A History of Epidemics in Britain, Volume 2 (of 2) by Charles Creighton

1655. There were twenty-seven victuallers or other ships riding in Dundalk

12598 words  |  Chapter 25

Bay; but the stores were bad, and the regimental surgeons had come unprovided with drugs that might have been useful in flux or fever. While the weather continued cold and wet, there was also a scarcity of firing and forage. On 14 October all the regimental surgeons were ordered to meet at ten in the morning to consult with Dr Lawrence how to check the sickness[426]. Several officers having died on the 16th and 17th, the camp was shifted on the 20th to new ground, the huts being left full of the sick. Gower’s regiment had sixty-seven men unable to march, besides a good many dead before or sent away sick. Story, the chaplain, went every day from the new camp to visit the sick of his regiment in the huts, and always at his going found some dead. He found the survivors in a state of brutal callousness, utterly indifferent to each other, but objecting to part with their dead comrades as they wanted the bodies to sit or lie on, or to keep off the cold wind. The ships at anchor had now received as many sick as they could hold, and the deaths on board soon became as many as on shore. On 25-27 October, the camp was again shifted, but the sickness continued apace. At length on 3 November, the Catholic army having dispersed to winter quarters, the sick were ordered to be removed to Carlingford and Newry. “The poor men were brought down from all places towards the Bridge End, and several of them died by the way. The rest were put upon waggons, which was the most lamentable sight in the world, for all the rodes from Dundalk to Newry and Carlingford were next day full of nothing but dead men, who, even as the waggons joulted, some of them died and were thrown off as fast.” Some sixteen or seventeen hundred had been left dead at Dundalk. The ships were ordered to sail for Belfast with the first wind, and the camp was broken up. There was snow on the hills and rain in the valleys; on the march to Newry, men fell out of the ranks and died at the road side. When the ships weighed anchor from Dundalk and Carlingford, they had 1970 sick men on board, but not more than 1100 of these came ashore in Belfast Lough, the rest having died at sea in coming round the coast of County Down. Such was the violence of the infection on board that several ships had all the men in them dead and nobody to look after them whilst they lay in the bay at Carrickfergus. An infective principle, once engendered in circumstances of aggravation such as these, is not soon extinguished. Belfast was the winter quarters, and in the great hospital there from 1 November, 1689, to 1 May, 1690, there died 3762, “as appears by the tallies given in by the men that buried them.” These numbers together make fully six thousand deaths, which agrees with the general statement that Schomberg lost one half of the men whom he had embarked at Hoylake in August. The Irish Catholic army began to sicken in their camp in the hills above Dundalk Bay just before they broke up, and they are said to have lost heavily by sickness in their winter quarters. The war ended with the Treaty of Limerick, in 1691. The Seven Ill Years followed,--ill years to Scotland, in a measure to England, and almost certainly to Ireland also; but it does not appear that the end of the 17th century was a time of special sickness and famine to the Irish, and it may be inferred from the fact of Scots migrating to Ireland during the ill years that the distress was not so sharp there. The epidemiology of Ireland is, indeed, a blank until we come to the writings of Dr Rogers, of Cork, in some respects the best epidemiologist of his time, which cover the period from 1708 to 1734. His account of the dysentery and typhus of the chief city of Munster in the beginning of the 18th century will show that the old dietetic errors of the Irish, noted in medieval times, had hardly changed in the course of centuries. A generation of Fevers in Cork. Rogers is clear that typhus fever was never extinct, while the three several times when it “made its appearance amongst us in a very signal manner,” are the same as its seasons in England, namely 1708-10, 1718-21 and 1728-30[428]. His experience relates only to the city of Cork, and, so far as his clinical histories go, only to the well-to-do classes therein; and although those seasons were years of scarcity and distress all over Ireland, yet Rogers does not seem to associate insufficient food with the fever, and never mentions scarcity. The fevers were in the winter, for the most part, and were usually accompanied by epidemic smallpox of a bad type, which in 1708 “swept away multitudes.” Nothing is said of dysentery for the earliest of the three fever-periods; but for 1718 and following years we read that “dysentery of a very malignant sort, frequently producing mortification in the bowels,” prevailed during the same space; and that the winters of the third fever-period, namely, those of 1728, 1729 and 1730 were “infamous for bloody fluxes of the worst kind.” It is clear that the fever spread to the richer classes in Cork, for his five clinical histories are all from those classes. The following is his general account of the symptoms: The patient is suddenly seized with slight horrors or rather chilliness, to which succeed a glowing warmth, a weight and fixed pain in the head, just over the eyebrows; soreness all over his flesh, as if bruised, the limbs heavy, the heart oppressed, the breathing laboured, the pulse not much altered, but in some slower; the urine mostly crude, pale and limpid, at first, or even throughout, the tongue moist and not very white at first, afterwards drier, but rarely black. An universal petechial effloresence not unlike the measles paints the whole surface of the body, limbs, and sometimes the very face; in some few appear interspersed eruptions exactly like the _pustulae miliares_, filled with a limpid serum. The earlier these petechiae appear, the fresher in colour, and the longer they continue out, the better (p. 5). The fixed pain in the head increasing, ends commonly in a coma or stupor, or in a delirium with some. Some few have had haemorrhage at the nose, a severe cough, and sore throat. In some he had observed a great tendency to sweats, even from the beginning: these are colliquative and symptomatic, not to be encouraged. In but few there have appeared purple and livid spots, as in haemorrhagic smallpox: some as large as a vetch, others not bigger than a middling pin’s head, thick set all over the breast, back and sometimes the limbs, the pulse in these cases being much below normal. The extremities cold from the 6th or 7th day, delirium constant, tongue dry and black, urine limpid and crude, oppression greater, and difficulty of breathing more. It is a slow nervous fever (p. 18). Rogers believed that mere atmospheric changes could not be the cause of these epidemics: “they may favour, encourage and propagate such diseases when once begun; but for the productive cause of them we must have recourse to such morbid effluvia as above described [particles of all kinds detached from the animal, vegetable and mineral kingdoms]; or resolve all into the θεῖον τί so often appealed to by Hippocrates[429].” But, as regards Cork itself, special interest attaches to the following “four concurring causes:” “1st, the great quantities of filth, ordure and animal offals that crowd our streets, and particularly the close confined alleys and lanes, at the very season that our endemial epidemics rage amongst us. 2nd, the great number of slaughter-houses, both in the north and south suburbs, especially on the north ridge of hills, where are vast pits for containing the putrefying blood and ordure, which discharge by the declivities of those hills, upon great rains, their fetid contents into the river. 3rd, the unwholesome, foul, I had almost said corrupted water that great numbers of the inhabitants are necessitated to use during the dry months of the summer. 4th, the vast quantities of animal offals used by the meaner sort, during the slaughtering seasons: which occasion still more mischief by the quick and sudden transition from a diet of another kind.” In farther explanation of the fourth concurring cause, he says that in no part of the earth is a greater quantity of flesh meat consumed than in Cork by all sorts of people during the slaughtering season--one of the chief industries of the place being the export of barrelled beef for the navy and mercantile marine. The meat, he says, is plentiful and cheap, and tempts the poorer sort “to riot in this luxurious diet,” the sudden change from a meagre diet, with the want of bread and of fermented liquors, being injurious to them[430]. Famine and Fevers in Ireland in 1718 and 1728. Thus far Rogers, for the city of Cork in the three epidemic periods, 1708-10, 1718-21, and 1728-30, two of which, if not all three, were periods of dysentery as well as of typhus. But it was usual in Ireland for the country districts and small towns to suffer equally with the cities. The circumstances of the Irish peasantry in the very severe winter of 1708-9 are not particularly known; if there was famine with famine-fever, it was not such as to have become historical. But for the next fever-period, 1718-20, we have some particulars. Bishop Nicholson, of Derry, writes: “Never did I behold even in Picardy, Westphalia or Scotland, such dismal marks of hunger and want as appeared he countenances of most of the poor creatures I met with on the road.” One of the bishop’s carriage horses having been accidentally killed, it was at once surrounded by fifty or sixty famished cottagers struggling desperately to obtain a morsel of flesh for themselves and their children[431]. This was a time when the population was increasing, but agriculture, so far from increasing in proportion to the number of mouths to feed, was positively declining, unless it were the culture of the potato. In a pamphlet of about 1724, on promoting agriculture and employing the poor, the complaint is of beef and mutton everywhere, and an insufficiency of corn. “Such a want of policy,” says one, “is there, in Dublin especially, on the most important affair of bread, without a plenty of which the poor must starve.” Another, a Protestant, has the following threat for the clergymen of the Established Church: “I’ll immediately stock one part of my land with bullocks, and the other with potatoes--so farewell tithes[432]!” From this it is to be inferred that potatoes were not made tithable until a later period, pasture being exempted to the last. For whatever reason, grazing, and not corn-growing, was then more general in Ireland than in the generations immediately preceding, much land having gone out of tillage. The culture of the potato was driven out of the fertile lowlands to the hill-sides, so as to leave the ground clear for ranges of pasture. Rack-renting was the rule, doubtless owing to the same reason as afterwards, the competition for farms. While the Protestants emigrated in thousands, the Catholics multiplied at home in beggary. A pamphleteer of 1727 says: “Where the plough has no work, one family can do the business of fifty, and you may send away the other forty-nine.” Thus we find the pasturing of cattle preferred to agriculture long after the barbaric or uncivilized period had passed, preferred indeed by English landlords or farmers[433]. There were three bad harvests in succession, 1726, 1727 and 1728, culminating in a famine in the latter year. Boulter, archbishop of Armagh, who then ruled Ireland, was able to buy oats or oatmeal in the south and west so as to sell it below the market price to the starving Protestants of Ulster, an interference with the distribution of food which led to serious rioting in Cork, Limerick, Clonmel and Waterford in the first months of 1728[434]. No full accounts of the epidemic fever of that famine remain. Rutty, of Dublin, says it was “mild and deceitful in its first attack, attended with a depressed pulse, and frequently with petechiae[435];” while, according to Rogers and O’Connell[436], the epidemic fever of Munster was the same. Of the famine itself we have a glimpse or two. Primate Boulter writes to the Duke of Newcastle on 7 March, 1727: “Last year the dearness of corn was such that thousands of families quitted their habitations to seek bread elsewhere, and many hundreds perished; this year the poor had consumed their potatoes, which is their winter subsistence, near two months sooner than ordinary, and are already, through the dearness of corn, in that want that in some places they begin already to quit their habitations[437].” Quitting their habitations to beg was a regular thing at a later time of the year. It was in the course of these bad years, in 1729, that Swift wrote his ‘Modest Proposal for preventing the Children of Poor People in Ireland from being a Burden to their Parents or Country.’ The scheme to use the tender babes as delicate morsels of food for the rich, was a somewhat extreme flight of irony, not so finished as in Swift’s other satires, but the circumstances out of which the proposal grew were more real than usual. “It is a melancholy object,” says the Dean of St Patrick’s, “to those who walk through this great town, or travel in the country, when they see the streets, the roads and cabin doors crowded with beggars of the female sex followed by three, four, or six children, all in rags, and importuning every passenger for an alms.” Having ventilated his project for the children, he proceeds to show that “their elders are every day dying and rotting by cold and famine, filth and vermin, as fast as can be reasonably expected.” All the while there was a considerable export of corn from Ireland. In the beginning of 1730, two ships laden with barley were stopped at Drogheda by a fierce mob and were compelled to unload[438]. The interval between those years of epidemic typhus in Ireland and the next, 1740-41, was filled, we may be sure, with at least an average amount of the endemial fever. Rutty specially mentions it in Dublin in the autumn and winter of 1734-35: “We had the low fever, called nervous (and sometimes petechial from the spots that frequently attended, although probably not essential).” He then adds: “It is no new thing with us for this low kind of fever to prevail in the winter season;” and gives figures from the Dublin Bills of Mortality for forty years. He mentions the petechial fever as being frequent next in January and February, 1736, corresponding to a bad time of it in Huxham’s Plymouth annals. In 1738 and 1739 the type of the Dublin fever was relapsing, in part at least, the same type having been seen at Edinburgh shortly before. * * * * * The economics of Ireland, at this time, gave occasion to Berkeley’s _Querist_, a series of weekly essays written in 1737 and 1738, and collected in 1740, on the eve of the next great famine and mortality[439]. A few of the bishop’s sarcasms, in the form of queries, will serve to show how anomalous was the economic condition of the country, and how easily a crisis of famine and pestilence could arise. “169. Whether it is possible the country should be well improved while our beef is exported, and our labourers live upon potatoes? “173. Whether the quantities of beef, butter, wool and leather, exported from this island, can be reckoned the superfluities of a country, where there are so many natives naked and famished? “174. Whether it would not be wise so to order our trade as to export manufactures rather than provisions, and of those such as employ most hands? “466. Whether our exports do not consist of such necessaries as other countries cannot well be without? “353. Whether hearty food and warm clothing would not enable and encourage the lower sort to labour? “354. Whether in such a soil as ours, if there was industry, there would be want? “418. Whether it be not a new spectacle under the sun, to behold in such a climate and such a soil, and under such a gentle government, so many roads untrodden, fields untilled, houses desolate, and hands unemployed? “514. Whether the wisdom of the State should not wrestle with this hereditary disposition of our Tartars, and with a high hand introduce agriculture? “534. Why we do not make tiles of our own, for flooring and roofing, rather than bring them from Holland? “539. Whether it be not wonderful that with such pastures, and so many black cattle, we do not find ourselves in cheese?” In several of his queries (381, 383) Bishop Berkeley is driving at the expediency of domestic slavery. It was two hundred years since the same expedient had been tried by Protector Somerset in England, during the intolerable state of vagabondage which followed the rage for pasture farming under the first Tudors. In Scotland, it was hardly more than a generation since the institution of domestic slavery had commended itself to Fletcher of Saltoun, as the only expedient that could free that country from the vagabondage of a tenth, or more, of the population. England had surmounted the difficulty long ago, Scotland got over it easily and speedily when she was admitted to the English and colonial markets for her linen manufacture by the Treaty of Union[440]. But in Ireland in the year 1740, and until long after, disabilities of all kinds, not only economic, but political and religious, were fastened upon the weaker nation by the stronger, the unfortunate cause of their long continuance having been the costly inheritance of loyalty to James II. and the Mass. The Famine and Fever of 1740-41. At the time when the bishop of Cloyne was issuing his economic queries from week to week (not much to the satisfaction of Primate Boulter), things were making up for the greatest crisis of famine and pestilence that Ireland experienced in the 18th century. There had been relapsing fever among the poor in Dublin in the autumn of 1738, and it appeared among them again in the summer and autumn of 1739. Rutty’s account of it is as follows: “It was attended with an intense pain in the head. It terminated sometimes in four, for the most part in five or six days, sometimes in nine, and commonly in a critical sweat. It was far from being mortal. I was assured of seventy of the poorer sort at the same time in this fever, abandoned to the use of whey and God’s good providence, who all recovered. The crisis, however, was very imperfect, for they were subject to relapses, even sometimes to the third time, nor did their urine come to a complete separation.” In October 1739, there appeared some dysenteries in Dublin. The winter of 1739 set in severely with cold and wet in November, and about Christmas there began a frost of many weeks’ duration which was more intense than anyone remembered. It is said to have made the ground like iron to the depth of nine inches; the ice on all the rivers stopped the corn mills, trees and shrubs were destroyed, and even the wool fell out of the sheep’s backs. In January 1740 the destitution was such that subscription-lists were opened in Dublin, Cork, Limerick, Waterford, Clonmel, Wexford and other places. Bishop Berkeley distributed every Monday morning twenty pounds sterling among the poor of Cloyne (near Cork) besides what they got from his kitchen. One morning he came down without powder on his wig, and all the domestics of the episcopal palace followed suit[441]. The distress became more acute as the spring advanced. The potato crop of 1739 had been ruined, not by disease as in 1845-46, but by the long and intense frost. It was usual at that time to leave the tubers in the ridges through most of the winter, with the earth heaped up around them. The frost of December found them with only that slight covering, and rotted them: “a dirissimo hoc et diuturno gelu penitus putrescebant,” says Dr O’Connell. Besides putrid potatoes, the people ate the flesh of cattle which had died from the rigours of the season. Owing to the want of sound seed-potatoes, the crop of 1740 was almost a blank. The summer was excessively dry and hot. In Dublin, the price of provisions had doubled or trebled, and some of the poor had died of actual starvation. In July dysenteries became common, and extended to the richer classes in the capital. Smallpox was rife at the same time, and peculiarly fatal in Cork. Dysentery continued in Dublin throughout the autumn and winter of 1740 (the latter being again frosty), and became the prevailing malady elsewhere. On 8 February, 1741, Berkeley writes that the bloody flux had appeared lately in the town of Cloyne, having made great progress before that date in other parts of the country. A week after he writes (15 Feb.), “Our weather is grown fine and warm: but the bloody flux has increased in this neighbourhood, and raged most violently in other parts of this and the adjacent counties[442].” This prevalence of dysentery, and not of fever, as the reigning malady of the winter of 1740-41 in Munster is confirmed by Dr Maurice O’Connell, who says that the typhus of the previous summer gave place to it. Dysentery in the winter and spring, preceding the fever of summer, was also the experience in the famine of 1817. Berkeley treated the subjects of dysentery, not with tar water, but with a spoonful of powdered resin dissolved in oil by heat and mixed in a clyster of broth[443]. As the year 1741 proceeded, with great drought in April and May, typhus fever (which had appeared the autumn before) and dysentery were both widely epidemic, so that it is impossible to say which form of disease caused most deaths. In Dublin during the month of March, 1741, the deaths from dysentery reached a maximum of twenty-one in a week, “though it was less mortal than in the country, to which the better care taken of the poor and of their food undoubtedly contributed.” Bishop Berkeley writes on the 19th of May: “The distresses of the sick and poor are endless. The havoc of mankind in the counties of Cork, Limerick and some adjacent places, hath been incredible. The nation probably will not recover this loss in a century. The other day I heard one from county Limerick say that whole villages were entirely depeopled. About two months since I heard Sir Richard Cox say that five hundred were dead in the parish where he lives, though in a country I believe not very populous. It were to be wished that people of condition were at their seats in the country during these calamitous times, which might provide relief and employment for the poor[444].” It was said that there were twenty-five cases of fever in the bishop’s own household, which were cured by the panacea, tar-water, drunk copiously--a large glass, milk-warm, every hour in bed, the same method being practised by several of his poor neighbours with equal success[445]. In a “Letter from a country gentleman in the Province of Munster to his Grace the Lord Primate[446]” it is said: “By a moderate computation, very near one-third of the poor cottiers of Munster have perished by fevers, fluxes and downright want.... The charity of the landlords and farmers is almost quite exhausted. Multitudes have perished, and are daily perishing, under hedges and ditches, some by fevers, some by fluxes, and some through downright cruel want in the utmost agonies of despair. I have seen the labourer endeavouring to work at his spade, but fainting for want of food,” etc. The loss of life must have been great also in Connaught. A letter of 8 July, 1741, from Galway, says: “The fever so rages here that the physicians say it is more like a plague than a fever, and refuse to visit patients for any fee whatever[447].” The Galway Assizes were held at Tuam[448], the races also being transferred to the same neighbourhood, not without their usual evening accompaniments of balls and plays. Of this famine and sickness it might have been said, in the stock medieval phrase, that the living were hardly able to bury the dead[449]. As in later Irish famines, there appear to have been, in 1740-41, three main types of sickness--dysentery, relapsing fever and typhus fever. In Dublin, as we know from the direct testimony of Rutty, there was relapsing fever in 1739, before the distress had well begun, and again in the summer of 1741, when the worst was over. So much is said of dysentery that we may well set down to it, and to its attendant dropsy, a great part of the deaths, as in the famine of 1846-47. But it is probable that true typhus fever, sometimes of a malignant type, as at Galway, was the chief infection in 1741, which was the year of its great prevalence in England. It was characterized by a mild and deceitful onset, like a cold. Spots were not invariable or essential; they were mostly of a dusky red, sometimes purple, and sometimes intermixed with miliary pustules. O’Connell mentions, for Munster, bleeding from the nose, a mottled rash as in measles, and pains like those of lumbago. One of the worst features of the Irish epidemic of 1740-41 was the prevalence of fever in the gaols. At Tralee above a hundred were tried, most of them for stealing the means of subsistence; the gaol was so full that there was no room to lie down, and fifty prisoners died in six weeks. Limerick gaol had dysentery and fever among its inmates, and the judge who held the Munster Circuit died of fever on his return to Dublin[450]. Rutty says that the fever fell most upon strong middle-aged men, less upon women, and least of all upon children. The number of orphans was so great after the famine that Boulter, the Anglican primate, seized the opportunity to start the afterwards notorious Charter Schools for the education of the rising generation according to the Protestant creed. In all the subsequent Irish famines it was the enormous swarms of people begging at a distance from their own parishes that spread the infection of fever; and there seems to have been as much of beggary in 1741, when Ireland was underpeopled with two millions, as in 1817-18, when it was overpeopled with six millions. A few years after the famine, Berkeley wrote in 1749: “In every road the ragged ensigns of poverty are displayed; you often meet caravans of poor, whole families in a drove, without clothes to cover, or bread to feed them, both which might be easily procured by moderate labour. They are encouraged in their vagabond life by the miserable hospitality they meet with in every cottage, whose inhabitants expect the same kind reception in their turn when they become beggars themselves.” The estimates of the Irish mortality in 1741 varied greatly, as they have done in the Irish famines of more recent times. One guessed a third of the cottiers of Munster, another said one-fifth; and it is known that, whereas in Kerry the hearth-money was paid in 1733 by 14,346, it was paid in 1744 by only 9372[451]. The largest estimates are 200,000 deaths or even 400,000 deaths in all Ireland in a population of less than two millions. But Dr Maurice O’Connell, who practised in Cork, and saw in Munster the mortality at its worst, estimated the deaths in all Ireland, in the two years 1740 and 1741, from fevers, fluxes and absolute want, at 80,000. Those who saw the famine, fever and dysentery of 1817-18 in a population increased by three times were inclined to doubt whether even the smallest estimate of 80,000 for 1740-41 was not too large; but it is clear that the famished and fever-stricken in the 18th century were in many places allowed to perish owing to the indifference of the ruling class or the exhaustion of their means, so that a much higher rate of fatality may be assumed for that epidemic than for the first of the 19th century Irish famines. * * * * * The distress came to an end before the winter of 1741, when food was so cheap in Dublin that a shilling bought twenty-one pounds of bread. The subsequent prevalence of typhus fever and dysentery in Ireland, whether epidemic or endemic, is very imperfectly known to the end of the century. It may be inferred that there was in that period no epidemic so great as that of 1740-41; but it is clear from the records kept by Rutty in Dublin down to 1764, and by Sims in Tyrone to 1772, that the indigenous fevers and fluxes of the country were never long absent, being more common in some years than in others[452]. The year 1744 was remarkable for a destructive throat distemper among children, described elsewhere, and the year 1745 for smallpox dispersed by swarms of beggars. In 1746 and 1748, the Dublin fever was relapsing in part, “terminating,” says Rutty, “the fifth, sixth, seventh or eighth day with a critical sweat. A relapse commonly attended, which however was commonly carried off by a second critical sweat.” In 1748, though the season was sickly, the diseases were not mortal, several of the fevers being “happily terminated by a sweat the fifth or sixth day.” But there were also fevers of the low kind, sometimes with petechiae, sometimes with miliary pustules, though not essentially with either. In the autumn of 1754 Rutty begins to adopt the language of the time concerning a “putrid” constitution, identifying the fever with the dangerous remittents which Fothergill was then writing about in London; “it is probable that ours was akin to them and owing to the same general causes.” In February, 1755, the fevers were fatal to many, raising the deaths to double the usual number; they attacked all ages, were of the low, depressed kind, and commonly attended with miliary pustules. He again identifies them with the low, putrid fever in London. From that time on to 1758, Rutty has frequent references to the same fever, under the names of low, putrid, petechial and miliary. It was at its worst in 1757, and was marked by the remarkable tremors described by Johnstone at Kidderminster, as well as by miliary eruptions and by a gangrenous tendency at the spots where blisters had been applied. In November, 1757, it was fatal to not a few of the young and strong in Dublin, “and we received accounts of a like malignity attending this fever in the country[453].” It was still prevalent in the North and West of Ireland in the spring of 1758. He describes also an unusual amount of fever in the end of 1762. Sims, of Tyrone, an epidemiologist in the same manner as Rutty, does not begin his full annals until 1765; but he sums up the years from 1751 to 1760 as unhealthy by agues in spring, dysenteries and cholera morbus in autumn, and “low, putrid or nervous fevers throughout the year[454].” He adds: “To the unhealthiness of these years the bad state and dearth of provisions might not a little contribute; the poor, being incapable to procure sufficient sustenance, were often obliged to be contented with things at which nature almost revolted; and even the wealthy could not by all their art and power render wholesome those fruits of the earth which had been damaged by an untoward season.” Much of the distress, however, was owing to the continual spread of pasture-farming, which made the labour of villagers unnecessary[455]. The nearest approach to a great Irish epidemic in the second half of the 18th century was in 1771, as described by Sims, the type of fever being clearly the same low, putrid or nervous fever, with offensive sweats and muscular tremors, that was commonly observed in England also in the middle third of the 18th century. Early in the summer of 1771 a fever began to appear which, as autumn advanced, raged with the greatest violence; nor was it overcome by a severe winter. It claimed the prerogative of the plague, almost all others vanishing from before its presence. It began twelve months sooner in the eastern parts of the kingdom, pursuing a regular course from East to West. Some symptoms suggest cerebro-spinal fever. The symptoms were languor, precordial oppression, want of appetite, slight nausea, pains in the head, back and loins, a thin bluish film on the tongue, turbid urine, eyes lifeless and dejected. After the fourth day, constant watchfulness, the eyes wild, melancholy, sometimes with bloody water in them, constant involuntary sighing, the tendons of the wrists tremulous, the pulse quick and weak, most profuse sweats, small dun petechiae principally at the bend of the arm and about the neck. At the height of the fever, on the ninth or tenth day, the tremulousness of the wrists spread to all the members, “insomuch that I have seen the bed-curtains dancing for three or four days to the no small terror of the superstitious attendants, who on first perceiving it, thought some evil spirits shook the bed. This agitation was so constant a concomitant of the fever as to be almost a distinguishing symptom.” The patients lay grinding their teeth; when awake, they would often convulsively bite off the edges of the vessel in which drink was given them. They knew no one, their delirium being incessant, low, muttering, their fingers picking the bed covering. The face was pale and sunk, the eyes hollow, the tongue and lips black and parched. Profuse clammy sweats flowed from them; the urine was as if mixed with blood: the stools were involuntary. Petechiae almost black came out, having an outer circle with an inner dark speck; sometimes there were the larger vibices. Bleedings at the nose were frequent. Those who were put to bed and sweated almost all died. Death took place about the 13th day. Curiously enough this disease showed itself even among the middle ranks of the people, especially those who lived an irregular life, used flesh diet and drank much. Among the poorer sort, who used vegetable food, the fever was more protracted and less malignant, but in the winter and spring it made much greater havoc among them. “Bleeding, that first and grand auxiliary of the physician in treating inflammatory disorders, seemed here to lose much of its influence.” It was, indeed, the long prevalence of this low or nervous type of fever in Britain and Ireland in the middle of the 18th century that drove blood-letting in fevers out of fashion until the return of a more inflammatory type (often relapsing fever) in the epidemic of 1817. In 1770, while such fevers more or less nervous, putrid, miliary, were beginning to be prevalent among the adults, there was a good deal of “worm fever” among children. They suffered from heat, thirst, quick, full pulse, vomiting, coma, and sometimes slight convulsions, universal soreness to the touch, and a troublesome phlegmy cough. When not comatose they were peevish. The fever was remitting, the cheeks being highly flushed at its acme, pale in its remission. It lasted several days, but seldom over a week, nor was it often fatal. In children under five or six years, it could hardly be distinguished from hydrocephalus internus[456]. The same association of the worm fever or remittent fever of children with the putrid or nervous fever of adults had been noticed at Edinburgh in 1735. Neither the fever of the adults nor that of the children will be found, on close scrutiny, to have had much in common with our modern enteric fever. The Epidemic Fevers of 1799-1801. Sims left Tyrone to practise as a physician in London, and with his departure what seems to have been the only contemporary record of epidemics in Ireland ceased. The last quarter of the 18th century in Ireland had probably as much epidemic fever as in England; but it is not until the years 1797-1801 that we again hear of fever and dysentery, on the testimony of the records of the Army Medical Board, of the Dublin House of Industry, and of the Waterford Fever Hospital. At the end of the year 1796 the health of the regiments in Ireland was everywhere good; but in December of that year, and in January 1797, the poor in the towns began to suffer more than usual from fever, and in the course of the year 1797 fever appeared in several cantonments of troops--at Armagh as early as February or March, at Limerick, at Waterford and in Dublin[457]. The summer and autumn were unusually wet, so that the peasantry of the southern and western counties were unable to lay in their usual supply of turf for fuel. In the course of the winter 1797-98 a considerable increase of fever and dysentery was remarked among them, and these two maladies appeared in various regiments in the early months of 1798. This was the year of the rebellion in the south-east of Ireland, pending the efforts for the union with England. The British troops were much engaged with the insurgents throughout the summer, and got rid in great part of the maladies of their quarters while they were campaigning. But in the end of the year fever began to spread, both among the inhabitants and among the troops. It was nothing new for English and Scots regiments to suffer from fever or dysentery during the greater part of their first year in Ireland; but the epidemics in the end of 1798 were more than ordinary. The Buckinghamshire Militia quartered in the Palatine Square of the Royal barracks, Dublin, lost by “malignant contagious fever” 13 men in October, 13 in November, and 15 in December. From November to January, the Warwick regiment suffered greatly in the same barrack. The Herefordshire regiment, 833 strong, lost 47 men at Fermoy, mostly from fever contracted in bad barracks; the Coldstream Guards at Limerick, the 92nd regiment at Athlone, and the Northamptonshire Fencibles at Carrick-on-Shannon, also lost men by fever. In July, 1799, not a single regiment in Ireland was sickly; but a wet and very cold autumn made a bad harvest, aggravating the distresses of the poor and causing much sickness, which the troops shared. The county of Wexford, the principal scene of the rebellion, suffered most, and next to it the adjacent county of Waterford. The fever-hospital of the latter town, the earliest in Ireland[458], was projected in 1799; the statement made in the report of a plan for the new charity, that fifteen hundred dependent persons suffered from contagious fever every year there, showed that the need for it was nothing new, although hardly a tenth part of the number sought admission to the hospital when it was at work. Next year, 1800, the managers of the newly-opened hospital gave some particulars of the causes of fever in Waterford--want of food, causing weakness of body and depression of mind, but above all the excessive pawning of clothes and bedding, whereby they suffered from cold and slept for warmth several in a bed. In the winter and spring of 1799-1800 the poor of Waterford had epidemic among them fever and dysentery, as well as smallpox. In Donagh-a-gow’s Lane nine persons died of dysentery between October 1799 and March 1800. The harvest of 1800 was again a failure, from cold and wet, bread and potatoes being dear and of bad quality. In the autumn and winter the distress, with the attendant fever and dysentery, became worse. At that time in Dublin all fever cases among the poor were received into the House of Industry (the Cork Street and Hardwick Hospitals were soon after built for fever-cases), at which the deaths for four years were as follows: Died in the Dublin Year House of Industry 1799 627 1800 1315 1801 1352 1802 384 The enormous rise of the deaths in 1800 and 1801 shows how severe the epidemic of fever must have been. Compared with the epidemic of 1817-18, it has few records, perhaps because the political changes of the union engrossed all attention. But the significant fact remains that the deaths in the Dublin House of Industry in 1800 and 1801 were nearly as many as in all the special fever-hospitals of Dublin during the two years, 1 Sept. 1817 to 1 Sept. 1819. At Cork, in 1800, there were 4000 cases of fever treated from the Dispensary; at Limerick the state of matters is said to have been as bad as in the great famine of 1817-18; and there is some reason to think that the same might have been said of other places. All the relief in 1800-1801 came from private sources, the example of Dublin in opening soup-kitchens having been followed by other towns. The troops shared in the reigning diseases, especially at Belfast and Dublin; in the latter city, the spotted fever was severe both among the military and all ranks of the civil population in August, 1801. The harvest of 1801 was abundant, and the fever quickly declined. It had been often of the relapsing type[459]. Dysentery appeared in the end of September, and became severe in many places in October and November, being attributed to the rains after a long tract of dry, hot weather. Ophthalmias and scarlatinal malignant sore-throats were common at the same time. The Growth of Population in Ireland. When the history of the great famine and epidemic sicknesses of 1817-18 was written, it was found that this calamity had fallen upon a population that had grown imperceptibly until it had reached the enormous figure of over six millions, the census of 1821 showing the inhabitants of Ireland to be 6,801,827. The increase from an estimated one million and thirty-four thousand in 1695 was, according to Malthus, probably without parallel in Europe. According to Petty, the inhabitants in 1672 numbered about one million one hundred thousand, living in two hundred thousand houses, of which 160,000 were “wretched, nasty cabins without chimney, window or door-shut, and wholly unfit for making merchantable butter, cheese, or the manufacture of woollen, linen or leather.” In 1695, the war on behalf of James II. having intervened, the population as estimated by South was 1,034,000. When the people were next counted in 1731, by a not incorrect method in the hands of the magistracy and Protestant clergy, they were found to have almost doubled, the total being 2,010,221. This increase, the exactness of which depends naturally upon the accuracy of Petty’s and South’s 17th century estimates, had been made notwithstanding the famines and epidemics of 1718 and 1728, and an excessive emigration, mostly of Protestants, to the West Indian and American colonies, which was itself attended by a great loss of life through disease. For the rest of the 18th century, the estimates of population are based upon the number of houses that paid the hearth-tax. In the following figures six persons are reckoned to each taxed hearth: Year Persons 1754 2,372,634 1767 2,544,276 1777 2,690,556 1785 2,845,932 The hearth-money was not altogether a safe basis of reckoning, for the reason that many were excused it on account of their poverty by certificate from the magistrates, and that hamlets in the hills, perhaps those which held their lands in rungale or joint-lease, often compounded with the collectors for a fixed sum; so that cabins might multiply and no more hearth-tax be paid[460]. It is probable that a considerable increase had taken place which was not represented in the books of the tax-collectors; for in 1788, only three years from the last date given, the number of hearths suddenly leapt up to the round figure of 650,000 (from 474,322), giving a population of 3,900,000, at the rate of six persons to a cabin or house. But it is undoubted that a new impulse was given to population in the last twenty years of the 18th century, firstly by the bounties on Irish corn exported, dating from 1780, which caused much grazing land to be brought under the plough, and secondly by the gradual removal, after 1791, of various penalties and disabilities which had rested on the Roman Catholics since the reign of Anne, affecting their tenure of land, and serving in various ways to repress the multiplication of families. Accordingly we find the hearths rated in 1791 at the number of 701,102, equal to a population of 4,206,612. The estimates or enumerations from 1788, to the census of 1831, show an increase as follows: Year Persons 1788 3,900,000 1791 4,206,612 1805 5,395,456 1812 5,937,856 1821 6,801,827 1831 7,784,539 The secret of this enormous increase was the habit that the Irish peasantry had begun to learn early in the 17th century of living upon potatoes. From that dietetic peculiarity, it is well known, much of the economic and political history of Ireland depends. At the time when it was losing its tribal organization (rather late in the day, although not so late as in the Highlands of Scotland), the country was in a fair way to pass from the pastoral state to the agricultural and industrial. It is conceivable that, if Ireland had peacefully become an agricultural country, wheaten bread would have become the staple food of the people, as in England in early times and again in later times; or that the standard might have been oatmeal in the northern province, as in Scotland: in which case one may be sure that the population would not have increased as it did. “Since the culture of the potatoes was known,” says a topographer of Kerry in 1756, “which was not before the beginning of the last century, the herdsmen find out small dry spots to plant a sufficient quantity of those roots in for their sustenance, whereby considerable tracts of these mountains are grazed and inhabited, which could not be done if the herdsmen had only corn to subsist on[461].” Twenty years later Arthur Young found an enormous extension of potato culture, the pigs being fed on the surplus crop[462]. The motive, on the part of the landlord or the farmer, was to have the peat bogs on the hill-sides reclaimed by the spade; the surface of peat having been removed, a poor subsoil was exposed, which might be made something of after it had grown several crops of potatoes, but hardly in any other way. Another motive was political; namely, the multiplication by landlords of forty-shilling freeholder dependent votes among the Catholics as soon as they became free to exercise the franchise[463]. Malthus relied so much upon statistics, that he found the case of Ireland, notable though it was, little suited to his method, and dismissed it in a few sentences. But he indicated correctly the grand cause of over-population: “I shall only observe, therefore, that the extended use of potatoes has allowed of a very rapid increase of population during the last century (18th). But the cheapness of this nourishing root, and the small piece of ground which, under this kind of cultivation, will in average years produce the food for a family, joined to the ignorance and depressed state of the people, which have prompted them to follow their inclinations with no other prospect than an immediate bare subsistence, have encouraged marriage to such a degree that the population is pushed much beyond the industry and present resources of the country; and the consequence naturally is, that the lower classes of people are in the most impoverished and miserable state.” In another section he showed that the cheapness of the staple food of Ireland tended to keep down the rate of wages: “The Irish labourer paid in potatoes has earned perhaps the means of subsistence for double the number of persons that could be supported by an English labourer paid in wheat.... The great quantity of food which land will bear when planted with potatoes, and the consequent cheapness of the labour supported by them, tends rather to raise than to lower the rents of land, and as far as rent goes, to keep up the price of the materials of manufacture and all other sorts of raw produce except potatoes. The indolence and want of skill which usually accompany such a state of things tend further to render all wrought commodities comparatively dear.... The value of the food which the Irish labourer earns above what he and his family consume will go but a very little way in the purchase of clothing, lodging and other conveniences.... In Ireland the money price of labour is not much more than the half of what it is in England.” Lastly, in a passage quoted in the sequel, he showed how disastrous a failure of the crop must needs be when the staple was potatoes; the people then had nothing between them and starvation but the garbage of the fields[464]. What the growth of population could come to on these terms was carefully shown for the district of Strabane, on the borders of Tyrone and Donegal, by Dr Francis Rogan, a writer on the famine and epidemic fever of 1817-18[465]. Strabane stood at the meeting of the rivers Mourne and Fin to form the Foyle; and in the three valleys the land was fertile. All round was an amphitheatre of hills, in the glens of which and among the peat bogs on their sides was an immense population. The farms were small, from ten to thirty acres, a farm of fifty acres being reckoned a large holding. The tendency had been to minute subdivisions of the land, the sons dividing a farm among them on the death of the father: “The Munterloney mountains,” says Rogan, “lie to the south and east of the Strabane Dispensary district. They extend nearly twenty miles, and contain in the numerous glens by which they are intersected so great a population that, except in the most favourable years, the produce of their farms is unequal to their support. In seasons of dearth they procure a considerable part of their food from the more cultivated districts around them; and this, as well as the payment of their rents, is accomplished by the sale of butter, black cattle, and sheep, and by the manufacture of linen cloth and yarn, which they carry on to a considerable extent.” These small farmers dwelt in thatched cottages of three or four rooms, in which they brought up large families[466]. Besides the farmers, there were the cottiers, who lived in cabins of the poorest construction, sometimes built against the sides of a peat-cutting in the bog. The following table shows the proportion of cottiers to small farmers on certain manors of the Marquis of Abercorn, near Strabane, at the date of the famine in 1817-18 (Rogan, p. 96): Number of Families Manor Farmers Cottiers Derrygoon 368 335 Donelong 243 322 Magevelin and Lismulmughray 319 668 Strabane 302 415 Cloughognal 328 279 The cottiers rented their cabins and potato gardens from the farmers, paying their rent, on terms not advantageous to themselves, by labour on the farm. For a time about the beginning of the century the practice by farmers of taking land on speculation to sublet to cottiers was so common that a class of “middlemen” arose. One pamphleteer during the distress of 1822 speaks of the class of middlemen as an advantage to the cottiers, and regrets that they should have been personally so disreputable as to have become extinct. It is not easy to understand how they served the interests of the cottiers: for the latter were answerable to the landlord for the middleman’s rent, and were themselves over-rented and underpaid for their labour. The system of middlemen did not in matter of fact answer; they hoped to make a profit from the tenants under them, and neglected to work on their own farms; it appears that they were a drunken class, and that they were at length swallowed up in bankruptcy. After the first quarter of the century the cottiers and the landlords (with the agents and the tithe proctors) stood face to face; but at the date of the famine of 1817 there was subletting going on, of which Rogan gives an instructive instance in his district of Ulster[467]. Under this system of subdividing farms and subletting potato gardens with cabins to cottiers, the following enormous populations had sprung up in four parishes within the Dispensary district of Strabane and in four manors of the Marquis of Abercorn adjoining them, but not included in the Dispensary District: Town of Strabane 3896 Parish of Camus 2384 " " Leck 5092 " " Urney 4886 Manor of Magevelin and Lismulmughray 5548 Manor of Donelong 3126 " " Derrygoon 2568 " " Part of Strabane 2796 In the language of the end of the 19th century, this would have been called a “congested district” of Ireland; but all Ireland was then congested to within a million and a half of the utmost limit, so that the famine, which we shall now proceed to follow in this part of Ulster, has to be imagined as equally severe in Connaught, in Munster, and even in parts of Leinster. The Famine and Fevers of 1817-18. The winter of 1815-16 had been unusually prolonged, so that the sowing and planting of 1816 were late. They were hardly over when a rainy summer began, which led to a ruined harvest. The oats never filled, and were given as green fodder to the cattle; in wheat-growing districts, the grain sprouted in the sheaf; the potatoes were a poor yield and watery; such of them as came to the starch-manufacturers were found to contain much less starch than usual. The peat bogs were so wet that the usual quantity of turf for fuel was not secured[468]. This failure of the harvest came at a critical time. The Peace of Paris in 1815 had depressed prices and wages and thrown commerce into confusion. During the booming period of war-prices, from 1803 to 1815, farms and small holdings had doubled or even trebled in rent, and had withal yielded a handsome profit to the farmers and steady work to the labourers. When the extraordinary war expenditure stopped, this factitious prosperity came to a sudden end. The sons of Irish cottiers were not wanted for the war, and the daughters were no longer profitable as flax-spinners to the small farmers. Weavers could hardly earn more than threepence a day, and labourers who could find employment at all had to be content with fourpence or sixpence, without their food. A stone of small watery potatoes cost tenpence; but the value of cattle fell to one-third, and butter brought little. By Christmas the produce of the peasants’ harvest of 1816 was mostly consumed. “Many hundred families holding small farms in the mountains of Tyrone,” says Rogan, “had been obliged to abandon their dwellings in the spring of 1817 and betake themselves to begging, as the only resource left to preserve their lives[469].” At Galway, in January, a mob gathered to stop the sailing of a vessel laden with oatmeal. At Ballyshannon the peasants took to the shore to gather cockles, mussels, limpets and the remains of fish. In some parts the seed potatoes were taken up and consumed. The people wandered about in search of nettles, wild mustard, cabbage-stalks and the like garbage, to stay their stomachs. It was painful, says Carleton, to see a number of people collected at one of the larger dairy farms waiting for the cattle to be blooded (according to custom), so that they might take home some of the blood to eat mixed with a little oatmeal. The want of fuel caused the pot to be set aside, windows and crevices to be stopped, washing of clothes and persons to cease, and the inmates of a cabin to huddle together for warmth. This was far from being the normal state of the cottages or even of the cabins, but cold and hunger made their inmates apathetic. Admitted later to the hospitals for fever, they were found bronzed with dirt, their hair full of vermin, their ragged clothes so foul and rotten that it was more economical to destroy them and replace them than to clean them. Some months passed before this state of things produced fever. The first effect of the bad food through the winter, such as watery potatoes eaten half-cooked for want of fuel, had been dysentery, which became common in February, and was aggravated by the cold in and out of doors. It was confined to the very poorest, and was not contagious, attacking perhaps one or two only in a large family. Comparatively few of those who were attacked by it in the country places came to the Strabane Dispensary; but the dropsy which often attended or followed it brought in a larger number. The following table of cases at the Dispensary shows clearly enough that dysentery and dropsy preceded the fever, which became at length the chief epidemic malady[470]: _Cases at Strabane Dispensary._ 1817 Dropsy Dysentery Typhus June 23 2 10 July 107 31 60 August 40 22 206 September 9 23 287 At a few of the larger towns in each of the provinces typhus had risen in the autumn of 1816 somewhat above the ordinary low level which characterized the years from 1803 to 1816 in Ireland as well as in Britain. At that time there was steadily from year to year a certain amount of typhus in the poorest parts of the towns and here or there among the cabins of the cottiers. Statistically this may be shown by the table of regular admissions to the fever hospitals of some of the chief towns from the date of their opening. _Admissions to Irish Fever Hospitals, 1799-1818._ Dublin, Dublin Cork Waterford Limerick Kilkenny Cork St. House of Fever Fever Fever Fever Year Hospital Industry Hospitals Hospital Hospital Hospital 1799 -- -- -- 146 -- -- 1800 -- -- -- 409 -- -- 1801 -- -- -- 875 -- -- 1802 -- -- -- 419 446 -- 1803 -- -- 254 188 86 73 1804 415 82 190 223 95 80 1805 1024 709 200 297 90 69 1806 1264 1276 441 165 86 56 1807 1100 1289 191 166 84 81 1808 1071 1473 232 157 100 96 1809 1051 1176 278 222 109 116 1810 1774 1474 432 410 120 135 1811 1471 1316 646 331 196 153 1812 2265 2006 617 323 146 156 1813 2627 1870 550 252 227 183 1814 2392 2398 845 175 221 236 1815 3780 2451 717 403 394 249 1816 2763 1669 1026 307 659 162 1817 3682 2860 4866 390 2586 1100 1818 7608 17894 10408 2729 4829 1924 In 1812 the first step was taken towards the adoption of the Poor Law, namely the division of the country into Dispensary Districts, which remained the units of charitable relief until 1839, when the old English system of a poor-rate and parochial Unions was applied to Ireland. During that intermediate period much was left to the medical profession, which contained many well-educated and humane men, to the priests and clergy, and to charitable persons among the laity. There was fever in many places where there were no fever hospitals. A physician at Tralee reported that the back lanes of the town, crowded with cabins, were seldom free from typhus. Rogan gives two instances from the Strabane district in the summer and winter of 1815, at a time when the district was remarkably healthy. A beggar boy was given a night’s lodging by a cottier at Artigarvan, three miles from Strabane. Next morning he was too ill to leave; he lay three weeks in typhus, and gave the disease to twenty-seven persons in the eight cabins which formed the hamlet. A few months after, about a mile from Strabane, a mother fell into typhus and was visited many times by her two married daughters and by others of her children at service in the neighbourhood. Nineteen cases were traced to this focus; “but the actual number attacked was probably more than three times this, as the disease, when once introduced into the town, spread so widely among the lower orders as to create general alarm, and led to the establishment of the small fever ward attached to the Dispensary.” It was in April, 1816, that this was done, two rooms, each with four beds, having been provided at Strabane for fever cases; but at no time until the summer of 1817 were they all occupied at once. The epidemic really began there in May, 1817, in a large house which had been occupied during the winter by a number of families from the mountains; they had brought no furniture with them, nor bedding except their blankets, and lay so close together as to cover the floors. Each room was rented at a shilling a week, the tenant of a room making up his rent by taking in beggars at a penny a night. The floors and stairs were covered with the gathered filth of a whole winter; the straw bedding, never renewed, was thrown into a corner during the day to be spread again at night. Every crevice was stopped to keep out the cold; the rain came in through the roof, the floors were damp, and the cellars of the house full of stagnant water turned putrid. Meanwhile more than a fourth part of the families resident in Strabane, to the number of 1026 persons, were being fed from a soup-house opened early in the spring of 1817, while there were others equally destitute but too proud to ask relief. The rumour of this charity soon brought crowds of people from the surrounding country, with gaunt cheeks, says Carleton, hollow eyes, tottering gait and a look of “painful abstraction” from the unsatisfied craving for food. In the crowd round the soup-shop, the timid girl, the modest mother, the decent farmer scrambled “with as much turbulent solicitation and outcry as if they had been trained, since their very infancy, to all the forms of impudent cant and imposture.” These soup-shops were opened in all the Irish towns. At Strabane some of the richer class lent money to procure supplies, for sale at cost price, of oatmeal, rice and rye-flour, the last being in much request in the form of loaves of black bread. The fever, having begun among the houseful of vagrants above mentioned, made slow progress until June, when it spread through the town, and in the autumn became a serious epidemic. Meantime the soup-kitchen was closed, the supplies having ceased, and the country people returned to their cabins carrying the infection of typhus everywhere with them. By the middle of October, 1817, the epidemic was general in the country round Strabane. The following table shows the rise and decline of the epidemic of typhus in the town itself. _Cases of Fever attended from Strabane Dispensary_[471]. 1817 1818 Jan. 9 83 Feb. 13 46 March 6 60 April 13 48 May 3 39 June 10 71 July 60 106 Aug. 206 90 Sept. 287 57 Oct. 233 49 Nov. 193 40 Dec. 140 38 The exact particulars from the Dispensary district of Strabane show clearly how famine in Ireland is related to fever. The epidemic of typhus was an indirect result of the famine, and was due most of all to the vagrancy which a famine was bound to produce in Ireland, in the absence of a Poor Law. In the spring of 1817, said a gentleman near Tralee, “the whole country appeared to be in motion.” “It was lamentable,” said Peel, in the Commons debate, on 22 April, 1818, “at least it was affecting, that this contagion should have arisen from the open character and feelings of hospitality for which the Irish character was so peculiarly remarkable.” They gathered also at funerals, and, as Graves said of a later epidemic, they were “scrupulous in the performance of wakes.” The concourse of people at the daily distributions of soup was another cause of spreading infection, many of them having come out of infected houses[472]. Of such houses, the lodging-houses of the towns, we have several particular instances. At Strabane, there were four such, which sent ninety-six patients to the fever hospital in eighteen months. At Dublin, a house in Cathedral-lane sent fifty cases to the fever hospitals in a twelvemonth; the house No. 4, Patrick’s close sent thirty cases in eight months; No. 52½ Kevin-street sent from five rooms nineteen persons in six weeks. The spread of the disease was much aided by the ordinary annual migration of harvest labourers. It was the custom every year for cottiers in Connaught to shut up their cabins after the potatoes were planted, and to travel to the country round Dublin in search of work at the hay and corn harvests, leaving their families to beg; in the same way there was an annual migration from Clare to Kilkenny, from Cavan, Longford and Leitrim into Meath, and from Derry into Antrim, Down and Armagh[473]. In the summer of 1817 some parishes of Derry were left with only four or five families. The keeper of the bridge at Toome, over the Bann, counted more than a hundred vagrants every day passing into Antrim, from the middle of May to the beginning of July; and the same might have been seen at the other bridge over the Bann at Portglenone. As the spread of contagion came to be realized, the ordinary hospitality to vagrants ceased. Rogan was struck with the apathy which at length arose towards sick or dead relatives; even parents became callous at the death of their children (of whom many died from smallpox). “For some time,” he says, “it has been as difficult for a pauper bearing the symptoms of ill-health to procure shelter for the night, as it was formerly rare to be refused it.” In Strabane they extemporised a poor’s fund by voluntary contributions of £30 a month, by means of which eighty poor families were kept from begging in the streets. In Dublin there was so much alarm of infection from the number of beggars entering the shops that trade was checked. The following, relating to a town in the centre of Ireland, is an extreme instance of the panic which the idea of contagion at length caused: “In Tullamore, when measures were proposed for arresting the progress of fever, by the establishment of a fever hospital, so little was the alarm that the design was regarded by most of the inhabitants as a well-intentioned project, uncalled for by the circumstances of the community. But when the death of some persons of note excited a sense of danger, alarm commenced, which ended in general dismay: military guards were posted in every avenue leading to this place, for the purpose of intercepting sickly itinerants. The town, from the shops of which the neighbouring country is supplied with articles of all kinds, was thus in a state of blockade. It was apprehended that woollen and cotton goods might be the vehicles of infection, and all intercourse between the shops and purchasers was suspended. Passengers who inadvertently entered the town considered themselves already victims of fever. No person would stop at the public inns, nor hire a carriage for travelling; in a word all communication between the town and the adjacent country was completely interrupted. Apprehension did not proceed in most other places to the same extent as in Tullamore[474].” Several isolated places escaped the epidemic of typhus, either for a time or altogether. The island of Rathlin, seven miles to the west of Antrim, which was as famished as the mainland, had no typhus at the time when it was epidemic along the nearest shore; the island of Cape Clear, at the southernmost point of Ireland, had a similar experience. The whole county of Wexford, where the soil was dry and the harvest of 1816 had been fair, kept free from typhus until 1818, partly because it was out of the way of vagrants. The town of Dingle, at the head of a bay in Kerry, with old Spanish traditions, was totally free from typhus at a time when its near neighbour, Tralee, was full of it, the immunity being set down to the well-being of the population from their industry at the linen manufacture (and fisheries) and their thrifty habits. But the counties of Wexford and Waterford, and other places more or less exempted in 1817, had a full share of the epidemic in 1818, which was the season of its greatest prevalence in most parts of Ireland except Ulster. The harvest of 1817 had been little better than that of the year before, although the potato crop was hardly a failure. The fine summer of 1818 brought out crowds of vagrants who slept in the open, and, when they took the infection, were placed in “fever-huts” erected near the roads[475]. The harvest of that year was abundant, and by the end of 1818 the epidemic had declined everywhere except in Waterford. The most carefully kept statistics of the sickness and mortality were those by Rogan for the Strabane Dispensary district, and the adjoining manors of the Marquis of Abercorn, for each of which a private dispensary was established under the care of a physician. Abstract of Returns of the Dispensary district of Strabane, shewing the numbers ill of fever from the commencement of the epidemic in the summer of 1817, till the end of September, 1818, the numbers labouring under the fever at that date, and the mortality caused by the disease (Rogan, p. 72). Population Ill of Fever Dead Remaining ill Town of Strabane 3896 639 59 13 Parish of Camus 2384 685 61 37 " " Leek 5092 1462 96 57 " " Urney 4886 1381 86 42 --------------------------------------------- 16,258 4167 302 149 Similar return for those parts of the Marquis of Abercorn’s estates not within the Dispensary district: Ill of fever Manors Population (to Oct. 1818) Dead Magevelin and} Lismulmughray} 5548 1666 101 Donelong 3126 1217 71 Derrygoon 2568 1215 90 Part of Strabane 2796 990 75 ----------------------------------- Totals 14,038 5088 337 The proportion of attacks in these tables for a part of Tyrone, one-third to one-fourth of the whole population, is believed to have been a fair average for the whole of Ireland. Each attack, with the weakness that it left behind, lasted about six weeks; cases would occur in a family one after another for several months; in some cottages, says Rogan, only the grandmother escaped. One hundred thousand cases were known to have passed through the hospitals. Harty thought that seven times as many were sick in their cabins or houses, making 800,000 cases in all Ireland in two years; Barker and Cheyne estimated the whole number of cases at a million and a half (1,500,000). The mortality was comparatively small. It comes out greater in the tables for the Strabane district than anywhere else in Ireland except the hospital at Mallow. The following table, compiled by Harty, shows how widely the fatality ranged (if the figures can be trusted), from place to place and from season to season: Proportions of fatal cases of typhus in the chief hospitals of Ireland 1817, 1818 and 1819 (Harty)[476]. 1817 1818 1819 Average One in One in One in One in Dublin 14½ 24 18¼ 20 Kilkenny 16½ 14⅚ 12⅔ 14¼ Dundalk 20-6/7 54 25 30 Belfast 19⅕ 15⅘ 19 17⅓ Newry 21-1/9 34½ 13½ 26 Cork 29 35 35 33⅕ Limerick 13½ 15⅔ 30⅔ 16½ Waterford 27⅓ 25 23⅓ 24⅗ Clonmel 27 18 18¼ 19⅓ Mallow 22½ 9⅗ 12 Killarney 74 67 33 62 Tralee 20¾ 69 43 39 What this meant to particular places will appear from some instances. In the parish of Ardstraw, Tyrone, with a population of about twenty thousand, 504 coffins are stated by the parish minister to have been given to paupers in eighteen months. The burials were about twice as many as in ordinary years, according to the register of the Cathedral churchyard of Armagh: 1815 247 burials 1816 312 " 1817 571 " 1 May-25 Dec. 1818 463 " Of the 463 burials in eight months of 1818, there were 165 from fever, 180 from smallpox, and 118 from other causes. Barker and Cheyne make the whole mortality of the two years from fever and dysentery to have been 65,000; Harty makes it 44,300. But not more than a sixth part of the latter total were registered deaths, and the estimate of the whole may be wide of the mark. In the county of Kerry, ten Catholic priests died of it. Many medical men took it, as well as apothecaries and nurses, and several physicians died, of whom Dr Gillichan, of Dundalk, a young man of good fortune, made a notable sacrifice of his life. Everyone bore willing testimony to the devotion of the Roman Catholic clergy. Some harrowing incidents were reported, such as those from Kanturk, in county Cork: Dr O’Leary visited a low hut in which lay a father and three children: “There were also two grown-up daughters who were obliged to remain for several nights in the open air, not having room in the hut till the father died, when the stronger of the two girls forced herself into his place. On the road leading to Cork, within a mile of this town, I visited a woman of the name of Vaughan, labouring under typhus; on her left lay a child very ill, at the foot of the bed another child just able to crawl about, and on her right the corpse of a third child, who had died two days previously, and which the unhappy mother could not get removed. When the grant arrived from Government, I visited a man of the name of Brahill near the chapel gate, who with his wife and six children occupied a very small house, all of them ill of fever with the exception of one boy, who was so far convalescent as to creep to the door to receive charity from the passengers.” Infants rarely took the fever. Dr Osborne, of Cork, stated that in one instance a physician in attendance on the poor had to separate two children from the bed of their dead brother, the father and mother being already in a fever hospital; in another instance, he had to remove an infant from the corpse of its mother who had just expired in a hovel[477]. Nosologically the epidemic of 1817-18 presented several features of interest. It began with dysentery, and ended with the same in autumn,

Chapters

1. Chapter 1 2. CHAPTER I. 3. CHAPTER II. 4. CHAPTER III. 5. CHAPTER IV. 6. CHAPTER V. 7. CHAPTER VI. 8. CHAPTER VII. 9. CHAPTER VIII. 10. CHAPTER IX. 11. CHAPTER I. 12. 1670. From 1673 to 1676, the constitution was a comatose fever, which 13. 1675. In 1678 the “intermittent” constitution returned, having been absent 14. 1709. The following shows the rise of the price of the quarter of wheat in 15. 600. The infection was virulent during the winter, when Portsmouth was 16. 1754. This outbreak was only one of a series; but as it attacked a 17. 1755. He had the weekly bills of mortality before him, and he makes 18. chapter II.) are not without value, as showing that the “putrid” or 19. 87. It passed as one of the healthiest cities in the kingdom, being far 20. 1795. This epidemic must have been somewhat special to Ashton, for it 21. 1828. It was a somewhat close repetition of the epidemic of 1817-19, 22. 619. In all England, the last quarter of 1846 was also most unhealthy, its 23. 1882. The registration district had only 95 deaths from enteric fever 24. CHAPTER II. 25. 1655. There were twenty-seven victuallers or other ships riding in Dundalk 26. 1818. It was in great part typhus, but towards the end of the epidemic, 27. 1835. It will appear from the following (by Geary) that it was largely an 28. 1849. After the subsidence of the great epidemic of relapsing and typhus 29. CHAPTER III. 30. 1782. It is possible that our own recent experience of a succession of 31. 1551. There were certainly two seasons of these agues, 1557 and 1558, the 32. 1675. The prevailing intermittent fevers, he says, gave place to a new 33. 1686. Sydenham records nothing beyond that date, having shortly after 34. 1775. The latter, however, was a summer epidemic, and was naturally less 35. 1762. On the other hand the epidemics of autumn, winter or spring in 1729, 36. 1782. In the London bills the weekly deaths rose in March, to an average 37. 3. After being general, did it occur for some time in single 38. 5. If so, is it likely that clothes or fomites conveyed it in any 39. 1837. The London bills of mortality compiled by the Parish Clerks’ Company 40. 1733. There is nothing to note between Boyle and Arbuthnot; for Willis 41. 1647. First catarrh mentioned in American annals, in the same year 42. 1655. Influenza in America, in the same year with violent earthquakes 43. 1675. Influenza in Europe while Etna was still in a state of 44. 1688. Influenza in Europe in the same year with an eruption of 45. 1693. Influenza in Europe in the same year with an eruption in Iceland 46. 1688. The greatest of them all, that of Smyrna, on the 10th of July, was a 47. CHAPTER IV. 48. 2. If the patient be sprung from a stock in which smallpox is wont to 49. 3. If the attack fall in the flower of life, when the spirits are 50. 4. If the patient be harassed by fever, or by sorrow, love or any 51. 5. If the patient be given to spirituous liquors, vehement exercise or 52. 6. If the attack come upon women during certain states of health 53. 8. If the heating regimen had been carried to excess, or other 54. 9. If the patient had met a chill at the outset, checking the 55. 11. If the attack happen during a variolous epidemic constitution of 56. 14. If the patient be apprehensive as to the result. 57. 1. Whether the distemper given by inoculation be an effectual security to 58. 2. Whether the hazard of inoculation be considerably less than that of the 59. 1200. In 1754 Middleton had done 800 inoculations, with one death. The 60. 1725. Forty-three died, “mostly of the smallpox.” 61. 1766. The annals kept by Sims of Tyrone overlap those of Rutty by a few 62. introduction of vaccination are still every year inoculated with the 63. introduction into the system;” and this he had been doing in the name of 64. CHAPTER V. 65. 1763. Before the date of the Infirmary Book, Watson records an 66. 1766. May to July. Many entries in the book; Watson says: 67. 1768. Great epidemic, May to July; one hundred and twelve in the 68. 1773. Nov. and Dec. Great epidemic: maximum of 130 cases of measles in 69. 1774. May. A slight outbreak (8 cases at one time). 70. 1783. March and April. Great epidemic: maximum number of cases in the 71. 1786. March and April. Maximum on April 5th--measles 47, recovering 72. 1802. 8 had measles, one died. 73. CHAPTER VI. 74. CHAPTER VII. 75. 1802. It ceased in summer, but returned at intervals during the years 76. introduction of the eruption of scarlatina into his description”--as if 77. CHAPTER VIII. 78. 1665. As Sydenham and Willis have left good accounts of the London 79. CHAPTER IX. 80. 1831. Two medical men were at the same time commissioned by the Government 81. 1832. But in June there was a revival, and thereafter a steady increase to 82. 1533. During the same time Gateshead with a population of 26,000, had 433 83. 1306. As in 1832, the infection appeared to die out in the late spring and 84. 849. The Irish papers in the second period are by T. W. Grimshaw, _Dub. 85. 1710. Engl. transl. of the latter, Lond. 1737. 86. 72. The contention of the inspector was that the water-supply had been 87. 113. Sir W. Cecil writing from Westminster to Sir T. Smith on 29th 88. 437. Heberden’s paper was read at the College, Aug. 11, 1767. 89. 1775. October weekly average 323 births 345 deaths 90. 1852. This has been reprinted and brought down to date by Dr Symes 91. 117. This writer’s object is to show that Liverpool escaped most of the 92. 1783. The influenza also began to appear again; and those who had coughs 93. 1786. In the middle of this season the influenza returned, and colds and 94. 1791. Influenza very bad, especially in London. 95. 1808. If it were possible, from authentic documents to compare the history 96. 142. In one of his cases Willis was at first uncertain as to the 97. 141. In those cases there was no inoculation by puncture or otherwise. 98. 1776. _An Introduction to the Plan of the Inoculation Dispensary._ 1778. 99. 5136. Price, _Revers. Payments_. 4th ed. I. 353. 100. 1799. In a subsequent letter (_Med. Phys. Journ._ V., Dec. 1800), he thus 101. 1809. The _Edin. Med. and Surg. Journal_ (VI. 231), in a long review of 102. 25. Read 1 July, 1794. 103. 1689. Engl. Transl. by Cockburn, 1693, p. 39.

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