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CLARE HOLDSWORTH*
In 1892 Dr John Thomas Arlidge, physician at the North Staffordshire Infirmary, published The hygiene, diseases and mortality of occupations.1 This lengthy volumeover 550 pages-was the first significant British publication on occupational diseases since Charles Turner Thackrah's The effects of the principal arts, trades and professions,
. . on health and longevity, published in 1831.2 Hygiene made Arlidge the leading late-- nineteenth-century authority on occupational diseases. The book was based principally on his experience of observing and treating occupational diseases-particularly those of potters-during his appointments at the North Staffordshire Infirmary and as Factory Certifying Surgeon for Stoke-on-Trent. His contribution to occupational medicine also included leadership of the Association of Certifying Medical Officers (ACMO),3 formed in 1868 to represent the interests of Certifying Surgeons. Arlidge was elected as its first and only President, and he dominated the ACMO until its demise ten years later. In the 1890s following the publication of Hygiene, he was also associated with the introduction of health and safety legislation in the pottery industry.4
This article addresses Arlidge's contribution to the practice of occupational medicine, especially his leadership of the ACMO, and to the medical understanding of occupational diseases, particularly respiratory diseases of potters. It extends previous accounts of his career, which have concentrated on his significance in North Staffordshire, by considering also his national reputation and his impact on the early-twentieth-century occupational health specialists who developed the discipline after his death in 1899.5
Mid-Nineteenth-Century Occupational Medicine
Though the association between work and health was recognized by factory reformers from the beginning of the nineteenth century, the development of occupational medicine was somewhat sporadic.6 Nineteenth-century factory legislation was introduced to address employers' responsibilities towards three classes of workers: children, young workers and women.7 Their predicament was the result of long working hours, lack of education and general insanitary working conditions, and it was to these issues that factory reformers devoted their attention. The concerns of present-day occupational health specialists, that is exposure to industrial hazards such as dust and toxins, were often of secondary importance; from a twentieth-century perspective occupational medicine remained "stillborn in the age of sanitary reform".8 The contribution of doctors to debates on work and health was often overshadowed by other interests. As Robert Gray suggests,...