1920 to 1928 On qualifying, Wills decided to research and teach in the department of Pregnant Pathology at the Royal Free. There she worked with Christine Pillman (who later married Ernest Ulysses Williams
OBE, a doctor on its teaching staff) who had been at Girton at the same time Wills was at Newnham, on metabolic studies of pregnancy.
To India In 1928 Wills began her seminal research work in India on
macrocytic anaemia in
pregnancy, a condition where the red blood cells are larger than normal. This was prevalent in a severe form among poorer women with dietary deficiencies, particularly those in the textile industry.
Dr Margaret Balfour of the
Indian Medical Service had asked her to join the Maternal Mortality Inquiry by the
Indian Research Fund Association at the
Haffkine Institute in Bombay, now
Mumbai. Wills was in India between 1928 and 1933, mostly based at the Haffkine. From April to October 1929, she moved her work to the
Pasteur Institute of India in
Coonoor (where
Sir Robert McCarrison was Director of Nutrition Research). In early 1931 she was working at the Caste and Gosha Hospital in Madras, now the Government Kasturba Gandhi Hospital for Women and Children of
Chennai (see
Gosha woman). In each of the summers of 1930–32 she returned to England for a few months and continued her work in the pathology laboratories at the Royal Free. She was back at the Royal Free full-time in 1933, but there was another 10-week working visit to the Haffkine Institute from November 1937 to early January 1938. On this occasion, and for the first time, Wills travelled by air to
Karachi and onward by sea. She travelled to India in October 1937 by air, a five-day journey on
Imperial Airways's recently inaugurated route carrying mail and some passengers. The aircraft was a Short 'C' Class
Empire flying boat, the Calypso, G AEUA. The route started at Southampton and involved landings on water for refuelling at Marseilles, Bracciano near Rome, Brindisi, Athens, Alexandria, Tiberias, Habbaniyah to the west of Baghdad, Basra, Bahrain, Dubai, Gwadar and Karachi, with overnight stops at Rome, Alexandria, Basra and Sharjah (just outside Dubai). This was the first IA flight to go beyond Alexandria. In Bombay Wills was on dining terms with
the governors and their wives at
Government House –
Sir Leslie Wilson in 1928 and
Sir Frederick Sykes in 1929. In 1929 she visited
Mysuru and wrote to her brother that "I was most fortunate to be under the wing of
Sir Charles Todhunter, who is a very important person there." Todhunter had been Governor of Madras and in 1929 was the secretary to the
Maharaja of Mysuru.
Anaemia of pregnancy Wills observed a correlation between the dietary habits of different classes of Bombay women and the likelihood of their becoming anaemic during pregnancy. Poor Muslim women were the ones with both the most deficient diets and the greatest susceptibility to anaemia. This anaemia was then known as '
pernicious anaemia of pregnancy'. However, Wills was able to demonstrate that the anaemia she observed differed from true pernicious anaemia, as the patients did not have achlorhydria, an inability to produce gastric acid. Furthermore, while patients responded to crude liver extracts, they did not respond to the 'pure' liver extracts (vitamin B12) which had been shown to treat true pernicious anaemia. She postulated that there must have been another nutritional factor responsible for this macrocytic anaemia other than vitamin B12 deficiency. For some years this nutritional factor was known as the 'Wills Factor', and it was later shown, in the 1940s, to be folate, of which the synthetic form is
folic acid. Wills decided to investigate possible nutritional treatments by first studying the effects of dietary manipulation on a macrocytic anaemia in albino rats. This work was done at the Nutritional Research Laboratories at the Pasteur Institute of India in Coonoor. Rats fed on the same diet as Bombay Muslim women became anaemic, pregnant ones dying before giving birth. The rat anaemia was prevented by the addition of yeast to synthetic diets which had no vitamin B. This work was later duplicated using rhesus monkeys as the rat results were tainted by a lice infection which may have skewed those results. They studied the source of anaemias, protein and vitamin deficiencies there. Their work was based on some flawed assumptions about the causes of these issues, while at the same time their recommendations were responsible for the introduction of free iron tablets for anaemic pregnant women and attempts to provide infants and children with increased protein intake through feeding programmes at schools and health centers. ==Personal life==