Conference report: Medical training, student experience and the transmission of knowledge by Anne Hanley

February 5, 2015, 8:16 am

≫ Next: The historical development of Irish Hospitals and the importance of their records by Brian Donnelly

≪ Previous: Childhood illness in twentieth-century Ireland by Ida Milne

$

0

0

In the first blog post of 2015, Dr Anne Hanley reports on 'Medical training, student experience and the transmission of knowledge' - a conference which took place at the Centre for the History of Medicine in Ireland in October and which was funded by the Irish Research Council and the Wellcome Trust. Podcasts of papers from the conference were recorded by Real Smart Media and may be accessed here. 

I recently attended the conference, 'Medical training, student experience and the transmission of knowledge, c.1800-2014' (or #MTSE14 if you want to look over our live tweets), at University College Dublin. Needless to say its focus, and the discussion generated from its wide-ranging collection of papers, was excellent and very much overdue.

Students dissecting

Medical education

Despite an ever-growing interest in the history of medicine, the subject of medical education and student experience continues to be overlooked (the last international symposium dedicated to this subject having taken place in the early 1990s). Yet throughout the nineteenth century medical education was being increasingly formalized, centralized, and consolidated. It became the backbone of one’s medical career. Strangely, however, it has occupied the negative space in histories of clinical practice and patient care. This omission is incredibly problematic (but I digress…).

So, when Laura Kelly emailed to ask if I would give a paper at a conference devoted to the history of medical training and knowledge production, I sent back an immediate and unequivocal ‘YES!!’. (There were so many excellent papers about which I want to talk that my own paper, ‘Venereology at the Polyclinic’, will have to take a back seat for now.)

Anne Hanley (University of Cambridge): Venereology at the Polyclinic: Postgraduate study among general practitioners in England, 1899-1914

An important focus of MTSE was the centrality of pedagogy. Traditionally, histories of medical education have been written as administrative histories of major teaching hospitals. They have concentrated on the big names, significant infrastructural changes, and major medical developments that altered practice in these hospitals. Rarely have such histories considered in the implications of the big names and significant changes for the day-to-day learning and experiences of students. Happily, however, historians of medicine are beginning to recognize the importance of pedagogically-focused histories and MTSE really demonstrated this change. It brought a whole host of issues to the fore and, as those of you who follow me on Twitter will have gathered, I was rather excited by the rich collection of papers.

Professor John Harley Warner delivering his keynote. Image courtesy of Real Smart Media

John Harley Warner keynote address

We began with the keynote address from John Harley Warner, who introduced us to his most resent and gruesomely fascinating work on the photographic history of dissection in American medical schools. As Warner observed, nineteenth-century medicine was often a solitary occupation and so medical schools provided an important opportunity for group learning and for developing a collective professional identity. And this is particularly well-evidenced in the strange collections of photographs in which groups of students posed around tables upon which they were dissecting cadavers. One particularly interesting aspect of Warner’s keynote was the figure of the medical school porter who often appeared in these photographs and who Warner identified as playing a key role in the facilitation of medical education (but I’ll return to this shortly).

Attendees at MTSE. Image courtesy of Real Smart Media.

Microbes to matron

Many fantastic papers followed, including Claire Jones’s presentation of her most recent research on the ‘Microbes to Matron’s’ project. Her focus on the pedagogy and practice of infection control in British nursing between 1870 and 1900 offers an important counterpoint to what have traditionally been male-focused accounts of medical education. It is very easy to forget that there were (and continue to be) other groups of trained medical professionals beyond doctors who provided care to a wide cross-section of the population. What also interested me about Jones’s paper were the types of sources she and her fellow project investigators are drawing upon. By using surgical nursing examinations, Jones demonstrated the increasingly active role of nurses in their own education, and in surgical practice more broadly.

Dollhouse diorama

Crime scenes and dollhouse dioramas

Similarly, Neil Pemberton’s paper on teaching crime scene investigation through dollhouse dioramas also prompted us to reconsider the role of women in medical and scientific training. By appropriating the traditional female practice of miniature making, women like Frances Glessner Lee created a new way of thinking about crime scene science. Nathalie Sage Pranchèrealso looked at the important role of women in medicine, speaking about the development of nineteenth-century French midwifery training. Importantly, she also described how obstetric teachers used models to develop the anatomical and obstetric knowledge of their midwifery students. As we saw with Pranchère’s paper, the role of material objects in medical training and practice is becoming an increasingly central focus of historical scholarship and this was reflected throughout MTSE. For example, Jenna Dittmar used the collections from Cambridge’s former Anatomical Museum to demonstrate how human remains allow biological anthropologists to examine the historical tools and techniques of dissection.

Speakers Greta Jones, Anne Hanley, Nadav Davidovitch and Victoria Bates. Image courtesy of Real Smart Media.

Spaces of medical education

Another important theme to emerge from MTSE was the different spaces of medical education. Warner described the dissection room as a space for developing collective professional identify. Michael Brown spoke about the dynamic space of the nineteenth century lecture theatre, in which students and their lecturers were appealing to culturally resonant sets of values. Clare Hickmanpresented eighteenth-century botanic gardens as important spaces for thinking about the material culture of medical teaching. Hickman’s paper, like Warner’s keynote, also demonstrated that the history of medical education is never simply about those who learned the art of medicine but also those in the background. Like the African American medical school porters who procured cadavers for students, gardeners were important (but silent and overlooked figures) in the maintenance of teaching spaces and the facilitation of teaching practices.

Attendees at MTSE. Image courtesy of Real Smart Media.

MTSE demonstrated how the nature of medical training has changed over time and within distinct national contexts. Through an excellent collection of papers we explored the emergence of centralized and consolidated systems of medical training. We looked at the development of new tools of training and the different spaces in which these tools were employed. And we looked at how medical knowledge and codes of professional identity were being assimilated by medical and dental students, nursing probationers, midwives, and qualified practitioners seeking further education.

I came away from MTSE with a new appreciation for the diversity of student experiences and systems of knowledge dissemination, and will certainly be drawing upon these ideas in future. With any luck, events like MTSE will slowly begin to generate greater interest in the important place of medical training in wider narratives of medical history.

Dr Anne Hanley is an LHRI Research Fellow at the University of Leeds with particular expertise in the history of modern medicine, medical education, health policy and the history of science. She recently completed her PhD at the University of Cambridge on the development and dissemination of venereological knowledge among English medical professionals, 1886-1913. She writes a blog Clinical Curiosities and tweets at @annerhanley.

---

The historical development of Irish Hospitals and the importance of their records by Brian Donnelly

March 24, 2015, 4:31 am

≫ Next: The Cork Street Fever Hospital Archive

≪ Previous: Conference report: Medical training, student experience and the transmission of knowledge by Anne Hanley

$

0

0

In this month's post, Brian Donnelly, senior archivist at the National Archives of Ireland, outlines the development of Irish hospitals from the eighteenth to the twentieth century.

Rotunda Hospital, Dublin (RCPI Archival collections: VM/1/4/19)

The establishment of the voluntary hospitals

The early eighteenth century saw the establishment of voluntary hospitals by philanthropists, mainly in Dublin but also in the larger provincial towns. Jervis Street hospital (the Charitable Infirmary) was the first voluntary hospital Ireland and was founded in 1718.  Many of these, like Dr. Steeven’s Hospital (founded in 1733) and Mercer’s (founded 1734) would survive into the twentieth century.  The eighteenth century also saw the establishment of specialist hospitals, most of them voluntary, such as the Rotunda Lying In Hospital, founded in 1745, St. Patrick’s Hospital for mental illness, founded in 1747 and the Westmoreland Lock Hospital, for the treatment of venereal disease, in 1792. 

A modern public health service at county level began in 1765 when a parliamentary enactment provided for the erection and support of an infirmary for each county in Ireland and also permitted support for several existing hospitals, mainly in Dublin and Cork, out of public funds.  The county infirmaries were to be maintained by grand jury presentments, parliamentary grants and local subscriptions. The grand juries were groups of landowners who were called together by the High Sheriff in each county twice a year for legal and local administrative reasons.

The House of Industry hospitals, district lunatic asylums and medical dispensaries

The Dublin house of industry, a precursor of the workhouses of the nineteenth century, was founded in 1772. This institution became in time a vast concern, providing hospitals for the sick, an asylum for children, bridewells, penitentiaries for women and young criminals, a house of industry for vagrants, and cells for lunatics.  From it evolved the House of Industry hospitals – the Richmond, Whitworth and Hardwicke - and it played a major role in establishing the first and largest of the public lunatic asylums – the Richmond Lunatic Asylum– which opened for patients in 1814. Following the report of the Committee on the Lunatic Poor in 1817, the Lord Lieutenant was enabled by statute to build asylums where he considered necessary and, over the next half century, a well-developed mental health infrastructure was in place. By 1871, twenty two asylums were being financially supported by the grand juries. In 1850 a central asylum “for insane persons charged with offences in Ireland” was opened in Dundrum. This institution, the first criminal lunatic asylum in these islands, was under the direct control of the Lord Lieutenant who appointed the staff and made regulations for its management. 

A few dispensaries were supported by voluntary subscriptions in several of the larger towns and cities from the late eighteenth century, but it was not until 1805 that grand juries were authorised to give grants to dispensaries in rural areas. By the early 1830s, there were 450 dispensaries throughout the country, administered by committees of management and supported partly by subscriptions and partly by grand jury grants. There were fewer dispensaries in poorer areas, where voluntary contributions were wanting, and where it was difficult to raise enough money to start them. Inadequate as many of these dispensaries were, they represented the first steps towards domiciliary medical treatment of the rural population.

Robert Graves (1796-1853)  (RCPI Archival collections: VM/1/2/S/35)

The impact of epidemics on the development of medical infrastructure

Epidemic disease was a major impetus in the development of a medical infrastructure. Typhus was a major scourge in Ireland in the early nineteenth century and, while several fever hospitals had been established in the larger towns in the late eighteenth century, it was not until 1807 that legislation was passed to encourage their construction throughout the country. A fever epidemic of unprecedented proportions raged in Ireland between 1816 and 1819. Under an 1818 Act, local boards of health could be established, supported partly by grand juries, which had extensive powers to combat disease. Grand juries were empowered to make presentments equal to twice the amount raised by private subscription to build fever hospitals. In 1819, legislation enabled officers of health to be appointed in parishes and a parish health tax could be levied. 

The establishment of the Central Board of Health in 1820 marked a major step in the centralisation of medical relief and local boards of health were to play a major role in combating epidemics over the following decades. The Central Board of Health collected statistics about local health conditions, advised where local boards of health should be established and when grant to hospitals should be made. When cholera broke out in Ireland in March 1832, the Central Board of Health, renamed the Cholera Board for the duration of the epidemic, supervised measures to combat the disease which included the establishment of local boards of health. 

Dublin hospitals like the Meath were at the forefront of the fight against infectious disease from the 1820s and introduced new methods of bedside clinical training to the English speaking world.  The census commissioners noted in 1854 that to these metropolitan hospitals “the Irish School of Medicine is largely indebted for the celebrity which it has so long enjoyed”. The Meath hospital received international recognition in the early nineteenth century due to the innovative teaching methods and research carried out by its physicians, Robert Graves and William Stokes. The latter had survived an attack of typhus in 1827 and identified the first case of cholera in Ireland in 1832. This new approach to clinical training had originated on the continent and its introduction into the Meath hospital heralded what has been described as the heroic age of the Irish School of Medicine. The voluntary hospital infrastructure continued to expand during the nineteenth century and following Catholic Emancipation many Catholic religious orders became involved in founding hospitals.

The Irish Poor Law, 1838

The enactment of the Irish Poor Law of 1838 was to have a dramatic effect on the provision of public health services for the rest of the nineteenth century. The country was divided into over one hundred and fifty poor law unions each with a workhouse at its centre and administered by a board of guardians.The structure of the poor law system, being modern and efficient and more easily subject to central control, was adapted on nearly all occasions where a new local function was created or an old one modified .The Medical Charities Act of 1851 led to the modernisation and extension of the old grand jury dispensary network under the boards of guardians and made a domiciliary medical service available to large sections of the population, the destitute poor, for the first time. 

By 1852, every poor law union had been divided into a number of dispensary districts, each with a dispensary and medical officer.  Patients had to apply to a poor law guardian for a ticket every time they wanted to attend a dispensary free of charge. Committees of management were responsible to the boards of guardians for the management of the dispensaries and appointing the dispensary doctors. In 1863, the dispensary doctors were made registrars of births and deaths and of Roman Catholic marriages and the practice of registering births, marriages and deaths was standardised on the 1^stof January 1864. When registering deaths, the dispensary doctors were required to note the cause of death and duration of illness, thus enabling accurate statistics of mortality to be compiled for the first time. The registration of births enabled such measures as the compulsory vaccination of children against smallpox to be carried out effectively and by the end of the nineteenth century this scourge had, to a great extent, been eliminated.

While many boards of guardians had allowed the non-destitute to enter workhouse hospitals for treatment during the 1850s, the 1862 Poor Law (Amendment) Act officially opened the workhouse hospitals to the non-destitute sick. As a result of these developments, Ireland had one of the most advanced health services in Europe in the mid-nineteenth century, if policy and structure are to be taken as criteria. The Local government (Ireland) Act, 1898, replaced the grand juries by democratically elected county and rural district councils. The county councils took over the administration, either directly or through joint committees, of the district lunatic asylums.

Newcastle Sanatorium, Wicklow. Image courtesy of NLI (L_ROY_05467)

Tuberculosis and the sanatorium

While Ireland had a low death rate from infectious disease in the first decade of the twentieth century, tuberculosis was the marked exception. The last years of the nineteenth century saw the first attacks made against the disease with the establishment of Newcastle Sanatorium in 1893. In 1904, the sanitary authorities of County Cork combined with Cork Corporation to establish Heatherside Sanatorium near Doneraile. In 1907, the Dublin City and County authorities established Crooksling Sanatorium. A Tuberculosis Prevention Act was passed in 1908 which gave the county councils power to provide sanatoria and brought the first veterinary inspectors into the employment of the sanitary authorities.  Peamount Sanatorium was founded in 1912 through the efforts of the Women’s National Health Association, the most formidable health pressure group of the early twentieth century.

Public health provision in post-independent Ireland

The turbulent years of the early 1920s saw some revolutionary changes in the public health system. In general, the boards of guardians outside Dublin were abolished and were replaced by county boards of health and public assistance, essentially sub-committees of the county councils. Most workhouses were closed to save money and central institutions called county homes were established in each county where the poor were to be relieved. While the newly styled county homes were to be reserved in theory for the old and infirm many soon included unmarried mothers, children and the mentally retarded.  Following the establishment of the Irish Free State the Department of Local Government and Public Health formally became, in 1924, the central government authority for local government and health administration. The Minister took over the Lord Lieutenant’s duties in relation to the mental hospitals. In 1930, the establishment of the Irish Hospitals Sweepstakes, a lottery to provide financial assistance to hospitals, provided a financial lifeline to many voluntary hospitals who were struggling to survive following a reduction in the number of endowments and bequests after the Great War.

The post-war period and declining mortality

There were significant developments in health care in the 1940s and 1950s. The Mental Health Treatment Act of 1945 modernised the legal code under which the mental services operated and provided important safeguards against the arbitrary detention of patients although the numbers of persons being treated continued to increase until, by 1959, there were 20,000 patients in Irish mental hospitals.  In the years immediately after 1945 there was a major effort to develop anti-tuberculosis services. The Tuberculosis (Establishment of Sanitoria) Act of 1945 permitted the Minister for Local Government and Public Health to arrange for the building of sanatoria and to transfer these to local authorities when completed. This was a major departure from established practice for the central authority as it stepped outside its normal functions of directing and co-ordinating the local services. Sanatoria were built at Dublin, Cork and Galway and were handed over when completed to the local authorities as was provided under the Act. 

There was also widespread building and conversion of buildings for the treatment of tuberculosis cases by local authorities.  These developments, together with the payment of maintenance allowances for dependents of persons undergoing treatment for infectious disease, mass radiography, BCG vaccination and new drugs such as streptomycin, led to a great decline in mortality for the disease and in the number of new cases appearing.  In 1947 the Department of Local Government and Public Health was divided into two separate departments. The Health Act of 1953 extended eligibility for general hospital services and maternity care to a much wider class. Health authorities were now required to provide child welfare clinic services and the school health service was improved. The dispensary service and dispensary doctors were transferred from the public assistance code to the health authorities. The old dispensary ticket system was done away with and replaced by medical cards. A more liberal code for the governing of county homes was introduced and provision was made for the development of a comprehensive rehabilitation service.

William Stokes (1804-78) and William Wilde (1815-76) (RCPI Archival Collections: PDH/6/2/12)

1970s regionalisation and the Irish 'love affair' with the hospital bed

By the 1960s, it was felt that as the state had taken over the major financial interest in the health service there should be a new administrative framework combining national and local interests.  For technical and logistical reasons it was believed that better services could be provided on a regional rather than a county basis.  The establishment of the health boards under the Health Act, 1970, marked a major break in the link between the health services and county administration. At this time Ireland had the highest proportion of hospital beds to population in western Europe and the Irish hospital system was described as “one of a large number of small institutions scattered throughout the country”. The following decades would see the closure or amalgamation of many voluntary and state hospitals into larger units and the dismantling of the old mental hospital infrastructure.

The historical value of Irish hospital records

That Irish hospital records are of great historical interest has long been acknowledged. Dr. William Wilde, the internationally renowned nineteenth century physician and statistician, recognised one hundred and seventy years ago that the hospital registers of the Rotunda Hospital represented the ‘most interesting and earliest statistical tables on record’.  Ireland’s medical institutions, both voluntary and public, have a peculiarly rich and varied history and have played a paramount role in medical advances over the last three centuries.  While some collections of hospital archives are now safe in archival custody, many collections remain in peril. These archives have no protection under the law and it is often only through the good offices of interested hospital staff that material has been preserved. 

Brian Donnelly is a Senior Archivist at the National Archives with responsibility for Business and Hospital records. Images courtesy of Fergus Brády, Archivist, RCPI. 

The Cork Street Fever Hospital Archive

May 5, 2015, 1:45 am

≫ Next: Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000

≪ Previous: The historical development of Irish Hospitals and the importance of their records by Brian Donnelly

$

0

0

In 2013, the Cork Street Fever Hospital archive was donated to the Royal College of Physicians of Ireland (RCPI). Following a recent funding award, the archivists at the RCPI began the process of cataloguing and preserving these extensive and important medical records. The project is now complete and the final collection list is available to browse through the online RCPI catalogue. In this month's post, Fergus Brady, Archivist, RCPI, reports on the archive and outlines the history of this fascinating Irish medical institution.

Nurses and patients on the 'lower landing', Cork Street Fever Hospital, 1903 (RCPI Archival Collections: CSFH/1/2/1/6)

RCPI win Wellcome Trust funding to catalogue Cork Fever Hospital Archive

A project, funded by the Wellcome Trust, to fully catalogue the archive of Cork Street Fever Hospital has been completed by the staff of the Royal College Physicians of Ireland Heritage Centre. As part of the project, appropriate measures were also taken to ensure the long-term preservation of the archive so that the hospital’s records will be accessible to researchers both in the present and into the future.

The origins of the House of Recovery and Fever Hospital, Cork Street, Dublin

Minutes, Governors of Cork Street Fever Hospital, 1801 (RCPI Archival Collections: CSFH/1/1/1)

The House of Recovery and Fever Hospital on Cork Street, Dublin, grew out of a series of meetings held between a group of wealthy and philanthropic men drawn from Anglican and Quaker congregations during October 1801. In the late eighteenth and early nineteenth centuries in Dublin, as elsewhere in Europe, insanitary conditions ensured that infectious diseases were prevalent among the general population. Those present at the October meetings had a clear idea of the nature and scale of such health issues, stating that ‘...no adequate Hospital accommodation has hitherto been provided for the relief of the Sick poor of Dublin afflicted with fever (especially such as may be of a contagious Nature)’. Influenced by the fever hospital movement in Britain, the provisional Committee believed that the solution lay in the ‘establishment of a House of Recovery to which patients on the first appearance of Fever might be removed’.¹

The fever hospital opens

Original entrance to the hospital, erected 1804 (RCPI Archival Collections: CSFH/7/1/6)

Less than three years later, on 14 May 1804, the newly-erected House of Recovery and Fever Hospital on Cork Street admitted its first batch of patients. As its name suggests, the hospital physically separated the sick from the convalescent by the constructing two buildings 116 feet apart in what was an early attempt at infection control.²The erection of such purpose-built buildings was intentional, as the hospital’s founders were influenced by prevailing theories regarding the control of infectious diseases.

Early years and fever epidemics

Cork Street Fever Hospital and House of Recovery, 1899 (RCPI Archival Collections: CSFH/1/2/1/5)

In the early decades of the hospital’s existence its catchment area expanded from the Dublin Liberties to the whole of the city. Hospital buildings were extended to meet the admissions triggered by the regular epidemics which ravaged the poorest districts in the city. A fever epidemic in 1817—1819 put severe pressure on the hospital, with admissions doubling in 1818. In 1826 an epidemic of typhus necessitated the erection of emergency tents. The 1830s and 1840s were periods of exceptional activity, as the number of patients admitted swelled due to outbreaks of cholera and typhus. In 1847 tents were erected and 400 emergency beds provided to allow for the admission of patients suffering from a typhus outbreak, which had been stimulated in large part by the influx into Dublin of thousands of famine-stricken refugees from the countryside. These regular epidemics took their toll on the health of the medical staff, and in particular the nursing staff, many of whom were struck down with fevers contracted during the course of their work.

The 'Red House'

Nurse and two children on the balcony of the Red House, 1909 (RCPI Archival Collections: CSFH1/2/1/6)

In the 1860s and 1870s epidemics of smallpox placed great pressure on the hospital’s resources, with a record case fatality rate of 21 per cent recorded in 1878. In the last few decades of the century measles, typhoid, scarlet fever and smallpox predominated, prompting the hospital governors to build the ‘Red House’ on the grounds of Cork Street, and to open an auxiliary hospital for convalescents at Beneavin, Finglas. In 1891, hospital reports recorded diphtheria for the first time, a disease which became a significant health problem in the early twentieth century with the arrival in Dublin of the virulentgravis strain.

The move to Cherry Orchard

Patient arriving at hospital in ambulance, 1896 (RCPI Archival Collections: CSFH/1/2/1/5)

In the early twentieth century there were two changes that significantly altered the running of the hospital: in 1904, the hospital was granted a Royal Charter under which Dr. John Marshall Day was designated first Medical Superintendent; and, in 1936, the Dublin Fever Hospital Act changed the hospital from voluntary to municipal control. This alteration sought to “make provision for the establishment of a new fever hospital in or near the city of Dublin and for the closing of the House of Recovery and Fever Hospital, Cork Street, Dublin”.³Planning for the development of a new hospital was long and protracted, however, with both the Second Word War and a 1944 sworn inquiry into alleged maladministration in the hospital contributing to delays. Led by the efforts of Dr. Day’s successor as Medical Superintendent, Dr. C. J. McSweeney, a 74-acre site was finally secured at Blackditch, Palmerstown, Co. Dublin, and building tenders received in early 1950. The hospital board decided that as the name Blackditch evoked images of plague and death, the address of the new hospital should be changed to Cherry Orchard. In November 1953, patients and staff vacated the premises at Cork Street and moved to the new House of Recovery and Dublin Fever Hospital, Cherry Orchard.

The Cork Street Fever Hospital archive

Staff of Cork Street Fever Hospital, 1938 Dr. C. J. McSweeney, Medical Superintendent, is pictured sixth from the right in the second row (RCPI Archival Collections: CSFH/1/3/4/1)

The archive of Cork Street Fever Hospital is large and varied, and consists of a series of records relating to hospital management, staff, students, patients, finances, buildings, hospital history and events. There are also records of inquiries, routine administration and domestic tasks, and individual Medical Superintendents. The run of minute books is remarkably complete, stretching from the first meetings of the provisional managing committee in 1801 to 1953, a span interrupted only by a gap of twelve years between 1828 and 1842. Similarly annual reports, which usually include medical reports, run from 1801 to 1953 with few omissions. Records relating to individual Medical Superintendents are particularly plentiful for Dr. C. J. McSweeney’s tenure (1934–1953), and consist for the most part in report books, research and teaching notes, drafts of articles and papers, and other ephemera. Patient records are, unfortunately, less comprehensive, with the earliest surviving register of patients dating from 1924 to 1929. Access to patient records and other sensitive files containing personal data are subject to Data Protection legislation and conditions laid out in the RCPI Heritage Centre’s guidelines. There are also some records across the various series which date from the decades following the transfer of the hospital to Cherry Orchard.

If you have any queries about the collection, please contact heritagecentre@rcpi.ie.

---

1. Cork Street Fever Hospital Committee Proceedings, 23 October 1801.↩
2. Patricia Conway, Sheila Fitzgerald and Seamus O’Dea, Cherry Orchard Hospital: The First 50 Years (Dublin, 2003), p.  2.↩
3. Ibid., p. 3.↩

Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000

May 20, 2015, 4:09 am

≫ Next: A Knight at the Theatre: the Adelaide Hospital and Denominational Divisions in Dublin's Voluntary Hospitals

≪ Previous: The Cork Street Fever Hospital Archive

$

0

0

Prisoner Health Project: Wellcome Trust Senior Investigator Award

A major new research project in the history medicine has just been launched: 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000'. This collaborative, five-year study, funded by a Wellcome Trust Senior Investigator Award, is being led by co-Principal Investigators, Professor Hilary Marland, of the Centre for the History of Medicine, University of Warwick, and Dr. Catherine Cox, Director of the Centre for the History of Medicine in Ireland, University College Dublin.

Strangely, the history of medicine, despite its strong focus on the history of institutions, has neglected the prison as a site of medical treatment. It's great to see that such an ambitious project is going to address this omission. That this is a comparative research project is also exciting; comparative historical analysis, despite its strong tradition in the social sciences and a limited recent resurgence, is long overdue a renewal.

Project aims

The co-Principal Investigators, Catherine and Hilary, are keen for the project's research to resonate with contemporary concerns in the prison service and they aim to tackle historical questions of prisoner health that are still relevant today. For example, they and their team are going to look at the high incidence of mental illness amongst prisoners, the health of women prisoners and the status of prison maternity services, as well as the response to prisoner substance abuse and the impact of HIV/AIDS. All of these topics are still major concerns in the medical management of contemporary prison populations in Ireland and England. 

Late nineteenth-century photographs of prisoners in Reading Gaol Berkshire Records Office P/RP1/5/2 Source: Berkshire Family Historian

Scope of project

Each of the different research strands within the project will cover the period from rise of the modern penal system during the mid-nineteenth century up to the present. Fundamental to the project is the comparative analysis of English and Irish prison services and the conceptual basis of prisoners' entitlement to health in both England and Ireland. 

Prisoner health and human rights

The project team is going to address the question of who advocates for prisoners' health, both within and without the prison service. They will also investigate the extent to which prisoners have been seen as entitled to health care and if human rights debates have had any influence on the provision of medical care for prisoners. Another principal area of historical inquiry is going to be the extent to which prison doctors have felt themselves to be constrained by dual and conflicting loyalties to the prison regime and to their prisoner patients. 

Policy workshops and public engagement

Hilary and Catherine have also said that the project is going to engage with policy makers and prison reform organisations, including the Howard League for Penal Reform. With that in mind, they are busily preparing several policy workshops and compiling a list of potential invitees. They also hope to engage with the general public and people working in the area of prisoner welfare through a series of outreach projects. Among the most interesting of these are their plans to commission both a theatrical production and a piece of artwork that will be based on their team's research findings. 

Project members

Dr. Catherine Cox, University College Dublin, Principal Investigator. 

Professor Hilary Marland, University of Warwick, Principal Investigator.

Both Hilary and Catherine are working on the relationship between the prison system and mental illness – a subject of acute contemporary relevance considering the high levels psychiatric morbidity amongst prisoners – and they are also looking at the impact of the prison on prisoner mental health. In addition, Catherine will focus on the evolution of the separate system in Ireland and its impact on mental health while Hilary will examine the question of women and mental health in the prison system.

Dr. Will Murphy, Mater Dei Institute, Dublin City University, is researching the health of political prisoners and the impact they had in shaping attitudes and practices of health and medicine in Irish and English prisons.

Dr. Fiachra Byrne, University College Dublin, Postdoctoral Research Fellow (3 years), is working on the mental health of juvenile prisoners in England and Ireland.

Dr. Nicholas Duvall, University of Warwick (year 1), University College Dublin (year 2), Postdoctoral Fellow (2 years), is going to be supporting Hilary and Catherine in their research and will also develop his own project on the health of prison officers. 

Dr. Margaret Charleroy, University of Warwick, Postdoctoral Research Fellow (3 years), is working on the management of prisoner health, disease and chronic illness.

A further Postdoctoral Fellow, who will be researching the history of HIV/AIDS in prisons under the supervision of Professor Virginia Berridge at the London School of Hygiene and Tropical Medicine is slated for appointment later this year (2015).  

Public Engagement Officers, at Warwick and Dublin, will be appointed in late 2015. They will have responsibility with implementing the project's arts and policy initiatives.

In 2016, there will be two PhDs appointed to the project. One, based at UCD, will work on prison reform movements; the other, based at Warwick, will investigate the health of women prisoners.

If you want to find out more about 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000', you can visit the UCD project page or the Warwick project page. The project team have also announced their Advisory Board members and provide a list of recent and upcoming project activities.

For further project details or inquiries, you can contact Hilary by email at hilary.marland@warwick.ac.uk or Catherine at catherine.cox@ucd.ie

A Knight at the Theatre: the Adelaide Hospital and Denominational Divisions in Dublin's Voluntary Hospitals

June 9, 2015, 3:53 am

≫ Next: A Question of Authority: the Management of Shell Shock at the Irish War Hospitals during the Great War

≪ Previous: Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000

$

0

0

One of the characteristic features of Dublin's voluntary hospitals has been their long-standing denominational divisions. In this month's blog post Dr Robbie Roulston, UCD, writes about Dublin's Adelaide Hospital, the 'most anti-Catholic hospital in the whole of Dublin', and the government's consternation arising in 1950 when the Irish President, Séan T. O'Kelly, received an invitation to attend one of the hospital's fundraising events. 

Adelaide nurses, on the main staircase of the hospital,1950s

Dublin's Adelaide Hospital

The Adelaide Hospital was founded in 1839 in Dublin for the treatment of poor Protestants in Ireland. As such, the royal charter it was granted placed denominational restrictions on the patients which should be admitted to the hospital. Similar restrictions applied to staff and management. However, what was unusual was the fact that this charter remained in place until 1980.

A 'bitter anti-Catholic reputation'

Such restrictive policies were not unknown to Irish policymakers and caused a considerable degree of tension. In June 1950, the Adelaide Hospital Society issued invitations to various dignitaries for the Gala American Concert, a fundraising event for the Adelaide at the Theatre Royal, in Dublin. Invitations were sent to the Taoiseach, Fine Gael’s John A. Costello, and his wife; to members of the Government; and to a number of Army Officers. All of these officials declined the invitation owing to what the Secretary to the Government described as ‘the bitter anti-Catholic reputation of the Hospital’.

A Knight of Columbanus

Medical students, Adelaide Hospital, n.d.

When an invitation for the President of Ireland, Fianna Fáil’s Seán T. O’Kelly, arrived the government assumed that he too would refuse the invitation. O’Kelly had strong Catholic credentials. He had been one of the few Knights of Columbanus in Eamon de Valera’s cabinet and a proponent of Catholic morality in Irish medical ethics and foreign policy during his career. He had form in condemning restrictive policies in hospitals and twenty years earlier had condemned hospitals which employed religiously restrictive admissions procedures. He had argued then that ‘These barriers are a relic of bygone days and they should be a relic of bygone days.’

'Things had changed now'

The President, Séan T. O'Kelly and Mrs. O'Kelly attend the Gala American Concert to launch the Adelaide Campaign (1950). L. to R.: The American Ambassador (Mr. George Garrett); Lord Farnham (President of the Hospital); Mrs. George Garrett; The President; Mrs. O'Kelly, Mr. Edward Bewley (Chairman).

The presidential O’Kelly, however, was mellower than his former self. When an official in his office approached O’Kelly on the subject, informing him that the Adelaide ‘has the reputation at the moment of being the most anti-Catholic hospital in the whole of Dublin’, O’Kelly responded that he was aware of this. He acknowledged that there was a time when a Catholic priest would not be allowed inside the hospital, but he pointed out that ‘things had changed now to the extent that Catholics are admitted and priests are permitted to see them and administer the sacraments.’

The government remained uneasy and the subject moved up the ladder of protocol when the Taoiseach raised it with O’Kelly the following day. O’Kelly remained firm and informed Costello that he had already accepted the invitation and had promised to go, and that he intended to honour that promise.

O’Kelly continued to attend Adelaide functions when invited and newspapers reported on him attending the Gala American Concert in 1950, a Joseph Szigeti violin recital in 1952, and an Arthur Rubinstein piano recital in 1954.

'She would bid him take out his cheque book'. Cartoon of Adelaide Hospital nurse collecting funds. Drawn by Adelaide doctor, n.d.

A slight against the President

All of this proved very uncomfortable for Irish officials. At the Rubinstein concert the order in which the dignitaries were listed was perceived by officials as a slight against the President – the British ambassador had been listed ahead of the Irish President! A series of notes were passed between the Office of the President, the Chief of Protocol in the Department of External Affairs, and the Irish Embassy in London to see what conventions held there. In the end it was ruled that the ‘the matter is one of tact and good taste rather than of a definitive rule.’ The officials concluded that the Adelaide Hospital erred in a lack of the former rather than by a breach of the latter.

It was decided that no formal protest should be made to the organisers of the concert, but that in future the President’s attendance at such events would be organised more closely with the Secretary to the President to ensure that protocol was followed more strictly.

Ending religious restrictions

Adelaide Hospital nurses in class, n.d.

In the end, the state’s real power to affect change in the management of the hospital would not lie in attendance or non-attendance at its functions or in furious memoranda on the finer points of protocol. Cash was king, and only as the Adelaide’s financial position slid from bad to worse could the state exact the concessions favoured by Irish policy makers and politicians, which was to open up admission and recruitment policies to all people irrespective of their religion. The Adelaide chose to ignore these demands while it was independent of state supports, but as it grew needy it softened its stance on various matters and relaxed most of its religious restrictions.

Dr Robbie Roulston recently completed PhD thesis is entitled, "The Church of Ireland and the Irish State, 1950–1972: Education, Healthcare and Moral Welfare." He has taught on the history of Protestants in twentieth century Ireland in the UCD School of History and Archives. Currently, he holds a position with UCD's Academic Secretariat, working in the areas of higher education policy, governance, strategy.

Below, you can listen to Robbie's presentation at the CHOMI Seminar Series, 3 April 2014, on the Adelaide Hospital

CHOMI Seminar Series, Thursday 3 April 2014
Dr Robbie Roulston (University College Dublin)
"The most priceless possession of Protestants in this country”: the Adelaide Hospital and upholding Protestant healthcare in Ireland 1950-1972.
5 pm, K114, School of History & Archives, UCD.

 

A Question of Authority: the Management of Shell Shock at the Irish War Hospitals during the Great War

August 28, 2015, 11:17 am

≫ Next: Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester One, 2015-2016

≪ Previous: A Knight at the Theatre: the Adelaide Hospital and Denominational Divisions in Dublin's Voluntary Hospitals

$

0

0

In this month's blog post Peter Reid, MLitt research student at the Centre for the History of Medicine in Ireland (CHOMI), UCD, looks at the treatment of shell shock in Ireland during the Great War. He argues that the formation of a rational medical service for these soldiers in Ireland was undermined by the antagonistic relationship between military and civilian medical authorities.

Queen Street, Dublin. Image provided courtesy of Peter Holder, Irish Historical Picture Company

On 22 July 1929, John Kelly, an ex-British soldier, fell from a window of his residence in Dublin's Queen Street and later died from his injuries while being treated at the Richmond Hospital. His wife did not witness his fatal fall, but said that her husband, 'had been in ill-health since his discharge from the army in 1919, suffering from paralysis and shell shock.¹

Until recently, there had been relatively little research undertaken on the management of shell shock in Irish institutions during the Great War. In the case of Britain, Peter Leese has shown that army and military concerns dominated over those of civilian medical experts.² This post argues that a similarly asymmetrical relationship between asylum and military medical personnel was one of the key factors inhibiting the development of a well-coordinated shell shock treatment system in Ireland.

The Irish War Hospitals

The Richmond War Hospital, 1916-1919. Image provided courtesy of the National Archives of Ireland.

In Britain, by 1916, demand had overwhelmed the capacity of treatment facilities for shell shocked soldiers. From the summer of that year, the first treatment centres in Ireland, which would include two war hospitals, began to open in the main urban centres of Dublin and Belfast. The first of the war hospitals, a thirty-two bed unit, the Richmond War Hospital, received its first patients in June 1916. This hospital was a separate block within the grounds of Dublin's Richmond District Lunatic Asylum, allocated by the asylum's board of governance for this purpose. It admitted only British Expeditionary Force soldiers, that is, those soldiers who had served overseas at the Western Front. The main Richmond Asylum itself, however, admitted non-British Expeditionary Forces - the home troops. The army paid a generous stipend to the Richmond Asylum for the care of both categories of soldier.

Belfast District Lunatic Asylum. Image provided courtesy of the National Library of Ireland.

In response to rising casualty numbers, the civil and military authorities agreed to relocate existing patients from the Belfast District Lunatic Asylum and use that facility as another war hospital. The Belfast War Hospital opened in May 1917 under the management of the existing District Lunatic Asylum Committee. It provided 500 beds for the use of both expeditionary and non-expeditionary British service personnel. Dr William Graham, the Medical Superintendent of the Belfast Asylum, remained in place as the medical authority running the new war hospital.

The evidence suggests that Dr William R. Dawson, already a leading figure in Irish medicine and highly regarded by the British army, played a key role in facilitating, if not initiating, both arrangements.

William R. Dawson, appointed by the War Office in 1915, as a specialist in nerve disease to treat British service personnel in Ireland. Image provided courtesy of the Royal College of Physicians of Ireland.

The Resident Medical Superintendents and the Royal Army Medical Corp

King George V Hospital, built 1902 (St Bricin's Military Hospital), Arbour Hill, Dublin. Image courtesy of the National Library of Ireland.

Tensions in the relationship between the Richmond Asylum's Medical Superintendent, Dr John O'Conor Donelan, and his military counterpart, Lieutenant Colonel Hearn, Officer in Charge, George V Hospital, Central Military Hospital Dublin, quickly became apparent. Hearn instructed Donelan by letter that as Officer in Charge of Central Hospital that he, Hearn, was ultimately responsible for all soldiers in the asylum, 'until such time as they are invalided out of the army'.³ Three days later, Hearn again wrote to Donelan and firmly reiterated the point that 'should a man in your opinion require to be moved to the General Asylum [from the Richmond War Hospital] he still remains a soldier until finally discharged from the service by recommendation of the Military Board'.⁴ 

Dr John O'Connor Donelan, Resident Medical Superintendent, Richmond District Lunatic Asylum, Dublin. Image by kind permission of Dr Aidan G. Collins, St. Vincent's Hospital, Fairview, Dublin 3.

The army's insistence on reserving the use of the war hospital solely for expeditionary soldiers, on prioritising their treatment over that of non-expeditionary soldiers, on maintaining their control over the admission and discharge of all military patients, and the complex bureaucratic needs of the military machine, served to insidiously undermine Donelan's authority. Donelan's dissatisfaction with the arrangement is evident in his asylum report of 1917 when he bemoaned the high number of discharges 'classified as only relieved'. He attributed this to 'the fact that a considerable proportion of these were soldiers under temporary treatment, who were removed by the Military Authorities to other asylums before recovery'.⁵ Donelan was implicitly criticising the military authorities for prioritising the needs of the army over the professional opinion of asylum medical officers, in particular himself.

When the Belfast War Hospital opened in May 1917, it was initially managed by the existing District Lunatic Asylum Committee. However, as Lieutenant Colonel J.B. Buchanan, Officer-in-Charge of Holywood Military Hospital, noted in 1919, 'this plan did not prove satisfactory'. When the Resident Medical Superintendent, Dr William Graham, died suddenly in November 1917, the Belfast War Hospital came under the direct control of the War Office.⁶

Consequences of an unsatisfactory relationship

Between 1916 and 1919, the Dublin and Belfast Irish war hospitals treated 1,577 soldiers. However, there were never enough beds in Ireland for emotionally traumatised soldiers such as John Kelly and, by 1921, the 'South Ireland Pension Area' - Ireland exclusive of the province of Ulster - had the longest waiting list in Britain and Ireland for treatment.⁷ The antagonistic relationship between medical and military actors was one factor contributing to this unfortunate situation.

Contemporary relevance

In a report issued in July 2015, the Mental Health Commission identified that a lack of cohesion and 'deep disharmony' between clinicians and managers had undermined clinical governance in Carlow/Kilkenny and South Tipperary and, in early 2014, was associated with a 'spike' in suicides in the region.⁸ This reflects the continuing importance not only of independent surveillance by bodies such as the Mental Health Commission and the Health Information and Quality Authority, but also of managerial and clinical relationships in the delivery of contemporary mental health services in Ireland.

Peter Reid completed a MA in the Social and Cultural History of Medicine at the Centre for the History of Medicine in Ireland (CHOMI), UCD, in 2014. The title of his MA dissertation was, 'The Institutional Management of Soldiers with Shell Shock in Ireland, 1916-19'. In September 2015, Peter will be commencing a MLitt at CHOMI, investigating the treatment of children with disability in early twentieth-century Ireland.

---

1 Irish Times, 24 July 1929.^↩
2 Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (Basingstoke and New York, 2002), 54-6, 98.^↩
3 Letter to Resident Medical Superintendent, Richmond Lunatic Asylum from Lieutenant Colonel Hearn, King George Fifth Hospital, 1 August 1916, Richmond War Hospital Admission and Discharge Book, BR/Priv 1223, NAI.^↩
4 Hearn to Resident Medical Superintendent, Richmond Lunatic Asylum, 4 August 1916.^↩
5 Richmond Asylum Joint Committee Minutes, 1917, 17, BR/Priv 1223, NAI.^↩
6 Medical History of the War: Report in Compliance with War Office Letter No. 24/General Number/6978 (A.M.D.2) 18 October 1919, WO 35/179.^↩
7 Joanna Burke, 'Effeminacy, ethnicity and the end of trauma: the suffering of "shell-shocked" men in Great Britain and Ireland, 1914-39, Journal of Contemporary History, 35, no. 1 (2000), 69.^↩
8 Irish Times, 22 July 2015.^↩

Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester One, 2015-2016

September 1, 2015, 4:50 am

≫ Next: AIDS and History

≪ Previous: A Question of Authority: the Management of Shell Shock at the Irish War Hospitals during the Great War

$

0

0

Centre for the History of Medicine in Ireland (CHOMI), Seminar Series

Semester One, 2015-2016

Thursday 17 September 2015
Dr Georgina Laragy (Queen's University, Belfast)
'Children, welfare and space in the industrial city: Belfast 1880-1939'

Thursday 8 October 2015
Dr John Cunningham (Trinity College Dublin)
'Medicine in early modern Ireland: identifying and locating practitioners'

Thursday 5 November 2015
Dr Ciarán McCabe (Maynooth University)
'"Contagion is supposed to have been introduced from the country": civic and charitable responses to the 1817-19 fever epidemic in Dublin city'

Time: 5 pm (for all seminars)
Location: Room K114, School of History and Archives corridor, Newman Building, Belfield, UCD, Dublin 4.

Download CHOMI Seminar Series Programme

AIDS and History

October 8, 2015, 5:24 am

≫ Next: Adolescence in Modern Irish History

≪ Previous: Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester One, 2015-2016

$

0

0

In this month's blog post, David Kilgannon, a Wellcome Trust funded PhD candidate in the Department of History, NUI Galway, looks at the response of two voluntary organisations, Gay Health Action and the Irish Haemophilia Society, to the arrival of AIDS in 1980s Ireland. In 2015, David completed his Wellcome Trust funded MA on the history of AIDS activism in Ireland at the Centre for the History of Medicine in Ireland, University College Dublin.

First Reported Cases of Aids

Report on the appearance of Kaposi's  Sarcoma and Pneumocystis Pneumonia  among homosexual men in New York  and California, Morbidity and Mortality Weekly Report, 3 July 1981.  Published by the Centers for Disease Control and  Prevention. Public domain.

The first clinical observed cases of AIDS arose among a group of homosexual men in Los Angeles in 1981. All five men presented with Pneumocystis pneumonia, a rare form of pneumonia, which is usually successfully fought off by the human immune system. The increasing prevalence of gay men with impaired immune systems throughout 1981-82 led the US Centers for Disease Control in June 1982 to classify this new disease as Gay Related Immune Deficiency (GRID). However, this model was soon found to be inadequate when non-homosexual patients, including women and children, presented with GRID symptoms. This resulted in the reclassification of the condition as Acquired Immune Deficiency Syndrome, or AIDS, in August 1982.

AIDS: State Response & Policy Failure 

Yet, the initial appearance of AIDS among gay men and intravenous drug users, and its continuing association with these socially marginalised groups was incredibly influential in shaping what were often desultory state responses to the syndrome, with the reaction of national healthcare systems to the incipient epidemic often appearing apathetic and lethargic. For example, in the United States it took a full three years after the first identification of the condition for the Department of Health and Human Services to produce and distribute their first AIDS information booklet for the public. While state responses were often insufficient, the appearance of AIDS instigated a substantial response by voluntary and activists groups. Roy Porter identified this phenomenon as one of the seminal features of the response to the spread of AIDS from the 1980s onwards.

AIDS Activism in Ireland

Number of cases of Sero-positivity in Ireland, 1985-1990

The historical study of AIDS, and AIDS activism in particular, has received sustained historical analysis in the United States and the United Kingdom. However, it has yet to be examined in Ireland. This lacuna is striking, as Ireland arguably presents a distinctive national context relating to AIDS. Three features are particularly notable. The principal prophylactic advocated for AIDS prevention, the condom, had limited availability in Ireland until 1985. Under the Health (Family Planning) Act (1979), anyone wishing to purchase a condom required a doctor's prescription. Secondly, the largest constituent group affected by AIDS in the United States, the gay community, was effectively criminalised in Ireland until 1993. Thirdly, in the 1980s the Irish health service underwent a period of drastic reductions in capacity, losing over a third of hospital beds during this decade. Taken together, these factors make a study of AIDS activism in Ireland particularly worthy of analysis in relation to its counterparts in the broader Anglophone world. My research attempted to examine two such examples of this phenomenon in Ireland. Namely, the activist responses from the gay and haemophilia communities to AIDS, as exemplified through the work of Gay Health Action and the Irish Haemophilia Society. 

Gay Health Action

Number of AIDs cases in Ireland, 1983-1990

The work of Gay Health Action was explored through an examination of their records found in the Irish Queer Archive held at the National Library of Ireland. These sources indicate that Gay Health Action's activism was directly influenced by the international impact and context of AIDS. Articles from the National Gay Federation's magazine Out reveal a community that was quite aware of the devastation of the gay community in other countries. This awareness played a key role in instigating the foundation of Gay Health Action in January 1985 even though AIDS was not yet then a prominent public health threat in Ireland. At that point, only eleven deaths had been attributed to the syndrome in Ireland. Gay Health Action worked to raise awareness by disseminating information on the disorder, producing information leaflets and running education seminars. The group organised itself within the existing structures of the gay community, using already established methods of information dissemination within the community and establishing a telephone helpline that had clear antecedents to earlier forms of gay activism. This led Gay Health Action to take an increasingly prominent role in the management of all matters relating to AIDS in Ireland, speaking as experts on the condition to media and running an information service that superseded the role of the state's Health Education Bureau.

Irish Haemophilia Society

Number of AIDS related deaths in Ireland, 1982-1990

Yet, this form of activist response was not replicated among the varied voluntary groups representing communities that were directly impacted by the advent of AIDS in Ireland. The Irish Haemophilia Society, many of whose members became afflicted with AIDS due to the use of imported blood products which were infected with HIV,  took a quite different approach. As a reading of Lindsay Tribunal Report, the Irish Haemophilia Society's proceedings transcripts, and the society's newsletters reveals, they only began to seriously grapple with the challenge of AIDS following the infection of more than a third of their members. This fact meant that the preventative, public education role fulfilled by an organisation such as Gay Health Action was less relevant to the Irish Haemophilia Society and its members. Instead the organisation focused primarily on providing pastoral care to infected Irish haemophilia sufferers, including supports that assisted those dying from AIDS.

The Voluntary Sector and Epidemic Disease

By examining previously unstudied responses by voluntary groups to an epidemic disease in 1980s Ireland, this project aspires to add greater depth to our knowledge of Irish health policy and the role of the voluntary sector in addressing the challenges associated with an epidemic disease.

David Kilgannon is a PhD researcher in the Department of History in the National University of Ireland (Galway). His project, which is co-supervised by Dr Kevin O'Sullivan and Dr Sarah-Anne Buckley, examines the changing treatment of the disabled in twentieth century Ireland and is funded by the Wellcome Trust. His Master's dissertation, 'How to survive a plague': AIDS activism in Ireland, 1983-1989', examined voluntary sector efforts against the AIDS virus in 1980s Ireland. It was completed in the Centre for the History of Medicine in Ireland, School of History, University College Dublin under the supervision of Dr Catherine Cox.

---

Adolescence in Modern Irish History

October 19, 2015, 2:27 am

≫ Next: Medical Practitioners in Early Modern Irish Wills

≪ Previous: AIDS and History

$

0

0

Purchase from Palgrave Macmillan

September of this year marked the timely arrival of a new and fascinating edited collection, Adolescence in Modern Irish History, published by Palgrave Macmillan - the latest addition to the publisher's impressive and well-received series, Palgrave Studies in the History of Childhood. Edited by Catherine Cox, (Director and co-founder of CHOMI, UCD) and Susannah Riordan, (School of History, UCD), the volume is the first of its kind to address the question of adolescence in Irish history. Its chapters draw together new archival sources and research findings by nine emerging and established scholars working at the cutting edge of research into Irish adolescence. 

Spanning the birth of the 'affective revolution' in the early nineteenth century up to the genesis of the teenager in 1960s Ireland, the essays in this collection explore the emergence of Irish adolescence in its social, economic, political and literary contexts. Engaging with the extensive international literature on the subject, the editors argue that Irish adolescence both resembled and diverged from the British, American and continental European experience during the nineteenth and twentieth centuries. Adolescence in Ireland was particularly shaped by its demography, tied as that was to practices of late marriage, permanent celibacy, large families and the extensive emigration of young people. Coupled with Ireland's limited industrial development and the persistence of the pre-industrial family economy, these conditions strongly informed the possibilities of Irish adolescence in terms of adolescence autonomy, educational opportunities, and employment prospects.

Naturally, the long-shadow of Ireland's apparently troubled relationship with institutions looms large across this volume with a chapter on Irish borstal offenders, extensive treatment of industrial schools, and the confinement of unmarried mothers. Yet Riordan, at least on the question of the young unmarried mother, cautions against the often axiomatic conclusion that the carceral and unforgiving approach to problematic female sexuality so favoured in Ireland can best attributed to clerical actors. Indeed, she finds that in the newly independent Irish state of the 1920s and 1930s, a 'social work lobby', comprising feminist, religious and social work organisations, sought the introduction of protective legislation against the sexual exploitation of the sexually-compromised adolescent who they characterised as typically innocent and subject to seduction and betrayal by older and more powerful men. More punitive perspectives on unmarried, adolescent motherhood were instead more typically the preserve of traditional practitioners of the law and medicine.

Editors: Adolescence in Modern Irish History

Catherine Cox, Director and co-founder of the Centre for the History of Medicine in Ireland (CHOMI), University College Dublin (UCD).

Susannah Riordan, lecturer in Modern Irish History, School of History, UCD, and an associated staff member of CHOMI. 

2010 Workshop

This collection emerged from a workshop in January 2010, which was funded by the Wellcome Trust, the Centre for the History of Medicine, University College Dublin, and the UCD Humanities Institute. 

Contents:

Introduction

Catherine Cox and Susannah Riordan

Robert Hyndman's Toe: Romanticism, Schoolboy Politics and the Affective Revolution in Late Georgian Belfast

Jonathan Jeffrey Wright

'A Sudden and Complete Revolution in the Female': Female Adolescence and the Medical Profession in Post-Famine Ireland

Ann Daly

The 'Wild Irish Girl' in Selected Novels of L.T. Meade

Sandra McEvoy

'The Most Dangerous, Reckless, Passionate .. Period of Their Lives': The Irish Borstal Offender, 1906-1921

Conor Reidy

An Irish Nationalist Adolescence: Na Fianna Éireann, 1909-1923

Marnie Hay

'Storm and Stress': Richard Devane, Adolescent Psychology and the Politics of Protective Legislation 1922-1935

Susannah Riordan

'How Will We Kill the Evening?': 'Degeneracy' and 'Second Generation' Male Adolescence in Independent Ireland

Bryce Evans

A Powerful Antidote? Catholic Youth Clubs in the Sixties

Carole Holohan

The Emergence of an Irish Adolescence: 1920s to 1970s

Mary E. Daly

Medical Practitioners in Early Modern Irish Wills

December 12, 2015, 9:11 am

≫ Next: Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester Two, 2015-2016

≪ Previous: Adolescence in Modern Irish History

$

0

0

The destruction of the Public Records Office of Ireland in the conflagration of 1922 took with it almost all records on the administration of English government in Ireland from the thirteenth century. In this month's blog post, John Cunningham, an Associate Research Fellow on the Wellcome Trust funded project, 'The medical world of early modern England, Wales and Ireland, c. 1500-1715', demonstrates how alternative extant sources can yet throw light on the world of medical practitioners in early modern Ireland.

The Four Courts in Dublin in flames during the Battle of Dublin, 30 June 1922. National Library of Ireland: NLI: HOG57. The Irish Four Courts was occupied by IRA irregulars from April 1922. Marking the beginning of the Irish Civil War, on 28 June, Irish Free-State forces began shelling the Four Courts. On 30 June 1922, the Public Record Office of Ireland, part of Four Courts Complex, was destroyed in a massive explosion of stored munitions.

Information relating to the lives and occupations of medical practitioners can be found scattered across a broad range of sources for the history of early modern Ireland. Given the fact that almost all Irish wills were destroyed in 1922, it could be reasonably assumed that the surviving material of this type is of very limited use for the study of practitioners. Fortunately, however, the availability of some useful indexes and the large number of extant abstracts and notes made by genealogists and others allows for the identification of hundreds of medics active in Ireland between the mid-sixteenth century and 1750.

Early Modern Practitioners Project

As part of my work for the Early Modern Practitioners Project at the University of Exeter, I have recently been exploring surviving wills and other testamentary materials. This research will help to inform the Irish content of our project database, which will contain information on many thousands of medical practitioners in early modern England, Ireland and Wales. In this blog post, I will discuss some of the research challenges posed by Irish wills and briefly highlight a number of ways in which they can serve as a useful source for the history of medicine in Ireland.

Irish Wills as a Historical Source

Although the body of fragmentary will data that has survived for early modern Ireland is dwarfed by the sources of that nature extant for England, wills nonetheless constitute a vital source for the study of many aspects of Irish society in that period. At the same time, it must be recognised that will-making was very far from being a universal activity in early modern Ireland, and that women and persons of lower social status are inevitably under-represented. Moreover, many wills from this period had already been lost before the nineteenth century, when greater efforts were made to preserve such documents and to compile useful indexes

Will Index

Title Page of Vicar's Index to Prerogative Wills.

Post-1922, our insight into a large portion of early modern Irish wills has been confined to index entries. Such indexes are most useful where occupational labels are included alongside names, addresses, and dates, such as in Sir Arthur Vicar's Index to the prerogative wills of Ireland, 1536-1810.¹ Roughly 180 medical doctors, apothecaries, barber-surgeons and surgeons are listed in Vicars for the period up to 1750. For diocesan wills, however, the available indexes often contain little or no occupation data. Here, the Dublin wills index published in 1894 forms a notable and valuable exception, listing the names and occupations of around 115 medics active prior to 1750.²

A will index entry can serve as a useful reference point around which to assemble further information relating to individual practitioners, whether from a related will abstract or from a variety of other sources. James Field M.D. provides a useful early example. His will is indexed in Vicars under the year 1624, with his address given as Dublin.³ A corresponding abstract can be found in Sir William Betham's MSS, giving the names of Field's wife and children, and this information is complemented by the further details given in Field's funeral entry.⁴ This individual can also be found as 'James Fildeus' in the register of medical graduates at Rheims in 1606, the earliest record of a Hibernus occurring in that rich source.⁵ Some context for Field's involvement in medicine is provided by the fact that his surname was an anglicised form of Ó Fithcheallaigh, a Gaelic hereditary medical family active in west Munster.⁶ For example, 'William Fihilly of Limerick, physician' had received a grant of 'English liberty'in 1557.⁷ Another member of this family, Dr John Field, was among those implicated in the 1641 rebellion in Co. Kerry; his estate outside Tralee was confiscated as a result.⁸

Master of the Barber-Surgeons' Guild

Entry in Vicars for William Kelly (1597).

There are at least two practitioners in Vicars who pre-dated Dr James Field: William Kelly, 'gent', who died in 1597; and John Morphy, 'alderman', who died in 1603.⁹ Kelly was master of the barber surgeons' guild in Dublin in 1576, the same year that he took on Morphy as an apprentice.¹⁰ Morphy in turn became master in 1588, and was elected alderman of Dublin in 1596.¹¹ These examples illustrate one of the pitfalls of relying on will indexes for an era when labels of status and occupation could be both fluid and multiple. Fortunately, details of the lives and deaths of both Kelly and Morphy can be recovered from other sources, not least the records of the barber-surgeons guild preserved in the library of Trinity College Dublin.¹² The latter source also sheds some light on the career of Stephen Cradocke, a barber who features in the Dublin diocesan will index under the year 1577.¹³

Dublin Wills entry for Stephen Cradock, a barber.

'Inventory Attached But No Interesting Names'

When moving from indexes to study more detailed will abstracts and copies, it is necessary to keep in mind the extent to which the latter body of material has been shaped by the priorities of nineteenth and early twentieth-century genealogists and other researchers. A brief note attached to an abstract of a Cloyne will from 1727 is illustrative: 'Inventory attached but no interesting names'.¹⁴ My colleague Alan Withey has shown how probate inventories for apothecaries's shops can be used to explore the 'medical marketplace' in early modern Wales. The absence of equivalent material for Ireland is unfortunate.¹⁵

Pages from of one Sybil Kirkpatrick's eight notebooks in which she copied the wills of Irish medical men from originals once held in the Public Record Office. Royal College of Physicians of Ireland, Heritage Centre, TPCK/5/3/1.

In most of the relevant manuscripts, it is necessary to pick out the medical wills from among those made by gentlemen, clergymen, merchants, widows, and others. An exception to this is provided by Sybil Kirkpatrick's notebooks preserved in the Royal College of Physicians of Ireland (RCPI), which contain transcripts of medical wills alone. Kirkpatrick's transcripts, made in the Public Record Office of Ireland in 1910-11, have preserved extensive details of forty pre-1750 wills.¹⁶ Most of these relate to prominent Dublin-based physicians. They thus complement the rich materials compiled by Sybil's better known brother, Thomas Percy Claude Kirkpatrick, also preserved in the RCPI.

Social Networks

Wills do not usually reveal extensive details about the nature and extent of an individual's medical practice. They can, however, contain useful information on aspects such as social networks, status and wealth, patron-client relationships, book ownership, and succession planning. The latter issue unsurprisingly features in some wills made by members of the Gaelic hereditary medical families. The 1663 will of Gerald Fennell, 'Doctor of Phisicke', demonstrated his concern to ensure that his cousin and namesake would be able to continue the family's long tradition of service to the Butlers. He used his will to recommend the younger doctor to the duke and duchess of Ormond, stating that he bad been 'bredd by me for the service of their house'.¹⁷ Similar concern for his family's medical future was shown in the 1728 will of Dr Patrick Shiel of Breandrum, Co. Mayo. He directed that 'unbyassed men' were to decide which of his two nephews, Owen or Patrick, was 'of a superior genius' for the study of medicine. These men were to take account of 'capacity of learning ... gravity of life, probity of manners, good humour and other virtuous qualities'. Shiel's will also reveals marital ties between his family and the Dunlevy or Ultagh family, who had been hereditary physicians to the O'Donnells of Tyrconnell. Shiel himself was closely involved with that branch of the O'Donnells who had relocated to Co. Mayo, in the previous century; he listed Colonel Manus O'Donnell among his 'trusty well beloved friendes'.¹⁸

Dublin College of Physicians

Wills can be helpful too for piecing together the relationship that existed between medics. In his will made in 1677, Dr William Hickey mentioned Dr Thomas Connor.¹⁹ Other sources show that Connor was Hickey's son-in-law, and that both men were active in the Dublin College of Physicians in the 1670s.²⁰ Hickey's will also made reference to the surgeon Nicholas Gernon, who evidently provided him with medical care in his final illness. Gernon was a native of Dublin who had been admitted to freedom in 1644.²¹ When he in turn died around 1692, his widow Bridget remarried to Francis Dempsey, another Dublin surgeon.²² Another of those active in the College of Physicians in the 1670s was Dr Edmund Meara.²³ Decades earlier, in 1638, he had been one of the witnesses to the will of John Verdon, MD, of Dublin.²⁴ A decade earlier again, Verdon and Edmund's father, Dr Dermot Meara, had been involved in efforts to establish a college of physicians in Dublin.²⁵ Another of the witnesses to Verdon's will in 1638 was the barber-surgeon Simon Cullen, while the apothecary Stephen Hore was appointed executor. Little is known of Verdon, but his surname suggests that he originated in Co. Louth, a likelihood reinforced by the reference he made to his 'loving cousin Sir Christopher Bellew'.²⁶

Medical Witnesses

Extract from Ferrar's description of Dr Hall's Alms House. History of Limerick (1787).

One of the trends evident across the period is the appearance of medics as beneficiaries, as executors, or as witnesses to wills of persons of high social status. Given that medics were trusted by their patients and that they were likely to be present when wills were being made shortly before death, this phenomenon is not surprising. A mid-sixteenth century example is provided by the will of Morrough O'Brien, first earl of Thomond, whose 1551 will was witnessed by 'Master Doctor Nelan'.²⁷ Other instances involving noble families include James Fennell, a physician who witnessed the earl of Ormond's will in 1614, and Dr Jeremie Hall, who witnessed the earl of Orrery's will in 1681 and was subsequently appointed an executor by the dowager countess in 1688.²⁸ A full transcript of Hall's will also survives; it provided for the foundation of almshouses and schools both in Limerick and in Boothtown, Yorkshire. This document, containing extensive details relating to his building plans, his books, legacies to Trinity College, Lord Powerscourt and the earls of Orrery, Donegall and Stafford, and various other matters, would have taken some time to compose.²⁹ It certainly lacks the urgency of the will of the Cromwellian Lieutenant-Colonel John Grey, made as he lay dying of wounds following the failed assault on Clonmel in May 1650. Those present included the surgeon John Hoggsfleshe, to whom Grey left £5.³⁰ An episode of altogether more intense medical care is suggested by the 1715 will of Henry Meredith Esq., of Newtown, Co. Meath. It was witnessed by three fellows of the King and Queen's College of Physicians of Ireland: Duncan Cuming; William Smith; and Edward Worth.³¹

Obscure Practitioners

While figures such as Cuming and Worth are relatively well-known, wills and related data can also provide vital evidence for the existence of far more obscure practitioners who may not have left any other trace in the archive. Loughlen Keaghry, 'Dr of Physicke', made his will at Laragh Beg near Athenry in November 1730; unfortunately, I have not yet come across any other reference to him.³² The Hugh Fergus who witnessed his will was presumably the MD of that name, a member of another of the Gaelic hereditary medical families that remained active into the eighteenth century.³³ Another of the obscure individuals to whom I have so far only found one reference is Millisent Alwright, a Dublin midwife who died around 1740.³⁴ It is likely that Keaghry and Alwright will remain among the very many practitioners about whom very little can now be discovered. In many other cases, however, the combination of will data with material drawn from a wide variety of other sources can enable us to learn more about the practitioners who populated the medical world of early modern Ireland.

Can You Help?

To date, my efforts to gather data relating to practitioners have been supported by a number of scholars of early modern Ireland, who have given advice on sources or kindly shared the findings of their own research. As it is not possible for one individual to consult every source, such collective endeavour is essential to maximising the value of our project database, which will be open access and fully available online. I would be very happy to hear from anyone who wishes to contribute advice or information. I can be contacted at cunninjo@tcd.ie

Dr John Cunningham

Dr John Cunningham is an Associate Research Fellow on the Wellcome Trust funded project, 'The Medical World of Early Modern England, Wales and Ireland, c. 1500-1715'. His research focus on this project is on medical practitioners in early modern Ireland. John previously held an Irish Research Council CARA Postdoctoral Mobility Fellowship, during which time he spent two years at the University of Freiburg and a year at Trinity College Dublin (TCD). His project was entitled 'Ireland and Bohemia in the seventeenth century'. He completed his PhD at NUI Galway in 2009. His dissertation was entitled 'Transplantation to Connacht, 1641-1680: theory and practice'. John has taught history in Galway and Dublin, including a seminar course at TCD called 'The Nobility in Early Modern Ireland'. His research interests include early modern Britain and Ireland, the history of medicine, and Central Europe in the early modern period.

Project Podcast

You can listen to a podcast about the project, 'The Medical World of Early Modern England, Wales and Ireland, c. 1500-1715', for BBC History Magazine, from 29 November 2012.

---

1 Arthur Vicars (ed.), Index to the prerogative wills of Ireland, 1536-1810 (Dublin, 1897).^↩
2 Deputy Keeper of Public Records in Ireland (hereafter DKPRI), Twenty-sixth report (Dublin, 1894).^↩
3 Vicars (ed.), Prerogative wills, p. 166.^↩
4 National Library of Ireland (hereafter NLI), Genealogical Office (hereafter GO) MS 225, p. 39; NLI, GO MS 79, p. 117.^↩
5 List of Rheims Graduates, kindly supplied by Professor Laurence Brockliss.^↩
6 Nollaig Ó Muraile, 'The hereditary medical families of Gaelic Ireland', Irish Texts Society Seminar, University College Cork, 7 November 2015. I am grateful to Dr Marc Caball and Dr Declan Downey for their insights into the Field family.^↩
7 Fiants of Philip & Mary, no. 140, in DKPRI, Ninth report (Dublin, 1877), p. 73.^↩
8 Deposition of Stephen Love, 2 February 1644, TCD MS 828, fos 124r-127v; Field, Dr John, The Down Survey of Ireland, Trinity College Dublin (2013).^↩
9 Vicars (ed.), Prerogative wills, pp 264, 337.^↩
10 Barber surgeons, Book of enrolment of apprentices and journeymen, 1530-1607, TCD MS 1447/6, fos 30v-31r.^↩
11 Ibid., fo. 40v; Calendar of the ancient records of Dublin, ed. John T. Gilbert and Rosa Gilbert (19 vols, Dublin 1889-1944), ii, 306.^↩
12 Barber surgeons, Book of enrolment of apprentices and journeymen, 1530-1607, TCD MS 1447/6; NLI, GO MS 65, pp 6, 82; NLI, GO MS 225, pp 188, 264; Fiants of Elizabeth, no. 3747, in DKPRI, Thirteenth report (Dublin, 1881), p. 143.^↩
13 DKPRI, Twenty-sixth report (Dublin, 1894), p. 196; NLI, GO MS 290, p. 70.^↩
14 NLI, GO MS 534, p. 62.^↩
15 Alun Withey, '"Persons that live remote from London": apothecaries and the medical marketplace in seventeenth- and eighteenth-century Wales', Bulletin of the History of Medicine, 85 (2011), pp 222-247.^↩
16 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1.^↩
17 Prerogative will book, 1664-84, NAI, MFGS 41/1, fos 99A-100B.^↩
18 Prerogative will book, 1728-9, NAI, MFGS 41/4, fos 359B-364A.^↩
19 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1, i, p. 71.^↩
20 Account book beginning 21 January 1672, Heritage Centre, RCPI, MS 3/3/1; NLI, GO MS 257, p. 143; NAI, RC 6/3, p. 23.^↩
21 'Nichus Gernon', Ancient Freemen of Dublin Database, Library and Heritage, Dublin City Council. ^↩
22 NLI, GO MS 258, p. 70.^↩
23 Account book beginning 21 January 1672, Heritage Centre, RCPI, MS 3/3/1.^↩
24 NLI, Reports on private collections, no. 32, pp 547-548.^↩
25 Marian Lyons, 'The role of the graduate physicians in professionalising medical practice in Ireland, c. 1619-1654', in James Kelly and Fiona Clark (eds), Ireland and medicine in the seventeenth and eighteenth centuries (Farnham, 2010), p. 25.^↩
26 NLI, Reports on private collections, no. 32, pp 547-548.^↩
27 Brian Ó Dálaigh, 'A comparative study of the wills of the first and fourth earls of Thomond', North Munster Antiquarian Journal, 34 (1992), pp 57-59.^↩
28 T. Blake Butler, Ormond Deeds, viii(Typescript in NLI MSS Reading Room), D3580; NLI, GO MS 532, pp 24-26.^↩
29 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1, i, pp 40-57.^↩
30 NLI, GO MS 530, p. 142.^↩
31 Registry of deeds: abstracts of wills, ed. P. Beryl Eustace (3 vols, Dublin 1954-84), i, no. 101.^↩
32 NLI GO MS 425, p. 109.^↩
33 Vicars (ed.), Prerogative of wills, p. 165; Diarmaid Ó Catháin, 'John Fergus MD: eighteenth-century doctor, book collector and Irish scholar', Journal of the Royal Society of Antiquaries of Ireland, 118 (1988), pp 139-162.^↩
34 NLI, GO MS 257, p. 225.^↩

Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester Two, 2015-2016

January 22, 2016, 6:34 am

≫ Next: 'The Vast and Often Unpermitted Collection Being Organised in my Diocese': The Central Remedial Clinic, the Catholic Church, and Polio Rehabilitation in Dublin During the 1950s

≪ Previous: Medical Practitioners in Early Modern Irish Wills

$

0

0

Centre for the History of Medicine in Ireland (CHOMI), Seminar Series

Semester Two, 2015-2016

Thursday 4 February 2016 

Dr Alice Mauger (University College Dublin)

'The cost of insanity: public, voluntary and private asylum care in nineteenth-century Ireland'

Thursday 3 March 2016

Dr Janet Greenlees (Glasgow Caledonian University)

'The tenuous relationship between gender, health and work, c. 1860-1960'

Thursday 7 April 2016

Dr Luz Mar González-Arias (University of Oviedo)

'Landscapes of pain: the representation of illness in Dorothy Molloy's cancer poetry'

All seminars take place at 5 pm, Room K114, School of History, Newman Building, UCD, Belfield, Dublin 4.

Download CHOMI Seminar Series Programme

'The Vast and Often Unpermitted Collection Being Organised in my Diocese': The Central Remedial Clinic, the Catholic Church, and Polio Rehabilitation in Dublin During the 1950s

January 26, 2016, 7:08 am

≫ Next: Website Launch: Exploring the History of Prisoner Health

≪ Previous: Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester Two, 2015-2016

$

0

0

As the incidence of polio began to rise in Ireland, voluntary organisations such as the Central Remedial Clinic were created to rehabilitate survivors of the disease. In this month's blog post Stephen Bance, PhD candidate at the Centre for the History of Medicine in Ireland, UCD, writes about Archbishop John Charles McQuaid's refusal to support the Central Remedial Clinic, given that it was not '100 per cent Catholic'. Others such as Bing Crosby saw no such problem, and were happy to lend a helping hand.

The Central Remedial Clinic

Occupational Therapy was an important part of the rehabilitation process for polio survivors. Source: Polio Journal: Official Publication of the Infantile Paralysis Fellowship, Ireland, 3:4 (1956), Front Cover.

The creation of rehabilitation facilities for polio survivors in Ireland during the mid-twentieth century was pioneered by voluntary groups. The most active and successful of these organisations was the Central Remedial Clinic (CRC). The CRC was established in 1950 by the remedial gymnast Kathleen O'Rourke and Lady Valerie Goulding, who became a central figure in rehabilitation and philanthropy in Ireland. As a civil-run, non-denominational organisation, the CRC depended upon revenue acquired through fundraising projects, and the success of these enterprises led to their expansion throughout the 1950s. During the same period, the polio rehabilitation unit at Baldoyle Orthopaedic Hospital, which was run by the Sisters of Mercy and was under the patronage of the Archbishop of Dublin John Charles McQuaid, sought public funds to renovate and improve their facility. The Baldoyle Polio Unit, established in 1943, had fallen into a state of disrepair by the early 1950s. The accommodation for patients on site was limited to a collection of dilapidated huts.¹ Reverend Mother Mary Polycarp, who was in charge of the facility, wrote to McQuaid detailing the many anxious nights she had spent praying that the huts would not be 'blown down on the little patients who are in danger'.²

Bing Crosby and the CRC

Bing Crosby, 1967, with his horse Dominion Day, which won the Blandford Stakes at the Curragh with trainer Paddy Prendergast. Crosby took part in fundraising drives for the CRC. Source: Dermot Barry/Irish Times.

With no state aid being made available, both the CRC and the Baldoyle Polio Unit began fundraising campaigns.³ The fundraising methods employed by the Baldoyle committee included radio broadcasts, newspaper advertisements, flag days, sweepstakes and sales of work.⁴ The CRC used similar methods; however, they also harnessed the allure of celebrity to bolster the public profile of their events. For example, a recorded appeal by Bing Crosby was aired on Radio Éireann in 1958,⁵ and Crosby later visited Dublin to speak at a CRC fundraising dinner.⁶

100 per cent Catholic, Only

Archbishop John Charles McQuaid, 1956, at the opening of Our Lady's Children's Hospital, Crumlin. Source.

As the popularity and success of the CRC's fundraising became evident, Archbishop McQuaid wrote to Mother Polycarp expressing his frustration at the 'vast and often unpermitted collection being organised in my diocese by so many persons.'⁷ Given the influence that McQuaid wielded within the voluntary sector, the CRC asked the Archbishop if he would be prepared to be represented on the trustees committee.⁸ McQuaid declined due to the fact that Lady Goulding was not a Catholic, stating that it wasn't his policy 'to belong to something unless it was one hundred per cent Catholic'.⁹

Baldoyle

The Baldoyle fundraising campaign was cut short when McQuaid and the building committee entered into a bargaining process with the Department of Health in order to complete the renovations. The Minister for Health, T.F. O'Higgins, offered to provide funding for the project on condition that the remit of the Baldoyle unit would be expanded to cater for cerebral palsy cases as well as polio cases. This proposal was accepted, and the government provided a £40,000 grant to finish the construction process.¹⁰ The hospital was opened in July 1956. The new facility could accommodate 114 patients and included a school, an occupational therapy unit and a phyisotherapy unit.¹¹

The Archbishop of Dublin, Most Rev. Dr. McQuaid, inspecting the occupational therapy department after he had opened and blessed the new Physiotherapy Unit in St. Mary's Orthopaedic Hospital, Baldoyle. Source: Irish Independent, 22 November 1957

Expansion of the CRC

Lady Valerie Goulding with President Eamon de Valera and children at the Central Remedial Clinic in the early 1970s. Source: Irish Independent.

The success of the fundraising initiatives undertaken by the CRC meant that they expanded independently of the state. A new clinic was opened in Goatstown in January 1955 while a school with the capacity to educate twenty pupils was established on the premises in 1957.¹² By the end of 1958, 700 patients were being treated annually.¹³ A new occupational therapy unit was built in November 1961 and a workshop was opened in March 1963.¹⁴ In December 1968, President de Valera opened the newest branch of the CRC at Clontarf.¹⁵ The Clontarf clinic was the first purpose built complex of its kind in Ireland, and cost approximately £250,000.¹⁶

An Absolutist Approach

McQuaid's snubbing of the CRC conformed to his absolutist approach to voluntarism along denominational lines; a similar situation had unfolded in 1943 when the presence of the Protestant Dorothy Price on the overwhelmingly Catholic executive committe of the National Anti-Tuberculosis League (NATL) led the Archbishop to publicly back the Red Cross Society as a Catholic alternative to the NATL.¹⁷ Similarly, the Baldoyle polio facility provided a 'one hundred per cent Catholic' alternative,and Reverend Mother Polycarp was optimistic that her unit could eventually replace the CRC. She wrote to McQuaid in 1957 stating that: 'when some of the Catholic doctors who are working with Lady Goulding realise your interest in the hospital they may send some of their little polio children on to us. I hope they do, for the children's sake'.¹⁸ This denominational approach to welfare was inherently divisive, but extremely prevalent in mid-twentieth century Ireland.¹⁹

Denominational Welfare

McQuaid's hostility towards the CRC was symptomatic of his combative attitude towards non-Catholic charitable organisations generally. Throughout the mid-twentieth century, the Archbishop readily pitched his organisation against other non-Catholic agencies, such as the St. John's Ambulance Brigade and the NATL.²⁰The social work undertaken by the Archbishop was underpinned by the conviction that the protection of Catholic children meant the protection of the next generation of souls.²¹ However, unlike his response to the NATL in 1943, McQuaid declined to publicly articulate his aversion to the CRC. Definitive reasons for this discreet approach are not clear, however the series of very public altercations involving the Catholic hierarchy, the state and medical community during the previous decade, not least the Mother and Child Controversy, may have tempered somewhat McQuaid's desire to openly oppose the activities of non-Catholic voluntarism in the field of polio rehabilitation.

Stephen Bance

Stephen Bance is an Irish Research Council funded PhD Candidate at the Centre for the History of Medicine in Ireland (CHOMI), UCD. His thesis is provisionally titled, '"Crippled, Maimed, Lamed, Shattered and Broken": The Irish Experience of Polio, 1942-1970'. His PhD supervisor is Dr Catherine Cox. He received his BA in Single Honours History (UCD) in 2012, and went on to successfully complete the CHOMI MA programme on the Social and Cultural History of Medicine the following year.

---

1 Letter of appeal Joseph Bryan, Treasurer Baldoyle Building Committee, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
2 Letter Sister M. Polycarp to John Charles McQuaid, Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
3 Letter Desmond O'Callaghan, Honorary Secretary, Baldoyle Building Committee, to Sister M. Polycarp, 16 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
4 Ibid.^↩
5 Irish Times, 13 Mar. 1958.^↩
6 Jacqueline Hayden, Lady G- A Biography of the Honourable Lady Goulding LL D (Dublin, 1994), p. 108.^↩
7 Letter from John Charles McQuaid to Sister M. Polycarp, 11 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
8 Letter from Father Paddy Crean to John Charles McQuaid, 13 May 1951, DDA L Files, Central Remedial Clinic 9/2.^↩
9 Hayden, Lady G-, p. 103.^↩
10 Irish Times, 5 July 1956.^↩
11 Ibid.^↩
12 Irish Times, 13 Jan 1955; Irish Times, 21 Feb. 1957.^↩
13 Irish Times, 1 Sept. 1958.^↩
14 Irish Times, 2 Nov. 1961; Irish Times, 15 Mar. 1963.^↩
15 Irish Times, 11 Jan. 1966.^↩
16 Irish Times, 17 Jan. 1966.^↩
17 See Anne MacLellan, '"That Preventable and Curable Disease": Dr Dorothy Price and the Eradication of Tuberculosis in Ireland, 1930-1960' (PhD Thesis, University College Dublin, 2011), p. 108.^↩
18 Letter from Sister M. Polycarp to John Charles McQuaid, 22 Nov. 1957, DDA Files, Central Remedial Clinic 9/1.^↩
19 Lindsey Earner-Byrne, Mother and Child: Maternity and Child Welfare in Dublin 1922-60 (Manchester, 2007), p. 223.^↩
20 Lindsey Earner-Byrne, 'Managing Motherhood: Negotiating a Maternity Service for Catholic Mothers in Dublin, 1930-54', Social History of Medicine 19:2 (2006), 267.^↩
21 Ibid.^↩

Website Launch: Exploring the History of Prisoner Health

February 5, 2016, 7:41 am

≫ Next: Parochial Officers of Health in pre-Famine Dublin by Ciarán McCabe

≪ Previous: 'The Vast and Often Unpermitted Collection Being Organised in my Diocese': The Central Remedial Clinic, the Catholic Church, and Polio Rehabilitation in Dublin During the 1950s

$

0

0

A new website, Exploring the History of Prisoner Health - or histprisonhealth.com - has been launched by the team (co-PIs Dr Catherine Cox (CHOMI, UCD) and Professor Hilary Marland (CHM, University of Warwick)) researching the Wellcome Trust-funded project, 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000'.

Policy Workshop

Exploring the History of Prisoner Health, has been launched in advance of the project's upcoming policy workshop, The Prison and Mental Health - From Confinement to Diversion, which is going to be held in the Shard, London, 12 February. The workshop itself aims  to explore the potential for historians, criminologists, NGOs, policy makers and prison service employees to share ideas and information around the theme of mental health in the prison system.

Project Themes

The website's blog details some of the main project research strands on prisoner mental illness, physical health, juvenile prisoners, political prisoners, as well as the Prison Medical Service. Content will be developed as research progresses and new strands come on board.

Parochial Officers of Health in pre-Famine Dublin by Ciarán McCabe

February 22, 2016, 3:27 am

≫ Next: MA in the History of Welfare and Medicine in Society

≪ Previous: Website Launch: Exploring the History of Prisoner Health

$

0

0

In this month's blog Dr Ciaran McCabe, an Irish Research Council funded postdoctoral fellow  (NUI Galway), considers the oft-neglected figure of the parochial health officer and his role in the prevention of contagion and fighting fever epidemics in early nineteenth-century Ireland. In 2011, Dr McCabe successfully completed a MA thesis at the Centre for the History of Medicine in Ireland, UCD, on the impact of the 1817-19 and 1826-27 fever epidemics on the Cork Street Fever Hospital, Dublin. 

Preventing the Danger of Contagion and Other Evils

The Fever Act of 1819 empowered parish  vestries to elect unpaid officers of health

From the middle of the seventeenth century, civil parish vestries in Ireland carried out functions which we would today associate with local government services: fire-fighting, tree planting, public lighting, and the repair of roads. Parishes also undertook to provide some assistance to local parishioners in distress and this relief included the support of local 'foundlings', the purchase of coffins for local paupers, payments of cash to widows and the maintenance of an alms-house, typically inhabited by local widows. Parish vestries were of such importance as units of local government that it was upon them that powers were bestowed for the prevention of contagion in response to the 1817-19 fever epidemic. The 1819 Fever Act empowered parish vestries to elect unpaid officers of health, who had the authority to direct that tenements, lanes and streets be cleaned, and that nuisances be removed from the streets. These officers also had the power to apprehend and dismiss from the parish 'all idle poor Persons, Men, Women, or Children, and all Persons who may be found begging or seeking Relief' in the interest of 'preventing the Danger of Contagion and other Evils'.¹

Officers of Health: Respectable Parishioners

The positions of officers of health were filled by respectable parishioners, who also typically served as churchwardens, sidesmen and overseers. To these men (and they were invariably men), such voluntary service gave them an opportunity to display their civil responsibilities, as well as asserting their prominence within the community. Toby Barnard has argued that 'as in England, so in Protestant Ireland, a willingness regularly to assume the burdens of parochial office may have helped the middling sort to define and so distinguish themselves from the lower ranks'.² Among the officers of health in St Michan's parish in the 1830s were Mark Flower of Old Church Street and merchant William Hill of 47 Pill Lane, who also served together as sidesmen and overseers of licenced houses.³ In some instances, parishioners who were qualified medical practitioners  were elected to serve as officers of health, such as David Brereton MD in St Michan's in 1831.⁴ In St Thomas's parish in 1828, four of the ten elected officers of health were medical practitioners.⁵

The Fever Act (1819)

A notice issued by the officers of health in St Werburgh parish, November 1831

The Fever Act was passed in June 1819, by which point the nationwide fever epidemic had petered out. With the emergency over, parishes were slow to fill the positions of officers of health, which, while not encompassing any salary, required the levying of a parish cess to cover expenses. Shortly after the legislation was passed, the Head of Police wrote to each of the Dublin parishes, reminding them of of their duties to elect officers under the new Fever Act.⁶ In St Catherine's the first officers of health were appointed two months after the legislation was passed while it took nine months for the first officers to be appointed in St Werburgh's parish.⁷ Such delays could be criticised, yet on the other hand, given that the worst of the epidemic had passed, parishes were understandably reluctant to assume additional expenditure on unnecessary undertakings.

Cholera Epidemic

Freeman’s Journal, 17 November 1831. The parish vestry  of St Anne’s in Dublin city appointed officers of health in  late-1831, following reports that cholera had reached  England and was believed likely to spread to Ireland

For the first decade after the enactment of the 1819 fever legislation, many parishes avoided filling these positions. Parish expenditure had to be raised through the taxation of local parishioners, who, in some cases in Dublin city, paid up to sixteen different taxes to various local authorities.⁸ The significance of the 1819 Fever Act, empowering parish vestries to spearhead the local responses to epidemic disease, was not realised until more than a decade after its enactment, when cholera made its first appearance in western Europe. In late-1831, when reports reached Ireland that cholera had been identified in England, parish vestries throughout the country held emergency meetings, drawing on their powers under the 1819 act and rapidly appointing officers of health as a measure to prevent – albeit unsuccessfully – the introduction and propagation of cholera.

To Guard Against Contagion

In St Andrew's parish in December 1831, a cess was levied on parishioners to enable the work of the officers of health by means of 'cleansing & whitewashing the dwellings of the poor in order to guard against contagion'.⁹ Two weeks earlier in St Catherine's parish, the sum of £50 was levied on parishioners following reports 'that a pestilential has raged in several parts of Europe form sometime under the name of Cholera Morbus, which it is feared may shortly extend its ravages to this Kingdom'.¹⁰ Cholera eventually reached Ireland in the spring of 1832 and throughout the epidemic, parochial officers of health carried out measures to mitigate the impact of the contagion. A question which remains unanswered is how the parochial officers of health interacted with other authorities, such as the state-run Board of Health. The rejection in October 1832 by officers of St James's parish of the Board of Health's right to interfere in parochial matters suggests the existence of inherent tensions between these parties, yet the extent to which this single instance is representative of a wider trend is as of yet unclear.¹¹

A dead cholera victim in Sunderland, 1832. Following the outbreak of cholera in north-east England, Irish parish vestries rushed to appoint officers of health. Wellcome Images

The Decline of the Parochial Officer of Health

Some parishes continued to appoint officers of health throughout the 1830s but the practice declined by the 1840s; yet there are some instances of officers being appointed by parishes in Ulster into the 1850s.¹² The power of parish vestries to appoint officers of health was repealed by the 1866 Sanitary Act,¹³ which extended earlier legislation for England to Ireland and was passed at the height of yet another cholera epidemic. Responsibility for sanitary regulations was transferred to a new Public Health Committee, which operated under the auspices of Dublin Corporation.¹⁴ As well as reflecting wider developments in public health reform in this period, the decline of the parochial officer of health was also a symptom of the gradual removal of civil functions from Irish parish vestries. Although constituting relatively short-lived positions with limited powers, and whose efficacy in mitigating the impact of contagion is difficult to gauge, parochial officers of health remain an interesting and neglected part of the social and medical landscape of nineteenth-century Ireland.

Dr Ciarán McCabe

Dr Ciarán McCabe is an Irish Research Council Government of Ireland postdoctoral fellow at the Moore Institute, NUI Galway. In 2015 he was awarded a PhD by Maynooth University for his thesis which examined begging and alms-giving in pre-Famine Ireland. He is currently writing a monograph arising from his doctoral research. Dr McCabe holds a Masters in the Social and Cultural History of Medicine from the Centre for the History of Medicine in Ireland (CHOMI), UCD and also serves as compiler for Irish History Online.

---

1 An act to establish Regulations for preventing Contagious Diseases in Ireland', 59 Geo. III, c. 41 (14 June 1819).^↩
2 Toby Barnard, A New Anatomy of Ireland: The Irish Protestants, 1649-1770 (New Haven and London), 2003), p. 242.^↩
3 St Michan's parish, Dublin, vestry minute book, 7 April 1828 (Representative Church Body Library (RCBL), St Michan's parish, Dublin, vestry minute books, P 276.05.5; ibid., 23 December 1828; ibid., 9 April 1832; 20 April 1835. Hill also served as churchwarden: ibid., 4 April 1836.^↩
4 St Michan's parish, Dublin, vestry minute book, 23 November 1831.^↩
5 St Thomas parish, Dublin, vestry minute book, 7 April 1828 (RCBL, St Thomas's parish, Dublin, vestry minute books, P 80.5.2).^↩
6 Saunder's Newsletter, 19 August 1819.^↩
7 St Catherine's parish, Dublin, vestry minutes, 24 August 1819 (RCBL, St Catherine's parish, Dublin, vestry minute books, P 117.05.7); St Werburgh's parish, Dublin, vestry minutes, 25 March 1820 (RCBL, St Werburgh's parish, Dublin, vestry minute books, P 326.05.2).^↩
8 Jacinta Prunty, Dublin Slums, 1800-1925: A Study in Urban Geography (Dublin, 1998), p. 67.^↩
9 St Andrew's parish, Dublin, vestry minutes, 12 December 1831 (RCBL, St Andrew's parish, Dublin vestry minute books, P 059.05.2).^↩
10 St Catherine's parish, Dublin, vestry minutes, 28 November 1831.^↩
11 The Pilot, 12 October 1832.^↩
12 Belfast Newsletter, 28 August 1851, 14 April 1852, 3 May 1854.^↩
13 'An act to amend the Law relating to Public Health', 29 & 30 Vict., c. 90, s. 69 (7 August 1866).^↩
14 Prunty, Dublin Slums, pp 70-71.^↩

MA in the History of Welfare and Medicine in Society

March 4, 2016, 9:35 am

≫ Next: Wellcome Trust Master's Award Scheme

≪ Previous: Parochial Officers of Health in pre-Famine Dublin by Ciarán McCabe

$

0

0

MA History of Welfare & Medicine in Society

Programme Director: Dr Catherine Cox

catherine.cox@ucd.ie

About the MA

Medicine, illness and welfare occupy a central place in all our lives. The MA is designed to enable you to understand the place of medicine and welfare in society and history (c1750-1980) and engage with critical debates through various media, including film, literature, and art, amongst others. 

The modules on the programme explore the main trends within welfare and medical history from social history, gender history, post-colonial history to individual experiences of poverty, and of illness throughout history. You will explore how medicine and welfare regimes and policies culturally constructed conceptions of femininity and masculinity.

The modules are taught through seminar and you will develop expertise in presenting, analytical thinking, effective communication, and writing with clarity and precision. You will also partake in a lively seminar series and benefit from a vibrant postgraduate research community.

The dissertation, at the core the MA, allows you to engage your own research-based interests.

Your fellow students will be from diverse academic backgrounds and the MA is popular among healthcare professionals keen to understand the historical contexts that shaped current practices and systems.

The MA has a reputation for excellence and is taught be lecturers with international profiles in the field. 

Dr Catherine Cox, Director and Co-Founder of the UCD Centre for the History of Medicine in Ireland

Why do this MA?

Graduates have secured employment in the fields of media, education, politics and in private and public sector management and policy.

Graduates have also proceeded to PhD studies at Irish, British, and European institutions, securing prestigious external funding.

Funding

To apply for the acclaimed Wellcome Trust Masters Scholarship, please contact MA Director, Dr Catherine Cox.

Further Details

Please see the course description for the MA in the History of Welfare & Medicine in Society at UCD Graduates Studies

Download the MA poster

---

Wellcome Trust Master's Award Scheme

March 18, 2016, 2:06 pm

≫ Next: The Cost of Insanity by Alice Mauger

≪ Previous: MA in the History of Welfare and Medicine in Society

$

0

0

Wellcome Trust Master's Award Scheme

The UCD Centre for the History of Medicine in Ireland (CHOMI) seeks a candidate for the 2016 Wellcome Trust's Master's Award scheme, offering fees and living allowance for one year of taught Master's study in the history of medicine or medical humanities.

UCD can propose one candidate per year to the Wellcome Trust, which considers applications from various institutions and determines whether funding is awarded. It is a highly competitive international competition. CHOMI has a strong track record of successful applications to the Master's scheme and many of the successful applicants have gone on to secure funding for doctoral studies. Details of the CHOMI MA programme are available at here.

Applications from international students are welcome. In addition to a living allowance, the scheme covers full fees for all Republic of Ireland, UK and European Union students, or full overseas fees for students from a list of eligible countries .

Application Process: Step 1

CHOMI runs an internal selection process to identify the strongest candidate to put forward for the Wellcome Trust competition. We now invite expressions of interest. 

Applicants must be strongly committed to developing a research career, and must have, or be predicted to have, at least a very high upper second-class degree at undergraduate level or an international equivalent .

If you would like to express an interest or discuss the possibility of an application, please contact the Director of CHOMI, Dr Catherine Cox (catherine.cox@ucd.ie)

The deadline for preliminary applications is Monday 11 April 2016. Preliminary applications should be sent to catherine.cox@ucd.ie

Your preliminary application should include:

1. 750-word statement outlining your relevant experience to date and your priorities for future research. If you have already developed a more concrete research proposal, please describe it here.
2. Current CV, 1 to 2 pages in length

Application Process: Step 2

If you are successful in your application to the internal CHOMI competition, you will then work with a CHOMI staff member in developing your final application to the Wellcome Trust.  You will need to be available to work on completing the proposal to a deadline in April, in order to meet the Trust's final deadline of Tuesday 3 May.

Full details of the Trust's policy on selection and entry requirements are provided here. 

The Cost of Insanity by Alice Mauger

April 11, 2016, 6:00 am

≫ Next: Local Health Authority Day Nurseries by Angela Davis

≪ Previous: Wellcome Trust Master's Award Scheme

$

0

0

The Cost of Insanity: Public, Voluntary and Private Asylum Care in Nineteenth-Century Ireland

How did Irish medical practitioners and lay people interpret and define mental illness? What behaviours were considered so out of the ordinary that they warranted locking up, in some cases never to return to society? Did exhibiting behaviour that threatened land and property interests, the financial success of the family or even just that which caused embarrassment eclipse familial devotion and render some individuals 'unmanageable'? These questions are addressed in this month's post by Dr Alice Mauger. In 2014, Alice successfully completed her doctoral thesis at the UCD Centre for the History of Medicine in Ireland on domestic and institutional provision for the non-pauper insane in Ireland during the nineteenth century.

The Evolution of Asylum Care

Paying patients in the Richmond District Asylum (1885-1900). Pictures courtesy of the Grangegorman Community Museum

The nineteenth century saw the evolution of asylum care in Ireland. While Jonathan Swift famously left most of his fortune to found Ireland's first lunatic asylum in 1746, it would be 70 years before the government followed his lead. In 1817 it enacted legislation permitting districts throughout Ireland to form asylums and by 1900, twenty-two such hospitals accommodated almost 16,000 patients. Growing demand for care for other social groups prompted the decision, in 1870, to admit some fee-paying patients, charged between £6 and £24 per annum, depending on their means. Out of this 16,000 only around 3% actually paid for their care. Private asylums, meanwhile, charged extremely high fees that were out of reach for the majority of society (usually several hundred pounds per year) and by 1900, thirteen private asylums housed 300 patients. Occupying a sort of middle ground, voluntary asylums, established by philanthropists, offered less expensive accommodation to those who could not afford high private asylum fees (from around £24 to a few hundred pounds). By 1900, these four voluntary asylum had outstripped the thirteen private ones, providing for 400 patients.

The Road to Committal

Advertisement for Farnham House, Private Asylum and Hospital for the Insane, Finglas Dublin. Source: Medical Directory (London, 1899), p. 1616.

Families were usually responsible for determining when it was time to commit a patient, where to send them and how much they should pay for their care. Factors such as cost, spending power, standard of accommodation, a hospital's religious ethos and the sort of people confined there all coloured these decisions. Broadly speaking, certain social groups (of the same religion) chose certain asylums.

Once admitted, patients were assessed by the medical authorities who determined a cause for their illness along with a diagnosis. This process was based on the medical certificate obtained prior to committal; evidence supplied by the patient and family; and the medical practitioner's own views. The two primary nineteenth-century diagnoses – mania and melancholia– reveal relatively little about reasons for committal. The causes named, however, were far more colourful and wide-ranging and expose much about contemporary perceptions of the life events or circumstances that led to mental illness and therefore committal. Given causes encompassed a range of 'psychological' factors such as grief, bereavement, business or money anxieties and religion, and physical influences including accidents and injuries, physical illnesses, hereditary and alcohol. These later two were the most frequently employed, demonstrating widespread medical understandings of the physical nature of insanity. However, many patients, families and increasingly asylum doctors, reported that fears about financial stability, land interests and the state of the economy had caused the illness.¹ In reality, it was often these anxieties that resulted in committal, especially among those with a degree of resources, such as white-collar workers, shopkeepers and farmers.

The Case of John D

Entries in Casebook 2, c.1898. Source: St John of God's Hospital, Patient Records.

Land and property interests certainly featured in the case of John D. In 1891, at the age of 77, John was committed to the Enniscorthy lunatic asylum by this two sons. John's sons provided details of his personal history to the asylum authorities; details which were later transcribed by the asylum's Resident Medical Superintendent, Dr Thomas Drapes, into his case notes. Reportedly a 'healthy old man', the first symptom noticed by John's sons was that he wanted to marry his servant, a girl of twenty:

Says if he doesn't marry her his soul is lost and that he'll burn in hell ... he is very supple and has often tried to take away across the country to get to this girl ... Son says he won't allow bedclothes to be changed or bed made since the girl left, as he says no one can make it but her.²

While John was a patient in the asylum, this girl visited him disguised as his niece. Following this, John's sons told Drapes to prevent any further communication between the pair. They were very much against the proposed marriage, insisting that 'she and her family are a designing lot' and 'all encourage her to get him to marry her'. One son informed Drapes that in his opinion his father would have married '"anything in petticoats" for past two years or so'. Allegedly, the girls he proposed to were 'not at all suitable, and "strealish" in appearance and habits'.

Underlying this narrative were anxieties about John's property. A farmer and a shopkeeper, John was certainly not a pauper. His maintenance in the asylum was £18 per annum and while he was in the asylum, John presented Drapes with a further £16 'to keep for him'. The sons made clear their anxieties about the family business. On one visit they stated that lately, their father 'was not capable of properly doing business in his shop'.

The real motivation for committing John, however, became clear when the patient later informed Drapes that 'he gave his sons up his land, but wished to retain his shop for himself and get a wife to mind it for him'. John also gave what Drapes termed a 'rational explanation' for his romance with the servant girl, explaining that:

the girl had been so spoken of in connection with him that her character had suffered, and that if he did not make her the only reparation he could by marrying her, he would suffer in the next world.³

Just two months after his committal Drapes discharged John. In his notes he wrote that this was 'greatly against the wishes of his sons, but I have not been able to find any distinct evidence of his insanity'.⁴ By 1901, John, now aged 87, had married a woman of 27, possibly the servant girl. However, ten years later, it was his son who resided at this address with his own wife and six children suggesting that he had ultimately inherited the property.⁵ The most plausible explanation for this outcome was that John's young wife had not borne him any children, which would have prevented her from being entitled to property rights following his death.

Conclusions

The case of John D adheres comfortably both to contemporary public hysteria over the perceived vulnerability of private patients to wrongful confinement and commonly held representations of the rural Irish.⁶ Although some historians have emphasised the detrimental impact of issues such as the consolidation of landholdings, emigration, land hunger and Famine memories on emotional familial bonds, historians of psychiatry have identified the 'range of familial emotional contexts' which asylum patients came from.⁷ Families often sent letters querying treatment, offering advice and enclosing food and money for patients.⁸

Yet, in cases where property or business interests were at stake, these factors tended to eclipse those of familial devotion. In fact, the high numbers of fee-paying patients who were unable to control their business or function in their profession suggests this was a major reason for committal. While the extent to which John D actually struggled in his shop is difficult to ascertain, it is conceivable that a number of other relatives' claims regarding patients' incapacity to work were genuine.

The association between working life and mental illness speaks volumes about contemporary society's interpretation of insanity and what drove families to commit relatives to asylums. In relation to social status, those unable to maintain their position within their given occupation were defined in terms of this failure. Land disputes and an inability to manage one's affairs threatened to shatter emotional familial bonds. In these cases, families may have viewed committal as a last resort in order to protect their resources or livelihood. After all, in smaller rural towns, relatives would have little control over the actions or interactions of a mentally-ill person positioned behind the shop-counter or at a farmers' market.

Dr Alice Mauger

Dr Alice Mauger was awarded a PhD by University College Dublin in 2014 for her thesis which examined institutions for the non-pauper insane in nineteenth-century Ireland. Prior to this she completed the MA programme on the Social and Cultural History of Medicine at the UCD Centre for the History of Medicine in Ireland, UCD. Both her MA and PhD were funded by the Wellcome Trust. Dr Mauger has published on the history of psychiatry in Ireland and is currently writing a monograph stemming from her doctoral research.

Below you can listen to Alice's talk, entitled 'The Cost of Insanity', given on 4 February 2016 as part of the UCD Centre for the History of Medicine in Ireland Seminar Series.

---

1 Fears of poverty and unemployment among pauper asylum patients are discussed by: Akihito Suzuki, 'Lunacy and labouring men: narratives of male vulnerability in mid-Victorian London' in Roberta Bivins and John V. Pickstone (eds), Medicine, Madness and Social History: Essays in Honour of Roy Porter (Basingstoke, 2007), p. 118; and, Catherine Cox, Negotiating Insanity in the Southeast of Ireland, 1820-1900 (Manchester, 2012), pp 59, 121.^↩
2 Clinical Record Volume No. 3 (Wexford County Council, St Senan's Hospital, Enniscorthy, p. 264)^↩
3 Ibid.^↩
4 Ibid.^↩
5 Census of Ireland 1901.^↩
6 David Fitzpatrick, 'Marriage in post-Famine Ireland', in Art Cosgrave (ed.), Marriage in Ireland (Dublin, 1985), pp 116-31; Timothy Guinnane, The Vanishing Irish: Households, Migration, and the Rural Economy in Ireland, 1850-1914 (Princeton, 1997).^↩
7 Cox, Negotiating Insanity, pp 108-9; Guinnane, The Vanishing Irish, pp 142-43, 230-35.^↩
8 Oonagh Walsh, 'Lunatic and criminal alliances in nineteenth-century Ireland' in Peter Bartlett and David Wright (eds), Outside the Walls of the Asylum: The History of Care in the Community 1750-2000 (London and New Brunswick, 2001), p. 145.^↩

Local Health Authority Day Nurseries by Angela Davis

May 4, 2016, 5:48 am

≫ Next: Sharing of Medical Ideas and Information among Early Modern Practitioners by Benjamin Hazard

≪ Previous: The Cost of Insanity by Alice Mauger

$

0

0

Local health authority day nurseries in post-1945 England 

In this month's blog Dr Angela Davis (University of Warwick) considers the fate of local health authority day nurseries in England from 1945 to the 1970s. While the national trajectory during this period may have been one of decline, this trend masks considerable local variation with some authorities regarding the day nursery as an intrinsic part of the health service and others considering them, at best, marginal.

War Nurseries

Handing over the Women's Voluntary Service War Nursery, Manor House, Wendover, Buckinghamshire, England, UK, 1941, © IWM (D 2424).

In a Ministry of Health Circular in 1945 the Minister of Health for England and Wales declared that the right policy to pursue would be to positively discourage mothers of young children under two from going out to work and to make provision for children between two and five by way of Nursery Schools and Nursery classes.

From the numerous and widely used local authority administered day nurseries, commonly known as ‘war nurseries’, which were open to all working mothers during World War Two (in 1944 there were around 1,450 full-time nurseries and 109 part-time nurseries), in the late 1970s the day nursery service had become a much more limited form of provision intended to prevent children being harmed by inadequate homes or parents and to avoid the last resort of resort of residential care, including children from difficult family backgrounds, one-parent households, and some handicapped children.

Local Variation

However these national trends figures mask the very real variation at the local level that took place. State-provided day nurseries remained the responsibility of Ministry of Health in the years after the war (responsibility was finally transferred to the Social Services Departments in 1971), and administered through the local health authorities. The local health authority day nurseries were under the ultimate control of the medical officer of health for the area and these medical Officers of Health had very different attitudes about the importance of the provision of day nurseries. While some thought the service was an intrinsic part of the health and welfare provision in their area others were keen to cease providing the service altogether. Throughout the period the provision offered by London Local Authorities was higher than anywhere else in the country. In contrast, the provision offered in rural areas was the most limited. In order to consider these local differences more fully, will look at three case studies – Coventry, Camden (London) and Oxfordshire.

London Borough of Camden

The London Borough of Camden was created in 1965 from the former area of the metropolitan boroughs of Hampstead, Holborn, and St Pancras, which had formed part of the County of London. In 1948 there were 23 day nurseries in the health division area 2, which most closely resembled the later borough of Camden. These nurseries had places for 1,398 children. The divisional health officer explained that many of the wartime nurseries that had been requisitioned for the duration of the war had since been returned to their original uses. As a result, the number of children on the waiting list, which numbered 3,121, far exceeded the number of places available and therefore a scheme of priorities for admissions to day nurseries has been drawn up to take into account of economic and health factors. The cost to parents at this time was negligible. A standard charge of 1s. a day was made for each child placed which covered the cost of the midday meal. However, even the following year, the tone of the reports was changing with the London County Council Medical Officer now stressing that the high cost of maintaining a child in a day nursery caused concern, and attempts were being made to effect economies. Instructions were issued as to economical ordering of supplies and preparation of meals. By 1951 it had become policy that the total day nursery provision should be kept at its existing level, although notably no expansion was planned. Moreover attendances at the nurseries were to be continually under review and closures and amalgamations were to take place when possible. The ratio of staff to children reduced. Nurseries were now to be closed on Saturdays and the priorities for admission were tightened.

Policy Reversal

Annual Report of the Medical Officer of Health and Principal School Medical Officer for the year 1965 by Wilfrid G. Harding (1966). Wellcome Library, London's Pulse: Medical Officer of Health Reports 1848-1972.

Interestingly, in 1953 there seemed to be a reversal in policy. The priorities for admission were softened. A third group was introduced, namely the children of working mothers whereby the parents income exceeded 9 pounds a week. Why did this occur? It seems clear that the council were concerned about falling attendances that had resulted from a central government order increase the charges for day nurseries with the charges for children at the nurseries was raised to a minimum of 4s. a day. As demand grew in the years that followed, however, the number of children admitted from priority group 3 was again reduced. Other groups were also seen as more needy, particularly those from ethnic minority backgrounds, but also children with disabilities. However there was no growth in the number of day nurseries to match the increased demand. In 1965, the report of the new Camden health authority, reported that the council had ten nurseries providing 541 places for children under five. This compared to the 23 nurseries with places for 1,398 that had existed in 1948.

Cutting Costs

So what do these reports from Camden reveal? Firstly, they indicate that provision declined rapidly after World War Two, but mainly from a desire to cut costs. Nowhere is it mentioned that the policy of the council was that the place of young children was to be with their mothers. The priorities for admission reflected this overriding economic concern. Priorities were tightened when the nurseries were over-subscribed and reduced when attendances fell. The authority seemed to be guided above all by a desire for the day nurseries to be cost effective and seemed to view them a worrying expense rather than an essential part of their service.

Coventry

Portrait of Sir A. Massey. Wellcome Library, London.

But not all authorities viewed day nurseries in the same way. In his Annual Report from 1944 Arthur Massey, the Coventry Medical Officer of Health stated that, ‘There is no doubt that there is a useful place in the peace-time maternity and child welfare scheme for day nurseries, for they offer valuable medical, nursing and educational care to the children in attendance. Moreover they could provide for the occasional care of children of mothers needing respite from the continual round of domestic work’ (p. 7).

It is clear from the outset that Coventry envisaged a wider for their day nurseries than the belief of central government that they should only be for children in ‘special need’. In consequence every effort was made to keep the nine day nurseries that had existed during the war in operation in the years that followed.

Reducing Charges

Coventry health authority also reacted in a very different way to London in response to Ministry of Health Circular No. 23/52 which increased the daily charges of the nurseries. Like London, Coventry quickly saw a fall in numbers, but unlike London, who responded by opening up the nurseries to non-priority groups, Coventry responded by reducing the charges. Moreover, rather than aiming to simply maintain provision at the level of the early 1950s as London did, Coventry wanted to increase day nursery provision. They were certainly not seeking to reduce their number of nurseries. Indeed the poor state of the current nurseries, the need to build new nurseries, and the increasing demand upon places was a constant refrain in the annual reports. By the mid-1960s, the medical officer reported that they could no longer offer places even to those deemed of high priority. Moreover in his report from 1969 the then Medical Officer of Health Thomas Clayton clearly indicated that he would like to reduce the stringency of the priorities imposed, stating: ‘The slowly declining birth rate has as yet had little effect on the under 5 population and the static day nursery provision is gradually becoming more inadequate. (p. 38). Moreover, unlike in Camden, the Medical Officer could report in 1970 that the number of day nurseries in Coventry had remained at the same level as at the end of the war. In 1948 there were 9 nurseries with 88,650 attendances. In 1970 there were still nine nurseries with 89,437 attendances.

An Essential Part of Health Authority Provision

So from the Coventry experience we can see that some local health authorities took a far more active approach to the provision of day nursery provision than my other case studies. The Coventry Medical Officer of Health saw day nurseries as an essential part of health authority provision in the area. Rather than seeking to reduce the service or being concerned about the cost of providing day nurseries, he was constantly wanting to expand the number of nurseries and places he could offer, and indeed make them available to children without ‘special needs’. Moreover, he was clearly frustrated with the lack of encouragement he received in this ambition from central government.

Oxfordshire

A Nursery School: Watlington Park Children in Wartime - Five Lithographs by Ethel Gabain. © IWM (Art.IWM ART LD 263).

The provision of day nurseries in Oxfordshire was considerably lower than in either Camden or Coventry. From the seven war nurseries that had been open throughout the county in 1945, only 2 remained in 1948, accommodating about 80 children.

The Medical Officer noted that they were ‘primarily intended for mothers who are forced by economic circumstances to go out to work. By 1951, there was only one day nursery provided by the county, in Banbury, accommodating 40 children. In 1960 the Medical Officer of Health was questioning the nursery’s continued existence. While the nursery did stay open, it was clearly not viewed as an essential service.

Better off at Home with Mother

The reason for this ambivalence may be in the Oxfordshire local health authority’s attitude towards the institutional care of children. They clearly felt that young children were better off with their mothers and in his 1966 report stated: ‘attendances under the age of two and a half are discouraged’ (pp. 18-19). However, the annual reports also documented the growing demand for day nursery care in Oxfordshire, which the Medical Officer of Health attributed to the increasing urbanisation of Oxfordshire. However, even in 1970, there remained only one nursery in the County. So it is clear that day nursery provision was considered as being rather marginal to the Oxfordshire local health authority. They were unsure about whether they should provide such a service and indeed whether young children should be in day nurseries at all.

Variable Provision

The provision local health authority day nurseries in postwar England was highly variable. It depended on the different material conditions and make-up of the populations in different areas, but also upon on local policies and personalities. For example the Medical Officer in Coventry championed day nurseries in a way that was not seen in Camden and which may account for the continued level of nursery places throughout the decades after the wars.

Angela Davis

Dr Angela Davis, Centre for the History of Medicine, School of History, University of Warwick.

Angela Davis is a Senior Research Fellow (Wellcome University Award) in the Department of History at the University of Warwick. Her research interests concern parenthood and childcare in Britain and Israel and the use oral history. Her book Pre-school Childcare, 1939-2010: Theory Practice and Experience was published with Manchester University Press in 2015.

You can listen to a podcast below of a talk by Angela, 'Developing Bodies and Minds: Children's Experiences of Preschool Childcare, Britain c.1939-1979',  given as part of the CHOMI Seminar Series, 29 January 2015.

Sharing of Medical Ideas and Information among Early Modern Practitioners by Benjamin Hazard

September 6, 2016, 1:14 am

≫ Next: Public Engagement Officer Posts

≪ Previous: Local Health Authority Day Nurseries by Angela Davis

$

0

0

In this month's blog, Dr Benjamin Hazard (School of History, UCD), writes about a recent scholarly meeting which he co-convened at the Edward Worth Library (1733) in association with UCD Centre for the History of Medicine (CHOMI). The meeting was entitled: 'The Sharing of Medical Ideas and Information among Early Modern Practitioners'.

Early Modern Medicine

To raise awareness of early modern medicine and to develop networks for future research, the UCD Centre for the History of Medicine in Ireland (CHOMI) and the Edward Worth Library presented a conference on Tuesday 2 August entitled 'The Sharing of Medical Ideas and Information among Early Modern Practitioners'. Open to the public with free admission, the event was held at Dr Steevens’ Hospital, founded in 1733. As one of the organisers of the event, I had the pleasure of introducing the meeting and welcoming the large audience in attendance. I'd also like to take this opportunity to thank once again to the Trustees of the Worth Library, to Dr Elizabethanne Boran, the Librarian, and to Dr Catherine Cox, the Director of UCD CHOMI, for their support. Nicole Fleming of Brown University, Visiting Intern at the Edward Worth Library, assisted with proceedings on the day.

Viringus and Military Medicine

Dr Benjamin Hazard (speaker) with Professor James Kelly (chair) at the meeting, 'The Sharing of Medical Ideas and Information among Early Modern Practitioners' (Dr Steevens' Hospital, 2 August 2016).

With the sharing of medical knowledge as the principal theme, the topics for discussion concentrated on the sixteenth, seventeenth and eighteenth centuries. Professor James Kelly MRIA of Dublin City University chaired the first sessions. Drawing attention to the composition of medical writings, Dr Jason Harris of the Centre for Neo-Latin Studies, University College Cork, explained that communicating in Latin was integral to the sense of identity among physicians. They were expected to demonstrate their grasp of Classical learning. Familiarity with Latin and Greek helped students recognise medical terms and also distinguished physicians from surgeons. Early-modern physicians held themselves in high regard but Johannes Walterius Viringus, a professor of medicine at Leuven in the late sixteenth century, did not limit the propagation of medical knowledge to his fellow physicians. In my paper, I described how Viringus wrote a manuscript of medical recipes for military chaplains in Spanish Flanders. This offered them the means for self-medication and illustrates the varied definition of the term practitioner.

Book Merchants, Auctions, and the Medical Mind

Dr Elizabethanne Boran presented detailed findings from her investigation of book merchants' catalogues according to criteria such as medical specialities and languages. This shows how the purchase of books containing scientific information helped to shape the medical mind. Auctions reflected book sellers' efforts to anticipate changing tastes while catering for as broad a readership as possible.

Professor Ole Grell

Chaired by Dr Catherine Cox, the keynote lecture was given by the renowned historian of early-modern medicine, Professor Ole Peter Grell of the Open University and the Royal Historical Society. Professor Grell considered the part that Olaus Wormius (1588-1654) played in the Republic of Letters by corresponding with key thinkers in distant places. Wormius, a Danish physician, antiquarian and natural philosopher, is recognised as one of the last great polymaths. Widely-travelled, he completed his medical studies in Basel, Padua, Montpellier and Paris before being called to Copenhagen. An avid collector, he kept his own museum and applied the information gathered in his correspondence to improve medical methods.

Dr Benjamin Hazard, School of History, University College Dublin

Dr Benjamin Hazard
Dr Benjamin Hazard (School of History, UCD) was born in London in 1971. He specialises in early-modern history. Among other matters, his research and publications deal with medical humanities with a particular focus on military medicine, its interaction with civilian life, and methods of education. In 2009, Benjamin published his monograph Faith and Patronage: The Political Career of Flaithrí Ó Maolchonaire c.1560–1629.

Public Engagement Officer Posts

November 25, 2016, 6:36 am

≫ Next: Event: Mind-Reading 2017

≪ Previous: Sharing of Medical Ideas and Information among Early Modern Practitioners by Benjamin Hazard

$

0

0

Two new Public Engagement Officer positions have been announced on the Wellcome Trust Senior Investigator Award Project, 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000', led by Principal Investigators Dr Catherine Cox (UCD CHOMI) and Professor Hilary Marland (CHM, University of Warwick).

Role

The successful applicants will act as key intermediaries between the project and relevant partners in the arts and policy, play a lead role in promoting the project through various media outlets and in the planning, organisation and promotion events. They are seeking applicants with previous experience of working in public or policy engagement.

Public Engagement Officer, CHOMI, University College Dublin

This Public Engagement post will be based at the UCD Centre for the History of Medicine in Ireland, School of History, University College Dublin. This part-time position will last for 24 months commencing from shortly after 9 January 2017. 

Salary: €33,900 per annum pro-rata (40% pro-rata, i.e. €13,560 per annum part-time)

Those interested should contact Dr Catherine Cox prior to making an application.

Closing Date: 4 December 2016

Reference Number: 008854

For further details and to apply, please see: Public Engagement Officer, UCD

Public Engagement Officer, CHM, University of Warwick

This Public Engagement post will be based at the Centre for the History of Medicine, Department of History, University of Warwick. This part-time position will last for 24 months commencing from shortly after 9 January 2017.

Salary: £29,301 – £38,183 per annum pro-rata (0.4 FTE).

Closing Date: 1 December 2016

For further details and to apply, please see: Public Engagement Officer (78714-106)