The Improvement of Society
Both William III and Anne's reigns were marked by definite efforts to improve society, for instance 7 Will. III, c. 9, 'An act for the more effectual supressing of prophane Cursing and Swearing' and 6 Anne, c. 17, 'An Act for suppressing lotteries and Gaming-tables' (11 Anne, c. 6, had a similar purpose). Despite tales of Hellfire Clubs, most parliamentarians upheld the Established Church and orthodox theology, and paid at least lip-service to the civilised conventions of the day; for instance, 7 Will. III, c. 17, was 'An Act for the better observance of the Lord's Day ...'. There was also a certain paternalism that led them to object to the sale of adulterated and bad drugs or medicines, highlighted in 9 Geo. II, c. 10. A social evil that repeatedly attracted the attention of parliament (6 Anne, c. 16; 9 Geo. II, c. 11) was the abduction and marriage of children, particularly heiresses, against their parents' will. Probably the problems tackled, and tackled repeatedly, by parliament were those caused by poverty and disease.
Poverty
'Employ,' said Arthur Young, 'don't hang them.' Unfortunately, Irish society was not sufficiently dynamic for the available employment to absorb its rising population. One of the major problems confronting Ireland in general, and the growing municipalities in particular, was the lack of any provision for the ever-increasing number of poor and destitute. The problem was appalling everywhere but it was particularly acute in the rapidly growing capital. The Elizabethan Poor Law, 39 Eliz., c. 3 (Eng.), had made the English poor the responsibility of the parish in which they resided. But this law and its subsequent modifications did not apply to Ireland. This, however, did not prevent the Irish parliament from trying to enforce similar provisions. For instance, in 1710 the House of Commons declared that 'the strict and due execution of the several laws in force in this Kingdom against sturdy beggars and vagrants and for confining the Poor thereof to their respective Parishes, would be a publick and seasonable service to this Kingdom.'
Parliament and the local authorities were well aware that the magnitude of the task of relieving poverty was beyond such institutional provision as the localities could provide. Hence they encouraged its supplementation by trying to create or sustain forms of outdoor relief. They were particularly anxious to discourage the sturdy beggar and support the deserving or unfortunate poor. To this end, 11 & 12 Geo. III, c. 30 and 15 & 16 Geo. III, c. 35, were enacted in the early 1770s to codify the many existing laws into a single statute. The preamble (15 & 16 Geo. III, c. 35) set out the official attitude:
Strolling beggars are very numerous in this kingdom: and whereas it is become equally necessary to give countenance and assistance to those poor who shall be found disabled by old age or infirmities to earn their living, as to restrain and punish those who may be able to support themselves by labour and industry, and yet may choose to live in idleness and begging; and it is just to call upon the humane and affluent to contribute to support of real objects of charity
Each county was to make arrangements to punish the idle and relieve the condition of the unfortunate, who, if they had resided for a year within the parish boundary, were to be licensed to beg and given a badge to indicate their virtuous necessity. The licence was to state the person's name, place of birth, character and cause of poverty, sickness or misfortune. Children under 10 years of age were to be inserted in their parents' licence, otherwise they could be taken into care by the authorities: 'that all poor children may as much as possible be prevented from strolling and may be put to trades or industry'. Fatherless or deserted children under eight years old found begging were to be sent to a charter school nursery and the rest to be apprenticed. As soon as they possessed funds the counties were to build, at as moderate expense as possible, plain and durable houses of industry, which were to be divided into four parts: poor helpless men, poor helpless women, sturdy beggars, idle and disorderly women. Any man above 15 years of age found begging without a badge was to be put in the stocks for up to three hours for a first offence and six hours for a second or subsequent offence. Hardened offenders of either sex were to be tried at the Quarter Sessions; if convicted they could face transportation to the American colonies or, later in the century, up to two months' imprisonment.
These efforts made discouragingly little impression on the problem. For instance, in 1764 a visitor considered that it would be 'happy ... if the method of parochial provision in England were introduced into this country, especially in the southern parts of it where the poor really are infamously neglected.' Yet a decade later Young was approving Ireland's lack of Poor Laws, for by this time early industrialisation in England encouraged a tolerant, even enthusiastic, view of labour mobility. In 1765 The Public Prompter and Irish Journal declared that:
Perhaps there is no city in Europe of equal extent and affluence [that] has so many public institutions and private provisions as ... Dublin: and notwithstanding, an uninformed Stranger to judge of our humanity by the prodigious number of beggars that crowd our streets and the various objects of real or feigned distress ... they are indeed an epidemic plague all over the Kingdom.
For some, begging was a profession. At the end of the century De Latocnaye wrote of Dublin that 'it would be difficult to say too much in praise of the zeal and activity of the kind persons who have done their best for the suffering humanity of this city', but he wondered whether this philanthropy was too concentrated in the capital, and whether 'it would be better if it were spread over the country'. Poverty was universally visible, and observers felt that it was more acute than elsewhere in Europe.
The Workhouse
The metropolis not only attracted and focused the social problems of the nation, but also gave a lead in attempting to solve them. In 1703, 2 Anne, c. 19, the Irish parliament established a workhouse in Dublin 'for the employing and maintaining the poor thereof'. It was in some respects a prototype of those established under the 1834 Poor Law Amendment Act, 3 & 4 Will. IV, c. 76. Dublin Corporation agreed to provide a piece of land and an income of £100 p.a. The institution was to be governed by a corporation whose membership included ex officio the Lord Lieutenant or Chief Governor, the Lord Mayor, the Lord Chancellor and the Archbishop of Dublin. Each donor of £50 or more was to be eligible for election to the office of Governor or Guardian. The 1703 statute was followed by another in 1707, 6 Anne, c. 13. This statute is mainly about servants, but clauses 7 and 8 are concerned with the children of the poor being trained to beg and the need for them to be taken into care. Clause 7 assumes the establishment of similar institutions throughout the country and arranged for their supervision. It states that the county official in charge is to submit a return to every Quarter Sessions for the respective county of all in his custody, stating when and by whom they had been committed: 'that so the Justices may in open court inquire into the condition and circumstances of each person, and either continue or discharge them, as shall seem to the court most just and reasonable'. The success of this statute was very limited.
The Dublin House of Industry was partly a national institution but, throughout the century, its administration was far from smooth. The elected Governors tended to disagree with the policies of their predecessors and, as it was in receipt of large parliamentary grants, its books were scrutinised by the Commissioners of Accounts. In 1797 it was discovered that the secretary had embezzled part of the funds. To resolve these and other problems, the Chief Secretary, Thomas Pelham, introduced a bill making Dublin Corporation responsible for electing seven governors to administer the affairs of the House of Industry. As with all such institutions at this time, its day-to-day administration was conducted with varying degrees of efficiency.
In the mid-1790s De Latocnaye reported that:
The House of Industry is a large establishment containing about 1,700 poor folk who, in part, support themselves by their labours. Their food is infinitely better than that found on the tables of the peasantry. They have meat once a week; bread, potatoes and other vegetables everyday; very clean beds; only their clothes remains as they were before entry; those who come of their own accord are allowed to go out one day weekly. Notwithstanding ... the love of liberty is so rooted in the heart of man there are very few who come of their own will, and others are constantly trying to escape. Artisans and tradesmen are generally occupied in making things foreign to their experience, and perhaps to this cause is to be attributed the mediocrity of most of the goods manufactured.444
A decade later Carr condemned the institution's mixed objectives, variety of inhabitants, relaxed discipline and 'most offensive' sewers.
The Governors could authorise the apprehension and setting to work of all vagabonds and beggars found in the city. Materials for their activities were to be provided by the House of Industry. Destitute children between five and 16 years old were to be kept in the institution, trained for apprenticeship to honest Protestants, and then apprenticed until the men reached the age of 24 and the women 21. The Governors were given powers to ensure that the regulations of the institution were enforced by inflicting reasonable punishment - recalcitrant vagrants and beggars could be set and kept at work for any period not exceeding seven years. Throughout the century the House of Industry's income was augmented by the proceeds from licensing up to 150 hackney coaches and 80 sedan chairs plying within the city and the adjoining Liberties. Each licensee paid an initial £5 and £2 p.a. thereafter. In addition, a tax of 3d per house was levied in the same way as tithes. A number of statutes, including 1 Geo. II, c. 27, applied public taxation to relieve the destitute. In passing them the Irish parliament not only recognised an important principle of social responsibility but also emphasised the need for both public and private support for the solution of communal problems.
There was a tendency for the poor to drift to the capital as a last resort, and the same was true of other cities, particularly Cork, where a House of Industry was erected by statute in 1735, 9 Geo. II, c. 25. Waterford and Limerick were also among the cities that followed Dublin's example in establishing Houses of Industry. In addition, various charitable foundations were established throughout the country; for instance, the Belfast Charitable Institution was founded in 1752 by private subscription. One of the worst social problems was that of destitute children. Abandoning unwanted children was for many a preferred alternative to infanticide, although its outcome in the harsh environment of the eighteenth century was hardly less certain. It was, however, legal, as 6 Anne c. 4, expressly forbade 'the Destroying and Murthering of Bastard Children'. Despite repeated enactments and inquiries, the Irish parliament tried without success to solve this major social and humanitarian problem.
In 1727, 1 Geo. II, c. 27, decreed that the exposed and 'very numerous' foundling children found in the city and Liberties of Dublin were to be the responsibility of the parish in which they were found until they reached the age of six. At six they were to be admitted to the House of Industry, taught to read and write and, if possible, prepared for a trade. But parliament expressed concern that most foundling children died before the age of six and, as the workhouse was neither large enough nor suitable for their reception, the only possibility of halting this mortality was that their welfare in infancy be made a parish concern. Each parish was to elect, annually at Easter, two or more Overseers of the Poor with special responsibility for supervising the nursing and maintaining of exposed or foundling children. A sum was added to the parish rate or cess for this purpose. The overseers were to account for this money and keep a register of the children stating where each was found, the time of their exposure, the names and abodes of the persons by whom they were nursed, and finally the circumstances of their death or removal from the parish. The only way to care for abandoned babies was to find a woman with an infant of her own who could feed the foundling and then look after it along with her own children. She was to be paid an annual stipend for the nursing and maintenance of children in the care of the parish. The overseers were required to see each child quarterly, with 'the intent that they may be truly informed of the state and condition of such child or children and whether they are sufficiently taken care of'.
Despite the good intentions of the legislators, the act proved unworkable: possibly, the bad harvests that followed its enactment placed an excessive burden on its operation, as two years later, in 1729, a further act, 3 Geo. II, c. 17, was passed. It had transpired that 'to avoid the said expense, it is notorious that a wicked and detestable practice hath been carried on in some parishes if not throughout the whole city, of lifting or running from one parish to another the said foundlings to the utter ruin and destruction of them.' To remedy this abuse a levy of 3d per £1 of the rateable value of every house in the city and its Liberties was made. This was to be collected and accounted for by the church wardens of the various parishes and paid to the Governors of the House of Industry, who would make arrangements for the nursing of the children until they were old enough to enter the institution. The Dublin Foundling Hospital predated the London Foundling Hospital by more than a decade. The children entrusted to the hospital were to be 'thoroughly instructed in the principles of the Protestant religion and the Church of Ireland by law established'. In 1772 in a further statute, 11 & 12 Geo. III, c. 11, which also consolidated previous legislation, the legislators decided that it was unsuitable for both institutions to exist under the same roof. The institutions were divided. A new House of Industry was built and the old building left to the Foundling Hospital.
The Foundling Hospital
The existing statutes of 1727 and 1729 proved inadequate to cope with the social distress that followed the famines of the 1740s. In 1750 yet another attempt was made to address this problem through remedial legislation: 23 Geo. II, c. 11, declared that 'there are in almost every part of this kingdom great numbers of helpless children who are forced to beg, and who will in all likelihood, if some care be not taken of their education, become hereafter not only unprofitable but dangerous to their country.' Any child between five and 12 years of age found begging, or being led or carried by a begging person, was to be apprehended by the agents of the government-sponsored charter schools and, with the consent of the local Justice of the Peace, assigned to the most convenient charter school available for their reception, which might or might not be the school nearest to their locality. Appeals against this action could be made to the next Quarter Sessions, but anyone who, in the interim, enticed such a child from the school to which they had been assigned would be tried in the local courts and, if found guilty, committed to the House of Correction for six months' hard labour. As poverty was the root of the problem and the poorest areas were likely to be Irish-speaking, redress in the English-speaking courts of Quarter Sessions was probably difficult. Moreover, as the charter schools had been founded for the double purpose of education and proselytisation, many parents felt that their educational benefits were outweighed by their spiritual dangers.
Meanwhile, the hospital accepted all abandoned children offered to it and, in the hope of preventing infanticide, they made it easy for the donor to remain anonymous by providing a cradle on a turning wheel in which the baby could be placed. A bell was rung to alert the door-keeper, who then turned the wheel and brought cradle and child into the hospital. An alternative method was to abandon the baby on the bank of a nearby canal, where many either drowned or died of exposure. Unfortunately, the hospital's open-entry policy combined with social attitudes towards illegitimacy to encourage the development of a professional class of foundling carriers, who brought children from all over Ireland to the hospital. The Tyrone story-teller, William Carleton writes of one of these in hisAutobiography:
The woman was notorious throughout most of Ulster, her name was Nell McCallum ... she had been one of those well known characters who were engaged in carrying illegitimate children up to the Foundling Hospital in Dublin ... She was subsequently prosecuted for robbing a carman, and transported.446
These people placed as many as eight or ten of these unfortunate infants in a kish or large wicker basket, and transported them to the capital either on horseback or in a springless cart. Many died on the way or arrived at the Hospital with broken limbs.
Once inside the Hospital their plight was little better. In the unhygienic conditions of the eighteenth century, collecting together a large number of infants, many of whom were ill on admission, made high mortality inevitable. Contemporaries, although accustomed to high infant mortality, were appalled by the result. In the period 1784-96, 25,253 children were entered on the hospital's admission records, and of these, 11,253 died. Not all of them died inside the hospital, for many were cared for outside. Nevertheless, the internal mortality was such that the porter regularly buried the dead infants after morning prayers on Mondays, Wednesdays and Fridays. In 1797 the horror reached its climax as on 19 consecutive days 116 children were admitted and 112 died.
By comparison, in the London Foundling Hospital the mortality of foundlings fell from approximately 50 per cent in the middle of the century to about 17 per cent at its close. This was exceptionally low; the Paris Foundling Hospital had a rate more comparable to the Dublin hospital. When the Cork House of Industry was opened in 1747, it also had a Foundling Hospital but not an internal nursery. Instead it accepted children exposed during the year each Easter, and arranged for their nursing and care until they were of an age to be admitted to the institution for their education and subsequent apprenticeship. The result was worse, as the overall mortality of these children was 70 per cent by the age of 15.
In 1792 the House of Commons was alerted to the high mortality in the Dublin Foundling Hospital by Sir John Blaquiere (0162), MP for Charleville. Blaquiere was particularly concerned about social issues - he had also been active in the movement for prison reform. By 1797 the situation had again degenerated, and he raised the question once more. Another committee was appointed to inquire into the conduct of the Hospital, and on 11 April 1797 a report was laid before the House that regretted the necessity of 'stating facts which carry a complexion of more than savage cruelty'. It emerged that although there was a physician, a surgeon and an apothecary attached to the Hospital, no attempt was being made to keep the children alive - on his preliminary inquiry Blaquiere 'had found 14 children stowed into an upper room - for the purpose of dying'. Parliament and society were shocked; the Hospital was reorganised and placed under the supervision of 13 Lady Governesses, including the Duchess of Leinster and Lady Castlereagh, the wife of the Chief Secretary.
For a time there was an improvement and the mortality rate fell, but by 1826 the situation had again degenerated and this time the Hospital was finally closed after an equally appalling report concluded that it was 'evidently the design of Providence that the infancy of children should be supervised by their parents, and that any great departure from this principle ... will be attended by circumstances of an untoward and perplexing nature'. Fear of making things worse was often one of the motives behind the doctrine of laissez-faire in social issues, especially when the fragile nature of the social structure was underlined by the failure of well-intentioned experiments in alleviating social distress. Effective mechanisms for the administration of welfare were only at the start of their long and often halting evolution. Nevertheless, nine years after the Foundling Hospital was closed, the Commissioners of the 1835 Poor Inquiry were informed that in certain areas, such as Tullow, Co. Carlow, 'the increase of infanticide generally has been awful since the closing of the Foundling Hospital'.
Hospitals and Medical Services
Dublin Hospitals
The basis of Ireland's civilian hospital system was established in the eighteenth century. It is difficult to assess the immediate effects of developments in social and medical care, for modern medicine was in its infancy and lack of scientific knowledge and antiseptics ensured that hospitals and treatment often produced the reverse effect to that intended. At the beginning of the century the only known hospitals were military ones. The first known civilian hospital in Ireland was opened in Dublin in 1726 and contained four beds. Then in 1733, under the will of Dr Steevens, who had died in 1717, Dr Steevens' Hospital was established, providing 40 beds for poor patients to be chosen without distinction of religion or ailment so long as the latter was not infectious. This foundation was expanded during the century; for instance, in 1737, Primate Boulter added a ten-bed ward which he maintained until his death in 1742. A year after Steevens' Hospital opened, Mercer's Hospital was founded by Mrs Mary Mercer. The mid-1740s saw the foundation of the Hospital for Incurables, sponsored by the Charitable Musical Society, and the Lying-in Hospital, the first maternity hospital in the British Isles, was established by Dr Bartholomew Mosse. Other hospitals included Sir Patrick Dun's, which became the university teaching hospital; St Patrick's, founded by Swift for the treatment of mental disease; Simpson's for blind and aged men; and the Lock for the treatment of venereal disease (which was a major scourge in the eighteenth century - in 1792-3 the hospital treated an estimated 2,000 cases).
The number of hospitals established in Dublin and throughout the country in the late eighteenth and early nineteenth centuries indicated a public desire to ameliorate distress, even if only a very small minority benefited from the efforts of devoted individuals. By the end of the century Dublin had ten hospitals. Some of these hospitals received irregular parliamentary grants, but all depended essentially on voluntary subscriptions or charitable fund-raising activities. The pattern of financing set by Steevens' Hospital was fairly typical. Its income always fell short of its expenditure, and in 1801 its Governors appealed to parliament for assistance. Throughout the century, it had operated on a mixture of private donation and various types of fund-raising, including a lottery. The Belfast Charitable Society raised some of its initial funds from a lottery. Lotteries were quite a common way of raising funds for charities or for the government purposes. The lottery was conducted stringently: there were two lottery wheels, one with numbered tickets and the other with prizes and blanks. Each number was drawn and concurrently matched against a prize or a blank from the other wheel.
Apart from lotteries, funds for charitable causes were raised in a wide variety of ways, including church collections following charity sermons by noted preachers. Very often people were carried away by the pleas of the preacher and further encouraged to generous giving by the social standing of those taking up the collection. For instance, Dr Drennan reported that one such sermon by Dean Kirwan had raised £418 but 'the town is thin ... one lady took out her purse and not thinking that enough threw a watch with trinkets into the plate which was handed round by Lord Clonmell.' These public occasions were supplemented by an assortment of individual efforts. De Latocnaye describes the charitable fund-raising in fashionable Dublin at the close of the century:
It was the fashion for people of high style to attend the charity sermons of a famous preacher, Mr Kirwan. It has happened often at these services that the collections have amounted to a thousand or twelve hundred pounds, the money being supplied to the support of schools for orphans. The Dublin ladies carry on little industries, providing the materials at their own charges, and selling the finished products for the benefit of the same schools. In most of the rich houses to which I was admitted I found the ladies occupied in this way. As the class below the highest is always disposed to imitate its superiors, charity sermons are very frequent over the city.
Concerts were another popular way of raising funds, particularly for hospitals. The most famous event of this type occurred in 1742 when the first performance of Handel's Messiah was conducted by the composer, who was visiting Dublin in response to the viceregal invitation of the 3rd Duke of Devonshire. The performance was sponsored by the Charitable Musical Society to raise funds for its projected Hospital for Incurables. In 1744, the year in which the hospital opened, Faulkner's Dublin Journal published the following advertisement explaining how the Society operated:
The Charitable Musical Society in Crow Street on account of the great expense attending the support of the Hospital for Incurables and intending to employ this Year a great number of performers, have thought it proper to raise their subscription to one guinea, each member having the privilege of two tickets for ladies each night. N.B. Every subscriber has a right of a vote in the disposal of the funds of the society.
Concert advertisements often requested ladies to come without hoops in their dresses in order to save room.
Among the most successful social fund-raisers was the Lying-in Hospital. Its buildings were originally designed by Cassels, who was a friend of its founder, Dr Bartholomew Mosse. The Assembly Rooms, whose functions were its principal support, became known as the Rotunda. Adjoining the hospital, they were conveniently situated in Rutland (Parnell) Square at the top of Sackville (O'Connell) Street. They were the social centre of Dublin. At least four famous Dublin architects - Cassels, John Ensor, Gandon and Richard Johnston, the elder brother of Francis Johnston - played a role in their final design and construction, as well as the gentleman architect and MP for Maryborough, Frederick Trench (2108 ). The Rotunda itself had a diameter of 80 feet (24.5m) and the ceiling was without a central support. When they were completed in the mid-1780s, it was proudly noted that the Dublin Assembly Rooms had only 20 square feet less space than those at Bath! There were six formal assemblies a year, to which a limited group of subscribers could apply for the 400 tickets. On these occasions there was dancing and card playing, with refreshments of coffee and lemonade, and a supper of plain meats and wine. It was Ireland's equivalent of Almanacs, and the proprieties were strictly observed.
Apart from these social highlights, the Rotunda provided facilities for other activities. In the 1790s the engraver James Malton declared that:
The entertainments of the Rotunda during the winter form the most elegant amusements of Dublin; it is open every Sunday evening in summer, for the purpose of promenade, when tea and coffee are given in the superb upper room. The receipts of the whole after defraying the incidental expenses go to the support of the hospital.
The irrepressible De Latocnaye, hearing that 'they have devised in Dublin a rather singular entertainment ... it is called a Promenade', attended one to discover that those present walked in the circular hall until a bell rang, when they all hurried through a door just opened. Groups of friends then settled round tea tables, and 'Everywhere there reigned a kind of quiet enjoyment.' He noticed that, although they tended to keep within their own groups, they had more freedom than at private entertainments, as: 'the good mammas were not very numerous, and those who were present appeared to be absent-minded. The young folk on the other hand were very numerous and making good use of their time - I think perhaps the Promenade attained its object along more lines than one.'
The County Infirmaries
Where Dublin led, the rest of the country followed. As with the Dublin hospitals, those throughout the country were largely the result of private enterprise and public subscription. Parliament, by an act of 1765, 5 Geo. III, c. 20, amended in 1767, 7 Geo. III, c. 8, attempted to provide a framework for the development of county infirmaries and, although the facilities and accommodation were totally inadequate to the need, by the end of the century almost every county had its infirmary. The 1765 legislation acknowledged the inadequacy of the funding for the existing public infirmaries at Dublin, namely the Charitable Infirmary, Mercer's and the Hospital for Incurables, as well as the two public infirmaries at Cork, the North and South Infirmaries, and made provision for £50 p.a. to be paid out of the Treasury to supplement their budgets. The statutes made the clergy of the Church of Ireland a perpetual corporation for the erection of infirmaries, and qualifications were laid down for additional Governors by subscription. Meetings required a quorum of five and were to be held quarterly, when the Treasurer would present his accounts. No person was to be admitted unless the Governors certified that he was a proper recipient of the charity, although the surgeon had discretion over emergency admissions. Parliament allocated £100 for the surgeon's salary and the Grand Jury was to supplement this with a grant towards the hospital's expenses. It was hoped that private charity would provide the remainder, and in some cases it did. For example, by the end of the century Belfast had in addition to a general infirmary a fever hospital, both largely dependent on public support.
Records for the establishment of the Co. Down Infirmary illustrate how the system operated. On 21 April 1767 the gentlemen of the County of Down met at Downpatrick, the county town, to establish an infirmary. They raised £810 10s 9d: £688 from subscriptions, a ball at the summer assizes raised £28, the county presented £50 from the cess, a ball at the Lent assizes raised a further £33 12s. Arrangements were made for collecting boxes to be put at the doors of the parish and the Presbyterian churches, in the market place and in the infirmary. By 14 July 1767 the Governors had taken a three-year lease of a house and appointed a housekeeper on a yearly salary of £10 with board. At this point the Governors and Governesses declared that the infirmary was ready for the receipt of patients. The surgeon, on a salary of £100 p.a., was not to absent himself from the hospital for more than 48 hours without written permission. The standing committee was to meet every fortnight at the infirmary, and more often if required. No member of the infirmary staff on pain of expulsion was to take a fee or gratuity from a patient. The duties of the staff and patients were carefully spelt out, as was the diet. Certain types of patients were excluded, for instance maternity cases, fevers, those in the last stage of consumption or incurable cases, for whose rejection a written explanation was required. There were to be no visitors before 11 a.m. or after 8 p.m. This pattern was repeated with varying degrees of efficiency and enthusiasm throughout the country.
Mental Illness
The problem of mental illness was well recognised in the eighteenth century although its origins remained mysterious. Abnormal behaviour provoked fear and hostility, and such treatment as was available was more likely to aggravate than cure the suffering of the afflicted. The treatment of George III during his 1788-9 illness was a case in point, while Dr Edward Jenner, of vaccination fame, found that violent patients could be moderated by making them vomit with tartar emetic. There was slender provision for the care of the insane in eighteenth-century Ireland, and visitors reported that they were left to fend for themselves. Occasionally the problem was recognised, but the resources were always inadequate. For instance, De Latocnaye discovered that in the hospital at Waterford, 'which is maintained by subscription and, in part, by a small endowment', there was specific provision for the mentally handicapped; he adds that 'this is a matter of great importance, for one of the most painful spectacles to be seen in nearly all the principal towns in Ireland is the number of weak-minded people in the streets.' For example, he considered that the authorities at Galway should 'prevent lunatics from running round in the streets'. Nevertheless, the picture that Carr paints of the institutional treatment of the mentally ill suggests that their lot was often infinitely worse. On visiting the House of Industry at Limerick, where some of the insane were confined, he found 'madmen stark naked girded only by their irons, standing in the rain, in an open court'.
In 1817 the Commissioners on the Select Committee inquiring into the expediency of making further provision for the relief of the lunatic poor in Ireland found that the existing provision was totally inadequate. Reviewing its antecedents, they reported that:
An hospital attached to the House of Industry in Dublin was originally the only receptacle in that city for persons of the lower classes who were afflicted with mental derangement; and the cells attached to the Infirmaries or Poor Houses in some of the counties were by no means calculated for the restoration to sanity or even for the safe custody of persons who were suffering under so dreadful a malady.
Major institutional arrangements for the insane were made only in 1815, with the completion of the Richmond Lunatic Asylum in Dublin. Authorised in 1810, it was built and supported by parliamentary grant. On its completion, 170 patients were moved there from the House of Industry but within two years the Commissioners found that its provision for 200 inmates was totally inadequate and, as the majority of patients were being sent from the remoter parts of the country, the only solution was the establishment of further similar institutions. The Quakers were pioneers in the compassionate treatment of the mentally deranged and the Richmond Asylum was, in 1817, being operated on the Pinel system that had been used successfully at the Quaker Asylum near York. It was based on kindness and good sense rather than restraint; the Commissioners reported that there was not 'a chain, fetter or handicuff' in the asylum and that any deaths were caused by bodily infirmity rather than the violence of mania.
Thomas Rice, the Commissioner assigned to visit asylums in the south of Ireland, also paid tribute to the work of the Society of Friends: 'in every public establishment in the South of Ireland which I have visited, I have found the prosperity of the establishment best attended to and its funds most increased by the exertions of one class of individuals ... I allude to the Quakers of independent fortunes and stations throughout the South of Ireland.' He considered that with the exception of Cork there was not a single establishment that could continue 'for half a year without the exertions and sacrifices of time and money given by the individuals I have alluded to'. Rice found that the Cork Asylum enjoyed considerable public support and that it was well run. The facilities at Waterford were poor but ameliorated by good management. However, at Limerick he found 'a contrast to all the merits, and an example of all the faults that I have met with in all the other Asylums that I have visited'. His description and condemnation of the condition of the lunatic poor in Limerick is utterly devastating, and Carr's strictures on it were still valid more than a decade later.
In Mayo the Rt Hon. Denis Browne (0253) reported that there had been no provision for the mentally ill until the grand jury, receiving £5,000 in fines from illicit distillation, had acquired the building of the charter school. This had been refurbished to provide about 20 cells at a cost of £400-500. The incurables were sent to the Dublin Asylum at a cost of £2 2s per person, but Browne reported that 'they treat them in the carriages very brutally.' He then pointed out that:
There is nothing so shocking as madness in the cabin of a peasant, where the man is out labouring in the fields for his bread and the care of the woman of the house is scarcely sufficient for the attendance on the children. When a strong young man or woman gets the complaint, the only way they have to manage is by making a hole in the floor of the cabin not high enough for a person to stand up in, with a crib over it to prevent his getting up, the hole is about five feet deep, and they give this wretched being his food there, and there he generally dies. Of all human calamity I know of none equal to this in the country parts of Ireland.
Adequate provision for the poor and the sick depended not only on resources but also on sustained supervision and interest on the part of all involved. Furthermore, it required a high degree of managerial coherence. Apart from the question of political will, the human capital required to implement proposed solutions was plainly unavailable, and individual reformers were no substitute for it. Bureaucratic excellence, in fact, was at a premium in the age that divined the first outlines of modern organisation and saw in them the solution to social problems. But it was to be a long and difficult period as the skills required for the effective implementation of social services were gradually hammered out. For instance, a 1788 review of the results of the 1765 County Infirmary Act showed a far from satisfactory situation. There were on average about ten patients in each of the county infirmaries established under the act, and the buildings left much to be desired. John Howard included them in his visitation of prisons and other institutions, and his remarks highlight the enormity of the problem and the lack of knowledge and resources, combined with a general slovenliness but redeemed by the odd oasis of achievement. A typical report from Howard states:
Limerick County Infirmary - thoroughly repaired, whitewashed and furnished with new bedding - a cleanly and notable matron ... Cavan County Hospital. All rooms very dirty, an upper room full of fowls, a dunghill in the small front courtyard ... Armagh County Hospital. Built by the Lord Primate in 1768. No baths; nor do I recollect any in use in other county hospitals, though very conducive to the health of the patients.
The Dispensary Movement
There was an increasing interest in providing outpatient medical relief from at least 1767, when a parliamentary statute, 7 Geo. III, c. 15, allowed the Dublin Society to use part of its grant to establish a pharmacopoeia pauperum 'for dispensing medicines to the poor of the city of Dublin according to a plan laid down by John Wade chemist'. Some wealthy people made individual arrangements with apothecaries for the supply of medicines to the poor. Then, in the closing decades of the century, there was an important development in medical care: the establishment of the Sick Poor's Institution in Dublin. Anyone subscribing a guinea a year could send a poor sick person for treatment or, if necessary, arrange a home visit from a physician, while required medicines were provided without cost. The idea became popular, and other institutions were established in the capital and elsewhere. By 1800 three of these dispensaries had been established in Dublin.
In the 1790 Almanac there is a record of the Dublin General Dispensary's first four-and-a-half years. The Dispensary had been established by six physicians and six surgeons to provide medical and surgical care and dispense medicines to the sick poor who for various reasons could not get into hospitals. The Duke of Leinster was president of the organisation, and the Dispensary was supported by voluntary contributions. Persons subscribing one guinea became annual Governors with the privilege of being able to nominate one patient to be constantly under attendance. Those subscribing five guineas became life Governors with the same privilege. It opened on 18 April 1784 in premises in the Old Post Office Yard, and by 1 November 1789, 3,227 patients had been treated. Of these 2,331 were cured or relieved at the Dispensary; 726 were visited at their own homes; 47 had died and 31 were recommended to other charities as being unable to sustain themselves at home; three were discharged as incurable and two dismissed as 'irregular'. In November 1789 there were 72 patients on the books. Persons meeting with sudden accidents would be visited immediately on application to the Dispensary, and assistance would be afforded in cases of apparent death from drowning or suffocation.
From Dublin the dispensary movement spread throughout the country. For instance, in 1792 the Belfast Dispensary advertised for support in the Belfast News Letter, and in 1793 a dispensary was established in Tanderagee, Co. Armagh. In 1795 a newspaper report on the dispensary movement stated that:
They are regularly attended by a physician, surgeon and apothecary, and have medicine, wine &c. distributed to them gratis. The cost is less than £20 a year, raised by donations from the gentry, and during the two years the scheme has been in operation two hundred individuals ... have been helped.
The dispensary movement gained great social importance in nineteenth- and early twentieth-century Ireland, but for a long time its infrastructure was too slender and its resources totally inadequate for the problems it was trying to alleviate.
Structural Problems
By the end of the century a model of sorts had been established to provide a foundation on which a more administratively sophisticated future could build. Responses to social problems in Ireland compared favourably with contemporary experience abroad. The willingness of governors and parliamentarians in a poor country to confront social problems positively, and not without courage, often placed them in the vanguard of humanitarian thinking. However, circumstances increasingly beyond their control overwhelmed their intentions as the rise in population was unaccompanied by a rise in economic opportunities. It could be argued that they were - in the classic Malthusian trap - faced with a race against time. Also, their achievements lacked visible continuity, and were therefore deprived of the accolades of hindsight, as nineteenth-century Irish affairs became further complicated by the advent of European romanticism.
Another consideration is that the second half of the eighteenth century saw an improvement in the weather, always vitally important in an agrarian community. Scarcities did not vanish, but they became less frequent and less severe. Although the itinerant population of the very poor was always a danger in terms of the spread of disease, there was also a decline in the virulence of epidemic disease. Smallpox in particular appears to have been less severe, and plague, which was known at the beginning of the century, had gone into abeyance. Inoculation became more widespread, although it had the danger of infecting a whole village if it got out of hand. Itinerant inoculators boasted of their success, pointing out that if their patient died they would have to flee for their lives. At the end of the century the much safer practice of vaccination became known. The population was rising sharply, and the great typhus and cholera epidemics of the nineteenth century lay in the future.
The 'condition of Ireland' problem, although present throughout the eighteenth century, became acute only at the very end and assumed its most menacing aspects in the post-Union decades. The post-1800 British parliamentary reports - a fascinating, if often horrendous, mine of information - were a response to the pressure that was increasing with every decade on a social infrastructure facing unprecedented conditions. Unfortunately, while these Reports could define problems, the executive machinery to implement their solution did not exist in the eighteenth or early nineteenth century, while Irish society lacked the industrial dynamic that might have ameliorated them.
