Thrust by the exigencies of war into the field of industrial medicine, Richard Schilling was to become the doyen of the subject in the United Kingdom and the leading proponent of a specialist service dedicated to the maintenance of health at work within the structure of the National Health Service.
Nothing, however, was further from his thoughts than a career in academic medicine when he was a medical student at St Thomas' Hospital, where he was known primarily for his good company and his prowess at sports, particularly at cricket, at which he excelled as a ferocious left-arm, round-the-wicket bowler. Nor did it loom any larger in the first few years after he qualified, when he undertook further training with the intention of becoming a general practitioner, nor when, in 1937, he took an appointment as an assistant industrial medical officer to earn enough money to be able to marry.
A subsequent appointment as a medical factory inspector proved, however, to be decisive; for, with the outbreak of war, the incidence of industrial disease, which resulted from the pressure of production in general and of munitions in particular, became a problem of national importance and doctors with any experience of factory conditions were in short supply.
When, therefore, he returned from Dunkirk with the British Expeditionary Force to France, which he had accompanied as a member of the Territorial Army, he was directed back to the medical inspectorate of factories and, two years later, was seconded to serve as scientific secretary of the Medical Research Council's Industrial Health Research Board. With this job he became wedded to the field for life.
The late 1940s were an exciting period for those interested in the subject. The Medical Research Council established a department for research in industrial medicine at the London Hospital, an industrial medical research unit in Birmingham, a pneumoconiosis research unit in Cardiff, and a toxicology unit in conjunction with the Ministry of Supply at Porton, while universities, for their part, established academic departments in industrial medicine in Manchester, Newcastle, and Glasgow.
Opportunities for enthusiasts consequently abounded. Schilling, therefore, decided to apply for an academic post, but before doing so he sought background training in public health at the London School of Hygiene and Tropical Medicine, which a Nuffield Foundation Fellowship enabled him to afford. Then, in 1947, he set foot on the academic ladder with an appointment as reader in the University Department of Industrial Medicine in Manchester, under Professor Ronald Lane.
Within a few years Schilling had clarified the characteristics of the respiratory disease that had been known to affect cotton workers for over 100 years, but which had been confused with the chronic bronchitis that commonly affected the general population. He showed that it was a specific disease with its own distinguishing features, now called byssinosis, and that it was caused by cotton dust and could be prevented by reducing the amount of the dust to which the workers were exposed. Its existence in other countries was initially denied, but subsequent studies showed that the disease was not peculiar to Lancashire, but affected cotton textile workers throughout the world.
By 1956, his growing reputation made Schilling the obvious choice to head the Rockefeller Unit of Occupational Health at the London School of Hygiene and Tropical Medicine, which was later expanded, under his direction, into an institute with endowment for an information centre from the Trades Union Congress. By the time of his retirement in 1976, the institute had achieved international status and more than 400 students from many countries had attended it for specialist training, and the book that he and his colleagues had written - Occupational Health Practice (1973) - had become a standard work on the subject. The institute, however, failed to thrive under his successors and lack of university support caused it to be closed in 1990.
Shortly before his death Schilling completed a further book giving a personal account of the development of industrial medicine over 60 years into a branch of medicine concerned to maximise the health and safety of everyone whilst at work. In A Challenging Life, to be published in December, he makes a special plea for the establishment of an occupational health service to cover all workers, like that recommended in 1985 by the International Labour Office and now provided in Finland.
Schilling's enthusiasm for occupational medicine and his concern that research in the subject should be conducted objectively and to the highest possible scientific standard will be a source of inspiration to all who work in the field for many years. It is not, however, only for his contributions to medicine that he will be remembered, but also for his personal qualities. No one who knew him will forget his unique combination of a commanding presence, gentleness, concern for others, and a highly developed sense of fun that made his company a constant delight.
Few things gave him greater pleasure than his election in 1996 to an honorary fellowship of his old medical school - now the United Medical and Dental School of Guy's and St Thomas' - and none was more fortunate in its outcome than his decision to abandon general practice for a salaried appointment in 1937. For it not only introduced him to industrial medicine, but it also made possible his outstandingly successful marriage, the 50th anniversary of which was celebrated in 1987 by a service of rededication at St Cross, Winchester.
- Richard DollReuse content