Pioneering physician with formidable scientific intellect

When Margaret Turner-Warwick, who has died aged 92, entered the field of respiratory medicine in the 1950s, it was a time of great change. Effective treatment for tuberculosis had recently been introduced, and the adverse effects of cigarette smoking on the lung were beginning to be appreciated.

The focus of academic research had been limited to understanding and measuring lung function, but with her colleagues Jack Pepys and Deborah Doniach, she expanded it to include the immunology of the lung, and particularly of the fibrosing lung diseases. She showed that they were associated with autoimmune diseases, rheumatoid arthritis, systemic sclerosis and the severe form of lupus known as systemic lupus erythematosus, and she demonstrated the presence of relevant autoantibodies in the blood.

Anticipating modern “personalised medicine”, she distinguished between different patterns of fibrosing lung disease, to identify the minority of patients who would respond well to steroids and the majority who would not, and for whom modern biological treatments are now being introduced.

Similarly, in her other major area of interest, asthma, she recognised different clinical patterns, based on differences in the patterns of peak flow records – rates of forceful exhalation – requiring different treatments. She was also responsible for several early clinical trials, most notably with inhaled corticosteroids, that have formed the mainstay of modern treatment. Her recognition of the importance of immunological mechanisms in lung disease led to the publication of many research papers and of her book Immunology of the Lung (1978).

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Humanity

Turner-Warwick combined a formidable scientific intellect with the humanity of an exceptional physician, and played a fundamental role in the development of modern respiratory medicine.

Born in London, she was the daughter of William Harvey Moore, QC, and his wife, Maud (née Baden-Powell). She decided on a career in medicine from an early age, and in 1943 went from St Paul's girls' school, west London, on an open scholarship to Lady Margaret Hall, Oxford, one of a quota of 7 per cent of female medical students admitted to the university in her year.

After completing her clinical training and early posts at University College and Brompton hospitals in London, in 1961 she was appointed a consultant physician at Elizabeth Garrett Anderson hospital, and six years later to a part-time consultant post at Brompton and London Chest hospitals and a senior lectureship at the Institute of Diseases of the Chest. When, in 1972, she became professor of medicine (thoracic medicine) at what had now become the Cardiothoracic Institute, University of London, she was, with Sheila Sherlock at the Royal Free hospital, one of only two women professors of medicine in London. She served as dean of the institute (1984-87), which is now part of the faculty of medicine of Imperial College London, and in 1991 was made a dame.

Tuberculosis

Turner-Warwick’s understanding of patients’ concerns was informed by her own time as a patient. During her final year at Oxford in 1946, before the advent of effective antibiotic treatment, she was diagnosed with pulmonary tuberculosis and treated for a year in a sanatorium. The year she spent there brought her into close contact with fellow patients, whose hopes and fears she came to understand.

Her growing reputation as a physician led to patients with uncommon and, on occasion, unrecognised respiratory diseases being referred to her from throughout the UK. Physicians from around the world visited Brompton hospital to learn from her clinical insights and experience and she was invited to lecture widely in the UK and abroad, particularly in the US and Australia.

She combined her career with a very happy family life. In 1950, she married Richard Turner-Warwick, a surgeon who specialised in the reconstruction and functional restoration of the urinary tract, and they had two daughters, Lynne and Gillian. She took particular pride in Lynne and her granddaughter Tabitha following her into medicine. A keen artist, she painted watercolours, often of the Dorset coast, for her Christmas cards.

Asked about how she had coped with a professional world dominated by men, she said that being in a small minority at Oxford had taught her to take no notice. She nonetheless became a role model for the many women who entered medicine in the subsequent generation.

She is survived by Richard, her daughters, four granddaughters and two grandsons, and four great-grandchildren.

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