Lecture 3 of 4 in "Is Health Better than Wealth"

1. DIS-EASE AND
DISEASE
THE TONIC
Waterford County Archivist
Joanne Rothwell

2. DIS-EASE
 Humours – yellow, black, phlegm, blood
 Blood- sanguine; Phlegm-phlegmatic; Yellow Bile- choleric; Black bile-
melancholic
 Melancholia – physical and mental disorder. An excess of black bile.
 A Treatise of Melancholie – Timothy Bright 1586 “an unnatural boyling
of heate with wyndines under the left syde” “shortness of breathing”
 Gary Lindquester's "History of Human Disease," Fever- a hot, dry
disease - yellow bile. So, the doctor would try to increase its
opposite, phlegm, by prescribing cold baths. With a cold, where there
were obvious symptoms of excess phlegm production, the regimen
would be to bundle up in bed and drink wine.
 Hellebore, a potent poison that would cause vomiting and diarrhea,
"signs" the imbalanced humor was eliminated.

3. MENTAL HEALTH
Idiot Lunatic Melancholic Hysterical - medical terms
Idiot – natural fool from birth
Lunatics – sometimes of sound memory and others not
Hysteria - associated with women “wandering womb”
By 18th Century – disease of the mind
James Boswell “a disorder of the mind itself , which neither the
most potent medicines nor the most violent exercise can remove”
Lunatic Asylums – ward in the Workhouse, violently insane
were moved to the District Lunatic Asylum in Waterford
1808 – County Asylums Act
Waterford District Lunatic Asylum – opened 7th July 1835. Built
to house 100 patients
1891- 359 patients new wings added in 1894

4. BATHS AND SPAS
Spas – taking the waters
Turkish Baths
Public Baths
Sea Bathing

5. Turkish Baths Dungarvan, 1901
Copyright Waterford County Archives

7. Healthy and Wealthy
 “heart disease caused most deaths among the gentry while
debility, infections and accidents carried off a high proportion
of the labouring classes.”
 Ireland was subject to outbreaks of fever due to famine and
poor living conditions– 1741, 1801, 1817/1818, 1822, 1826,
1829-31,1832...
 Robert Peel in 1816- wet weather meant no turf could be
saved contributing factor to the deaths by fever
 Select Committee investigating typhus epidemic identified
unemployment as the major factor and sought out ways to
provide work
 Waking the Dead – efforts by Church and State to stop the
practice failed. Special appeals in 1818 and 1832
 1799 and 1816 Window Tax became known as the “typhus

8. SMALLPOX
Contagious Disease – variola virus
30% death rate, survivors “pock marked”
In 18th Century Europe 1/3 of all reported cases of
blindness a result of smallpox
Edward Jenner – cowpox vaccine
in 1865 ten children, all under four years, died in
Lismore Workhouse
In Ireland 1871-1881 – 7550 deaths attributed to
smallpox in Ireland
1881-1891 – 241
1901-1910 – 65
1864-1900 – 25 people in Waterford

9. TYPHUS AND TYPHOID
 Two different diseases
 Typhus – spread by lice and rats, flies. Symptoms are fever and sores.
Overcrowding – Gaol Fever.
 Typhoid – infected faeces in the water or food supply
 Typhus epidemics in Ireland 1816-1819, 1830s and during the Famine
 1 in 7 caught typhus in the 1816-1819 epidemic in Waterford city
 1.5 million sick and 65,000 dead
 National Fever Committee – granted £1000 to Waterford City (Sir John
Newport MP – friend of Peel)
 Increase in number of fever hospitals, boards of health established
 Suppression of wakes, burning of straw in infected houses, prohibition
on selling of old clothes, better conditions and ventilation, suppression
of mendicity
 Typhus – index of poverty

10. TYPHUS
 Theories on Causes: cesspools, stagnant air, hunger. Clothing suspected
as carrier
 1849 – William Jenner distinguished between typhus, typhoid and
relapsing fever
 1869 Irish Registrar General separated typhus from typhoid
 1909 Charles Nicolle Institut Pasteur made the connection between lice
and typhus
 Fear – boycotting
 Quarantine – impact on trade
 Waterford Fever Hospital 1817:469 male admissions and 461 females.
1818:1277 males and 1452 females
 Among the poor the disease spread to the entire household but in better
class families the disease was confined to the fever victim – poor had a
higher survival rate on contracted the disease
 High rate of medical mortality
 Famine and Fever as a Cause and Effect in Ireland, Dominic Corrigan,

11. TYPHUS TREATMENT
 1742 – “bleeding, purging and a cool regimen”
 Leeches behind the ears or at the temples
 Dr. Bracken, Waterford 1816-19 purging “the most
distinguished place” among his treatments
 Robert Graves – importance of wholesome food
 Wine, tea, coffee, ale, porter and beer recommended to
treat patients and build them up
 Mortality rates declined from 1880s 1883: 20 in County 107
in City 1893: 20 in the County 31 in the City 1900: 4 in the
County 11 in the City
 James Deaney – “Ireland was the last country in Western
Europe with louse-borne typhus”

12. CHOLERA
 Cholera – bacterial infection of small intestine. Very high
mortality rate
 1832 – Cholera epidemic in Ireland
 March 1832 Cholera Board met in Dublin – April notice of
symptoms and advice issued around the country
 Arrived in Waterford on 20th May1832
 “the windows of the apartment should be thrown open and
remain freely admitting air for 3 days”
 The affluent were told their best measure of safety was to
provide for the poor
 Cholera struck all classes
 Vagrants and beggars spread disease – certain towns had
special constables to prevent them from entering

13. CHOLERA
 1832 Waterford County Cholera Board received £1812:6:7
grant aid from the Cholera Board
 Waterford City received £1850:4:3
 1832 – 51,153 cases and 18, 955 people died
 1832-1834 - 46, 175 deaths
 In England and Wales 16, 437 people died in the epidemic
 26 April 1849 – Report of Dr. Christian Dvan Union – “ A
genuine case of spasmodic cholera has occurred and is now
under treatment” May – several cases
 1846-1850 Dungarvan 723 cases of cholera with 344 deaths
47.4% mortality rate (1st case 29th April 1849 and last case 11th
September 1849)
 1864-1900 45 people died of cholera in Waterford

14. TUBERCULOSIS
 Infection of the lungs – consumption, phthisis
 Benjamin Martin, an English physician and author of A New
Theory of Consumption (1720), hypothesized that TB resulted
from the actions of “wonderfully minute living creatures.”.
He further theorized that close contact with a consumptive,
including frequent conversation so close as to “draw in part
of the breath he emits from the Lungs,” was enough to
transmit the disease.
 Medical theory still held that it was spontaneous and
occurred in predisposed people
 1882 Robert Koch discovered tubercle bacillus
 Sanatorium cure – clean air, rest, good nutrition

15. SCARLET FEVER and
SCARLATINA
 Bacterial infection – sore throat, fever, rash
 Regular epidemics
 the bowels should be regulated afterwards with two grains of aloes and
ten of salts given in treacle, at night, when required. The patient should
be confined to bed in a well-aired room, with covering sufficient to
retain warmth
When the throat is much affected the fever is always higher, and
determination to the brain is apt to supervene. As soon as heat of head
or delirium indicates this, the hair should at once be shaved off entirely.
Any attempt to retain it is futile, as it must fall after the fever, and its
presence imperils life. After being shaved the head should be elevated a
little, and kept constantly cool by rags wet with cold water often
renewed, or by ice in a bladder or oiled silk.
 care must be taken that the bladder and bowels be emptied at proper
intervals—the bladder every six hours, and the bowels once in twenty-
four hours.

16. DIPTHERIA
Bacterial infection – spread by coughing,
sneezing and infected foods e.g. Milk
Mainly affects respiratory tract – sore throat,
fever
Leading cause of death among children in
Europe
Bacteria identified in the 1880s antitoxin
developed 1890s. 1st vaccine 1920s

17. CONCLUSION
Widespread poverty lead to widespread
disease
Increasing awareness of the connection –
lots of reports
Actions?
Next week – Chronic Conditions in
Health and Wealth