William Henry Duncan (1805–1863) was born in Liverpool, qualified in Edinburgh, then moved back to Liverpool to work in general practice. He became physician to the Liverpool Infirmary and began to campaign for improvements to the appalling living conditions of his patients. He was appointed Liverpool's Medical Officer of Health on 1 January 1847 — Britain's first.
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References
1.
The account of Duncan's early life is drawn from Frazer WM. Duncan of Liverpool: Being an Account of the Work of Dr W. H. Duncan, Medical Officer of Liverpool, 1847–63.London: Hamish Hamilton, 1947. See also note 33, below, on Frazer.
2.
Duncan of Liverpool: Being an Account of the Work of Dr W. H. Duncan, Medical Officer of Liverpool, 1847–63.: p. 5.
3.
The author's authority for this observation is derived from his daughter, a nurse, and his cousin, a doctor at the hospital, who, with their colleagues, are among its regular clientele.
4.
These figures are taken from “Liverpool past and present in relation to sanitary operations”, a paper read to the Public Health Section of the National Association for the Promotion of Social Science by James Newlands, Liverpool borough engineer, in October 1858;Liverpool city archives, ref. H.628.n.NEW.
5.
MitchellBRDeaneP. Abstract of British Historical Statistics. Cambridge: Cambridge University Press, 1962: p. 24.
6.
MossW. A Familiar Medical Survey of Liverpool. Liverpool, 1784.
7.
FrazerWM (op. cit. ref. 1): p. 5.
8.
Dr James Currie (1756–1805) studied medicine at Edinburgh and Glasgow; practised as a physician in Liverpool from 1780; FRS 1792; a pioneer in the use of the clinical thermometer and in the treatment of fevers; also active in the campaign for the abolition of slavery.
9.
NewlandsJ (op. cit. ref. 4): p. 9.
10.
NewlandsJ (op. cit. ref. 4): p. 11.
11.
Liverpool city archives, ref. Hq.050 KAL.
12.
This prohibition was common. Only in 1847 did legislation enable the authorities to compel London householders to connect their cesspools, closets and drains to public sewers. For an account of these developments, see HallidayS. The Great Stink of London. Stroud: Sutton Publishing, 1999: ch.2.
13.
For an account of this relationship by Sir Christopher Booth, see (at p. 239) BoothC. Medical radicals in the age of the Enlightenment. Journal of Medical Biography2000;8:228–40.
14.
WhiteBDA History of the Corporation of Liverpool 1835–7914. Liverpool: Liverpool University Press, 1951: pp. 35et seq.
15.
Republished by Edinburgh University Press in 1965.
16.
DuncanWH“On the physical causes of the high rate of mortality in Liverpool”; Liverpool city archives, ref. H.614.DUN.
17.
HallidayS. William Farr: Campaigning statistician,. Journal of Medical Biography2000;8:220–7.
18.
Duncan used his lectures as the basis for information he gave to the Royal Commission on the State of Large Towns and Populous Districts; see Parliamentary Papers, 1844, volume 17, for his testimony.
19.
Parliamentary Papers: p. 50.
20.
For a discussion of the persistence of the miasmatic theory and its slow abandonment, see BoothC (op. cit. ref. 13).
21.
Holme's evidence is reported in Parliamentary Papers (op. cit. ref. 18): pp. 185et seq.
22.
WhiteBD (op. cit. ref. 14): pp.40 et seq.
23.
Punch1847;12:44.
24.
Newlands' appointment and role are described by White BD (op. cit. ref. 14): pp.40 et seq.
25.
Liverpool city archives, ref. 352 HEA 1/1.
26.
DuncanWH (op. cit. ref. 16): information cited is from pp. 5–21.
27.
Liverpool city archives. Report to the Health Committee of the Borough of Liverpool on the Health of the Town, 1847–50, published 1851; the information quoted is from pp. 5–61.
28.
DuncanWH (op. cit. ref. 16): pp. 56–7.
29.
Liverpool city archives, ref. Min/Hea II 1/1, minutes of 13 March 1847, p. 100.
30.
Liverpool city archives, ref. Min/Hea II 1/1, minutes of 13 March 1847, p. 228.
31.
The figures of mortality are taken from the Seventeenth Annual Report of the Registrar-General for the Year 1854. London, 1856: appendix, table 14, p. 84. Available in the library of the Office for National Statistics, London.
32.
London in 1851 recorded a population of 2,362,000 and in the 1848–9 epidemic suffered 14,137 deaths. The figures for Liverpool were 222,954 population and 5245 deaths.
33.
FrazerWM (op. cit. ref. 1). WM Frazer (1888–1958) was Professor of Hygiene, and subsequently of Public Health, at the University of Liverpool (1933–53), and the city's Medical Officer (1931–53) and thus a successor to Duncan.
34.
See notes 22 and 25 (above) concerning the volume of Duncan's correspondence.
35.
Liverpool city archives, 352 HEA 1/1, letter books, p. 481, contains the letter to Chadwick.
36.
Liverpool city archives. Report to the Health Committee of the Borough of Liverpool on the Health of the Town, 1851, p. 100.
37.
The process of cellar clearance and house cleansing which Duncan pursued is recounted by MidwinterE. Old Liverpool. Newton Abbot: David and Charles, 1971: pp. 80et seq.
38.
Liverpool city archives, ref. 352 HEA 1/1, letter to Dr Head, dated 23 November 1853.
39.
The report for 1854 is missing from the Liverpool city archives, but the Seventeenth Annual Report of the Registrar-General for the Year 1854 (op. cit. ref. 31) records cholera deaths in Liverpool during the 1849 epidemic as 4173 compared with 1084 for 1854;the population in the intervening five years had, of course, increased.
40.
Annual Report of the Medical Officer of Health, 1866, pp. 139–43, Liverpool city archives; Dr W S Trench (1810–1877) was Duncan's successor as Medical Officer (1863–1877).
41.
FrazerWM (op. cit. ref. 1): pp. 101–2.
42.
FrazerWM (op. cit. ref. 1): p. 98.
43.
Liverpool Echo, 10 September 2001: 9.
44.
Duncan Society literature, August 2001. The Society has its own Website at www.duncansociety.org.uk.
