Chapter II: Fever and Dysentery in Ireland (1)

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.