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The development of medical statistics based on the concepts of probability and error-theory developed by Francis Galton, Karl Pearson, George Udny Yule, R A Fisher, and their colleagues, has had a profound impact on medical science in the present century. This has been associated especially with the activities of the Medical Research Council (MRC) Statistical Unit at the London School of Hygiene and Tropical Medicine (LSHTM). It was here in 1946 that the world's first statistically rigorous clinical trial was undertaken, and where in the 1950s Austin Bradford Hill and Richard Doll revealed a statistical relationship between smoking and lungcancer. But how and why was this key institution founded, and why were its methods probabilistic?'
One might assume that the sheer brilliance of the work produced by Pearson and his statistical followers was sufficient to win over the medical profession, and to attract funding for the MRC Unit. However, one might question the extent to which an association with Pearson, and with the mathematical technicalities of his statistics, immediately endeared the fledgling discipline of biostatistics to the medical community. As J Rosser Matthews has shown recently, Pearsonian statistics were only haltingly accepted by medical scientists in Britain in the 1920s and 1930s, and were little understood by medical practitioners.Z How then was such a university-based infrastructure for medical statistics established? Ultimately, of course, the Statistical Unit depended upon the MRC and the Ministry of Health for the funding.3 However, if one is to believe scholars such as Roger Davidson, the early twentieth century was a period when the narrow requirements of an administrative elite of civil servants dedicated to preserving the status quo, and eager not to baffle politicians with unfamiliar methods of analysis, acted as a brake on the development of statistical work within government.' Why then did the MRC Statistical Unit at the LSHTM gain such financial support?
The background to this development is plainly the rise of specialization in medicines and the creation of university medical departments as the powerhouses of medical research. The latter gave aspiring medical professionals an enviable degree of recognition and financial security in an often difficult health-care market.b But the crucial question here is why this particular specialism in this particular place? Much of the story to...