For biographies of these two pioneers, see: FrazerWM. Duncan of Liverpool. London: Hamish Hamilton, e1974f; and Lambert R. Sir John Simon 1816–1904 and English Sanitary Administration. London: Macgibbon & Kee, 1963.
2.
For example, W Rendle, who resigned in 1865 as MOH for St George the Martyr, Southwark, and denounced his former employers in London Vestries and their Sanitary Work: Are They Willing and Able to Do It? And May They Be Trusted In the Face of a Severe Epidemic? London, 1865 (reprinted from the South London Journal).
3.
EylerJM. Victorian Social Medicine: The Ideas and Methods of William Farr. Baltimore: Johns Hopkins University Press, 1979: 9–41.
4.
He also won the not inconsiderable sum of 20 guineas in each of the three sessions between 1858–9 and 1860–1, which must have been a great boost to the newly married student.
5.
From 1833, St Andrews University awarded the degree to successful candidates who attended a series of oral examinations, held over a period of several days; it was not at that time necessary to have matriculated as a student there in order to sit these examinations. I am grateful to Dr Norman Reid for this information.
6.
For an excellent examination of the developing role of the MOH, see PorterD. Stratification and its discontents: Professionalization and conflict in the British public health service, 1848–1914. In: FeeEAchesonRM, eds. A History of Education in Public Health. Oxford: Oxford University Press, 1991.
7.
BrandJL. The parish doctor: England's Poor Law medical officers and medical reform 1870–1900. In: BurnsCR, ed. Legacies in Law and Medicine. New York: Science History Publications, 1977: 126.
8.
His salary of £160 a year for the part-time post (he spent three hours every weekday at the workhouse) was supposed to cover all drugs other than quinine, cod liver oil and sarsparilla; but he only spent £20 a year on prescribed medication for his pauper patients, as nearly three-quarters of them were on his list in order to get a better diet, which was not chargeable to him. Report of Dr Edward Smith on the Metropolitan Workhouses and Sick Wards, 26 June 1866. PP. Session 1866, vol. 61, p. 151.
9.
BMJ, 27 September 1879.
10.
BMJ, 19 October 1870.
11.
Godrich, the son of a prominent local doctor, was Kensington's first MOH, appointed in 1856 under the previous year's Sanitary Act. He began his career in quite spectacular fashion by almost clearing the notorious Potteries district of its large population of pigs, and also made great improvements in Jennings' Buildings, the parish's only “rookery”. By the 1860s, however, he had lapsed into lassitude, and no longer pursued his duties with any conviction. He was pressurized into resigning in 1870 “due to bad health”. Godrich, under a pseudonym, attacked the vestry in the local press in the 1880s for neglect of the northern part of the parish.
12.
The dual occupation was not without its problems. When he took up his post at Kensington in 1871, the 900 inmates of the Westminster workhouse presented him with an ink-stand in recognition of his outstanding service to them. At the same time, the guardians reappointed him to the post, but cut his salary by £50 per annum. This did not go down well in the British Medical Journal, which remarked, “Such thoughtful generosity deserves to be widely known”, 21 January 1871.
13.
BMJ, 25 May 1872. In 1878 his salary was increased by a further £100 to £500 a year, thereby allowing him to resign from the Westminster union position.
14.
In Henry Rumsey's Essays on State Medicine (London: John Churchill, 1856: 297–316), the perfect MOH was described as having no private practice, but most metropolitan MOHs had not only their own patients, but held other public appointments (such as dispensary physician) until the last decade of the nineteenth century. Porter D (op. cit. ref. 6).
15.
Most MOHs were employed on annual contracts, renewable at the discretion of the vestry or board of works. Security of employment was not attained until the London Government Act of 1891, which decreed that no sanitary authority in the capital could dismiss an officer without the approval of the Local Government Board, and that contracts of limited period were not to be imposed on the MOHs. By this date, the diploma in public health had become a necessary qualification for all aspiring MOHs, and the Society of Medical Officers of Health had done much to enhance the status of the profession. Dorothy Porter has shown that the majority of MOHs did not adopt the public health office as their full-time employment until this period. Porter D (op. cit. ref. 6).
16.
In the census returns for 1871, 1881 and 1891 (Public Record Office references RG10/35; RG11/27 and RG12/32) he describes himself as a general medical practitioner, but his entries in the medical register invariably give him as the MOH for Kensington, and not as a private practitioner.
17.
Other MOHs who gained high reputations in their field were John Tripe (Hackney, 1856–94), Edward Ballard (Islington, 1856–71), and Conway Smith (the Strand, 1856–92).
18.
The MOHs for Greenwich and St George in the East, Stepney, were two of the few who openly acknowledged their use of Dudfield's prodigious published output in their own annual reports; however, an analysis of other London MOH annual reports before their standardization in the 1880 s reveals blatant plagiarism of his work by his peers.
19.
For this, he required a police escort, and some courage, to withstand the bricks, mud, and other material flung at him by disgruntled pig-keepers.
20.
His contributions to discussions at the Society for Medical Officers of Health in the first years of his membership were dominated by papers on slaughterhouses, cow sheds, and cattle diseases.
21.
In the 1840s, the appalling treatment of the sick poor by the Kensington union was the subject of a House of Commons Select inquiry. Hodgkinson R. The Origins of the National Health Service. London: Wellcome Historical Medical Library, 1967: 130–1.
22.
Public Health (Journal of the Society of Medical Officers of Health); jubilee number, 1906: 80.
23.
Under the Sanitary Act of 1866, MOHs could effect the removal to hospital of the infectious sick who had no proper lodging; Dudfield was one of the few to take advantage of this power. The Infectious Diseases Act of 1889 and the 1891 Public Health (London) Act confirmed the right of the MOHs to remove infectious cases compulsorily, and expanded the notification process.
24.
Public Health1906: 70.
25.
Throughout his career, he was active in the Association, being concerned particularly with attaining central and local government recognition for the profession, and persuading the Local Government Board to protect the members against the worst aspects of local government employment terms and conditions. At the time of his death, he was its representative on the Sanitary Inspectors' Examination Board.
26.
Society of Medical Officers of Health, minutes, 11 April 1890.
27.
By 1902, the borough recorded 1034 workshops, employing over 12, 000 workers. Dudfield TO. Women's Place in Sanitary Administration. London: Adlard and Sons, 1904: 4.
28.
SquireRE. Thirty Years in the Public Service, an Industrial Retrospect. London: Nisbet & Co., 1927: 22.
29.
Laundries were not covered by the 1891 Factory Act, and the distinction between a factory and a workshop facilitated the continuation of such practices in workshops as inadequate toilet facilities, poor ventilation, and long hours.
30.
When they were first appointed, the women had no legal status and, as such, could not serve statutory notices for the abatement of nuisances. Whenever a notice was required, a male colleague had to serve it on the employer. Thomas Dudfield had been instrumental in establishing the Sanitary Inspectors' Examination Board, so, presumably, he gave his female staff excellent advice on how to be successful.
31.
Kensington vestry appointed Miss Annie Duncan as Lucy Deane's replacement, but did not extend her contract after the first six months, arguing that, as the most serious faults had been remedied, one woman inspector was now sufficient to inspect female employment matters in the whole district. A second woman inspector, François de Chaumont, was not employed again until 1901.
32.
The London County Council requested other boroughs to employ women sanitary staff in the investigation of restaurant kitchens and the 1901 Factory and Workshop Act standardized the cubic footage per factory worker at the level decided upon by the Kensington sanitary team in 1893.
33.
His salary was increased to £1000 a year on Christmas Day 1900 (at the upper end of the MOH scale of remuneration), which the new Royal Borough of Kensington felt was the maximum they could offer for a part-time post. Given his prodigious output as MOH, it is difficult to envisage him undertaking any other work. Kensington vestry minutes, 10 December 1900.
34.
Daily News, 30 January 1893.
35.
DudfieldTO. Annual Report of the Kensington Medical Officer of Health 1894.London: Kensington Council, 1894: 155–65.
36.
He and his wife, Lydia Waters, were married in 1858. Their other children were: Lionel (born 1861), Florence (1862), Frederick (1863), Amelia Elizabeth (1866), Lydia (1868), Margaret (1874), and Christopher (1878).
37.
BMJ, 21 November 1908; Lancet, 5 September 1908. Samuel Reginald Dudfield ma md dph, was Paddington's MOH for over 30 years, edited Public Health, the magazine of the Society of Medical Officers of Health from 1896 to 1901, and wrote the history of the Society for its fiftieth anniversary in 1906. During his father's last illness he acted as Kensington MOH, and inherited several of Thomas's functions in the Society of Medical Officers of Health. He joined the army in 1914 (at the age of 53), serving until 1918, when he returned to Paddington. He resigned from the Society in 1921, shocked at the policy of aggressive lobbying for salary increases and political influence adopted by younger members, and died in 1925 some weeks after undergoing an appendectomy.
