Andrew Malcolm – Physician and Public Health Reformer

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Background

A.G. Malcolm - Physician and Public Health Reformer
A.G. Malcolm

Andrew George Malcolm was born in 1818. His father, of the same name, was a Presbyterian minister in Dunmurry and then Newry. His mother was Eleanor Hunter. Andrew was educated at Belfast Academical Institution and completed his medical training at Edinburgh, graduating in 1842.

By 1843 Andrew Malcolm had returned to his home town and was working as a medical attendant at the General Dispensary. He lived nearby at 29 York Street with his mother. His father had died of typhus while attending to his parishioners, when Andrew was only 5.

Career & medical interests

At the age of 28 Andrew was employed as a doctor in the General Hospital on Frederick Street, while he still kept his job at the Dispensary. Part of his role, as attending physician, was to teach students, he was soon known as an innovative medical instructor. He encouraged a ‘hands on’ approach with full student involvement in addition to clinical lectures and autopsy demonstrations. Malcolm has been described by his biographer, John S Logan as “a powerful and assiduous teacher”.

Andrew Malcolm believed in the importance of the microscopical examination of fluids and tissue. He wrote many articles on clinical and pathological correlations – this was before the study of bacteria. Malcolm wrote “If our profession is to advance much as a practical study, it can only be by elaborate, but ordinary intelligent observation at the bedside, going hand-in-hand with the results of pure scientific research”.

Impacts of the industrialisation of Belfast

Andrew Malcolm was very concerned about the social and medical implications of Belfast’s rapid industrialisation. The changes in conditions from cottage to factory and the effects on a workers mental and physical health. In 1854 he successfully gained the post of ‘certifying factory surgeon’.

At this time Belfast had 25 mills with over 11,000 employees. In particular Malcolm was worried about the damage dust and airborne fibres could do to a person’s lungs. He published the statistical Paper the ‘Influence of Factory Life on the Health of Operatives’ to emphasise his concerns.

Malcolm was ahead of his day in believing that mental health and well-being was of equal importance as physical condition. He believed that providing stimulation such as reading and recreation would lead to a healthier and happier workforce.

In 1846, with the backing of like-minded friends, he founded the Belfast Working Classes Association for the Promotion of General Improvement. He also produced a journal, The Belfast Peoples Magazine, to promote his ideas of self-improvement. In June 1846, he set up a Peoples News-Room, where subscribers could read newspapers and magazines. The following year he established a Peoples Circulatory Library. Both these were very popular and of immense value.

Belfast Medical Society

Andrew Malcolm was also an enthusiastic member of the Belfast Medical Society (now the Ulster Medical Society) , aiming to improve its resources and amenities. He was the first secretary of the Belfast Sanitary Committee and was determined to help improve working and living standards for Belfast’s poor. Malcolm was also involved in the newly formed Society for the Amelioration of the Condition of the Working Classes. He was especially concerned with the provision of public baths and wash-houses, as a first step in increasing hygiene in over-crowded houses. His work ‘The Sanitary State of Belfast’ and his Papers on ‘Asiatic Cholera in Belfast’ and on the dysentery epidemic in the north of Ireland, continued to highlight his fears.

The Sanitary State of Belfast - Book 1852
The Sanitary State of Belfast by A.G. Malcolm, M.D.

Medical Historian

Malcolm was also a keen medical historian. His most notable work is an account of the development of the Belfast General Hospital published in 1851. It covers the foundation of the Belfast Dispensary in 1792 until 1850. This covers the Famine years and is a valuable resource to all those wishing to understand the effects on the local populace of the Famine and how the authorities endeavoured to cope with the great calamity. The book also illustrates the author’s innate kindness and affectionate nature as well as his practical philanthropy and admiral moral character.

In 1854 Andrew Malcolm had married Maria Glenny Home in the First Belfast (Non-Subscribing) Presbyterian Church. Their son, also Andrew George, was born in Dublin on 31st August 1856. Malcolm himself was in poor health, suffering from rheumatic valvular heart disease. Sadly he died
only a couple of weeks later on 19th September, aged 38. Tragically his baby son died at 5 months old from meningitis. Andrew Malcolm’s funeral was on 22nd September from his home on York Street. He is buried in Dunmurry, where his father had been minister.

His colleague, Professor Ferguson described Andrew Malcolm “I think he may be put before you, my young friends, as a good specimen of the working man of our profession, well worthy of your imitation”.


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