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Published online by Cambridge University Press: 04 February 2015
The eighteenth century, a period when pain, suffering and illness was an ‘omnipresent threat’, saw medicine became more institutionally-based, increasingly state-funded, and wedded to a more scientific and analytical approach to disease. Voluntary hospitals, county infirmaries, medical supply dispensaries for the poor, the Royal Colleges of Physicians and Surgeons, and various medical guilds, schools and societies, were established or grew in importance. Collectively these institutions did much to influence how Ireland's main medical practitioners (physicians, surgeons, apothecaries) were educated, trained and organised, as well as the way the sick were cared for. While university-trained Irish physicians catered mostly for wealthy elites, the sick, rural poor usually only possessed the means or opportunity to engage the services of apothecaries or, occasionally, surgeons. Along with commercial, patent medicines, domestic remedies and self-medication, the sick had at their disposal an array of untrained, unregulated empirics, quacks, mountebanks, druggists, oculists, and faith and magical healers.
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27 I.L.D.
28 Lloyd’s Evening Post, 14 June 1766. The Privy Council amendment ensured that parliamentary subvention was paid directly to the Infirmary treasurer and not the district tax collector: see British Privy Council, Irish Bills committee report, 13 May 1766 (The National Archives, London (T.N.A.), Privy Council Records, PC 1/8/24).
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30 In common with all acts discussed in this article, the following examination of the 1765/6 Act (5 Geo. III, c.20) relies on the text of the original statute. See The statutes at large passed in the Parliaments held in Ireland (20 vols, Dublin, 1786–1801).
31 For an example of ‘improving’ rhetoric being used to lend moral legitimacy to attempts to develop Ireland's fishing industry, see Sneddon, ‘Legislating for economic development’, pp 153–4.
32 John Whittingham to James Hamilton, eighth earl of Abercorn, 31 Aug. 1767 (P.R.O.N.I., T2541/IA/1/7/95); Galbraith Lowry Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/70).
33 Foster, EdwardAn essay on hospitals. Or succinct directions for the situation, construction and administration of country hospitals … (Dublin, 1768):Google Scholar ‘Blessed is he that considereth the poor; the Lord will deliver him in the time of trouble’ (Ps. 41:1); ‘I was naked, and ye clothed me; I was sick, and ye visited me’(Matt. 25:36). See also Geary, Medicine and charity, p. 43.Google Scholar
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38 Lisburn in County Antrim; Mallow in County Cork; Castlebar in County Mayo; Letterkenny in County Donegal; Kildare in County Kildare; Navan in County Meath; Cashel in County Tipperary.
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40 It should be noted that the 1765/6 Infirmary Act also provided Mercer's Hospital, Dublin, the North and South Charitable Infirmaries of Cork, the Charitable Infirmary, Dublin, and the Hospital for Incurables in Townsend Street (then Lazar’s Hill) with an annual subvention of £50 each. It also stipulated that these institutions were to receive between £50 and £100 annually from grand jury presentments.
41 These examples, given in parenthesis, of typical infirmary income and expenditure are taken from an examination of the following records: Monaghan Infirmary minutes, 9 Aug. 1770, 13 July 1775, 19 Aug. 1783 (N.L.I., Hospital Records, Monaghan Infirmary minute book (MB), 1768’1857, accession number, 2006/100); Minutes of the Governors of Antrim Infirmary, 7 Apr. 1767, 2 Feb. 1772, 8 Aug. 1777, 2 Nov. 1785, 5 May 1789, 1 Aug. 1792 (P.R.O.N.I., Hospital records, HOS/7/3/1/A/1); Down Infirmary minutes, Jan. 1768 – June 1800 (P.R.O.N.I., HOS/14/2/1/A/1, pp 1–4, 16, 34, 62–77, 82–99); Armagh Infirmary minutes, 1777, 1788 (Armagh County Museum (A.C.M.), Infirmary minute book (MB) 14, pp 261–2).
42 For examples of this type of financial study, see: Borsay, ‘Cash and conscience’, and Berry, Amanda ‘“Balancing the books”: funding provincial hospitals in eighteenth-century England’ in Accounting, Business and Financial History, 7, no. 1 (1997), pp 1–30.CrossRefGoogle Scholar
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48 James Hamilton to Abercorn, 30 May 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/75).
49 Hamilton to Abercorn, 30 May 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/75); see also Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., D623/A/37/70).
50 Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., D623/A/37/70).
51 It is accepted that contentions made regarding religious background or ethnicity based on surname analysis are inherently conjectural.
52 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I., HOS/14/2/1/A/1, p. 9); Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, ‘Rules of Infirmary’); minutes of Governors of Antrim Infirmary, 3 May, 2 Aug. 1768, 10 Nov. 1772, 2 May 1775 (P.R.O.N.I., HOS/7/3/1/A/1, pp 13–14, 31, 40).
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62 Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, ‘Rules of Infirmary’).
63 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I. HOS/14/2/1/A/1, pp 10, 15).
64 Minutes of Governors of Antrim Infirmary, 1 Aug. 1769 (P.R.O.N.I., HOS/7/3/1/A/1, p. 6158).
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67 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I., HOS/14/2/1/A/1, p. 15).
68 Ibid., 8 Oct. 1788, pp 85–6.
69 William Stewart to James Hamilton, eighth earl of Abercorn, 3 Jan. 1775 (P.R.O.N.I., Abercorn papers, D623/A/42/48).
70 Down Infirmary minutes, 21 Apr. 1767 to 24 June 1800 (P.R.O.N.I., HOS/14/2/1/A/1, pp 1–104).
71 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxcii. For John Howard, see Ole Peter Grell, 'A journey of body and soul: the significance of the hospitals in southern, Catholic Europe for John Howard's views of health care and the creation of the utopian hospital' in Ole Peter Grell, Andrew Cunningham and Roeck, Bernd (eds), Health care and poor relief in 18th and 19th century southern Europe (Aldershot, 2005), pp 289–316.Google Scholar
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73 Monaghan Infirmary minutes, 12 Jan. 1768 (N.L.I., MB 2006/100).
74 Minutes of Standing Committee of Antrim Infirmary, 6 Jan. 1767 to 1 Jan. 1782 (P.R.O.N.I., HOS/7/3/1/B/1, pp 1–41).
75 Ibid., 6 Jan., 20 Feb. 1767, 25 Aug., 1 Sept., 13 Oct. 1777, 3 Apr. 1780, pp 1, 7, 26–7, 34.
76 Minutes of Standing Committee of Antrim Infirmary, 16 Sept. 1772 (P.R.O.N.I., HOS/7/3/1/B/1, p. 18).
77 Ibid., 2, 13 Feb., 25 Aug. 1767, 1 Oct. 1781, pp 5, 7, 11, 40.
78 Minutes of Standing Committee of Antrim Infirmary, 16 Sept. 1772, 3 Dec. 1781 (P.R.O.N.I., HOS/7/3/1/B/1, pp 18, 40).
79 Ibid., 6 Jan. 1783, p. 43.
80 Monaghan Infirmary minutes, 25 Sept., 12 Oct., 16 Dec. 1782, 22 Apr. 1793, 8 Feb. 1796 (N.L.I., MB 2006/100); minutes of Governors of Antrim Infirmary, 10 Feb., 17 Mar. 1777 (P.R.O.N.I., HOS/7/3/1/A/1); Armagh Infirmary minutes, 2 Mar., 6 Apr. 1776, 19 Nov. 1787, 8 Feb. 1788 (A.C.M., MB 14, pp 27-8, 40, 41).
81 Armagh Infirmary minutes, 13 July, 8 Aug. 1767 (A.C.M., MB 14, p. 14).
82 Monaghan Infirmary minutes, 8 Feb. 1796 (N.L.I., MB 2006/100).
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85 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxciv.
86 John James Hamilton, first marquess of Abercorn, to Stewart, 18–20 Dec. 1794 (P.R.O.N.I., D623/A/79/30); Moore to Abercorn, 24 July 1795 (P.R.O.N.I., D623/A/147/29).
87 Abercorn to Moore, 31 July 1795 (P.R.O.N.I., Abercorn papers, D623/A/79/115).
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89 Specifically those in Counties Londonderry, Down, Monaghan, Armagh, Antrim and Down, see: Down Infirmary minutes, 6 Oct. 1767 (P.R.O.N.I., HOS/14/2/1/A/1, p.7); Howard, Account of the principal lazarettos, p. 97; Monaghan Infirmary minutes, 20 Apr. 1770 (N.L.I., MB 2006/100, ‘Loose leaf inserted in minute book’); minutes of Governors of Antrim Infirmary, 17 Mar. 1777 (P.R.O.N.I., HOS/7/3/1/A/1); Armagh Infirmary minutes, 1777 (A.C.M., MB 14, p. 262).
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94 Commons jn. Ire. (3rd ed.), xxv, 277.
95 Commons jn. Ire. (3rd ed.), xxv, 331; idem., appendix, cccxci-cccci. For Sir Jeremiah Fitzgerald, see MacDonagh, OliverThe inspector general: Sir Jeremiah Fitzpatrick and the politics of social reform, 1783–1802 (London, 1981).Google Scholar
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100 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxciii.
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104 Monaghan Infirmary minutes, 1 Aug. 1788, 27 July 1789, 11 Feb. 1793 (N.L.I., MB 2006/100).
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107 For examples of this legislation and their passage through parliament, see: 11 & 12 Geo. III, c.23 (1771); 13 & 14 Geo. III, c.43 (1773); 15 & 16 Geo. III, c.31 (1775); 19 & 20 Geo. III, c.44 (1779); 23 & 24 Geo. III, c.29 (1783); 25 Geo. III, c.40 (1785); 25 Geo. III, c.39 (1785); 26 Geo. III, c.21 (1786); 39 Geo. III, c.17 (1799); Parliamentary register, iii, 10–12; Armagh Infirmary Minutes, August 1777 (A.C.M., MB 14, p. 261); British Privy Council register, 7 May 1772 (T.N.A., PC 2/116: 217); I.L.D.; Commons jn. Ire. (4th ed.), viii, 120, 515; ibid., ix, 29 , 64; Richard Lewis (ed.), The Dublin guide: or a description of the city of Dublin (Dublin, 1787), pp 181–2; The Times, 15 Mar. 1786; Morning Chronicle and London Advertiser, 6 Feb. 1786.
108 7 Geo. III, c.8 (1767).
109 I.L.D.; British Privy Council, Irish bills committee report, 20 Apr. 1768 (T.N.A., Privy Council Records, PC 1/9/18, f.4r); British Privy Council register, 19 Apr. 1768 (T.N.A., PC 2/113, p. 131).
110 17 & 18 George III, c.15 (1777); I.L.D.; Commons jn. Ire. (2nd ed.), xviii, 379; British Privy Council, Irish bills committee report, 13 May 1778 (T.N.A., Privy Council records, PC 1/11/80, f.3r).
111 36 Geo. III c.9 (1796).
112 Lloyd’s Evening Post, 8 Apr. 1791; Parliamentary Register, xii, 290–3; Commons jn. Ire. (3rd ed.), xxviii, pp 1102, 1131; minutes of Royal College of Surgeons, 5 Apr., 2 May 1791 (Royal College of Surgeons, minute books, RSCI/COL/1, pp 204–9); Kelly, ‘Infanticide,’ p. 20;Google ScholarGeary, Medicine and charity, p. 132.Google Scholar
113 15 & 16 George III c.31 (1775); ‘To amend an act passed in this kingdom in the 5th year of the reign of his present majesty, entitled, an act for erecting and establishing public infirmaries or hospitals in this kingdom’ (1795, failed); ‘To amend an act passed in the 5th year of the reign of his present majesty, entitled, an act for erecting and establishing public infirmaries or hospitals in this kingdom’ (1796, failed). For details of this legislation, see I.L.D.
114 This assertion is based on an examination of legislative promoters contained in the I.L.D., as well as biographical details of M.P.s in Johnston-Liik, History of the Irish Parliament. Details of initiatives which began life as parliamentary petitions have been taken from Commons jn. Ire. and Lords jn. Ire. For improving medical practitioners, see Barnard, Toby ‘The wider cultures of eighteenth-century Irish doctors’ in Kelly, and Clark, (eds), Ireland and medicine, pp 185, 187, 191.Google Scholar
115 See Grell, Ole Peter, Cunningham, Andrew and Jutte, Robert (eds), Health care and poor relief in 18th and 19th century northern Europe (Aldershot, 2002),Google Scholar and Grell, Cunningham and Roeck (eds), Health care in southern Europe.
116 For a list of voluntary hospital legislation, see Sneddon, Andrew ‘Institutional medicine and state intervention in eighteenth-century Ireland’ in Kelly, and Clark, (eds), Ireland and medicine, pp 157–62.Google Scholar For details of their content and passage through Parliament, see: I.L.D.; Commons jn. Ire. (4th ed.), xiii, 173; ibid., v, 29; ibid., xiv, 36; Lords jn. Ire., iii, 378–9; ibid., viii, 399, 410, 433–4, 452, 459; Stat. Ire., vii, 248–54, 836; Kirkpatrick, Steevens’ Hospital, pp 42–4;Google ScholarGeary, Medicine and charity, p. 17.Google Scholar
117 See Sneddon, ‘Institutional medicine’, pp 137–56;Google ScholarKelly, and Clark, ‘Introduction’, pp 11–12, 15.Google Scholar
118 For studies which place state intervention at the centre of a medical enlightenment, see Porter, Roy ‘Was there a medical enlightenment in eighteenth-century England?’ in British Journal of Eighteenth-Century Studies, 5 (1982), p. 53,Google Scholar and Gentilcore, David ‘“The golden age of quackery” or medical enlightenment? Licensed charlatanism in eighteenth-century Italy’ in Cultural and Social history, 3, no. 3 (2006), p. 257.Google Scholar For an article which questions the idea of an enlightened Ireland see, O’Brien, Gerard ‘Scotland, Ireland and the antithesis of enlightenment’ in Connolly, S.J., Houston, R.A., and Morris, R.J. (eds), Conflict, identity and economic development: Ireland and Scotland 1600–1939 (Preston, 1995), pp 125–34.Google Scholar
119 Bergin, John ‘The Quaker lobby and its influence on Irish legislation, 1692–1705’ in Eighteenth-Century Ireland, 19 (2004), pp 9–36, and Sneddon, ‘State intervention’.Google Scholar
* This article was researched and written using Wellcome Trust Grant number 088643MA. I would like to thank Stephen Scarth of the Public Record Office of Northern Ireland, and Dr Allan Blackstock, Professor Greta Jones, Dr Leanne McCormick and Professor James Kelly for their comments on earlier drafts.
