Week II
Barely 70 years after the famine and disease of the 1730s, the West of Ireland was hit by a second outbreak of typhus which was slowly making its ruinous journey through the whole county. Its cause, yet again, was triggered by famine which followed the poor harvests of 1816 and 1817. The summer and autumn of 1816 were wet and cold, resulting in rotting potatoes and mouldy oatmeal. The incessant rain prevented the saving of turf on which the people depended for heating and cooking.
Once again crowds of hungry, cold and poorly clothed peasants came into Galway and other towns, seeking relief. They sought shelter in the town’s cellars, and huddled in crowded, and insanitary conditions, which tragically, were ideal for the spread of typhus, a deadly bacterial disease, spread from human to human through fleas, lice and mites.
Fortuitously, for the first time, Dublin which had become alarmed at past incidences of the rapid spread of disease, had made funds available for a fever hospital. This was a welcomed move, and with local support, a fever hospital opened on Earls Island (the building is now the university’s sports club ), just as the typhus epidemic was spreading. The hospital had accommodation for 40 patients in four wards, with room for a further 20 beds if required. No fewer than six doctors were appointed to provide medical care.
Fever hospital
Even before the spread of typhus in 1818 there was an urgent need for a fever hospital in Galway. Until the early 20th century, especially among the poor in overcrowded city areas, infectious diseases were common. Typhoid, typhus, relapsing fever, smallpox and consumption were endemic, but reached epidemic proportions at frequent intervals, particularly at time of famine.
Unfortunately, when faced by a tsunami of typhus patients desperate for help, the management at the fever hospital collapsed. There were accusations of poor medical care, dirty wards, insufficient bed clothes and blankets, and a report that Head Nurse Mrs Barnacle had her husband and child living with her at the hospital, while other members of staff kept livestock in the grounds.
Dr McHugh, in charge of the hospital, caught the disease and died. Other doctors were ill. The situation was so serious that the General Board of Health in Dublin recommended to the Lord Lieutenant that a group of doctors should be immediately sent to Galway and take over the care of the sick.
Brilliant doctor
Dr Robert Graves, undoubtedly the most brilliant medical man in Ireland, answered the call. In September 1822 he led a team of volunteer doctors into Galway where they revolutionised the treatment of fever in the west, and probably saved the citizens of Galway from wipe-out.
Dr Graves and his courageous group of doctors, comprising of Drs Mollan, Cuming, Benson, and Birch all of Dublin, and Dr Cahill from Galway, displayed enormous courage and charity of the highest order in coming to Galway, knowing, as they must, the real hazards involved.
They lost no time in getting to work. Dr Cahill took over the hospital, where two of the remaining doctors, McHugh and Keogh, had recently died of the disease. Cahill quickly removed all obstacles which had made the hospital inefficient, getting it as prepared as possible to deal with the onslaught he knew was coming. Others in Dr Graves’ team took to the parishes, and with the help of the local clergy, to which Graves was lavish in their praise, endeavoured to put some order on the shambles and distress that had overtaken the town.
Claddagh was free
Graves describes vividly the terror of the people, and yet found praise for the townspeople who gave shelter to the emaciated sufferers fleeing the famine in the surrounding countryside. He reckoned that more than 4,000 refugees crowded into the town, and sought shelter mainly in the poorer areas around the fish market and quays. There were often three or four families to a room, and many were obliged to sleep in the lanes and entrances. The upper classes of society were not immune to the disease, among whom the death rate was considerably higher, amounting to a third of those attacked.
Graves appreciated the importance of ventilation, cleanliness and the separation of the sick from the healthy. He noted that the Claddagh remained free of the disease for fully three months after it had become prevalent in the town just across the river. He ascribed this to the fact that the Claddagh was relatively isolated from the town, and the fact that its inhabitants had ‘an aversion to outsiders’.
The relative cleanliness and better housing must have helped. When ultimately the fever spread to the Claddagh, Graves described the inhabitants were ‘reduced to a state of extreme poverty and despondency’, because of poor fishing during the spring and summer. Graves had difficulty isolating the sick because of the reluctance of the Claddagh people to leave their homes for hospital.
Generous subscriptions
Surprisingly, and in stark contrast to the relief given during the Great Famine in the 1840s, a generous supply of money was available, owing mainly to the generous subscriptions from local sources, from the rest of Ireland and from England. Stores of provisions were collected and food was given to everyone who asked for it. ‘As the glad tidings of this spread, the needy flocked to it from all parts of the county, but none in greater numbers, or in more miserable condition, than from Connemara. Some arrived on foot, and in many boats which ply between the coasts of that district and the town of Galway. All were in a state of the utmost wretchedness and many almost starved to death…many were so exhausted by previous suffering, that they survived their arrival but a few days.’
On October 3 Graves reports that there were 404 cases of fever in the town and suburbs, out of a population of about 30,000, including 130 already in the hospital. There were 91 new cases during that week, 78 the following week, 121 cases the week later, but by the end of the month only 59 new cases were reported.
To deal with the overflow of patients at the hospital, a wooden shed and tents were erected close by. October was a stormy month and tents were blown down. These were quickly replaced.
Calmed down
But by November, the fever and alarm in Galway had considerably calmed down. In his final report Graves noted that fever, dysentery and ‘mild cholera’ had occurred throughout County Galway, with Oughterard, Ballinakill, Loughrea, Ardrahan, and Kilcolgan which suffered most. Fever was rampant in north Galway but a relief committee was formed in Tuam, to which the London Taverner Committee made a generous contribution. Ballygaddy House was used as a temporary fever hospital.
Dr Graves obtained permission to leave Galway in November, concluding his report with the sad news that Dr Stephen Burke, who had been appointed to the Fever Hospital, and had come from Dublin to take the post, died of the fever in March 1823. ‘Burke was the third physician to that institution carried off within the short space of 12 months.’
That same year there was a plentiful harvest, with an abundant potato crop.
Next week: The gradual improvement of hospital accommodation, and the beneficial impact of Religious Orders’ selfless acts of care, education and kindness. All to be lost in the Great Famine of 1845.
NOTES : Dr Robert James Graves (1796 - 1853 ), only lived 57 years, but in his lifetime brought more permanent change to the Irish medical system than perhaps any other doctor. He is best remembered for the first comprehensive description of Graves’ disease, an autoimmune disorder that causes enlargement of the thyroid gland, affecting mood, weight, and mental and physical energy levels.
Born in 1796 to a wealthy Anglo-Irish Dublin family, Graves graduated with a medical degree in 1818 from Trinity College Dublin (where his father and maternal grandfather were both Senior Fellows ), and proceeded on a three-year tour of medical schools on the continent that left a profound impact on his pedagogical style. He had several adventures including imprisonment in Austria suspected of being a spy. The authorities were sceptical that an Irishman could speak German so fluently. He also spoke fluent French and Italian.
He returned to Ireland in 1821 and became chief physician and lecturer at The Meath Hospital, where he was responsible for two major achievements. First, Graves threw out Latin-language medical lectures, which were then still common practice, in favour of English lectures, making the subject more accessible to students. Then, having seen students participate in doctors’ rounds at patients’ bedsides in Germany, he introduced the same practice in Dublin. Under Graves, students were able to observe patients in the hospital, ask questions, and assist the primary physician in diagnoses and treatment plans.
Considered one of the most eminent teachers of clinical medicine of the 19th century, Graves was co-founder of the Park Street School of Medicine, which became a renowned centre for modern medical practice. Graves was a prolific writer, a very private and deeply religious man with strong evangelical beliefs. Among his many talents was drawing and painting. As a young man he travelled and sketched with J M W Turner in Italy.
His report on the outbreak of fever in Galway is part of his ‘Transactions of the Association of Fellows and Licentiates of the King and Queen’s College of Physicians, (1824 ).
Other sources include James P Murray’s excellent Galway: A Medico Social History, publish by Kenny’s 1992; and an essay on Dr Graves by Helen Andrews, Dictionary of irish Biography.
