James was educated at Glasgow, and at Charing Cross Hospital, London, and took the diplomas of L.S.A. in 1901 and of L.M.S.S.A. in 1907. He went into practice at Kidsgrove, North Staffordshire, where he was medical officer and public vaccinator to the Kidsgrove and Goldenhill district of the Wolstanton and Burslem Union, as well as being surgeon to the police and to the St John Ambulance, and county director of the Staffordshire Branch of the British Red Cross Society. He served with the 25th Field Hospital in the South African war, receiving the medal, and held the honorary rank of Lieutenant in the Army from 1st March 1903. He acquired the rank of major in the R.A.M.C., Special Reserve on 18th June 1914, then entered the war in France on 21st August, serving with the 19th Field Ambulance. On 26th August 1914, during the Retreat of Mons, he was taken prisoner at Landrecies. After he was repatriated, James was promoted to lieutenant-colonel, and was sent to serve on H.M.H.S. “Glenart Castle”.