Abstract
Alfred Caleb Taylor was the first radiographer at the Peterborough Infirmary and Dispensary from 1896 to 1923. He constructed the first X-ray apparatus and oversaw the development of the X-ray service in Peterborough. He contracted a chronic radiation dermatitis from exposure to X-rays which was a source of considerable suffering for him. When he died in 1927, X-ray dermatitis was considered to have contributed to his death, and he was recognised as an X-ray martyr and a victim of science. In spite of his achievements and his ill-health from working with X-rays, his name is not included on the Martyrs Memorial in Hamburg.
Introduction
On 8 November 1895, William Conrad Röntgen (1845–1923), Professor of physics at the University of Würzburg, discovered X-rays. He had been studying the phenomena resulting from the discharge of electricity through a vacuum in a glass tube, and one of the tubes that he had been working with was a Crookes tube, named after Sir William Crookes (1832–1919).1,2 Within a short time, the practical application of Röntgen’s discovery to medicine was realised. X-rays could be used to detect radio-opaque foreign bodies and assist in fracture diagnosis. 3
In 1896, the ‘new photography’ was rapidly taken up by medical men, electrical engineers and those with an interest in ordinary photography. The early users of X-rays did not have instruments to measure the strength of radiation fields. They used their hands to test the penetrating ability or quality of the X-ray tube. The harmful biological effects of X-rays were not initially anticipated, and none of the early experimenters took measures to protect themselves from exposure. Reports of adverse effects soon started to appear in the literature. These included conjunctivitis, erythema and necrosis of the skin, alopecia, chronic dermatitis and later aplastic anaemia and cancer.4,5 Cancer was a common cause of death among the X-ray pioneers.
It was common for the hands of the early radiologists to be exposed to very high doses of radiation. This led to the development of a chronic X-ray dermatitis with itching of the skin which progressed with intense pain, ulceration, gangrene and loss or amputation of fingers resulting from damage to skin, blood vessels and bone. 6 The pain in particular was persistent, debilitating and severe. With further progression of the condition, there was continued suffering and general ill-health, relentless pain, the risk of the development of cancer, amputation of the arm or hand and premature death. These early X-ray pioneers undertook their work believing that what they were doing was for the benefit of their fellow man. In 1898, the (British) Röntgen Society established a Committee on X-ray injuries, initiating the discipline of radiation protection. 7
The Society of Radiographers was founded in 1920 to promote the science and to regulate the practice of radiography. Those who had been active in practice for over 10 years were given membership without examination. The Society was concerned that radiographers should receive adequate technical training and introduced a Diploma examination.8,9
Alfred Caleb Taylor (Figure 1) pioneered the use of X-rays at the Peterborough Infirmary in the late 19th and early 20th centuries.
Alfred Caleb Taylor c. 1920. Reproduced by kind permission of Stephen Perry.
Family and personal history
Taylor was born in Newark-on-Trent on 29 December 1860. He was the grandson of a chemist, and his father was an engineer. He was the eldest of three sons. The family subsequently moved to Boston in Lincolnshire and then on to Peterborough when he was aged 10 years. He pursued an interest in dispensing, and in the late 1870s, he secured a position as dispenser with Dr William Thomson, Medical Officer for the City of Peterborough.10,11 He was appointed as the first whole time dispenser at the Peterborough Infirmary and Dispensary on 2 September 1880. In 1888, he became the first official secretary of the Infirmary. 12 He had a good working relationship with the surgeons at the Infirmary. He assisted with operations or held the antiseptic steam spray when required. 13
Taylor developed the X-ray service and was the first radiographer at the Infirmary from 1896. At that time, the term radiographer was used for anyone undertaking X-ray work, whether they were medically qualified or not. In December 1922, Taylor became a member of the Society of Radiographers. 14 He resigned from his post as radiographer in 1923 because of health issues resulting from his work as a radiographer but continued in his role as the hospital secretary until his death in 1927.
In 1883, he married Emma Allen (1863–1940), and together they had eight children. One died in childhood. Their sons were successful in their chosen careers. The eldest son, Frank Taylor (1885–1965), was appointed secretary at the Infirmary after his father’s death. 15 The second son, William Allen (b. 1888), was for a time assistant organist at Peterborough Cathedral and later became Director of Music at Cheltenham College. The third son, Philip John (1892–1988) became an architect in London and the youngest son, George Hugh (1899–1985), was a science master at Imperial Service College, Windsor. Taylor’s granddaughter, Joyce Taylor, was a radiographer at Peterborough District Hospital in 1968. 16
Taylor’s interests included music and photography. He was a Committee member of the Peterborough Orchestral Society and a member of the Operatic Society. 17 He shared a keen interest in photography with George Kirkwood (1853–1916) and Thomas James Walker (1835–1916), surgeons at the Infirmary. 18 His interest and skill with photography included both the artistic and technical aspects and was essential to his X-ray work. The early X-ray workers needed to be good at practical photography in order to undertake X-ray work. With Kirkwood, he was a founder member of the Peterborough Photographic Society in 1887.19,20 He was the first secretary and then a committee member of the Society, and in 1916, he became the second President.
The first X-ray apparatus
In 1896, X-rays were seen as a new type of photography. It was therefore not surprising that, given his interest in photography, Taylor started experimenting with X-rays at the Infirmary and resolved to put the discovery into practical application. He was able to progress the development of an X-ray service at the Infirmary which was considered to be of help to the surgeons in the diagnosis of traumatic injuries and location of foreign bodies. His work with X-rays was certainly encouraged by the doctors at the Infirmary. The first mention of X-rays in the Infirmary annual reports was in 1896 by the physician, Leonard Cane (1848–1911), who recorded that ‘The application of the new Röntgen Rays to medical cases has received attention under the scientific direction of Mr Taylor, who has devoted much time to the subject’. 21 It is, in fact, quite remarkable that Taylor was undertaking X-ray work at such an early stage.
The first demonstration of X-rays was given at the Infirmary by Taylor at the 84th meeting of the Peterborough Photographic Society on 21 May 1896. An X-ray was taken of a hand using a special focus tube and a 5 minutes exposure time, but unfortunately a satisfactory image was not obtained. Further X-rays taken of objects in purses with an exposure time of 7 minutes proved more successful. 22 The focus tube was the first modification of the Crookes tube by Professor (later Sir) Herbert Jackson (1863–1936) of Kings College, London. This tube produced a more concentrated beam of X-rays, and the X-ray picture was more sharply defined. 23 However, it appears that although Taylor was familiar with the superior Jackson tube, he used a Crookes tube for his X-ray work.
At the 90th meeting of the Peterborough Photographic Society on 11 January 1897 at the Infirmary, there was a ‘Demonstration by Mr Taylor of “Fluorescence” and the Röntgen Rays’. 24 Taylor clearly had an understanding of the science related to X-rays. The minutes of the meeting show that he gave a description of the electricity source, induction coil, the Crookes tube and explained the electrical actions taking place in each before proceeding to a demonstration. The fluorescent screen was coated with barium platinocyanide, and he showed that an opaque object such as a hand placed in front of the screen threw a shadow on to the screen. He also gave a demonstration of fluorescence in a Geissler vacuum tube, an early gas discharge tube named after Heinrich Geissler (1814–1897). 25 In addition, a local gentleman who thought that a piece of lead was embedded in the palm of his hand was subjected to examination by the aid of X-rays, and it was clearly shown that no metallic substance was present. This meeting generated considerable interest and was reported in the local newspaper. 26
The first generation of X-ray practitioners had to use a ‘home-made’ installation as there were no manufacturers as such, and the apparatus was usually self-funded. Taylor started his work on X-rays in a small room under the hall stairs at the Infirmary in 1896 with a ‘home-made’ installation which he funded himself. He had a 6-inch spark coil, and he designed a small X-ray tube of his own which was approximately 10 inches long. This was made by and purchased from Messrs. Brady and Martin of Newcastle-upon-Tyne. There was no electricity supply at the Infirmary in 1896. Mains electricity did not become available until 1900. 27 He initially made his own bichromate batteries which worked well but only gave 20–30 hours of power. He subsequently constructed an accumulator which consisted of six large cells, and better results were obtained. The accumulator needed two people to lift it, and it had to be taken to the local flour mill which had the facility for recharging. Despite the difficulties encountered, Taylor persevered with the development of his X-ray apparatus and was able to help the surgeons by obtaining radiographs of injured feet, hands and arms. At that time, an X-ray of the hand required a 20 minutes exposure but by 1926 with the improvements in the equipment being used, exposure times were 2–3 seconds.
It is interesting to note that one of the surgeons at the Infirmary, Dr Kirkwood, thought that doctors would ‘want to use the X-rays and would lose all sense of touch’. 28 This was an important point made by Kirkwood. X-rays would be of value in making a diagnosis; however, they would complement and not replace bedside observation and clinical examination as pointed out by Bythell and Barclay in 1912. 29 This is a point still made by radiologists today.
In 1908, the doctors at the Infirmary reported that the X-ray apparatus was proving useful in the diagnosis of fractures and the location of foreign bodies. 30
Upgrading the X-ray apparatus
When it became necessary to upgrade the X-ray apparatus, Harry Cox (1863–1910), a London electrician was consulted. He had started manufacturing X-ray tubes in 1896. He was a pioneer apparatus maker and was able to supply complete X-ray sets. 31 Unfortunately, he suffered from X-ray dermatitis as a result of chronic radiation exposure which eventually led to the amputation of his right arm, general ill-health and the development of cancer.31,32 Mr Cox was able to equip the Infirmary with a complete X-ray apparatus. A special room, albeit small, was made available. The apparatus and installation were paid for by contributions from the medical staff, Andrew Carnegie (1835–1919) (who was Peterborough’s first Freeman), and the citizens of Peterborough. 33 The first complete X-ray outfit was installed by 1912.
A new X-ray tube was invented by William Coolidge (1873–1975), an American physicist and engineer, in 1913. This tube, which became known as a Coolidge tube, produced more penetrating, high-energy X-rays and improved medical imaging. However, to use this tube, a more powerful induction coil was required. In 1915, Mr John Williamson, who had been Mayor of Peterborough, funded the necessary induction coil as a memento of his mayoralty. 34 This early use of a Coolidge tube is indicative of Taylor’s innovative attitude.
Figure 2 shows the equipment which was in use between 1916 and 1923, and one can perhaps appreciate how small the X-ray room was. The equipment was said to include a shield for the X-ray tube which is not shown in this photograph. It may have been removed to show the tube more clearly. The tube was commonly placed in a lead glass holder. The absence of electrical protection is also evident at this time before the use of shockproof apparatus. By 1916, lead gloves were being used for protection by the X-ray operator.
X-ray apparatus 1916 showing the switch board (1), the interrupter (2), the new induction coil (3), the X-ray tube (4), the fluorescent screen (5), a lead glass funnel for applying the X-rays (6), the valve for preventing back-passage of current into the X-ray tube (7), the induction coil in use (8), the old interrupter (9), high frequency apparatus (10) and lead gloves (11). The patient would have been positioned between the X-ray tube and fluorescent screen when an X-ray was taken. The tube and screen would have been removed to make this possible (Numbers 7 and 8 shown in white). Reproduced by kind permission of Vivacity-Peterborough Museum and Art Gallery.
For a long time, the Infirmary was one of the few centres between London and the North where radiography could be secured. In 1917, the ‘X-ray department conducted 101 examinations of fractures and dislocations, 71 for detection of foreign bodies, 55 of stomach and intestines, 14 of the kidney and bladder’.
35
In addition, it was noted that there were ‘142 therapeutic applications’ indicating that X-rays were being used for treatment, but there is no mention of what was actually being treated. It was recorded that 252 examinations had been undertaken in 1918 and that Mr Taylor was ‘absolutely indispensable in the X-ray department’.
36
Figure 3 shows an X-ray of a hand taken at the Infirmary in 1919 which was ‘touched up for newspaper reproduction’.
37
X-ray of a hand taken at the Infirmary in 1919. Reproduced by kind permission of Vivacity-Peterborough Local Studies and Archives.
The Peterborough Trades and Labour Council funded the cost of a vertical X-ray screen in 1919, and both the tube and fluorescent screen could ascend and descend. This had been requested by the County Tuberculosis Officer possibly because chest X-rays had become important for diagnosis and investigation of tuberculosis. 37
In 1920, the Infirmary Governors acknowledged that the existing ‘accommodation for the X-ray work’ was ‘totally inadequate’ and that it was ‘imperative that a large X-ray room should be provided’. 38 Dr John Hall-Edwards (1858–1926), who became recognised as a radiation martyr, had produced a set of 10 rules for protection from X-rays in 1908. The first rule on his list was that ‘(T)he room in which the X-ray apparatus was used must be large and well ventilated’. 39
In the early days of radiology, it was not immediately obvious why workers were being injured. The possible sources of injury included radiation, electrocution from contact with high tension cables, gases generated by high tension equipment and the chemicals used in processing. Ventilation was considered important to reduce the risk. Based on the inverse square law principle, a large room enabled the operator to be at a distance from the equipment where the risk from the radiation and injury would be reduced. By 1922, a new X-ray room had been constructed, and in 1923, new X-ray apparatus was installed. 40 Funding for the new room and X-ray equipment was provided by the Hospital Saturday Fund Committee. 41
It appears that Taylor was involved in reporting on X-rays requested by the surgeons and physicians and advising on X-ray therapy until he died in 1927. After that time, Dr John Norton Collins (1870–1961), who was a surgeon in Peterborough from 1903 to 1928, undertook the X-ray work. The first radiologist, Dr Wilfred Percy Tindal-Atkinson (1885–1953), was appointed in January 1929. 42 He had trained in London.
A great sacrifice
As a consequence of radiation exposure, Taylor developed a chronic radiation dermatitis affecting both hands. With the progression of this condition, he lost three fingers from his left hand and one from the right. In February 1923, he decided that he could no longer continue radiography work at the Infirmary because he could not manage the manipulation of the X-ray apparatus.
43
In the local newspaper, it was reported that during the annual meeting of the governors Taylor admitted: I cannot do what I used to do – my hands will no longer let me … There is one thing which will hurt me – (and here his voice seemed to shake with emotion almost to the point of breaking) – and that is, you have a large new X-ray room and I am not able to carry on the work.
44
In 1920, a report in The Times newspaper recorded that Taylor had ‘fallen victim to X-ray dermatitis in a virulent form’ and that he was a patient in a private ward at the Infirmary. 46 In 1926, the local newspaper reported that, he had ‘lost another finger (in 1925) and had a serious breakdown in his health’ resulting in absence from his secretarial role at the Infirmary. 47
When Taylor was considering retirement from his post of secretary at the Infirmary in 1926, a report appeared in The Times noting that ‘four of his fingers have had to be amputated, his hands are sadly maimed, and his general health is seriously impaired. The Infirmary Governors … have opened a public subscription to express appreciation of Mr Taylor’s great sacrifice’. 48
Public appreciation
It was not permitted to use hospital funds to help any employee, however loyal they might have been to the Infirmary, when the time came for them to retire.49,50 Furthermore, there were no pension arrangements when it came to retirement. There were over 300 subscribers to the public subscription fund which raised £700. At a special presentation ceremony, it was noted that Taylor ‘had worked quietly and unostentatiously … the dangers of X-rays were not known in the earlier days, and as a result Mr Taylor had suffered considerably in health’.
51
He was also presented with a silver tray which bore the inscription: ‘Presented to Mr A C Taylor, together with a cheque for £700, in recognition of his 46 years’ faithful service as Secretary of the Peterborough Infirmary and Dispensary, and in appreciation of his pioneer work as X-ray operator. 1926’.
51
At the ceremony, tributes were paid to his ‘great work’, and in reply he said: I have only done my duty, and if I have sacrificed bits of my fingers so that I am not able to tie up my shoe-laces, I feel I have been compensated, for I have loved the X-ray work and its excitements. For all the trouble I had at the beginning I have been more than compensated by your appreciation, and although I have lost bits of my fingers I would still do the same if I had my life to come over again.
51
After his death, it was suggested that perhaps the Freedom of the City of Peterborough should have been conferred on him for ‘his self-sacrificing labours in the cause of relieving human suffering’ and that ‘it is a matter of regret that one of our citizens who deserved so well of his City, never received it’. 52
His final illness
Taylor did not, in fact, reach his retirement. He was working up until three weeks before his death. It appears that his condition gradually deteriorated and he died on 26 July 1927. His death certificate indicates that he had died from mitral heart disease, chronic nephritis and rheumatic fever. X-ray dermatitis was noted to have contributed to his death but was not related to the condition causing it. 53 There was no post-mortem, and there is no evidence that he suffered from cancer as a consequence of his chronic radiation exposure. His death was reported in the local newspapers as well as a number of newspapers around the country.54–58 His funeral was held in Peterborough Cathedral, and he was buried in Longthorpe Churchyard in Peterborough. 59 The inscription on his grave reads: ‘He lived not for himself but for others’.
Carnegie Hero Fund Trust
Andrew Carnegie (1835–1919) was a Scottish-American industrialist and philanthropist who made his fortune in the American steel industry. In 1908, he established the Carnegie Hero Fund Trust. The purpose of the fund was to provide financial assistance for those ‘following peaceful vocations, who may have been injured in the effort to save human life’. 60 In 1926, the Infirmary Management Committee approached the Carnegie Hero Fund Trust concerning Taylor’s heroic, unselfish work and sacrifices for the benefit of his fellow man. They had had a favourable reception and were led to believe that when Taylor retired, his services would be recognised by the Carnegie Hero Fund Trust. On 30 September 1927, two months after Taylor’s death, the trustees of the fund based in Dunfermline, awarded a memorial certificate to his widow, in recognition of his heroism and also arranged a grant of £100 for their youngest daughter who was an undergraduate at Oxford, for educational purposes.61–64
The certificate (Figure 4) dated 29 September 1927, and signed by the Chairman and Secretary of the Carnegie Hero Fund Trust, was presented privately to Mrs Taylor by the Chairman of the Infirmary on behalf of the Trust.
65
The Memorial Certificate. Reproduced by kind permission of Vivacity-Peterborough Museum and Art Gallery.
The memorial gift
In 1928, a new hospital, the Memorial Hospital was opened in Peterborough, and the Infirmary was closed. In 1943, the X-ray department at the Memorial Hospital was in need of an extension. It was decided that the extension should be in memory of Taylor as he had done so much for the development of the X-ray service in Peterborough. A sum of over £1200 was raised by ‘some 10,000 people’ who ‘remembered his work in gratitude’.
66
A Commemorative tablet was erected which had the following inscription: In grateful memory of Alfred Caleb Taylor, who died on the 26th July 1927. He was for many years Secretary of the Old Infirmary, and on the discovery of X-rays, devoted himself to experimental research with such skill and enthusiasm that the first apparatus in any provincial hospital was installed in this City. After years of suffering he died an honoured martyr. His courage and self-sacrifice having been recognised by the award of the Vellum of the Carnegie Heroes Fund.
67
An X-ray martyr
In 1936, a memorial was erected at St George’s Hospital, Hamburg to the memory of the doctors, physicists, chemists, technicians, laboratory workers and nurses of all nations who were known to have lost their lives as a result of over-exposure to ionising radiations. There were 150 names from 15 different nations. 69 A further 28 British names were added in 1956 including Harry Cox. However, Taylor’s name was not included. 70 There is no evidence that Taylor died as a direct consequence of his radiation injuries. Nevertheless, he did endure considerable pain and debility as a consequence of his radiation exposure. This did affect his quality of life and may have hastened his death.
At the annual meeting of the Infirmary Governors on 31 December 1927, the death of Mr Taylor was noted and the minutes of the management committee record ‘We shall all remember with gratitude the personal sacrifices and suffering that Mr Taylor made and endured in connection with his pioneer work as an X-ray operator’. 71
After his death, reports in the newspapers throughout the country including Leeds, Bristol, Portsmouth, Taunton and Dundee recognised him as an X-ray martyr and a victim of science.54,57,72–74
In October 1933, the Lancashire Daily Post reporting the death of Dr William Hope Fowler (1876–1933) another X-ray martyr, also listed the names of a number of X-ray workers who had ‘sacrificed their lives in the cause of human suffering’. 75 The list included Alfred Caleb Taylor. In addition, the Hartlepool Northern Daily Mail when reporting the death of Hope Fowler, also listed Alfred Caleb Taylor ‘(A)mong those who had succumbed to the slow and painful dermatitis caused by their labours’. 76 Hope Fowler is included in the list of names on the Martyrs Memorial.
Conclusion
The discovery of X-rays was a technological advance which resulted in the introduction of a new investigation to assist doctors in diagnosis and treatment. When the risk from repeated X-ray exposure was realised, appropriate measures were put in place to reduce and prevent the risk. However, for those early workers in the field who developed radiation injuries, the pain and suffering affected their quality of life, and cancer was a common cause of death. Alfred Caleb Taylor had an interest in photography and a knowledge of the science associated with X-rays. He was an X-ray pioneer who was one of the first to develop an X-ray service in a provincial hospital. He had a close working relationship with the Clinicians and the Management Committee at the Infirmary. This was important for the establishment and development of the X-ray service. He continued working as a radiographer until the side-effects of the X-ray dermatitis which he contracted prevented this. He does not appear to have recognised himself to be an X-ray martyr or a victim of science. He simply considered that what he was doing was for the benefit of others. He is remembered in Peterborough for his personal sacrifice and heroic contribution to the development of the X-ray service for the benefit of his fellow man. Perhaps, a case can be made for Alfred Caleb Taylor’s name to be included on the Memorial to X-ray martyrs in Hamburg, even at this stage.
Footnotes
Acknowledgements
I am grateful for the advice from Dr Michael Collins from the British Society for the History of Medicine and those who made records available: Stephen Perry, Peterborough Historian; Clem Tacconi, Peterborough Photographic Society; Glenys Waas at Vivacity-Peterborough Museum and Art Gallery and the Staff at Vivacity-Peterborough Local Studies and Archives.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interests with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research authorship and/or publication of this article.
