Chapter II: Fever and Dysentery in Ireland (2)

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].