SMITH, EDWARD

(b. Heanor, Derbyshire, England, 1818[?]; d London, England, 16 November 1874)

physiology, nutrition, public health.

Strikingly little is known about Edward Smith, a competent and highly influential nineteenth-century British physiologist and public health worker. His birth was not recorded in the parish register at Heanor, and the exact date is unknown. His father was Joseph Smith, apparently a successful businessman in Derbyshire; the surname of his mother, whose Christian name was Martha, is not recorded. Smith obtained his initial medical degree (M.B.) at the Royal Birmingham Medical School in 1841, and the M.D. degree followed in 1843, The medical school shortly afterward became Queen’s College, and its certificates were recognized by the University of London. In 1848 Smith received the London B.A. and LL.B. from Queen’s College. He is known to have practiced medicine in Birmingham from 1841 to about 1848.

Smith’s religion seems to have been Wesleyan, a matter of some significance at the time and for much of the nineteenth century. Candidates for admission to Oxford or Cambridge (although not to the University of London system) were required to subscribe to the tenets of the Church of England and could not be Dissenters. To adhere to doctrines not sanctioned by the official church was a handicap in other ways as well; it made easy access to Britain’s highest intellectual and political strata considerably more than a matter of course. Smith’s religious convictions, at least as a young man. would seem to have been intense, judging from a prize essay written while he was in medical school. The essay was basically a theological tract that employed the aortic system to support various fundamentalist religious theses. Smith married Matilda Frearson Clarke (an American citizen, according to the census of 1861) at Nottingham on 4 May 1843. Two daughters were born between 1847 and 1850. Smith made a rapid survey of living conditions in Texas in 1849, possibly requested by relatives of his wife, and published the results within a few weeks of his return to Britain.

Sometime in 1851 Smith established practice in London, having become fellow of the Royal College of Surgeons by examination in that year. Late in 1851 he was appointed lecturer in botany at the Charing Cross Medical School, and within a short time he became demonstrator in anatomy there. He also held an appointment as physician-accoucheur at the West London Lying-in Institution. All went well for a short time; but within a year he was involved in acrimonious dispute with the medical committee of Charing Cross Hospital. The incident was the first in a series of controversies with authorities and colleagues that characterized much of his professional career. It resulted in his dismissal from Charing Cross Medical School in 1853.

For several years Smith occupied himself with practice and writing on medical topics for the layman as well as for the professional. On 29 March 1855 he was appointed assistant physician at the Brompton Hospital for Consumption, a post he held for ten years. No later than 1862 Smith became known to public health officials in Britain, and in 1866 he was appointed inspector and medical officer to the Poor Law Board. For a time he was very influential in medical aspects of Britain’s welfare system. But he ultimately came into conflict with Sir John Simon, head of the Local Government Board’s medical department, and the remaining years of his life were spent somewhat in limbo.

Smith was elected fellow of the Royal Society in 1860. He was also a fellow of the Royal College of Physicians (1863), president of the Physiological Subsection of the British Association, and member of the National Association for the Promotion of Social Science.

Smith’s claim to scientific distinction rests on his pioneering work in respiratory physiology, metabolism, and nutrition. It is also clear that scientific curiosity was not his primary motivating force; he was at heart a social reformer and was unique among scientific investigators of his time in that he mobilized his research to support reform movements.

While on the staff at Brompton Hospital, Smith devised ingenious and original methods for measurement of respiratory function and related metabolic phenomena. His interest in measuring the effects of physical exertion on respiration seems to have directed his attention to the punitive treadmill, a device then used in Britain’s prisons. Prisonsoners sentenced to hard labor were required to spend many hours each day on the treadmill; and Smith, perceiving an opportunity, asked prison authorities for permission to use prisoners as experimental subjects. This experience seems to have led him to consider the diet and living conditions of prisoners. His published work dealt with both subjects and ultimately brought him election to the Royal Society.

The work also allied Smith with groups and individuals seeking to reform Britain’s prisons and may have been a factor in arousing a more general interest in the plight of Britain’s lower classes. In 1863 he testified before a parliamentary commission investigating prison conditions and presented physiological evidence to show that the treadmill, as it was used, was a cruel and inhumane device.

The work on respiration at rest and during exercise led naturally to a consideration of metabolism of foodstuffs and energy sources under the same conditions. Once again Smith’s emphasis was on measurement, this time of foods ingested and metabolic products excreted. He made short work, in the process, of Liebig’s dogmatic assertion that the energy for muscle exercise comes entirely from protein.

The cotton famine of 1862 (in Lancashire) brought Smith formally into what is now known as public health. In December of that year Sir John Simon, then medical officer of health, asked him to visit six stricken towns in order to determine the general state of nutrition of the unemployed and “the least outlay of money which [will] procure food enough for life.” A second and larger survey was carried out in the summer of 1863. The results, although in many respects imperfect, provided very valuable quantitative information concerning diet and economic conditions. Probably more important is that Smith’s surveys pointed the way to, and the necessity for, health research on entire populations. They were, in fact, the forerunners of larger and more elaborate field studies done before and after both world wars.

Smith subsequently did additional studies of nutrition and working conditions of specific types of workers. reporting the results in the language of the reformer. Tailors in the London area, he found. had mortality rates that were higher, at all ages, than the rates for farmers. In London’s printshops the condition of young boys, working twelve hours a day, six days a week, demanded “instant amelioration.” As a Poor Law official, Smith had a great deal of influence on workhouse dietary practice, the provision of medical care, and the design of the workhouses themselves.

The last ten years of Smith’s life undoubtedly were anticlimactic. He was involved in almost continuous controversy and, in some instances, did not acquit himself well. One such case was the bitter quarrel with Sir John Simon. An obituary in the British Medical Journal said; “... medically, Dr. Edward Smith met with little success in practice nor did he contrive to conciliate the affections of his colleagues.” This was probably a fair assessment. But neither the Journal nor other publications at the time credited him with his great innovations in the quantitative study of respiration and metabolism, and in the nutrition of populations. Smith was the first to devise quantitative methods suitable for studies on the human being during exercise. His monumental data on inspiratory volume, respiratory and pulse rates, and carbon dioxide production at rest and at various levels of exercise served as the basis for much of the work on muscular exercise in the latter part of the nineteenth century. But most British physiologists, in sharp contrast to those on the Continent, seem to have known little of Smith and his work, although both groups built on his concepts and results. His work on nutrition, although innovative and fundamental, fared little better until quite recently.

Smith’s reputation may well have suffered during his life and after his death owing to the numerous quarrels in which he was involved. But he was also very much ahead of his time: he was not only scientifically gifted and innovative; he also believed in seeing that his results were applied pro bono publico. Partly for this reason and partly because of belated recognition of the excellence of his scientific work, Smith’s life and work have recently been rescued from obscurity.

BIBLIOGRAPHY

I. Original Works. Smith’s writings include “The Spirometer: Its Construction, Indications and Fallacies,” in Medical Circular, 9 (1856), 294, 305, 313–314; 10 (1857), 5, 40, 64–65: “The Influence of the Labour of the Treadwheel Over Respiration and Pulsation, and Its Relation to the Waste of the System, and the Dietary of the Prisoners,” in Medical Times and Gazette, n.s. 14 (1857), 601–603; “Inquiries Into the Quantity of Air Inspired Throughout the Day and Night and Under the Influence of Exercise, Food, Medicine, Temperature, etc.,” in Proceedings of the Royal Society, 8 (1857), 451–454; “Inquiries Into the Phenomena of Respiration,” ibid., 9 (1858), 611–614: “Experimental Inquiries Into the Chemical and Other Phenomena of Respiration, and Their Modifications by Various Physical Agencies,” in Philosophical Transactions of the Royal Society, 149 (1859), 681–714: “On the Immediate Source of the Carbon Exhaled by the Lungs.” in Philosophical Magazine, 4th ser., 18 (1859), 429–436; “Report on the Action of Prison Diet and Discipline on the Bodily Functions of Prisoners. Part I,” in Report of the British Association for the Advancement of Science, 31 (1861), 44–81, written with W. R. Milner; “Report on the Food of the Poorer Labouring Classes in England,” in Sixth Report of the Medical Officer Privy Council (London, 1864), 216–329 (app. 5); “Report on the Sanitary Circumstances of Printers in London,” ibid., 383–415; “Report on the Sanitary Circumstances of Tailors in London,” ibid., 416–430: “Dietaries for the Inmates of Work Houses,” in House of Commons. Parliamentary Papers (Reports From Commissioners for 1866), XXXV, 321–629: “Metropolitan Workhouse Infirmaries and Sick Wards,” ibid. (Accounts and Papers) (1866), LXI, 171–388: and “Report on the Sufficiency of the Existing Arrangements for the Care and Treatment of the Sick in Forty-Eight Provincial Workhouses Situated in Various Parts of England and Wales,” ibid. (1867–1868), LX. 325–483.

II. Secondary Literature. See T. C. Barker, D. J. Oddy, and John Yudkin. The Dietary Surveys of Dr. Edward Smith, 1862–3. Occasional paper no. 1. Dept. of Nutrition, Queen Elizabeth College (London, 1970); and Carleton B. Chapman, “Edward Smith (?1818–1874). Physiologist, Human Ecologist, Reformer,” in Journal of the History of Medicine and Allied Sciences, 22 (Jan. 1967), 1–26.

Carleton B. Chapman