Much the same as today in Third World countries, famine is always accompanied by disease. Ireland was no stranger to famine diseases. But in the 1845-50 period the whole country was ravaged. Those parts of Ireland that experienced the worst of the Great Famine suffered most from disease. It must be pointed out in relation to the chart Ennistymon Union, Summary of Diseases that the deaths referred to are those which took place within the workhouse and its auxiliaries. These were only a part of the total, as many died in their cabins or by the roadside. The total of those who died of famine disease will never be known but it is estimated that about ten times more died of disease than starvation. Historians generally maintain that between 1846-50, one million died either of disease or starvation.
The most widespread and deadly of diseases was that which became known as "Famine Fever". It consisted of two separate diseases, Typhus and Relapsing Fever. Both were conveyed by the common louse and in the crowded and filthy conditions prevailing in homes, workhouses and hospitals, spread like wildfire among a people whose resistance was greatly undermined by famine.
Typhus is caused by microscopic organisms, now known as Rickettsia. Rickettsia attack the small blood vessels especially those of the brain and skin. The circulation of the blood is impeded, the face swells and the skin turns a dark congested hue, which has given it its Irish name "Flabhras Dubh" (Black Fever).
Relapsing Fever is caused by micro organisms belonging to the group called spirochaetes. They enter the human blood stream through the skin. Within a few hours of infection high fever and vomiting begin which last for several days. A crisis point is reached, marked by profuse sweating which is then followed by extreme exhaustion. Six or seven days later there is a relapse, hence the name relapsing fever, and the whole process is repeated again and may be repeated as often as four times should the patient survive. Relapsing fever is usually accompanied by jaundice, which gives the fever its Irish name "Fiabhras Buidhe" (Yellow Fever).
Typhus and Relapsing fever were not the only diseases to plague the starving people. Chief among these was dysentery. Ireland was notorious for dysentery long before the famine. It reappeared in 1847 in epidemic proportions. Two types of dysentery occurred in Ireland during the famine and often the two were confused.
Dysentery producing diarrhoea was caused mainly by the deficiency and unsuitability of a diet which, after the potato failure consisted mainly of wild berries, dog leaves, old cabbage leaves, raw turnips, seaweed, grass and Indian meal half cooked or raw. It was fatal in many cases for children, and painful and exhausting for adults. But the real danger was that it paved the way for Bacillary Dysentery.
Bacillary Dysentery is caused by a group of Bacilli transmitted by human and fly excrement and contaminated food. The Bacilli are swallowed with infected food or inhaled from excrement, and multiply in the stomach and bowels. Inflamation, ulcers, diarrhoea, violent straining, the passing of clots of blood, and gangrene follow infection. A high percentage of cases of Bacilli Dysentery were fatal.
Famine Dropsy or Hunger Oedema as it is medically known, is that disease which causes the limbs and then the body to swell abnormally and finally burst. Famine dropsy has no connection with the condition normally termed dropsy. It is produced in the last stages of starvation, resulting only from extreme hunger.
Scurvy is a non-infectious disease caused by lack of vitamin c, the vitamin mainly supplied by fresh fruit and vegetables. Scurvy was unknown while potatoes formed a staple part of the Irish diet. The process of scurvy is painful and revolting. Gums become spongy, teeth fall out, joints are enlarged, blood vessels burst under the skin, especially on the legs, producing dark disfiguring patches. In advanced stages the legs turn black up to the thigh. This gave it its Irish name "Cos Dubh" (Black Leg).
Cholera, a deadly infectious disease marked by vomiting and diarrhoea and caused by insanitary conditions, broke out in the Ennistymon Union in March 1846, and between then and June of that year Cholera Hospitals were in operation at Ennistymon Workhouse, at Sandfield Auxiliary Workhouse, at Ballyvaughan and at Miltown Malbay.
Ophthalmia, an infectious inflammation of the eyes associated with dirty overcrowded conditions, became a problem among workhouse children. It often led to blindness, between 1849-1850 a total of 41,000 cases occurred in the Irish Workhouses. The great majority were young children and over 1000 lost their sight.
Meeting held on the 12th March 1847.
Medical Report
In the fever hospital and infirmary we have 129 patients in fever and 24 labouring under diarrhoea, and other diseases besides those under medical treatment in the infirmary and other wards. Out of the 129 now in fever, 5 are new cases taken into hospital today.
We have had 22 deaths since Friday of which a good many were taken into the house on that and the board day previous.
In fact the people are coming into the house for the sake of getting coffins. One woman named ………… aged 60 died in 2 hours after the master took her in off the side of the road. I need not inform the guardians of the state of destitution in which most of the paupers are taken in, a great number of them are all but dead and are in such a state from bowel complaints that it is almost impossible to go near them and their constitutions so broken down that medical treatment is of little or no use.
Charles Finucane.
M.R.C.S.L.