Henry David (also Daniel) Rooke Kingston qualified as Bachelor of Medicine (MB) and Master of Surgery (CM) at the University of Edinburgh in 1875. He was licensed to practice in the Cape Colony in July 1881 and that same year asked for an appointment as district surgeon. By 1885 he was living in Knysna, but by 1893 had moved to the South African Republic (Transvaal). Though he was not registered to practice in either the South African Republic or, after the Anglo-Boer War (1899-1902), in the Transvaal Colony, he was still living there in 1907. By 1915 he was living in London. In 1890 he was awarded the degree Doctor of Medicine (MD) by the University of Edinburgh after submitting a thesis on Leprosy elephantiasis graecorum: with special reference to its occurrence in the colony of the Cape of Good Hope.
Around 1900 Kingston excavated various caves at the mouth of the Grootrivier, about midway between Plettenberg Bay and Jeffreys Bay. He described the work in a paper, "Notes on some caves in the T'Zitzikamma or Outeniqua district, near Knysna, South Africa, and the objects found therein", which was published in the Journal of the Anthropological Institute of Great Britain and Ireland (1900, Vol. 30, pp. 45-49). Goodwin (1935) described the finds as including bored stones, nacre spoons, bone shell-openers, grindstones, and stone artefacts of the Mossel Bay type. However, the excavation was carelessly conducted. Some of Kingston's material from Knysna and the Tsitsikamma coast was sent to the Pitt Rivers Museum, Oxford, in 1900 and 1905. He was interested also in ethnology and collected smoking pipes from Natal. In collaboration with Henry Balfour* he described these in "Native smoking pipes from Natal" (Man, 1901, Vol. 1, pp. 11-12).