Hopes and cures sent to the world from a capital flat
Dr Robert Philip’s work on a TB outbreak in Edinburgh brought hope to victims of a disease long linked to vice and sin. By Alison Campsie
He led the fight against disease from three rooms in an Edinburgh flat – and brought hope to the world. Dr Robert Philip is remembered for his pioneering work in the fight against tuberculosis, a disease which was responsible for 10 per cent of all deaths in the Scottish capital in 1890.
Now the work of the doctor is being illuminated by the National Library of Scotland (NLS), which has published online the breakthrough mapping exercise carried out by the doctor, who tracked patients and recorded the spread of the disease.
The data was used to inform his approach to treatment, which split patients into three broad categories, with many urged not to isolate in their homes but instead to recuperate in the fresh air.
Chris Fleet, map curator at the NLS, said the disease was poorly understood at the time and popularly blamed on everything from prostitution to vampires.
“But even the well-educated tended to see it as a fellow-traveller of vice and sin,” he said.
Dr Philip, who was born in Govan but relocated to Edinburgh as a boy, led the fight to better understand the disease and help its sufferers from the Victoria Dispensary for Consumption and Diseases of the Chest. First located in a set of flats in Bank Street, Edinburgh, it moved to 26 Lauriston Place in 1891. This dispensary was the first preventative institution of its kind in the world, and particularly valuable for the poorer inhabitants of the city. In time, it was replicated in other countries.
Chris said: “The way he analysed data on TB, and the way that he used it, resulted in a dramatic fall in cases. He really set up the scheme to tackle the disease which was replicated across Europe.”
Dr Philip, the son of a minister, reported that Edinburgh’s medical provisions of 1892 were completely inadequate to treat or isolate tuberculosis patients, with many sufferers being confined to their homes.
“If there be the slightest degree of truth in the contagious view of tuberculosis, such chronic foci of infection ought not to be permitted to smoulder under conditions which are calculated to encourage the fatal propagation,” he said.
He argued that the best way to treat tuberculosis patients was to build up their general constitution to allow them to resist the infection.
Fresh air, clean surroundings, a nutritious diet, physiological rest and careful exercise were all preferred routes to beating the disease.
Dr Philip believed the disease could be treated most effectively if it was caught early in its development. As he regarded the home as the main site of transmission, he used home visits as an opportunity to search out other cases by lining up contacts and examining them for signs of the disease – a procedure he liked to call a “march past”, according to the National Dictionary of Biography.
Dr Philip put TB sufferers into three categories. The really serious cases were put to the City Fever Hospital at Craiglockhart, which was set up in 1897 following pressure form the medic.
Early-onset cases were sent to a sanatorium, usually the Victoria Hospital for Consumption in Craigleith, later the Royal Victoria Hospital, which opened in 1894.
Those requiring isolation and rest were often sent to Polton Farm Colony, near Lasswade, where patients could engage in gentle agricultural work.
Chris said: “These approaches are analogous with the different ways different countries are dealing with coronavirus.
“At the time TB was very poorly understood but Dr Philip really focused on the empirical data and how that can be best used.”
The doctor was widely regarded for his work on TB. He was knighted in 1913 and then appointed physician to King George V.