MacDonald (McDonald), James Alexander (1853–1928), rugby international and rugby and medical administrator, was born in Newtownards, Co. Down, on 1 July 1853 (some sources suggest 1848/9), one of at least four brothers, two of whom (Robert and Malcolm) were connected with banking. Initially he was a teacher at Methodist College, Belfast, but later he decided to study medicine, graduating from QCB (1889). He was one of the pioneers of rugby football in Ireland, playing a leading role in the formation and development of the Northern Football Union (NFU), one of the forerunners of the IRFU, and playing on the first Irish international team, losing to England (1875) at the Kennington Oval, London. He played thirteen times for Ireland (1875–84), including Ireland's first ever international victory, against Scotland in Belfast (19 February 1881), and in an 1882 draw with England. In 1884 he was given the captaincy of the side after he announced that it would be his last year in international football. An energetic front row forward, MacDonald was Ireland's most capped player on his retirement and remained so for ten years until his total was eclipsed by C. V. Rooke (qv). He was also a talented soccer player, playing for Cliftonville, and reputedly played lacrosse for Ireland with three of his brothers.
Shortly after graduating, MacDonald moved to England, where he had a large and successful medical practice for almost forty years in Taunton, Somerset, becoming a prominent figure in local political circles as chairman of the local Conservative Association and as grand officer of the Freemasons. He also served as consulting physician at the county hospital in Taunton. A natural administrator and a skilled chairman, he rose to the very top in medical politics, serving as chairman of the British Medical Association Representative Body (1906–9), and later as chairman of the BMA council for what was then an unprecedented ten years (1911–20). On his retirement from that post, he remained involved as chairman of the British Medical Association Journal Committee. In 1911 he was awarded an honorary degree of LLD from Birmingham University, and received the BMA's gold medal of merit in 1913. Tributes paid to him on his death suggest a man of strong conviction and character who commanded respect even from those who disagreed with him. He was a strong supporter of Edward Carson (qv). He died 23 April 1928 in Taunton and is buried there. He was unmarried.