Dr Honor Smith

In the mid-1940s tuberculosis was one of the great killing diseases; and tuberculous meningitis was universally fatal. The use of Streptomycin as a treatment (first in 1945, in the United States) was a tremendous advance and it provoked Honor Smith, under the guidance of Hugh Cairns of the Neurosurgery Unit at the Radcliffe Infirmary, into her main life's work - the creation and running of the Tuberculous Meningitis Unit in Oxford. This became world-famous and is remembered still by those (in India for example) who visited it and learnt from it.

With a background training in neurosurgery Smith evolved management techniques which led to the best results anywhere, from the beginning in 1946 to the 1960s, when tuberculosis was disappearing from Western society. She used methods of observation, recording and prospective study which were way in advance of her time.

Smith travelled widely in Africa, teaching and advising, and was associated with Salisbury University. She became May Reader in Clinical Medicine in Oxford University (1954-61). Because of her expertise in tuberculosis of the nervous system she was appointed Honorary Consultant Neurologist to the Army's specialist neurology unit, Wheatley Military Hospital, and for her work there was appointed OBE in 1962.

Honor Smith was born in 1908, the sixth of seven children of Vivian Smith, a banker, later the first Lord Bicester. She was educated at home and when she was 17 her governess encouraged her to enter for matriculation at London University; an unusual step for girls in her circle. In other ways Honor continued the life expected of her: being presented at Court, travelling and, her greatest enjoyment, hunting.

At 25 she was faced with a choice: becoming Master of Hounds of the Bicester Hunt or a medical student. She chose the latter, mainly because of her mother's influence. Sybil Smith, daughter of the sixth Earl of Antrim, was a close friend of Lady Barrett, Dean of the London School of Medicine for Women, where Honor enrolled. She flourished there and later at the Royal Free Hospital, where she met Alice Stewart, her mentor and lifelong friend. Honor Smith's student life was distinguished by her insistence on taking Wednesdays off for hunting.

After qualifying in 1940 Smith worked at the Elizabeth Garrett Anderson Hospital (evacuated to St Albans) and then moved to Oxford. She worked in Herbert Seddon's Nerve Injuries Unit and in 1943 moved to Hugh Cairns's Neurosurgery Unit at the Radcliffe Infirmary. She was Rockefeller Fellow at Boston Sick Childrens' Hospital in 1948, and took her London MD that same year.

In 1959, at the request of the World Health Organisation, Smith went to Morocco, with John Spalding, to advise on an epidemic of "paralysis" (quickly traced to cooking oil contaminated with orthocresyl- phosphate). Throughout these years she developed her work in clinical neurology, publishing many original papers, on meningitis, and also on multiple sclerosis (another, albeit less fruitful interest). She retired in 1971.

Smith was Research, then Additional Fellow at St Hugh's College from 1950, and later an Honorary Fellow. Her college work included being Garden Steward. She was also linked with Chelsea Physic Garden, in London. Her circle in the academic and other worlds was wide, including many distinguished women, among them Kathleen Kenyon, Janet Vaughan, Edith Bulbring and Isobel Henderson, all constant visitors to her house in Park Town, north Oxford.

Honor Smith had more friends than most, but was intimate with very few. Her devotion was to her family. On retirement she went to live in Herefordshire. There she continued her tradition of hospitality and fine cooking, and created a garden out of a wilderness. She had time to indulge her favourite sport, fishing, catching her last salmon at the Hirsel, the Berwickshire seat of Lord Home of the Hirsel, when she was 80.

Her friends talk of her kindness and generosity, but most of all about her lively, entertaining and erudite talk. My memory is of the crescendo of her laugh as she approached the scurrilous climax of a story. She was the greatest good company and the delight of her circle.

Judith Hockaday

Honor Mildred Vivian Smith, physician: born 13 November 1908; Senior Research, Additional, later Honorary Fellow, St Hugh's College, Oxford 1950-95; Reader in Medicine, Oxford University 1954-61; Consultant Neurologist, Military Hospital, Wheatley 1954-62; OBE 1962; died 18 January 1995.