The Cork Street Fever Hospital Archive by Fergus Brady

In 2013, the Cork Street Fever Hospital archive was donated to the Royal College of Physicians of Ireland (RCPI). Following a recent funding award, the archivists at the RCPI began the process of cataloguing and preserving these extensive and important medical records. The project is now complete and the final collection list is available to browse through the online RCPI catalogue. In this month's post, Fergus Brady, Archivist, RCPI, reports on the archive and outlines the history of this fascinating Irish medical institution.

Nurses and patients on the 'lower landing', Cork Street Fever Hospital, 1903
(RCPI Archival Collections: CSFH/1/2/1/6)

RCPI win Wellcome Trust funding to catalogue Cork Fever Hospital Archive

A project, funded by the Wellcome Trust, to fully catalogue the archive of Cork Street Fever Hospital has been completed by the staff of the Royal College Physicians of Ireland Heritage Centre. As part of the project, appropriate measures were also taken to ensure the long-term preservation of the archive so that the hospital’s records will be accessible to researchers both in the present and into the future.

The origins of the House of Recovery and Fever Hospital, Cork Street, Dublin

Minutes, Governors of Cork Street Fever Hospital, 1801
(RCPI Archival Collections: CSFH/1/1/1)

The House of Recovery and Fever Hospital on Cork Street, Dublin, grew out of a series of meetings held between a group of wealthy and philanthropic men drawn from Anglican and Quaker congregations during October 1801. In the late eighteenth and early nineteenth centuries in Dublin, as elsewhere in Europe, insanitary conditions ensured that infectious diseases were prevalent among the general population. Those present at the October meetings had a clear idea of the nature and scale of such health issues, stating that ‘...no adequate Hospital accommodation has hitherto been provided for the relief of the Sick poor of Dublin afflicted with fever (especially such as may be of a contagious Nature)’. Influenced by the fever hospital movement in Britain, the provisional Committee believed that the solution lay in the ‘establishment of a House of Recovery to which patients on the first appearance of Fever might be removed’.¹

The fever hospital opens

Original entrance to the hospital, erected 1804
(RCPI Archival Collections: CSFH/7/1/6)

Less than three years later, on 14 May 1804, the newly-erected House of Recovery and Fever Hospital on Cork Street admitted its first batch of patients. As its name suggests, the hospital physically separated the sick from the convalescent by the constructing two buildings 116 feet apart in what was an early attempt at infection control.² The erection of such purpose-built buildings was intentional, as the hospital’s founders were influenced by prevailing theories regarding the control of infectious diseases.

Early years and fever epidemics

Cork Street Fever Hospital and House of Recovery, 1899
(RCPI Archival Collections: CSFH/1/2/1/5)

In the early decades of the hospital’s existence its catchment area expanded from the Dublin Liberties to the whole of the city. Hospital buildings were extended to meet the admissions triggered by the regular epidemics which ravaged the poorest districts in the city. A fever epidemic in 1817—1819 put severe pressure on the hospital, with admissions doubling in 1818. In 1826 an epidemic of typhus necessitated the erection of emergency tents. The 1830s and 1840s were periods of exceptional activity, as the number of patients admitted swelled due to outbreaks of cholera and typhus. In 1847 tents were erected and 400 emergency beds provided to allow for the admission of patients suffering from a typhus outbreak, which had been stimulated in large part by the influx into Dublin of thousands of famine-stricken refugees from the countryside. These regular epidemics took their toll on the health of the medical staff, and in particular the nursing staff, many of whom were struck down with fevers contracted during the course of their work.

The 'Red House'

Nurse and two children on the balcony of the Red House, 1909
(RCPI Archival Collections: CSFH1/2/1/6)

In the 1860s and 1870s epidemics of smallpox placed great pressure on the hospital’s resources, with a record case fatality rate of 21 per cent recorded in 1878. In the last few decades of the century measles, typhoid, scarlet fever and smallpox predominated, prompting the hospital governors to build the ‘Red House’ on the grounds of Cork Street, and to open an auxiliary hospital for convalescents at Beneavin, Finglas. In 1891, hospital reports recorded diphtheria for the first time, a disease which became a significant health problem in the early twentieth century with the arrival in Dublin of the virulent gravis strain.

The move to Cherry Orchard

Patient arriving at hospital in ambulance, 1896
(RCPI Archival Collections: CSFH/1/2/1/5)

In the early twentieth century there were two changes that significantly altered the running of the hospital: in 1904, the hospital was granted a Royal Charter under which Dr. John Marshall Day was designated first Medical Superintendent; and, in 1936, the Dublin Fever Hospital Act changed the hospital from voluntary to municipal control. This alteration sought to “make provision for the establishment of a new fever hospital in or near the city of Dublin and for the closing of the House of Recovery and Fever Hospital, Cork Street, Dublin”.³ Planning for the development of a new hospital was long and protracted, however, with both the Second Word War and a 1944 sworn inquiry into alleged maladministration in the hospital contributing to delays. Led by the efforts of Dr. Day’s successor as Medical Superintendent, Dr. C. J. McSweeney, a 74-acre site was finally secured at Blackditch, Palmerstown, Co. Dublin, and building tenders received in early 1950. The hospital board decided that as the name Blackditch evoked images of plague and death, the address of the new hospital should be changed to Cherry Orchard. In November 1953, patients and staff vacated the premises at Cork Street and moved to the new House of Recovery and Dublin Fever Hospital, Cherry Orchard.

The Cork Street Fever Hospital archive

Staff of Cork Street Fever Hospital, 1938
Dr. C. J. McSweeney, Medical Superintendent, is
pictured sixth from the right in the second row
(RCPI Archival Collections: CSFH/1/3/4/1) 

The archive of Cork Street Fever Hospital is large and varied, and consists of a series of records relating to hospital management, staff, students, patients, finances, buildings, hospital history and events. There are also records of inquiries, routine administration and domestic tasks, and individual Medical Superintendents. The run of minute books is remarkably complete, stretching from the first meetings of the provisional managing committee in 1801 to 1953, a span interrupted only by a gap of twelve years between 1828 and 1842. Similarly annual reports, which usually include medical reports, run from 1801 to 1953 with few omissions. Records relating to individual Medical Superintendents are particularly plentiful for Dr. C. J. McSweeney’s tenure (1934–1953), and consist for the most part in report books, research and teaching notes, drafts of articles and papers, and other ephemera. Patient records are, unfortunately, less comprehensive, with the earliest surviving register of patients dating from 1924 to 1929. Access to patient records and other sensitive files containing personal data are subject to Data Protection legislation and conditions laid out in the RCPI Heritage Centre’s guidelines. There are also some records across the various series which date from the decades following the transfer of the hospital to Cherry Orchard.

If you have any queries about the collection, please contact heritagecentre@rcpi.ie.

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1. Cork Street Fever Hospital Committee Proceedings, 23 October 1801.↩
2. Patricia Conway, Sheila Fitzgerald and Seamus O’Dea, Cherry Orchard Hospital: The First 50 Years (Dublin, 2003), p.  2.↩
3. Ibid., p. 3.↩

Childhood illness in twentieth-century Ireland by Ida Milne

In this month's blog post, Dr Ida Milne,  Irish Research Council ELEVATE fellow co-funded by Marie Curie Actions, writes about her postdoctoral project on childhood illness in twentieth-century Ireland.

We live in an era where we expect our children to survive to adulthood without having their lives threatened by common infectious diseases of childhood.  The situation was rather different in the Ireland of the early part of the twentieth century. In 1911, more than 2,000 infants under the age of two died from diarrhoeal illnesses, almost double the number that died the previous year.  The increase was not helped by the hot summer, which exacerbated the hygiene difficulties in an era when many houses, even of the affluent, did not have running water or flush toilets. As a twenty first century mother, I find the idea of nursing a child suffering from diarrhoea in an overcrowded third floor  bathroomless tenement almost unimaginable. 

Child mortality in the early-twentieth century

Having healthy children who would survive to adulthood was not taken as the norm, as we do now. Statistics tabulated by the Registrar-General in 1911 show that one-fifth of the total 72,475 deaths in 1911 were children under 5; of these, 945 were caused by ‘convulsions’ and 1,370 by bronchitis. Scarlet fever claimed the lives of 260 children under fifteen; 460 under-fifteens died from measles, and 819 under tens from whooping cough.  

Slums in Dublin, c.1865-1914 (Image from NLI collection: L_ROY_07881)

Dublin tenements, poverty, and childhood illness

Few families, rich or poor, remained untouched by these deaths, but the over-crowded living conditions of the poor could bring extremes of ill health. Stella Larkin McConnon, trade unionist James Larkin’s granddaughter, told me that the poor health of the nation’s children was one reason he became so interested in improving living conditions for families.  The Larkins had good reason to be aware of the suffering.  Stella’s own mother was brought up in Marlborough Street in the heart of Dublin’s tenements, and was the only one of ten children to survive to adulthood.  Stella still remembers visiting the tenement, one room with only one metal bed, the only toilet downstairs in another part of the tenement, the cooking done on an open fire.

Improving child health

By 1981, the landscape of death in childhood had changed radically. There were no deaths in either Northern Ireland or the Republic from scarlet fever or whooping cough, and only two from measles.  Only 2.78 per cent of the total deaths, 916 of 32,929, were of children under five.

Many factors contributed to the improvements over the course of the twentieth century:  among them vaccination schemes and more effective medicines, public health education and increased state intervention in the health of children, better housing and diet and improved air quality. It didn’t happen by accident – throughout the century, there were individuals who identified areas to change and worked to effect that change.  Their number includes the first chief medical officer for Dublin, Sir Charles Cameron, trade unionists like James Larkin who worked to give families a decent wage, pioneering TB Dr Dorothy Stopford Price,  Department of Local Government and Public Health Chief Medical Officer James Deeny, Noel Browne and many others who played macro and micro roles in the significant reduction in deaths from disease in childhood.

Research project on childhood disease

In October, I began a three year  Irish ResearchElevate Fellowship in the National University of Ireland and Queen’s University, Belfast to research this dramatic changing landscape of childhood disease, which is in general a good news story for Irish society and Irish public health.  While statistical and documentary sources will be important to the project, a key feature will be a series of qualitative interviews with medical professionals, with people who worked in relevant Government and local authority roles, and with parents and sufferers. I intend that these interviews should, at the conclusion of the project, be available in an open access archive to other researchers. 

Mother (to District Visitor): "Lumme, miss! There ain't no danger

of infection. Them children wet's got the measles is at the 'ead of 

the bed, and them wet ain't is at the foot.

London Mail, 23 October 1913

Image courtesy of the Wellcome Library

The project builds on and was partly inspired by the RAMI Living Medical History project; Susan Mullaney, Mary O’Doherty and  Patrick Plunkett of the RAMI section on history of medicine devised this innovative project to interview retired medical doctors about their working lives, collecting memories on the changes in medical practice over the course of their careers. Several of the LMH interviewees had either suffered from diseases like diphtheria and tuberculosis themselves, or had family who did, and this really brought home to me how all-pervasive the effects of childhood disease were on Irish society, that they were not merely confined to the poor and the badly-housed, but could also invade better-off families.

Oral history of medical practitioners

Oral history interviews can add flesh to the dry bones of statistics. When working on my PhD on the effects of the 1918-19 influenza pandemic here,  the people who spoke to me about suffering this influenza as small children, or who told me about how their families coped with the tragic losses of children or parents to the 1918-19 flu, breathed life into its history, recreating the fear caused by the unpredictability of  this most awesome of influenza pandemics.

In the case of this new project, I am hoping to find people who can talk about the changing landscape of childhood illness in the twentieth century, from their own perspective, whether as medical workers, patients, parents or as Department of Health officials and politicians.

I’m curious about issues like knowledge transfer – how and what did parents learn about treating the illnesses their children caught?  As a child growing up in the 1960s, I recall my mother hanging blankets over the windows when we caught measles; the information she had been passed down by her mother was that children with measles could damage their eyesight if they read or were in daylight.

When I had my own children in the 1990s, I was struck by the efficiency and dedication of a district nurse in north Kildare who made sure we parents brought our children for vaccinations, and cajoled and informed those parents who had reservations about allowing their children to be vaccinated. Getting medical workers like her to talk about their work is one of the goals of this project. This district nurse was, it seems to me, a local hero, a micro role player who was a small but significant cog in the expanding machinery which managed and significantly improved the health of our children over the course of the twentieth century. 

Dr Ida Milne is a social historian based at NUI Maynooth and Queen's University Belfast. She holds an ELEVATE Irish Research Council International Career Development Fellowship co-funded by Marie Curie Actions.