Lives of the fellows

William Fletcher

b.11 October 1872 d.18 September 1938
BA Cantab(1893) MB BCh Cantab(1896) MD Cantab(1910) MRCP(1926) FRCP(1933)

William Fletcher was born in 1872, the son of the Rev. John Price Alcock Fletcher, of Burbage, Leicestershire, and Mary Ann Darker Banks. He entered Caius College, Cambridge, in 1890, took honours in the natural sciences tripos and obtained a scholarship to St. Mary’s Hospital, Paddington, from which he qualified in 1896. He held a resident appointment at the Metropolitan Hospital, and then spent several years in general practice in Coventry before entering the Malayan Medical Service in 1903.

He was posted first to the State of Perak and then to the State of Selangor as district surgeon. In 1907 he was seconded to the Institute for Medical Research at Kuala Lumpur to assist Dr Henry Fraser and Dr Thomas Ambrose Stanton in their nutritional investigations which culminated in proof that beri-beri is a disease of deficiency caused by a diet of rice from which the outer layers have been removed by over-milling.

In 1909 he was appointed to the Institute as pathologist. His studies of an outbreak of plague in Kuala Lumpur in 1911 are the most complete in the annals of the Institute; his clinical records on blackwater fever collected in 1912 and 1913 are the most detailed Malayan records of this disease, and his observations on the Wasserman and Luetin reactions in leprosy have that lucidity of presentation which marks all his technical writing.

Returning to Malaya in 1919 after service in the Middle East and as a pathologist in the University War Hospital, Southampton, he did much to re-establish confidence in the use of quinine and the cinchona alkaloids for the treatment of malaria, and by his critical observations dispelled the fear then prevalent in Malaya that some cases were resistant to quinine. He confirmed the value of cinchona febrifuge (Bull. Inst. med. Res. Kuala Lumpur, 1925, no. 3), proved the dangers of rectal quinine, and exposed the risk of careless quinine injections, re-affirming the efficiency and sufficiency in most cases of simple oral quinine, and bringing a breath of sanity to the therapeutic extravagances of the post-war period.

As with malaria so with dysentery, Fletcher’s work had a salutary effect on the patterns of therapy. With Miss Margaret Jepps he made a clinical, bacteriological and protozoological study of a series of one thousand cases, explored the fallacy of emetine-resistant amoebic dysentery, and showed the futility of serum treatment in half-starved debilitated cases of bacillary dysentery (Stud Inst. med. Res. Kuala Lumpur, 1927, no. 19).

He was also well-known for the work he had done with A. T. Stanton on melioidosis (Bull. Inst. med. Kuala Lumpur, 1924, no. 5; Stud. Inst. med. Res. Kuala Lumpur, 1921, no. 16; 1932, no. 21).

Fletcher became director of the Institute in 1926 and retired the next year. His best known contributions to medicine came during his last three years in Malaya and are recorded most completely in the Studies and Bulletins of the Institute. Then, in quick succession, from the confusion of the undiagnosed fevers of Malaya he sifted tropical typhus in 1924, leptospirosis in 1925, and the tsutsugamushi disease in 1926, his findings being published in the Transactions of the Royal Society of Tropical Medicine and Hygiene in 1928 and 1929. The significance of this work, not only to the medical officer in Malaya, but to the scientific world, needs no emphasis.

After retirement from Malaya Fletcher lived quietly in London. He was a member, and sometime secretary, of the Colonial Medical Research Committee, and vice-president from 1933 to 1935 of the Royal Society of Tropical Medicine and Hygiene. He served on the Malaria Commission of the League of Nations Health Organisation, and his excellent reviews in the Tropical Diseases Bulletin on malaria and typhus will long be remembered by workers in these fields. But his health was not good and his activities were much restricted. In September of 1938, after a fortnight of anginal pain, he developed a fatal coronary thrombosis.

In 1915 he married Mary Beatrice Hillman, by whom he had a son and a daughter.

Richard R Trail

[Brit.med.J., 1938, 2, 815-16; Lancet, 1938, 2, 808.]

(Volume V, page 138)

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