connected with the theatre. Her interests were many and varied and included travel and natural history. She loved music and played the violin.

23 Dec 1971 Died at home at Falmouth, aged 88 years.