II. FEVER AND DYSENTERY IN IRELAND

II. FEVER AND DYSENTERY IN IRELAND

The history of the public health in Ireland has been so remarkable that it may be useful to take a continuous view of it in a chapter apart, so far as concerns flux, or dysentery, and typhus with relapsing fever.

Ireland is a country which would have given Hume, had he thought of it, the best of all his illustrations of the difficult problem handled in the essay “Of National Characters”--how far the habits, customs, temperaments and, he might have added, morbid infections have been determined by climate, and how far by laws and government, by revolutions in public affairs, or by the situation of the nation with regard to its neighbours. Not only is there something special and peculiar in the actual epidemiology of Ireland, but its political and social history has been apt to borrow the phrases of medicine in a figure. “First the physicians are to take care,” says Burke, “that they do nothing to irritate this epidemical distemper. It is a foolish thing to have the better of the patient in a dispute. The complaint, or its cause, ought to be removed, and wise and lenient arts ought to precede the measures of vigour[410].” And this singular use of the imagery of disease in Irish history might be illustrated from many other passages of the same orator and essayist, just as it may be seen any day in the columns of newspapers in our own time. Giraldus Cambrensis began it, within a few years of the first English conquest of Irish territory by Henry II. Writing of that singular effect upon the English settlers by contact with the native Irish, whereby they became, in the words of another medieval author, ipsis Hibernis hiberniores, he resorts to the medical figure of “contagion” as the best way to account for it. So again, to overleap six centuries, Bishop Berkeley in his query “whether idleness be the mother or daughter of spleen[411],” is trying upon the Irish both Hume’s problem of national character and the use of the medical figure. And, to take a modern instance, Lord Beaconsfield used the same figure of the old humoral pathology, and gave his adhesion to a theory of national characters adverse to the sense of Hume, when he ascribed the habits and manners of the Irish, and the course of their national history, to their propinquity to a “melancholy” ocean.

As far back as we can go in the history, two diseases are conspicuous--the flux or “the country disease,” and the sharp fever or “Irish ague.” When Henry II. invaded Ireland in 1172, his army suffered from flux, which the contemporary chronicler, Radulphus de Diceto, dean of St Paul’s, set down to the unwonted eating of fresh meat (recentium esus carnium), the drinking of water, and the want of bread[412]. Less than a generation after, Giraldus of Wales wrote his “Topography of Ireland,” wherein he remarks that hardly any stranger, on his first coming to the country, escapes the flux by reason of the juicy food (ob humida nutrimenta)[413]. At that time Ireland was almost wholly a pastoral country, and a pastoral country it has remained to a far greater extent than England or Scotland. It is to this comparative want of tillage, an almost absolute want when Giraldus was there, that we shall probably have to look in the last resort for an explanation of the two national maladies that here concern us--the “country disease” and the “Irish ague.” The same dietetic reason that the dean of St Paul’s gave in 1172 for the prevalence of flux in the army of Henry II., the want of bread and the eating of fresh meat, can be assigned for the country disease long after, and, in some periods, on the explicit testimony of observers. As to the Irish ague, or typhus fever, Giraldus mentions it in the medieval period; and Higden, copying him exactly, says: “The inhabitants of Ireland are vexed by no kind of fever except the acute, and that seldom”--the word acuta being the original of “the ague,” or, as in another translation of the passage, “the sharp axes[414].” In this pastoral country, according to Giraldus, there was little sickness and little need of physicians; but there is hardly an instance of military operations by the English unattended with sickness among the troops, and famine with sickness among the native Irish.

The generalities of Fynes Moryson, a traveller of the time of James I., who included Ireland among the many countries that he visited and described, throw light upon the dietetic peculiarities of the Irish. Having little agriculture, and at that time no general cultivation of the potato (although they adopted it much sooner than the English and Scots), they lived, says Moryson, mostly on milk (as Giraldus Cambrensis also records in the twelfth century), and upon the flesh of unfed calves, which they cooked and ate in a barbarous fashion. “The country disease” is also noted. The experience in Ireland from time immemorial, that a bellyful was a windfall, must have been the origin of a habit observed by Moryson:

“I have known some of these Irish footemen serving in England to lay meate aside for many meales to devoure it all at one time.” And again: “The wilde Irish in time of greatest peace impute covetousnesse and base birth to him that hath any corne after Christmas, as if it were a point of nobility to consume all within these festivall dayes.” The Irish slovenliness or filthiness in their food, raiment and lodging was apt, he says, “to infect” the English who came to reside in their country[415].

About a generation after we come to the earliest medical account of the sicknesses of Ireland, by Gerard Boate, compiled during the Cromwellian occupation[416]. The following occurs under the head of The Looseness:

The English have given it the name of the Country Disease. The subjects of it are often troubled a great while, but take no great harm. It is easily cured by good medicines: “But they that let the looseness take its course do commonly after some days get the bleeding with it; ... and last it useth to turn to the bloody flux, the which in some persons having lasted a great while, leaveth them of itself; but in far the greatest number is very dangerous, and killeth the most part of the sick, except they be carefully assisted with good remedies.”

The other reigning disease is the “Irish Ague,” a continued fever of the nature of typhus:

“As Ireland is subject to most diseases in common with other countries, so there are some whereunto it is peculiarly obnoxious, being at all times so rife there that they may justly be reputed for Ireland endemii morbi, or reigning diseases, as indeed they are generally reputed for such. Of this number is a certain sort of malignant feavers, vulgarly in Ireland called Irish agues, because that at all times they are so common in Ireland, as well among the inhabitants and the natives, as among those who are newly come thither from other countries. This feaver, commonly accompanied with a great pain in the head and in all the bones, great weakness, drought, loss of all manner of appetite, and want of sleep, and for the most part idleness or raving, and restlessness or tossings, but no very great nor constant heat, is hard to be cured.” If blood-letting be avoided and cordial remedies given, “very few persons do lose their lives, except when some extraordinary and pestilent malignity cometh to it, as it befalleth in some years.” Those who recover “are forced to keep their beds a long time in extreme weakness, being a great while before they can recover their perfect health and strength.”

The occasion of Boate’s writing was the subjugation of Ireland by Cromwell, in the course of which we hear from time to time of sickness. The greatest of the calamities was the utter destruction of the prosperity of Galway by the frightful plague of 1649-50, and by the suppression of the Catholics, who had brought the port of Connaught to be a place of foreign commerce[417].

Cromwell’s troops in 1649 incurred dysentery through the hardships of campaigning. On 17 September, 1649, the Lord General writes from Dublin to Mr Speaker Lenthall after the storming of Tredah or Drogheda: “We keep the field much; our tents sheltering us from the wet and cold. But yet the country-sickness overtakes many: and therefore we desire recruits, and some fresh regiments of foot, may be sent us.” And on 25 October, “Colonel Horton is dead of the country-disease[418].”

Another general reference to the “country disease” of Ireland, by Borlase, is very nearly the same as Boate’s. It is introduced early in the history, on the occasion of the death in 1591 of Walter, Earl of Essex, earl marshal of Ireland:

“The dysentery, or flux, so fatal to this worthy person, is commonly termed the country disease; and well it may, for it reigns nowhere so epidemically as in Ireland; tainting strangers as well as natives. But whether it proceeds from the peculiar disposition of the air, errour in diet, the laxity and waterishness of the meat, or some occult cause, no venomous creature living there to suck that which may be thought (in other countries) well distributed amongst reptilious animals, I shall not determine, though each of these circumstances may well conduce to its strength and vigour. Certain it is that regular diet preserves most from the violence, and many from the infection of this disease; yet as that which is thought very soveraign--I must say that the stronger cordial liquors (viz. brandy, usquebeh, treacle and Mithridate waters) are very proper, or the electuaries themselves, and the like[419].”

From the Restoration to the Revolution little is known of epidemics in Ireland. It is probable that Dublin and the other considerable towns fared much the same as English towns. A Dublin physician writing to Robert Boyle on 27 February, 1682, speaks of a petechial fever, marked by leaping of the tendons, which had been fatal to very many in that city for these twelve or fourteen months[420]. With the Revolution the troubles of the country begin again, and enter on their peculiarly modern phase. For our history, two characteristic incidents come at the very beginning of the new period of disorder among the Irish--the sicknesses of the siege of Londonderry and the unparalleled havoc of disease among the troops of Schomberg in the camp of Dundalk. In both, the old “country disease,” which had affected Cromwell’s troops, was the primary malady, occurring, of course, in circumstances special enough to have bred it anywhere; in both, the dysentery was attended or followed by typhus fever, the old “Irish ague;” and although the epidemics of Londonderry and Dundalk in 1689 are properly examples of war sickness, yet the circumstances of each may help to realize the connexion between dysentery and typhus in the ordinary history of the Irish.

Dysentery and Fever at Londonderry and Dundalk, 1689.

The siege of Londonderry[421] by the Catholic Irish army of James II. began in April and ended on 28 July, having lasted 105 days. On 19 April the garrison numbered 7020 men, and the total of men, women and children in the town was estimated at 30,000, a number which included refugees from the neighbouring country and would have been more but for many Protestants at the beginning of the siege leaving the city and taking “protection” at the hands of the besiegers. On 21 May, a collection was made for the poor, who began to be in want. Sickness is heard of on 5 June, when several that were sick were killed in their beds by the enemy’s bombs. The dread of the bombs in the houses caused the people to lie about the walls or in places remote from the houses all night, so that many of them, especially the women and children, caught cold, which along with the want of rest and failing food, threw them into fluxes and fevers. The pinch of hunger began to be felt before the middle of June, about which time and for six weeks after the fluxes and fevers were rife. A great mortality spread through the garrison as well as the inhabitants; fifteen captains and lieutenants died in one day, and it was estimated that ten thousand died during the siege, “besides those who died soon after.” The want, the dysentery, the fever and the vast numbers of dead every day must have produced a horrible state of things; when, on 2 July, five hundred useless persons were put outside the walls, to disperse as they best could, the besiegers are said to have recognized them when they met them “by the smell.”

About the middle of June large quantities of provisions were found in cellars and places of concealment under ground; after that the garrison had always bread, although the allowance was small. An ingenious man discovered how to make pancakes of starch and tallow, of which articles there was no lack; the pancakes not only proved nutritious, but are said to have been an infallible cure of the flux, or preservative from it. At length, on 28 July some of the victuallers and ships of war which had been in Lough Foyle since the 15th of June, sailed up to the head of the Lough on the evening flood tide, finding little resistance from the enemy’s batteries and none from “what was left of” the tide-tossed boom of logs across the mouth of the river. Provisions poured in, and the siege was raised; but it is clear that the infection continued for some time after, having been found among such of the released garrison as repaired to Schomberg’s camp at Dundalk.

The Catholic army is said (by the Protestants) to have lost 8000 or 9000 before the walls of Londonderry, “most by the sword, the rest of fever and flux, and the French pox, which was very remarkable on the bodies of several of the dead officers and soldiers[422].”

Not far off, at Dundalk, there began, a few weeks after, an extraordinary outbreak of war-sickness, which, unlike the pestilence in Londonderry, was altogether inglorious in its circumstances. In many respects it resembled the disaster to Cromwell’s troops at the first occupying of Jamaica in 1655-56[423]; but it was worse than that, and it is probably unexampled in the military annals of Britain[424].

Supplies had been voted in Parliament for quelling the Catholic rebellion in Ireland, and an expedition was got together under the illustrious Marshal, Duke of Schomberg. The force consisted of some ten thousand foot, most of them raw levies from the English peasantry, with one regiment of seasoned Dutch troops (“the blue Dutch”), and cavalry. While the bulk of the force was undisciplined, their clothes, food, tents and other munitions of war were bad or insufficient through the fraud of contractors. The expedition embarked at Hoylake on the Dee and landed on the 15th of August, 1689, nearly three weeks after the relief of Londonderry, at Bangor, on the south side of Belfast Lough. Schomberg took Carrickfergus, and began to advance on Dublin; but finding the towns burned and the country turned into a desert, he threw himself into an entrenched camp around the head of Dundalk Bay, nearly a mile from the town of Dundalk. His camp was on a low moist bottom at the foot of the hills. The Irish Catholic army took up a position among the hills “on high sound ground,” not more than two miles distant from the English lines, and, being in superior force, in due time they offered battle, which was declined. Schomberg, who had been joined by the Enniskillen regiments of dragoons and by men from Londonderry, had under him some 2000 horse and not less than 12,000 foot at the time when James II. offered battle. The undisciplined state of his English troops and the suspected treachery of a body of French Protestants were among the causes that held Schomberg back; but he had to reckon also with sickness almost from the moment of sitting down at Dundalk. At a muster on 25 September, several of the regiments were grown thin “by reason of the distemper then beginning to seize our men.” The distemper was dysentery and fever. The two maladies were mixed up, as they usually are in war and famines, the flux commonly preceding the fever, and perhaps affording the virulent matters in the soil and in the air upon which the epidemic prevalence of the fever depends. It was easy to account for the dysentery among the troops at Dundalk; but as to the fever, there was an ambiguity at the outset which Story is careful to note: “And yet I cannot but think that the feaver was partly brought to our camp by some of those people that came from Derry; for it was observable that after some of them were come amongst us, it was presently spread over the whole army, yet I did not find many of themselves died of it.” Where the cause of death is specially named, it is fever, as in the cases of Sir Thomas Gower, Colonel Wharton and other officers on the 28th and 29th October. The fever was a most malignant form of typhus, marked by the worst of all symptoms, gangrene of the extremities, so that the toes or a whole foot would fall off when the surgeon was applying a dressing[425].

It seems probable that most of the enormous mortality was caused by infection, and not by dysentery due to primary exciting causes.

The primary exciting causes were obvious, but seemingly irremovable. Schomberg had a great military reputation, but he was now over eighty, and it does not appear that he made himself personally felt in the camp, although he issued incessantly orders to inspect and report. As the mortality proceeded apace during the six or eight weeks of inactivity, murmurings arose against the commander. He was unfortunate in his choice of a camping ground, and in an unusually cold and wet season. The newly raised English troops seem to have been lacking equally in intelligence and in moral qualities. Their foul language and debauchery were the occasion of a special proclamation; their laziness and inability to make themselves comfortable called forth numerous orders, but all to no purpose. The regiment of Dutch troops were so well hutted that not above eleven of them died in the whole campaign; but the English would not be troubled to gather fern or anything else to keep themselves dry and clean withal: “many of them, when they were dead, were incredibly lousy.”

The camping ground not only received the drainage of the hills, but, strange to say, the rain would be falling there all day while the camp of the enemy, only a few miles farther inland, would not be getting a drop. On 1 October the tents on the low ground were moved a little higher up. On the same date there were distributed among the regiments casks of brandy--Macaulay says it was of bad quality--which appears to have been the trusted remedy against camp sickness, as in the Jamaica expedition of 1655. There were twenty-seven victuallers or other ships riding in Dundalk Bay; but the stores were bad, and the regimental surgeons had come unprovided with drugs that might have been useful in flux or fever. While the weather continued cold and wet, there was also a scarcity of firing and forage. On 14 October all the regimental surgeons were ordered to meet at ten in the morning to consult with Dr Lawrence how to check the sickness[426]. Several officers having died on the 16th and 17th, the camp was shifted on the 20th to new ground, the huts being left full of the sick. Gower’s regiment had sixty-seven men unable to march, besides a good many dead before or sent away sick. Story, the chaplain, went every day from the new camp to visit the sick of his regiment in the huts, and always at his going found some dead. He found the survivors in a state of brutal callousness, utterly indifferent to each other, but objecting to part with their dead comrades as they wanted the bodies to sit or lie on, or to keep off the cold wind. The ships at anchor had now received as many sick as they could hold, and the deaths on board soon became as many as on shore. On 25-27 October, the camp was again shifted, but the sickness continued apace. At length on 3 November, the Catholic army having dispersed to winter quarters, the sick were ordered to be removed to Carlingford and Newry. “The poor men were brought down from all places towards the Bridge End, and several of them died by the way. The rest were put upon waggons, which was the most lamentable sight in the world, for all the rodes from Dundalk to Newry and Carlingford were next day full of nothing but dead men, who, even as the waggons joulted, some of them died and were thrown off as fast.” Some sixteen or seventeen hundred had been left dead at Dundalk. The ships were ordered to sail for Belfast with the first wind, and the camp was broken up. There was snow on the hills and rain in the valleys; on the march to Newry, men fell out of the ranks and died at the road side. When the ships weighed anchor from Dundalk and Carlingford, they had 1970 sick men on board, but not more than 1100 of these came ashore in Belfast Lough, the rest having died at sea in coming round the coast of County Down. Such was the violence of the infection on board that several ships had all the men in them dead and nobody to look after them whilst they lay in the bay at Carrickfergus. An infective principle, once engendered in circumstances of aggravation such as these, is not soon extinguished. Belfast was the winter quarters, and in the great hospital there from 1 November, 1689, to 1 May, 1690, there died 3762, “as appears by the tallies given in by the men that buried them.” These numbers together make fully six thousand deaths, which agrees with the general statement that Schomberg lost one half of the men whom he had embarked at Hoylake in August. The Irish Catholic army began to sicken in their camp in the hills above Dundalk Bay just before they broke up, and they are said to have lost heavily by sickness in their winter quarters.

The war ended with the Treaty of Limerick, in 1691. The Seven Ill Years followed,--ill years to Scotland, in a measure to England, and almost certainly to Ireland also; but it does not appear that the end of the 17th century was a time of special sickness and famine to the Irish, and it may be inferred from the fact of Scots migrating to Ireland during the ill years that the distress was not so sharp there. The epidemiology of Ireland is, indeed, a blank until we come to the writings of Dr Rogers, of Cork, in some respects the best epidemiologist of his time, which cover the period from 1708 to 1734. His account of the dysentery and typhus of the chief city of Munster in the beginning of the 18th century will show that the old dietetic errors of the Irish, noted in medieval times, had hardly changed in the course of centuries.

A generation of Fevers in Cork.

Rogers is clear that typhus fever was never extinct, while the three several times when it “made its appearance amongst us in a very signal manner,” are the same as its seasons in England, namely 1708-10, 1718-21 and 1728-30[428]. His experience relates only to the city of Cork, and, so far as his clinical histories go, only to the well-to-do classes therein; and although those seasons were years of scarcity and distress all over Ireland, yet Rogers does not seem to associate insufficient food with the fever, and never mentions scarcity. The fevers were in the winter, for the most part, and were usually accompanied by epidemic smallpox of a bad type, which in 1708 “swept away multitudes.” Nothing is said of dysentery for the earliest of the three fever-periods; but for 1718 and following years we read that “dysentery of a very malignant sort, frequently producing mortification in the bowels,” prevailed during the same space; and that the winters of the third fever-period, namely, those of 1728, 1729 and 1730 were “infamous for bloody fluxes of the worst kind.” It is clear that the fever spread to the richer classes in Cork, for his five clinical histories are all from those classes. The following is his general account of the symptoms:

The patient is suddenly seized with slight horrors or rather chilliness, to which succeed a glowing warmth, a weight and fixed pain in the head, just over the eyebrows; soreness all over his flesh, as if bruised, the limbs heavy, the heart oppressed, the breathing laboured, the pulse not much altered, but in some slower; the urine mostly crude, pale and limpid, at first, or even throughout, the tongue moist and not very white at first, afterwards drier, but rarely black. An universal petechial effloresence not unlike the measles paints the whole surface of the body, limbs, and sometimes the very face; in some few appear interspersed eruptions exactly like the pustulae miliares, filled with a limpid serum. The earlier these petechiae appear, the fresher in colour, and the longer they continue out, the better (p. 5). The fixed pain in the head increasing, ends commonly in a coma or stupor, or in a delirium with some. Some few have had haemorrhage at the nose, a severe cough, and sore throat. In some he had observed a great tendency to sweats, even from the beginning: these are colliquative and symptomatic, not to be encouraged. In but few there have appeared purple and livid spots, as in haemorrhagic smallpox: some as large as a vetch, others not bigger than a middling pin’s head, thick set all over the breast, back and sometimes the limbs, the pulse in these cases being much below normal. The extremities cold from the 6th or 7th day, delirium constant, tongue dry and black, urine limpid and crude, oppression greater, and difficulty of breathing more. It is a slow nervous fever (p. 18).

Rogers believed that mere atmospheric changes could not be the cause of these epidemics: “they may favour, encourage and propagate such diseases when once begun; but for the productive cause of them we must have recourse to such morbid effluvia as above described [particles of all kinds detached from the animal, vegetable and mineral kingdoms]; or resolve all into the θεῖον τί so often appealed to by Hippocrates[429].”

But, as regards Cork itself, special interest attaches to the following “four concurring causes:”

“1st, the great quantities of filth, ordure and animal offals that crowd our streets, and particularly the close confined alleys and lanes, at the very season that our endemial epidemics rage amongst us.

2nd, the great number of slaughter-houses, both in the north and south suburbs, especially on the north ridge of hills, where are vast pits for containing the putrefying blood and ordure, which discharge by the declivities of those hills, upon great rains, their fetid contents into the river.

3rd, the unwholesome, foul, I had almost said corrupted water that great numbers of the inhabitants are necessitated to use during the dry months of the summer.

4th, the vast quantities of animal offals used by the meaner sort, during the slaughtering seasons: which occasion still more mischief by the quick and sudden transition from a diet of another kind.”

In farther explanation of the fourth concurring cause, he says that in no part of the earth is a greater quantity of flesh meat consumed than in Cork by all sorts of people during the slaughtering season--one of the chief industries of the place being the export of barrelled beef for the navy and mercantile marine. The meat, he says, is plentiful and cheap, and tempts the poorer sort “to riot in this luxurious diet,” the sudden change from a meagre diet, with the want of bread and of fermented liquors, being injurious to them[430].

Famine and Fevers in Ireland in 1718 and 1728.

Thus far Rogers, for the city of Cork in the three epidemic periods, 1708-10, 1718-21, and 1728-30, two of which, if not all three, were periods of dysentery as well as of typhus. But it was usual in Ireland for the country districts and small towns to suffer equally with the cities. The circumstances of the Irish peasantry in the very severe winter of 1708-9 are not particularly known; if there was famine with famine-fever, it was not such as to have become historical. But for the next fever-period, 1718-20, we have some particulars. Bishop Nicholson, of Derry, writes: “Never did I behold even in Picardy, Westphalia or Scotland, such dismal marks of hunger and want as appeared he countenances of most of the poor creatures I met with on the road.” One of the bishop’s carriage horses having been accidentally killed, it was at once surrounded by fifty or sixty famished cottagers struggling desperately to obtain a morsel of flesh for themselves and their children[431].

This was a time when the population was increasing, but agriculture, so far from increasing in proportion to the number of mouths to feed, was positively declining, unless it were the culture of the potato. In a pamphlet of about 1724, on promoting agriculture and employing the poor, the complaint is of beef and mutton everywhere, and an insufficiency of corn. “Such a want of policy,” says one, “is there, in Dublin especially, on the most important affair of bread, without a plenty of which the poor must starve.” Another, a Protestant, has the following threat for the clergymen of the Established Church: “I’ll immediately stock one part of my land with bullocks, and the other with potatoes--so farewell tithes[432]!” From this it is to be inferred that potatoes were not made tithable until a later period, pasture being exempted to the last. For whatever reason, grazing, and not corn-growing, was then more general in Ireland than in the generations immediately preceding, much land having gone out of tillage. The culture of the potato was driven out of the fertile lowlands to the hill-sides, so as to leave the ground clear for ranges of pasture. Rack-renting was the rule, doubtless owing to the same reason as afterwards, the competition for farms. While the Protestants emigrated in thousands, the Catholics multiplied at home in beggary. A pamphleteer of 1727 says: “Where the plough has no work, one family can do the business of fifty, and you may send away the other forty-nine.” Thus we find the pasturing of cattle preferred to agriculture long after the barbaric or uncivilized period had passed, preferred indeed by English landlords or farmers[433].

There were three bad harvests in succession, 1726, 1727 and 1728, culminating in a famine in the latter year. Boulter, archbishop of Armagh, who then ruled Ireland, was able to buy oats or oatmeal in the south and west so as to sell it below the market price to the starving Protestants of Ulster, an interference with the distribution of food which led to serious rioting in Cork, Limerick, Clonmel and Waterford in the first months of 1728[434]. No full accounts of the epidemic fever of that famine remain. Rutty, of Dublin, says it was “mild and deceitful in its first attack, attended with a depressed pulse, and frequently with petechiae[435];” while, according to Rogers and O’Connell[436], the epidemic fever of Munster was the same. Of the famine itself we have a glimpse or two. Primate Boulter writes to the Duke of Newcastle on 7 March, 1727:

“Last year the dearness of corn was such that thousands of families quitted their habitations to seek bread elsewhere, and many hundreds perished; this year the poor had consumed their potatoes, which is their winter subsistence, near two months sooner than ordinary, and are already, through the dearness of corn, in that want that in some places they begin already to quit their habitations[437].”

Quitting their habitations to beg was a regular thing at a later time of the year. It was in the course of these bad years, in 1729, that Swift wrote his ‘Modest Proposal for preventing the Children of Poor People in Ireland from being a Burden to their Parents or Country.’ The scheme to use the tender babes as delicate morsels of food for the rich, was a somewhat extreme flight of irony, not so finished as in Swift’s other satires, but the circumstances out of which the proposal grew were more real than usual.

“It is a melancholy object,” says the Dean of St Patrick’s, “to those who walk through this great town, or travel in the country, when they see the streets, the roads and cabin doors crowded with beggars of the female sex followed by three, four, or six children, all in rags, and importuning every passenger for an alms.” Having ventilated his project for the children, he proceeds to show that “their elders are every day dying and rotting by cold and famine, filth and vermin, as fast as can be reasonably expected.”

All the while there was a considerable export of corn from Ireland. In the beginning of 1730, two ships laden with barley were stopped at Drogheda by a fierce mob and were compelled to unload[438].

The interval between those years of epidemic typhus in Ireland and the next, 1740-41, was filled, we may be sure, with at least an average amount of the endemial fever. Rutty specially mentions it in Dublin in the autumn and winter of 1734-35: “We had the low fever, called nervous (and sometimes petechial from the spots that frequently attended, although probably not essential).” He then adds: “It is no new thing with us for this low kind of fever to prevail in the winter season;” and gives figures from the Dublin Bills of Mortality for forty years. He mentions the petechial fever as being frequent next in January and February, 1736, corresponding to a bad time of it in Huxham’s Plymouth annals. In 1738 and 1739 the type of the Dublin fever was relapsing, in part at least, the same type having been seen at Edinburgh shortly before.

* * * * *

The economics of Ireland, at this time, gave occasion to Berkeley’s Querist, a series of weekly essays written in 1737 and 1738, and collected in 1740, on the eve of the next great famine and mortality[439]. A few of the bishop’s sarcasms, in the form of queries, will serve to show how anomalous was the economic condition of the country, and how easily a crisis of famine and pestilence could arise.

“169. Whether it is possible the country should be well improved while our beef is exported, and our labourers live upon potatoes?

“173. Whether the quantities of beef, butter, wool and leather, exported from this island, can be reckoned the superfluities of a country, where there are so many natives naked and famished?

“174. Whether it would not be wise so to order our trade as to export manufactures rather than provisions, and of those such as employ most hands?

“466. Whether our exports do not consist of such necessaries as other countries cannot well be without?

“353. Whether hearty food and warm clothing would not enable and encourage the lower sort to labour?

“354. Whether in such a soil as ours, if there was industry, there would be want?

“418. Whether it be not a new spectacle under the sun, to behold in such a climate and such a soil, and under such a gentle government, so many roads untrodden, fields untilled, houses desolate, and hands unemployed?

“514. Whether the wisdom of the State should not wrestle with this hereditary disposition of our Tartars, and with a high hand introduce agriculture?

“534. Why we do not make tiles of our own, for flooring and roofing, rather than bring them from Holland?

“539. Whether it be not wonderful that with such pastures, and so many black cattle, we do not find ourselves in cheese?”

In several of his queries (381, 383) Bishop Berkeley is driving at the expediency of domestic slavery. It was two hundred years since the same expedient had been tried by Protector Somerset in England, during the intolerable state of vagabondage which followed the rage for pasture farming under the first Tudors. In Scotland, it was hardly more than a generation since the institution of domestic slavery had commended itself to Fletcher of Saltoun, as the only expedient that could free that country from the vagabondage of a tenth, or more, of the population. England had surmounted the difficulty long ago, Scotland got over it easily and speedily when she was admitted to the English and colonial markets for her linen manufacture by the Treaty of Union[440]. But in Ireland in the year 1740, and until long after, disabilities of all kinds, not only economic, but political and religious, were fastened upon the weaker nation by the stronger, the unfortunate cause of their long continuance having been the costly inheritance of loyalty to James II. and the Mass.

The Famine and Fever of 1740-41.

At the time when the bishop of Cloyne was issuing his economic queries from week to week (not much to the satisfaction of Primate Boulter), things were making up for the greatest crisis of famine and pestilence that Ireland experienced in the 18th century. There had been relapsing fever among the poor in Dublin in the autumn of 1738, and it appeared among them again in the summer and autumn of 1739. Rutty’s account of it is as follows:

“It was attended with an intense pain in the head. It terminated sometimes in four, for the most part in five or six days, sometimes in nine, and commonly in a critical sweat. It was far from being mortal. I was assured of seventy of the poorer sort at the same time in this fever, abandoned to the use of whey and God’s good providence, who all recovered. The crisis, however, was very imperfect, for they were subject to relapses, even sometimes to the third time, nor did their urine come to a complete separation.”

In October 1739, there appeared some dysenteries in Dublin.

The winter of 1739 set in severely with cold and wet in November, and about Christmas there began a frost of many weeks’ duration which was more intense than anyone remembered. It is said to have made the ground like iron to the depth of nine inches; the ice on all the rivers stopped the corn mills, trees and shrubs were destroyed, and even the wool fell out of the sheep’s backs. In January 1740 the destitution was such that subscription-lists were opened in Dublin, Cork, Limerick, Waterford, Clonmel, Wexford and other places. Bishop Berkeley distributed every Monday morning twenty pounds sterling among the poor of Cloyne (near Cork) besides what they got from his kitchen. One morning he came down without powder on his wig, and all the domestics of the episcopal palace followed suit[441]. The distress became more acute as the spring advanced. The potato crop of 1739 had been ruined, not by disease as in 1845-46, but by the long and intense frost. It was usual at that time to leave the tubers in the ridges through most of the winter, with the earth heaped up around them. The frost of December found them with only that slight covering, and rotted them: “a dirissimo hoc et diuturno gelu penitus putrescebant,” says Dr O’Connell. Besides putrid potatoes, the people ate the flesh of cattle which had died from the rigours of the season. Owing to the want of sound seed-potatoes, the crop of 1740 was almost a blank. The summer was excessively dry and hot. In Dublin, the price of provisions had doubled or trebled, and some of the poor had died of actual starvation. In July dysenteries became common, and extended to the richer classes in the capital. Smallpox was rife at the same time, and peculiarly fatal in Cork. Dysentery continued in Dublin throughout the autumn and winter of 1740 (the latter being again frosty), and became the prevailing malady elsewhere.

On 8 February, 1741, Berkeley writes that the bloody flux had appeared lately in the town of Cloyne, having made great progress before that date in other parts of the country. A week after he writes (15 Feb.), “Our weather is grown fine and warm: but the bloody flux has increased in this neighbourhood, and raged most violently in other parts of this and the adjacent counties[442].” This prevalence of dysentery, and not of fever, as the reigning malady of the winter of 1740-41 in Munster is confirmed by Dr Maurice O’Connell, who says that the typhus of the previous summer gave place to it. Dysentery in the winter and spring, preceding the fever of summer, was also the experience in the famine of 1817. Berkeley treated the subjects of dysentery, not with tar water, but with a spoonful of powdered resin dissolved in oil by heat and mixed in a clyster of broth[443].

As the year 1741 proceeded, with great drought in April and May, typhus fever (which had appeared the autumn before) and dysentery were both widely epidemic, so that it is impossible to say which form of disease caused most deaths. In Dublin during the month of March, 1741, the deaths from dysentery reached a maximum of twenty-one in a week, “though it was less mortal than in the country, to which the better care taken of the poor and of their food undoubtedly contributed.” Bishop Berkeley writes on the 19th of May:

“The distresses of the sick and poor are endless. The havoc of mankind in the counties of Cork, Limerick and some adjacent places, hath been incredible. The nation probably will not recover this loss in a century. The other day I heard one from county Limerick say that whole villages were entirely depeopled. About two months since I heard Sir Richard Cox say that five hundred were dead in the parish where he lives, though in a country I believe not very populous. It were to be wished that people of condition were at their seats in the country during these calamitous times, which might provide relief and employment for the poor[444].”

It was said that there were twenty-five cases of fever in the bishop’s own household, which were cured by the panacea, tar-water, drunk copiously--a large glass, milk-warm, every hour in bed, the same method being practised by several of his poor neighbours with equal success[445]. In a “Letter from a country gentleman in the Province of Munster to his Grace the Lord Primate[446]” it is said:

“By a moderate computation, very near one-third of the poor cottiers of Munster have perished by fevers, fluxes and downright want.... The charity of the landlords and farmers is almost quite exhausted. Multitudes have perished, and are daily perishing, under hedges and ditches, some by fevers, some by fluxes, and some through downright cruel want in the utmost agonies of despair. I have seen the labourer endeavouring to work at his spade, but fainting for want of food,” etc.

The loss of life must have been great also in Connaught. A letter of 8 July, 1741, from Galway, says: “The fever so rages here that the physicians say it is more like a plague than a fever, and refuse to visit patients for any fee whatever[447].” The Galway Assizes were held at Tuam[448], the races also being transferred to the same neighbourhood, not without their usual evening accompaniments of balls and plays.

Of this famine and sickness it might have been said, in the stock medieval phrase, that the living were hardly able to bury the dead[449].

As in later Irish famines, there appear to have been, in 1740-41, three main types of sickness--dysentery, relapsing fever and typhus fever. In Dublin, as we know from the direct testimony of Rutty, there was relapsing fever in 1739, before the distress had well begun, and again in the summer of 1741, when the worst was over. So much is said of dysentery that we may well set down to it, and to its attendant dropsy, a great part of the deaths, as in the famine of 1846-47. But it is probable that true typhus fever, sometimes of a malignant type, as at Galway, was the chief infection in 1741, which was the year of its great prevalence in England. It was characterized by a mild and deceitful onset, like a cold. Spots were not invariable or essential; they were mostly of a dusky red, sometimes purple, and sometimes intermixed with miliary pustules. O’Connell mentions, for Munster, bleeding from the nose, a mottled rash as in measles, and pains like those of lumbago. One of the worst features of the Irish epidemic of 1740-41 was the prevalence of fever in the gaols. At Tralee above a hundred were tried, most of them for stealing the means of subsistence; the gaol was so full that there was no room to lie down, and fifty prisoners died in six weeks. Limerick gaol had dysentery and fever among its inmates, and the judge who held the Munster Circuit died of fever on his return to Dublin[450].

Rutty says that the fever fell most upon strong middle-aged men, less upon women, and least of all upon children. The number of orphans was so great after the famine that Boulter, the Anglican primate, seized the opportunity to start the afterwards notorious Charter Schools for the education of the rising generation according to the Protestant creed. In all the subsequent Irish famines it was the enormous swarms of people begging at a distance from their own parishes that spread the infection of fever; and there seems to have been as much of beggary in 1741, when Ireland was underpeopled with two millions, as in 1817-18, when it was overpeopled with six millions. A few years after the famine, Berkeley wrote in 1749:

“In every road the ragged ensigns of poverty are displayed; you often meet caravans of poor, whole families in a drove, without clothes to cover, or bread to feed them, both which might be easily procured by moderate labour. They are encouraged in their vagabond life by the miserable hospitality they meet with in every cottage, whose inhabitants expect the same kind reception in their turn when they become beggars themselves.”

The estimates of the Irish mortality in 1741 varied greatly, as they have done in the Irish famines of more recent times. One guessed a third of the cottiers of Munster, another said one-fifth; and it is known that, whereas in Kerry the hearth-money was paid in 1733 by 14,346, it was paid in 1744 by only 9372[451]. The largest estimates are 200,000 deaths or even 400,000 deaths in all Ireland in a population of less than two millions. But Dr Maurice O’Connell, who practised in Cork, and saw in Munster the mortality at its worst, estimated the deaths in all Ireland, in the two years 1740 and 1741, from fevers, fluxes and absolute want, at 80,000. Those who saw the famine, fever and dysentery of 1817-18 in a population increased by three times were inclined to doubt whether even the smallest estimate of 80,000 for 1740-41 was not too large; but it is clear that the famished and fever-stricken in the 18th century were in many places allowed to perish owing to the indifference of the ruling class or the exhaustion of their means, so that a much higher rate of fatality may be assumed for that epidemic than for the first of the 19th century Irish famines.

* * * * *

The distress came to an end before the winter of 1741, when food was so cheap in Dublin that a shilling bought twenty-one pounds of bread. The subsequent prevalence of typhus fever and dysentery in Ireland, whether epidemic or endemic, is very imperfectly known to the end of the century. It may be inferred that there was in that period no epidemic so great as that of 1740-41; but it is clear from the records kept by Rutty in Dublin down to 1764, and by Sims in Tyrone to 1772, that the indigenous fevers and fluxes of the country were never long absent, being more common in some years than in others[452].

The year 1744 was remarkable for a destructive throat distemper among children, described elsewhere, and the year 1745 for smallpox dispersed by swarms of beggars. In 1746 and 1748, the Dublin fever was relapsing in part, “terminating,” says Rutty, “the fifth, sixth, seventh or eighth day with a critical sweat. A relapse commonly attended, which however was commonly carried off by a second critical sweat.” In 1748, though the season was sickly, the diseases were not mortal, several of the fevers being “happily terminated by a sweat the fifth or sixth day.” But there were also fevers of the low kind, sometimes with petechiae, sometimes with miliary pustules, though not essentially with either. In the autumn of 1754 Rutty begins to adopt the language of the time concerning a “putrid” constitution, identifying the fever with the dangerous remittents which Fothergill was then writing about in London; “it is probable that ours was akin to them and owing to the same general causes.” In February, 1755, the fevers were fatal to many, raising the deaths to double the usual number; they attacked all ages, were of the low, depressed kind, and commonly attended with miliary pustules. He again identifies them with the low, putrid fever in London. From that time on to 1758, Rutty has frequent references to the same fever, under the names of low, putrid, petechial and miliary. It was at its worst in 1757, and was marked by the remarkable tremors described by Johnstone at Kidderminster, as well as by miliary eruptions and by a gangrenous tendency at the spots where blisters had been applied. In November, 1757, it was fatal to not a few of the young and strong in Dublin, “and we received accounts of a like malignity attending this fever in the country[453].” It was still prevalent in the North and West of Ireland in the spring of 1758. He describes also an unusual amount of fever in the end of 1762. Sims, of Tyrone, an epidemiologist in the same manner as Rutty, does not begin his full annals until 1765; but he sums up the years from 1751 to 1760 as unhealthy by agues in spring, dysenteries and cholera morbus in autumn, and “low, putrid or nervous fevers throughout the year[454].” He adds:

“To the unhealthiness of these years the bad state and dearth of provisions might not a little contribute; the poor, being incapable to procure sufficient sustenance, were often obliged to be contented with things at which nature almost revolted; and even the wealthy could not by all their art and power render wholesome those fruits of the earth which had been damaged by an untoward season.”

Much of the distress, however, was owing to the continual spread of pasture-farming, which made the labour of villagers unnecessary[455].

The nearest approach to a great Irish epidemic in the second half of the 18th century was in 1771, as described by Sims, the type of fever being clearly the same low, putrid or nervous fever, with offensive sweats and muscular tremors, that was commonly observed in England also in the middle third of the 18th century. Early in the summer of 1771 a fever began to appear which, as autumn advanced, raged with the greatest violence; nor was it overcome by a severe winter. It claimed the prerogative of the plague, almost all others vanishing from before its presence. It began twelve months sooner in the eastern parts of the kingdom, pursuing a regular course from East to West. Some symptoms suggest cerebro-spinal fever.

The symptoms were languor, precordial oppression, want of appetite, slight nausea, pains in the head, back and loins, a thin bluish film on the tongue, turbid urine, eyes lifeless and dejected. After the fourth day, constant watchfulness, the eyes wild, melancholy, sometimes with bloody water in them, constant involuntary sighing, the tendons of the wrists tremulous, the pulse quick and weak, most profuse sweats, small dun petechiae principally at the bend of the arm and about the neck. At the height of the fever, on the ninth or tenth day, the tremulousness of the wrists spread to all the members, “insomuch that I have seen the bed-curtains dancing for three or four days to the no small terror of the superstitious attendants, who on first perceiving it, thought some evil spirits shook the bed. This agitation was so constant a concomitant of the fever as to be almost a distinguishing symptom.” The patients lay grinding their teeth; when awake, they would often convulsively bite off the edges of the vessel in which drink was given them. They knew no one, their delirium being incessant, low, muttering, their fingers picking the bed covering. The face was pale and sunk, the eyes hollow, the tongue and lips black and parched. Profuse clammy sweats flowed from them; the urine was as if mixed with blood: the stools were involuntary. Petechiae almost black came out, having an outer circle with an inner dark speck; sometimes there were the larger vibices. Bleedings at the nose were frequent. Those who were put to bed and sweated almost all died. Death took place about the 13th day.

Curiously enough this disease showed itself even among the middle ranks of the people, especially those who lived an irregular life, used flesh diet and drank much. Among the poorer sort, who used vegetable food, the fever was more protracted and less malignant, but in the winter and spring it made much greater havoc among them. “Bleeding, that first and grand auxiliary of the physician in treating inflammatory disorders, seemed here to lose much of its influence.” It was, indeed, the long prevalence of this low or nervous type of fever in Britain and Ireland in the middle of the 18th century that drove blood-letting in fevers out of fashion until the return of a more inflammatory type (often relapsing fever) in the epidemic of 1817. In 1770, while such fevers more or less nervous, putrid, miliary, were beginning to be prevalent among the adults, there was a good deal of “worm fever” among children. They suffered from heat, thirst, quick, full pulse, vomiting, coma, and sometimes slight convulsions, universal soreness to the touch, and a troublesome phlegmy cough. When not comatose they were peevish. The fever was remitting, the cheeks being highly flushed at its acme, pale in its remission. It lasted several days, but seldom over a week, nor was it often fatal. In children under five or six years, it could hardly be distinguished from hydrocephalus internus[456]. The same association of the worm fever or remittent fever of children with the putrid or nervous fever of adults had been noticed at Edinburgh in 1735. Neither the fever of the adults nor that of the children will be found, on close scrutiny, to have had much in common with our modern enteric fever.

The Epidemic Fevers of 1799-1801.

Sims left Tyrone to practise as a physician in London, and with his departure what seems to have been the only contemporary record of epidemics in Ireland ceased. The last quarter of the 18th century in Ireland had probably as much epidemic fever as in England; but it is not until the years 1797-1801 that we again hear of fever and dysentery, on the testimony of the records of the Army Medical Board, of the Dublin House of Industry, and of the Waterford Fever Hospital. At the end of the year 1796 the health of the regiments in Ireland was everywhere good; but in December of that year, and in January 1797, the poor in the towns began to suffer more than usual from fever, and in the course of the year 1797 fever appeared in several cantonments of troops--at Armagh as early as February or March, at Limerick, at Waterford and in Dublin[457]. The summer and autumn were unusually wet, so that the peasantry of the southern and western counties were unable to lay in their usual supply of turf for fuel. In the course of the winter 1797-98 a considerable increase of fever and dysentery was remarked among them, and these two maladies appeared in various regiments in the early months of 1798. This was the year of the rebellion in the south-east of Ireland, pending the efforts for the union with England. The British troops were much engaged with the insurgents throughout the summer, and got rid in great part of the maladies of their quarters while they were campaigning. But in the end of the year fever began to spread, both among the inhabitants and among the troops. It was nothing new for English and Scots regiments to suffer from fever or dysentery during the greater part of their first year in Ireland; but the epidemics in the end of 1798 were more than ordinary. The Buckinghamshire Militia quartered in the Palatine Square of the Royal barracks, Dublin, lost by “malignant contagious fever” 13 men in October, 13 in November, and 15 in December. From November to January, the Warwick regiment suffered greatly in the same barrack. The Herefordshire regiment, 833 strong, lost 47 men at Fermoy, mostly from fever contracted in bad barracks; the Coldstream Guards at Limerick, the 92nd regiment at Athlone, and the Northamptonshire Fencibles at Carrick-on-Shannon, also lost men by fever. In July, 1799, not a single regiment in Ireland was sickly; but a wet and very cold autumn made a bad harvest, aggravating the distresses of the poor and causing much sickness, which the troops shared. The county of Wexford, the principal scene of the rebellion, suffered most, and next to it the adjacent county of Waterford. The fever-hospital of the latter town, the earliest in Ireland[458], was projected in 1799; the statement made in the report of a plan for the new charity, that fifteen hundred dependent persons suffered from contagious fever every year there, showed that the need for it was nothing new, although hardly a tenth part of the number sought admission to the hospital when it was at work. Next year, 1800, the managers of the newly-opened hospital gave some particulars of the causes of fever in Waterford--want of food, causing weakness of body and depression of mind, but above all the excessive pawning of clothes and bedding, whereby they suffered from cold and slept for warmth several in a bed. In the winter and spring of 1799-1800 the poor of Waterford had epidemic among them fever and dysentery, as well as smallpox. In Donagh-a-gow’s Lane nine persons died of dysentery between October 1799 and March 1800. The harvest of 1800 was again a failure, from cold and wet, bread and potatoes being dear and of bad quality. In the autumn and winter the distress, with the attendant fever and dysentery, became worse. At that time in Dublin all fever cases among the poor were received into the House of Industry (the Cork Street and Hardwick Hospitals were soon after built for fever-cases), at which the deaths for four years were as follows:

Died in the Dublin Year House of Industry

1799 627 1800 1315 1801 1352 1802 384

The enormous rise of the deaths in 1800 and 1801 shows how severe the epidemic of fever must have been. Compared with the epidemic of 1817-18, it has few records, perhaps because the political changes of the union engrossed all attention. But the significant fact remains that the deaths in the Dublin House of Industry in 1800 and 1801 were nearly as many as in all the special fever-hospitals of Dublin during the two years, 1 Sept. 1817 to 1 Sept. 1819. At Cork, in 1800, there were 4000 cases of fever treated from the Dispensary; at Limerick the state of matters is said to have been as bad as in the great famine of 1817-18; and there is some reason to think that the same might have been said of other places. All the relief in 1800-1801 came from private sources, the example of Dublin in opening soup-kitchens having been followed by other towns. The troops shared in the reigning diseases, especially at Belfast and Dublin; in the latter city, the spotted fever was severe both among the military and all ranks of the civil population in August, 1801. The harvest of 1801 was abundant, and the fever quickly declined. It had been often of the relapsing type[459]. Dysentery appeared in the end of September, and became severe in many places in October and November, being attributed to the rains after a long tract of dry, hot weather. Ophthalmias and scarlatinal malignant sore-throats were common at the same time.

The Growth of Population in Ireland.

When the history of the great famine and epidemic sicknesses of 1817-18 was written, it was found that this calamity had fallen upon a population that had grown imperceptibly until it had reached the enormous figure of over six millions, the census of 1821 showing the inhabitants of Ireland to be 6,801,827. The increase from an estimated one million and thirty-four thousand in 1695 was, according to Malthus, probably without parallel in Europe. According to Petty, the inhabitants in 1672 numbered about one million one hundred thousand, living in two hundred thousand houses, of which 160,000 were “wretched, nasty cabins without chimney, window or door-shut, and wholly unfit for making merchantable butter, cheese, or the manufacture of woollen, linen or leather.” In 1695, the war on behalf of James II. having intervened, the population as estimated by South was 1,034,000. When the people were next counted in 1731, by a not incorrect method in the hands of the magistracy and Protestant clergy, they were found to have almost doubled, the total being 2,010,221. This increase, the exactness of which depends naturally upon the accuracy of Petty’s and South’s 17th century estimates, had been made notwithstanding the famines and epidemics of 1718 and 1728, and an excessive emigration, mostly of Protestants, to the West Indian and American colonies, which was itself attended by a great loss of life through disease. For the rest of the 18th century, the estimates of population are based upon the number of houses that paid the hearth-tax. In the following figures six persons are reckoned to each taxed hearth:

Year Persons

1754 2,372,634 1767 2,544,276 1777 2,690,556 1785 2,845,932

The hearth-money was not altogether a safe basis of reckoning, for the reason that many were excused it on account of their poverty by certificate from the magistrates, and that hamlets in the hills, perhaps those which held their lands in rungale or joint-lease, often compounded with the collectors for a fixed sum; so that cabins might multiply and no more hearth-tax be paid[460]. It is probable that a considerable increase had taken place which was not represented in the books of the tax-collectors; for in 1788, only three years from the last date given, the number of hearths suddenly leapt up to the round figure of 650,000 (from 474,322), giving a population of 3,900,000, at the rate of six persons to a cabin or house. But it is undoubted that a new impulse was given to population in the last twenty years of the 18th century, firstly by the bounties on Irish corn exported, dating from 1780, which caused much grazing land to be brought under the plough, and secondly by the gradual removal, after 1791, of various penalties and disabilities which had rested on the Roman Catholics since the reign of Anne, affecting their tenure of land, and serving in various ways to repress the multiplication of families. Accordingly we find the hearths rated in 1791 at the number of 701,102, equal to a population of 4,206,612. The estimates or enumerations from 1788, to the census of 1831, show an increase as follows:

Year Persons

1788 3,900,000 1791 4,206,612 1805 5,395,456 1812 5,937,856 1821 6,801,827 1831 7,784,539

The secret of this enormous increase was the habit that the Irish peasantry had begun to learn early in the 17th century of living upon potatoes. From that dietetic peculiarity, it is well known, much of the economic and political history of Ireland depends. At the time when it was losing its tribal organization (rather late in the day, although not so late as in the Highlands of Scotland), the country was in a fair way to pass from the pastoral state to the agricultural and industrial. It is conceivable that, if Ireland had peacefully become an agricultural country, wheaten bread would have become the staple food of the people, as in England in early times and again in later times; or that the standard might have been oatmeal in the northern province, as in Scotland: in which case one may be sure that the population would not have increased as it did. “Since the culture of the potatoes was known,” says a topographer of Kerry in 1756, “which was not before the beginning of the last century, the herdsmen find out small dry spots to plant a sufficient quantity of those roots in for their sustenance, whereby considerable tracts of these mountains are grazed and inhabited, which could not be done if the herdsmen had only corn to subsist on[461].” Twenty years later Arthur Young found an enormous extension of potato culture, the pigs being fed on the surplus crop[462]. The motive, on the part of the landlord or the farmer, was to have the peat bogs on the hill-sides reclaimed by the spade; the surface of peat having been removed, a poor subsoil was exposed, which might be made something of after it had grown several crops of potatoes, but hardly in any other way. Another motive was political; namely, the multiplication by landlords of forty-shilling freeholder dependent votes among the Catholics as soon as they became free to exercise the franchise[463].

Malthus relied so much upon statistics, that he found the case of Ireland, notable though it was, little suited to his method, and dismissed it in a few sentences. But he indicated correctly the grand cause of over-population:

“I shall only observe, therefore, that the extended use of potatoes has allowed of a very rapid increase of population during the last century (18th). But the cheapness of this nourishing root, and the small piece of ground which, under this kind of cultivation, will in average years produce the food for a family, joined to the ignorance and depressed state of the people, which have prompted them to follow their inclinations with no other prospect than an immediate bare subsistence, have encouraged marriage to such a degree that the population is pushed much beyond the industry and present resources of the country; and the consequence naturally is, that the lower classes of people are in the most impoverished and miserable state.”

In another section he showed that the cheapness of the staple food of Ireland tended to keep down the rate of wages:

“The Irish labourer paid in potatoes has earned perhaps the means of subsistence for double the number of persons that could be supported by an English labourer paid in wheat.... The great quantity of food which land will bear when planted with potatoes, and the consequent cheapness of the labour supported by them, tends rather to raise than to lower the rents of land, and as far as rent goes, to keep up the price of the materials of manufacture and all other sorts of raw produce except potatoes. The indolence and want of skill which usually accompany such a state of things tend further to render all wrought commodities comparatively dear.... The value of the food which the Irish labourer earns above what he and his family consume will go but a very little way in the purchase of clothing, lodging and other conveniences.... In Ireland the money price of labour is not much more than the half of what it is in England.”

Lastly, in a passage quoted in the sequel, he showed how disastrous a failure of the crop must needs be when the staple was potatoes; the people then had nothing between them and starvation but the garbage of the fields[464].

What the growth of population could come to on these terms was carefully shown for the district of Strabane, on the borders of Tyrone and Donegal, by Dr Francis Rogan, a writer on the famine and epidemic fever of 1817-18[465]. Strabane stood at the meeting of the rivers Mourne and Fin to form the Foyle; and in the three valleys the land was fertile. All round was an amphitheatre of hills, in the glens of which and among the peat bogs on their sides was an immense population. The farms were small, from ten to thirty acres, a farm of fifty acres being reckoned a large holding. The tendency had been to minute subdivisions of the land, the sons dividing a farm among them on the death of the father:

“The Munterloney mountains,” says Rogan, “lie to the south and east of the Strabane Dispensary district. They extend nearly twenty miles, and contain in the numerous glens by which they are intersected so great a population that, except in the most favourable years, the produce of their farms is unequal to their support. In seasons of dearth they procure a considerable part of their food from the more cultivated districts around them; and this, as well as the payment of their rents, is accomplished by the sale of butter, black cattle, and sheep, and by the manufacture of linen cloth and yarn, which they carry on to a considerable extent.”

These small farmers dwelt in thatched cottages of three or four rooms, in which they brought up large families[466]. Besides the farmers, there were the cottiers, who lived in cabins of the poorest construction, sometimes built against the sides of a peat-cutting in the bog. The following table shows the proportion of cottiers to small farmers on certain manors of the Marquis of Abercorn, near Strabane, at the date of the famine in 1817-18 (Rogan, p. 96):

Number of Families Manor Farmers Cottiers

Derrygoon 368 335 Donelong 243 322 Magevelin and Lismulmughray 319 668 Strabane 302 415 Cloughognal 328 279

The cottiers rented their cabins and potato gardens from the farmers, paying their rent, on terms not advantageous to themselves, by labour on the farm. For a time about the beginning of the century the practice by farmers of taking land on speculation to sublet to cottiers was so common that a class of “middlemen” arose. One pamphleteer during the distress of 1822 speaks of the class of middlemen as an advantage to the cottiers, and regrets that they should have been personally so disreputable as to have become extinct. It is not easy to understand how they served the interests of the cottiers: for the latter were answerable to the landlord for the middleman’s rent, and were themselves over-rented and underpaid for their labour. The system of middlemen did not in matter of fact answer; they hoped to make a profit from the tenants under them, and neglected to work on their own farms; it appears that they were a drunken class, and that they were at length swallowed up in bankruptcy. After the first quarter of the century the cottiers and the landlords (with the agents and the tithe proctors) stood face to face; but at the date of the famine of 1817 there was subletting going on, of which Rogan gives an instructive instance in his district of Ulster[467].

Under this system of subdividing farms and subletting potato gardens with cabins to cottiers, the following enormous populations had sprung up in four parishes within the Dispensary district of Strabane and in four manors of the Marquis of Abercorn adjoining them, but not included in the Dispensary District:

Town of Strabane 3896 Parish of Camus 2384 " " Leck 5092 " " Urney 4886 Manor of Magevelin and Lismulmughray 5548 Manor of Donelong 3126 " " Derrygoon 2568 " " Part of Strabane 2796

In the language of the end of the 19th century, this would have been called a “congested district” of Ireland; but all Ireland was then congested to within a million and a half of the utmost limit, so that the famine, which we shall now proceed to follow in this part of Ulster, has to be imagined as equally severe in Connaught, in Munster, and even in parts of Leinster.

The Famine and Fevers of 1817-18.

The winter of 1815-16 had been unusually prolonged, so that the sowing and planting of 1816 were late. They were hardly over when a rainy summer began, which led to a ruined harvest. The oats never filled, and were given as green fodder to the cattle; in wheat-growing districts, the grain sprouted in the sheaf; the potatoes were a poor yield and watery; such of them as came to the starch-manufacturers were found to contain much less starch than usual. The peat bogs were so wet that the usual quantity of turf for fuel was not secured[468]. This failure of the harvest came at a critical time. The Peace of Paris in 1815 had depressed prices and wages and thrown commerce into confusion. During the booming period of war-prices, from 1803 to 1815, farms and small holdings had doubled or even trebled in rent, and had withal yielded a handsome profit to the farmers and steady work to the labourers. When the extraordinary war expenditure stopped, this factitious prosperity came to a sudden end. The sons of Irish cottiers were not wanted for the war, and the daughters were no longer profitable as flax-spinners to the small farmers. Weavers could hardly earn more than threepence a day, and labourers who could find employment at all had to be content with fourpence or sixpence, without their food. A stone of small watery potatoes cost tenpence; but the value of cattle fell to one-third, and butter brought little. By Christmas the produce of the peasants’ harvest of 1816 was mostly consumed. “Many hundred families holding small farms in the mountains of Tyrone,” says Rogan, “had been obliged to abandon their dwellings in the spring of 1817 and betake themselves to begging, as the only resource left to preserve their lives[469].” At Galway, in January, a mob gathered to stop the sailing of a vessel laden with oatmeal. At Ballyshannon the peasants took to the shore to gather cockles, mussels, limpets and the remains of fish. In some parts the seed potatoes were taken up and consumed. The people wandered about in search of nettles, wild mustard, cabbage-stalks and the like garbage, to stay their stomachs. It was painful, says Carleton, to see a number of people collected at one of the larger dairy farms waiting for the cattle to be blooded (according to custom), so that they might take home some of the blood to eat mixed with a little oatmeal. The want of fuel caused the pot to be set aside, windows and crevices to be stopped, washing of clothes and persons to cease, and the inmates of a cabin to huddle together for warmth. This was far from being the normal state of the cottages or even of the cabins, but cold and hunger made their inmates apathetic. Admitted later to the hospitals for fever, they were found bronzed with dirt, their hair full of vermin, their ragged clothes so foul and rotten that it was more economical to destroy them and replace them than to clean them.

Some months passed before this state of things produced fever. The first effect of the bad food through the winter, such as watery potatoes eaten half-cooked for want of fuel, had been dysentery, which became common in February, and was aggravated by the cold in and out of doors. It was confined to the very poorest, and was not contagious, attacking perhaps one or two only in a large family. Comparatively few of those who were attacked by it in the country places came to the Strabane Dispensary; but the dropsy which often attended or followed it brought in a larger number. The following table of cases at the Dispensary shows clearly enough that dysentery and dropsy preceded the fever, which became at length the chief epidemic malady[470]:

Cases at Strabane Dispensary.

1817 Dropsy Dysentery Typhus

June 23 2 10 July 107 31 60 August 40 22 206 September 9 23 287

At a few of the larger towns in each of the provinces typhus had risen in the autumn of 1816 somewhat above the ordinary low level which characterized the years from 1803 to 1816 in Ireland as well as in Britain. At that time there was steadily from year to year a certain amount of typhus in the poorest parts of the towns and here or there among the cabins of the cottiers. Statistically this may be shown by the table of regular admissions to the fever hospitals of some of the chief towns from the date of their opening.

Admissions to Irish Fever Hospitals, 1799-1818.

Dublin, Dublin Cork Waterford Limerick Kilkenny Cork St. House of Fever Fever Fever Fever Year Hospital Industry Hospitals Hospital Hospital Hospital

1799 -- -- -- 146 -- -- 1800 -- -- -- 409 -- -- 1801 -- -- -- 875 -- -- 1802 -- -- -- 419 446 -- 1803 -- -- 254 188 86 73 1804 415 82 190 223 95 80 1805 1024 709 200 297 90 69 1806 1264 1276 441 165 86 56 1807 1100 1289 191 166 84 81 1808 1071 1473 232 157 100 96 1809 1051 1176 278 222 109 116 1810 1774 1474 432 410 120 135 1811 1471 1316 646 331 196 153 1812 2265 2006 617 323 146 156 1813 2627 1870 550 252 227 183 1814 2392 2398 845 175 221 236 1815 3780 2451 717 403 394 249 1816 2763 1669 1026 307 659 162 1817 3682 2860 4866 390 2586 1100 1818 7608 17894 10408 2729 4829 1924

In 1812 the first step was taken towards the adoption of the Poor Law, namely the division of the country into Dispensary Districts, which remained the units of charitable relief until 1839, when the old English system of a poor-rate and parochial Unions was applied to Ireland. During that intermediate period much was left to the medical profession, which contained many well-educated and humane men, to the priests and clergy, and to charitable persons among the laity. There was fever in many places where there were no fever hospitals. A physician at Tralee reported that the back lanes of the town, crowded with cabins, were seldom free from typhus. Rogan gives two instances from the Strabane district in the summer and winter of 1815, at a time when the district was remarkably healthy. A beggar boy was given a night’s lodging by a cottier at Artigarvan, three miles from Strabane. Next morning he was too ill to leave; he lay three weeks in typhus, and gave the disease to twenty-seven persons in the eight cabins which formed the hamlet. A few months after, about a mile from Strabane, a mother fell into typhus and was visited many times by her two married daughters and by others of her children at service in the neighbourhood. Nineteen cases were traced to this focus; “but the actual number attacked was probably more than three times this, as the disease, when once introduced into the town, spread so widely among the lower orders as to create general alarm, and led to the establishment of the small fever ward attached to the Dispensary.” It was in April, 1816, that this was done, two rooms, each with four beds, having been provided at Strabane for fever cases; but at no time until the summer of 1817 were they all occupied at once.

The epidemic really began there in May, 1817, in a large house which had been occupied during the winter by a number of families from the mountains; they had brought no furniture with them, nor bedding except their blankets, and lay so close together as to cover the floors. Each room was rented at a shilling a week, the tenant of a room making up his rent by taking in beggars at a penny a night. The floors and stairs were covered with the gathered filth of a whole winter; the straw bedding, never renewed, was thrown into a corner during the day to be spread again at night. Every crevice was stopped to keep out the cold; the rain came in through the roof, the floors were damp, and the cellars of the house full of stagnant water turned putrid. Meanwhile more than a fourth part of the families resident in Strabane, to the number of 1026 persons, were being fed from a soup-house opened early in the spring of 1817, while there were others equally destitute but too proud to ask relief. The rumour of this charity soon brought crowds of people from the surrounding country, with gaunt cheeks, says Carleton, hollow eyes, tottering gait and a look of “painful abstraction” from the unsatisfied craving for food. In the crowd round the soup-shop, the timid girl, the modest mother, the decent farmer scrambled “with as much turbulent solicitation and outcry as if they had been trained, since their very infancy, to all the forms of impudent cant and imposture.” These soup-shops were opened in all the Irish towns. At Strabane some of the richer class lent money to procure supplies, for sale at cost price, of oatmeal, rice and rye-flour, the last being in much request in the form of loaves of black bread.

The fever, having begun among the houseful of vagrants above mentioned, made slow progress until June, when it spread through the town, and in the autumn became a serious epidemic. Meantime the soup-kitchen was closed, the supplies having ceased, and the country people returned to their cabins carrying the infection of typhus everywhere with them. By the middle of October, 1817, the epidemic was general in the country round Strabane.

The following table shows the rise and decline of the epidemic of typhus in the town itself.

Cases of Fever attended from Strabane Dispensary[471].

1817 1818

Jan. 9 83 Feb. 13 46 March 6 60 April 13 48 May 3 39 June 10 71 July 60 106 Aug. 206 90 Sept. 287 57 Oct. 233 49 Nov. 193 40 Dec. 140 38

The exact particulars from the Dispensary district of Strabane show clearly how famine in Ireland is related to fever. The epidemic of typhus was an indirect result of the famine, and was due most of all to the vagrancy which a famine was bound to produce in Ireland, in the absence of a Poor Law. In the spring of 1817, said a gentleman near Tralee, “the whole country appeared to be in motion.” “It was lamentable,” said Peel, in the Commons debate, on 22 April, 1818, “at least it was affecting, that this contagion should have arisen from the open character and feelings of hospitality for which the Irish character was so peculiarly remarkable.” They gathered also at funerals, and, as Graves said of a later epidemic, they were “scrupulous in the performance of wakes.” The concourse of people at the daily distributions of soup was another cause of spreading infection, many of them having come out of infected houses[472]. Of such houses, the lodging-houses of the towns, we have several particular instances. At Strabane, there were four such, which sent ninety-six patients to the fever hospital in eighteen months. At Dublin, a house in Cathedral-lane sent fifty cases to the fever hospitals in a twelvemonth; the house No. 4, Patrick’s close sent thirty cases in eight months; No. 52½ Kevin-street sent from five rooms nineteen persons in six weeks.

The spread of the disease was much aided by the ordinary annual migration of harvest labourers. It was the custom every year for cottiers in Connaught to shut up their cabins after the potatoes were planted, and to travel to the country round Dublin in search of work at the hay and corn harvests, leaving their families to beg; in the same way there was an annual migration from Clare to Kilkenny, from Cavan, Longford and Leitrim into Meath, and from Derry into Antrim, Down and Armagh[473]. In the summer of 1817 some parishes of Derry were left with only four or five families. The keeper of the bridge at Toome, over the Bann, counted more than a hundred vagrants every day passing into Antrim, from the middle of May to the beginning of July; and the same might have been seen at the other bridge over the Bann at Portglenone.

As the spread of contagion came to be realized, the ordinary hospitality to vagrants ceased. Rogan was struck with the apathy which at length arose towards sick or dead relatives; even parents became callous at the death of their children (of whom many died from smallpox). “For some time,” he says, “it has been as difficult for a pauper bearing the symptoms of ill-health to procure shelter for the night, as it was formerly rare to be refused it.” In Strabane they extemporised a poor’s fund by voluntary contributions of £30 a month, by means of which eighty poor families were kept from begging in the streets. In Dublin there was so much alarm of infection from the number of beggars entering the shops that trade was checked. The following, relating to a town in the centre of Ireland, is an extreme instance of the panic which the idea of contagion at length caused:

“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:

Ill of fever Manors Population (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 1818 1819 Average One in One in One in One in

Dublin 14½ 24 18¼ 20 Kilkenny 16½ 14⅚ 12⅔ 14¼ Dundalk 20-6/7 54 25 30 Belfast 19⅕ 15⅘ 19 17⅓ Newry 21-1/9 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 St John and and St Mary 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 Average Average mortality. mortality. Year Admitted Died One in Attended Died 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.

Average Ages in mortality Years Admitted Died per cent.

1-5 81 2 2¼ 5-10 489 13 2½ 10-15 762 18 2¼ 15-20 701 37 5¼ 20-25 362 22 6 25-30 304 27 8¾ 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 7¼

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.

Deaths from Fever Deaths in Hospitals and from Fever Localities Public Institutions 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:

“On the 29th of last month (July) I passed from Cork to Dublin, and this doomed plant bloomed in all the luxuriance of an abundant harvest. Returning on the 3rd instant (August) I beheld with sorrow one wide waste of putrefying vegetation. In many places the wretched people were seated on the fences of the decaying gardens wringing their hands and wailing bitterly the destruction that had left them foodless[500].”

The relief-works and distribution of Indian meal, which had been estimated by the Government to last only to August, 1846, at a cost of £476,000 (one-half of it being a free grant), were resumed under the pressure of public opinion, in the winter of 1846 and spring of 1847, a cost of £4,850,000, one-half of the sum being again a free grant. Before the distress was over, other free grants and advances were made; so that, on 15 February, 1850, Lord John Russell summed up the famine-indebtedness of Ireland to the Consolidated Fund at £3,350,000, (which was to be repaid out of the rates in forty years from that date). Allowing an equal sum freely gifted from the national exchequer, the whole public cost of the famine would have been about seven millions sterling.

The short crops in Britain in 1846 were an excuse for not interfering with the export of oats from Ireland. The imports of Indian meal were left to the ordinary course of the market, and the distribution to retail traders. The corn merchants of Cork, Limerick and other ports made fortunes out of the American cargoes, and the dealers throughout the country made large profits.

To encourage the influx of foreign food-supplies, and to lower freights, the Navigation Laws were suspended for a few months, so that corn could be carried in other than British bottoms. When Parliament met in January, 1847, the distress in Ireland occupied the greater part of the Queen’s Speech.

Lord George Bentinck proposed that sixteen millions should be advanced for the construction of railroads, so as to give employment and wages to the starving multitudes. The Government, however, objected that such relief would operate at too great a distance, in most cases, from the homes of the people; and it was urged by independent critics that a State loan for railways would really be for the relief of the landlords more than of the peasantry. The large sums actually voted were spent in road-making and in procuring food and medical relief. A Board of Works directed the relief-works. A Commissariat, with two thousand Relief Committees under it, directed the distribution of food. A Board of Health provided temporary fever-hospitals and additional physicians. It was not to be expected that this machinery would work well, and, in fact, the public relief was costly in its administration and often misdirected in its objects. Private charities, especially that of the Society of Friends, gave invaluable help, money being subscribed by all classes at home and sent from distant countries, including a thousand pounds from the Sultan of Turkey. On one day, the third of July, 1847, nearly three millions in Ireland received food gratuitously from the hands of the relieving officers. In March, 1847, the public works were employing 734,000. The number relieved out of the poor rates at one time reached 800,000. Workhouses were enlarged, and temporary fever-hospitals were built to the number of 207, which in the two years 1847 and 1848, received 279,723 patients.

Emigration to the United States and Canada, which had averaged 61,242 persons per annum from the last half of 1841 to the end of 1845, rose steadily all through the famine until it reached a total of 214,425 in the year 1849, the passage money to the amount of millions sterling having come largely from the savings of the Irish already settled in the New World.

The grand effect of the famine upon the population of Ireland was revealed by the census of 1851. The people in 1841 had numbered 8,175,124; in 1851 they numbered 6,515,794. The decrease was 28·6 per cent. in Connaught, 23·5 per cent. in Munster, 16 per cent. in Ulster, and 15·5 per cent. in Leinster. In many remote parishes the number of inhabitants, and of cabins, fell to nearly a half. The depopulation was wholly rural, so much so that there was a positive increase of inhabitants not only in the large county towns, but even in small towns such as Skull and Kanturk, situated in Poor Law unions where the famine and epidemics had made the greatest clearances all over[501]. Our business here is with the epidemical maladies, which contributed to this depopulation; but a few words remain to be said on the subject at large.

Malthus had been prophetic about this crisis in the history of Ireland. Criticizing Arthur Young’s project to encourage the use of potatoes and milk as the staple food of the English labourer instead of wheat, so as to escape the troubles of scarcity and high prices of corn, Malthus says:

“When, from the increasing population, and diminishing sources of subsistence, the average growth of potatoes was not more than the average consumption, a scarcity of potatoes would be, in every respect, as probable as a scarcity of wheat at present; and when it did arrive it would be beyond all comparison more dreadful. When the common people of a country live principally upon the dearest grain, as they do in England on wheat, they have great resources in scarcity; and barley, oats, rice, cheap soups and potatoes, all present themselves as less expensive, yet at the same time wholesome means of nourishment; but when their habitual food is the lowest in this scale, they appear to be absolutely without resource, except in the bark of trees, like the poor Swedes; and a great portion of them must necessarily be starved[502].”

The forecast of Malthus was repeated in his own way by Cobbett, although neither of them foresaw the potato-blight as the means.

“The dirty weed,” said Cobbett in a conversation in 1834, “will be the curse of Ireland. The potato will not last twenty years more. It will work itself out; and then you will see to what a state Ireland will be reduced.... You must return to the grain crops; and then Ireland, instead of being the most degraded, will become one of the finest countries in the world. You may live to see my words prove true; but I never shall[503].”

This is what has come to pass in a measure, and will come to pass more and more. Only in some remote parts do the Irish cottiers now live upon potatoes and milk. It has come to be quite common for them to grow an Irish half acre of wheat, and, what is more to the purpose, to consume what they thus produce instead of selling it to pay the rent. Doubtless the enormous imports of American, Australian and Black Sea wheat have made it easier for the Irish to have wheaten bread. But, whatever the reason, they have at length adopted the ancient English staff of life, a staple or standard which they were in a fair way to have achieved long ago, had not their addiction to “lost causes and impossible loyalties” given an unfavourable turn to the natural progress of the nation[504].

We come at length to the purely medical side of the great famine of 1846-47[505]. The distress in the latter part of the year 1846 was felt first in the west and south-west--in the districts to which the famine of 1822 had been almost confined. It happened that the state of matters around Skibbereen, the extreme south-western point of Ireland, was brought most under public notice; but it is believed that there were parts of the western sea-board counties of Mayo, Galway, Clare and Kerry from which equally terrible scenes might have been reported at an equally early period. It was in Clare that relief at the national charges was longest needed.

Dr Popham, one of the visiting physicians to the Cork Workhouse, wrote as follows:

“The pressure from without upon the city began to be felt in October [1846], and in November and December the influx of paupers from all parts of this vast county was so overwhelming that, to prevent them from dying in the streets, the doors of the workhouse were thrown open, and in one week 500 persons were admitted, without any provision, either of space or clothing, to meet so fearful an emergency. All these were suffering from famine, and most of them from malignant dysentery or fever. The fever was in the first instance undoubtedly confined to persons badly fed or crowded into unwholesome habitations; and as it originated with the vast migratory hordes of labourers and their families congregated upon the public roads, it was commonly termed ‘the road fever’[506].”

It was the same in the smaller towns of the county, such as Skibbereen; in the month of December, 1846, there were one hundred and forty deaths in the workhouse; on one day there were fifteen funerals waiting their turn for the religious offices. Still farther afield, in the country parishes, the state of matters was the same. The sea-board parish of Skull was a typical poor district, populous with cabins along the numerous bays of the Atlantic, but with few residential seats of the gentry. On the 2nd of February, 1847, the parish clergyman, the Rev. Traill Hall (himself at length a victim to the contagion), wrote as follows:

“Frightful and fearful is the havock around me. Our medical friend, Dr Sweetman, a gentleman of unimpeachable veracity, informed me yesterday that if he stated the mortality of my parish at an average of thirty-five daily, he would be within the truth. The children in particular, he remarked, were disappearing with awful rapidity. And to this I may add the aged, who, with the young--neglected, perhaps, amidst the widespread destitution--are almost without exception swollen and ripening for the grave[507].”

They were “swollen” by the anasarca or general dropsy, which was reported from nearly all parts of Ireland as being, along with dysentery and diarrhoea, the prevalent kind of sickness before the epidemic fever became general in the spring of 1847. The same had been remarked as the precursor of the fever of 1817-18. In the end of March, Dr Jones Lamprey, sent by the Board of Health, found the parish of Skull “in a frightful state of famine, dysentery and fever.” Dysentery had been by far more prevalent than fever in this district, as in many others. “It was easily known,” says Dr Lamprey, “if any of the inmates in the cabins of the poor were suffering from this disease, as the ground in such places was usually found marked with clots of blood.” The malady was most inveterate and often fatal. It must have had a contagious property, for the physician himself went through an attack of it[508].

In the Skibbereen district the dead were sometimes buried near their cabins; at the town itself many were carried out in a shell and laid without coffins in a large pit[509]. Along the coast of Connemara for thirty miles there was no town, but only small villages and hundreds of detached cabins; this district is said to have been almost depopulated[510].

Besides the dysentery and dropsy, which caused most of the mortality in the winter of 1846-47, another early effect of the famine was scurvy, a disease rarely seen in Ireland and unknown to most of the medical men. It was by no means general, but undoubtedly true scurvy did occur in some parts: thus in the Ballinrobe district, county Mayo[511], it was very prevalent in 1846 for some months before the epidemic fever appeared, being “evidenced by the purple hue of the gums, with ulceration along their upper thin margin, bleeding on the slightest touch, and deep sloughing ulcers of the inside of the fauces, with intolerable foetor”--affecting men, women, and children. In some places, as at Kilkenny early in 1846, there was much purpura[512]. These earlier effects of the famine (dysentery and diarrhoea, dropsy, scurvy and purpura), were seen in varying degrees before the end of 1846 in most parts of Ireland. The counties least touched by them were in Leinster and Ulster, such as Down, Derry, Tyrone, Fermanagh and some others, where the peasantry lived upon oatmeal as well as on potatoes. But even these were invaded by the ensuing epidemic of fever, the only place in all Ireland which is reported to have escaped both the primary and the secondary effects of the famine having been Rostrevor, on the coast of Down, a watering-place with a rich population, which was also one of the very small number of localities that escaped in 1817-18.

According to the following samples of admissions to the Fever Hospital of Ennis in the several months, the summers were the season of greatest sickness, a fact which was noted also in the epidemic of 1817-18:

Year Month Patients

1846 November 93 " December 224 1847 June 757 1848 February 210 " May 705 " November 400

The almost uniform report of medical men was that the epidemic of fever began in 1847, in the spring months in most places, in the summer in others. Relapsing fever was the common type. It was usually called the famine fever for the reason that it was constantly seen to arise in persons “recovering from famine,” on receiving food from the Relief Committees[513]. It was a mild or “short” fever, apt to leave weakness, but rarely fatal. Dr Dillon, of Castlebar, reports that he would be told by the head of a family: “We have been three times down in the fever, and have all, thank God, got through it.” Dr Starkey, of Newry, “knew many families, living in wretched poverty on the mountains near the town, who were attacked with fever, and who without any medical attendance, and but little attendance of any kind, passed through the fever without a single death.” The doctor of Bryansford and Castlewellan, county Down, (where there was no famine), declared that the recoveries of the poor in their own cottages destitute of almost every comfort, were astonishing. In the Skibbereen district, Dr Lamprey was “often struck with the rarity of the ordinary types of fever among the thousands suffering from starvation.” In some of the most famine-stricken places, such as the islands off the coast of Mayo and Galway, and in Gweedore, Donegal, not more than one in a hundred cases of relapsing fever proved fatal. In Limerick the mortality was “very small.” In many places it is given at three in the hundred cases, in some places as high as six in the hundred. When deaths occurred, they were often sudden and unexpected,--more probable in the relapse than in the first onset. At Clonmel it was remarked that a certain blueness of the nose presaged death; in Fermanagh it was called the Black Fever, from the duskiness of the face. The report from Ballinrobe, Mayo, says that it was attended by rheumatic pains, which caused the patients to cry out when they stirred in bed[514]. It was mostly a fever of the first half of life, and more of the female sex than of the male. One says that it was commonest from five to fifteen years of age, another from ten to thirty years.

Relapsing fever was the most common fever of the famine years, in the cabins, workhouses and fever hospitals, in the country districts as well as the towns and cities. Dr Henry Kennedy says of Dublin: “Cases of genuine typhus were through the whole epidemic very rare, I mean comparatively speaking.” But everywhere there was a certain admixture of typhus, and in some not unusual circumstances the typhus was peculiarly malignant or fatal--many times more fatal than the relapsing fever. The poor themselves do not appear to have suffered much from the more malignant typhus, unless in the gaols and workhouses. When the doors of the Cork workhouse were thrown open in December, 1846, five hundred were admitted pell mell in one week; the deaths in that workhouse were 757 in the month of March, 1847, and 3329 in the whole year. In the Ballinrobe workhouse, county Mayo, “men, women and children were huddled together in the same rooms (the probationary wards), eating, drinking, cooking, and sleeping in the same apartment in their clothes, without even straw to lie on or a blanket to cover them.” Typhus at length appeared in that workhouse, said to have been brought in by a strolling beggar, and the physician, the master and the clerk died of it. Wherever the better-off classes caught fever, it was not relapsing but typhus, and a very fatal typhus. At Skibbereen the relapsing fever “was not propagated by contagion; but in persons so affected, when brought in contact with the more wealthy and better fed individuals, was capable of imparting fevers of different types[515].” There were many opportunities for such contact-in serving out food at the depôts, in superintending the gangs working on the roads, in attending the sessions, in visiting the sick. The crowds suffering from starvation, famine-fever or dysentery exhaled the most offensive smells, the smell of the relapsing fever and the anasarca being peculiar or distinguishable[516]. There appeared to be a scale of malignity in the fevers in an inverted order of the degree of misery. The most wretched had the mildest fever, the artizan class or cottagers had typhus fatal in the usual proportion, the classes living in comfort had typhus of a very fatal kind. This experience, however strange it may seem, was reported by medical observers everywhere with remarkable unanimity. One says that six or seven of the rich died in every ten attacks, others say one in three. Forty-eight medical men died in 1847 in Munster, most of them from fever; in Cavan county, seven medical men died of fever in twelve months, and three more had a narrow escape of death: two of the three physicians sent by the Board of Health to the coast of Connemara died of fever[517]. Many Catholic priests died as well as some of the Established Church clergy; and there were numerous fatalities in the families of the resident gentry, and among others who administered the relief. Yet a case of fever in a good house did not become a focus of contagion; the contagion came from direct contact with the crowds of starving poor, their clothes ragged and filthy, their bodies unwashed, and many of them suffering from dysentery. The greater fatality of fever among the richer classes had been a commonplace in Ireland since the epidemic of 1799-1801, and is remarked by the best writers[518]. At Loughrea, in Galway, Dr Lynch observed that “in the year 1840 the type of fever was very bad indeed, and very many of the gentry were cut off by it.” He reckoned that ordinarily one in six cases of fever among the richer class proved fatal, one in fifteen among the poor[519]. But in the great famine, six years after, the fever of the poor assumed the still milder type of relapsing, fatal perhaps to one in a hundred cases, or three in a hundred, while the fever which contact with them gave to those at the other extreme of well-being became a peculiarly malignant typhus, fatal to six or seven in ten cases, as Dr Pemberton of Ballinrobe found, or to three or four in ten cases, as many others found. Of course it was the peasantry who made up by far the greater part of the mortality in the years of famine; but they were cut off by various maladies, nondescript or definite, while the richer classes died, in connexion with the famine, of contagious typhus and here or there of contagious dysentery.

Even in the crowded workhouses and gaols, more deaths occurred from dysentery than from fever. But in some of the gaols great epidemics arose which cut off many of the poor by malignant infection. That was an old experience of the gaols, studied best in England in the 18th century; the worst fevers, or those most rapidly fatal, were caught by the prisoners newly brought to mix with others long habituated to their miserable condition. The gaols in Ireland during the famine were crowded to excess, not so much because the people gave way to lawlessness--their patience and obedience were matters of common complimentary remark--but because they committed petty thefts, broke windows, or the like, in order to obtain the shelter and rations of prisoners. The mortality in the gaols rose and fell as follows[520]:

Year Deaths in gaol

1846 130 1847 1320 1848 1292 1849 1406 1850 692 1851 197

Most of the deaths in these larger totals came from two or three great prison epidemics in each of the series of years--at Tralee, Carrick-on-Shannon, Castlebar and Cork in 1847, at Galway in 1848, at Clonmel, Limerick, Cork and Galway in 1849, the highest mortality being 485 deaths in Galway county gaol in 1848. Descriptions remain of the state of the gaols at Tralee and Castlebar in 1847, from which it appears that they were frightfully overcrowded and filthy. Dr Dillon, of Castlebar, says that the county gaol there in March, 1847, had twice as many prisoners as it was built for, “those committed being in a state of nudity, filth and starvation.” He expected an outbreak of typhus, and applied to the magistrates to increase the accommodation, which they declined to do. In due time, very bad maculated typhus broke out, of which the chaplain, matron and others of the staff died. This contagious fever is said to have proved fatal to forty per cent. of those attacked by it. The deaths for the year are returned at 83 in Castlebar gaol, those in Tralee gaol at 101, and in the gaol of Carrick-on-Shannon at 100.

No exact statistical details of the mortality in the great Irish famine of 1846-49 were kept. Ireland had then no systematic registration of deaths and of the causes of death, such as had existed in England since 1837. Information as to the mortality was got retrospectively once in ten years by means of the census, heads of families being required to fill in all the deaths, with causes, ages, years, seasons, &c., of the same, that had occurred in their families within the previous decennial period. This was, of course, a very untrustworthy method, more especially so for the famine years, when many thousands of families emigrated, leaving hardly a trace behind, many hamlets were wholly abandoned, and many parishes stripped of nearly half their inhabited houses. When a certain day in the year 1851 came round for the census papers to be filled up, a fourth part of the people were gone, and that fourth could have told more about the famine and the deaths than an equal number of those that remained. However, the Census Commissioners did their best with the defective, loose or erroneous data at their service. Much of the interest of the Irish Census of 1851 centered, indeed, in the Great Famine; and the two volumes of specially medical information compiled by Sir William Wilde, making Part V. of the Census Report, are a store of facts, statistical and historical, of which only a few can be given here[521].

Table of Workhouses and Auxiliary Workhouses in Ireland during the Famine.

No. of Numbers Numbers Ratio of deaths Year Workhouses relieved that died One in

1846 129 250,822 14,662 17·11 1847 130 332,140 66,890 6·92 1848 131 610,463 45,482 13·4 1849 131 932,284 64,440 14·47 1850 163 805,702 46,721 17·74

During the ten years from 6 June, 1841, to 30 March, 1851, the deaths from the principal infective or “zymotic” diseases in the workhouses were as follows:

Dysentery 50,019 Diarrhoea 20,507 Fevers 34,644 Measles 8,943 Cholera 6,716 Smallpox 5,016

Besides the workhouses, there were during the famine 227 temporary fever hospitals, which received 450,807 persons from the beginning of 1847 to the end of 1850, of whom 47,302 died.

According to the Census returns, the deaths from the several causes connected with the famine were as follows in the respective years:

Dysentery Year Fever (with Diarrhoea) Starvation

1845 7,249 ------ ----- 1846 17,145 5,492 2,041 1847 57,095 25,757 6,058 1848 45,948 25,694[522] } 1849 39,316 29,446[523] } 9,395 1850 23,545 19,224 -----

According to this table, fever caused more deaths than dysentery. But there are reasons for thinking that the deaths from dysentery, anasarca and other slow effects of famine and bad food really made up more of the extra mortality of the famine-years than the sharp fever itself. In the returns from the workhouses, dysentery is actually credited with about one-half more deaths than fever. It is known that most of the mortality at the beginning of the famine, the winter of 1846-47, was from dysentery and allied chronic forms of sickness. Dysentery also followed the decline of the relapsing-fever epidemic of 1847-48. Dillon, of Castlebar, says that many, who had gone through the fever in the autumn of 1847, fell into dysentery in 1848, during which year it was very prevalent. Mayne says that dysentery often attacked those recovering from fever, and proved fatal to them[524]. In the General Hospital of Belfast the fatality of fever-cases was 1 in 8, “but this included dysentery.” Probably the same explanation should be given of the high rates of fatality in the Fever Hospital of Ennis, the chief centre of relief for the greatly distressed county of Clare: 1846, 1 in 12½; 1847, 1 in 5¾; 1848, 1 in 5½.

It will be noticed that some thousands of deaths were put down to starvation in the Census returns. Perhaps a more technical nosological term might have been found for a good many of these, such as anasarca or general dropsy. But even if physicians had made the returns, instead of the priests or relatives, they would have put many into a nondescript class, for which starvation was a sufficiently correct generic name. Scurvy was another disease of malnutrition which was far from rare during the famine; the deaths actually set down to that cause were some hundreds over the whole period.

The deaths from all causes in the decennial period covered by the Census of 1851 were 985,366. But these returns were made, as we have seen, on a population which had been reduced by a fourth part in the course of ten years, so that they fall considerably short of the reality. If the population of Ireland had multiplied at the same rate as that of England and Wales from 1841 to 1851, namely, 1·0036 per cent. per annum, it should have been 9,018,799 in the year 1851; but it was only 6,552,385. Emigration beyond the United Kingdom had averaged 61,242 persons per annum from the 30th of June, 1841, to the 31st December, 1845; next year, 1846, it rose to 105,955, in 1847 it was “more than doubled,” in 1848 it was 178,159, in 1849, 214,425, in 1850 it was 209,054, and in 1851 it touched the maximum, 249,721. Nearly a million emigrated in the six years preceding the date of the Census, and there was besides a considerable migration to Liverpool, Glasgow, London and other towns of England and Scotland. It is probable that emigration accounts for two-thirds of the decrease of inhabitants revealed by the Census of 1851; but the extra mortality of the famine years, or the deaths over and above the ordinary deaths in Ireland during a decennial period, can hardly be estimated below half a million.

Decrease of Typhus and Dysentery after 1849.

The potato famines of 1845-48 were a turning-point in the history of Ireland. From that time the population has steadily declined and the well-being of the people steadily improved. By the Census of 1871 the population was 5,386,708, by that of 1881 it was 5,144,983, by that of 1891 it was 4,704,750. Registration of births and deaths, which began in 1864, shows the following samples:

Year Births Deaths

1867 144,318 98,911 1871 151,665 88,720 1880 128,010 102,955 1888 109,557 85,892

The enormous amount of pauperism which followed the great famine was at length brought within limits: from 1866 to the present time it has been marked by a steady increase of out-door relief, and by some increase in the numbers within the Union Workhouses; the out-door paupers have increased from 10,163 on 1 Jan., 1866, to 53,638 on 1 Jan., 1881, the absolute number of indoor paupers having remained, on an average of good and bad years, somewhat steady in a declining population.

The public health has been undisturbed by great epidemics since the potato famine, although the effects of that calamity did not wholly cease until some years after. It is best estimated by the mean annual average of deaths among a thousand inhabitants, a ratio which has been low for the provinces of Connaught and Munster, and not excessive for the provinces of Ulster and Leinster. The following tables are of the death rates in two sample years, 1880 and 1889 respectively[525]:

1880 1889

Connaught 15·3 12·4 Munster 19·5 15·1 Ulster 20·0 16·8 Leinster 23·3 18·3

Four healthiest counties:

1880 | 1889 Mayo 14·5 | Galway 11·8 Sligo 15·3 | Kerry 12·1 Galway 15·6 | Leitrim 12·1 Roscommon 15·8 | Cavan 12·2

Four unhealthiest counties:

1880 | 1889 Dublin co. 31·7 | Dublin co. 24·5 Waterford co. 24·9 | Antrim 21·2 Louth 22·6 | Down 18·6 Antrim 21·9 | Armagh 17·0

The higher death rates of some counties are chiefly owing to their greater urban populations. The health of the cottier districts is remarkably good, and is rarely if ever disturbed by any morbus miseriae. The cabins, except in a few remote parts, are more comfortable than they used to be, the diet is better, the clothing is better, the education of the children is better. The present happier lot of the Irish peasantry can be measured not unfairly by the statistics showing the decrease in the number of cabins of the lowest class, and the increase of dwellings in the higher classes.

The history of fever and dysentery in Ireland subsequently to the great epidemics of 1846-49 has few salient points. Dysentery, the old “country disease,” has steadily declined to about a hundred deaths in the year, while the considerable mortality from diarrhoea, nearly two thousand deaths in a year, is nearly all from the cholera infantum or summer diarrhoea of children in the large towns. The history of the continued fevers is made complex by the modern identification of typhoid or enteric fever. According to the testimonies of several, it played but a small part in the epidemics of 1846-49, even in Dublin itself[526], and it can hardly be doubted that its recent increase in that city is not apparent but real. The following table from the year 1880 to the present time will show how the deaths from continued fever are now divided in the registration returns:

Simple Year Typhus continued Enteric

1880 934 1073 1087 1881 859 774 813 1882 744 657 844 1883 810 593 853 1884 628 572 693 1885 505 443 716 1886 394 380 772 1887 405 385 740 1888 362 330 741 1889 359 250 968 1890 391 231 855 1891 266 183 859 1892 268 210 714

This decline of typhus in a country where for many generations it seemed to be a national malady is a remarkable testimony to the influence of the changed conditions which have made typhus rare everywhere.

There are some interesting points in connexion with Irish typhus since 1849. After the subsidence of the great epidemic of relapsing and typhus fevers (1847-49), says Dr Dennis O’Connor, of Cork, “intermittent fever made its appearance, and, as long as it lasted, scarcely a case of continued fever was seen. As soon as the last cases of intermittent disappeared, the present epidemic broke out (1864-65), and still rages with much severity. This alternation of continued and intermittent fever is remarkable. Indeed it might have been observed that the fever of 1847 passed first into a remittent form, and gradually into the intermittent which prevailed more or less for ten years subsequently[527].” The same succession of relapsing fever by intermittent fever was observed after the epidemic of 1826 by Dr John O’Brien, of Dublin[528]. The epidemic of fever which Dr O’Connor describes for Cork in 1864-65, appeared in Dublin about the same time--the latter half of 1864. It was of the nature of typhus in both cities, cerebro-spinal in part, but probably not typhoid[529]. At Cork it had some peculiarities--a croupous-like exudation on the tongue, resembling thrush in the mouth, and a dark mottled rash (rubeola nigra), or fiery red spots on a dark red ill-defined base. “The true typhoid rash has been seen but seldom, and the petechiae of genuine typhus, so frequent in former epidemics, have been equally rare. The latter I attribute to the improved condition of our poor in good clothing and the ventilation of their dwellings.” The intellect was little disturbed in this fever, there was usually a crisis about the fourteenth day, and there were no relapses. The sequelae were peculiar--“great nervous debility, leading to a semi-paralysed state of the limbs,” congestion of the lungs, sometimes solidification, or gangrene or suppuration of them. It occurred at a time “when the food of the people is most abundant and of the best quality.” There had been three bad harvests in succession from 1860, but it may be inferred from a Dublin article of August, 1863, that no epidemic of typhus had arisen in Ireland down to that date, although there was much typhus in England, especially in Lancashire owing to the “cotton famine.” When the epidemic did arise in Dublin, Cork, and doubtless elsewhere in Ireland, in the latter part of 1864, to continue throughout 1865, it was not connected with scarcity or distress among the common people. On the other hand, Dr Grimshaw, of Dublin, found that it was subject to influences of the weather, as if the infective principle had been a soil poison like that of plague, yellow fever, cholera, or enteric fever. Taking the Cork Street Fever Hospital for his study, he made out that there was a very close correspondence, from the 29th of May to the 31st of December, 1864, between the fluctuating pressure upon its accommodation and the periodic rises in the atmospheric moisture and heat, the crowd of patients being always greater when a high temperature coincided with a large rainfall[530]. One would not have been surprised to find some such law as that in enteric or typhoid fever, although a correspondence from day to day is subject to many sources of fallacy; but, by all accounts, the disease was typhus, the last of the considerable outbreaks of it in Ireland hitherto, and an outbreak that seemed to require, both at Cork and Dublin, the language of Sydenham’s epidemic constitutions for its adequate description. For a good many years, the continued fever of Dublin has been chiefly enteric or typhoid. As late as 1862 a physician to the Fever Hospital, unconvinced by the method of Sir William Jenner, believed that he observed a transition from the old typhus into the new enteric: “The change at first seemed to be to the gastric type; to which was shortly added diarrhoea in nearly every instance; and this latter, again, occurring in a large number of cases which presented all the characters of typhus, including a dense crop of petechiae[531].” Assuming that there had been a mixture of cases of enteric and typhus fevers, the latter must have had diarrhoea among the symptoms, as they often had in special circumstances (as well as tympanitis). Since that time the species of typhus has greatly declined, and the species of typhoid has considerably increased. The remodelling which Dublin has undergone, like all other old cities, explains the one fact. The notorious Liberties have been in great part rebuilt, and the conditions of typhus, as well as its actual fomites, to that extent removed. On the other hand, something has happened to encourage the soil poison of enteric fever. It is not easy to say what are the conditions that have favoured the enteric poison in modern towns; but there can be little doubt about the fact in general, or that Dublin and Belfast are among the best fields for the study of the problem[532].