Budd, William

(b. North Tawton, Devon, England, 14 September 1811; d. Clevedon, Somerset, England, 9 January 1880)

medicine, epidemiology.

Budd, a pioneer epidemiologist and a precursor of the Pasteurian germ theory of disease, was born in a small town near the northern edge of Dartmoor. His father, Samuel Budd, practiced surgery there; his mother was the former Catherine Wreford, who came of an old Devon family. Of their ten children, William was the fifth of nine sons. The children received their primary education at home, but their father had inherited landed property from his grandfather, an Anglican clergyman, and could afford to send all his sons to good universities. Six of them graduated as doctors of medicine, three from Edinburgh and three from Cambridge. Two of Budd’s older brothers, George and Richard, became fellows of the Royal College of Physicians of London, and George and William were elected fellows of the Royal Society.

Budd’s professional training was unusually prolonged, partly because of two severe illnesses. An attack of typhoid fever interrupted his medical studies at the École de Médecine in Paris, where he intermittently spent three and a half years between October 1828 and September 1837, under such well-known teachers as Broussais, Cruveilhier, Lisfranc, Louis, Orfila, and Ricord. During the intervals Budd assisted his father, except for the winter of 1835–1836, when he attended the Middlesex Hospital, London. In the autumn of 1837, he went to Edinburgh University to complete the courses required for the M.D. degree. He graduated in August 1838, returned to general practice at North Tawton for about eighteen months, and was then appointed assistant physician to the Dreadnought, the Seaman’s Hospital at Greenwich. An illness, which Budd apparently considered a second attack of typhoid, forced his early resignation. In 1841 he moved to Bristol and spent the rest of his working life in that city.

Budd was appointed physician to St. Peter’s Hospital in 1842, lecturer in medicine at Bristol Medical College in 1845, and physician to the Bristol Royal Infirmary in 1847. He founded the Bristol Microscopical and Pathological societies, and served ten years as councillor of the Bath and Bristol branch of the Provincial Medical and Surgical Association, becoming its president in 1855–1856. Thereafter he played an active part on the Council of the British Medical Association until 1866. Budd gave valuable evidence before the Health of Towns Commission in 1841, and before the Royal Sanitary Commission in 1869. For the originality and importance of his views on infection and epidemiology, he was elected a fellow of the Royal Society in 1871.

In 1847, Budd married Caroline Mary Hilton, daughter of a landowner in Kent; they had three sons and six daughters. Although he had a healthy appearance and a fine physique, Budd was subject to attacks of intense headache, and in later life to bouts of nervous exhaustion, attributed to overwork. In 1873 he suffered a stroke, which left him an invalid. He died at the little seaside town of Clevedon, and was buried in Arnos Vale Cemetery, Bristol.

Budd’s distinction as a physician was fostered by his family environment, thorough training, and warm humanity. His medicopolitical involvements, like his epidemiological and sanitary investigations, were governed by a sense of obligation to extend medical knowledge and to improve the public health. His forthrightly expressed convictions on the communicability and prevention of certain diseases, involving a scientific approach and inductive logic, set him apart from his medical contemporaries. John Tyndall praised him as “a man of the highest genius”, whose “doctrines are now everywhere victorious, each succeeding discovery furnishing an illustration of his marvellous prescience”.

Budd’s essential doctrine, that specific infective agents determine the epidemic phenomena of communicable diseases, stemmed from his investigations of over eighty cases of typhoid at North Tawton in 1839–1840. Long before he described this epidemic in 1859, he had concluded that the “poisons” of typhoid and cholera multiply in the victim’s intestines and are “cast off”. His pamphlet Malignant Cholera (1849), which declared this disease to be waterborne, appeared about a month after the comparable Mode of Communication of Cholera by John Snow, whose priority he fully acknowledged. Budd’s report erred in claiming that a fungus was the causal agent. Among preventive measures he stressed disinfection of the patient’s excreta as well as purification of the water supply. His regimen successfully curbed the spread of cholera in Bristol during the 1866 outbreak.

In his classic monograph Typhoid Fever (1873), Budd integrated and expanded several previously published papers. This scholarly, fearless, and occasionally scornful document impressively marshaled the evidence that indicates the disease is contagious. Many of his medical contemporaries were “non-contagionists” or “miasmatists”, who buttressed their beliefs by the outmoded but die-hard dogma of spontaneous generation, or by such fashionable fallacies as Murchison’s pythogenic theory (that the intestinal fevers arise de novo from filth and neglect), and Pettenkofer’s theory that the specific agents of typhoid and cholera are not infective until they have undergone metamorphosis in suitable soil. Budd’s task was especially difficult because these heresies were popular within the ranks of the “sanitary reformers”, whose main objectives he ardently supported.

In the 1860’s Budd applied his principles mutatis mutandis to other communicable diseases of man, such as diphtheria, scarlet fever, and tuberculosis. His masterly report of a sheep-pox epizootic and reviews of rinderpest and hog cholera reinforced his basic contentions: that each specific agent of contagion multiplies at certain sites within the sick host, is eliminated and transported by definite routes, and can be destroyed or interrupted in its passage to other susceptible hosts.

Budd invested his contagious agents with fairly precise properties—e.g., reproducibility and relative lack of resistance to heat and to disinfectants—but he was almost as noncommittal about their exact nature as Fracastoro (unknown to him) had been about contagium vivum three centuries before. There were formidable impediments to accurate visualization of these microbic agents, including the high heat resistance of some species of sporulating contaminants, the inadequate resolving power of available microscopes, and the lack of solid nutrient media on which pathogenic bacteria could be grown and differentiated. Within a few years of Budd’s death, these deficiencies had been remedied by Pasteur, Abbe, and Koch.

BIBLIOGRAPHY

I. Original Works. Budd’s works include “Remarks on the Pathology and Causes of Cancer”, in Lancet, 2 (1841–1842), 266–270, 295–298; Malignant Cholera: Its Mode of Propagation and Its Prevention (London, 1849); “On Intestinal Fever: Its Mode of Propagation”, in Lancet, 2 (1856), 694–695; “Intestinal Fever Essentially Contagious”, ibid., 2 (1859), 4–5, 28–30, 55–56, 80–82; “On Intestinal Fever”, ibid., 131–133, 207–210, 432–433, 458–459, and 1 (1860), 187–190, 239–240; “Diphtheria”, in British Medical Journal, 1 (1861), 575–579; “Observations on Typhoid or Intestinal Fever: The Pythogenic Theory”, ibid., 2 (1861), 475–459, 485–487, 523–525, 549–551, 575–577, 604–605, 625–627; “On the Occurrence (Hitherto Unnoticed) of Malignant Pustule in England”, in Lancet, 2 (1862), 164–165; “Variola Ovina, Sheep’s Small-Pox; or the Laws of Contagious Epidemics Illustrated by an Experimental Type”, in British Medical Journal, 2 (1863), 141–150; “Investigation of Epidemic and Epizootic Diseases”, ibid., 2 (1864), 354–357; “The Siberian Cattle Plague; or, the Typhoid Fever of the Ox,” ibid., 2 (1865), 169–179; “Typhoid (Intestinal) Fever in the Pig”, ibid., 81–87; “Asiatic Cholera in “Bristol In 1866”, ibid., 1 (1867), 413–420; “Memorandum on the Nature and the Mode of Propagation of Phthisis”, in Lancet, 2 (1867), 451–452; “Scarlet Fever, and Its Prevention”, in British Medical Journal, 1 (1869), 23–24; and Typhoid Fever; Its Nature, Móde of Spreading, and Prevention (London, 1873; New York, 1931).

II. Secondary Literature. Works on Budd include G. T. Bettany, “Budd, William”, in Dictionary of National Biography, VII (1886), 220–221; W. Michell Clarke, “William Budd, M.D., F.R.S., ‘In Memoriam’”, in British Medical Journal, 1 (1880), 163–166; E. W. Goodall, Willaim Budd, M.D. Edin, F.R.S. (Bristol, 1936); and W. C. Rucker, “Willaim Budd F.R.S., Pioneer Epidemiologist”, in Bulletin of the Johns Hopkins Hospital, 28 (1916), 208–215.

Claude E. Dolman