Alcohol, Medicine and Irish Society, c.1890-1970 by Alice Mauger

Wellcome Trust Medical Humanities Fellowship

A Wellcome Trust Postdoctoral Fellowship has been awarded to Dr. Alice Mauger. Her three-year project on ‘Alcohol, Medicine and Irish Society, c.1890-1970’ is being hosted by the UCD Centre for the History of Medicine in Ireland (CHOMI). It is mentored by Dr. Lindsey Earner-Byrne, Deputy Head of the School of History, UCD and sponsored by Associate Professor Catherine Cox, Director of UCD CHOMI.

The project explores the evolution of medicine’s role in framing and treating alcoholism in Ireland. It assesses the period from the 1890s, when acceptance of inebriety as a disease led to the creation of the short-lived inebriate reformatories, to the 1970s, when dedicated rehabilitation facilities were formed in response to the rising number of psychiatric patients diagnosed with alcohol-related illnesses.

Until now, the history of medicine has offered little reflection on the relationship between medicine and alcoholism in Ireland. While the ubiquitous “drunken Irish” stereotype, still prevalent today, has been evaluated from several viewpoints, we have yet to discover how international and Irish medical communities interpreted, informed and absorbed this label. By investigating care in asylums and inebriate reformatories, along with medical debates and shifting government policies, the project questions how the exchange of medical, government and lay ideas came to shape understandings and experiences of alcoholism in Irish society.

Still image from the television show, 'Home Truths', featuring a segment
on alcoholism,  RTÉ, 7 December 1966. Image courtesy of the RTÉ Stills Department.

Context

Despite the popularity of temperance and pioneer movements in Ireland since the mid-nineteenth century and high levels of abstinence reported into the 1950s, the Irish have traditionally been viewed as being especially prone to alcoholism. Irish emigrants were persistently portrayed as heavy drinkers, while the emergent Irish nationalist movement sought to associate abstinence with patriotism – some prominent members even claiming that the British encouraged Irish drinking to demoralise the population. In these ways, alcoholism was inextricably linked to theories or fears of Irish degeneration.

This project questions the extent to which enduring stereotypes of the Irish as violent and drunken permeated contemporary medical conceptions of alcoholism, and whether this in turn influenced political and lay interpretations.

Internationally, several works have focussed on shifting medical concepts of addiction. This project situates Irish therapeutic and diagnostic trends alongside those in other western countries, including Britain, America and Australia. It also seeks to inform the extensive literature on the history of psychiatry, particularly degeneracy and ethnicity, and related discourses in Irish social history covering themes such as poverty, violence and the family.

Aims

The project aims to make a significant contribution to the medical humanities, exploring historical sources to better understand and contextualise Irish society’s relationship with alcohol. In doing so, it hopes to inform present-day social and cultural concerns.

Keys findings from the project will be presented in a monograph, journal article and a series of posts on the CHOMI blog, as well as papers given at relevant forums.

In 2019, Alice will organise an interdisciplinary workshop on ‘Alcohol, Medicine and Society’ at CHOMI, inviting policy makers and academics from Ireland and overseas. A call for papers for this event will feature on this blog.

Alice has also planned a one-month knowledge exchange to the Centre for History in Public Health in the London School of Hygiene and Tropical Medicine to engage with prominent experts on addiction history including Professor Virginia Berridge and Dr. Alex Mold.

Biography

Dr Alice Mauger

Dr Alice Mauger is a postdoctoral fellow at the UCD Centre for the History of Medicine in Ireland, University College Dublin. She was awarded a PhD by UCD in 2014 for her thesis which examined public, voluntary and private asylum care in nineteenth-century Ireland. Prior to this she completed the MA programme on the Social and Cultural History of Medicine at the UCD Centre for the History of Medicine in Ireland, UCD. Both her MA and PhD were funded by the Wellcome Trust. Dr Mauger has published on the history of psychiatry in Ireland and is currently finalising her first monograph: The Cost of Insanity in Nineteenth-Century Ireland: Public, Voluntary and Private Asylum Care.

Public Engagement Officer Posts

Two new Public Engagement Officer positions have been announced on the Wellcome Trust Senior Investigator Award Project, 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000', led by Principal Investigators Dr Catherine Cox (UCD CHOMI) and Professor Hilary Marland (CHM, University of Warwick).

Role

The successful applicants will act as key intermediaries between the project and relevant partners in the arts and policy, play a lead role in promoting the project through various media outlets and in the planning, organisation and promotion events. They are seeking applicants with previous experience of working in public or policy engagement.

Public Engagement Officer, CHOMI, University College Dublin

This Public Engagement post will be based at the UCD Centre for the History of Medicine in Ireland, School of History, University College Dublin. This part-time position will last for 24 months commencing from shortly after 9 January 2017. 

Salary: €33,900 per annum pro-rata (40% pro-rata, i.e. €13,560 per annum part-time)

Those interested should contact Dr Catherine Cox prior to making an application.

Closing Date: 4 December 2016

Reference Number: 008854

For further details and to apply, please see: Public Engagement Officer, UCD

Public Engagement Officer, CHM, University of Warwick

This Public Engagement post will be based at the Centre for the History of Medicine, Department of History, University of Warwick. This part-time position will last for 24 months commencing from shortly after 9 January 2017.

Salary: £29,301 – £38,183 per annum pro-rata (0.4 FTE).

Closing Date: 1 December 2016

For further details and to apply, please see: Public Engagement Officer (78714-106)

Wellcome Trust Master's Award Scheme

Wellcome Trust Master's Award Scheme

The UCD Centre for the History of Medicine in Ireland (CHOMI) seeks a candidate for the 2016 Wellcome Trust's Master's Award scheme, offering fees and living allowance for one year of taught Master's study in the history of medicine or medical humanities.

UCD can propose one candidate per year to the Wellcome Trust, which considers applications from various institutions and determines whether funding is awarded. It is a highly competitive international competition. CHOMI has a strong track record of successful applications to the Master's scheme and many of the successful applicants have gone on to secure funding for doctoral studies. Details of the CHOMI MA programme are available at here.

Applications from international students are welcome. In addition to a living allowance, the scheme covers full fees for all Republic of Ireland, UK and European Union students, or full overseas fees for students from a list of eligible countries .

Application Process: Step 1

CHOMI runs an internal selection process to identify the strongest candidate to put forward for the Wellcome Trust competition. We now invite expressions of interest. 

Applicants must be strongly committed to developing a research career, and must have, or be predicted to have, at least a very high upper second-class degree at undergraduate level or an international equivalent .

If you would like to express an interest or discuss the possibility of an application, please contact the Director of CHOMI, Dr Catherine Cox (catherine.cox@ucd.ie)

The deadline for preliminary applications is Monday 11 April 2016. Preliminary applications should be sent to catherine.cox@ucd.ie

Your preliminary application should include:

1. 750-word statement outlining your relevant experience to date and your priorities for future research. If you have already developed a more concrete research proposal, please describe it here.
2. Current CV, 1 to 2 pages in length

Application Process: Step 2

If you are successful in your application to the internal CHOMI competition, you will then work with a CHOMI staff member in developing your final application to the Wellcome Trust.  You will need to be available to work on completing the proposal to a deadline in April, in order to meet the Trust's final deadline of Tuesday 3 May.

Full details of the Trust's policy on selection and entry requirements are provided here. 

MA in the History of Welfare and Medicine in Society

MA History of Welfare & Medicine in Society

Programme Director: Dr Catherine Cox

catherine.cox@ucd.ie

About the MA

Medicine, illness and welfare occupy a central place in all our lives. The MA is designed to enable you to understand the place of medicine and welfare in society and history (c1750-1980) and engage with critical debates through various media, including film, literature, and art, amongst others. 

The modules on the programme explore the main trends within welfare and medical history from social history, gender history, post-colonial history to individual experiences of poverty, and of illness throughout history. You will explore how medicine and welfare regimes and policies culturally constructed conceptions of femininity and masculinity.

The modules are taught through seminar and you will develop expertise in presenting, analytical thinking, effective communication, and writing with clarity and precision. You will also partake in a lively seminar series and benefit from a vibrant postgraduate research community.

The dissertation, at the core the MA, allows you to engage your own research-based interests.

Your fellow students will be from diverse academic backgrounds and the MA is popular among healthcare professionals keen to understand the historical contexts that shaped current practices and systems.

The MA has a reputation for excellence and is taught be lecturers with international profiles in the field. 

Dr Catherine Cox, Director and
Co-Founder of the UCD Centre for
the History of Medicine in Ireland

Why do this MA?

Graduates have secured employment in the fields of media, education, politics and in private and public sector management and policy.

Graduates have also proceeded to PhD studies at Irish, British, and European institutions, securing prestigious external funding.

Funding

To apply for the acclaimed Wellcome Trust Masters Scholarship, please contact MA Director, Dr Catherine Cox.

Further Details

Please see the course description for the MA in the History of Welfare & Medicine in Society at UCD Graduates Studies

Download the MA poster

Website Launch: Exploring the History of Prisoner Health

A new website, Exploring the History of Prisoner Health - or histprisonhealth.com - has been launched by the team (co-PIs Dr Catherine Cox (CHOMI, UCD) and Professor Hilary Marland (CHM, University of Warwick)) researching the Wellcome Trust-funded project, 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000'.

Policy Workshop

Exploring the History of Prisoner Health, has been launched in advance of the project's upcoming policy workshop, The Prison and Mental Health - From Confinement to Diversion, which is going to be held in the Shard, London, 12 February. The workshop itself aims  to explore the potential for historians, criminologists, NGOs, policy makers and prison service employees to share ideas and information around the theme of mental health in the prison system.

Project Themes

The website's blog details some of the main project research strands on prisoner mental illness, physical health, juvenile prisoners, political prisoners, as well as the Prison Medical Service. Content will be developed as research progresses and new strands come on board.

'The Vast and Often Unpermitted Collection Being Organised in my Diocese': The Central Remedial Clinic, the Catholic Church, and Polio Rehabilitation in Dublin During the 1950s by Stephen Bance

As the incidence of polio began to rise in Ireland, voluntary organisations such as the Central Remedial Clinic were created to rehabilitate survivors of the disease. In this month's blog post Stephen Bance, PhD candidate at the Centre for the History of Medicine in Ireland, UCD, writes about Archbishop John Charles McQuaid's refusal to support the Central Remedial Clinic, given that it was not '100 per cent Catholic'. Others such as Bing Crosby saw no such problem, and were happy to lend a helping hand.

The Central Remedial Clinic

Occupational Therapy was an important part of the rehabilitation
process for polio survivors.
Source: Polio Journal: Official Publication of the Infantile
Paralysis Fellowship, Ireland, 3:4 (1956), Front Cover.

The creation of rehabilitation facilities for polio survivors in Ireland during the mid-twentieth century was pioneered by voluntary groups. The most active and successful of these organisations was the Central Remedial Clinic (CRC). The CRC was established in 1950 by the remedial gymnast Kathleen O'Rourke and Lady Valerie Goulding, who became a central figure in rehabilitation and philanthropy in Ireland. As a civil-run, non-denominational organisation, the CRC depended upon revenue acquired through fundraising projects, and the success of these enterprises led to their expansion throughout the 1950s. During the same period, the polio rehabilitation unit at Baldoyle Orthopaedic Hospital, which was run by the Sisters of Mercy and was under the patronage of the Archbishop of Dublin John Charles McQuaid, sought public funds to renovate and improve their facility. The Baldoyle Polio Unit, established in 1943, had fallen into a state of disrepair by the early 1950s. The accommodation for patients on site was limited to a collection of dilapidated huts.¹ Reverend Mother Mary Polycarp, who was in charge of the facility, wrote to McQuaid detailing the many anxious nights she had spent praying that the huts would not be 'blown down on the little patients who are in danger'.²

Bing Crosby and the CRC

Bing Crosby, 1967, with his horse Dominion Day, which won the
Blandford Stakes at the Curragh with trainer Paddy Prendergast.
Crosby took part in fundraising drives for the CRC.
Source: Dermot Barry/Irish Times.

With no state aid being made available, both the CRC and the Baldoyle Polio Unit began fundraising campaigns.³ The fundraising methods employed by the Baldoyle committee included radio broadcasts, newspaper advertisements, flag days, sweepstakes and sales of work.⁴ The CRC used similar methods; however, they also harnessed the allure of celebrity to bolster the public profile of their events. For example, a recorded appeal by Bing Crosby was aired on Radio Éireann in 1958,⁵ and Crosby later visited Dublin to speak at a CRC fundraising dinner.⁶

100 per cent Catholic, Only

Archbishop John Charles McQuaid, 1956, at the opening of
Our Lady's Children's Hospital, Crumlin. Source.

As the popularity and success of the CRC's fundraising became evident, Archbishop McQuaid wrote to Mother Polycarp expressing his frustration at the 'vast and often unpermitted collection being organised in my diocese by so many persons.'⁷ Given the influence that McQuaid wielded within the voluntary sector, the CRC asked the Archbishop if he would be prepared to be represented on the trustees committee.⁸ McQuaid declined due to the fact that Lady Goulding was not a Catholic, stating that it wasn't his policy 'to belong to something unless it was one hundred per cent Catholic'.⁹

Baldoyle

The Baldoyle fundraising campaign was cut short when McQuaid and the building committee entered into a bargaining process with the Department of Health in order to complete the renovations. The Minister for Health, T.F. O'Higgins, offered to provide funding for the project on condition that the remit of the Baldoyle unit would be expanded to cater for cerebral palsy cases as well as polio cases. This proposal was accepted, and the government provided a £40,000 grant to finish the construction process.¹⁰ The hospital was opened in July 1956. The new facility could accommodate 114 patients and included a school, an occupational therapy unit and a phyisotherapy unit.¹¹

The Archbishop of Dublin, Most Rev. Dr.
McQuaid, inspecting the occupational therapy
department after he had opened and blessed the
new Physiotherapy Unit in St. Mary's
Orthopaedic Hospital, Baldoyle.
Source: Irish Independent, 22 November 1957

Expansion of the CRC

Lady Valerie Goulding with President Eamon de Valera
and children at the Central Remedial Clinic in the early 1970s.
Source: Irish Independent.

The success of the fundraising initiatives undertaken by the CRC meant that they expanded independently of the state. A new clinic was opened in Goatstown in January 1955 while a school with the capacity to educate twenty pupils was established on the premises in 1957.¹² By the end of 1958, 700 patients were being treated annually.¹³ A new occupational therapy unit was built in November 1961 and a workshop was opened in March 1963.¹⁴ In December 1968, President de Valera opened the newest branch of the CRC at Clontarf.¹⁵ The Clontarf clinic was the first purpose built complex of its kind in Ireland, and cost approximately £250,000.¹⁶

An Absolutist Approach

McQuaid's snubbing of the CRC conformed to his absolutist approach to voluntarism along denominational lines; a similar situation had unfolded in 1943 when the presence of the Protestant Dorothy Price on the overwhelmingly Catholic executive committe of the National Anti-Tuberculosis League (NATL) led the Archbishop to publicly back the Red Cross Society as a Catholic alternative to the NATL.¹⁷ Similarly, the Baldoyle polio facility provided a 'one hundred per cent Catholic' alternative,and Reverend Mother Polycarp was optimistic that her unit could eventually replace the CRC. She wrote to McQuaid in 1957 stating that: 'when some of the Catholic doctors who are working with Lady Goulding realise your interest in the hospital they may send some of their little polio children on to us. I hope they do, for the children's sake'.¹⁸ This denominational approach to welfare was inherently divisive, but extremely prevalent in mid-twentieth century Ireland.¹⁹

Denominational Welfare

McQuaid's hostility towards the CRC was symptomatic of his combative attitude towards non-Catholic charitable organisations generally. Throughout the mid-twentieth century, the Archbishop readily pitched his organisation against other non-Catholic agencies, such as the St. John's Ambulance Brigade and the NATL.²⁰The social work undertaken by the Archbishop was underpinned by the conviction that the protection of Catholic children meant the protection of the next generation of souls.²¹ However, unlike his response to the NATL in 1943, McQuaid declined to publicly articulate his aversion to the CRC. Definitive reasons for this discreet approach are not clear, however the series of very public altercations involving the Catholic hierarchy, the state and medical community during the previous decade, not least the Mother and Child Controversy, may have tempered somewhat McQuaid's desire to openly oppose the activities of non-Catholic voluntarism in the field of polio rehabilitation.

Stephen Bance

Stephen Bance is an Irish Research Council funded PhD Candidate at the Centre for the History of Medicine in Ireland (CHOMI), UCD. His thesis is provisionally titled, '"Crippled, Maimed, Lamed, Shattered and Broken": The Irish Experience of Polio, 1942-1970'. His PhD supervisor is Dr Catherine Cox. He received his BA in Single Honours History (UCD) in 2012, and went on to successfully complete the CHOMI MA programme on the Social and Cultural History of Medicine the following year.

---

1 Letter of appeal Joseph Bryan, Treasurer Baldoyle Building Committee, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
2 Letter Sister M. Polycarp to John Charles McQuaid, Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
3 Letter Desmond O'Callaghan, Honorary Secretary, Baldoyle Building Committee, to Sister M. Polycarp, 16 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
4 Ibid.^↩
5 Irish Times, 13 Mar. 1958.^↩
6 Jacqueline Hayden, Lady G- A Biography of the Honourable Lady Goulding LL D (Dublin, 1994), p. 108.^↩
7 Letter from John Charles McQuaid to Sister M. Polycarp, 11 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.^↩
8 Letter from Father Paddy Crean to John Charles McQuaid, 13 May 1951, DDA L Files, Central Remedial Clinic 9/2.^↩
9 Hayden, Lady G-, p. 103.^↩
10 Irish Times, 5 July 1956.^↩
11 Ibid.^↩
12 Irish Times, 13 Jan 1955; Irish Times, 21 Feb. 1957.^↩
13 Irish Times, 1 Sept. 1958.^↩
14 Irish Times, 2 Nov. 1961; Irish Times, 15 Mar. 1963.^↩
15 Irish Times, 11 Jan. 1966.^↩
16 Irish Times, 17 Jan. 1966.^↩
17 See Anne MacLellan, '"That Preventable and Curable Disease": Dr Dorothy Price and the Eradication of Tuberculosis in Ireland, 1930-1960' (PhD Thesis, University College Dublin, 2011), p. 108.^↩
18 Letter from Sister M. Polycarp to John Charles McQuaid, 22 Nov. 1957, DDA Files, Central Remedial Clinic 9/1.^↩
19 Lindsey Earner-Byrne, Mother and Child: Maternity and Child Welfare in Dublin 1922-60 (Manchester, 2007), p. 223.^↩
20 Lindsey Earner-Byrne, 'Managing Motherhood: Negotiating a Maternity Service for Catholic Mothers in Dublin, 1930-54', Social History of Medicine 19:2 (2006), 267.^↩
21 Ibid.^↩

Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester Two, 2015-2016

Centre for the History of Medicine in Ireland (CHOMI), Seminar Series

Semester Two, 2015-2016

Thursday 4 February 2016 

Dr Alice Mauger (University College Dublin)

'The cost of insanity: public, voluntary and private asylum care in nineteenth-century Ireland'

Thursday 3 March 2016

Dr Janet Greenlees (Glasgow Caledonian University)

'The tenuous relationship between gender, health and work, c. 1860-1960'

Thursday 7 April 2016

Dr Luz Mar González-Arias (University of Oviedo)

'Landscapes of pain: the representation of illness in Dorothy Molloy's cancer poetry'

All seminars take place at 5 pm, Room K114, School of History, Newman Building, UCD, Belfield, Dublin 4.

Download CHOMI Seminar Series Programme

Adolescence in Modern Irish History

Adolescence in Modern Irish History

September of this year marked the timely arrival of a new and fascinating edited collection, Adolescence in Modern Irish History, published by Palgrave Macmillan - the latest addition to the publisher's impressive and well-received series, Palgrave Studies in the History of Childhood. Edited by Catherine Cox, (Director and co-founder of CHOMI, UCD) and Susannah Riordan, (School of History, UCD), the volume is the first of its kind to address the question of adolescence in Irish history. Its chapters draw together new archival sources and research findings by nine emerging and established scholars working at the cutting edge of research into Irish adolescence. 

Spanning the birth of the 'affective revolution' in the early nineteenth century up to the genesis of the teenager in 1960s Ireland, the essays in this collection explore the emergence of Irish adolescence in its social, economic, political and literary contexts. Engaging with the extensive international literature on the subject, the editors argue that Irish adolescence both resembled and diverged from the British, American and continental European experience during the nineteenth and twentieth centuries. Adolescence in Ireland was particularly shaped by its demography, tied as that was to practices of late marriage, permanent celibacy, large families and the extensive emigration of young people. Coupled with Ireland's limited industrial development and the persistence of the pre-industrial family economy, these conditions strongly informed the possibilities of Irish adolescence in terms of adolescence autonomy, educational opportunities, and employment prospects.

Naturally, the long-shadow of Ireland's apparently troubled relationship with institutions looms large across this volume with a chapter on Irish borstal offenders, extensive treatment of industrial schools, and the confinement of unmarried mothers. Yet Riordan, at least on the question of the young unmarried mother, cautions against the often axiomatic conclusion that the carceral and unforgiving approach to problematic female sexuality so favoured in Ireland can best attributed to clerical actors. Indeed, she finds that in the newly independent Irish state of the 1920s and 1930s, a 'social work lobby', comprising feminist, religious and social work organisations, sought the introduction of protective legislation against the sexual exploitation of the sexually-compromised adolescent who they characterised as typically innocent and subject to seduction and betrayal by older and more powerful men. More punitive perspectives on unmarried, adolescent motherhood were instead more typically the preserve of traditional practitioners of the law and medicine.

Editors: Adolescence in Modern Irish History

Catherine Cox, Director and co-founder of the Centre for the History of Medicine in Ireland (CHOMI), University College Dublin (UCD).

Susannah Riordan, lecturer in Modern Irish History, School of History, UCD, and an associated staff member of CHOMI. 

2010 Workshop

This collection emerged from a workshop in January 2010, which was funded by the Wellcome Trust, the Centre for the History of Medicine, University College Dublin, and the UCD Humanities Institute. 

Contents:

Introduction

Catherine Cox and Susannah Riordan

Robert Hyndman's Toe: Romanticism, Schoolboy Politics and the Affective Revolution in Late Georgian Belfast

Jonathan Jeffrey Wright

'A Sudden and Complete Revolution in the Female': Female Adolescence and the Medical Profession in Post-Famine Ireland

Ann Daly

The 'Wild Irish Girl' in Selected Novels of L.T. Meade

Sandra McEvoy

'The Most Dangerous, Reckless, Passionate .. Period of Their Lives': The Irish Borstal Offender, 1906-1921

Conor Reidy

An Irish Nationalist Adolescence: Na Fianna Éireann, 1909-1923

Marnie Hay

'Storm and Stress': Richard Devane, Adolescent Psychology and the Politics of Protective Legislation 1922-1935

Susannah Riordan

'How Will We Kill the Evening?': 'Degeneracy' and 'Second Generation' Male Adolescence in Independent Ireland

Bryce Evans

A Powerful Antidote? Catholic Youth Clubs in the Sixties

Carole Holohan

The Emergence of an Irish Adolescence: 1920s to 1970s

Mary E. Daly

AIDS and History by David Kilgannon

In this month's blog post, David Kilgannon, a Wellcome Trust funded PhD candidate in the Department of History, NUI Galway, looks at the response of two voluntary organisations, Gay Health Action and the Irish Haemophilia Society, to the arrival of AIDS in 1980s Ireland. In 2015, David completed his Wellcome Trust funded MA on the history of AIDS activism in Ireland at the Centre for the History of Medicine in Ireland, University College Dublin.

First Reported Cases of Aids

Report on the appearance of Kaposi's 

Sarcoma and Pneumocystis Pneumonia 

among homosexual men in New York 

and California, Morbidity and Mortality

Weekly Report, 3 July 1981.  Published

by the Centers for Disease Control and 

Prevention. Public domain.

The first clinical observed cases of AIDS arose among a group of homosexual men in Los Angeles in 1981. All five men presented with Pneumocystis pneumonia, a rare form of pneumonia, which is usually successfully fought off by the human immune system. The increasing prevalence of gay men with impaired immune systems throughout 1981-82 led the US Centers for Disease Control in June 1982 to classify this new disease as Gay Related Immune Deficiency (GRID). However, this model was soon found to be inadequate when non-homosexual patients, including women and children, presented with GRID symptoms. This resulted in the reclassification of the condition as Acquired Immune Deficiency Syndrome, or AIDS, in August 1982.

AIDS: State Response & Policy Failure 

Yet, the initial appearance of AIDS among gay men and intravenous drug users, and its continuing association with these socially marginalised groups was incredibly influential in shaping what were often desultory state responses to the syndrome, with the reaction of national healthcare systems to the incipient epidemic often appearing apathetic and lethargic. For example, in the United States it took a full three years after the first identification of the condition for the Department of Health and Human Services to produce and distribute their first AIDS information booklet for the public. While state responses were often insufficient, the appearance of AIDS instigated a substantial response by voluntary and activists groups. Roy Porter identified this phenomenon as one of the seminal features of the response to the spread of AIDS from the 1980s onwards.

AIDS Activism in Ireland

Number of cases of Sero-positivity in Ireland, 1985-1990

The historical study of AIDS, and AIDS activism in particular, has received sustained historical analysis in the United States and the United Kingdom. However, it has yet to be examined in Ireland. This lacuna is striking, as Ireland arguably presents a distinctive national context relating to AIDS. Three features are particularly notable. The principal prophylactic advocated for AIDS prevention, the condom, had limited availability in Ireland until 1985. Under the Health (Family Planning) Act (1979), anyone wishing to purchase a condom required a doctor's prescription. Secondly, the largest constituent group affected by AIDS in the United States, the gay community, was effectively criminalised in Ireland until 1993. Thirdly, in the 1980s the Irish health service underwent a period of drastic reductions in capacity, losing over a third of hospital beds during this decade. Taken together, these factors make a study of AIDS activism in Ireland particularly worthy of analysis in relation to its counterparts in the broader Anglophone world. My research attempted to examine two such examples of this phenomenon in Ireland. Namely, the activist responses from the gay and haemophilia communities to AIDS, as exemplified through the work of Gay Health Action and the Irish Haemophilia Society. 

Gay Health Action

Number of AIDs cases in Ireland, 1983-1990

The work of Gay Health Action was explored through an examination of their records found in the Irish Queer Archive held at the National Library of Ireland. These sources indicate that Gay Health Action's activism was directly influenced by the international impact and context of AIDS. Articles from the National Gay Federation's magazine Out reveal a community that was quite aware of the devastation of the gay community in other countries. This awareness played a key role in instigating the foundation of Gay Health Action in January 1985 even though AIDS was not yet then a prominent public health threat in Ireland. At that point, only eleven deaths had been attributed to the syndrome in Ireland. Gay Health Action worked to raise awareness by disseminating information on the disorder, producing information leaflets and running education seminars. The group organised itself within the existing structures of the gay community, using already established methods of information dissemination within the community and establishing a telephone helpline that had clear antecedents to earlier forms of gay activism. This led Gay Health Action to take an increasingly prominent role in the management of all matters relating to AIDS in Ireland, speaking as experts on the condition to media and running an information service that superseded the role of the state's Health Education Bureau.

Irish Haemophilia Society

Number of AIDS related deaths in Ireland, 1982-1990

Yet, this form of activist response was not replicated among the varied voluntary groups representing communities that were directly impacted by the advent of AIDS in Ireland. The Irish Haemophilia Society, many of whose members became afflicted with AIDS due to the use of imported blood products which were infected with HIV,  took a quite different approach. As a reading of Lindsay Tribunal Report, the Irish Haemophilia Society's proceedings transcripts, and the society's newsletters reveals, they only began to seriously grapple with the challenge of AIDS following the infection of more than a third of their members. This fact meant that the preventative, public education role fulfilled by an organisation such as Gay Health Action was less relevant to the Irish Haemophilia Society and its members. Instead the organisation focused primarily on providing pastoral care to infected Irish haemophilia sufferers, including supports that assisted those dying from AIDS.

The Voluntary Sector and Epidemic Disease

By examining previously unstudied responses by voluntary groups to an epidemic disease in 1980s Ireland, this project aspires to add greater depth to our knowledge of Irish health policy and the role of the voluntary sector in addressing the challenges associated with an epidemic disease.

David Kilgannon is a PhD researcher in the Department of History in the National University of Ireland (Galway). His project, which is co-supervised by Dr Kevin O'Sullivan and Dr Sarah-Anne Buckley, examines the changing treatment of the disabled in twentieth century Ireland and is funded by the Wellcome Trust. His Master's dissertation, 'How to survive a plague': AIDS activism in Ireland, 1983-1989', examined voluntary sector efforts against the AIDS virus in 1980s Ireland. It was completed in the Centre for the History of Medicine in Ireland, School of History, University College Dublin under the supervision of Dr Catherine Cox.

Centre for the History of Medicine in Ireland (CHOMI) Seminar Series, Semester One, 2015-2016

Centre for the History of Medicine in Ireland (CHOMI), Seminar Series

Semester One, 2015-2016

Thursday 17 September 2015
Dr Georgina Laragy (Queen's University, Belfast)
'Children, welfare and space in the industrial city: Belfast 1880-1939'

Thursday 8 October 2015
Dr John Cunningham (Trinity College Dublin)
'Medicine in early modern Ireland: identifying and locating practitioners'

Thursday 5 November 2015
Dr Ciarán McCabe (Maynooth University)
'"Contagion is supposed to have been introduced from the country": civic and charitable responses to the 1817-19 fever epidemic in Dublin city'

Time: 5 pm (for all seminars)
Location: Room K114, School of History and Archives corridor, Newman Building, Belfield, UCD, Dublin 4.

Download CHOMI Seminar Series Programme

A Question of Authority: the Management of Shell Shock at the Irish War Hospitals during the Great War by Peter Reid

In this month's blog post Peter Reid, MLitt research student at the Centre for the History of Medicine in Ireland (CHOMI), UCD, looks at the treatment of shell shock in Ireland during the Great War. He argues that the formation of a rational medical service for these soldiers in Ireland was undermined by the antagonistic relationship between military and civilian medical authorities.

Queen Street, Dublin.
Image provided courtesy of Peter Holder,
Irish Historical Picture Company

On 22 July 1929, John Kelly, an ex-British soldier, fell from a window of his residence in Dublin's Queen Street and later died from his injuries while being treated at the Richmond Hospital. His wife did not witness his fatal fall, but said that her husband, 'had been in ill-health since his discharge from the army in 1919, suffering from paralysis and shell shock.¹

Until recently, there had been relatively little research undertaken on the management of shell shock in Irish institutions during the Great War. In the case of Britain, Peter Leese has shown that army and military concerns dominated over those of civilian medical experts.² This post argues that a similarly asymmetrical relationship between asylum and military medical personnel was one of the key factors inhibiting the development of a well-coordinated shell shock treatment system in Ireland.

The Irish War Hospitals

The Richmond War Hospital, 1916-1919.
Image provided courtesy of the
National Archives of Ireland.

In Britain, by 1916, demand had overwhelmed the capacity of treatment facilities for shell shocked soldiers. From the summer of that year, the first treatment centres in Ireland, which would include two war hospitals, began to open in the main urban centres of Dublin and Belfast. The first of the war hospitals, a thirty-two bed unit, the Richmond War Hospital, received its first patients in June 1916. This hospital was a separate block within the grounds of Dublin's Richmond District Lunatic Asylum, allocated by the asylum's board of governance for this purpose. It admitted only British Expeditionary Force soldiers, that is, those soldiers who had served overseas at the Western Front. The main Richmond Asylum itself, however, admitted non-British Expeditionary Forces - the home troops. The army paid a generous stipend to the Richmond Asylum for the care of both categories of soldier.

Belfast District Lunatic Asylum.
Image provided courtesy of the National Library of Ireland.

In response to rising casualty numbers, the civil and military authorities agreed to relocate existing patients from the Belfast District Lunatic Asylum and use that facility as another war hospital. The Belfast War Hospital opened in May 1917 under the management of the existing District Lunatic Asylum Committee. It provided 500 beds for the use of both expeditionary and non-expeditionary British service personnel. Dr William Graham, the Medical Superintendent of the Belfast Asylum, remained in place as the medical authority running the new war hospital.

The evidence suggests that Dr William R. Dawson, already a leading figure in Irish medicine and highly regarded by the British army, played a key role in facilitating, if not initiating, both arrangements.

William R. Dawson, appointed by the War Office in 1915,
as a specialist in nerve disease to treat British service personnel in Ireland.
Image provided courtesy of the Royal College of Physicians of Ireland.

The Resident Medical Superintendents and the Royal Army Medical Corp

King George V Hospital, built 1902
(St Bricin's Military Hospital), Arbour Hill, Dublin.
Image courtesy of the National Library of Ireland.

Tensions in the relationship between the Richmond Asylum's Medical Superintendent, Dr John O'Conor Donelan, and his military counterpart, Lieutenant Colonel Hearn, Officer in Charge, George V Hospital, Central Military Hospital Dublin, quickly became apparent. Hearn instructed Donelan by letter that as Officer in Charge of Central Hospital that he, Hearn, was ultimately responsible for all soldiers in the asylum, 'until such time as they are invalided out of the army'.³ Three days later, Hearn again wrote to Donelan and firmly reiterated the point that 'should a man in your opinion require to be moved to the General Asylum [from the Richmond War Hospital] he still remains a soldier until finally discharged from the service by recommendation of the Military Board'.⁴ 

Dr John O'Connor Donelan, Resident Medical Superintendent,
Richmond District Lunatic Asylum, Dublin.
Image by kind permission of Dr Aidan G. Collins,
St. Vincent's Hospital, Fairview, Dublin 3.

The army's insistence on reserving the use of the war hospital solely for expeditionary soldiers, on prioritising their treatment over that of non-expeditionary soldiers, on maintaining their control over the admission and discharge of all military patients, and the complex bureaucratic needs of the military machine, served to insidiously undermine Donelan's authority. Donelan's dissatisfaction with the arrangement is evident in his asylum report of 1917 when he bemoaned the high number of discharges 'classified as only relieved'. He attributed this to 'the fact that a considerable proportion of these were soldiers under temporary treatment, who were removed by the Military Authorities to other asylums before recovery'.⁵ Donelan was implicitly criticising the military authorities for prioritising the needs of the army over the professional opinion of asylum medical officers, in particular himself.

When the Belfast War Hospital opened in May 1917, it was initially managed by the existing District Lunatic Asylum Committee. However, as Lieutenant Colonel J.B. Buchanan, Officer-in-Charge of Holywood Military Hospital, noted in 1919, 'this plan did not prove satisfactory'. When the Resident Medical Superintendent, Dr William Graham, died suddenly in November 1917, the Belfast War Hospital came under the direct control of the War Office.⁶

Consequences of an unsatisfactory relationship

Between 1916 and 1919, the Dublin and Belfast Irish war hospitals treated 1,577 soldiers. However, there were never enough beds in Ireland for emotionally traumatised soldiers such as John Kelly and, by 1921, the 'South Ireland Pension Area' - Ireland exclusive of the province of Ulster - had the longest waiting list in Britain and Ireland for treatment.⁷ The antagonistic relationship between medical and military actors was one factor contributing to this unfortunate situation.

Contemporary relevance

In a report issued in July 2015, the Mental Health Commission identified that a lack of cohesion and 'deep disharmony' between clinicians and managers had undermined clinical governance in Carlow/Kilkenny and South Tipperary and, in early 2014, was associated with a 'spike' in suicides in the region.⁸ This reflects the continuing importance not only of independent surveillance by bodies such as the Mental Health Commission and the Health Information and Quality Authority, but also of managerial and clinical relationships in the delivery of contemporary mental health services in Ireland.

Peter Reid completed a MA in the Social and Cultural History of Medicine at the Centre for the History of Medicine in Ireland (CHOMI), UCD, in 2014. The title of his MA dissertation was, 'The Institutional Management of Soldiers with Shell Shock in Ireland, 1916-19'. In September 2015, Peter will be commencing a MLitt at CHOMI, investigating the treatment of children with disability in early twentieth-century Ireland.

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1 Irish Times, 24 July 1929.^↩
2 Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (Basingstoke and New York, 2002), 54-6, 98.^↩
3 Letter to Resident Medical Superintendent, Richmond Lunatic Asylum from Lieutenant Colonel Hearn, King George Fifth Hospital, 1 August 1916, Richmond War Hospital Admission and Discharge Book, BR/Priv 1223, NAI.^↩
4 Hearn to Resident Medical Superintendent, Richmond Lunatic Asylum, 4 August 1916.^↩
5 Richmond Asylum Joint Committee Minutes, 1917, 17, BR/Priv 1223, NAI.^↩
6 Medical History of the War: Report in Compliance with War Office Letter No. 24/General Number/6978 (A.M.D.2) 18 October 1919, WO 35/179.^↩
7 Joanna Burke, 'Effeminacy, ethnicity and the end of trauma: the suffering of "shell-shocked" men in Great Britain and Ireland, 1914-39, Journal of Contemporary History, 35, no. 1 (2000), 69.^↩
8 Irish Times, 22 July 2015.^↩

Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000

Prisoner Health Project: Wellcome Trust Senior Investigator Award

histprisonhealth.com

A major new research project in the history medicine has just been launched: 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000'. This collaborative, five-year study, funded by a Wellcome Trust Senior Investigator Award, is being led by co-Principal Investigators, Professor Hilary Marland, of the Centre for the History of Medicine, University of Warwick, and Dr. Catherine Cox, Director of the Centre for the History of Medicine in Ireland, University College Dublin.

Strangely, the history of medicine, despite its strong focus on the history of institutions, has neglected the prison as a site of medical treatment. It's great to see that such an ambitious project is going to address this omission. That this is a comparative research project is also exciting; comparative historical analysis, despite its strong tradition in the social sciences and a limited recent resurgence, is long overdue a renewal.

Project aims

The co-Principal Investigators, Catherine and Hilary, are keen for the project's research to resonate with contemporary concerns in the prison service and they aim to tackle historical questions of prisoner health that are still relevant today. For example, they and their team are going to look at the high incidence of mental illness amongst prisoners, the health of women prisoners and the status of prison maternity services, as well as the response to prisoner substance abuse and the impact of HIV/AIDS. All of these topics are still major concerns in the medical management of contemporary prison populations in Ireland and England. 

Late nineteenth-century photographs of
prisoners in Reading Gaol
Berkshire Records Office P/RP1/5/2
Source: Berkshire Family Historian

Scope of project

Each of the different research strands within the project will cover the period from rise of the modern penal system during the mid-nineteenth century up to the present. Fundamental to the project is the comparative analysis of English and Irish prison services and the conceptual basis of prisoners' entitlement to health in both England and Ireland. 

Prisoner health and human rights

The project team is going to address the question of who advocates for prisoners' health, both within and without the prison service. They will also investigate the extent to which prisoners have been seen as entitled to health care and if human rights debates have had any influence on the provision of medical care for prisoners. Another principal area of historical inquiry is going to be the extent to which prison doctors have felt themselves to be constrained by dual and conflicting loyalties to the prison regime and to their prisoner patients. 

Policy workshops and public engagement

Hilary and Catherine have also said that the project is going to engage with policy makers and prison reform organisations, including the Howard League for Penal Reform. With that in mind, they are busily preparing several policy workshops and compiling a list of potential invitees. They also hope to engage with the general public and people working in the area of prisoner welfare through a series of outreach projects. Among the most interesting of these are their plans to commission both a theatrical production and a piece of artwork that will be based on their team's research findings. 

Project members

Dr. Catherine Cox, University College Dublin, Principal Investigator. 

Professor Hilary Marland, University of Warwick, Principal Investigator.

Both Hilary and Catherine are working on the relationship between the prison system and mental illness – a subject of acute contemporary relevance considering the high levels psychiatric morbidity amongst prisoners – and they are also looking at the impact of the prison on prisoner mental health. In addition, Catherine will focus on the evolution of the separate system in Ireland and its impact on mental health while Hilary will examine the question of women and mental health in the prison system.

Dr. Will Murphy, Mater Dei Institute, Dublin City University, is researching the health of political prisoners and the impact they had in shaping attitudes and practices of health and medicine in Irish and English prisons.

Dr. Fiachra Byrne, University College Dublin, Postdoctoral Research Fellow (3 years), is working on the mental health of juvenile prisoners in England and Ireland.

Dr. Nicholas Duvall, University of Warwick (year 1), University College Dublin (year 2), Postdoctoral Fellow (2 years), is going to be supporting Hilary and Catherine in their research and will also develop his own project on the health of prison officers. 

Dr. Margaret Charleroy, University of Warwick, Postdoctoral Research Fellow (3 years), is working on the management of prisoner health, disease and chronic illness.

A further Postdoctoral Fellow, who will be researching the history of HIV/AIDS in prisons under the supervision of Professor Virginia Berridge at the London School of Hygiene and Tropical Medicine is slated for appointment later this year (2015).  

Public Engagement Officers, at Warwick and Dublin, will be appointed in late 2015. They will have responsibility with implementing the project's arts and policy initiatives.

In 2016, there will be two PhDs appointed to the project. One, based at UCD, will work on prison reform movements; the other, based at Warwick, will investigate the health of women prisoners.

If you want to find out more about 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850–2000', you can visit the UCD project page or the Warwick project page. The project team have also announced their Advisory Board members and provide a list of recent and upcoming project activities.

For further project details or inquiries, you can contact Hilary by email at hilary.marland@warwick.ac.uk or Catherine at catherine.cox@ucd.ie