Donald started his postgraduate medical training at the end of the 1930s, and planned to specialise in obstetrics with a position in Obstetrics and
Gynaecology at St Thomas. He started his
residency in 1939. In 1946 he was awarded an
MBE for bravery. By 1952, Donald and Young had built a new medical negative-pressure respirator that they demonstrated at a Physiological Society meeting in the
Royal Free Hospital.
Trip spirometer Later in 1952, Donald resigned his role at St Thomas's Hospital Medical School to take up a position as a
reader at the Institute of Obstetrics and Gynecology at
Royal Postgraduate Medical School located in
Hammersmith Hospital. At the medical school, Donald continued his research into neonatal breathing disorders. He worked to improve the device that he and Young had built: the servo patient-cycled respirator . While at the school, Donald worked on a third device: a positive-pressure respirator. Donald found that the negative-pressure device he had built with Young was not ideal, as it was complicated to set up, difficult to use, and required more than one person to operate; It sent a stream of oxygen mixture onto the baby's face and the device could be applied to an ailing infant in under a minute.
Obstetric ultrasound Whilst Donald was Professor of Regius Midwifery at Glasgow University, he first explored the use of obstetric
ultrasound in the 1950s in a collaboration with
John MacVicar, a
registrar and obstetrician in the Department of Obstetrics and Gynaecology at the Western Infirmary, and
Tom Brown, an industrial engineer who worked for
Kelvin & Hughes Scientific Instrument Company, developed the first contact compound sector scanner, The article contained the first published ultrasound image of a fetus. The development of Donald's interest in ultrasound started when one of his patients introduced her husband to him. The patient's husband was the director of the boiler fabrication company
Babcock and Wilcox, and he offered a tour of the plant to Donald, who accepted.When he returned to the hospital, Donald's goal was to find an ultrasound machine that he could continue to experiment with. He obtained a Kelvin Hughes Mark lIb supersonic flaw detector from
William Valentine Mayneord at the
Royal Cancer Hospital. Brown immediately looked up Donald and arranged a meeting. When they met, Brown noticed that the Mark lIb was not manufactured by Kelvin & Hughes, but instead had been manufactured under contract. He also noticed that the machine had been converted from using a double probe, one to produce pulses and one to receive the pulses, to a single probe. Brown phoned Alex Rankin, the man who collaborated with Brown on the automatic flaw detector for help and who later became director of the department of Medical Ultrasonics at the company. Rankin offered to gift the latest Mk IV flaw detector, which was subsequently forwarded to
Glasgow Central station from the
Barkingside Labs location for delivery to Brown. Rankin also spoke to the three directors at the company who decided to vote £500, a considerable sum in those days to support experiments. The new machine considerably improved on the older machine with the difference being described as "chalk and cheese" by Donald. The Mk IV was a double transducer probe machine. For Donald, the camera was particularly significant, as it enabled a record to be kept, an archive of images to be created that could be printed in published works. Donald set about establishing a framework of use for the device, how it could be used, what the information on the screen meant. By 1956 Donald and MacVicar became proficient with the machine after scanning 250 patients. For most of that period, they had tried to determine why particular scans produced a particular image. They discovered that if there was fluid in the abdomen, e.g. an
ovarian cyst, there would be a clear gap in the image until the ultrasound reached the other side of the cyst. The images produced by the device were still of poor quality and many still felt there was no future in the new machine. Brown felt that the A-scope presentation was incompatible with the nature of the problem, To start building the new scanner, Donald sent a letter to Ted Smith, a London-based salesman of Kelvin & Hughes, which became part of
Smiths Industries. After Brown delivered his spiel to Halliday, it was several months before Brown received a reply in the form of a memo, which stated that £500 had been allocated by Smiths for the development and that Brown was able to spend half a day per week working with Donald. In the same year, Donald started to experiment with taking images of pregnancy, and discovered that their original theories about ascites were correct. In a landmark paper on 7 June 1958 published by Donald, McVicar and Brown discussed the development of the A-mode scanner and decisions that led to the B-mode scanner. Donald and McVicar also described the first successful diagnosis using obstetric ultrasound with the B-mode machine, which occurred when a woman patient was diagnosed with terminal cancer of the stomach using traditional clinical methods, palpation and by X-ray. The paper highlighted the importance of the instant feedback that was available from the operating room to improve the quality of the image. Also described in the paper was a description of testing of ultrasound on the brains of kittens to determine if there was any obvious changes in tissue structure: there was none.In 1958, Brown and the engineers at Hughes started work on the new automatic scanner. The probe was mounted in a steel ball connected to a column suspended from a gantry that oscillated. When it was at a 30° angle to the
normal of the skin, sensed by what Brown described as "rather indelicate looking projections on either side of the ball", the motion was reversed and the gantry supporting the column moved about 15 mm, and the process was repeated. The scans could be done in the longitudinal plane, i.e. up or down the abdomen lengthways, rather than only across the width. the original £500 allocated to the project had stretched into thousands of pounds and the company could no longer afford it. Glasgow University had established links with Lund University since
John Martin Munro Kerr's time. and Donald found that fetal echoes were visible at an early stage, which led to the distinction between a case of threatened abortion and a case with a hydatidiform mole, both with bleeding. Donald presented the results of the experiments at a meeting of the
Royal Society of Medicine on 12 January 1962. By 1970, Donald could image fetal development during pregnancy using the Diasonograph, which led to new criteria diagnosing pregnancy failure, and resulted in his techniques being widely adopted as standard clinical practice in the 1970s. ==Queen Mother's Maternity Hospital==