Last week’s article on the cholera outbreak in Offaly in 1832 attracted a huge readership. This week Dr O’Neill (a Mucklagh, Tullamore native) contributes this piece on Pandemics in Ireland. The Offaly History research team has added some local material on the effects of the Spanish Flu (1918–19) in the county and some pictures by way of further reading. Enjoy and stay positive. Read our 179 articles posted to offalyhistoryblog and catch up on Camus.
As some of you love novels and literature let me begin with just two writers. My modest suggestions.
1. The Story of San Michele by Axel Munthe is the classic account of one Swedish doctor’s experience of treating cholera patients in Naples during the Cholera epidemic in the 1880s. Munthe was a newly qualified doctor when he went to Naples to embrace the challenge of proving medical aid. This was incredible brave of him as the causes of cholera were only discovered by the German microbiologist, Robert Koch in 1883. Munthe was risking his life by going to Naples. It had some of the worst slums in Europe and cholera was more severe there than perhaps anywhere else at the time. Munthe is a fascinating character, philanthropist, animal lover, personal physician to the Queen of Sweden, lover and writer in the style of Somerville and Ross. His life was spent in Sweden, Capri in Italy, France and England. His primary account of the epidemic in Naples is in Letters from a mourning city (1884) and published by John Murray in London.
2. Albert Camus, La Peste (The Plague). For my generation in college in the early 1960 he was a cult figure read by all. He won the Nobel Prize in 1957 at the age of 44. He is a great writer and an intellectual. For the radical youth of the 60s, he was seen as an existentialist anarchist. We read “The Plague” and his political works with enthusiasm.
Ireland’s epidemic diseases
Ireland in the modern period had a serious problem with endemic diseases that flared up episodically. These were Typhus, the most common, relapsing fever, dysentery, scurvy and smallpox. The first epidemic in the nineteenth century was the typhus epidemic of 1817-19. This resulted in one and a half million people contracting the disease and 65,000 dying. The response to this epidemic was the beginnings of a centralized health system organized by government in Dublin Castle. A Central Board of Health was set up and a host of new fever hospitals were opened. The older hospitals opened fever sections. In Dublin, The Whitworth Chronic Hospital opened and the number of fever beds in the city was increased by 456 with provision for more. Sir Patrick Dun’s and the renamed Whitworth Fever Hospital opened in 1818.
The real fear following the typhus epidemic was the news that cholera was beginning to spread from the Ganges Delta following an outbreak in Jessore in India in 1817. There are hundreds of types of cholera and two of these are known to cause epidemics. Cholera existed from the age of Hippocrates, of medical oath fame, in 4th century Greece. It was endemic in India and outbreaks occurred in 1543 in the Ganges Delta. There were to be four major cholera epidemics that affected Europe in the nineteenth century. The spread from India halted in Europe around 1824 but it began to reappear in 1829 in the Middle East and Southern Russia. From there it progressed through Europe. English doctors went to Russia to study the disease and it arrived in Sunderland in 1831. The Board of Health in Ireland issued proclamations to inform the public. Local Boards of Health would be established and preventive measures were promised. This was an attempt to prevent panic.
It was only a matter of time before it arrived in Ireland. Cholera came to Ireland by Belfast on the 18th March 1832. St Patrick’s Day is a great day for epidemics!!! It had spread to Dublin on the 25th March and from there throughout the country. On the 13th April 1832 the Cholera Board issued a proclamation that was a large poster that was distributed around the country. The symptoms were described and everyone was urged to seek medical advice or run the risk of death. Because of insanitary housing open windows, for three days and clean everywhere with “lime wash with a mixture of freshly slacked quicklime and water. It gave advice that the dead should be wrapped in tarred cloth and graves should be six foot deep. People who had cholera and survived should not visit family, churches or any crowded assembly for fourteen days after recovery. In this era before Fr Mathew, it warned against intemperance as a predisposing cause of cholera and in a country of poor people it advised people to keep warm, dress well, eat well cooked food and avoid sleeping on bare ground. The Board gave graphic descriptions of the symptoms including the following;
“The skin, on the hands and feet, becoming wrinkled – the surface of the body cold, damp and clammy – the tongue moist, often white and loaded, but always flabby and chilled, like a piece of dead fish.”
The cholera spread quickly during the ensuing months and the Cholera Board sent doctors to various parts of the country. Many towns had fever hospitals set up by local subscriptions and state aid. Local cholera boards listed the local proprietors and the amounts they contributed and local measures were begun. The west was very poorly served with these institutions and no one knows how the really remote areas fared.
The cholera caused terror largely because people died within hours in some cases and there was no antidote. The panic was made worse by some beliefs. In June, Humphrey O’Sullivan, a schoolteacher living in Callan, County Kilkenny, recorded in his diary:
“The lower classes of the Irish are a credulous people. Some practical joker sent a fool out with a small piece of charred stick, or some other bit of kindling, which had been extinguished in Easter-water, or holy water, and told him to divide it into four parts, and give it to four persons in four houses, telling them that the cholera would kill them unless each one of them did the same thing. By this means 16 persons, and 64, and 256, and 1,024, and 4,096 etc., etc., got this fire, until the entire country was a laughing stock for Protestants.”
There may have been no social media but the word spread in the fashion of the time. The panic led to some town placing guards to prevent wandering beggars entering and a siege mentality arose.
The question of Quarantine arose and restrictions were imposed on ships from ports in Turkey and Africa where cholera was known to exist. After cholera appeared in Kirkintillock, a quarantine was imposed on all ships from Glasgow and the Irish Board imposed quarantine on ships from Milford Haven, Standgate Creek and the Firth of Forth. In each of these ports there were hospital ships. There was some pressure to stop the Board publishing numbers of patients and casualties in case ships from Ireland would be quarantined at their ports of destination. It happened. Liverpool quarantined ships from Dublin, Newry and Cork. Ships from Alexandria that was plague ridden were quarantined.
The epidemic led to businesses closing, two distilleries and a brewery in Athlone closed. Cotton Mills in Balbriggan also closed. The wealthy fled from the towns and it is interesting to see where the political leaders were during these months. Rev Dr Martin in his radio talk was very measured and called for the old and the vulnerable to avoid crowds and ended with a modest proposal to exhort people to pry. His predecessor in 1832 was much more forthright. He acknowledged that many had died and went on;
“Profit by this admonition, You have disregarded the warnings of the word of God. He has sent a preacher to your doors to teach you by facts which force themselves on your view that ‘all flesh is grass, and all the glory thereof as the flower of the field’. ”
The Cholera Board distributed £148,013 during 1832. 18,955 people died in 1832 in Ireland where 16,437 died in England and Wales. Mortality rates were higher in Ireland. The main cause of the spread of cholera was by infected water supplies. Chadwick’s sanitary reports showed where the problems lay in London. And the improvement in water supplies began as health measures long before the actual causes of cholera were understood. John Snow the father of modern epidemiology mapped the cholera cases that arose in the Soho district of London. He showed the source to have been contaminated water from a public well.
There was a less severe cholera epidemic during the great famine and again in the 1850s and in the 1860s. The last epidemic was in the 1880s but none were on the scale of the 1817 or 1832 epidemics. Some European cites suffered severely. In the 1860s the European nations came together in Istanbul to halt the progress of the cholera that was faster with the arrival of an extensive railway network. In the later epidemics Hungary lost 160,000 and Hamburg 1.5 million in the last epidemic. Naples was even worse and there they demolished large parts of the city following the outbreak. That is where A. Munthe went as a young doctor.
The Spanish Flu in 1918 affected 800,000 in Ireland and 3,000 died and there is an excellent book on that.
Many historians would agree that epidemics and cholera epidemics in particular have been the stimulus that encouraged governments to supply clean water and sanitation. Historical experience has shown the value of water and it also shows that this requires reinvestments of money, energy and attention. The importance of clean water can be forgotten and its importance as a social need associated with health is often lost.
The cholera accelerated the building of a vast network in Ireland of district and town fever hospitals. These changed to geriatric homes and other uses. They were largely abandoned in favour of centres-of-excellence hospitals. Like the Workhouses the fever hospitals had poor historical associations. Most of the fine built Victorian workhouses were torn down in the same spirit as big houses were burned in the 1920s. Those buildings could have been modernised and restored.
One aspect of the past that is never now mentioned is philanthropy. Anthropologists often claim that gifts bind societies together. The local fever hospitals were funded by charitable and state funds. They left a great legacy of epidemics.
Perhaps instead of temporary beds as have been announced today we should be more ambitious in our aims for the future.
Spanish Flu cases in Offaly, 1918-19, a few examples
1. Death of Peter McMahon jun aged 24 of Henry St. Brother to Patrick McMahon, victualler, Harbour St and brother in law to Frank Slattery of Egan’s. Contracted influenza on Wed the third, died on 8th. Failed to take all necessary precautions to combat the disease which is so prevalent. He was an Irish Volunteer coffin draped in tric-colour and coffin was borne from Church St to cemetery, Cumann na mBan and Boy Scouts represented (19180713).
2. Portarlington visited for the first time with the Spanish flu. A few cases of a mild type.
3. T.M. Russell released from a Bermingham prison. He was arrested a day or two before the big batch of arrests made in connection with the bogus ‘German plot’/ 21 9 not correct still in prison. Released temporarily from prison. Six months in all including Mountjoy and Bermingham. Three boys ill with flu, Cecil aged 10 very ill on arrival of father and died. Buried in Glasnevin. Account of funeral in Tullamore coffin borne on the shoulders of the local volunteers to Tullamore Railway Station. Three other of his children down with flu are making good progress. 8 1918
4. Death of Madge Lyons, trainee nurse of 22 and of Charleville Parade, Tullamore flu (10 1918). Many people in Tullamore are suffering from the influenza. Patrick Flanagan of Killeigh died last Friday in his 26th year. Also James Corrigan NT, Secretary of the Offaly GAA, took place in Birr
5. Large number of people are affected with influenza in Tullamore and district. (11 1918). Report on in Tullamore – a great number of shop assistants and others. All making rapid recovery. In Clara scarcely a family has escaped
6. List of those who died in Tullamore district since 29 Oct. about 15 and included Andrew Walsh of Tinnycross leaving a wife and three small children. Epidemic not so virulent in Daingean, but in Geashill and Walsh Island savagely felt at times. Death of Miss H. Byrne, Cruith./ TKI 19181123 deaths of John Gavin, Clara and Lizzie White at her residence at Church Street, Clara; also Peter Quinn of Ballinvalley, Killeigh, Mrs Patrick Flynn, Main Street, Daingean, – in Daingean thoughtful work of Dr Barry has helped reduce the severity of the epidemic
7. Death of a boy aged 11 in an outhouse in Killoughey. His mother was dead and father in the army boy was Joseph Gorman. An aunt fom Geashill took him out of the workhouse in July 1917 at the request of the boy’s father as he was going into the army. She was to get the separation allowance and got the four children out of the workhouse. Died of flu.
8. 43 deaths, nearly half the patients attacked in Ballanasloe asylum. Mullingar asylum fared better with only 2 deaths. Inoculation the key. Castlerea workhouse large no of cases
9. Appears to be on the decline in Philipstown. Rhode suffered severly from the start. Mrs Stoney, the wife of a farmer and her two sons buried. The local maternity nurse died when visiting her mother. In some districts whole family got it and dependent on neighbours. Picture house in Tullamore re-opened on Sunday last having been closed for almost a month. Mr Pike, the popular postman recovering. His comrade James Dunne died after a few days. Dr Moorhead’s report
10. Foresters cinema has re-opened a few weeks ago having been shut down during the flu epidemic (2 1919)
11. Flu has made its reappearance in the neighbourhood.. Richard Goodbody of Woodfield has been suffering for a few days with the attack but on the mend at the house of his father, James Perry Goodbody. Some deaths one flu victim was Thoms Keenan/ TKI 19190301 Recommendations from Dr Moorhead in Tullamore and 300 employees in Goodbodys prostrated. Only a small percentage of deaths have occurred. Wakes and coffins/ TKI 15 Mar. 1919. Philipstown now badly hit whereas it largely escaped the othe visits. Schools closed. (2 1919)
12. Influenza Epidemic – Dr. Moorhead, M.O.H., Tullamore issued the following recommendations with reference to the recurrence of influenza in the town and districts, that influenza having broken out in the town and district recommended the closing of schools (3 1919)
13. At one time six brothers of St Conleth’s and upwards of 200 boys were down with flu. Two Oblate brothers dead (3 1919)