The eleven papers in this volume, which were originally presented at a workshop at the University of Warwick in 2005, traverse more than two hundred years of Irish medical history, with the focus firmly on the period that followed the Great Famine of the mid-nineteenth century. The rubric under which the collection is presented, ‘cultures of care’, is never defined or explained but suggests a cohesiveness which, in fact, does not exist. The volume does not have a single or overriding theme – other than the Irish dimension – although some of the chapters are thematically linked.
Ireland was not a single political entity during the entire period covered in this work and in their introduction the editors draw attention to early twentieth century political developments, to partition, and to the emergence of Northern Ireland and the Irish Free State. The volume is framed chronologically and the first seven chapters deal with the island as a whole, the remaining four with Ireland after partition, although only one deals specifically with the northern jurisdiction, Leanne McCormick’s ‘Venereal disease in interwar Northern Ireland’. After 1922, legislation and practices relating to medicine and healthcare evolved separately in the two states, the most obvious difference, as the editors remind us, was the introduction of the National Health Service to Northern Ireland in 1949.
The volume’s chronological structure offers a linear perspective over the period 1750–1970. The editors might have opted for a different approach, distinguishing discrete studies and linking those that addressed similar themes or areas of study. The individually distinct chapters are James Kelly’s accessible and well-rounded analysis of healthcare provision and therapeutics in eighteenth-century Ireland; Michael J. Clark’s elegant exploration of the difficult relationship between general medical practice and coroners’ practice, not least the thorny question of the payment of fees for medico-legal work, in the period from the 1830s to the 1890s; Catherine Cox’s evaluation of the post-Famine medical dispensary service, one that focuses on the organisation and administration of the service rather than on the patient or patient entitlement. Many of the features referred to in this chapter did not emerge sui generis after the Great Famine but featured just as strongly before that event, perhaps even more so, given the country’s greater population and rural impoverishment; James McGeachie’s engaging attempt to restore the ‘late Victorian phenomenon’ Dr George Sigerson to public memory and to reassess his contribution to Irish medical, scientific, literary and political life in the late nineteenth and early twentieth centuries; Caitríona Foley’s examination of the impact on Ireland of the influenza outbreak of the early 1890s and of the far more destructive 1918/9 pandemic; and Mary E. Daly’s incisive analysis of disease and mortality in the independent Irish state in the half century after its foundation.
A number of connecting threads – medico-legal and a broadly defined sexuality – run through the remaining chapters: the legal implications of suicide, the insanity plea in cases of infanticide and child murder, illegitimacy and infanticide, and other outcomes of unwanted pregnancies, contraception, venereal disease, and, overarchingly, the moral, political, religious and social climate that sanctioned and shaped such practices and transgressions.
The editors acknowledge the historiographic significance of Elizabeth Malcolm and Greta Jones’s edited volume, Medicine, Charity and the State in Ireland, 1650–1940 (Cork: Cork University Press, 1998), which, on its publication in 1998, broke new ground in the social history of medicine in Ireland. The current collection addresses some of the lacunae identified in that volume, subscribes to its broad agenda, maintains its general standards, retains some of the original contributors and, like its predecessor, points to neglected areas of study that require research and analysis.
