This is extracted from a short article by Roger Gabriel published in the BMJ in 2003, when Gabriel was consultant nephrologist at St. Mary’s Hospital, Paddington. He had been Milne’s senior registrar at Westminster Hospital in the early 1970s, where Milne held the chair of medicine.

Malcolm Davenport Milne (1915-1991)

I have had the good fortune to work for and with physicians whose grasp and practice of medicine set them comfortably beyond their competent fellows. One such was Malcolm Milne for whom I worked as senior registrar at Westminster Hospital.

Milne   was an outstanding clinical scientist (FRS 1978). From a grammar school boy he grew into a short fat man, not given to self advancement. He was gruff on ward rounds, and shy in social matters, but not when discussing medicine, or giving one of his invariably entertaining lectures in his flat Mancunian accent. The speed and depth of his thinking and his replies to questions were impressive. It was a pleasure to observe, and at times uncomfortable to suffer from, his ability to ask simple questions that dissected unthinking statements.

Ward rounds were excellent: he knew everything and missed nothing. It was always instructive to accompany him to see patients referred to him by other physicians. Difficult cases made simple. Many unwell physicians consulted him – a ‘physician’s physician’.

I first heard of Milne when I was a house physician at Hammersmith Hospital, where he was invariably referred to as distinguished – an endorsement not frequently used in that establishment. I recall a small group of my fellows at Hammersmith wincing at the intellectual strength of Milne ripping through the traps they had set him for the Wednesday morning clinicopathological conference.

His first degree was in chemistry, which he applied to human metabolism. In the 1950s and 60s journals were peppered with his contributions. One piece with which Milne was pleased was his clarification of the tyramine monoamine-oxidase inhibitor interaction (the “cheese reaction”). His substantial reputation would have been enhanced further if he could have had the then undescribed aldosterone assayed from a hypokalaemic, alkalotic, hypertensive woman. He postulated its presence but had no method to detect an excess of a sodium retaining hormone. The following year the same patient consulted a Dr. Conn.

Using himself and staff for experimental purposes was part of Milne’s practice.  On my first day on his unit I was recruited to save my dejecta for three weeks and later learnt the art of stool blending. Unfortunately a rival unit published before our assays were completed.  Milne did not replicate others’ findings. Homogenates and aliquots were discarded. Instead we drank amino acid slurries.

Milne taught me to ask obvious questions. I am grateful for his influence.

Roger Gabriel (consultant nephrologist, St. Mary’s Hospital, London)

(first published in BMJ  2003; 327: 479)

Last Updated on November 5, 2025 by John Feehally