Budd did not put his views before the profession until 1857-60 when he published a series of papers in The Lancet, afterwards embodied in his work Typhoid Fever in 1873. He had long since taught them in the Bristol Medical School. During the depressing period of opposition that he encountered, he gained support from fellow country doctors; otherwise one of his few admirers was Sir Thomas Watson, who reckoned his investigations to be of priceless value. Budd maintained that, in both typhoid fever and cholera, the contagious matter was in the dejecta. He is credited, through application of his preventive methods, with having greatly reduced the spread of cholera in Bristol.
Budd’s main work, Typhoid Fever, was published in 1873 long after his original rural observations in North Tawton. In it he declared that ‘the sewer has been looked upon as the actual and primary source of the disease, while the infected man has been altogether lost sight of. The British Medical Journal reviewer was impressed by the story of the two sawyers with typhoid in North Tawton and the girl returning to St Arno’s convent. However, this commentary also noted the view of Dr. Charles Murchison at the time, that many cases had had an independent origin. Another criticism was that no one had found the genesis of epidemics of enteric fever. The reviewer quoted Dr Maclagan of Dundee who believed that enteric fever occurred spontaneously. An epidemic in an isolated farmhouse was attributed to altered positioning of a drain, because the ‘possibility of importation of the disease seemed excluded: all the servants and residents had been there for some months at least: no one had been in any locality in which the fever existed, and no one had visited the place who was in the least degree likely to have brought the infection with them’. The concept of the symptom-free carrier had clearly not dawned on anyone, Budd included. The conclusion of the reviewer was that ‘though we hesitate to subscribe to the whole of Dr. Budd’s proposition, we think he has proved that enteric fever sometimes arises from contagion.
- Bettany G.Eminent Doctors: their Lives and Work. London: John Hogg, 1885: 129
- Reviews and notices.BMJ 1874;ii: 835-8. Commenting on Typhoid Fever: Its Nature, Mode Of Spreading, And Prevention. By William Budd, MD FRS. London: Longmans, Green, and Co, 1873