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Elizabeth Fee and Thedore M. Brown

Elizabeth Fee is with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md. Theodore M. Brown is with the Departments of History and of Community and Preventive Medicine at the University of Rochester, Rochester, NY.

Correspondence: Requests for reprints should be sent to Elizabeth Fee, PhD, Building 38, Room 1E21, 8600 Rockville Pike, Bethesda, MD 20894 (e-mail: elizabeth_fee{at}nlm. nih.gov).

JOHN HENRY BELL WAS BORN in 1832 in Bradford, in the northern wool-manufacturing region of England, of Scottish parents. At the age of 14, he left school and began to study medicine through a 6-year apprenticeship with a local doctor. He then became assistant to a lecturer in the Leeds Medical School, attended classes there, took his examinations after 2 rather than the usual 3 years, and passed with distinction. In 1857, he qualified as member of the Royal College of Surgeons and as licentiate of the Society of Apothecaries. While in Leeds, he was elected to membership in the Hey Society, an honorary medical society. When he became president of the society, he gave one of the earliest descriptions of miners' nystagmus, an occupational disease of coal miners characterized by involuntary rapid eye movements.

Bell moved to Bradford to establish his medical practice and was one of the founders of the Royal Eye and Ear Hospital, where he worked as a surgeon for 40 years. While in Bradford, he became very concerned about the sudden deaths of young able-bodied men in the wool trade, some of whom were his patients. Until the middle of the 19th century, wool sorting had been considered a very healthy occupation.¹ But after wool and hair from abroad were introduced into the trade, sudden fatalities began to occur among the woolsorters. At first, these attracted little attention and the deaths were ascribed to various pulmonary afflictions. But on February 27, 1878, the following letter appeared in the Bradford Observer:

Sir:—Within a month three woolsorters have died from blood poisoning contracted in the same shed of the same factory in Manchester-road. Occasional deaths from blood poisoning, through the handling of some foreign wools, may perhaps be inevitable, but the recurrence within so short a time of three such cases seems to suggest either that the wool itself, or the shed in which it was sorted, is specially unwholesome.²

This letter provoked a postmortem examination at which Dr Bell was present. In his notes, he labeled the case "Case 7 of woolsorters' disease." Bell reasoned that the deaths could not be due to fibers, dust, or hair because the woolsorters did not suffer more than others from cough and because inhalation of fibers and dust usually led to chronic disease, not sudden death. Bell thought at first that woolsorters' disease must be caused by a "septic poison" derived from decomposing animal matter. Then a colleague who had been visiting European bacteriologic laboratories suggested that the disease might have some connection with the splenic fever of sheep and cattle, which Robert Koch had shown conclusively in 1877 to be caused by the anthrax bacillus.

Bell now inoculated animals with blood from a fatal case of woolsorters' disease. They all died, and he found anthrax bacilli in their blood. Bell reasoned that mortality could be considerably lessened if fresh air were blown through the wool for 24 hours before workmen handled it. He also advocated treating the wool with antiseptic and disinfecting it with steam. Wool manufacturers were, however, reluctant to undertake these precautions, and a newspaper war on the subject waxed strong. The woolsorters demanded that manufacturers carry out the medical recommendations, while manufacturers protested that the medical profession was not unanimous as to the best method of disinfecting the wool. Dr Bell wrote about woolsorters' disease in the Bradford Observer:

I will not enter into the particulars as to its cause, nature, and symptoms (these are more suited for the medical press), except to say that it is produced by the inhalation of living organisms derived from the fleeces of animals that have died from anthrax. It may readily be communicated from man to animals, and their blood when examined after death abounds with bacteria (bacillus anthrax) like caterpillars without legs—millions in a drop.³

In May 1880, a man named Samuel Firth contracted the disease and died. Bell attended the man and wrote on the death certificate that the man had died from woolsorters' disease as a result of his employer's neglect in not having the wool disinfected beforehand. He sent the certificate to the police, forcing them to order an inquest; the jury recommended a series of specific measures to prevent the disease and, since no relevant legislation existed, forwarded the recommendations to the sanitary committee of the Bradford Corporation. They conferred with representatives of the woolsorters, the manufacturers, and the local medical community and came out with a series of voluntary guidelines. These were reaffirmed and expanded in 1884 and were continued by voluntary compliance until 1899, when they were adopted as official policy by the British Home Office.

These preventive measures were only partially effective because neither Bell nor other physicians realized how resistant anthrax spores could be; nonetheless, deaths from woolsorters' disease declined dramatically throughout this period. The woolsorters recognized Dr Bell's contributions by presenting him at a public dinner with a gold watch and chain "as a token of the regard in which he was held by those whose cause he had so nobly maintained."⁴

References

1. Cunningham W. The work of two Scottish medical graduates in the control of woolsorters' disease. Med Hist.1976;20:169–173.[Medline]

2. Eurich FW. The history of anthrax in the wool industry of Bradford and of its control. Lancet. 1926;i:57–58.

3. Little A. The life and work of Dr John Henry Bell, of Bradford. Caledonian Med J.1907;7:126–137.

4. J. M. Obituary: John Henry Bell, MD, MRCS. Br Med J. 1906;ii:735–736.

This article has been cited by other articles:

				V. Sidel, H. W. Cohen, and R. M. Gould From Woolsorters to Mail Sorters: Anthrax Past, Present, and Future Am J Public Health, May 1, 2002; 92(5): 705 - 706. [Full Text] [PDF]

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