Henry Duncan Littlejohn

Many Fellows of the College have pursued distinguished careers in fields other than surgery. Few however have done so in public health. Hector Gavin (qv) achieved this, but the most famous was Henry Littlejohn, whose appointment as the first Medical Officer of Health for Edinburgh was the first appointment of its kind in Scotland. He pioneered compulsory notification of infectious disease in Edinburgh leading to the introduction of such notification throughout Great Britain. The resultant mapping of diseases allowed active prevention and led to significant reduction in mortality during the 50 years of his office. He also achieved distinction in Forensic Medicine as an expert Crown witness for most of the major Scottish trials in the latter half of the 19th century.

The seventh son of Thomas Littlejohn, a baker, Henry Littlejohn was born in Leith Street, Edinburgh. Schooled at Perth Academy and the Royal High School of Edinburgh, he graduated in medicine from Edinburgh in 1847. After a short spell in general practice, he embarked on a career in what was then called Medical Jurisprudence, a combination of forensic medicine and public health. After taking the Fellowship of the College, he became a Lecturer in Medical Jurisprudence at the Extra Mural medical and surgical school at Surgeons Hall. In 1862 he became Medical Officer of Health for Edinburgh, the first appointment of its kind in Scotland. He was to hold this post for almost 50 years and his tenure was a prestigious one. At this time, epidemic diseases such as cholera, typhoid, diptheria and smallpox remained endemic in Scotland. He was instrumental in the passing of an Act of Parliament making the vaccination of infants compulsory. Early in his experience he recognised the benefits of compulsory notification by general practitioners of infectious disease. The medical practitioners of the city, perhaps understandably, opposed this, but in 1879 a clause was included in the local Police Act requiring such notification giving Edinburgh the lead to the whole of Great Britain. This was to prove one of the major advances in public health of the 19th century. His “Report on the Sanitary Condition of the City of Edinburgh” proved a blueprint for social reform. It clearly demonstrated the effect of population density on the spread of disease and mortality. He was able to define the incidence of dip patients throughout the city and demonstrated a clear correlation between deprivation, disease and mortality. His proposals to improve this included recommendations about building, sewage, water pollution and limiting overcrowding. The Town Council were responsive to his recommendations and demolished many aging properties which had become dangers to health.

By the time of his retiral in 1908, after 46 years of service, mortality rates in Edinburgh from infectious disease had halved. Largely as a result of his efforts cholera and typhus had disappeared and smallpox had become a rarity.

He was able to pursue a parallel, and equally distinguished, career in forensic medicine. Eloquent and erudite, he was regarded as an outstanding teacher amidst Edinburgh contemporaries who included some of the greatest medical teachers in the world. As advisor to the Crown in criminal cases, he was an Expert witness in many famous trials. In 1897, at the age of 71, he succeeded Sir Douglas MacLagan (q.v.) in the Chair of Medical Jurus Prudence in the University.

He was elected President of the College in 1875 and President of the British Institute of Public Health in 1893. The University of Edinburgh conferred the degree of LLD.