© 1999 Tht Societyforthe Social History of Medicine

DISCUSSION POINT

Food, Hygiene, and the Laboratory. A Short History of

Food Poisoning in Britain, circa 1850-1950

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By ANNE HARDY

SUMMARY. Public health concern with food safety and food poisoning emerged in Britain
in the 1880s following thefirstindication that acute gastric illness was caused by a specific
organism. Although incidents were for many years only sparsely reported, the central
medical department and its scientists were anxious to extend their knowledge of the inci-
dence, specific causal organisms, and epidemiology of the illness. This paper argues for a
widespread incidence of food poisoning in Britain in the nineteenth century and traces the
social, economic, and hygienic contexts within which it occurred. As deadlier infections
retreated, food poisoning became an increasing concern of local and national health author-
ities, who sought both to raise public awareness of the condition as illness, and to regulate
and improve food handling practices. Notification of cases was begun in 1939, and this,
together with social changes during and after the Second World War, produced an esca-
lating spiral of reported incidents which still continues. This trend, it is argued, is essentially
an artefact, whose significance is reduced if considered in its broader historical context.
KEYWORDS: food safety, hygiene, bacteriology, meat, statistics, salmonellas

June, 1880, was not a month of heat and sunshine but cold and wet: rain fell every
day until the 26th.1 None the less, the well-to-do of the English Midlands could be
lured into the countryside on expeditions of business and pleasure. Among the
month's attractions was a big sale of machinery and timber at Welbeck Abbey, the
very grand and rather mad country seat of the Duke of Portland, which lies in
Nottinghamshire, not far from the town of Mansfield. The sale was held from the
15th to the 19th of the month, and some 2,000 visitors from six counties flocked to
attend the sale and to see the 'remarkable place'. Refreshments were provided on
site by a Mansfield hotel, which stored its foodstuffs overnight in an underground
storeroom. Beginning on Thursday 17 June, numbers of visitors to the sale fell ill
with 'griping pains in the belly', chills, headache, vomiting and diarrhoea.
Seventy-two cases were documented in all, and there were four deaths (the corpses
•Wellcome Institute for the History of Medicine, 183 Euston Road, London NW1 2BE, UK.
E-mail: <j./i<m/y@uWfcome.<ic.ufe
The first version of this paper was presented at the Annual Scientific Meeting of the Association of
Clinical Microbiologists and Golden Jubilee of the Public Health Laboratory Service in May 1996. I
am grateful to Dr Edward Guy of the PHLS for inviting me to speak on that occasion; to colleagues at
the Wellcome Unit, Oxford University, the London School of Hygiene and Tropical Medicine, and
the Centre for the History of Medicine, Sheffield," who listened to, and commented on, the expanded
version of that paper; and to an anonymous referee for constructive advice. All deficiencies in this
published version remain my own.
1
J. Glaisher, 'Remarks on the Meteorology of the Year 1880', Registrar-General's Annual Report,
PP, 1882, XIX, pp. xxxiv-v.
0951-631X Social History of Medicine Vol. 12 No. 2 pp. 293-311
294 Anne Hardy

were said to look like cholera victims), but it was accepted that many more cases
went undiscovered.2
Suspicion centred on imported American hams, which had been used both in
cold meat platters and in sandwiches by the caterers. The local medical men
thought it might be trichinosis (which had been discovered by James Paget in
1835), but Edward Ballard (1820-97), investigating for the Local Government
Board, thought it more likely that the meat had, in the storeroom, 'undergone

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some chemical change short of putridity which had rendered it unwholesome'. 3
He had discovered that the storeroom contained a long open drainage channel,
connecting with a sewer, and he thought that an escape of sewer air might have
poisoned the meat. He sent portions of the suspect meat to his colleague, the
microbiologist Edward Klein (1844—1925), for examination and experiment.
Klein identified a 'living parasitic thing capable of spreading by its growth and
reproduction through the material in which it was found, and capable of pro-
ducing disease in animals into whose system it was introduced; capable also of
growth and reproduction within the system of those animals'. Importantly, too,
Klein found his parasite only in the thicker and less well cooked portions of the
meat—as Ballard sourly remarked, hotel hams, and domestic ones too, were all too
often inadequately cooked.4 For Klein, the laboratory scientist, and for his co-
workers and successors, this episode marked the beginning of extensive researches
into infective organisms found in food; for Ballard, the epidemiologist, and for the
public health organization with which he was associated, it was the beginning of a
growing concern for the hygienic preparation and storage of food, and of the
creation of'food poisoning' as a public health problem.
'Food poisoning' as 'commonly understood' was defined in 1935 by Arthur
MacNalty (1880-1969), then Chief Medical Officer of the Ministry of Health, as
'an acute gastro-enteritis due to the ingestion of food or drink which either con-
tains living bacteria of species capable of setting up an acute inflammation of the
alimentary t r a c t . . . or contains irritative substances—"toxins"—produced by the
growth of bacteria in food and drink'.5 This definition of the condition, which
excludes as causal factors chemical adulteration and preservation processes such as
canning, except where micro-organisms or their toxins have survived the canning
process, will be adopted here.
It is a distinction with historic roots: plant toxins and poisoning on the Borgia
model apart, two types of illness associated with foodstufls were recognized by the
nineteenth century, the one associated with adulteration, the other with foods
normally not causing illness and apparently incapable of adulteration, such as meat
and fish. The last type had long been associated with decomposition; in the early
nineteenth century it was thought to be due to chemical poisons, later to
ptomaines, or putrefactive alkaloids.6 Uncooked fruit and vegetables were also
2
E. Ballard, 'On an Acute Specific Disease', Medical Officer's Annual Report, Local Government
Board, PP, 1881, XLVI, Appendix A no 5, pp. 752-83.
3
Ibid., p. 764.
4
Ibid., pp. 765-6.
5
Chief Medical Officer's Annual Report, Ministry ofHealth, 1935, p. 146.
6
E. B. Dewberry, Food Poisoning. Food-borne Infection and Intoxication (London, 1959), pp. 6-7.
 Food Poisoning in Britain c. 1850-1950 295

associated with upset stomachs, but here illness was generally attributed to unripe-
ness or acidity.
Most of the nineteenth-century literature on ptomaine poisoning derived from
Germany; in Britain it received little medical attention. Occasional incidents were
reported in the English medical press, but into the 1870s these were treated as
curiosities, or as essentially of medico-legal interest.7 It was not until the later 1880s

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that the generic term 'food poisoning' emerged: before this, and still occasionally
for decades thereafter, episodes were usually described by the precise item of food
involved: 'cheese poisoning', 'meat poisoning', 'pork-pie poisoning'.8 It was only
when the central medical department began collecting outbreaks in the 1880s that
the term food poisoning came into use, initially in inverted commas.9
The 1880s was the key decade in which the concept of bacterial food poisoning
displaced that of ptomaine poisoning, among interested researchers and public
health administrators. The term 'ptomaine poisoning' continued to be used, how-
ever, until well into the twentieth century by less interested medical men to denote
incidents of bacterial food poisoning, much to the fury of food poisoning experts.10
In the late 1870s, German researchers had begun to draw attention to connections
between septic and pyaemic disease in animals used for food and meat poisoning
outbreaks, and in the early 1880s to investigate meat poisoning outbreaks bac-
teriologically. Their work does not seem to have been reported in Britain.11
The Welbeck outbreak was the critical incident alerting the English public
health authorities to a new food-related problem: that of food which was to all
appearances sound, but which caused illness when ingested, apparently because it
contained an illness-inducing organism. Despite Robert Koch's identification of
the specific organism of anthrax four years previously, this was the first time
anyone in England had thought to associate a living organism with the much more
ordinary affliction of vomiting and diarrhoea, or had made a connection to meat
7
See J. Buckenham, 'Extraordinary Case of Poisoning' (letter), Lancet, ii (1862), 297; J. Lowe,
'Symptoms of Poisoning from Eating Game' (letter), ibid., 347; E. Crisp, 'The Meat Pie' (letter),
ibid., i (1863), 48—9; E. Maclcey, 'Symptoms of Irritant Poisoning from Pork Brawn', British Medical
Journal, i (1873), 533. The latter noted specifically, '[Such cases] deserve record, because they have a
medico-legal interest, and may be required for reference and precedent'.
8
See, for example, H. E. Durham, 'The Present Knowledge of Outbreaks of Meat Poisoning',
British Medical Journal, i (1898), 1797-801; K. F. Peckham, 'An Outbreak of Pork Pie Poisoning at
Derby' Journal of Hygiene, 22 (1923-24), 69-76.
9
In his annual report for 1889, the Chief Medical Officer, George Buchanan, first referred
specifically to food poisoning. His report included the remark, 'The phenomena that we speak of as
"food poisoning" . . .': Medical Officer's Annual Report for 1889, Local Government Board, PP, 1890,
XXXIV, pp. 19-20. A year later, Edward Ballard referred to 'so-called "food poisoning'": ibid., PP,
1890-91, XXXIV, Appendix 21, p. 245.
10
See, for example, W. G. Savage, Food Poisoning and Food Infections (Cambridge, 1920), p. vii.
11
Dewberry, Food Poisoning, pp. 9—10. A trawl through the Lancet and the British Medical Journal
failed to turn up reports on the German investigations; neither George Buchanan, the Chief Medical
Officer, nor Ballard himself, mention the earlier German literature in their discussions of the Welbeck
case. The 1880 report of the Pathological Society's Pyaemia Committee similarly made no mention of
German research in this area: Lancet, i (1880), 225. The earliest German work on this subject
(1876-80), that of Bollinger, District Veterinarian of Dinter, Saxony, appears not to have been pub-
lished, but communicated at scientific meetings: R. Ostertag, Handbook of Meat Inspection, translated by
E. V. Wilcox (London, 1904), pp. 712—18. Dewberry, for example, mentions Bollinger's work, but
gives no reference for it.
296 Anne Hardy

that was not fully cooked rather than to meat that had decayed. Klein, by extend-
ing his investigation with the new techniques of bacteriology, had opened a fresh
field of public health concern. Although mid-nineteenth-century concerns about
the purity and wholesomeness of food had resulted in legislation, it specifically
addressed chemical adulteration (the Adulteration Acts 1860, 1872, and 1875),
and unsoundness (the Nuisances Removal Act, 1855). The former could be

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demonstrated by chemical analysis, and policed by inspection; the latter adjudged
and policed also by inspectors. Dangerous food which offered no telltale indi-
cations of smell, taste, or appearance presented a serious problem of identification.
It is perhaps also significant that the Welbeck outbreak occurred not only at the
beginning of the bacteriological search for specific agents of disease, but also
shortly after the appointment of George Buchanan (1831-95) as principal medical
officer to the Local Government Board: Buchanan's interest in problems of animal
health and food hygiene dated back to the 1860s, when he was Medical Officer of
Health for St Giles Vestry.12 Following Welbeck, Ballard began compiling a list of
food poisoning incidents coming to the Board's attention—a task made easier by
the extension of the medical officer of health provision to all urban and rural
districts under the Public Health Act, 1872.
The Welbeck poisoning case could have happened at any time in earlier English
history. Undercooked meat was certainly served on many occasions in the past.
Gastric illness has, however, been more generally associated with specific food-
stuffs, rather than their preparation, although also with other factors. Samuel
Pepys, for example, attributed a sudden looseness in his bowels to catching cold,
while Smollett's Matthew Bramble, describing in gruesome detail the horrid
pollutions of London's eighteenth-century food supply, did not associate them
with illness either in himself or in others.13 People questioned in one early
twentieth-century survey attributed their attacks of 'typical epidemic diarrhoea'
variously to heat, cold, teething, chocolates, medicine, currants, and fruit.14 Plums,
in particular, have had a evil reputation in this respect.15 When cholera arrived in
London in 1848, the citizens expressed their beliefs and anxieties very clearly in
their food marketings—sales of fruit, vegetables, and particularly fish, plummeted,
and the city's costermongers, who depended on this trade for their livelihoods,
were reduced to desperate straits.16 Times of crisis, therefore, reveal beliefs which
in the normal way may be hidden, or dealt with quite differently. There was, for
example, a Yorkshire farmer who, visiting London, ate lobster for the first time in
his life on the evening of his arrival. It disagreed with him. 'My stomach would not
keep it,' he reported, 'but determined to show who would be master, I gave it
lobster every night, and it never refused it again'.17 Until well into the present
12
'Sir George Buchanan", Public Health, 7 (1894-95), 322.
13
R. C. Latham and W. Matthews (eds), The Diary of Samuel Pepys (London, 1971), vol. 6, p. 244;
see also vol. 5, pp. 171, 249; Tobias Smollett, Humphrey Clinker (Harmondsworth, 1967),
pp. 151-3.
14
O. H. Peters, Epidemic Diarrhoea (Cambridge, 1911), p. 22.
15
Ibid., p. 83.
16
H. Mayhew, London Labour and the London Poor (Toronto and London, 1975), vol. 1, pp. 57—8.
17
J. Haddon, 'Poisoning by Beetroot' (letter), British MedicalJournal, ii (1914), 155.
 Food Poisoning in Britain c. 1850-1950 297
century, Coroners' courts and the popular press generally ascribed any sudden
death following on acute gastric illness to food poisoning, even where the
epidemiological and postmortem evidence clearly ran counter to such a verdict.18
Anecdotes apart, the incidence, even the existence, of food-bome disease is
hidden for much of the nineteenth century, even for England and Wales, where
cause of death had to be certified from 1837 onwards. There are good grounds,

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however, for believing that food-borne infections were widespread in English
society by the 1850s, and that this was a relatively new phenomenon, and the result
of social change. In the course of the nineteenth century, Britain became an urban
society. Where only a fifth of the population lived in towns in 1801, by 1901 four-
fifths did so. The implications for national food supplies, for their marketing and
management, and for health and hygiene, were vast. The coming of the railways
after 1830 and of steam-ships from the 1860s opened up both national and global
sources of food, but also facilitated the spread of infections. And with life in towns,
food habits changed. Fast food and shop-prepared dinners are no twentieth-
century invention: they have their precedents in earlier urban societies. Already in
the 1840s, working people in London were buying sandwiches and hot pies in the
streets for their lunches, and by the 1880s townspeople all over Britain were taking
home fish and chips or hot roast dinners from the local cookshop in the evenings.19
Levels of hygiene in the preparation and handling of such foods were usually
dubious; their contents often dubious as well. Those in the know refused to eat
these foods: the London costermongers, for example, would never eat eel pies,
because they knew they were often made from seriously dead eels.2 Indeed, a
waste-not-want-not attitude prevailed widely in the livestock and food industries
at this time, with animals 'killed to save their lives' constandy entering the food
chain.21
Hard historical evidence for an increasing incidence of food-borne infections in
nineteenth-century towns is lacking—as noted, food poisoning did not feature in
the General Register Office's lists, and the condition was not made notifiable until
1939. There are, however, two indicators for the behaviour of food infections in
Victorian cities: typhoid and epidemic diarrhoea. Typhoid, which first emerged as
a major urban hazard in the 1830s, was, of course, largely water-borne, but the role
of human carriers and of contaminated foodstuffs is likely to have been significant.
Death rates from typhoid fell rapidly between 1870 and 1885, as urban water
supplies were improved, but then stabilized until the early years of this century.22
With the discovery of the human carrier, and of foodstuffs as a vehicle of infec-
tion, and with greater attention paid to the rapid hospitalization of patients, death
18
W . G. Savage and P. Bruce W h i t e , ' F o o d Poisoning', Medical Research Council, Special Report
Series, n o . 92 (1925), p p . 9 - 1 0 .
19
M a y h e w , London Labour, vol. 1, pp. 1 5 8 - 7 8 ; E. Ballard, ' O n a Series of Cases of Acute Specific
Disease (Similar t o that Observed in the Welbeck Outbreak) Following o n t h e Eating of H o t Baked
Pork', Medical Officer's Annual Report, Local G o v e r n m e n t Board, PP, 1881, XLVI, Appendix A n o 6,
pp. 7 7 4 - 8 7 ; J. W a l t o n , Fish and Chips and the British Working Class (Leicester, 1992), p p . 2 6 - 4 4 .
20
M a y h e w , London Labour, vol. 1, p . 5 2 .
21
W . G. Savage, Food Poisoning, p . 5; see also R . Perren, The Meat Trade in Britain 1840-1914
(London, 1978), chs 3, 6.
22
M . G r e e n w o o d , Epidemics and Crowd Diseases (London, 1935), p . 157.
298 Anne Hardy

rates again fell rapidly, so that typhoid had virtually disappeared as a public health
problem by 1920. None the less, cases continued to be reported and, as late as
1946, the Chief Medical Officer noted that typhoid and paratyphoid 'are widely
endemic and, even with safe water supplies, outbreaks will be avoided only just so
long as a decent standard of personal cleanliness is observed'.23 Human carriers
were clearly implicated in this endemicity. Although carriers are usually con-

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sidered safe if they do not handle food, the case of'Mrs R', described by James
Watt, Medical Officer for Aberdeenshire in 1923, is instructive. The wife of a
manufacturer, she seems unlikely to have had anything to do with her household's
food preparation at this period. Yet between 1894 and 1910, 12 cases of typhoid
occurred in her house, despite everything being done in the way of sanitary
improvement. In 1910, however, she was diagnosed as being a double carrier (that
is, both faecal and urinary), and thereafter all new maidservants coming into the
house were inoculated against typhoid. No further cases occurred, or were traced
to Mrs R, up to her death in 1922.24
Epidemic diarrhoea offers another, perhaps even more pertinent, perspective on
food poisoning. The term encompasses infant diarrhoea, the condition responsible
for some 30 per cent of infant mortality before 1901. Paul Huck's local studies have
shown that rising infant mortality was closely associated with the growth of the
industrial towns in the early nineteenth century, and that there was also a critical
transition from a winter peak in mortality to a late summer one. 25 (This late
summer peak echoed those of typhoid and food poisoning.26) Diarrhoea exerted a
powerful influence on the peaks and troughs of urban infant mortality throughout
the later nineteenth century, as Woods, Woodward, and Watterson have shown.27
Yet these deaths were only the visible iceberg of extensive familial episodes of
diarrhoea occurring throughout the summer months in Victorian cities, and not
infrequently also in the winter. One of the earliest contemporary studies of infant
diarrhoea, in Leicester in 1878, found numerically more adults than children
affected, with multiple cases in households common, the illness often affecting
both parents and children.28 Similar patterns were noted by later investigators,
notably by a detailed study of the disease in Mansfield in 1908, which emphasized
a very high degree of multiple infection in households, together with the
'considerable part' played by parents in the introduction and first development of
infection within families.29
23
Chief Medical Officer's Annual Report, Ministry o f H e a l t h (1945), p . 2 9 .
24
J. P. Watt, 'Typhoid Carriers in Aberdeenshire' Journal of Hygiene, 22 (1923-24), 425.
25
P. Huck, 'Infant Mortality in Nine Industrial Parishes in Northern England, 1813-1836',
Population Studies, 48 (1994), 513-26.
Savage and Bruce White, 'Food Poisoning', p. 23.
27
R. I. Woods, J. Woodward, and P. Watterson, 'The Causes of Rapid Infant Mortality Decline in
England and Wales, 1861-1921', Part 1, Population Studies, 42 (1988), 343-66; Part 2, ibid., 43 (1989),
113-32; see also N. Williams and C. Galley, 'Urban-Rural Differentials in Infant Mortality in
Victorian England', ibid., 49 (1995), 401-20.
28
W . J o h n s t o n , ' T h e E t i o l o g y o f S u m m e r D i a r r h o e a ' , Transactions of the Epidemiological Society, 1
(1876-81), 203-4.
29
Peters, Epidemic Diarrhoea, pp. 11—12, 166; see also A. N e w s h o l m e , ' A C o n t r i b u t i o n t o t h e Study
ofEpidemic Diarrhoea', Public Health, 12 (1899-1900), 167-8; idem, 'Domestic Infection in Relation
to Epidemic Diarrhoea' Journal of Hygiene, 6 (1906), 139-48.
 Food Poisoning in Britain c. 1850-1950 299
The link had also been made to infection through foodstuffs. Edward Ballard,
who undertook the first systematic investigation of infant diarrhoea for the Local
Government Board in 1880, not only remarked on its familial nature, and the
enhanced ability of older children to resist the infection, but also indicated that the
disease was food-borne.30 As early as 1894, Sheridan Delepine, professor of bac-
teriology and head of the public health department at Manchester University,

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suggested a link between infant diarrhoea and food poisoning. In 1902, he
explored the linkage further, on the 'supposition that epidemic diarrhoea is
generally the result of a more widely disseminated, and less massive form of bac-
terial infection of food than is the case with regard to the more definite outbreaks
of food poisoning'.31 Indeed, when the first bacteriological analyses of epidemic
diarrhoea came to be performed, the leading contenders for causation (in England
at least) came from the salmonella family.32
The elucidation of possible routes of transmission for the organisms of infant
diarrhoea preoccupied many health officers at the turn of the nineteenth century.
Ian Buchanan's research has associated infant diarrhoea with refuse tips and flies;
and the Victorians also made this association.33 Around 1900, the health authorities
began to turn their attention to the house fly as a transmitter of diarrhoeal diseases,
and began to wage extensive anti-fly campaigns both through public education,
and against the breeding grounds of the flies themselves.34 At much the same time,
suspicions began to focus on contaminated milk, whether fresh or from opened
tins, as a vehicle of infection. Subsequent charitable and educational, and eventu-
ally voluntary and municipal, efforts at providing improved supplies gradually
began to yield dividends although probably only with any wider degree of
effectiveness in the interwar period.35
Meanwhile food-borne disease as manifested in outbreaks of acute food poison-
ing continued to be documented by the English public health authorities. Gustav
Gaertner's discovery, in 1888, of the bacillus he named b. enteritidis (Salmonella
enteritidis), which is commonly accepted as the most important landmark in the
history of bacterial food poisoning, gave further stimulus to English research into
such outbreaks. Unlike Klein eight years earlier, Gaertner had been able positively
to demonstrate that the bacillus he found in the flesh of an emergency slaughtered
cow (she had had diarrhoea) had caused gastro-enteritis in the people who had
30
E. Ballard, ' R e p o r t to the Local G o v e r n m e n t Board upon the Causation of the Annual Mortality
from "Diarrhoea" w h i c h is Observed Principally in the S u m m e r Season of the Year', Diarrhoea and
Diphtheria. Supplement in Continuation of the Report of the Medical Officer for 1887, PP, 1899, XXXV,
p. 10. See also Newsholme, 'A Contribution', pp. 166-7.
31
S. Delepine, 'The Bearing of Outbreaks of Food Poisoning, upon the Etiology of Epidemic
Diarrhoea'JoHma/ of Hygiene, 3 (1903), 74.
32
Ibid., p . 7 0 ; J. N i v e n , ' S u m m e r D i a r r h o e a a n d E n t e r i c F e v e r ' , Proceedings of the Royal Society of
Medicine, 3.2 (1909-10), 133.
33
1 . H. Buchanan, 'Infant Feeding, Sanitation, and Diarrhoea in Colliery Communities,
1880-1911', in D. J. Oddy and D. S. Miller (eds), Diet and Health in Modem Britain (London, 1985),
pp. 148-77.
34
See, for example, Medical Officer's Annual Report, L o n d o n C o u n t y C o u n c i l (1907), p . 6 3 .
35
P. J. Atkins, 'White Poison?: The Social Consequences of Milk Consumption in London,
1850-1939', Social History of Medicine, 5 (1992), 207-28; D. Dwork, 'The Milk Option: An Aspect of
the Infant Welfare Movement in England, 1898-1908', Medical History, 31 (1987), 51-69.
300 Anne Hardy

eaten her meat.36 The discovery of other such organisms quickly followed: in the
pioneering bacteriological laboratories of the 1890s, the identification of the
specific agents of disease had become a competitive game. In the early years,
however, the identification of food poisoning bacteria was greatly complicated by
their morphological similarity to each other. Between 1894 and 1896, however,
European bacteriologists developed the techniques of serum diagnosis, exempli-

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fied by Widal's simple, reliable and rapidly accepted method for the diagnosis of
typhoid.37 Two years later, the gifted English bacteriologist Herbert Durham
(1866—1945) demonstrated that the hitherto indistinguishable food poisoning
bacteria could be separated into at least two distinct groups with the use of agglu-
tination tests, and further, that serological examination was of diagnostic value in
patients suffering from food poisoning.38
Despite these new techniques, the bacteriology of food poisoning appeared to
be an immensely complicated subject, partly because of the number of different
organisms apparently involved in the process, and partly because of the vexed
questions of their nature and natural habitat. In 1898, Durham attempted to
resolve some of this confusion by describing a broad 'colon' group ofbacilli, which
he divided into three separate groups, on a spectrum from typhoid and the para-
typhoids (highly pathogenic), through the salmonellas (less pathogenic) to the
escheria coli group, which were regarded as harmless inhabitants of the normal
human gut, highly useful in detecting faecal contamination in water supplies.39
Although this typology had its critics, it achieved popular currency in the pre-
ventive literature in the early decades of the new century.40 The natural history of
the salmonellas was also an important preventive issue. Were they, as the Germans
argued, natural inhabitants of the human and animal intestine? Or were they only
present in diseased animals? Were they present in the flesh of the animal, or also in
its evacuations? In any case, as the ubiquity of salmonella organisms became ever
clearer, scientists became increasingly intrigued by them. In the years up to 1950,
dozens of microbiologists in Europe, the USA and elsewhere engaged in the
differentiation and classification of salmonella organisms, while English research
contributed not only to this process, but more particularly to the elucidation of
salmonella reservoirs, and the serotyping of the different organisms.41
The discovery of food poisoning organisms also stimulated the English public
health authorities to draw this emerging field into preventive medicine. The
existing English food and drugs legislation related purely to chemical adulteration
36
D e w b e r r y , Food Poisoning, p . 10.
37
W . H u n t e r , ' T h e S e r u m Diagnosis of T y p h o i d Fever Journal of State Medicine, 8 (1900), 6 8 8 - 9 .
38
H. E. Durham, 'On an Epidemic of Gastro-enteritis Associated with the Presence of a Variety of
the Bacillus Ententidis (Gaertner) and with Positive Sero-diagnosDc Evidence (in vivo and in vitro),'
British Medicaljoumal, ii (1898), 600-1; idem, 'On Infections by Unsound Meat, More Especially with
Regard to the Bacillus enteritidis (Gartner)', Transactions of the Pathological Society, 50 (1899), 262-8.
H . E. D u r h a m , ' O n the Serum Diagnosis o f T y p h o i d Fever, w i t h Especial Reference t o the
Bacillus of Gartner and its Allies', Lancet, i (1898), 1 5 4 - 7 .
40
See G. S. Buchanan, in discussion of F. A. Bainbridge, "The Aetiology and Epidemiology of
Paratyphoid Fever and "Food-poisoning"', Proceedings of the Royal Society of Medicine, 4.2 (1910—11),
63; Savage, Food Poisoning, p . 6 1 .
41
See Dewberry, Food Poisoning, p p . 9 - 1 8 , for an account of these discoveries.
 Food Poisoning in Britain c. 1850-1950 301

and unsoundness, and the weight of vested interests, and uncertain support from
the veterinary profession, meant that expanding its provision to include bacterial
contamination was, for the time being, out of the question. In 1905, however,
William Power (1842-1916), then Chief Medical Officer, was instrumental in the
setting up of a new food inspectorate as a sub-division of his department.42 Two
years later, an apparent attempt by the Local Government Board to evade vested

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interests by acquiring unrestricted regulatory powers over all food and drink
(except drugs and water) was thwarted by Parliament, and the new Food Depart-
ment remained primarily concerned with matters of purity and adulteration, but
also with the condition of imported and canned foods.43 More importantly,
perhaps, Power began to commission scientific research into the natural history of
the known food poisoning organisms. These commissions were distributed by
Edward Klein, and his choice for the food poisoning investigations was a young
man named William Savage (1872-1961), then Medical Officer for Colchester,
later for the County of Somerset, who had already published a paper on the bac-
teriological examination of water supplies. It seems to have been an inspired
choice. Savage was a man of great energy and determination, one of the last
medical officers of health to succeed in combining his administrative responsi-
bilities with active research throughout his career.44 For the rest of his life, until his
death aged 89, food poisoning remained the active focus of his research and
medical interests.
Savage's first Local Government Board commissions related to the bacterial
contamination of milk, and to the distribution of salmonella group bacteria in the
animal intestine.45 Both these investigations were directed towards the problem of
natural bacterial content, and Savage continued to make studies in this area up to
the First World War.46 Although his early investigations revealed that the milk of
healthy cows, obtained under conditions which virtually excluded all bacteria
except those present in the udder, generally contained both streptococci and
staphylococci, by 1908 Savage had accepted that his negative findings with regard
to salmonella in healthy animal guts indicated that meat must in general be con-
taminated by excremental matter either at or after slaughter. 'All those familiar
with the inspection of places where food is prepared', he observed, 'know that
faecal contamination of food must be very common.' 47 The recognition of the
42
Medical Officer's Annual Report, Local G o v e r n m e n t Board, P P , 1907, X X V , p . xiv; ibid., P P ,
1908, XXX, p. 9.
43
Hansard, The Parliamentary Debates, fourth series, vol. 179 (1907), cols. 1 4 4 1 - 5 5 . I m p o r t e d a n d
canned foods (meats in particular) had become a special concern following the Chicago meat packing
scandal of 1905-06: Lancet, u (1906), 1626,1719,1729,1787.
44
'Sir W i l l i a m S a v a g e ' , British Medical Journal, i ( 1 9 6 1 ) , 1 1 1 3 .
45
W. G. Savage, 'Report on Bacterial Studies of Milk from Healthy Cows and Diseased
Cows', Medical Officer's Annual Report, Local Government Board, PP, 1908, XXX, Appendix B no 4,
pp. 227—74; idem, 'Report on the Distribution of Organisms of die Gaertner Group in the Animal
Intestine', ibid., Appendix B no 5, pp. 375-400.
46
See, for example, W. G. Savage, 'Report upon the Gaertner Group of Bacilli in Prepared Meat
and Allied Foods', Medical Officer's Annual Report, Local Government Board, PP, 1910, XXXIX,
Appendix B no 3, pp. 492-519.
4
' W. G. Savage, 'Further Report on the Presence of Gaertner Group Organisms in Animal Intest-
ines', Medical Officer's Annual Report, Local Government Board, PP, 1909, XXVIII, p. 479.
302 Anne Hardy

human typhoid carrier in 1906 suggested ways in which even animals that are
apparently healthy at slaughter might convey specific infections to man. In 1910,
for example, bacteriologists working at the Lister Institute reported a lethal
salmonella outbreak among their stock of guinea pigs: most of the 500 or so
animals died, but of the survivors, half a dozen were still excreting bacteria
intermittently some five months later.48

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The recognition of animal reservoirs of salmonella infection served to reinforce
the complex public health aspects of the food poisoning problem. As the Kent
County pathologist remarked years later, the problem in the prevention of typhoid
lay in stopping the routes by which bacteria might pass from the intestine of one
human being to the mouth of another, but in food poisoning there were additional
factors to consider.49 From the public health view, therefore, the food poisoning
problem composed several elements: there was the animal health aspect, with
veterinary, slaughterhouse and culinary factors to consider; there was the personal
hygiene aspect, which involved toilet and handwashing habits; there was the
question of legislation; and there was the bacteriological aspect, which indicated
the need for more extensive laboratory provision to help in unravelling evidence
from the field. Already in 1913, Arthur Newsholme, then Chief Medical Officer,
was alert to some basic requirements:
recent additions to our knowledge . . . tend to emphasize rather than to lessen the impor-
tance of inspection of meat at slaughterhouses, of the exercise of adequate control in regard
to the suitability of places where food is prepared and stored, and of measures to secure
cleanliness in all stages of food preparation.

William Savage had already gone further. In 1909, he issued an urgent plea for
further research into the bacteriology of foods sold in retail outlets, with a view to
the eventual adoption of standards of bacteriological purity for such foods. He was,
however, well aware that 'many questions in regard to food contaminations and
their influence upon health' remained to be authoritatively settled, and he called
on his colleagues to make use of such powers as they did have to inspect premises
where food was manufactured and supplied, and to collect random samples for
bacteriological examination.51
The number of colleagues undertaking such examinations was few, but by the
1920s it was well recognized that most cases of food poisoning were associated
with meat, especially with beef and pork, and particularly with prepared meats,
such as brawn, potted meats, meat pies, and meat sold retail from the tin.52 (This
situation contrasted with that in continental Europe, where raw and undercooked

48
R. A. O'Brien, 'Guinea Pigs as Chronic Carriers of an Organism Belonging to the Food Poison-
ing Group' Journal of Hygiene, 10 (1910), 231-6.
49
E. R . J o n e s , ' F o o d Poisoning:—Its E p i d e m i o l o g y and Bacteriology '.Journal of State Medicine, 4 5
(1937), 4 0 5 .
50
Introduction to W. G. Savage, 'On Bacterial Food Poisoning and Food Infections', Reports on
Public Health and Medical Subjects, New Series, no. 77 (1913), ii.
51
W. G. Savage, 'Administrative Measures for the Protection of the Food Supply', Journal of the
Royal Institute of Public Health, 27 (1909), 682.
b
Food and the Public Health (London, 1919), p. 123.
 Food Poisoning in Britain c. 1850-1950 303

meats were mostly at fault.53) Food hygiene with respect to meat supplies and their
preparation was therefore a special anxiety. Abattoirs were a problem in two
respects. First, there was the question of diseased animals. This had been a public
health concern since the 1850s at least, and had become increasingly acute with the
discovery of bovine tuberculosis, and subsequently of swine tuberculosis, and the
transmissibility of pleuro-pneumonia and foot-and-mouth disease to man. English

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public health provisions with respect to diseased animals were virtually non-
existent: unlike Germany, there was not even provision for compensation to
farmers for diseased livestock.54 Nor was there any effective system for the inspec-
tion of stock before slaughter: the condition of the animal was assessed not on the
hoof, but after slaughter as dressed carcase, a procedure which had obvious public
health disadvantages. As W. A. Letham of the Ministry of Health noted:
Meat may befloodedwith the toxins of disease without showing any very obvious changes.
If the symptoms of ill-health alone do not warrant the immediate inspection and condem-
nation of the sickly animal, it can be given a more thorough inspection after killing than
that provided for an apparently healthy animal.55

As pertinendy, given the presence of salmonellas in animal intestines, hygienic

conditions in slaughterhouses were frequendy unsatisfactory. Not only did animals
on the verge of slaughter litter the floor with their droppings, but the intestinal
contents of slaughtered animals were splashed broadcast, contaminating floors,
walls, utensils, and carcases alike.56 Supervision was impossible, because the
slaughter trade was decentralized among some 16,000 private and 150 public
abattoirs. Moreover, tighter supervision and the rejection of unfit animals would
raise prices. Since the end of the war, cheap food had been a political icon in
Britain, while the farming industry was in serious difficulties, and resisting any
sanitary measures which would further deplete profits.57 What Letham called
'national diffidence in interfering with trade rights and vested interests' was a
serious obstacle to any enforcement of hygiene standards in slaughterhouse
practice.58 Under normal circumstances, however, the negative consequences of
slaughtering practices could not be linked to any particular premises, except
when the local slaughterhouse was also involved in the production of prepared
meat products, as was the case in an outbreak caused by pork pies at Derby in
1922.59

53
Ibid., pp. 43, 56.
54
J. T. Hodgson, 'The Importation of Foreign Cattle', The Veterinarian, 22 (1849), 7.
55
W. A. Letham, 'Slaughterhouse Practice at Home and Abroad: A Comparison Between the
Systems of Different Countries, the Methods of Meat Inspection and the Practice of Humane Killing',
Joumalofthe Sanitary Institute, 5 8 ( 1 9 3 7 - 3 8 ) , 564.
56
See R . B . Haines, 'Observations o n t h e Bacterial Flora o f S o m e Slaughterhouses', Journal of
Hygiene, 3 3 (1933), 1 6 5 - 7 4 .
Major Q. Gumey, 'Veterinary Medicine and Agriculture from a Farmer's Standpoint', Journal of
State Medicine, 42 (1934), 435-7.
58
Letham, 'Slaughterhouse Practice', p. 563.
59
F. Peckham, 'An Outbreak of Pork Pie Poisoning at Derby'.Jouma/ of Hygiene, 22 (1923-24),
69-76.
304 Anne Hardy

II

The anxieties which increased bacteriological knowledge generated in public

health officers and microbiologists were not apparently shared by the general
public. The reporting of food poisoning incidents remained low. Unless one or
more deaths were involved, or the outbreak was on a considerable local scale,
incidents of gastro-enteritis rarely came to the knowledge of the authorities. As

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had been noted by the earliest observers, infants sick with gastro-enteritis were
taken to the doctor, but other cases were treated at home, and the doctor was
never called unless illness was severe.60 Stomach upsets were just too ordinary and
trivial to warrant the expense of medical attention. Even where outbreaks did
come to the knowledge of the authorities, they often did so at a stage when bac-
teriologically useful material, such as suspected foodstuffs, was no longer available.
When deaths did occur, postmortems were often unaccompanied by appropriate
investigations. Savage complained, for example, after a case in which an elderly
woman died as the result of eating tinned salmon (in such cases tinned food was
often found to have been contaminated after opening):
[This] outbreak is an excellent illustration of the present unsatisfactory way in which so
many of these little outbreaks are treated. A post-mortem was performed, but in the
absence of bacteriological investigations disclosed nothing of value. No blood examinations
were made nor was the salmon examined. Yet the elaborate machinery of a coroner's
inquiry, including an inquest, was held and a verdict as to the cause of death obtained.61

Not only were the formal procedures for the investigation of apparent food
poisoning not yet in place, but public health laboratory provision was still, at this
period, very patchy, provided largely on a commercial basis by hospitals and
independent laboratories. Such laboratories did not necessarily have the bacterio-
logical reserves or expertise to deal with food poisoning incidents, more especially
where serological typing was crucial to an investigation.62 Although the Ministry
of Health's own laboratory was available to local authorities for the examination of
specimens from suspected cases of food poisoning, there were relatively few takers.
In most cases, perishable specimens had to be first obtained and then dispatched by
post for bacteriological examination—a procedure which discouraged Medical
Officers, general practitioners, and police surgeons from pursuing relevant
inquiries.63
Difficulties in reportage and adequate investigation were acknowledged ob-
stacles to a fuller understanding of the nature of, and factors involved in, bacterial
food poisoning.64 Already in 1913, the Assistant Medical Officer for Leeds

60
Ballard, "'Diarrhoea'", p. 33.
61
Savage and Bruce White, 'Food Poisoning', p. 105.
62
Editorial, 'The Salmonella Group and Food Poisoning Outbreaks', Public Health, 40 (1926-27), 9.
63
R . E . O . Williams, Microbiology for the Public Health: The Evolution of the Public Health Laboratory
Service 1939-1980 (London, 1985), pp. 1-3. While some municipal public health laboratories did
exist, university, hospital and independents were much more common.
64
W. G. Savage, 'Foreword' to Peckham, 'An Outbreak of Pork Pie Poisoning', p. 69; W. L.
Burgess, 'An Outbreak of Food Poisoning Caused by the Bacillus Aertrycke', Proceedings of the Royal
Society of Medicine, 18.1-2 (1924-25), 61.
 Food Poisoning in Britain c. 1850-1950 305

declared the notification of food poisoning to be necessary, as the only way to

investigate outbreaks thoroughly and to obtain specimens which 'will throw light
on the source of infection'.65 Moreover, the state of the law with regard to food
hygiene and inspection was so inadequate as to constitute no protection at all
against the transmission of food poisoning bacteria by such channels as were
recognized. Although the 1875 Public Health Act empowered Medical Officers of

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Health and inspectors of nuisances to inspect live animals exposed for sale, seizures
virtually never occurred.66 The Food and Drugs Act was exclusively concerned
with chemical adulteration, and the Ministry of Health inspectors with imported
and canned foods.67 As a result, health officers were powerless against many
obvious sources of bacterial contamination, and were forced back to the familiar
and doubtful position of relying on public education to achieve cleaner food
supplies. Indeed, for some this was the only way to achieve effective legislation:
Charles Porter, Medical Officer for Marylebone in the 1920s, argued that the only
way was to educate the people that they in turn might force the hand of traders and
the legislature. Educating the trader was more or less hopeless:
Of educating the legislature I do not speak.We cannot do it effectively. The people are the
best teachers, and a dozen housewives with market baskets complete could more easily
move a Minister of Health than a dozen Medical Officers of Health with sacks full of
hygienic and scientific reasons.68
Most health officers recognized, however, that the situation was serious. Savage,
indeed, went so far as to declare that the risks of infection from different foodstuffs
was so considerable, 'that everyone acquainted with things as they are and not as
they ought to be acquires a violent prejudice in favour of well-cooked food'.69
The potential for the transmission of disease through diseased or contaminated
meat focused attention on food preparation and kitchen hygiene. The health
authorities became increasingly concerned about domestic and food hygiene in
general during the interwar years. In Charles Porter's judgement, the 'sanitary
conscience' of the English people had been almost completely awakened, except as
regarded food: 'it has always appeared distincdy curious that the portion of that
apparatus concerned with food has remained to a large extent unaffected'.70 The
Assistant Medical Officer for Manchester agreed, and gave details of deficient

65
W . Angus, 'Notes o n an Outbreak of Food Poisoning', Journal of the Sanitary Institute, 37 (1916),
15.
66
J. McPhail, 'Administrative Measures for the Protection of the Food Supply Produced in this
C o u n t r y ' , Journal of the Royal Institute of Public Health, 17 (1909), 6 7 3 .
67
Savage, 'Administrative Measures', p p . 681—2.
68
C . Porter, 'Cleanliness in F o o d H a n d l i n g : Impressions of American M e t h o d s ' , Journal of the
Sanitary Institute, X X V (1924-25), 289.
69
Savage, Food and the Public Health, p . 5 6 .
70
C . Porter, "The Public and F o o d H y g i e n e ' Journal of the Sanitary Institute, X L V I ( 1 9 2 4 - 2 5 ) , 4 2 7 .
For t h e w i d e r history o f hygiene see M . Douglas, Purity and Danger ( L o n d o n , 1966); N . Elias, The
Civilising Process (Oxford, 1978—82); G. Vigarello, Concepts of Cleanliness. Changing Attitudes in France
from the Middle Ages (Cambridge, 1988); A. Coibin, The Foul and the Fragrant. Odour and the French
Social Imagination (Leamington Spa, 1986); S. Hoy, Chasing Dirt: The American Pursuit of Cleanliness
(Oxford, 1995); N. Tomes, The Gospel of Germs. Men, Women, and the Microbe in American Life
(Cambridge, MA, 1998).
306 Anne Hardy

food-handling practices: glasses, for example, were commonly only dipped in dirty
water before being reused; personal cleanliness was uncommon among food-
handlers, who regularly licked their fingers when dealing with wrapping paper,
and blew into paper bags to open them. Handwashing after opening the bowel was
generally neglected, and the habit of putting fingers into the nose and mouth while
serving food could regularly be observed. The very structure of many food shops,

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restaurant kitchens and so on militated against cleanliness, and the contamination
of food by flies and dust was almost universal.71 In these years English preventive
officers repeatedly compared the condition of the English food trade unfavourably
with that of the USA and Scandinavia—as late as 1937, it was emphatically stated
that the degree of food exposure permitted in England would not be tolerated in
'any third-class Scandinavian town'. 72
However, the exposure and the handling of goods for sale was a long-standing
practice in the English food trades. Customers expected to be able to handle and
examine foodstuffs before purchase: dubious traders, lack of quality control, and
problems in long-term storage made it a thrifty habit.73 When, in the 1930s, some
local authorities began to attempt to secure the enclosure of foods in glass cases, the
innovation proved 'definitely unpopular' with housewives.74 Again, the intro-
duction of wrapped bread was resisted by consumers, because the wrappers got so
dirty: they failed to realize that without the wrappers the dirt would be on the
bread—customarily transported from bakery to retail oudets in open-topped vans,
the condition of the wrappers was an eloquent testimony to the contaminations
invisible on the surface of unprotected loaves.75
Exposure was one hazard; handling was another with potential for the transfer of
pathogenic bacteria of both human and animal origin. Issues of personal hygiene
began to receive closer attention, but the instilling of hygienic practices, let alone
the provision of facilities, proved an uphill struggle. In 1910, for example, a Lancet
leader ridiculed an American author who saw in unwashed hands woes unnum-
bered, recounted in horrid detail observed contaminations of bread, fruit, vege-
tables, pastry, and money, and urged that natural functions should not be
performed 'except under full aseptic ritual'. 'That dirty hands carry the seeds of
disease and death is a truism,' declared the journal, 'But are we therefore to spend
all our time washing our hands?'76
Denigration of handwashing was easy, in fact, in a society which offered few
opportunities for the exercise. In homes, schools, public houses, and restaurants
alike, lavatory facilities were constructed without handbasins. It was only among a
71
W. St C. McClure, 'The Importance of Cleanliness in the Preparation and Distribution of Food',
Journal of the Sanitary Institute, XLIV (1923-24), 315. See also S. E. Jones, 'Food Hygiene: with
Abstracts from an Inspector's Diary', ibid., XLV (1924-25), 23-5; Councillor C. Bennett, 'Street
Trading from the Public Health Point of View' Journal of State Medicine, 40 (1932), 543-8.
72
G. S. Elliston, in discussion following V. T. Thierens, "The Control of Food and its Preparation',
Journal of the Royal Sanitary Institute, 57 (1936-37), 579.
73
Jones, 'Food Hygiene', p. 24; Porter, 'Cleanliness in Food Handling', p. 280; C. E. Goddard,
'Accidental Contamination of Food', British MedicalJournal, ii (1925), 563—4.
74
Elliston, note 72 above, p. 579.
"Ibid.
76
'Sanitary Superstition1, Lancet, i (1910), 398.
 Food Poisoning in Britain c. 1850-1950 307
privileged few in all social classes, declared a Royal Army Medical Corps officer in
1913, that 'adequate lavatory arrangements allow of the opportunity of systemati-
cally practising the habit [of handwashing] at any time'.77 Moreover, the purpose
of the exercise was rarely made clear in civilian life: instead of explaining that
disease could be spread by hands soiled in micturition or defecation, 'the exact
means by which infection is conveyed is left to the imagination'.78 In the dis-

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cussion that followed, one local authority official made the telling observation that
'certain classes' of the population never used toilet paper, and therefore inevitably
soiled their hands and clothes. He agreed that the use of paper and handwashing
should be taught in schools, but declared serious complications:
to establish a habit of handwashing after micturition as well as defecation requires the
provision of washing accommodation in every lavatory. To urge such provision may be our
duty... but it would add to the cost of building, and would invite criticism andridicule. . .79
Further dimensions to this problem can be gleaned from a military study in the mid
1920s, which noted that the toilet paper generally in use was 'sufficiendy thin and
porous to contaminate the fingers with faeces almost every time, especially when
the paper is used singly, or the faeces are soft and watery'. Further—and this in
spite of military medical officer educational efforts—hardly one man in a regiment
(that is, one in a thousand) made a habit of washing his hands after a visit to the
latrine. Thus, the writer insisted, the simple act of handing on a cigarette, or
cutting a slice of bread for a friend, could result in the passing on of pathogenic
bacteria.80 While it is possible that there was some improvement in the provision
and use of washing facilities between the wars, the Ministry of Health, early in
the Second World War, could still call attention to the 'inadequate provision of
lavatory facilities in many houses, restaurants, canteens and other places in which
food is prepared for sale or sold . . . and even when adequate facilities are provided
it is by no means uncommon to find them unused'.81 Handwashing remains one of
the most neglected elementary precautions against bacterial food infections. A
recent survey at the London School of Hygiene and Tropical Medicine revealed
that even within that School's portals, 44 per cent of toilet users either did not
wash their hands (11 per cent), or did not use soap (33 per cent). The survey con-
cluded, 'If staff and students at the School of Hygiene are promoting handwashing
and stool avoidance in their professional life . .. they are not always practising what
they preach'.82
" C a p t a i n A. H . Hayes, 'Enteric Fever Carriers', Journal ofthe Sanitary Institute, 34 (1913), 113.
78
Ibid.
79
Ibid., p . 120.
80
F. G. Whitbread, 'Faecal Organism Carriers' Journal of State Medicine, 34 (1926), 734. T h e paper
quality referred to may have been that in military rather than civilian use: the context is not fully clear.
It seems likely, however, that similar inexpensive toilet papers were used b y both civilians and the
military. T h e differences in quality and effectiveness of various types of toilet paper, their modes of
use, and social implications remain to be explored. Whitbread's concerns recall Victoria Radlett o n
her father's financial crises: ' W h e n the loo paper gets thicker and the writing-paper thinner it's always
a bad sign, at h o m e ' : N . Mitford, Love in a Cold Climate (London, 1949), p . 197.
81
Ministry of Health, 'Precautions Against the Spread of Alimentary Infections', Circular n o . 2198,
25 N o v e m b e r 1940, cited in Ministry of Health Annual Report, year ended 31 March 1946, 29.
82
N . Habib et al., ' N o w Wash Y o u r Hands!!', The Chariot, 62 (1997), 10.
308 Anne Hardy

Against this background of public health concern for food supplies and their
hygiene, the microbiologists were extending their understanding of food poison-
ing organisms and their habitat. Both the Ministry of Health and the Medical
Research Council took an interest in food poisoning between the wars. In the
early 1920s, under their joint sponsorship, Savage, together with Philip Bruce
White (1892-1957), began a major study of the salmonellas, partly bacteriological,

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partly epidemiological. Published in two parts in 1925, the final report consisted
first of a meticulous identification and classification of the known salmonella
organisms which described the physiological effect of infection in animals, and
demonstrated their connection with a wide range of wild and domestic animals;
and secondly, of a detailed investigation of 100 outbreaks of food poisoning
reported between 1923 and 1925.83 An important element in these studies was
their formal indictment of the role of domestic vermin in the diffusion of
salmonella organisms; by the later 1920s, public health action against rats and mice
had become well established, with an annual national 'Rat Week', and special
attention in public health exhibitions and literature to the problem of rats and
mice.84 While continuing anxieties about bubonic plague played some part in this
concern, Savage's laboratory-based investigations contributed to the new anxieties
about food-contamination in this decade and helped to focus attention on
domestic vermin. At the same time, intricate research in the identification of new
salmonella strains was done by Dr W. M. Scott at the Ministry of Health's labora-
tory. Scott was the first (in 1930) to demonstrate eggs, at this period duck eggs, as
vehicles for salmonella transmission.85 In the case of both eggs and vermin, and
later of domestic pets, laboratory researches had helped to strengthen public health
concerns about the wider environmental sources of food poisoning organisms. In
the meantime, international interest in the salmonellas continued, leading to the
establishment by the International Society of Microbiologists of a committee for
the taxonomy and nomenclature of salmonellas, and to a network of 'salmonella
centres' which by 1939 extended to 37 countries engaging in a 'worldwide inten-
sive study' of salmonella problems.86 The interwar period saw the creation of an
international salmonella industry in microbiology whose enterprise, allied to the
social changes accompanying war, was to lift food poisoning to greater pro-
minence as a public health concern.
Before the Second World War, most food poisoning incidents undoubtedly
remained hidden. Of the 100 outbreaks documented by Savage for the Medical
Research Council survey between 1923 and 1925, most were very small domestic
83
W. G. Savage and P. Bruce White, 'An Investigation of the Salmonella Group with Special
Reference to Food Poisoning', Medical Research Council, Special Report Series, no. 91 (1925); idem,
'Food Poisoning'.
84
See, for example, Editorial, 'Rat Week, 1926", Public Health, 40 (1926-27), 35-6; idem,
'Homsey Clean Food Exhibition', ibid., 39 (1925-26), 202-2.
85
S. H. Warren and W. M. Scott, 'A New Serological Type of Salmonella', Journal of Hygiene, 29
(1929-30), 415-17; W. M. Scott, 'Food Poisoning Due to Eggs', British Medical Journal, ii (1930),
56-8.
86
Salmonella Subcommittee of the Nomenclature Committee of die International Society for
Microbiology, 'The Genus salmonella Lignieres, 1900', Journal of Hygiene, 34 (1934), 333—50;
'Discussion on Salmonella Infections', Proceedings oftlie Royal Society of Medicine, 33.1 (1939—40), 370.
 Food Poisoning in Britain c. 1850-1950 309

ones, and it seems clear that with exceptions such outbreaks were very local in
cause and limited in effect.87 In 1938, however, following a prolonged review of
local authority powers, the legislature finally passed a new, consolidatory Food and
Drugs Act. This Act, which provided for local authority bye-laws regarding
cleanly conditions and practice in the handling, wrapping, and delivery of food,
including the provision of adequate washing facilities, also made food poisoning
compulsorily notifiable from 1 January 1939.88 With the outbreak of war, anxieties

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about bacteriological warfare and the disease consequences of air bombardment
and evacuation led to die establishment of the Emergency Public Health Labora-
tory Service—a network of 19 provincial and ten metropolitan laboratories, whose
services were to be available free of charge to medical officers of health if required
for the investigation and control of infectious diseases.89 The combination of
notification and increased facilities for laboratory investigation was to be of critical
importance for die public profile of food poisoning.
The Second World War is generally seen as a seminal event in die history of
food poisoning. During and after the war, there was a rapid extension of mass
catering, both in terms of feeding large numbers of people in canteens and restaur-
ants, and in the sense of the mass production of prepared foodstuffs. Regulation of
die practices of bulk commercial food manufacturers, and changing cooking
methods, presented new problems. Egg-borne salmonella poisoning received
widespread publicity, for example, when incidents were traced to the use of bulk-
imported American powdered egg. Moreover, rationing and communal feeding
encouraged the practice of reheating foodstuffs, which had been far less common
before the war, but which favoured bacterial survival and multiplication, especially
where cooking involved large quantities of meat. Trade in both human and animal
foodstuffs became internationalized, opening Britain to a large number of exotic
salmonellas from all over the world. During the war, the centralization of slaugh-
tering led to an increase in infections among animals waiting longer together
before slaughter, while the introduction of modern methods of intensive farming
after the war also led to an increased incidence of salmonellosis in farm animals.
Although a reflection of emerging standards of household hygiene, the increas-
ingly widespread use of household detergents interfered with the effective pro-
cessing of sewage.90 Such explanations emphasize changes in the scale and
organization of food-production and consumption, and, by implication, the
increased numbers of infecting organisms all leaping at opportunities offered by
human hygienic frailty. There is another side to this story.
87
Savage and Bruce W h i t e , 'Food Poisoning', p p . 5 5 - 1 0 9 . T h e n u m b e r o f m o r e extensive inci-
dents reported t o the Ministry of Health averaged b e t w e e n 3 and 6 a year between the wars.
88
Food and Drugs Act, 1938: 1 & 2 G e o VI c. 5 6 , General and Public Acts and Measures, 1 9 3 7 - 3 8 ,
pp. 6 7 3 - 7 6 2 . See also D . Thomas, ' F o o d and Drugs Act, 1938' Journal of the Royal Sanitary Institute, 59
(1938-39), 5 8 2 - 9 1 ; C . E. Sanderson, ' T h e Supervision of Food Supplies', ibid., 61 (1940-41), 7 5 - 8 0 .
89
Williams, Microbiology for the Public Health, p p . 6 - 7 , 9.
90
F. Fenner, 'Infectious Diseases a n d Social C h a n g e ' , Medical Journal of Australia, 2 (1971), 1044; W .
G. Savage, 'Problems of Salmonella F o o d P o i s o n i n g ' , British Medical Journal, ii (1956), 3 1 7 - 2 3 ; W . H .
Parry, 'The Epidemiology of 'Clostridium Welchii' Food Poisoning', Public Health, 81 (1966-67),
22-30; J. H. Macoy, 'Trends in Salmonella Food Poisoning in England and Wales, 1941-72' Journal
of Hygiene, 74 (1975), 271-5; Williams, Microbiologyfor the Public Health, pp. 21-2, 62.
310 Anne Hardy

With the introduction of compulsory notification in 1939, food poisoning

acquired a statistical profile. After an uncertain start, notifications began to rise
steadily after 1941, and from an initial couple of hundred had reached over 3,000 a
year within a decade. Surveying the post-war rise in reported cases of food
poisoning, William Savage insisted that improvements in the reporting and detec-
tion of food-borne infections could not alone be responsible for what he regarded
as the staggering rise in notifications after 1941.91 It seems likely, however, that he

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had a relatively rosy view of the situation regarding food-borne disease in his
youth. Already in 1890, Edward Ballard had been aware that food poisoning
outbreaks occurred both because of poor hygiene and because of improper
cooking, and that vast numbers of the English working class habitually ate poorly
cooked meat because thorough cooking was not practicable on their inadequate
domestic fires.92 Ballard had also been made aware, at Welbeck, that far more
food-related illness existed than was ever reported, while William Angus, investi-
gating by house-to-house visitation an outbreak of 153 cases in the Woodhouse
district of Leeds over Whitsun, 1915, found an additional 30 unrelated cases of
gastro-enteritis in the small geographical area affected, suggesting that 'minor
outbreaks of food poisoning are very common'. 93 Indeed, the fact that well over
half the reported cases in the quinquennium 1949—54 were sporadic, rather than
associated with recognizable outbreaks, suggests that these notifications occurred
only because of enhanced popular awareness and medical consultation.94 A com-
mentator writing in 1967 reiterated that only a small minority of food poisoning
cases ever came to the notice of doctors: he estimated that the average adult
accepted a couple of attacks a year of 'mild or moderately severe' diarrhoea and
vomiting subsiding within 48 hours, without requiring medical attention.95
Rising public awareness of gastro-enteritis as an illness, and the increased avail-
ability of medical services, may have a good deal to do with the apparent rise in
food-borne infections in the second half of this century. Before the advent of the
National Health Service, medical treatment was an expensive luxury for working
people, more especially for those not covered by the National Insurance Act
provisions. Brief incidents of gastric illness commonly went unreported. It is
notable that two leaps in reporting occurred in the 1940s, one in 1946, the first
year of peace, and another, much larger (2,428 cases over 808 in 1948), in 1949,
the first full year in which free general practitioner services were available to the
British people.96 Free access to medical treatment plainly encouraged people to
greater intolerance of relatively minor illness. Moreover, growing concerns within
the public health establishment over the hygienic implications of rising notifi-

91
Savage, 'Problems of Salmonella Food Poisoning', pp. 317—23.
92
E . Ballard, ' A S u m m a r y R e v i e w o f 14 Instances R e p o r t e d U p o n since 1879 . . . in w h i c h Disease
of a Specific Character has been Communicated or Spread . . . ' , Medical Officer's Annual Report, Local
Government Board, PP, 1890-91, XXXLV, Appendix 21, p. 258.
93
Ballard, 'Acute Specific Disease', p. 752; W. Angus, 'Notes on an Outbreak of Food Poisoning',
Journal of the Sanitary Institute, 3 7 (1916), 1 5 .
94
Savage, 'Problems of Salmonella Food Poisoning', p. 317.
95
Editorial, ' F o o d Poisoning', Public Health, 81 (1966-67), 4 9 .
96
The figures are taken from Savage, 'Problems of Salmonella Food Poisoning', p. 317.
 Food Poisoning in Britain c. 1850-1950 311

cations, and among employers over the economic consequences of minor illness,
resulted in campaigns to publicize the condition and its causes. In the 1960s, for
example, the Ministry of Health actively sought to promote popular consciousness
of the condition, enlisting among others women's magazine editors in popu-
larizing the symptoms and causes of food-related illness.97
Current concerns over increases in the reported incidence of food poisoning,

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and alarm over highly publicized larger outbreaks, should be set within this wider
historical context. Much of the available statistical evidence for the modern rise of
food poisoning can be discounted, distorted as it is by changing perceptions of
illness and health, and by the increased availability and afFordability of medical care.-
The history of food poisoning in Britain is a history of social and scientific change,
but it is not simply one of an increasing preference for foodstufis prepared outside
the home rather than within it. Rather, it the story of how social and scientific
change has gradually exposed the unchanging economies of time and hygiene
which most people have always made in their everyday lives. The agent of
exposure has been the bacteriological laboratory, which permitted the identifi-
cation of food poisoning organisms, and the discovery of their natural history and
modes of transmission. In this instance, scientific curiosity uncovered a mare's nest
of organisms and an intractable aspect of human behaviour with unpredictable
implications for human health. As more serious and fatal infections ceased to be
major public health concerns, so health officials found more time for the consider-
ation of problems of food hygiene. The rise of the laboratory permitted the
creation of a public health problem by public health professionals and laboratory
scientists intrigued by the microbiological complexity and hygienic ramifications
of a very common, rarely fatal, and very evanescent complaint.

1
'Food Poisoning', note 95 above.