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Influenza, war and revolution in Ireland, 1918–19
Author: Ida Milne

Ireland offers a particularly interesting canvas to study the social and political effects of the 1918–19 influenza pandemic, which is the largest the world has ever known. The influenza inserted itself into every running theme in Irish society, from the over-burdened and disjointed medical system, to the growing discontent with British rule, and the difficulties imposed by World War I. The influenza pandemic was contemporaneous with the so-called German plot, where anti-conscription campaigners had been interned on a trumped up charge by the government. Two of the internees would die from the disease, even as nationalists warned of the dangers of being imprisoned at this time. This work also draws on oral histories with survivors who spoke of this disease they suffered as children at the end of their lives. It tells how doctors had their new confidence in bacteriology challenged as it failed to provide answers to cure patients. It tells too of the families who suffered loss, and often changing financial circumstances when parents died. Life, for some, was never the same, whether through continued ill health or loss of loved ones.

Ida Milne

This chapter explores the death statistics collected by the registrar general for Ireland on the influenza, and explains how the work of the RG is based on accepted international disease classifications. The statistics are, by the RG’s and the LGB’s admission, incomplete, as doctors were too busy treating the ill to document all the dead. But as they are, they indicate that this influenza officially killed 20,057, and made many more ill. They permit an analysis of the dead by age, gender, county, and by week, and in Dublin by social class and occupation. So we can see that those most likely to die were either children under the age of five, or young adults, between 20 and 35; with both groups the key risk factor seemed to be what job supported the family, rather than social class. If the breadwinner worked with the public, they had a higher chance of dying relative to other occupations within their class. So bankers, military personnel, the police, shopkeepers, priests and clergy, medical workers, postman, prison warders, and hawkers were the most likely to die within the four classes used by the RG, whereas domestic service was a surprisingly protected job.

in Stacking the coffins
Ida Milne

How was medical care managed in early 20th century Ireland? How did the patient access the system? How did the Government manage the pandemic? This chapter argues that the influenza epidemic, by placing pressure on the medical system and its institutions, highlighted pre-existing tensions between the Local Government Board and the boards of guardians as local administrators of the Poor Law dispensary system, and highlighted problems over the terms and conditions of the employment of the Poor Law medical officers of health. It shows that the Local Government Board, like the Local Government Board for England and Wales, took a back seat in the management of the disease, without any central plan, leaving the management to the local agents of the Poor Law dispensary service, the Boards of Guardians, to individual hospitals and local authorities, and to schemes set up by local charitable organisations and communities. The local authorities’ medical officers of health, in some areas, relished the challenge, and became proactive in coming forward with suggestions to the public and to businesses on how to handle it.

in Stacking the coffins
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Medical puzzle, politics and search for cures
Ida Milne

This chapter concentrates on looks at the main arguments about the origins of Spanish influenza, which is viewed through contemporary ideas about disease founded in bacteriology, and explores the medical circles’ debate about the identification and treatment of Spanish influenza in an Irish context. Influenza was understood to be bacterial: Pfeiffer’s bacillus. As the flu spread around Ireland, various laboratories developed vaccines which were administered both as prophylaxis and as medicine, and doctors debated their efficacy. The Irish debate about identification and treatment of the Spanish influenza virus touched on many of the universal themes about Spanish influenza, the dread of some terrible disease emerging out of a terrible war, the fear of the public and the medical sphere alike as it prostrated and killed, the futile search for vaccines and treatments, and the fascination the disease held for pioneering doctors who queried the limits of their own medical knowledge and sought to improve the answers. It also looks at the ramifications of the influenza for medical politics.

in Stacking the coffins
Coping with crises
Ida Milne

This chapter examines influenza’s effects on institutions. It pieces together different sources, including the correspondence between the General Prisons Board and their officers, and the journal reports from Clongowes Wood College, a Jesuit boarding school in County Kildare, to create a narrative of how the flu impinged on the daily life of people within these institutions, and how their management reacted to reduce the impact.

in Stacking the coffins
Ida Milne

The influenza epidemic ran a parallel path with the conscription crisis. As the Government sought to introduce conscription to Ireland, it brought in a new executive team, Edward Shortt as chief secretary and Sir John French as lord lieutenant, to play hard ball on the issue. They devised a plan to intern the leading anti-conscription campaigners. Sinn Fein swiftly adapted the emerging flu crisis to the cause of releasing the internees, warning that the internees’ health was being put in jeopardy by their detention in harsh prison conditions; they maintained the campaign through the national and regional newspapers, through letter-writing, news stories and editorials.. The flu served Sinn Fein well, as the death of Richard Coleman in the week before the pivotal general election of 1918 reinforced the point, when many of the internees were standing for election. The newspages in the week before the election and on the day itself were covered with the death of Coleman, the refusal of the prison authorities to admit his family to the prison, and the bringing back of his body to Ireland; the day after the election, a massive funeral was orchestrated through the streets of Dublin.

in Stacking the coffins
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Eye witnesses
Ida Milne

This chapter uses oral history interview with survivors who recall the disease ninety years later; some, as small children, had been in grave danger of dying, yet they survived into their nineties or hundreds to tell of their experience. Some had acute memories: one said the pain in his throat was something he could never forget, and recalled the Poor Law doctor coming at 3am. For others, the memory was hazy, mediated through a lens of febrile fog. There are also interviews with those who succumbed, telling sad stories of how families coped with changing economic conditions as well as emotional loss. These stories not only tell of individual or familial trauma: they also show how the medical system worked, what treatments were given, living conditions at the time, and most significantly, they add the human voice to impersonal records like death statistics and news reports.

in Stacking the coffins
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The long aftermath
Ida Milne

What long term repercussions did the flu have in the private, public and medical spheres? How did it influence changes in public health management? What influence did it have on the coming revolution? This influenza pandemic was the last great crisis to face the Local Government Board and a disjointed medical system which had received harsh criticism from its servants over the previous fifty years.

Although no direct mention was made of the influenza epidemic, Ireland’s most recent acute health crisis and the most traumatic since the cholera epidemic associated with the Great Famine, in the report of the Irish Public Health Council (1920), many of the council’s findings were germane to the problems mentioned earlier in this work which were highlighted by the pressure the influenza crisis placed on the medical institutions and systems. But yet again, health care reform was shelved, as the change in governance intervened.

This chapter suggests that the biggest impact the influenza made was not on politics, medicine, Government structures or public health administration, but on the people, and that these memories informed and guided domestic medicine in the ensuing years.

in Stacking the coffins
Ida Milne

This chapter introduces the initially unknown disease that appeared in Ireland in the summer of 1918, and describes the initial fears that the disease was perhaps a plague that had emerged from the conditions of war. It looks at the historiography of the disease to date, and sets the disease in the context of other major disease events in Irish and world history.

in Stacking the coffins
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A news perspective
Ida Milne

This section explores how flu is reported by the newspapers, looking at the regional impact, and telling dramatic stories of multiple deaths in households. It shows the changes in the way the epidemic is spoken about over the course of two years, and shows how it disrupted Irish society, silencing entire towns as it travelled through, disrupting business, court sittings, concerts, football matches and school life.

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