It is ten years since School Doctor, and later School Archivist, Dr. Robert Mackay, died. Bob was coming into School to volunteer his services in the archive into his 90s. Along with creating the first archive catalogue, Bob researched and wrote detailed histories of the School Doctors, which make for fascinating reading. In honour of Dr. Mackay, and the work he did for the School, we will be making his articles available online. This week, is a biography of the First School Doctor:
Alfred Alexander Mumford was first appointed to the Manchester Grammar school staff in 1909 as Lecturer in Hygiene and Honorary Medical Referee. In this post he followed Dr. G.H. Darwin M.D. (1907-8) and Dr. F.H. Westmacott FRCS (1908 - 9) who held the Lecturer's post before him. Indeed it was on Dr. Westmacott's suggestion that he became the Lecturer in Hygiene.
The name of Colonel Westmacott appears regularly in the records of MGS, as an Old Mancunian, a Lecturer in Hygiene and a Governor. In that last capacity he was something of a 'eminence grise' in the selection and preferment of the Medical Officers to the School.
He was born in 1867 and attended MGS before taking his medical training at the new Owen's College. He was unsure of his medical career development and worked as a ship's doctor and then in the far East where he became interested in and proficient in ear, nose and throat surgery. On his return to Manchester he found it difficult to obtain a hospital appointment and took part in the founding of the St. John's Hospital for the Ear in Byrom Street. It was not until 1913 that he was appointed to the Manchester Royal Infirmary as consultant surgeon.
Dr. Westmacott was a charismatic personality as described in Dr. Brockbank's book on the lives of MRI doctors. He was a vigorous organiser, in particular in the service of the Volunteer Territorial Force - the forerunner of the Territorial Army. He was a combatant officer, in the 2nd Volunteer Battalion of the Manchester Regiment in which he was an instructor in musketry and machine guns. He was also Commandant of the Owen's College company of the OTC. Later he became an officer in the Territorial Medical Service in which he rose to the rank of Major. With this rank he entered the Great War in 1914 in command of the 2nd Western General Hospital and rose the rank of Colonel before demobilisation. As the Lecturer in Hygiene at MGS he promoted the appointment of Dr. Mumford to follow him and later, as a Governor, was instrumental in the appointment of the William Brockbank. He was a loyal and enthusiastic supporter of MGS. He regularly attended the meetings of the Governors, though in the five years before his death he was limited by ill health due to heart disease. He died in 1935 and his will bequeathed £1000 to the Scholarship Aid Fund and £100 towards the furnishing of the Memorial Hall.
The title of the post was soon changed to Medical Advisor. Dr. Mumford made such an impression on the School that Governors invited him in 1910 to take the post of Medical Officer in response to the Education Act of 1906, which established the School Medical Service in the National (State) Schools.
Dr. Mumford was an Old Mancunian. He was born in London (Stoke Newington) on October 29th 1862 to William and Ruth Mumford, the youngest of five children. His father was partner in the family business - retail lace merchants - and a Freeman of the City of London. Because of this, Alfred was able to attend Christ's Hospital school, at first in the Junior School in Hertford and later at the City School in Newgate Street, Greyfriars. During this time the business was taken over following the bankruptcy of several of their customers, but William and his brother Henry were retained as managers. William moved north with his family to take charge of the Manchester branch and Alfred entered Manchester Grammar School in 1878, being recorded in the form lists for that year as joining Classical Lower Remove. He matriculated from Mathematical Sixth in 1880 and left school with an MGS scholarship for Owen's College to read for a medical qualification. During the Medical Course he took a B.Sc. probably at the 2nd MB stage in Anatomy and Physiology. He passed the examinations for M.B., Ch.B. in 1887 and since it was common practice in those times, sat and passed the examinations for the Conjoint Diploma of the Royal College of Surgeons of England and the Royal College of Physicians of London.
The General Practitioner
On qualification, he started in General Practice at Gable Nook, Chorlton-cum-Hardy in 1887. At that time it was not required for newly qualified doctors to take hospital posts before practising, and such posts were only obtained through patronage. He continued to study and two years later obtained his M.D. from London University. He continued in general practice until 1908 and his enthusiasm is reflected in an article he wrote for the Manchester Medical School Gazette in 1904 entitled 'General Practice as a Career'.
His interest in the diseases of children and the study of growth in childhood began at an early stage, for in 1896, together with the celebrated children's Physicians, Dr. Henry Ashby and Professor Alexander, he founded a scientific association, called "The Manchester Child Study Society". During his years at MGS, this interest resulted in many articles, addresses and a book "healthy Growth" which is based on his work at the School and at the Greengate Hospital and School.
Alongside his personal general medical practice he held several public appointments before he took the post at MGS. He was District Medical Officer for the Poor Law (1895 - 1909), for the Post Office (1904) and for the G.C.R. Provident Society (1893 - 1909) From 1903 he became Honorary Consultant Physician. This rather special centre had been founded in 1854, first as a school for homeless children which in 1870 included a Medical Mission. Later it became a recognised centre for the management of rickets, a condition all too common in Manchester at that time. Dr. A. A. Mumford's family also played a part in the Greengate Dispensary, with his wife a member of the Ladies Committee, and their eldest daughter Margaret as teacher-in-charge for two years (1919-20) following her graduation from Girton College Cambridge (2nd class honours in Mathematics) and obtaining a Diploma in Infant and Nursery School Teaching.
The Paediatrician
From 1908 with his appointment as Assistant Physician to the Manchester Northern (Clinical) Hospital and to Manchester Grammar School, Dr. Mumford moved away from general practice into the field of paediatrics. This included a responsibility for sick children at the Northern Hospital and the Greengate Dispensary and healthy and even gifted children at the Grammar School. He moved from Chorlton-cum-Hardy to 44, Wilmslow Road in Fallowfield and opened consulting rooms at 14 St. Ann's Square.
In 1919, shortly after the end of the First World War, he suffered multiple injuries from a serious road accident including what was considered to be fractured skull. He was unable to work for nearly a year with difficulties with speech and concentration. After his return to work he was promoted to Consulting Physician in Children's Diseases at the Northern Hospital and finally, to Honorary Consulting Physician until his retirement in 1938.
It is of interest to the modern paediatrician that he trained a junior, the famous Dr. Catherine Chisholm who founded The Duchess of York Babies Hospital and who became School Medical Officer to the Manchester High School for Girls, and Dr. Sylvia Guthrie who became the School Medical Officer to the Withington Girls' School.
The health prospects for children of all walks of life were very different from today. Intercurrent Diseases, infections, tuberculosis and acute rheumatic fever were common at all levels of society and minor ailments no less common than nowadays. There were striking differences in the health and physique between the Grammar School boys and the children attending the Greengate Dispensary. This comparison is explored in chapters of 'Healthy Growth'. Dr. Mumford studied these results in increasing detail, always relating the increase in weight and stature to the development of physical function and intellectual powers. Although physical disease was a constant threat, he was passionately concerned that schools should promote health by hygienic measures - i.e. by physical exercise - the optimum development of each individual child. He held strongly to the opinion that the 'modern' school doctor should be similarly concerned with the positive promotion of health and should not be satisfied with disease medicine. The conclusions formed the material for his Presidential Address to the Manchester Medical Society in 1926. In 1928 he spoke at the Annual General Meeting of M.O.S.A. as a Vice President and he expounded the above views under the title of 'The School Medical Officer of the Future'.
While he was working at MGS, Dr. Mumford applied (1913) for a vacancy as Lecturer in Children's Diseases at the Victoria University of Manchester Medical School. With the application he included the testimonial from the High Master, J.L. Paton, quoted here, who had promoted his initial appointment to the school in 1909. In spite of this, Dr. Mumford was unsuccessful in the application. In view of his attitudes and teaching as a prototype of modern Community Paediatrics, it is interesting to speculate on how the development of paediatrics in Manchester and even nationally, might have evolved if he had been appointed. As often happens, he was too far ahead of his contemporaries in an age when the treatment of sick children took priority.
Dr. Mumford had a long-standing involvement with medical scientific societies He joined the Manchester Medical Society in November 1888 when Dr. Henry Ashby as also a member and regularly attended Society meetings. He was elected to the Committee in 1912 and 1913 and in 1921 was elected Vice President. In 1924 he was elected a Life Member and on 5th of May 1926, President of the Society.
During his year as the President of the Manchester Medical Society there is a record of a varied scientific programme. It included lectures by J.S. Haldane on 'Biology and Medicine', Dr. John Ward on 'Spastic Paralysis in Children', and one by his son Dr. Percival B. Mumford on 'Skin Disorders'. His Presidential Address on October 6th 1926 was on 'Physique, Stamina and Efficiency in Schoolboys'. That meeting was held in the Medical School and was honoured by the presence of the Vice Chancellor. Committee business during the year was predictably humdrum but he did chair the discussions on an amendment to Law 10 which had the effect after ratification of deciding on the expulsion of members more than one year and one month in arrears with subscription. A proposal to develop the Medical school Gazette as a medical journal was referred to a Faculty liaison meeting. The Committee minutes record a decisin to give Christmas gratuities to attending staff from £1-10s-0d (£1.50) to the Head Porter to 5/- (25p) for each of the two cleaners. Dr. Mumford does not appear to have held office after 1927.
He joined the Medical Officers of Schools Association (M.O.S.A. - founded in 1884) in 1915 and must have contributed to the affairs of the Association because by 1928 he was a Vice President and in that year he addressed the AGM on the topic 'The School Medical Officer of the Future'. Although he may have been a members of the Council earlier, the only record of attendance at those meetings in between 1930 and 1933.
He does not seem to have been a member of the British Paediatric Association, which is not surprising since it was not formed until 1928, when he was approaching the end of his career. The B.P.A. was a very small organisation at first, after a very shaky start the first Annual Meeting recorded 56 members, most of them from the academic 'paediatric' departments of the British Isles.
There is no record of how long the 'Manchester Child Study Society' lasted after his participation in its establishment, but it preceded by 52 years the formation of the Manchester Paediatric Club which later became the Paediatric Section of the Manchester Medical Society.
Dr. Mumford had an advanced understanding of statistics and reported and published his work through academic and scientific bodies of which he was a member - the Manchester Statistical Society, the Manchester Literary and Philosophical Society and the Manchester Medical Society.
The School Doctor
Dr. Mumford was appointed to the school staff in 1909, as Lecturer in Hygiene and Honorary Medical Referee. In 1910 the post was changed to Medical Advisor and later that year to Medical Officer in response to the Education Act of 1906. The post of Lecturer in Hygiene must have involved the delivery of formal lectures though there is no mention of these until 1911 (Ulula Vol. 39 pg. 50) when a lecture on 'Health and hygiene' is included with other notices. In 1912, a lecture on 'The Working of the Brain' is listed (Ulula Vol. 40 pg. 162) and later reported (Ulula Vol. 40 pg. 216) as delivered to the Upper School on October 1st and to the Lower School on October 3rd. A report in 1920 (Ulula Vol. 48 pg. 62) mentions a lecture on 'The crusade against tuberculosis' as given in 1911-1912 but is not recorded in contemporary issues. It is not clear whether these lectures were part of a special series in the school programme though the announcements are linked with lectures on other topics. Presumably other lectures were part of routine classroom teaching. His abilities in this seem to have impressed J.L. Paton who described him in the testimonial as 'an excellent teacher - he has the gift of utterance and exposition'.
The only account of Mumford's clinical work in school is in his book, 'Healthy Growth' (1927) published near the end of his time at the school. In it he describes the Entrance Medical Examination and illustrates the record card used (pg. 69). The description of the examination is traditional but does convey his serious concern for the successful adjustment of the young pupil to the school. He emphasises the essential quality of the relationship between school and parents on behalf of that pupil. The description of the examination is general, even diffuse, and no clinical criteria are listed. It is not clear how often review examinations took place or the indications for review. It seems obvious that some reassessment must have been needed on the return of a boy to school after the more serious intercurrent illnesses of the time. The health record card introduced by Dr. Mumford (p. 94 - 95) implies review of two-year cohorts but these refer primarily to physical measurements and academic and athletic development. There is room for only brief notes on the state of health.
The main theme of his publications and lectures was on the pattern of physical development of young people and the relationship of that with personal academic and athletic performance. The annual measurements of boys in the gymnasium were the basis for his studies to which he added his own results of physiological measurements. Tests that he considered of special interest included the use of spirometry, what he called his 'Persistence Test' which demonstrated after blowing into a tube containing mercury, how long the subject could maintain the pressure. He also developed the use of 'The Buoyancy Index' as early attempt to compare body build.
The School also made a contribution to Dr. Mumford's work at the Greengate Hospital and School by the provision in 1919 of a number of beds made in school to be used for the daytime rest periods of the pupils (Ulula vol. 47 pg. 30). Dr. Mumford's expression of thanks is recorded in Ulula. In 1922 'score' of children from Greengate school visited MGS and were shown the natural history museum, amongst other sights and were treated to 'tea and buns'. Dr. Mumford acted as guide for the afternoon (Ulula Vol. 50 pg. 170). A party of the Christian Union visited Greengate Dispensary and School on March 10th 1926 and Dr. Mumford conducted the group through the institution. The following week he gave a lecture at MGS on his work at Greengate.
Whereas the testimonial provided by the famous High Master, J.L. Paton, for an application for a University post referred to 'his enthusiastic support of every aspect of school life' it is difficult to find documentary evidence to illustrate that support. Over the years Ulula carries reports referring to Dr. Mumford's activities. There are reports in Ulula of his support for the Alderley camp, held annually on the estate of the then Lord Sheffield. The support was probably financial, though one year #the inimitable Doc.' was seen on visitors' day. (Ulula Vol. 38 pg. 102, Vol. 40 pg. 119, Vol. 42 pg. 132). In 1912 Ulula acknowledges his support for the Grasmere camp (Ulula Vol. 40 pg. 172) but nowhere is there the suggestion that he attended. One should remember that at that time Dr. Mumford had a busy consulting practice and five children, two of whom were already pupils at MGS. A report in 1916 (Ulula Vol. 44 pg. 197) expresses thanks to the doctor for his part in instructing Scouts for the King's Scout Badge tests and for examining candidates for the Badge. In 1919 (Ulula Vol. 47 pg. 54) he presented to the school museum a collection of hells, coral and mineral specimens 'in a table case made by himself in his student days'. After relinquishing the prime responsibilities of Medical Officer to Dr. William Brockbank M.D. in 1928 he continued his association with the School as Honorary Medical Officer and finally retired in 1931 (Ulula vol. 59 pg. 106).
Old Mancunian
Dr. Mumford was certainly an active member of the Old Mancunians Association from its' foundation by J.L. Paton in 1904. His name appears on the list of members attached to the minutes of the first AGM in 1905. It is possible that as an active members of the newly formed Old Mancunians Association, he was taking part in extra-curricular activities before he joined the staff. The June issue of Ulula for 1911 prints an account of the annual Three Shires Route March (Ulula Vol. 39 pg. 115) and refers to the presence of 'the doctor'. In the following year the doctor's participation was recorded 'with warm appreciation' and there is reference to 'a truly Ruskinian spirit.' (Ulula Vol. 40 pg. 117). This account makes reference to 'the doctor's support for the past nine years' which suggests a first contact in 1903. In none of these accounts is the doctor names but there is no report of the March in Ulula earlier than 1911.
At the 115th Old Boys Dinner in 1910, he proposed the toast to 'The City of Manchester and the Borough of Salford' (Ulula Vol. 38 pg. 48). The following year he was Junior Steward at the 116th Old Boys' Dinner (Ulula Vol. 39 pg. 85) where he proposed the traditional toast to 'The Pious Memory of Hugh Oldham' with an erudite speech comparing Maeterlinch's Blue Bird of Happiness with the 'Grey Bird of Wisdom'. By December 1911 he was elected to a vacancy on the Council of the O.M.A. (Ulula Vol. 39 pg. 230). In 1916 he addressed the AGM of the O.M.A on the history of the School (Annual Report and Register, 1916).
In 1931, the year in which he ended his service to the School, and after 27 years of service to the O.M.A., he was elected Vice President which honour he held until his death in 1943. With his retirement to Beaconsfield he became a 'London member' and his part in establishing the London Branch is recognised in a nostalgic article by 'H.S.' in Ulula (Vol. 59 pg.11)
The Author
Besides his medical publications including his book 'Healthy Growth', where there is an extensive review of earlier work in anthropometry tracing the results and the development of statistical methods of evaluating clinical findings, Dr. A.A. Mumford was also a dedicated amateur historian. In 1919 he published 'The History of Manchester Grammar School, 1515 - 1915'. It was advertised several times in Ulula during 1920 at double the normal price (10s 6d), to support the Old Mancunians' Fourth Centenary Fund (Ulula Vol. 49 pp 55, 82, 112, 146). This book is much more than a history of the School and begins with a review of the development of organised education from the Middle ages. Dr. Mumford was aware of his inexperience as a historian and includes self-criticism in the foreword. In spite of this the book became a classics for OMs. He also researched a life of the Founder of the school, Hugh Oldham, Bishop of Exeter, was published in 1936.
He produced historical reviews and vignettes from time to time and in 1929 published a life of John Partington in the Medical School Gazette. In 1921 he addressed the Lancashire and Cheshire Antiquarians Society on the School history, describing a Speech Day of 1640 (Ulula Vol. 49 pg. 2) and in the same year reported information on the will of Robert Clough 1618, which endowed a scholar at M.G.S. and at Christ's College, Cambridge (Ulula Vol. 49 pg. 105). He also found time to trace his own family history in detail back to the 16th century when they were farmers and freeholders on the Warwickshire Northamptonshire borders.
Husband and Father
A. A. Mumford's first wife died in childbirth in 1892 and the infant did not survive. In 1894 he married Edith Emily Read, daughter of a London physician and a distinguished graduate of Girton College, Cambridge. She was the first woman to gain a double first in mathematics. Dr. Mumford's own achievements in statistics were certainly enhanced by intellectual exchanges with his wife who made other contributions to his publications. There is a reference to her likely involvement in the History of MGS in a friendly but critical review by a colleague, F. A. Bruton (Maths, Modern Languages and Mature Study - 1892 - 1925) (Ulula Vol. 47, pg. 139).
She published her own work extensively, usually under the name E.E. Read Mumford, on the psychological and religious development of children. This work must have clearly influenced her husband in his work on the physical development of young people.
They had five children of whom the three boys all attended MGS. The eldest, Percival B. Mumford graduated in Medicine at Manchester, later becoming a successful Manchester dermatologist. In 1922 it is recorded that he helped his father during his recovery from his head injury with some lectures at School (Ulula Vol. 50, pg. 121) where Dr. Mumford Senior was congratulated on 'a wonderful recovery'.
His second son, Bryant became an expert on global agricultural problems working in New York with the United Nations and the youngest son Edward, after studying at Cambridge and later Oxford University, became Professor of Entomology at University of California, publishing widely on the effect of isolation on the Origin of Species.
On retirement in 1931 (Ulula Vol. 59, pg. 106) he progressively spent more time whilst building a new home in Beaconsfield, which became his full-time residence in 1938. He lived there until his death on February 23rd 1943 in his eighty-first year. Mrs. Mumford survived until 1953.
Conclusions
A. A. Mumford practised in an age of enthusiasm for physical exercise, particularly Swedish Drill. This was considered a passport to health and success and Dr. Mumford acknowledges and reviews the work of International Authorities in the field. His views at that time were very acceptable in the world of education as shown by the many publications in educational journals and the invited lectures to conferences of educationalist. These studies were directed towards improvement of achievement of the young person in education but represent the earliest attempts to practised what is now considered the specialty of Sports Medicine.
Dr. Mumford took enormous trouble over the statistical evaluation of these measurements and constructed tables and graphs to illustrate his results. In retrospect these results are not very striking since no account is taken o variations in biological maturity other than those manifested by an accelerated growth rate. There is an assumption that all the subjects are equally healthy and qualitatively different from the deprived, delicate and diseased children he saw at the Greengate Hospital. Evaluated from the end of the twentieth century, one can see in Dr. Mumford' work, research and attitude, the embryogenesis of a paediatric practice recognised today as Community Paediatrics.
Ulula recorded in February 1922 the publication in the Times Educational Supplement of an article in which there was an appraisal of Dr. Mumford's work in the School. In spite of a careful search of the microfilm of the issues of 1921 and 1922, the article has not been found and in the absence of a more precise reference, quotation is not possible.
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