Showing posts with label Wellcome Trust. Show all posts
Showing posts with label Wellcome Trust. Show all posts

Thursday, 22 June 2017

Disorder Contained: Theatre Performances, Coventry, Dublin, Belfast

A Theatrical Examination of Madness, Prison and Solitary Confinement

Disorder Contained: A theatrical examination of madness, prison and solitary confinement is a major public engagement activity for the Wellcome Trust funded project Prisoners, Medical Care and Entitlement to Health in England and Ireland 1850-2000. It draws on the work of Associate Professor Catherine Cox (UCD) and Professor Hilary Marland (Warwick) and forms the final part of The Asylum Trilogy exploring various aspects of the history of mental health.

The production, created with Talking Birds and to be performed in Coventry, Dublin, Belfast, and London during 2017, will be accompanied by Expert Panel Discussions as well as Post-show Artistic Conversations which will be recorded along with the performance.

Book Tickets

See Also

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Friday, 7 April 2017

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.

Monday, 11 April 2016

The Cost of Insanity by Alice Mauger

The Cost of Insanity: Public, Voluntary and Private Asylum Care in Nineteenth-Century Ireland

How did Irish medical practitioners and lay people interpret and define mental illness? What behaviours were considered so out of the ordinary that they warranted locking up, in some cases never to return to society? Did exhibiting behaviour that threatened land and property interests, the financial success of the family or even just that which caused embarrassment eclipse familial devotion and render some individuals 'unmanageable'? These questions are addressed in this month's post by Dr Alice Mauger. In 2014, Alice successfully completed her doctoral thesis at the UCD Centre for the History of Medicine in Ireland on domestic and institutional provision for the non-pauper insane in Ireland during the nineteenth century.

The Evolution of Asylum Care


Paying patients in the Richmond District Asylum (1885-1900).
Pictures courtesy of the Grangegorman Community Museum
The nineteenth century saw the evolution of asylum care in Ireland. While Jonathan Swift famously left most of his fortune to found Ireland's first lunatic asylum in 1746, it would be 70 years before the government followed his lead. In 1817 it enacted legislation permitting districts throughout Ireland to form asylums and by 1900, twenty-two such hospitals accommodated almost 16,000 patients. Growing demand for care for other social groups prompted the decision, in 1870, to admit some fee-paying patients, charged between £6 and £24 per annum, depending on their means. Out of this 16,000 only around 3% actually paid for their care. Private asylums, meanwhile, charged extremely high fees that were out of reach for the majority of society (usually several hundred pounds per year) and by 1900, thirteen private asylums housed 300 patients. Occupying a sort of middle ground, voluntary asylums, established by philanthropists, offered less expensive accommodation to those who could not afford high private asylum fees (from around £24 to a few hundred pounds). By 1900, these four voluntary asylum had outstripped the thirteen private ones, providing for 400 patients.

The Road to Committal


Advertisement for Farnham House, Private Asylum and
Hospital for the Insane, Finglas Dublin.
Source: Medical Directory (London, 1899), p. 1616.
Families were usually responsible for determining when it was time to commit a patient, where to send them and how much they should pay for their care. Factors such as cost, spending power, standard of accommodation, a hospital's religious ethos and the sort of people confined there all coloured these decisions. Broadly speaking, certain social groups (of the same religion) chose certain asylums.

Once admitted, patients were assessed by the medical authorities who determined a cause for their illness along with a diagnosis. This process was based on the medical certificate obtained prior to committal; evidence supplied by the patient and family; and the medical practitioner's own views. The two primary nineteenth-century diagnoses – mania and melancholia – reveal relatively little about reasons for committal. The causes named, however, were far more colourful and wide-ranging and expose much about contemporary perceptions of the life events or circumstances that led to mental illness and therefore committal. Given causes encompassed a range of 'psychological' factors such as grief, bereavement, business or money anxieties and religion, and physical influences including accidents and injuries, physical illnesses, hereditary and alcohol. These later two were the most frequently employed, demonstrating widespread medical understandings of the physical nature of insanity. However, many patients, families and increasingly asylum doctors, reported that fears about financial stability, land interests and the state of the economy had caused the illness.1 In reality, it was often these anxieties that resulted in committal, especially among those with a degree of resources, such as white-collar workers, shopkeepers and farmers.

The Case of John D


Entries in Casebook 2, c.1898.
Source: St John of God's Hospital,
Patient Records.
Land and property interests certainly featured in the case of John D. In 1891, at the age of 77, John was committed to the Enniscorthy lunatic asylum by this two sons. John's sons provided details of his personal history to the asylum authorities; details which were later transcribed by the asylum's Resident Medical Superintendent, Dr Thomas Drapes, into his case notes. Reportedly a 'healthy old man', the first symptom noticed by John's sons was that he wanted to marry his servant, a girl of twenty:

Says if he doesn't marry her his soul is lost and that he'll burn in hell ... he is very supple and has often tried to take away across the country to get to this girl ... Son says he won't allow bedclothes to be changed or bed made since the girl left, as he says no one can make it but her.2
While John was a patient in the asylum, this girl visited him disguised as his niece. Following this, John's sons told Drapes to prevent any further communication between the pair. They were very much against the proposed marriage, insisting that 'she and her family are a designing lot' and 'all encourage her to get him to marry her'. One son informed Drapes that in his opinion his father would have married '"anything in petticoats" for past two years or so'. Allegedly, the girls he proposed to were 'not at all suitable, and "strealish" in appearance and habits'.

Underlying this narrative were anxieties about John's property. A farmer and a shopkeeper, John was certainly not a pauper. His maintenance in the asylum was £18 per annum and while he was in the asylum, John presented Drapes with a further £16 'to keep for him'. The sons made clear their anxieties about the family business. On one visit they stated that lately, their father 'was not capable of properly doing business in his shop'.

The real motivation for committing John, however, became clear when the patient later informed Drapes that 'he gave his sons up his land, but wished to retain his shop for himself and get a wife to mind it for him'. John also gave what Drapes termed a 'rational explanation' for his romance with the servant girl, explaining that:

the girl had been so spoken of in connection with him that her character had suffered, and that if he did not make her the only reparation he could by marrying her, he would suffer in the next world.3

Just two months after his committal Drapes discharged John. In his notes he wrote that this was 'greatly against the wishes of his sons, but I have not been able to find any distinct evidence of his insanity'.4 By 1901, John, now aged 87, had married a woman of 27, possibly the servant girl. However, ten years later, it was his son who resided at this address with his own wife and six children suggesting that he had ultimately inherited the property.5 The most plausible explanation for this outcome was that John's young wife had not borne him any children, which would have prevented her from being entitled to property rights following his death.

Conclusions


The case of John D adheres comfortably both to contemporary public hysteria over the perceived vulnerability of private patients to wrongful confinement and commonly held representations of the rural Irish.6 Although some historians have emphasised the detrimental impact of issues such as the consolidation of landholdings, emigration, land hunger and Famine memories on emotional familial bonds, historians of psychiatry have identified the 'range of familial emotional contexts' which asylum patients came from.7 Families often sent letters querying treatment, offering advice and enclosing food and money for patients.8

Yet, in cases where property or business interests were at stake, these factors tended to eclipse those of familial devotion. In fact, the high numbers of fee-paying patients who were unable to control their business or function in their profession suggests this was a major reason for committal. While the extent to which John D actually struggled in his shop is difficult to ascertain, it is conceivable that a number of other relatives' claims regarding patients' incapacity to work were genuine.

The association between working life and mental illness speaks volumes about contemporary society's interpretation of insanity and what drove families to commit relatives to asylums. In relation to social status, those unable to maintain their position within their given occupation were defined in terms of this failure. Land disputes and an inability to manage one's affairs threatened to shatter emotional familial bonds. In these cases, families may have viewed committal as a last resort in order to protect their resources or livelihood. After all, in smaller rural towns, relatives would have little control over the actions or interactions of a mentally-ill person positioned behind the shop-counter or at a farmers' market.

Dr Alice Mauger


Dr Alice Mauger was awarded a PhD by University College Dublin in 2014 for her thesis which examined institutions for the non-pauper insane 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 writing a monograph stemming from her doctoral research.
Below you can listen to Alice's talk, entitled 'The Cost of Insanity', given on 4 February 2016 as part of the UCD Centre for the History of Medicine in Ireland Seminar Series.



1 Fears of poverty and unemployment among pauper asylum patients are discussed by: Akihito Suzuki, 'Lunacy and labouring men: narratives of male vulnerability in mid-Victorian London' in Roberta Bivins and John V. Pickstone (eds), Medicine, Madness and Social History: Essays in Honour of Roy Porter (Basingstoke, 2007), p. 118; and, Catherine Cox, Negotiating Insanity in the Southeast of Ireland, 1820-1900 (Manchester, 2012), pp 59, 121.
2 Clinical Record Volume No. 3 (Wexford County Council, St Senan's Hospital, Enniscorthy, p. 264)
3 Ibid.
4 Ibid.
5 Census of Ireland 1901.
6 David Fitzpatrick, 'Marriage in post-Famine Ireland', in Art Cosgrave (ed.), Marriage in Ireland (Dublin, 1985), pp 116-31; Timothy Guinnane, The Vanishing Irish: Households, Migration, and the Rural Economy in Ireland, 1850-1914 (Princeton, 1997).
7 Cox, Negotiating Insanity, pp 108-9; Guinnane, The Vanishing Irish, pp 142-43, 230-35.
8 Oonagh Walsh, 'Lunatic and criminal alliances in nineteenth-century Ireland' in Peter Bartlett and David Wright (eds), Outside the Walls of the Asylum: The History of Care in the Community 1750-2000 (London and New Brunswick, 2001), p. 145.

Friday, 18 March 2016

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

Friday, 4 March 2016

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

Friday, 5 February 2016

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.


Saturday, 12 December 2015

Medical Practitioners in Early Modern Irish Wills by John Cunningham

The destruction of the Public Records Office of Ireland in the conflagration of 1922 took with it almost all records on the administration of English government in Ireland from the thirteenth century. In this month's blog post, John Cunningham, an Associate Research Fellow on the Wellcome Trust funded project, 'The medical world of early modern England, Wales and Ireland, c. 1500-1715', demonstrates how alternative extant sources can yet throw light on the world of medical practitioners in early modern Ireland.

The Four Courts in Dublin in flames during the Battle of Dublin,
30 June 1922. National Library of Ireland: NLI: HOG57. The Irish
Four Courts was occupied by IRA irregulars from April 1922.
Marking the beginning of the Irish Civil War, on 28 June, Irish
Free-State forces began shelling the Four Courts. On 30 June 1922,
the Public Record Office of Ireland, part of Four Courts Complex,
was destroyed in a massive explosion of stored munitions.
Information relating to the lives and occupations of medical practitioners can be found scattered across a broad range of sources for the history of early modern Ireland. Given the fact that almost all Irish wills were destroyed in 1922, it could be reasonably assumed that the surviving material of this type is of very limited use for the study of practitioners. Fortunately, however, the availability of some useful indexes and the large number of extant abstracts and notes made by genealogists and others allows for the identification of hundreds of medics active in Ireland between the mid-sixteenth century and 1750.

Early Modern Practitioners Project


As part of my work for the Early Modern Practitioners Project at the University of Exeter, I have recently been exploring surviving wills and other testamentary materials. This research will help to inform the Irish content of our project database, which will contain information on many thousands of medical practitioners in early modern England, Ireland and Wales. In this blog post, I will discuss some of the research challenges posed by Irish wills and briefly highlight a number of ways in which they can serve as a useful source for the history of medicine in Ireland.

Irish Wills as a Historical Source


Although the body of fragmentary will data that has survived for early modern Ireland is dwarfed by the sources of that nature extant for England, wills nonetheless constitute a vital source for the study of many aspects of Irish society in that period. At the same time, it must be recognised that will-making was very far from being a universal activity in early modern Ireland, and that women and persons of lower social status are inevitably under-represented. Moreover, many wills from this period had already been lost before the nineteenth century, when greater efforts were made to preserve such documents and to compile useful indexes

Will Index


Title Page of Vicar's Index to
Prerogative Wills.
Post-1922, our insight into a large portion of early modern Irish wills has been confined to index entries. Such indexes are most useful where occupational labels are included alongside names, addresses, and dates, such as in Sir Arthur Vicar's Index to the prerogative wills of Ireland, 1536-1810.1 Roughly 180 medical doctors, apothecaries, barber-surgeons and surgeons are listed in Vicars for the period up to 1750. For diocesan wills, however, the available indexes often contain little or no occupation data. Here, the Dublin wills index published in 1894 forms a notable and valuable exception, listing the names and occupations of around 115 medics active prior to 1750.2

A will index entry can serve as a useful reference point around which to assemble further information relating to individual practitioners, whether from a related will abstract or from a variety of other sources. James Field M.D. provides a useful early example. His will is indexed in Vicars under the year 1624, with his address given as Dublin.3 A corresponding abstract can be found in Sir William Betham's MSS, giving the names of Field's wife and children, and this information is complemented by the further details given in Field's funeral entry.4 This individual can also be found as 'James Fildeus' in the register of medical graduates at Rheims in 1606, the earliest record of a Hibernus occurring in that rich source.5 Some context for Field's involvement in medicine is provided by the fact that his surname was an anglicised form of Ó Fithcheallaigh, a Gaelic hereditary medical family active in west Munster.6 For example, 'William Fihilly of Limerick, physician' had received a grant of 'English liberty' in 1557.7 Another member of this family, Dr John Field, was among those implicated in the 1641 rebellion in Co. Kerry; his estate outside Tralee was confiscated as a result.8

Master of the Barber-Surgeons' Guild


Entry in Vicars for William Kelly (1597).
There are at least two practitioners in Vicars who pre-dated Dr James Field: William Kelly, 'gent', who died in 1597; and John Morphy, 'alderman', who died in 1603.9 Kelly was master of the barber surgeons' guild in Dublin in 1576, the same year that he took on Morphy as an apprentice.10 Morphy in turn became master in 1588, and was elected alderman of Dublin in 1596.11 These examples illustrate one of the pitfalls of relying on will indexes for an era when labels of status and occupation could be both fluid and multiple. Fortunately, details of the lives and deaths of both Kelly and Morphy can be recovered from other sources, not least the records of the barber-surgeons guild preserved in the library of Trinity College Dublin.12 The latter source also sheds some light on the career of Stephen Cradocke, a barber who features in the Dublin diocesan will index under the year 1577.13

Dublin Wills entry for Stephen Cradock, a barber.

'Inventory Attached But No Interesting Names'


When moving from indexes to study more detailed will abstracts and copies, it is necessary to keep in mind the extent to which the latter body of material has been shaped by the priorities of nineteenth and early twentieth-century genealogists and other researchers. A brief note attached to an abstract of a Cloyne will from 1727 is illustrative: 'Inventory attached but no interesting names'.14 My colleague Alan Withey has shown how probate inventories for apothecaries's shops can be used to explore the 'medical marketplace' in early modern Wales. The absence of equivalent material for Ireland is unfortunate.15

Pages from of one Sybil Kirkpatrick's eight notebooks in which
she copied the wills of Irish medical men from originals once
held in the Public Record Office. Royal College of Physicians of
Ireland, Heritage Centre, TPCK/5/3/1.
In most of the relevant manuscripts, it is necessary to pick out the medical wills from among those made by gentlemen, clergymen, merchants, widows, and others. An exception to this is provided by Sybil Kirkpatrick's notebooks preserved in the Royal College of Physicians of Ireland (RCPI), which contain transcripts of medical wills alone. Kirkpatrick's transcripts, made in the Public Record Office of Ireland in 1910-11, have preserved extensive details of forty pre-1750 wills.16 Most of these relate to prominent Dublin-based physicians. They thus complement the rich materials compiled by Sybil's better known brother, Thomas Percy Claude Kirkpatrick, also preserved in the RCPI.

Social Networks


Wills do not usually reveal extensive details about the nature and extent of an individual's medical practice. They can, however, contain useful information on aspects such as social networks, status and wealth, patron-client relationships, book ownership, and succession planning. The latter issue unsurprisingly features in some wills made by members of the Gaelic hereditary medical families. The 1663 will of Gerald Fennell, 'Doctor of Phisicke', demonstrated his concern to ensure that his cousin and namesake would be able to continue the family's long tradition of service to the Butlers. He used his will to recommend the younger doctor to the duke and duchess of Ormond, stating that he bad been 'bredd by me for the service of their house'.17 Similar concern for his family's medical future was shown in the 1728 will of Dr Patrick Shiel of Breandrum, Co. Mayo. He directed that 'unbyassed men' were to decide which of his two nephews, Owen or Patrick, was 'of a superior genius' for the study of medicine. These men were to take account of 'capacity of learning ... gravity of life, probity of manners, good humour and other virtuous qualities'. Shiel's will also reveals marital ties between his family and the Dunlevy or Ultagh family, who had been hereditary physicians to the O'Donnells of Tyrconnell. Shiel himself was closely involved with that branch of the O'Donnells who had relocated to Co. Mayo, in the previous century; he listed Colonel Manus O'Donnell among his 'trusty well beloved friendes'.18

Dublin College of Physicians


Wills can be helpful too for piecing together the relationship that existed between medics. In his will made in 1677, Dr William Hickey mentioned Dr Thomas Connor.19 Other sources show that Connor was Hickey's son-in-law, and that both men were active in the Dublin College of Physicians in the 1670s.20 Hickey's will also made reference to the surgeon Nicholas Gernon, who evidently provided him with medical care in his final illness. Gernon was a native of Dublin who had been admitted to freedom in 1644.21 When he in turn died around 1692, his widow Bridget remarried to Francis Dempsey, another Dublin surgeon.22 Another of those active in the College of Physicians in the 1670s was Dr Edmund Meara.23 Decades earlier, in 1638, he had been one of the witnesses to the will of John Verdon, MD, of Dublin.24 A decade earlier again, Verdon and Edmund's father, Dr Dermot Meara, had been involved in efforts to establish a college of physicians in Dublin.25 Another of the witnesses to Verdon's will in 1638 was the barber-surgeon Simon Cullen, while the apothecary Stephen Hore was appointed executor. Little is known of Verdon, but his surname suggests that he originated in Co. Louth, a likelihood reinforced by the reference he made to his 'loving cousin Sir Christopher Bellew'.26

Medical Witnesses



Extract from Ferrar's description of Dr Hall's Alms House.
History of Limerick (1787).
One of the trends evident across the period is the appearance of medics as beneficiaries, as executors, or as witnesses to wills of persons of high social status. Given that medics were trusted by their patients and that they were likely to be present when wills were being made shortly before death, this phenomenon is not surprising. A mid-sixteenth century example is provided by the will of Morrough O'Brien, first earl of Thomond, whose 1551 will was witnessed by 'Master Doctor Nelan'.27 Other instances involving noble families include James Fennell, a physician who witnessed the earl of Ormond's will in 1614, and Dr Jeremie Hall, who witnessed the earl of Orrery's will in 1681 and was subsequently appointed an executor by the dowager countess in 1688.28 A full transcript of Hall's will also survives; it provided for the foundation of almshouses and schools both in Limerick and in Boothtown, Yorkshire. This document, containing extensive details relating to his building plans, his books, legacies to Trinity College, Lord Powerscourt and the earls of Orrery, Donegall and Stafford, and various other matters, would have taken some time to compose.29 It certainly lacks the urgency of the will of the Cromwellian Lieutenant-Colonel John Grey, made as he lay dying of wounds following the failed assault on Clonmel in May 1650. Those present included the surgeon John Hoggsfleshe, to whom Grey left £5.30 An episode of altogether more intense medical care is suggested by the 1715 will of Henry Meredith Esq., of Newtown, Co. Meath. It was witnessed by three fellows of the King and Queen's College of Physicians of Ireland: Duncan Cuming; William Smith; and Edward Worth.31

Obscure Practitioners


While figures such as Cuming and Worth are relatively well-known, wills and related data can also provide vital evidence for the existence of far more obscure practitioners who may not have left any other trace in the archive. Loughlen Keaghry, 'Dr of Physicke', made his will at Laragh Beg near Athenry in November 1730; unfortunately, I have not yet come across any other reference to him.32 The Hugh Fergus who witnessed his will was presumably the MD of that name, a member of another of the Gaelic hereditary medical families that remained active into the eighteenth century.33 Another of the obscure individuals to whom I have so far only found one reference is Millisent Alwright, a Dublin midwife who died around 1740.34 It is likely that Keaghry and Alwright will remain among the very many practitioners about whom very little can now be discovered. In many other cases, however, the combination of will data with material drawn from a wide variety of other sources can enable us to learn more about the practitioners who populated the medical world of early modern Ireland.

Can You Help?


To date, my efforts to gather data relating to practitioners have been supported by a number of scholars of early modern Ireland, who have given advice on sources or kindly shared the findings of their own research. As it is not possible for one individual to consult every source, such collective endeavour is essential to maximising the value of our project database, which will be open access and fully available online. I would be very happy to hear from anyone who wishes to contribute advice or information. I can be contacted at cunninjo@tcd.ie

Dr John Cunningham


Dr John Cunningham is an Associate Research Fellow on the Wellcome Trust funded project, 'The Medical World of Early Modern England, Wales and Ireland, c. 1500-1715'. His research focus on this project is on medical practitioners in early modern Ireland. John previously held an Irish Research Council CARA Postdoctoral Mobility Fellowship, during which time he spent two years at the University of Freiburg and a year at Trinity College Dublin (TCD). His project was entitled 'Ireland and Bohemia in the seventeenth century'. He completed his PhD at NUI Galway in 2009. His dissertation was entitled 'Transplantation to Connacht, 1641-1680: theory and practice'. John has taught history in Galway and Dublin, including a seminar course at TCD called 'The Nobility in Early Modern Ireland'. His research interests include early modern Britain and Ireland, the history of medicine, and Central Europe in the early modern period.

Project Podcast


You can listen to a podcast about the project, 'The Medical World of Early Modern England, Wales and Ireland, c. 1500-1715', for BBC History Magazine, from 29 November 2012.




1 Arthur Vicars (ed.), Index to the prerogative wills of Ireland, 1536-1810 (Dublin, 1897).
2 Deputy Keeper of Public Records in Ireland (hereafter DKPRI), Twenty-sixth report (Dublin, 1894).
3 Vicars (ed.), Prerogative wills, p. 166.
4 National Library of Ireland (hereafter NLI), Genealogical Office (hereafter GO) MS 225, p. 39; NLI, GO MS 79, p. 117.
5 List of Rheims Graduates, kindly supplied by Professor Laurence Brockliss.
6 Nollaig Ó Muraile, 'The hereditary medical families of Gaelic Ireland', Irish Texts Society Seminar, University College Cork, 7 November 2015. I am grateful to Dr Marc Caball and Dr Declan Downey for their insights into the Field family.
7 Fiants of Philip & Mary, no. 140, in DKPRI, Ninth report (Dublin, 1877), p. 73.
8 Deposition of Stephen Love, 2 February 1644, TCD MS 828, fos 124r-127v; Field, Dr John, The Down Survey of Ireland, Trinity College Dublin (2013).
9 Vicars (ed.), Prerogative wills, pp 264, 337.
10 Barber surgeons, Book of enrolment of apprentices and journeymen, 1530-1607, TCD MS 1447/6, fos 30v-31r.
11 Ibid., fo. 40v; Calendar of the ancient records of Dublin, ed. John T. Gilbert and Rosa Gilbert (19 vols, Dublin 1889-1944), ii, 306.
12 Barber surgeons, Book of enrolment of apprentices and journeymen, 1530-1607, TCD MS 1447/6; NLI, GO MS 65, pp 6, 82; NLI, GO MS 225, pp 188, 264; Fiants of Elizabeth, no. 3747, in DKPRI, Thirteenth report (Dublin, 1881), p. 143.
13 DKPRI, Twenty-sixth report (Dublin, 1894), p. 196; NLI, GO MS 290, p. 70.
14 NLI, GO MS 534, p. 62.
15 Alun Withey, '"Persons that live remote from London": apothecaries and the medical marketplace in seventeenth- and eighteenth-century Wales', Bulletin of the History of Medicine, 85 (2011), pp 222-247.
16 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1.
17 Prerogative will book, 1664-84, NAI, MFGS 41/1, fos 99A-100B.
18 Prerogative will book, 1728-9, NAI, MFGS 41/4, fos 359B-364A.
19 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1, i, p. 71.
20 Account book beginning 21 January 1672, Heritage Centre, RCPI, MS 3/3/1; NLI, GO MS 257, p. 143; NAI, RC 6/3, p. 23.
21 'Nichus Gernon', Ancient Freemen of Dublin Database, Library and Heritage, Dublin City Council.
22 NLI, GO MS 258, p. 70.
23 Account book beginning 21 January 1672, Heritage Centre, RCPI, MS 3/3/1.
24 NLI, Reports on private collections, no. 32, pp 547-548.
25 Marian Lyons, 'The role of the graduate physicians in professionalising medical practice in Ireland, c. 1619-1654', in James Kelly and Fiona Clark (eds), Ireland and medicine in the seventeenth and eighteenth centuries (Farnham, 2010), p. 25.
26 NLI, Reports on private collections, no. 32, pp 547-548.
27 Brian Ó Dálaigh, 'A comparative study of the wills of the first and fourth earls of Thomond', North Munster Antiquarian Journal, 34 (1992), pp 57-59.
28 T. Blake Butler, Ormond Deeds, viii(Typescript in NLI MSS Reading Room), D3580; NLI, GO MS 532, pp 24-26.
29 Sybil Kirkpatrick will notebooks, Heritage Centre, RCPI, TPCK 5/3/1, i, pp 40-57.
30 NLI, GO MS 530, p. 142.
31 Registry of deeds: abstracts of wills, ed. P. Beryl Eustace (3 vols, Dublin 1954-84), i, no. 101.
32 NLI GO MS 425, p. 109.
33 Vicars (ed.), Prerogative of wills, p. 165; Diarmaid Ó Catháin, 'John Fergus MD: eighteenth-century doctor, book collector and Irish scholar', Journal of the Royal Society of Antiquaries of Ireland, 118 (1988), pp 139-162.
34 NLI, GO MS 257, p. 225.

Thursday, 8 October 2015

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 Report3 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.

Wednesday, 20 May 2015

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

Prisoner Health Project: Wellcome Trust Senior Investigator Award

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