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Dalton believed PMS and postnatal syndrome were caused by lack of the hormone progesterone. Her treatments, with diet and large doses of progesterone, were based on her trials and her patients’ experiences. They have not been universally sanctioned by the medical establishment. Some doctors feel that PMS is more a psychological condition than a physical one; others prefer to use selective serotonin re-uptake inhibitors. Yet many of Dalton’s patients hailed her as the first — and almost the only — doctor to address a condition that undermines their lives, and maintained that both her analyses and her treatments were invaluable.
Katharina “Kittie” Dorothea Kuipers was born in London in 1916, the second of five children of Dutch émigrés. She attended the Royal Masonic School for Girls at Rickmansworth and won a scholarship to the London Foot Hospital to study chiropody. In 1936 she started work as a chiropodist in London. Noticing the lack of a good textbook on the subject, she wrote it herself: Essentials for Chiropody was published in 1938 and stayed in print for some twenty years.
In 1939 she married Wilfred Thomson, who was killed in action with the RAF. In 1943 she enrolled at the Royal Free School of Medicine in London as a mature student with a child. In 1944 she married Tom Dalton, who qualified as a doctor in 1948. Although by then the mother of three children, she went into traineeship in general practice in Wood Green and Edmonton in North London.
Within a month of starting as a general practitioner, she was called out in the middle of the night to an asthmatic with severe breathing problems. As she left, the husband apologised and mentioned that he had to call a doctor out every month. Dalton remembered her own migraines, which she suffered monthly, but never when pregnant. On advice from a former teacher, the endocrinologistDr Raymond Greene, she had found relief from them with natural progesterone.
In the same month Dalton made a note of each woman patient who visited the surgery, observing when this was a “regular” — ie, monthly — call. Eventually, after discussions with Greene, she decided to treat a couple of the patients with progesterone. It brought immediate relief, and together with Greene she wrote the first paper on the subject of premenstrual syndrome. Published in the Medical Journal in 1953, it was the first of many.
In the subsequent years, she pursued her career as a GP while conducting parallel research into premenstrual syndrome. This involved regular visits to Holloway prison, where she interviewed newly committed prisoners. She found that 49 per cent had been sentenced for crimes committed during the paramenstruum (four days prior to the start of menstruation and first four days of menstruation).
In the late 1950s she was appointed a clinical assistant to the department of psychological medicine at University College Hospital. There she started the first premenstrual syndrome clinic. By the mid-1960s she was seeing patients privately in rooms in Harley Street, and eventually she withdraw as a general practitioner in the NHS. She continued with a limited list of 80 patients to pursue her research and to practise full time, seeing patients from all over Britain and overseas and in cases of hardship charging no fee.
She also lectured extensively in the US, where her theories were sometimes given a better reception than in her home country, and in Europe.
Her testimony was frequently sought to defend women who pleaded diminished responsibility because of premenstrual syndrome. She was an expert witness for the defence of Anna Reynolds, a woman charged with manslaughter, and of Nicola Owen, an arsonist who struck at intervals that were multiples of 28 days. Both women were acquitted.
Her publications included Premenstrual Syndrome (1964); The Menstrual Cycle (1969); Premenstrual Syndrome and Progesterone Therapy (1977); Once a Month (1978); and Depression After Childbirth (1980).
Dalton’s primary research was into PMS, although she did a good deal of work on migraine and its link to diet as well as on progesterone and its effects on the foetus, progesterone prophylaxis for pre-eclampsia and progesterone prophylaxis for postnatal depression.
She was a founder member of the Royal College of General Practitioners and in 1982 she was made a fellow of the college. In 1970, she served as president of the General Practitioners’ Section of the Royal College of Medicine. Despite incapacitating arthritis, she continued to work until she was 84, retiring in 2000 having run her clinic for 40 years.
Her husband died in 1992. She is survived by their son and two daughters, and by a son from her first marriage.
Dr Katharina Dalton, general practitioner, was born on November 11, 1916. She died on September 17, 2004, aged 87.
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