On the 28th of February, 1832 at around
midnight, Bernard Murtagh, a 34 year
old cooper who resided in a lodging house on Quay Lane Belfast, a narrow
street near the River Lagan, became violently ill. Described as a man of
irregular habits he had been suffering from diarrhoea for two or three days
previously but had not complained of any other symptoms when he went to bed
following his usual supper of stirabout and milk. Around midnight his condition
worsened and towards morning was accompanied with intense cramps and vomiting,
the fluid (from both ends) described as whitish and like milk or meal and
water. He was seen by Surgeon McBurney the following morning and was found to
be in a state of extreme weakness and collapse, extremely cold and without a
perceptible pulse at the wrist. A mustard emetic was administered around midday
after which he appeared to revive a little. However, this proved only to be a
temporary respite and he died between 7 and 8 p.m. that evening some nineteen
hours after becoming ill.
 |
High
Street Belfast c.1831. A water cart can be seen to the right of the picture
Source: Ulster Museum IC/High
St/831 |
Murtaugh had become the first recognised victim
in Ireland to have died from what was then perceived as a new a frightening
disease from the East, Asiatic cholera, though in truth it was new only to the
West. Cholera, notable for its severity, rapidity and high mortality had been
endemic in India in for some time before spreading throughout Asia after 1817
and Europe after 1829. Its signature symptoms, violent vomiting and diarrhoea
resembling rice husks were usually accompanied by agonising cramps, muscular
spasms, a weakened pulse, low temperature, and a blue tinge to the nails and
skin. They were caused by infection with a microorganism, vibrio cholerae, usually following the ingestion of water contaminated by the
excreta of another cholera sufferer, particularly in places where infected
sewage was able to seep into the public water supply. In the towns and cities
of nineteenth century Ireland where sanitary practices and sewage systems were
often rudimentary at best this particular method of dissemination was a common
and deadly hazard.
In Ireland alone around 40% of those who
contracted cholera between 1832 and 33 would die as a consequence and in some
areas mortality rates were as high as 76%. In a second outbreak during 1848/49
mortality rates were even higher, with the disease finding easy prey in the
form of a population severely weakened by Famine and its associated illnesses.
Belfast’s mortality rate at just 16% was however, much more favourable than anywhere
else in the country and was significantly lower than Dublin or Cork who
experienced rates in excess of 40%.
 |
A
Court For King Cholera. This famous cartoon depicts conditions conducive to the
spread of cholera.
Source: Wellcome Images
|
Nineteenth century Belfast was Irelands only industrialised town and
outwardly appeared successful and prosperous. Described by one commentator as
looking as if it ‘had money in its pocket and roast beef for dinner’. However,
while industrialisation had created opportunity, it also created serious social
issues particularly in the provision of housing, water supply and sanitation. Housing
for the labouring poor was laid out in a grid pattern of confined and
insanitary courts, lanes and alleys, commonly consisting of two story buildings
occupied by two or more families. Few houses were provided with piped water and over 7,000 houses were
supplied from public fountains, by water carts, or from pumps sunk by
landlords. Sewers were
often constructed to deposit their effluent directly into the town’s main
watercourses and high tides and flooding regularly carried effluvia back onto
the streets and into the homes of those who lived in their vicinity, making
sanitary conditions and their likelihood of contracting serious illnesses
inherently worse.
When cholera came however, Belfast appears to have been as well, if
not better prepared to combat the disease than most. The initial response was
the remit of the Police Commissioners and of an ad hoc and hastily formed Board of Health. Working closely together, a systematic
programme of street cleaning and of whitewashing and fumigating houses was
instigated. Temporary hospital accommodation was provided in the grounds of the
towns Fever Hospital with Dr Henry McCormac placed in charge. McCormac combined
a strict isolation policy with treatments which included bloodletting and the
administration of calomel (mercury), opiates and dilute sulphuric acid. Though
mortality in the hospital was much higher (22%) than for the rest of the town
there does appear to have been less resistance in Belfast to the idea of going
to hospital than was the case elsewhere. In Dublin for example, opposition was
such that carriages carrying the sick to hospital were occasionally set upon,
the patients ‘rescued’ and the carriages thrown in the Liffey.
 |
Cholera Localities Belfast 1832
Source: A.G. Malcolm ‘The Sanitary State of Belfast with Suggestions for its Improvement’
http://www.tara.tcd.ie
|
By the end of the first epidemic over 400
people had died in Belfast and cholera, as did on-going preventative public health provision, passed
quickly from public consciousness. Thus,
when cholera returned to Ireland in 1848 practically nothing had changed in the
way it was fought. However, during this second epidemic, the efforts of
Belfast’s new Board of Guardians, the physician and sanitary reformer Dr Andrew
Malcolm and additional sanitary powers granted to the new Town Corporation by town
improvement legislation arguably prevented a much higher death toll than was
experienced elsewhere. The Guardians, for example acted in defiance of the Poor
Law Commissioners when they opened the Belfast Workhouse in 1841 with ten beds
for the reception of the sick, rapidly increasing this to 100. The Corporation introduced
new housing regulations and were granted additional sanitary powers, giving
them more authority to require landlords and property owners to remove
nuisances and pave streets. However, by 1848 Dr Malcolm reported that there
continued to be a ‘lamentable deficiency’ with regard to the removal of
offensive remains. As fears of choleras immanent
arrival grew the influential Malcolm rose to the fore to guide the municipal
authorities. A Sanitary Committee headed by Malcolm and specifically aimed at
dealing with cholera in the first instance was formed in 1848. The Committee
published and distributed reports, magistrate’s orders
were issued for the removal of nuisances, poor families were provided with
straw bedding, houses were whitewashed and new sewers were constructed in some
parts of the town.
Despite the preparations however,
fatalities were almost treble those of 1832. Though Belfast now had two
hospitals capable of receiving cholera patients the willingness of the sick to
be admitted had declined decidedly. The Committee of the General Hospital attributed the reluctance to
‘prejudices or perhaps the state of apathy and hopelessness which accompanies
this severe malady’ and commented that it was a ‘matter of regret,
that that the advantages of the hospital were not more generally or duly
appreciated by the poor’. By the end of the epidemic 3,538 cases and 1,163
deaths had been recorded but mortality at 33% was again lower than that of
other sizable Irish towns. However, in Belfast’s worst
affected areas, poverty and deficiencies in sanitation and hygiene had clearly
been instrumental in the spread of the disease. And while the town’s municipal authorities had effected much civic enhancement,
major sanitary improvements had not been instigated in the areas of the town
where they were most required. Nevertheless, some lasting lessons had been
learned and when cholera returned again in 1853 and 1866 mortality rates were almost
insignificant by comparison.
Nigel
Farrell is a third year PhD student based at the University of Ulster Coleraine
and is researching cholera and the development of public health in Belfast between
1832 and 1878. The above post is based on his winning entry to the History of
Medicine in Ireland Prize competition.
.jpg)
Charles Lucas was born on 16th
September 1713. Left penniless on the death of his father, Lucas was
apprenticed to a Dublin apothecary. Apothecaries, at that time, were the least
respectable branch of the rapidly expanding medical profession, but the only
one a man in Lucas’ position could hope to access. The apothecaries’ trade was
notorious at the time for fraud, malpractice, adulteration of medicines and the
use of poison. Lucas actively campaigned for legislation to control the
profession, and was partly responsible for the 1735 act which gave this College
the power to regulate the Apothecaries trade. .jpg)
