Introducing his Guide for Irish Medical Practitioners (1889), Professor Richard J. Kinkead noted that care of the sick population in Ireland devolved on state-supported functionaries to a far greater extent than in England or other European countries. In England, he observed, none but the actually destitute were entitled to medical relief, and therefore the artisan class “provided for themselves in sickness by the agency of co-operative organizations such as ‘clubs’ or by resort to cheap practitioners. In Ireland, on the contrary, all such citizens look as a matter of course to the tax-payer for medical relief.” Kinkead calculated that the Irish poor law provided medical aid to over 840,000 people each year, or nearly one fifth of the population. Such dependency on state help in times of sickness was, he suspected, far from “beneficial for any community … because of the want of self-reliance and domestic providence which it inculcates, but as the system is such, the medical practitioner naturally assumes an importance in Ireland in advance of that which attaches to this position in other countries.” Poor law medical officers were “incomparably the most important servants of the community … exercising the most direct and lasting influence upon the prosperity and happiness of the Irish people.” Yet despite the centrality of the poor law to the development of medical provision in Ireland, the history of Irish poor law medical services remains to be written.