The political economy of scientific medicine: Science, education and the transformation of medical practice in sheffield, 1890–1922

Medical History

Volumn 36, Issue 2, 1992, Pages 125-159

  Sturdy, Steve ^a  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLINICAL MEDICINE; HISTORY; HISTORY OF MEDICINE; HOSPITAL; LABORATORY; MEDICAL EDUCATION; UNITED KINGDOM;

CLINICAL MEDICINE; EDUCATION, MEDICAL; ENGLAND; HISTORY OF MEDICINE, 19TH CENT.; HISTORY OF MEDICINE, 20TH CENT.; HOSPITALS; LABORATORIES;

EID: 0026844447     PISSN: 00257273     EISSN: 20488343     Source Type: Journal    
DOI: 10.1017/S0025727300054983     Document Type: Article

References (256)

1. Dorothy Watkins, ‘The English revolution in social medicine, 1889–1911’, Ph.D. thesis, University of London, 1984;
2. Barbara Gutmann Rosenkrantz, Public health and the state: changing views in Massachusetts, 1842–1936, Cambridge, Mass., Harvard University Press, 1972;
3. W. D. Foster, A short history of clinical pathology, Edinburgh, Livingstone, 1961;
4. Edward T. Morman, ‘Clinical pathology in America, 1865–1915: Philadelphia as a test case’, Bull. Hist. Med., 1984, 58: 198–214.
5. A. McGehee Harvey, Science at the bedside: clinical research in American medicine, 1905–1945, Baltimore, Johns Hopkins University Press, 1981;
6. Christopher C. Booth, ‘Clinical research’, in Joan Austoker and Linda Bryder (eds), Historical perspectives on the role of the MRC: essays in the history of the Medical Research Council of the United Kingdom and its predecessor, the Medical Research Committee, 1913–53, Oxford University Press, 1989, pp. 205–241.
7. Ronald L. Numbers and John Harley Warner have recently emphasized that other periods and other cultures may have their own science of medicine, and that to speak of scientific medicine in the singular is thus to assume an ethnocentric point of view: see their paper on ‘The maturation of American medical science’, in Nathan Reingold and Marc Rothenberg (eds), Scientific colonialism, 1800–1930: a cross–cultural comparison, Washington, D.C., Smithsonian Institution Press, 1987. This caveat is well taken. However, as a matter of convenience, I propose to use the term “scientific medicine” in this paper to designate the recognizably modern alliance of the laboratory with medical practice.
8. See Christopher Lawrence, ‘Incommunicable knowledge: science, technology and the clinical art in Britain 1850–1914’, J. contemp. Hist., 1985, 20: 503–20.
9. Gerald L. Geison, ‘Divided we stand: physiologists and clinicians in the American context’, and Russell C. Maulitz, ‘“Physician versus bacteriologist”: the ideology of science in clinical medicine’, both in Morris J. Vogel and Charles E. Rosenberg (eds), The therapeutic revolution: essays in the social history of American medicine, Philadelphia, University of Pennsylvania Press, 1979, pp. 67–90 and 91–107 respectively.
10. see Gerald L. Geison, ‘Pasteur, Roux, and rabies: scientific versus clinical mentalities’, J. Hist. Med., 1990, 45: 341–65.
11. see J. V. Pickstone (ed.), Medical innovation in historical perspective, London, Macmillan, 1992.
12. A valuable review of American scholarship in this field prior to 1985 is John Harley Warner, ‘Science in medicine’, Osiris, 2nd series, 1985, 1: 37–58.
13. See, for example, Joan Austoker, ‘Walter Morley Fletcher and the origins of a basic biomedical research policy’, and David Cantor, ‘The MRC's support for experimental radiology during the inter–war years’, both in Austoker and Bryder (eds), note 2 above, pp. 23–33 and 181–204 respectively.
14. Charles Rosenberg has emphasized the importance of social and institutional context in shaping scientists’ disciplinary interests: Rosenberg, ‘Toward an ecology of knowledge: on discipline, context, and history’, in Alexandra Oleson and John Voss (eds), The organization of knowledge in modern America, Baltimore, Johns Hopkins University Press, 1979, pp. 440–55.
15. See, for instance, Robert E. Kohler, From medical chemistry to biochemistry: the making of a biomedical discipline, Cambridge University Press, 1982, pp. 40–92.
16. S. E. D. Shortt has argued that laboratory science was introduced into medical education in the second half of the nineteenth century because it was now seen as an important part of a liberal education, and that it was accepted by doctors precisely because it failed to have any immediate implications for practice: Shortt, ‘Physicians, science and status: issues in the professionalization of Anglo–American medicine in the nineteenth century’, Med. Hist., 1983, 27: 51–68.
17. see L. S. Jacyna, ‘The laboratory and the clinic: the impact of pathology on surgical diagnosis in the Glasgow Western Infirmary, 1875–1910’, Bull. Hist. Med., 1988, 62: 384–406;
18. Joel D. Howell, ‘Early use of X-ray machines and electrocardiographs at the Pennsylvania Hospital’, J.A.M.A., 1986, 255: 2320–3.
19. Christopher Lawrence, ‘Moderns and ancients: the “new cardiology” in Britain 1880–1930’, Med. Hist., Supplement No. 5, 1985, 1–33;
20. Joel D. Howell, ‘Cardiac physiology and clinical medicine? Two case studies’, in Gerald L. Geison (ed.), Physiology in the American context 1850–1940, Bethesda, American Physiological Society, 1987, pp. 279–292;
21. Susan Leigh Star, Regions of the mind: brain research and the quest for scientific certainty, Stanford University Press, 1989. What such accounts lack, however, is a satisfactory historical account of the interests that led to and sustained this integration.
22. Rosemary Stevens, The practice of medicine in modern England, New Haven, Yale University Press, 1966;
23. idem, American medicine and the public interest, New Haven, Yale University Press, 1971;
24. Paul Starr, The social transformation of American medicine, New York, Basic Books, 1982;
25. Barbara G. Rosenkrantz, ‘The search for professional order in 19th century American medicine’, Proceedings of the 14th International Congress on the History of Science, Tokyo, Science Council of Japan, 1975, no. 4, pp. 113–24.
26. John Harley Warner, ‘Ideals of science and their discontents in late–nineteenth–century American medicine’, Isis, 1991,82: 454–78.
27. Ian Inkster, ‘Marginal men: aspects of the social role of the medical community in Sheffield 1790-1850’, in John Woodward and David Richards (eds), Health care and popular medicine in nineteenth century England, London, Croom Helm, 1977, pp. 128-163;
28. Arnold Thackray, ‘Natural knowledge in cultural context: the Manchester model’, Am. hist. Rev., 1974, 79: 672–709;
29. Robert H. Kargon, Science in Victorian Manchester: enterprise and expertise, Manchester University Press, 1977.
30. Paul Weindling (ed.), The social history of occupational health, London, Croom Helm, 1985;
31. Angela Nugent, ‘Fit for work: the introduction of physical examinations in industry’, Bull. Hist. Med., 1983, 57: 578-595;
32. Roger Cooter, ‘Medicine and the goodness of war’, Canadian Bull, of med. Hist., 1990, 7: 147–59.
33. Deborah Stone, ‘Physicians as gatekeepers: illness certification as a rationing device,’ Public Policy, 1979, 27: 227–54.
34. Susan Reverby, ‘Stealing the golden eggs: Ernest Amory Codman and the science and management of medicine’, Bull. Hist. Med., 1981, 55: 156–171;
35. Morris Vogel, ‘Managing medicine: creating a profession of hospital administration in the United States, 1895–1915’, in Lindsay Granshaw and Roy Porter (eds), The hospital in history, London, Routledge, 1989, pp. 234–260;
36. Charles Rosenberg, ‘Inward vision and outward glance: the shaping of the American hospital, 1880–1914’, Bull. Hist. Med., 1979, 53: 346–91.
37. E. Richard Brown, Rockefeller medicine men: medicine and capitalism in America, Berkeley, University of California Press, 1979;
38. Howard S. Berliner, A system of scientific medicine: philanthropic foundations in the Flexner era, New York, Tavistock Publications, 1985;
39. Stephen J. Kunitz, ‘Efficiency and reform in the financing and organization of American medicine in the Progressive Era’, Bull. Hist. Med., 1981, 55: 497–515.
40. Bruno Latour, The Pasteurization of France, transl. Alan Sheridan and John Law, London, Harvard University Press, 1988.
41. Thus Joel D. Howell has shown how the physiological redefinition of heart disease during the First World War increased the rate at which disabled soldiers were either discharged or returned to combat: Howell, “‘Soldiers's heart”: the redefinition of heart disease and speciality formation in early twentieth–century Great Britain’, Med. Hist., Supplement No. 5, 1985: 34–52.
42. Martin S. Pernick has discussed an earlier instance of the use of science to decide who should and who should not receive anaesthetics, in his A calculus of suffering: pain, anaesthesia and utilitarian professionalism in nineteenth–century American medicine, New York, Columbia University Press, 1985.
43. Stephen J. Kunitz, ‘Classifications in medicine’, in Russell C. Maulitz and Diana E. Long (eds), Grand rounds: one hundred years of internal medicine, Philadelphia, University of Pennsylvania Press, 1988, pp. 279–96.
44. Daniel M. Fox, Health policies health politics: the Britishand American experience 1911–1965, Princeton University Press, 1986.
45. Harry M. Marks makes a related case for viewing randomized control trials as a technique for managing the behaviour of medical practitioners in the interests of producing standardized therapeutic knowledge: Marks, ‘Notes from the underground: the social organization of therapeutic trials’, in Maulitz and Long, Health policies health politics: the Britishand American experience 1911–1965, note 17 above, pp. 297–336.
46. See also Rosemary Stevens's thoughtful essay on ‘The curious career of internal medicine: functional ambivalence, social success’, in Health policies health politics: the Britishand American experience 1911–1965, note 17 above, pp. 339–64.
47. Roger Cooter develops a closely related set of arguments, but from the perspective of a single medical specialism, in his Surgery and society in peace and war: orthopaedics and the organisation of modern medicine, 1880–1948, London, Macmillan, in press. John V. Pickstone's discussion of medical science and the specialization of hospital work in another northern industrial city has also provided useful insights: Pickstone, ‘Sciences, specialists and capital: the modernisation of Manchester hospitals’, chapter 9 of his Medicine and industrial society: a history of hospital development in Manchester and its region, 1752–1946, Manchester University Press, 1985.
48. Alfred R. Chandler, The visible hand: the managerial revolution in American business, Cambridge, Mass., Harvard University Press, 1977.
49. For the early years of the Medical School, cf. William Smith Porter, The Medical School in Sheffield, 1828–1928, Sheffield, J. W. Northend, 1928.
50. John G. McCrie, ‘The Sheffield Medical School’, Hist. Med., 1973, 5, No. 2, 3–6.
51. Cf. S. T. Anning, ‘Provincial medical schools in the nineteenth century’, in F. N. L. Poynter (ed.), The evolution of medical education in Britain, London, Putnam Medical, 1966, pp. 121–34.
52. Arthur Hall, The Sheffield School of Medicine Some personal notes on the history of the Sheffield School of Medicine during the last half-century or more), bound typescript deposited in Sheffield University Library, 1944;
53. A. E. Barnes, ‘Medical student days’, typescript, Sheffield University Archives (hereafter SUA) 5/1/26, ff. 3–27.
54. Porter, note 20 above, p. 71.
55. Arthur W. Chapman, The story of modern university: a history of the University of Sheffield, Oxford University Press, 1955.
56. Cf. Stella V. F. Butler, ‘A transformation in training: the formation of university medical faculties in Manchester, Leeds, and Liverpool, 1870–84’, Med. Hist., 1986, 30: 115–32.
57. Chapman, note 22 above, pp. 92–98, 133–48, 176–8.
58. Sidney Pollard, A history of labour in Sheffield, Liverpool University Press, 1959;
59. Dennis Smith, Conflict and compromise: class formation in English society 1830–1914. A comparative study of Birmingham and Sheffield, London, Routledge & Kegan Paul, 1982.
60. Michael Sanderson, The universities and British industry 1850–1970, London, Routledge & Kegan Paul, 1972, pp. 68, 78–81.
61. Michael Sanderson, ‘The professor as industrial consultant: Oliver Arnold and the British steel industry, 1900–14’, Econ. Hist. Rev., 1978, 31: 585–600
62. Chapman, note 22 above, pp. 44–67.
63. Chapman, note 22 above, pp. 124, 126–7.
64. On Robertson, see obituaries: Lancet, 1936, ii: 1548-1549;
65. Brit. med. J., 1936, ii: 1337–8.
66. Linda Bryder, Below the magic mountain: a social history of tuberculosis in twentieth–century Britain, Oxford University Press, 1988, pp. 41–42;
67. F. B. Smith, The retreat of tuberculosis 1850–1950, London, Croom Helm, 1988, pp. 68–9.
68. Chapman, note 22 above, pp. 157–8, 228–9;
69. Hall, note 21 above, pp. 42–46, 52–3.
70. Chapman, note 22 above, p. 426.
71. see Medical Faculty Minutes, 31 August 1916, 2 October 1919. (The bound volumes of Medical Faculty Minutes referred to in this paper are held in SUA 8 5.)
72. Hall, note 21 above, pp. 60, 61.
73. see Medical Faculty Minutes, 22 June 1914.
74. J. S. MacDonald, who came to the physiology chair from Liverpool University in November 1902
75. see H. S. Raper, ‘John Smyth Macdonald 1867–1941’, Obit. Not. Fellows Roy. Soc. Lond., 1939–41, 3: 853–66.
76. Rudolph Peters, ‘John Beresford Leathes 1864–1956’, Biog. Mem. Fellows Roy. Soc., 1958,4: 185–91.
77. A. E. B[oycott], ‘James Sholto Cameron Douglas 1879–1931’, J. Path. Bact., 1932, 35: 135–6, on p. 136.
78. C. J. Martin, ‘Arthur Edwin Boycott 1877–1938’, Obit. Not. Fellows Roy. Soc. Lond., 1936–38, 2: 561–571.
79. Robert E. Kohler, ‘Bacterial physiology: the medical context’, Bull. Hist. Med., 1985, 59: 54–74.
80. Steven W. Sturdy, ‘A co–ordinated whole: the life and work of John Scott Haldane’, Ph.D. thesis, University of Edinburgh, 1987, pp. 251–5.
81. see Schafer to Sir L. J. Grant and Professor Hudson Beare, 30 October 1918, in Edinburgh University Library, Special Collections Department, Gen. 2007 5.
82. Myers Ward stayed in Sheffield only from 1898 to 1902, when he moved to the Charing Cross Hospital Medical School. Likewise, the full–time professor of pathology, Louis Cobbett, appears to have “found the routine work of a laboratory, the making of autopsies and the teaching of students, rather irksome”, and had been in Sheffield less than a year when he answered “the call of Cambridge”
83. Hall, note 21 above, p. 59.
84. A useful critique of this implicit teleology is Keith Vernon, ‘Pus, sewage, beer and milk: microbiology in Britain, 1870–1940’, Hist. Sci., 1990, 28: 289–325.
85. W. H. G. Armytage described the civic universities as “community service stations”: see his Civic universities: aspects of a British tradition, London, Ernest Benn Ltd., 1955.
86. David R. Jones, The origins of civic universities: Manchester, Leeds and Liverpool, London, Routledge, 1988.
87. MacDonald, in particular, was a keen advocate of the new civic universities, and he “used to say that it was only when he found himself [in Liverpool]& with a group of men who were trying to turn the University College into a University, that he began to realize what a university really was”
88. Raper, note 31 above, p. 854.
89. He used his Liverpool experience to advance the Sheffield bid for an independent university charter: Hall, note 21 above, pp. 50–51, 64–5.
90. In 1910, Beattie told the Nottingham division of the British Medical Association that “the pathologist who neglects the post mortem room or even the bedside cannot fully realize the greatest problems of disease. In his work, therefore, he must be assisted by the clinician, and in their hearty co-operation% the advance in scientific medicine must be greatly aided”: J. M. Beattie, ‘An address on the activity of the cells and fluids of the body in the prevention and cure of disease: a plea for more thorough pathological investigation’, Brit. med. J., 1910, i: 977–979, on p. 979.
91. Henry R. Dean, ‘Pathology and the medical student’, Edin. med. J., 1918, N.S., 20: 307–18, on pp. 307, 308.
92. H. R. Dean, ‘Idiocy and congenital syphilis’, Brit. J. Child. Dis., 1912, 9: 385–96
93. When, in 1913, an appeal for research funds was made to the Home Office Committee on Tuberculosis, it was stressed that the local notification scheme had already “afforded such valuable data for information”: Sheffield University to Departmental Committee on Tuberculosis, 14 February 1913, SUA 5/1/26, ff. 337–8.
94. In similar vein, Douglas later argued that routine testing under the Venereal Diseases Act of 1916 should be performed in the pathology department “not only in the public interest, but also for the opportunities presented for study and the extension of knowledge on this subject”: Medical Faculty Minutes, 31 August 1916.
95. see the 1903 report of the Board of Medical Studies to the Senate on ‘The requirements for forming a medical faculty of a university’, SUA 5/1/26, ff. 28–38, on f. 37.
96. Beattie was particularly active in pursuing such work: J. M. Beattie, ‘Hygiene of the steel trade’, J. Roy. San. Inst., 1912, 33: 501–505;
97. W. Harwood Nutt, J. M. Beattie and R. J. Pye Smith, ‘Arsenic cancer: a case: a pathological report on the parts removed: together with summaries of 39 other collected cases, and remarks’, Lancet, 1913, ii: 210–216, 282–4.
98. J. S. MacDonald, ‘Calorimetric observation on man’, J. Physiol., 1912, 44: iv-vP;
99. idem, ‘Studies in the heat production associated with muscular work. (Preliminary communication: Section A.—Methods; Section B.—Results.)’, Proc. Roy. Soc. B, 1913, 87: 96—112;
100. idem, ‘Mechanical efficiency of man’, J. Physiol., 1914, 48: xxxii;
101. idem, ‘Man's mechanical efficiency in work performance and the cost of the movements involved (treated separately)’, Proc. Roy. Soc. B, 1916, 89: 394–410.
102. Richard Gillespie, ‘Industrial fatigue and the discipline of physiology’, in Geison (ed.), note 9 above, pp. 237–262;
103. A. J. McLvor, ‘Manual work, technology, and industrial health, 1918–39’, Med. Hist., 1987, 31: 160–89.
104. Inkster, note 11 above, p. 142;
105. cf. S.W.F. Holloway,‘Medical education in England, 1830–1858: a sociological analysis’, History, 1964, 49: 299–324.
106. Chapman, note 22 above, pp. 474–8.
107. M. E. Fissell, Patients, power and the poor in eighteenth century Bristol, Cambridge University Press, 1991, which explores some of these issues.
108. Cf. Christopher Lawrence, ‘Alexander Monro primus and the Edinburgh manner of anatomy’, Bull. Hist. Med., 1988, 62: 193–214.
109. Hall, note 21 above, p. 15.
110. The doctors most closely identified with the Medical School at this stage, and with the efforts to regenerate it through anatomy teaching, were the surgeons Arthur Jackson and William Favell, and the physician W. Tusting Cocking. See their obituaries in, respectively: Brit. med. J., 1896, i: 117–118;
111. [Robert] Platt, ‘Hall, Sir Arthur John (1866-1951)’, DNB 1951–1960, 451–452;
112. A. Gurney Yates, ‘Sir Arthur J. Hall’, Sheffield University Gazette, February 1951, No. 10, pp. 2–4.
113. He met resistance, for instance, from Arthur Jackson, who was adamant that “The school shall stand or fall by its anatomy theatre”: Hall, note 21 above, p. 15.
114. In fact, the first full–time teaching post to be created in the School, in 1894, was in anatomy; the incumbent was Christopher Addison, later to become Britain's first Minister of Health: DNB 1951–1960, pp. 3–7.
115. Yates, note 47 above, p. 2.
116. Ivan Waddington, The medical profession in the industrial revolution, Dublin, Gill and Macmillan, pp. 1984, pp. 9–18;
117. idem, ‘General practitioners and consultants in early nineteenth–century England: the sociology of an intra–professional conflict’, in Woodward and Richards (eds), note 11 above, pp. 164–188;
118. M. Jeanne Peterson, The medical profession in mid–Victorian London, Berkeley, University of California Press, 1978, pp. 227–231, 272–3;
119. Rosemary Stevens, Medical practice in modern England: the impact of specialization and state medicine, New Haven and London, Yale University Press, 1966, 31–4.
120. Hall, note 21 above, pp. 6, 14.
121. Hall, note 21 above, pp. 28–29.
122. J. A. G[unn], ‘Brunton, Sir Thomas Lauder’, DNB, 1912–21, pp. 75–76;
123. William F. Bynum, ‘Brunton, Thomas Lauder’, DSB, Vol. II, pp. 547–8.
124. Arthur J. Hall, ‘Case of sporadic cretinism, in which a relapse occurred owing to omission of thyroid extract’, Brit. med. J., 1902, i: 1259–1261;
125. idem, ‘Clinical observations on the effects of certain drugs in diabetes mellitus’, Q. J. Med., 1908–9, 2: 417–31.
126. Arthur J. Hall, ‘Case of sporadic cretinism, in which a relapse occurred owing to omission of thyroid extract’, Brit. med. J., 1902, i: 1259–1261;
127. Beattie and Hall, ‘A fatal case of secondary syphilitic nephritis: with remark’, Brit. med. J., 1911, i: 1102–4.
128. J. M. Beattie and A. G. Yates, ‘Sugar tests and pathogenicity in the differentiation of streptococci’, J. Path. Bact., 1911–12, 16: 247–256;
129. idem, ‘Bateriological examination of the synovial membrane from the knee–joints in eighty–five consecutive post–mortems’, J. Path. Bact., 1911–12, 16: 404–405;
130. idem, ‘The variations in the morphological characters of bacteria and their reaction with sugars under different conditions’, Brit. med. J., 1912, ii: 1304–1305;
131. idem, ‘The streptococcus in rheumatism’, J. Path. Bact., 1912–13,17: 416–418.
132. R. J. Pye Smith, who collaborated with Beattie and W. Harwood Nutt, Medical Officer to the Sheffield Union Workhouse and Honorary MO to the X-ray department at the Royal Hospital, in a study of a local trade disease: Nutt, Beattie and Pye Smith, note 41 above.
133. Arthur Hall, ‘Some remarks on forms of trade dermatitis occurring in the silver and electro–plating trades’, Br. J. Derm., 1902, 14: 121–6.
134. see, in particular, the ‘Discussion on diseases of the lungs caused by dust’, Brit. med. J., 1908, ii: 480–5
135. Arnold Wilson and Hermann Levy, Workmens compensation, vol. 1, Social and political development, London, Oxford University Press, 1939, pp. 174, 263–5.
136. British Medical Journal, ‘Sheffield Local Medical Advisory Committee’, Brit. med. J., 1924, ii: 1132.
137. The encephalitis work was published as The Sheffield outbreak of epidemic encephalitis in 1924, MRC Special Report series No. 108 (1926)
138. Platt, note 47 above, p. 451.
139. obituary, Sheffield Telegraph, 4 January 1951.
140. A. G. Y[ates], ‘Great teachers of surgery in the past: Sir Ernest Finch (1884–1960)’, Br. J. Surg., 1965,52: 81–84, on p. 83.
141. A. G. Yates himself (obituary, in Gordon Wolstenholme (ed.), Munk's roll, vol. 7, Lives of the Fellows of the Royal College of Physicians of London continued to 1983, Oxford, IRL Press, 1984, pp. 627–628)
142. A. E. Barnes (obituary, Brit. med. J., 1956, ii: 1060–1061)
143. A. E. Naish (obituary, in Gordon Wolstenholme (ed.), Munk's roll, vol. 5, Oxford, IRL Press, 1965, pp. 302–303).
144. John D. Leader and Simeon Snell, Sheffield Royal Infirmary 1797–1897, Sheffield, published on behalf of the Infirmary Board 1897;
145. E. F. Skinner, A short history of the Sheffield Royal Hospital, 1832–1932, Sheffield, Greenup & Thompson, 1932.
146. Waddington, The medical profession, note 50 above, pp. 26–28, 30 f;
147. Jeanne Peterson, note 50 above, pp. 138–51;
148. John Woodward, To do the sick no harm: a study of the British voluntary hospital system to 1875, London, Routledge & Kegan Paul, 1974, pp. 23–6.
149. Indeed, association with the large provincial infirmaries was a positive selling point for academically less prestigious medical schools like Sheffield, and was stressed, for instance, in the 1903 report on ‘The requirements for forming a medical faculty of a university’, note 41 above, f. 37.
150. Cf. Stella V. F. Butler, ‘Centers and peripheries: the development of British physiology, 1870–1914’, J. Hist. Biol., 1988, 21: 473–500.
151. Porter, note 20 above, pp. 97–100.
152. see especially the letter from W. M. Gibbons to H. Frank Heath, 17 February 1911, at f. 243.
153. Porter, note 20 above, p. 100.
154. Arthur Hall, note 21 above, pp. 30–1, 38.
155. Jacyna, note 8 above.
156. Hall, ‘Clinical observations’, note 53 above, pp. 417–18.
157. Report on ‘The requirements for forming a medical faculty of a university’, note 41 above.
158. Hall, note 21 above, pp. 60, 61.
159. Beattie, note 39 above, p. 979.
160. Michael Worboys, ‘Vaccine therapy and laboratory medicine in Edwardian Britain’, in J. V. Pickstone (ed.), Medical innovation in historical perspective, note 5 above, pp. 84–103.
161. J. Henry Dible, ‘Henry Roy Dean 19th February 1879–13th February 1961’, J. Path. Bact., 1962, 83: 587–97, on pp. 587–8;
162. Hall, note 21 above, p. 65.
163. Hall, note 21 above, p. 76;
164. Medical Faculty Minutes, 29 April 1935.
165. Dean argued that “accommodation, equipment and staff should be adequate for the bacteriological, chemical, and histological examination of the cases in the wards”:, note 39 above, p. 315.
166. Report inserted in Medical Faculty Minutes, 13 September 1915, cancellation as original.
167. Medical Faculty Minutes, 16 February 1915, 17 May 1915, 13 September 1915, 22 November 1915.
168. Report inserted in Medical Faculty Minutes, 13 September 1915.
169. The Dawson Report on The future provision of medical and allied services, published in 1920
170. Brian Abel-Smith, The hospitals 1800–1948, London, Heinemann, 1964, pp. 299–300, and passim.
171. Daniel Fox has argued that this model of medical regionalization was central to inter–war attempts to modernize and rationalize health services, not just in Britain, but in America also:, note 18 above.
172. Joint Consultative and Advisory Hospitals Council, General statement of the position of the voluntary hospitals of Sheffield, Sheffield, 1920.
173. See also ‘Reform of Sheffield Hospitals. Drastic proposals by the Honorary Medical Staffs’, Sheffield Daily Telegraph, 11 June 1919.
174. British Medical Journal, ‘Relief for the shortage of hospital beds in Sheffield’, Brit. med. J., 1920, ii: 93;
175. ‘Co–operation among voluntary hospitals’, Brit. med. J. 1923, i: 1027–1028;
176. idem, ‘Sheffield Joint Hospitals Council’, Brit. med. J. 1923, ii: 483;
177. idem, ‘Sheffield Joint Hospitals Council’, Brit. med. J., 1924, ii: 1176.
178. British Medical Journal, ‘Co–operation among voluntary hospitals’, note 81 above, p. 1027.
179. W. G. MacPherson, History of the Great War. Medical services: general history, Vol. I, London, HMSO, 1921.
180. Platt, note 47 above, p. 452.
181. Yates, note 47 above, pp. 3–4.
182. Yates, note 60 above.
183. Of the eight doctors who signed the letter from the “Joint Medical Staffs”, Hall, Barnes and four others taught clinical subjects in the Medical School: Joint Consultative and Advisory Hospitals Council, note 80 above.
184. Abel-Smith, note 78 above, p. 300.
185. Pollard, note 24 above, pp. 265f.
186. British Medical Journal, ‘Sheffield Joint Hospitals Council’, note 81 above.
187. Medical Faculty, Annual Report, 1919–1920, copy in SUA 5 1 135.
188. Sheffield Hospitals Council, Inc., ‘Record of the ld in the £ scheme’, Sheffield, 1949.
189. Medical Faculty, Annual Report, 1919–1920, copy in SUA 5 1 135;
190. report of the sub–committee of the Clinical Studies Committee, inserted in Medical Faculty Minutes, 4 April 1919;
191. Medical Faculty Minutes, 26 June, 2 October 1919.
192. Report of the sub–committee of the Clinical Studies Committee, inserted in Medical Faculty Minutes, 4 April 1919.
193. Medical Faculty, Annual Report 1918–1919, in Medical Faculty Minutes, 27 October 1919.
194. “The systematic lectures in medicine and surgery will thus regain much of their former prestige which they have lost to a great extent owing to their being divorced from the patient”. Report of the sub–committee of the Clinical Studies Committee, inserted in Medical Faculty Minutes, 4 April 1919.
195. Medical Faculty, Annual Report, 1920–1921, copy in SUA 5/1/26, f. 354.
196. see report of the sub–committee of the Clinical Studies Committee, inserted in Medical Faculty Minutes, 4 April 1919;
197. Clinical (Medical) Studies Committee, ‘Report re Chair of Pharmacology and proposed modification in curriculum’, inserted in Medical Faculty Minutes, 2 October 1919.
198. where the chair of pathological chemistry to which Leathes was recruited was “created for the very purpose of giving a scientific term to the final professional subjects”: A. B. MacAllum to William Osler,, 14 April 1908, University of Toronto, Thomas Fisher Rare Books Library, A. B. MacAllum papers, B66-0005 001(01).
199. Medical Faculty, Annual Report 1919–1920, copy in SUA 5 1 35.
200. J. B. Leathes, ‘Renal efficiency tests in nephritis and the reaction of the urine’, Brit. med. J., 1919, ii: 165–7.
201. Newman, ‘Grants to medical schools’, memorandum to the Secretary of the Board of Education, 22 October 1918, PRO ED 24/1961.
202. George Graham, ‘The formation of the medical and surgical professorial units in the London teaching hospitals’, Annals of Science, 1970, 26: 1–22.
203. George Newman, Some notes on medical education in England. A memorandum addressed to the President of the Board of Education, Cd. 9124, London, HMSO, 1918;
204. idem, An outline of the practice of preventive medicine. A memorandum addressed to the Minister of Health, Cmd. 363, London, HMSO, 1919.
205. Clinical (Medical) Studies Committee, ‘Report re Chair of Pharmacology and proposed modification in curriculum’, inserted in Medical Faculty Minutes, 2 October 1919.
206. Medical Faculty Minutes, 1 December 1919;
207. Finance Committee Minutes, December 1919.
208. Barnes, ‘Medical student days’, note 21 above, f. 9.
209. Medical Faculty Minutes, 1 October and 25 November 1918, and 4 April, 2 June and 26 June 1919;
210. Barnes, ‘Medical student days’, note 21 above, f. 20.
211. Henry Hadow (Vice Chancellor of Sheffield University) to William McCormick (Chairman of the UGC), 31 January 1920, SUA 5 1 135.
212. UGC minute, 11 February 1920, PRO UGC 1/1. This was the only such grant awarded outside London.
213. Hadow to McCormick, 31 January 1920, SUA 5 1 135.
214. Henry H. Dale, ‘Edward Mellanby 1884–1955 ’, Biogr. Mem. Fellows Roy. Soc., 1955, 1: 193–222.
215. Edward Mellanby to A. V. Hill, 4 April 1920, in A. V. Hill papers, Churchill Archive Centre, AVHL 11 4 61).
216. Dale, note 103 above, p. 204)
217. Edward Mellanby, ‘A short chemical study of a case of cyclical vomiting, with some remarks on creatinuria and acidosis’, Lancet, 1911, ii: 8–12;
218. idem, ‘An experimental investigation on diarrhoea and vomiting in children’, Q. J. Med., 1915–16, 9: 165–215.
219. S. J. Cowell, a “biochemically oriented physician” who dealt with most of Mellanby's clinical duties while the professor worked on his dogs (obituary, Stuart Jasper Cowell
220. Gordon Wolstenholme (ed.), Munk's roll, vol. 6, Oxford, IRL Press, 1982, pp. 124–6, on p. 125
221. Thomas Lewis to Arthur Hall, 5 July 1933, SUA 5 1 128, f. 23.
222. Edward Mellanby and May Mellanby, ‘The application of the results obtained in experiments on the hyperplasia of dogs’ thyroids to the treatment of exophthalmic goitre (Graves’ disease)’, J. Physiol., 1921, 55: x;
223. S. J. Cowell and E. Mellanby, ‘The effect of iodine on hyperthyroidism in man’,Q. J. Med., 1924–25, 18: 1–26.
224. British Medical Journal, ‘Physiology and clinical medicine in Sheffield’, Brit. med. J., 1921, i: 648.
225. Arthur J. Hall, ‘Physiology and clinical medicine in Sheffield’, Brit. med. J. 1921, i: 688.
226. Joel A. Tarr, ‘The city and the telegraph: urban telecommunications in the pre-telephone era’, J. Urban Hist., 1987, 14: 38–80;
227. Joel A. Tarr and Gabriel Dupuy,Technology and the rise of the networked city in Europe and America, Philadelphia, Temple University Press, 1988.
228. Digby and Bosanquet, ‘Doctors and patients in an era of national health insurance and private practice’, Economic History Review, 2nd series, 1988, 41: 74–94.
229. Hall, note 21 above, p. 53.
230. Cf. Patrice Pinell, ‘Cancer policy and the health system in France: “big medicine” challenges the conception and organization of medical practice’, Soc. Hist. Med., 1991, 4: 75–101
231. Starr, note 10 above, passim.
232. Smith, note 24 above, pp. 241–247;
233. Pollard, note 24 above, pp. 265–8.
234. Harold Perkin, The rise of professional society: England since 1880, London, Routledge, 1989.
235. Pollard, note 24 above, pp. 93–105.
236. Derek Frazer Power and authority in the Victorian city, Oxford, Basil Blackwell, 1979, pp. 139–48.
237. A. E. Barnes, ‘Medical student days’, note 21 above, f. 11.
238. Gordon Wolstenholme (ed.), Munk's roll, volume 5, Oxford, IRL Press, 1965, pp. 28–29.
239. Smith, note 24 above, pp. 151–4, 159.
240. An important statement of this point is Roger Cooter, ‘Anticontagionism and history's medical record’, in P. Wright and A. Treacher (eds), The problem of medical knowledge, Edinburgh University Press, 1982, pp. 87–108
241. On statistics see John M. Eyler, ‘Mortality statistics and Victorian health policy: program and criticism’, Bull. Hist. Med., 1976, 50: 335–355;
242. Karl H. Metz, ‘Social thought and social statistics in the early nineteenth century: the case of sanitary statistics in England’,Int. Rev. Soc. Hist., 1984, 29: 254–73.
243. Walter Fletcher, ‘Medical research and daily life’, Brit. med. J. 1922, ii: 941–3.
244. David Smith and Malcolm Nicolson, ‘The “Glasgow School” of Paton, Findlay and Cathcart: conservative thought in chemical physiology, nutrition and public health’, Soc. Stud. Sci., 1989, 19: 195–238;
245. Naomi Aronson, ‘Nutrition as a social problem: a case study of entrepreneurial strategy in science’, Soc. Probl., 1982, 29: 474–87.
246. Charles Newman, The evolution of medical education in the nineteenth century, London, Oxford University Press, 1957, pp. 194–264;
247. George Newman, note 96 above; idem, Recent advances in medical education in England. A memorandum addressed to the Minister of Health, London, HMSO, 1923
248. F. N. L. Poynter (ed.), The evolution of medical education in Britain, London, Pitman, 1966, pp. 169–93.
249. C. J. Patten, sought to add embryology, morphology and physical anthropology to the “limited branch&. of Topographical and Applied Anatomy” that had previously been taught to medical students: Patten to University Senate, April 1904, and other correspondence, SUA 5 1 26, ff. 53–83.
250. A complementary analysis of the social relations of the medical teaching laboratory is to be found in Larry Owens, ‘Pure and sound government: laboratories, playing fields, and gymnasia in the nineteenth-century search for order’, Isis, 1985, 76: 182–94.
251. Irvine S. L. Loudon and Rosemary Stevens, ‘Primary care and the hospitals’, in John Fry (ed.j, Primary care, London, Heinemann, 1980, pp. 139–75.
252. Report of the sub–committee of the Clinical Studies Committee, inserted in Medical Faculty Minutes, 4 April 1919, SUA 8 5 6.
253. Hall, note 109 above.
254. Kohler, note 7 above, pp. 40–72.
255. C. S. Sherrington to J. S. Burdon Sanderson, 17 and 19 February, 8 March 1902, in University College London Library, Burdon Sanderson Papers, MSS Add 179, file 9, ff. 77, 81–6
256. Steve Sturdy, ‘State strategies for health care and the development of clinical science, 1900–1920’, paper given to the Wellcome Unit for the History of Medicine, Oxford University, 22 February 1990.