“In Tullamore, when measures were proposed for arresting the progress of fever, by the establishment of a fever hospital, so little was the alarm that the design was regarded by most of the inhabitants as a well-intentioned project, uncalled for by the circumstances of the community. But when the death of some persons of note excited a sense of danger, alarm commenced, which ended in general dismay: military guards were posted in every avenue leading to this place, for the purpose of intercepting sickly itinerants. The town, from the shops of which the neighbouring country is supplied with articles of all kinds, was thus in a state of blockade. It was apprehended that woollen and cotton goods might be the vehicles of infection, and all intercourse between the shops and purchasers was suspended. Passengers who inadvertently entered the town considered themselves already victims of fever. No person would stop at the public inns, nor hire a carriage for travelling; in a word all communication between the town and the adjacent country was completely interrupted. Apprehension did not proceed in most other places to the same extent as in Tullamore[474].”

Several isolated places escaped the epidemic of typhus, either for a time or altogether. The island of Rathlin, seven miles to the west of Antrim, which was as famished as the mainland, had no typhus at the time when it was epidemic along the nearest shore; the island of Cape Clear, at the southernmost point of Ireland, had a similar experience. The whole county of Wexford, where the soil was dry and the harvest of 1816 had been fair, kept free from typhus until 1818, partly because it was out of the way of vagrants. The town of Dingle, at the head of a bay in Kerry, with old Spanish traditions, was totally free from typhus at a time when its near neighbour, Tralee, was full of it, the immunity being set down to the well-being of the population from their industry at the linen manufacture (and fisheries) and their thrifty habits. But the counties of Wexford and Waterford, and other places more or less exempted in 1817, had a full share of the epidemic in 1818, which was the season of its greatest prevalence in most parts of Ireland except Ulster. The harvest of 1817 had been little better than that of the year before, although the potato crop was hardly a failure. The fine summer of 1818 brought out crowds of vagrants who slept in the open, and, when they took the infection, were placed in “fever-huts” erected near the roads[475]. The harvest of that year was abundant, and by the end of 1818 the epidemic had declined everywhere except in Waterford.

The most carefully kept statistics of the sickness and mortality were those by Rogan for the Strabane Dispensary district, and the adjoining manors of the Marquis of Abercorn, for each of which a private dispensary was established under the care of a physician.

Abstract of Returns of the Dispensary district of Strabane, shewing the numbers ill of fever from the commencement of the epidemic in the summer of 1817, till the end of September, 1818, the numbers labouring under the fever at that date, and the mortality caused by the disease (Rogan, p. 72).

    Population   Ill of Fever   Dead   Remaining ill
Town of Strabane   3896   639   59   13
Parish of Camus   2384   685   61   37
""Leek   5092   1462   96   57
""Urney   4886   1381   86   42
  16,258   4167   302   149

Similar return for those parts of the Marquis of Abercorn’s estates not within the Dispensary district:

Manors   Population   Ill of fever
(to Oct. 1818)
  Dead
Magevelin and Lismulmughray   5548   1666   101
Donelong   3126   1217   71
Derrygoon   2568   1215   90
Part of Strabane   2796   990   75
Totals   14,038   5088   337

The proportion of attacks in these tables for a part of Tyrone, one-third to one-fourth of the whole population, is believed to have been a fair average for the whole of Ireland. Each attack, with the weakness that it left behind, lasted about six weeks; cases would occur in a family one after another for several months; in some cottages, says Rogan, only the grandmother escaped.

One hundred thousand cases were known to have passed through the hospitals. Harty thought that seven times as many were sick in their cabins or houses, making 800,000 cases in all Ireland in two years; Barker and Cheyne estimated the whole number of cases at a million and a half (1,500,000). The mortality was comparatively small. It comes out greater in the tables for the Strabane district than anywhere else in Ireland except the hospital at Mallow. The following table, compiled by Harty, shows how widely the fatality ranged (if the figures can be trusted), from place to place and from season to season:

Proportions of fatal cases of typhus in the chief hospitals of Ireland 1817, 1818 and 1819 (Harty)[476].

    1817
One in
  1818
One in
  1819
One in
  Average
One in
Dublin   14½   24   18¼   20
Kilkenny   16½   14⅚   12⅔   14¼
Dundalk   2067   54   25   30
Belfast   19⅕   15⅘   19   17⅓
Newry   2119   34½   13½   26
Cork   29   35   35   33⅕
Limerick   13½   15⅔   30⅔   16½
Waterford   27⅓   25   23⅓   24⅗
Clonmel   27   18   18¼   19⅓
Mallow   22½   9⅗       12
Killarney   74   67   33   62
Tralee   20¾   69   43   39

What this meant to particular places will appear from some instances. In the parish of Ardstraw, Tyrone, with a population of about twenty thousand, 504 coffins are stated by the parish minister to have been given to paupers in eighteen months. The burials were about twice as many as in ordinary years, according to the register of the Cathedral churchyard of Armagh:

1815   247 burials
1816   312 "
1817   571 "
1 May-25 Dec. 1818   463 "

Of the 463 burials in eight months of 1818, there were 165 from fever, 180 from smallpox, and 118 from other causes.

Barker and Cheyne make the whole mortality of the two years from fever and dysentery to have been 65,000; Harty makes it 44,300. But not more than a sixth part of the latter total were registered deaths, and the estimate of the whole may be wide of the mark. In the county of Kerry, ten Catholic priests died of it. Many medical men took it, as well as apothecaries and nurses, and several physicians died, of whom Dr Gillichan, of Dundalk, a young man of good fortune, made a notable sacrifice of his life. Everyone bore willing testimony to the devotion of the Roman Catholic clergy. Some harrowing incidents were reported, such as those from Kanturk, in county Cork:

Dr O’Leary visited a low hut in which lay a father and three children: “There were also two grown-up daughters who were obliged to remain for several nights in the open air, not having room in the hut till the father died, when the stronger of the two girls forced herself into his place. On the road leading to Cork, within a mile of this town, I visited a woman of the name of Vaughan, labouring under typhus; on her left lay a child very ill, at the foot of the bed another child just able to crawl about, and on her right the corpse of a third child, who had died two days previously, and which the unhappy mother could not get removed. When the grant arrived from Government, I visited a man of the name of Brahill near the chapel gate, who with his wife and six children occupied a very small house, all of them ill of fever with the exception of one boy, who was so far convalescent as to creep to the door to receive charity from the passengers.”

Infants rarely took the fever. Dr Osborne, of Cork, stated that in one instance a physician in attendance on the poor had to separate two children from the bed of their dead brother, the father and mother being already in a fever hospital; in another instance, he had to remove an infant from the corpse of its mother who had just expired in a hovel[477].

Nosologically the epidemic of 1817-18 presented several features of interest. It began with dysentery, and ended with the same in autumn, 1818. It was in great part typhus, but towards the end of the epidemic, in Dublin, at Strabane, and doubtless elsewhere, it changed to relapsing fever, that is to say, the sick person “got the cool” about the fifth or seventh day instead of the tenth or twelfth, but was apt to have one or more relapses or recurrences of the fever. The relapsing type was milder in its symptoms and was more rarely fatal. The average fatality of typhus was much less than in ordinary years, while a good many of the fatal cases came from the richer classes, to whom the contagion reached, the proportion of fatalities among them being noted everywhere as very high, up to one death in three or four cases[478]. The fatalities were most common, as usual, at ages from forty to sixty. A full share of the women and children took the fever, perhaps an excess of women, allowing for their excess in the population. The following were the numbers at each period of life among 18,891 cases treated in the hospitals of Dublin and Waterford:

Years of age   1-10   10-20   20-30   30-40   40-50   50 and over
Cases   2426   6116   5230   2476   1415   1228

The action of the English Government was thought by some to have been apathetic. Nothing was done to check the export of corn from Irish ports. Peel, who held the office of Irish Secretary in 1817, was probably actuated in this by the same constitutional and economic considerations which led him, as Prime Minister in 1845, to refuse O’Connell’s demand for a proclamation against the export of corn.

Carleton says that there were scattered over the country “vast numbers of strong farmers with bursting granaries and immense haggards,” and that long lines of provision carts on their way to the ports met or intermingled with the funerals on the roads, the sight of which exasperated the famishing people. Several carts were attacked and pillaged, some “strong farmers” were visited, and here or there a “miser” or meal-monger was obliged to be charitable with a bad grace; but on the whole there was little lawlessness, less indeed than in England in 1756 and 1766, or in Edinburgh in 1741. In September, 1817, Peel commissioned four Dublin physicians to visit the respective provinces and report on the causes and extent of the epidemic fever. On 22 April, 1818, Sir John Newport, member for Waterford, for whom Dr Harty had been collecting information, raised a debate on the epidemic in the House of Commons, and moved for a Select Committee. The debate, after the opening speech and a sensible brief reply by Peel, degenerated at once into irrelevant talk on the inadequacy of the fever hospital of London. The Select Committee was named, and quickly reported on the 8th of May.

A Bill embodying the recommendations of the Committee received the royal assent on 30th May. The Act provided for the extension of fever hospitals, the exemption of lodging-houses, under certain regulations, from the hearth-tax and the window-tax, and the formation of Boards of Health with powers to abate and remove nuisances. The Boards of Health were found unworkable, partly by reason of expense, partly of excessive powers. The epidemic having visited Waterford somewhat late in its progress, Sir John Newport again called attention to it on 6th April, 1819, and moved for the revival of last year’s Committee. Mr Charles Grant, afterwards Lord Glenelg, who was now Irish Secretary, gave much satisfaction to the patriotic members both by his sympathetic speech on the occasion and by his previous action at the Irish Office in the way of pecuniary help to the fever hospitals or Dispensary district officers. The Second Report of the Committee remarked that the rich absentee landlords had given nothing. Another Act, of June, 1819 (59 Geo. III. cap 41), defined the duties of officers of health, and contained an important clause (ix.) relating to the spread of contagion by vagrants. By that time the epidemic was over; nor can it be said that the action of the Government from first to last had made much difference to its progress.

Vagrancy was the principal direct cause; and behind the vagrancy were usages and traditions, with interests centuries old, which made the landlords resolute not to pay poor-rates on their rentals. It was not until twenty years after that the English Poor Law was applied to Ireland (in 1839), whereby the pauper class were dealt with as far as possible in their respective parishes. How far that measure was effective in checking the spread of contagion will appear when we come to the great famine and epidemic of dysentery and fever in 1846-49.

It will not be necessary to follow with equal minuteness the successive famines and epidemics of typhus, relapsing fever and dysentery in Ireland, to the great famine of 1846-49. After 1817 distress became chronic among the cottiers and small farmers. Leases had been entered into at high rents during the years of war prices, and in the struggle for holdings tenants at will offered the highest rate. When peace came and prices fell, rents were found to be excessive, not to say impossible. But in Ireland with a rapidly increasing population it was easier to put the rents up than to bring them down. Other things helped to embarrass the poor cottager: he paid twice over for his religion, tithes to the parson, dues to the priest; and he paid all the more of the tithe in that the graziers, who were mostly of the established Church and the occupiers of the fertile plains, had taken care to make potato land titheable (at what date this innovation arose is not stated) but had used their power in the Irish Parliament to resist the tithe on arable pastures. Again the cottiers or cottagers paid, in effect, the whole of the poor rate in the form of alms; for the dogs of the gentry kept all beggars from their gates.

 

Famine and Fever in the West of Ireland, 1821-22.

The next famine in 1821-22 is remarkable for two things besides its purely medical interest. Owing to the number of desperate evicted tenants, it gave occasion to an increased activity of the secret associations, especially the Whiteboys of Tipperary and Cork[479]; and it called forth the first great dole of English charity in the form of princely subscriptions to a Famine Fund. The English charity in 1822 was prompt and large-hearted, contrasting with the tardy help from the exchequer in the much more serious famine of 1817-18. The true explanation of it is, doubtless, that England on the second occasion had more money to spare. The trouble in 1821-22 came from the total loss of the potato crop in Mayo, Galway, Clare and Kerry, and from a partial loss of it in some other counties of the south and west. There was no corn famine, and no general dearth. Accordingly it affected the poorest class only, and the most remote districts chiefly. The planting season of 1821 had not been favourable, and the yield of potatoes had been poor. But the autumn was so wet in the west that the floods in some places washed away the soil with the potatoes in it, and in other places drowned the potatoes after they had been pitted. The flooded state of the basin of the Shannon was a natural calamity on the great scale that touched the imagination and loosened the purse-strings. A Committee was formed at the London Tavern, which sat through the spring of 1822, and quickly raised an immense sum. The great mercantile firms of the City and of Liverpool gave each a thousand pounds; a ball at the Opera House under the patronage of the king (George IV.) brought six thousand, and from all sources the Committee found themselves with three hundred thousand pounds at their disposal (forty-four thousand of it from Ireland), while a fund at the Dublin Mansion House amounted to thirty thousand more. Much of this was sent to Galway, Mayo, Clare and Kerry, in time to save many thousands of families from starvation[480]; it was, no doubt, wastefully given away, and there was a balance of sixty thousand pounds sterling unused. More tardily in June, 1822, Parliament voted one hundred thousand “for the employment of the poor in Ireland,” and in July two hundred thousand to meet contingencies of the famine. It was generally admitted that the Government grants were jobbed and misappropriated to a scandalous extent. The towns had to be made the centres of relief and the depôts of provisions; and yet the towns were not suffering from famine or fever but only from penury. The fever hospital at Ennis, the county town of Clare, was constantly filled by strangers, the townspeople remaining healthy. Kerry was one of the most afflicted counties, but Tralee and Killarney had no unusual sickness. Limerick town had hardly more fever than in an ordinary year. In Dublin the admissions for fever in 1822 were a good deal below the usual number. On the other hand, Sligo town had much fever, and Galway town had an altogether unique experience, the history of which, as related by Dr Graves, will be the best possible view of the peculiar circumstances of 1821-22[481].

In Connemara, where the distress was acute, there were no roads over which the provisions from England could be carted to the famished districts. Accordingly a great store was made in Galway, to which crowds flocked from the country in boats and on foot. Many died a few days after they arrived, from exhaustion or from the surfeit of food after long hunger. Galway, a crowded place at best, with narrow streets and lanes, contained thousands of strangers, who slept about the quays and the fish-market, or in the lanes and entries, or in crowded lodging-houses four or five in a bed. The fever began in May, and quickly spread so much that the priests were kept fully employed by calls to the dying. In June and July the sixty beds of the fever hospital were filled, principally with the fugitives from Connemara. Sixty more beds were added, and these by the middle of September were insufficient. The infection had now spread to many good houses. When Dr Graves and three other Dublin physicians arrived, on 26 September, they found ropes stretched across the streets to stop the wheel traffic. The shops of tradesmen were avoided. The town was like a place in the plague; people passing along the streets put their handkerchiefs to their noses when they came to a house with fever in it. Yet the number of cases was not remarkable; on 3 October, there were 404 sick in a population of 30,000, of whom 130 were in the fever hospital and 274 at their homes, the new cases occurring at the rate of 29 per diem. At length it was found practicable to set up depôts of provisions in country places, and the crowd of strangers left Galway. The fever was mild but tedious among the poor, more violent and fatal among the well-to-do. In many country places dysentery and choleraic diarrhœa were prevalent, as well as fever. In Erris, county Mayo, dysentery and dropsy were more common than fever, many of the cottiers having subsisted on weeds, shell-fish, or new potatoes dug six weeks after the seed was planted. In this famine the people ate the flesh of black cattle dead of disease. Excepting in Connemara the county of Galway was not so soon affected as some other parts of Ireland; but, as in 1818, the contagion of fever was spread abroad by vagrants. After Mayo, Galway, Clare and Kerry, the counties most affected were Roscommon and Sligo, and next to these Leitrim, Tipperary and Cork.

 

Dysentery and Relapsing Fever, 1826-27.

Fever and dysentery decreased to an ordinary level in 1823, but rose somewhat again in 1824, the summer of which was hot and moist. But it was in the hot and dry summers of 1825 and 1826 that dysentery became notably common in Ireland generally and in Dublin in particular. It began in the capital in June—among the richer class of people. About the middle of August admissions for dysentery were perceptibly raising the number of patients in the Cork Street Fever Hospital, and continued to do so throughout the autumn. At one dispensary three out of four applicants had dysentery. All those admitted to hospital were over twenty years of age; of thirty-five cases under Dr O’Brien, nine died, all of which had ulceration of the great intestine, in one case gangrenous. The mortality was not nearly so great among the richer classes, in which respect dysentery reversed the rule of typhus fever. O’Brien had one obvious case illustrating the curious connexion between dysentery and rheumatic fever, originally remarked by English observers in the 18th century. A hospital porter was admitted with “fever of a mixed catarrhal and rheumatic type.” Having been blooded and subjected to free evacuations, his fever left him on the fourth day, but he was at once seized with dysentery, which ran its course[482].

It is to be noted that this epidemic of dysentery began in Dublin in the hot June weather of 1825 among the richer classes, and that there was no notable increase of fever while it lasted. It appears to have declined in Dublin in the early part of 1826. After a cold and dry spring there began one of the hottest and driest summers on record. The first rain for four months fell on the 15th of July, 1826, the thermometer rose as high as 86°, and was on a mean several degrees above summer temperature in Dublin. In the spring labour had become slack, and before long it was estimated that 20,000 artizans in the Liberties (weavers and others) were out of work. Early in May there began a most extraordinary epidemic of relapsing fever, with which some typhus was mixed. By the 9th of May, the 220 beds of the Cork Street Hospital were full, and applicants were sent away daily. On 4 August, a temporary hospital of 240 beds was opened in the garden of the Meath Hospital; on the 18th, the Wellesley Hospital, in North King Street, was opened with 113 beds; on the 15th, tents to hold 180 patients were erected on the lawn of the Cork Street Hospital, raising its accommodation to 400; a warehouse in Kevin Street was furnished with beds for 230 patients, and some increase was made to the beds in Sir Patrick Dun’s and Stevens’s Hospitals. The whole number of fever-beds in Dublin hospitals at length reached 1400; but not half the number of cases was provided for. At a meeting in the Mansion House on 26 October, it was stated that there were at that date 3200 persons sick of the fever at their homes, besides the 1400 in the hospitals. Funds were subscribed, soup-kitchens and dispensaries opened in various districts of Dublin, and kept open most of the winter, “but they made little impression on the epidemic, which continued with unabated violence.” In March, 1827, it began suddenly to decline, and fell rapidly until it was nearly extinct in May; and that, too, although “the complaints of distress and want are to the full as loud as at the commencement of the epidemic, and provisions are dearer[483].” The corresponding sicknesses in Edinburgh and Glasgow were later—the fever chiefly in 1828, the dysentery in 1827 and 1828.

This great epidemic was mainly one of relapsing fever. The patient “got the cool,” or passed the crisis of the fever, usually on the evening of the fifth or seventh day, sometimes on the ninth, the evening exacerbation, which was to prove critical, being ushered in generally with a rigor, and passing off in profuse perspiration throughout the night. The five-day fever was more certain to relapse than that of seven days, the seven-day fever was more likely to relapse than that of nine days. The relapses might be one or two or three or more, prolonging the illness for weeks. The clear interval varied from twenty-four hours to fourteen days. There were some cases with jaundice which led Stokes and Graves to speak loosely of “yellow fever[484].” O’Brien saw only four cases with exquisite icterus in fifteen hundred cases of relapsing fever. There was a small proportion of cases of ordinary typhus of a severe kind, marked by unusual delirium or phrensy and the absence of sordes on the teeth or petechiae on the skin; the typhus cases became more numerous in the winter season, or, in other words, the original attack lasted to nine, eleven, or thirteen days, with little or no tendency to relapse. Gangrene was not uncommon in one part of the body or another, and in four cases the feet became gangrenous[485].

Even with the admixture of pure typhus cases, and with dysenteric complications in the autumn and winter, the mortality of the whole epidemic was small—not more than it would have been among a third part the number of fever cases in an ordinary year. At the Cork Street Hospital alone (including the tents) there were 8453 admissions from 4th August, 1826, to 4th April, 1827, with 332 deaths, or four deaths in a hundred cases. The proportion of recoveries was quite as remarkable in known instances in the squalid homes of the poor, where two or three would be found ill of fever on one pallet, or a father and six children in one room, shunned by the neighbours.

The strangest thing in this epidemic was the sequel of it. In the spring of 1827, intermittent fever, which had not made its appearance for several years in Dublin, began to prevail pretty generally; whilst the ordinary continued fever showed a strong tendency to assume the intermittent and remittent forms. It is not surprising, therefore, that Dr O’Brien, who had these varied experiences of epidemic dysentery in 1825, of epidemic relapsing fever and typhus in 1826, and of intermittent fever in 1827, should adopt Sydenham’s language of epidemic constitutions, and revert to the old Sydenhamian doctrine of causes. While the sequence of epidemic diseases in Dublin was some dysentery in the autumn and winter of 1825 and relapsing fever on a vast scale during the excessively dry spring and summer of 1826, in country districts of Ireland, such as Skibbereen, dysentery became epidemic after the great drought and heat of 1826, while “fever disappeared altogether,” and indeed all other prevalent forms of sickness gave way before it, so general was it. Such is the report from Skibbereen, county Cork, a district that became early notorious, in the great famine of 1846-47, and was perhaps a kind of barometer of Irish distress twenty years earlier. The epidemic dysentery of 1826 attacked all classes there, but chiefly the poorest; it was apt to begin insidiously, and, as it was often neglected, so it often became obstinate and hard to cure. Dr McCarthy attributed it to the drought of 1826, the commercial distress of 1825, the lack of employment for labourers, the overgrowth of population, and the alarming rise in the prices of food[486]. He uses the same economic illustrations as O’Connell and Smith O’Brien in the Great Famine twenty years after, which were, indeed, as old as the time of Bishop Berkeley[487].

Although little is heard of the fever of 1826-27 except in Dublin, it is probable that the same causes which produced it there were operative in other large towns. The admissions to the Limerick Fever Hospital rose rapidly in the end of 1826. Geary, who was appointed one of its physicians that year, estimates that about one in twelve of the population of Limerick (63,310) were treated for fever in 1827 at public institutions, besides those treated in private practice. It was relapsing fever, as in Dublin[488].

 

Perennial Distress and Fever.

According to all the figures of Irish fever-hospitals, and the generalities of their physicians, fever was now constantly present in the towns. After the relapsing epidemic of 1826-27 had subsided, there was no rise above the steady level until the years 1831 and 1832, when a considerable increase appears in the admissions to the hospitals of Dublin, Limerick and Belfast. But the fever of 1831-32 was totally eclipsed by the cholera, and little is heard of typhus in Irish writings until 1835-36, when an epidemic arose, purely of typhus fever, which is said to have been as severe upon some districts as that of 1817-18 had been. This outbreak fell at the time of the Commission presided over by the Earl of Devon, the report of which is authoritative for the state of the Irish lower class and the causes of the same. The country cottiers and the poor of the towns were always on the verge of starvation. Dr Geary, of Limerick, in 1836 estimated as follows the proportion of poor to the whole population, “the poor” being taken to mean “those who would require aid if a Poor Law existed[489]:”

Proportion of “Poor” in the several Parishes of Limerick, 1836.

    St Nicholas
and St Mary
  St John and
St Laurence
  St Munchin   St Michael
Population   14,629   15,667   4,071   16,226
Number of Poor   7,000   6,400   930   2,500

Most of the poor lived in the old town of Limerick in lofty and closely-built houses which the better classes had abandoned. These dilapidated barracks were the abodes of misery and filth, two and often three families occupying a single room: “It is here, as in the decayed Liberties of Dublin[490], that the indigent room-keeper, the ruined artisan, the unemployed labourer, and the ejected country cottier, with their famishing families retreat.” Their degradation, Dr Geary thought, was owing to the delay of Parliament in giving Ireland the Poor Law. The sanitary state of the old town was disgraceful. Heaps of manure were carefully kept in back yards, to be sold to farmers in the spring—“a very principal source of livelihood” for those who collected it. Certain houses near these depôts had always fever in them, dysentery was frequent, and Exchange-lane never free from it[491]. An extensive glue-mill in the Abbey poisoned the air with the effluvia of putrid animal matters. The following table shows the number of fever-cases admitted to the Hospital or attended from the Dispensary in 1827 and in four ordinary years thereafter:

Limerick:—Table of Hospital Cases of Fever and Cases at their Homes attended from the Dispensary.

    Hospital Cases   Dispensary Cases
Year   Admitted   Died   Average
mortality.
One in
  Attended   Died   Average
mortality.
One in
  Total
1827   2781   137   20   2800   80   35   5581
1828   854   37   23   960   22   39   1714
1829   506   23   22   640   18   35   1146
1830   806   34   23½   910   25   36   1716
1831   1015   65   15½   920   31   29   1935
Totals   5962   296   20   6130   176   34   12092

From 1831 to 1836 the admissions to hospitals were as follows:

Year   Admitted   Died
1832   1028   57
1833   824   42
1834   906   55
1835   1484   121
1836   3227   235

The last lines show the epidemic increase, which began in the autumn of 1835. It will appear from the following (by Geary) that it was largely an epidemic of young people, and that the fatality was by far the greatest among the comparatively small number of persons attacked at the higher ages—a well-known law of typhus of which this Limerick demonstration was perhaps the first numerically precise:

Table of the Numbers admitted to Limerick Fever Hospital at stated ages of five years, with the deaths, from 6 Jan. 1836 to 6 Jan. 1837.

Ages in
Years
  Admitted   Died   Average
mortality
per cent.
1-5   81   2  
5-10   489   13  
10-15   762   18  
15-20   701   37  
20-25   362   22   6
25-30   304   27  
30-35   100   12   12
35-40   203   45   23¼
40-45   70   13   18½
45-50   82   22   27
50-55   23   5   21½
55-60   36   12   33¼
60-65   2   1   50
65-70   10   5   50
Over 70   2   1   50
Total   3227   235  

One-sixth of these Limerick hospital cases, to the number of 567, came from the county, chiefly from the damp, boggy districts five to sixteen miles from the city. The whole admissions were rather more than the same hospital received in the famine year, 1817. But, although 1836 was not a year of special scarcity, there must have been some cause at work to raise the perennial typhus to the height of an epidemic, not only in Limerick, but in Dublin, Cork, Waterford, Ennis, Belfast, and other towns. In the country, an epidemic outburst during the months of March, April and May, 1836, in the parish of Donoughmore, Donegal, is perhaps only a sample of others unrecorded: it was remarkable in that nine-tenths of the cases of fever had as a sequel large boils on various parts of the body, but principally on the limbs[492].

In Dublin, the influenza of the first months of 1837 seemed to check the prevalence of typhus for a time; but the latter increased greatly when the influenza was over, so that the admissions to the Cork Street Hospital until the end of 1838 nearly equalled those of the worst epidemics since the hospital was opened in 1804[493]. Females in typhus were admitted greatly in excess of males; a large proportion (1847 in two years) were under fifteen years of age; the fever rarely relapsed, so that it was mostly typhus, as in England and Scotland at the same time. In twelve months of the same period (Oct. 1837 to Sept. 1838) there were 1786 admissions for fever at Cork, 1840 at Limerick, and 1706 at Belfast[494].

In Dublin, as in London, Edinburgh and Glasgow, the continued fevers of the “thirties” were distinctively spotted typhus, which was a new constitution. Graves, lecturing at Dublin in November, 1836, said: “We are now at a point of time possessing no common interest for the reflection of medical observers. It is now nearly two years since my attention was first arrested by the appearance of maculated fever, of which the first examples were observed in some hospital cases from the neighbourhood of Kingstown. This form of fever has lasted ever since, prevailing universally, as if it had banished all other forms of fever, and being almost the only type noticed in our wards[495].”

This increase of fever in Ireland, as well as the change in its type, corresponded closely to the great epidemic outburst in Scotland and England. The census of Ireland, taken in June, 1841, for the ten years preceding, gave a somewhat loose return of the causes of death in each year of the decennial period[496].

The worst years for fever were 1837 and 1840, the best year 1841. The deaths from fever in ten years were 112,072, being 1 in 10·59 of the deaths from all causes. The counties with highest fever mortality were Cavan, Mayo, Galway and Clare; the worst towns were Belfast, Kilkenny, Dublin, Limerick and Carrickfergus. Of these deaths from typhus-like fevers, 14,501 occurred in 86 fever-hospitals, which were open, or which kept records, for more or less of the decennial period. The following table shows the proportions of rural, urban and hospital fever-deaths in each of the four provinces:

Deaths from fever in ten years, 1831-41.

    Leinster   Munster   Ulster   Connaught
Rural fever-deaths   16,159   23,718   21,616   19,319
Urban   4,626   4,878   3,183   1,262
Hospital   9,030   5,465   2,439   386
  29,815   34,061   27,238   20,958
 
Rural population in 1841   1,531,106   2,009,220   2,160,698   1,338,635
Ratio of do. per sq. mile   247   332   406   386

The following detailed table for the province of Leinster shows the enormous preponderance of fever-deaths in the cottages or cabins[497]. Only Dublin and Kilkenny have most of the deaths in their fever hospitals or public institutions; it was not until near the end of this decennial period, the year 1839, that workhouses, with their infirmaries, began to be provided for all the poor-law unions:

Fever Mortality in Leinster, 1831-41.

Localities   Deaths from Fever
in Hospitals and
Public Institutions
  Deaths
from Fever
at home
  Total
Carlow County   202   891   1093
Drogheda Town   1   238   239
Dublin County   111   1248   1359
Dublin City   6393   2369   8762
Kildare County   276   1068   1284
Kilkenny County   114   2378   2492
Kilkenny City   487   204   691
King’s County   126   1754   1880
Longford County   3   1265   1268
Louth County   1   1201   1202
Meath County   294   2151   2445
Queen’s County   84   1763   1847
Westmeath County   54   1550   1604
Wexford County   637   1736   2373
Wicklow County   280   1002   1282
    9063   20,758   29,821

 

The Great Famine and Epidemic Sicknesses of 1846-49.

The great epidemic of relapsing fever, typhus, dysentery, anasarca and purpura, which arose in Ireland in the end of 1846 or spring of 1847 and lasted until the beginning of 1849, had for its direct antecedents the more or less complete loss of the potato-crop through blight in two successive autumns, 1845 and 1846, while the state of distress and sickness was prolonged by the potato disease in 1847 and 1848[498]. The potato-blight, which caused so much alarm in Ireland for the first time in September, 1845, had been seen in Germany several years before, in Belgium in 1842, in Canada in 1844, and in England about the 19th of August, 1845. Shortly after the last date, it attacked the Irish potato-fields, first in Wexford, and before the end of the year it was estimated that one-third to one-half of the yield, which was a fifth larger than usual from the greater breadth planted and the abundant crop, was lost by absolute rottenness or unfitness for food, the process of decay being of a kind to make great progress after the tubers were pitted. The loss to Ireland was estimated at about one pound sterling per head of the population. Sir Robert Peel was keenly alive to the magnitude of the calamity which threatened the Irish peasantry. His first step was to summon to his aid a botanist, Dr Lindley, and a chemist, Dr Playfair; the latter went down to Drayton Manor, and joined the prime minister in examining samples of the diseased potatoes. The question was whether some chemical process could not be found to arrest the decay of the tubers. Sir Robert Peel, in a much talked-of address at the opening of the Tamworth Reading-Room in the winter of 1840, had hailed the rising sun of science and useful knowledge. It was only in reference to morals and religion that Peel’s deliverance called forth criticism, more particularly the memorable series of letters to the Times by John Henry Newman. But one of Newman’s gibes was in a manner prophetic of Peel’s attitude in approaching the material distress of Ireland: “Let us, in consistency, take chemists for our cooks, and mineralogists for our masons.” The two professors proceeded to Ireland, but could only confirm the fact, already known, that one-third, or one-half, of the potato-crop would be lost.

Botany and chemistry being powerless to stay the effects of the potato-blight, the appeal was next to economics. Ireland produced not only potatoes but also corn. But for the most part the cottiers and cottagers tasted little of the oats or wheat which they grew; as soon as the harvest was gathered, the corn was sold to pay the November rents, and was exported. Ireland was still in the paradoxical condition which Bishop Berkeley puzzled over a hundred years before: “whether our exports do not consist of such necessaries as other countries cannot well be without?” The industry and trade of Irish ports was largely that of corn-milling and shipping of oatmeal, flour and other produce; thus Skibbereen in the extreme south-west, where the horrors of famine were felt first, had several flour-mills and a considerable export trade in corn, meal, flour and provisions. The Irish corn harvest of 1845 had been abundant: O’Connell cited the Mark Lane Express for the fact that 16,000 quarters of oats from Ireland had arrived in the Thames in a single week of October; on the 23rd of the same month the parish priest of Kells saw fifty dray-loads of oatmeal on the road to Drogheda for shipment. Ireland paid its rent to absentee landlords in corn and butter, just as a century before it had paid it largely in barrelled beef, keeping little for its own use besides potatoes and milk. In the face of the potato famine, the measure approved by the Irish leaders of all parties, O’Connell and Smith O’Brien as well as ducal proprietors, was to keep some of the oatmeal at home. A committee which sat at the Dublin Mansion House were of opinion, on 19 November, 1845, that the quantity of oats already exported of that harvest would have sufficed to feed the entire population of Ireland. O’Connell’s plan was to raise a million and a half on the annual revenue of the Irish woods and forests (£74,000), and to impose a tax on landlords, both absentee and resident, and with the moneys so obtained to buy up what remained of the Irish corn harvest for use at home. In the ensuing session of Parliament, both he and Smith O’Brien protested that Ireland had no need of English doles, having resources of her own if the landlords were compelled to do their duty.

About the same time Lord John Russell, leader of the Opposition, was led by the danger of famine in Ireland to pronounce for the repeal of the Corn Laws of 1815; and at the meetings of the Cabinet in December, Peel urged the same policy upon his colleagues for the same reason. The political history does not concern us beyond the fact that the threatened Irish distress caused by the first partial potato-blight of 1845 was the occasion of the Corn and Customs Act of June, 1846, by which the Corn Laws were repealed, and that an Irish Coercion Bill, brought in on account of outrages following an unusual number of evictions, was made the occasion of turning out Peel’s ministry at the moment of its Free Trade victory, by a combination of Tory protectionists, Whigs and Irish patriots.

The direct effects of the potato-blight of 1845 were not so serious as had been expected. The Government quietly bought Indian meal (maize flour) in America without disturbing the market, and had it distributed from twenty principal food-depots in Ireland, to the amount of 11,503 tons, along with 528 tons of oatmeal. This governmental action ceased on the 15th of August, 1846, by which time £733,372 had been spent, £368,000 being loans and the rest grants. The people were set to road-making, so as to pay by labour for their food, the number employed reaching a maximum of 97,000 in August. The Government, having been led by physicians in Dublin to expect an epidemic of fever, passed a Fever Act in March, 1846, by which a Board of Health was constituted. But no notable increase of sickness took place, and the Board was dissolved. There was a small outbreak of dysentery and diarrhoea at Kilkenny (and possibly elsewhere) in the spring of 1846, which the physician to the workhouse set down to the use of the Indian meal “and other substitutes for potatoes[499].”

It was the total loss of the potato crop in the summer and autumn following, 1846, together with a failure of the harvest in England and in other countries of Northern Europe, that brought the real Irish distress. A large breadth of potatoes had been planted as usual, but doubtless with a good deal of the seed tainted. An ordinary crop would have been worth, according to one estimate, sixteen millions sterling, according to another, twice as much. The crop was a total loss. The fields looked well in the summer, but those who dug the early potatoes found them unusually small. About the beginning of August the blight began suddenly and spread swiftly. A letter of the celebrated Father Mathew, the temperance reformer, brings this out: