Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-17T01:17:34.923Z Has data issue: false hasContentIssue false
  • English
  • Français

State intervention and provincial health care: the county infirmary system in late eighteenth-century Ulster

Published online by Cambridge University Press:  04 February 2015

Andrew Sneddon
Andrew Sneddon*
Affiliation:
School of English and History, University of Ulster, Coleraine
Get access Rights & Permissions [Opens in a new window]

Extract

The eighteenth century, a period when pain, suffering and illness was an ‘omnipresent threat’, saw medicine became more institutionally-based, increasingly state-funded, and wedded to a more scientific and analytical approach to disease. Voluntary hospitals, county infirmaries, medical supply dispensaries for the poor, the Royal Colleges of Physicians and Surgeons, and various medical guilds, schools and societies, were established or grew in importance. Collectively these institutions did much to influence how Ireland's main medical practitioners (physicians, surgeons, apothecaries) were educated, trained and organised, as well as the way the sick were cared for. While university-trained Irish physicians catered mostly for wealthy elites, the sick, rural poor usually only possessed the means or opportunity to engage the services of apothecaries or, occasionally, surgeons. Along with commercial, patent medicines, domestic remedies and self-medication, the sick had at their disposal an array of untrained, unregulated empirics, quacks, mountebanks, druggists, oculists, and faith and magical healers.

Type
Research Article
Information
Irish Historical Studies , Volume 38 , Issue 149 , May 2012 , pp. 5 - 21
Copyright
Copyright © Irish Historical Studies Publications Ltd 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Kelly, James, ‘“Bleeding, vomiting and purging”: the medical response to ill-health in eighteenth-century Ireland’ in Cox, Catherine and Luddy, Maria(eds), Cultures of care in Irish medical history, 1750–1970 (Basingstoke, 2010), p. 15.Google Scholar

2 Kelly, James ‘The emergence of scientific and institutional medical practice in Ireland, 1650–1800’ in Jones, Greta and Malcolm, Elizabeth (eds), Medicine, disease and the state in Ireland (Cork, 1999), pp 21–39.Google Scholar

3 Kelly, ‘Emergence’, p. 21;Google Scholar idem, ‘Domestic medication and medical care in late early modern Ireland’ in Clark, Fiona and Kelly, James (eds), Ireland and medicine in the seventeenth and eighteenth centuries (Farnham, 2010), p. 109;Google ScholarBarnard, TobyA new anatomy of Ireland: the Irish Protestants, 1649–1770 (London, 2003), pp 129–12.Google Scholar

4 Brockliss, Laurence ‘Medicine, religion, and social mobility in eighteenth- and early nineteenth-century Ireland’ in Kelly, and Clark, (eds), Ireland and medicine, pp 77–9;Google ScholarKelly, James and Clark, Fiona ‘Introduction’ in ibid., p. 4;Google ScholarBarnard, New anatomy, pp 129–35, 138–10;Google ScholarFagan, PatrickCatholics in a Protestant country: the papist constituency in eighteenth-century Dublin (Dublin, 1998), pp 77–100;Google ScholarKelly, , ‘“Bleeding, vomiting and purging”’, p. 22.Google Scholar

5 Kelly, ‘Domestic medication’, pp 134–5.Google Scholar

6 Kelly, James ‘Health for sale: mountebanks, doctors, printers and the supply of medication in eighteenth-century Ireland’, RIA proc., 108c (2008), pp 1–38;Google ScholarFarmar, TonyPatients, potions and physicians: a social history of medicine in Ireland, 1654–2004 (Dublin, 2004), pp 34, 37–8;Google ScholarKelly, ‘Domestic medicine’, pp 113–14;Google ScholarSneddon, AndrewWitchcraft and magic in Ireland, 1586–1949 (forthcoming), chapter 4.Google Scholar

7 Kelly, ‘Emergence’, pp 21–39;Google ScholarGeary, Laurence M.Medicine and charity in Ireland 1718–1851 (Dublin, 2004), chapter 1.Google Scholar See also: Widness, J.D.H.The Charitable Infirmary, Jervis Street, 1718–1968 (Dublin, 1968);Google ScholarKirkpatrick, T.P.C.History of Dr Steevens’ Hospital, Dublin, 1720–1920 (Dublin, 1924);Google ScholarLyons, J.B.The quality of Mercer’s: the story of Mercer’s Hospital, 1734–1991 (Dublin, 1991);Google ScholarMalcolm, ElizabethSwift’s Hospital: a history of Swift’s Hospital Dublin, 1745–1989 (Dublin, 1989).Google Scholar

8 For voluntary hospitals in England, see: Borsay, Anne ‘Cash and conscience: financing the general hospital at Bath 17381750’ in Social History of Medicine, 4, no. 2 (1991), pp 207–29;Google ScholarPorter, Roy ‘The gift relation: philanthropy and provincial hospitals in eighteenth-century England’ in Granshaw, Lindsay and Porter, Roy (eds), The hospital in history (London, 1989), pp 149–78;Google ScholarPickstone, John V.Medicine and industrial society: a history of hospital development in Manchester and its region, 1752–1946 (Manchester, 1985);Google ScholarCroxson, Bronwyn ‘The foundation and evolution of the Middlesex Hospital’s lying-in service, 1745–86’ in Social History of Medicine, 1, no. 1 (2001), pp 27–57.Google Scholar

9 Kirkpatrick, T.P.C.The book of the Rotunda Hospital (London, 1913), pp 29–31, 37–8;Google ScholarKelly, , ‘Emergence,’ pp 28–9;Google ScholarGeary, Medicine and charity, pp 25, 35–6. See n. 40 below.Google Scholar

10 In the sixty years after 1720, twenty-seven voluntary hospitals opened in England (twenty-three in the provinces and four in London), along with three in Scotland, see Borsay, ‘Cash and conscience,’ p. 228.Google ScholarPubMed

11 Geary, Medicine and charity, p. 40.

12 See notes 18, 37–8 below.

13 See Kelly, and Clark, ‘Introduction’, pp 2–3.Google Scholar The nineteenth century is much better catered for, see: Prior, P.M.Madness and murder: gender, crime and mental disorder in nineteenth-century Ireland (Dublin, 2008);Google ScholarCrossman, Virginia and Gray, Peter (eds), Poverty and welfare in Ireland 1838–1948 (Dublin, 2011);Google ScholarGráda, Cormac Ó and McCabe, Desmond ‘“Better off thrown behind a ditch”: Enniskillen workhouse during the Irish Famine’ in De Nie, Michael and Farrell, Sean (eds), Power and popular culture in modern Ireland: essays in honour of James S. Donnelly Jr (Dublin, 2010);Google ScholarFinnane, MarkInsanity and the insane in post-famine Ireland (Totowa, N.J., 1981).Google Scholar

14 Weatherup, D.R.M. ‘The foundation of the Armagh County Infirmary’ in Hughes, A.J. and Nolan, William (eds), Armagh history and society: interdisciplinary essays on the history of an Irish county (Dublin, 2001), pp 713–43;Google ScholarBeale, G.M. ‘Treating Ulster’s poor: the County Infirmaries of Armagh and Down, 1766–1851’ in Ulster Medical Journal, 71, no. 2 (2002), pp 111–20;Google ScholarGeary, Laurence ‘Medical charities in pre-famine North Cork’ in Mallow Field Club Journal, 19 (2001), pp 117–30;Google Scholar idem, ‘Medical charities in Queen’s County, 1765–1851’ in Lane, Padraig G. and Nolan, William (eds), Laois history and society: interdisciplinary essays on the history of an Irish county (Dublin, 1999), pp 513–14.Google Scholar

15 See Jones, Greta and Malcolm, Elizabeth ‘Introduction: an anatomy of Irish medical history’ in Jones, and Malcolm, (eds), Medicine, disease, and the state, pp 1–17.Google Scholar

16 Geary, ‘Medical charities in Cork’, pp 117–20;Google Scholar idem, ‘Medical charities in Queen’s County’, pp 513–14; idem, Medicine and charity, pp 40, 43–5, 104–5, 131–2.

17 Hayton, D.W. ‘Introduction: the long apprenticeship’ in Hayton, David W. (ed.), The Irish Parliament in the eighteenth century (Edinburgh, 2001), pp 8–12;Google ScholarKelly, James ‘Harvests and hardship: famine and scarcity in Ireland in the late 1720s’ in Studia Hibernica, 26 (1991–2), pp 79, 95–100;Google ScholarSneddon, Andrew ‘Legislating for economic development: Irish fisheries as a case study in the limitations of “improvement”’ in Hayton, DavidKelly, James and Bergin, John (eds), The eighteenth-century composite state: representative institutions in Ireland and Europe, 1690–1800 (Basingstoke, 2010), pp 136–59.Google Scholar

18 Infirmaries in Ulster were located in the following locations: Londonderry (Derry); Donegal (Letterkenny named in 1765/6 act, changed to Lifford in 1767 amendment act); Tyrone (Omagh); Fermanagh (Enniskillen); Armagh (Armagh); Cavan (Cavan); Antrim (Lisburn); Down (Downpatrick); Monaghan (Monaghan).

19 See Kelly, and Clark, ‘Introduction’, pp 1–15,Google Scholar and Jones, and Malcolm, ‘Introduction’, pp 1–17.Google Scholar

20 King, Steven and Weaver, Alan ‘Lives in many hands: the medical landscape in Lancashire, 1700–1820’ in Medical History, 14 (2000), pp 173–5.CrossRefGoogle Scholar

21 For narrative histories of Ulster medical institutions see Clarke, R.S.J.The Royal Victoria Hospital Belfast: a history, 1797–1997 (Belfast, 1997), and n. 14 above.Google Scholar

22 For the Kildare Infirmary see Kildare Infirmary Governors' minute books, 16 May 1768 – 5 Dec. 1799 (N.L.I., Kildare Infirmary minute books, Ms 19446); for Mallow Infirmary, County Cork, see Jephson, Maurice Denham (ed.), An Anglo-Irish miscellany: some records of the Jephsons of Mallow (Dublin, 1964), appendix vii.Google Scholar

23 Minutes survive for the Monaghan, Antrim, Down and Armagh Infirmaries.

24 Bardon, JonathanA history of Ulster (Belfast, 1992, repr. 2005), pp 179–239.Google Scholar

25 5 Geo. III, c.20 (1765); Irish Legislation Database (I.L.D.), (www.qub.ac.uk/ild/).

26 ‘Heads of a bill for erecting public county infirmaries in this kingdom (failed, 1765)’; I.L.D.; Commons jn. Ire. (4th ed.), viii, 117.

27 I.L.D.

28 Lloyd’s Evening Post, 14 June 1766. The Privy Council amendment ensured that parliamentary subvention was paid directly to the Infirmary treasurer and not the district tax collector: see British Privy Council, Irish Bills committee report, 13 May 1766 (The National Archives, London (T.N.A.), Privy Council Records, PC 1/8/24).

29 Dickson, DavidNew foundations: Ireland 1660–1800 (Dublin, 2nd ed., 2000), p. 186;Google Scholar idem, ‘In search of the old Irish Poor Law’ in Mitchison, Rosalind and Roebuck, Peter (eds), Economy and society in Scotland and Ireland 1500–1939 (Edinburgh, 1988), pp 150–2, 154–6;Google ScholarO’Carroll, Joseph ‘Contemporary attitudes towards the homeless poor, 1725–1775’ in Dickson, David (ed.), The gorgeous mask: Dublin 1700–1850 (Dublin, 1987), pp 65–82;Google ScholarBarnard, New anatomy, pp 316–23;Google ScholarKelly, James ‘Infanticide in eighteenth-century Ireland’ in Irish Social and Economic History, 19 (1992), p. 20;Google Scholar idem, ‘Jonathan Swift and the Irish economy in the 1720s’ in Eighteenth-Century Ireland, vi (1991), pp 7–36.

30 In common with all acts discussed in this article, the following examination of the 1765/6 Act (5 Geo. III, c.20) relies on the text of the original statute. See The statutes at large passed in the Parliaments held in Ireland (20 vols, Dublin, 1786–1801).

31 For an example of ‘improving’ rhetoric being used to lend moral legitimacy to attempts to develop Ireland's fishing industry, see Sneddon, ‘Legislating for economic development’, pp 153–4.

32 John Whittingham to James Hamilton, eighth earl of Abercorn, 31 Aug. 1767 (P.R.O.N.I., T2541/IA/1/7/95); Galbraith Lowry Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/70).

33 Foster, EdwardAn essay on hospitals. Or succinct directions for the situation, construction and administration of country hospitals … (Dublin, 1768):Google Scholar ‘Blessed is he that considereth the poor; the Lord will deliver him in the time of trouble’ (Ps. 41:1); ‘I was naked, and ye clothed me; I was sick, and ye visited me’(Matt. 25:36). See also Geary, Medicine and charity, p. 43.Google Scholar

34 Foster, Essay on hospitals, p. 1.Google Scholar

35 Barnard, T.C.The kingdom of Ireland 1641–1760 (Basingstoke, 2004), pp 80–9;Google Scholar idem, Improving Ireland? Projectors, prophets and profiteers 1641–1786 (Dublin, 2008).

36 See Borsay, ‘Cash and conscience’, pp 215–21, 228.Google ScholarPubMed

37 Armagh, Cavan, Down, Fermanagh, Londonderry, Monaghan, Tyrone, Carlow, Kilkenny, King's County, Longford, Louth, Leitrim, Queen's county, Westmeath, Wexford, Wicklow, Clare, Kerry, Limerick, Galway, Roscommon and Sligo.

38 Lisburn in County Antrim; Mallow in County Cork; Castlebar in County Mayo; Letterkenny in County Donegal; Kildare in County Kildare; Navan in County Meath; Cashel in County Tipperary.

39 Geary, Medicine and charity, p. 41.Google Scholar

40 It should be noted that the 1765/6 Infirmary Act also provided Mercer's Hospital, Dublin, the North and South Charitable Infirmaries of Cork, the Charitable Infirmary, Dublin, and the Hospital for Incurables in Townsend Street (then Lazar’s Hill) with an annual subvention of £50 each. It also stipulated that these institutions were to receive between £50 and £100 annually from grand jury presentments.

41 These examples, given in parenthesis, of typical infirmary income and expenditure are taken from an examination of the following records: Monaghan Infirmary minutes, 9 Aug. 1770, 13 July 1775, 19 Aug. 1783 (N.L.I., Hospital Records, Monaghan Infirmary minute book (MB), 1768’1857, accession number, 2006/100); Minutes of the Governors of Antrim Infirmary, 7 Apr. 1767, 2 Feb. 1772, 8 Aug. 1777, 2 Nov. 1785, 5 May 1789, 1 Aug. 1792 (P.R.O.N.I., Hospital records, HOS/7/3/1/A/1); Down Infirmary minutes, Jan. 1768 – June 1800 (P.R.O.N.I., HOS/14/2/1/A/1, pp 1–4, 16, 34, 62–77, 82–99); Armagh Infirmary minutes, 1777, 1788 (Armagh County Museum (A.C.M.), Infirmary minute book (MB) 14, pp 261–2).

42 For examples of this type of financial study, see: Borsay, ‘Cash and conscience’, and Berry, Amanda ‘“Balancing the books”: funding provincial hospitals in eighteenth-century England’ in Accounting, Business and Financial History, 7, no. 1 (1997), pp 1–30.CrossRefGoogle Scholar

43 O’Neill, Timothy P. ‘Fever and public health in pre-famine Ireland,’ in R.S.A.I.Jn., 103 (1973), pp 5, 7;Google ScholarGeary, ‘Medical charities in Cork’, p. 118.Google Scholar

44 Commons jn. Ire. (2nd ed.), xv, 26. This number was the same two years later, see Commons jn. Ire. (3rd ed.), xvi, 23.

45 Minutes of Governors of Antrim Infirmary, 1 Jan. 1767 (P.R.O.N.I., HOS/7/3/1/A/1, pp 1-2); Weatherup, 'Armagh infirmary', p. 715; Down Infirmary minutes, Jan. 1768 -June 1800 (P.R.O.N.I., HOS/14/2/1/A/1, pp 4–104); James Hamilton to James Hamilton, eighth earl of Abercorn, 2 Feb. 1779 (P.R.O.N.I., Abercorn papers, D623/A/43/186); Monaghan Infirmary minutes, 1 Jan. 1768 (N.L.I., MB 2006/100).

46 Crawford, W.H. ‘The creation and evolution of small towns in Ulster in the seventeenth and eighteenth centuries’ in Borsay, Peter and Proudfoot, Lindsay (eds), Provincial towns in early modern England and Ireland: change, convergence and divergence (Oxford, 2002), p.116;Google Scholar Weatherup, ‘Armagh County Infirmary,’ pp 716–17; O’Neill, ‘Fever and public health’, pp 5, 7.Google Scholar

47 Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., D623/A/37/70).

48 James Hamilton to Abercorn, 30 May 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/75).

49 Hamilton to Abercorn, 30 May 1767 (P.R.O.N.I., Abercorn papers, D623/A/37/75); see also Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., D623/A/37/70).

50 Corry to Abercorn, 27 Apr. 1767 (P.R.O.N.I., D623/A/37/70).

51 It is accepted that contentions made regarding religious background or ethnicity based on surname analysis are inherently conjectural.

52 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I., HOS/14/2/1/A/1, p. 9); Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, ‘Rules of Infirmary’); minutes of Governors of Antrim Infirmary, 3 May, 2 Aug. 1768, 10 Nov. 1772, 2 May 1775 (P.R.O.N.I., HOS/7/3/1/A/1, pp 13–14, 31, 40).

53 Barnard, New anatomy, pp 317–18.Google Scholar

54 Minutes of Governors of Antrim Infirmary, 3 May 1768, 2 Nov. 1779 (P.R.O.N.I., HOS/7/3/1/A/1, pp 13, 56).

55 Geary, Medicine and charity, p. 33.Google Scholar

56 See Milne, KennethThe Irish charter schools, 1730–1830 (Dublin, 1996);Google ScholarSneddon, Andrew ‘Church of Ireland missions to Roman Catholics, c.1700–1800’ in Francis, Keith and Gibson, William (eds), The Oxford handbook of the British sermon, 1689–1901 (Oxford, forthcoming).Google Scholar

57 Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, 'Rules of Infirmary').

58 Minutes of Governors of Antrim Infirmary, 5 May 1767, 2 Feb., 2 Aug. 1768, 1 Aug. 1770, 5 Feb., 7 May, 8 Aug. 1771, 3 May 1774, 7 Nov. 1775 (P.R.O.N.I., HOS/7/3/1/A/1, pp 8, 11, 14, 22, 25–7, 36, 41); Howard, JohnAn account of the principal lazarettos in Europe. (London, 1789), p. 98.Google Scholar

59 Geary, Medicine and charity, p. 44;Google Scholar Monaghan Infirmary minutes, 2 Oct. 1770, 5 July 1783 (N.L.I., MB 2006/100); Howard, Account of the principal lazarettos, pp 95–9;Google Scholar Armagh Infirmary minutes, 1777 (A.C.M., MB 14, pp 261–2); Minute Book of the Standing Committee of Antrim Infirmary, 6 Jan. 1767, 2 Sept. 1776, 3 Apr. 1780 (P.R.O.N.I., Hospital records, HOS/7/3/1/B/1, pp 1, 24, 34).

60 Geary, ‘Medical charities in Queen’s County’, p. 513;Google Scholar idem, ‘Medical charities in Cork’, p. 117.

61 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I., HOS/14/2/1/A/1, pp 9–10); Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, loose leaf entitled, ‘Rules of Infirmary’).

62 Armagh Infirmary minutes, c.1766? (A.C.M., MB 14, ‘Rules of Infirmary’).

63 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I. HOS/14/2/1/A/1, pp 10, 15).

64 Minutes of Governors of Antrim Infirmary, 1 Aug. 1769 (P.R.O.N.I., HOS/7/3/1/A/1, p. 6158).

65 Geary, Medicine and charity, pp 54–9;Google Scholar see also Cox, Catherine “Access and authority: the medical dispensary service in post-Famine Ireland’ in Cox, and Daly, (eds), Cultures of care, pp 57–78.Google Scholar

66 Monaghan Infirmary minutes, 5 July 1783 (N.L.I., MB 2006/100); minutes of Governors of Antrim Infirmary, 10 Nov. 1772, 4 May 1773 (P.R.O.N.I., HOS/7/3/1/A/1, pp 31, 33–4).

67 Down Infirmary minutes, 12 Jan. 1768 (P.R.O.N.I., HOS/14/2/1/A/1, p. 15).

68 Ibid., 8 Oct. 1788, pp 85–6.

69 William Stewart to James Hamilton, eighth earl of Abercorn, 3 Jan. 1775 (P.R.O.N.I., Abercorn papers, D623/A/42/48).

70 Down Infirmary minutes, 21 Apr. 1767 to 24 June 1800 (P.R.O.N.I., HOS/14/2/1/A/1, pp 1–104).

71 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxcii. For John Howard, see Ole Peter Grell, 'A journey of body and soul: the significance of the hospitals in southern, Catholic Europe for John Howard's views of health care and the creation of the utopian hospital' in Ole Peter Grell, Andrew Cunningham and Roeck, Bernd (eds), Health care and poor relief in 18th and 19th century southern Europe (Aldershot, 2005), pp 289–316.Google Scholar

72 Weatherup, ‘Armagh Infirmary’, p. 717.

73 Monaghan Infirmary minutes, 12 Jan. 1768 (N.L.I., MB 2006/100).

74 Minutes of Standing Committee of Antrim Infirmary, 6 Jan. 1767 to 1 Jan. 1782 (P.R.O.N.I., HOS/7/3/1/B/1, pp 1–41).

75 Ibid., 6 Jan., 20 Feb. 1767, 25 Aug., 1 Sept., 13 Oct. 1777, 3 Apr. 1780, pp 1, 7, 26–7, 34.

76 Minutes of Standing Committee of Antrim Infirmary, 16 Sept. 1772 (P.R.O.N.I., HOS/7/3/1/B/1, p. 18).

77 Ibid., 2, 13 Feb., 25 Aug. 1767, 1 Oct. 1781, pp 5, 7, 11, 40.

78 Minutes of Standing Committee of Antrim Infirmary, 16 Sept. 1772, 3 Dec. 1781 (P.R.O.N.I., HOS/7/3/1/B/1, pp 18, 40).

79 Ibid., 6 Jan. 1783, p. 43.

80 Monaghan Infirmary minutes, 25 Sept., 12 Oct., 16 Dec. 1782, 22 Apr. 1793, 8 Feb. 1796 (N.L.I., MB 2006/100); minutes of Governors of Antrim Infirmary, 10 Feb., 17 Mar. 1777 (P.R.O.N.I., HOS/7/3/1/A/1); Armagh Infirmary minutes, 2 Mar., 6 Apr. 1776, 19 Nov. 1787, 8 Feb. 1788 (A.C.M., MB 14, pp 27-8, 40, 41).

81 Armagh Infirmary minutes, 13 July, 8 Aug. 1767 (A.C.M., MB 14, p. 14).

82 Monaghan Infirmary minutes, 8 Feb. 1796 (N.L.I., MB 2006/100).

83 Geary, Medicine and charity, pp 128, 131.Google Scholar

84 James Hamilton to James Hamilton, eighth earl of Abercorn, 23 June 1780 (P.R.O.N.I., D623/A/44/36); same to same, 9 July 1780 (P.R.O.N.I., D623/A/44/38); Commons jn. Ire. (3rd ed.), xxv, appendix, cccxcii.

85 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxciv.

86 John James Hamilton, first marquess of Abercorn, to Stewart, 18–20 Dec. 1794 (P.R.O.N.I., D623/A/79/30); Moore to Abercorn, 24 July 1795 (P.R.O.N.I., D623/A/147/29).

87 Abercorn to Moore, 31 July 1795 (P.R.O.N.I., Abercorn papers, D623/A/79/115).

88 Malcomson, A.P.W. ‘A lost natural leader: John James Hamilton, first Marquess of Abercorn, 1756–1815’ in RIA Proc, 88C, no. 4 (1988), pp 61–86;Google ScholarJohnston-Liik, E.M.History of the Irish Parliament 1692–1800: commons, constituencies and statutes (6 vols, Belfast, 2002), 3, 39–4;Google Scholar ibid., iv, 341–2.

89 Specifically those in Counties Londonderry, Down, Monaghan, Armagh, Antrim and Down, see: Down Infirmary minutes, 6 Oct. 1767 (P.R.O.N.I., HOS/14/2/1/A/1, p.7); Howard, Account of the principal lazarettos, p. 97; Monaghan Infirmary minutes, 20 Apr. 1770 (N.L.I., MB 2006/100, ‘Loose leaf inserted in minute book’); minutes of Governors of Antrim Infirmary, 17 Mar. 1777 (P.R.O.N.I., HOS/7/3/1/A/1); Armagh Infirmary minutes, 1777 (A.C.M., MB 14, p. 262).

90 Geary, Medicine and charity, pp 124–5.Google Scholar

91 Weatherup, ‘Armagh County Infirmary’, pp 725–6.

92 Kelly, ’“Bleeding, vomiting and purging”’, p. 19;Google Scholar idem, ‘Emergence’, pp 33–4; Fleetwood, John F.The history of medicine in Ireland (2nd ed., Dublin, 1983), pp 66–9, 81;Google ScholarLyons, J.B.A pride of professors: the professors of medicine at the Royal College of Surgeons in Ireland, 1813–1985 (Dublin, 1999), p. 2;Google ScholarO’Flaherty, Eamon ‘Medical men and learned societies in Ireland, 1680–1785’ in Devlin, Judith and Clarke, Howard B. (eds), European encounters: essays in memory of Albert Lovett (Dublin, 2003), pp 256, 258.Google Scholar

93 Commons jn. Ire. (2nd ed.), xviii, 205–6, 353, 366, 371–2, 432, 499; Armagh Infirmary minutes, Aug. 1777 (A.C.M., MB 14, p. 261).

94 Commons jn. Ire. (3rd ed.), xxv, 277.

95 Commons jn. Ire. (3rd ed.), xxv, 331; idem., appendix, cccxci-cccci. For Sir Jeremiah Fitzgerald, see MacDonagh, OliverThe inspector general: Sir Jeremiah Fitzpatrick and the politics of social reform, 1783–1802 (London, 1981).Google Scholar

96 Geary, Medicine and charity, pp 43–5.Google Scholar

97 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxci-cccci; Howard, Account of the principal lazarettos, pp 95–8;Google ScholarGeary, Medicine and charity, p. 44;Google ScholarMacDonagh, Inspector general, p. 21.Google Scholar

98 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxcix.

99 Ibid., cccc.

100 Commons jn. Ire. (3rd ed.), xxv, appendix, cccxciii.

101 Geary, Medicine and charity, p. 44.Google Scholar

102 Commons jn. Ire. (3rd ed.), xxv, 326–7.

103 The parliamentary register; or a history of the proceedings and debates of the House of Commons of Ireland (15 vols, Dublin, 1784–95), ix, 328; Commons jn. Ire. (3rd ed.), xxvi, 274; Armagh Infirmary minutes, July 1788 (ACM, MB 14: 261); Weatherup, ‘Armagh County Infirmary’, p. 715.

104 Monaghan Infirmary minutes, 1 Aug. 1788, 27 July 1789, 11 Feb. 1793 (N.L.I., MB 2006/100).

105 SirCoote, CharlesStatistical survey of the county of Monaghan … (Dublin, 1801), p. 171.Google Scholar

106 Down Infirmary minutes, 12 Jan. 1773, 8 Oct. 1788 (P.R.O.N.I., Hospital records, HOS/14/2/1/A/1, pp 46, 86); Beale, 'Treating Ulster's poor', p. 116.

107 For examples of this legislation and their passage through parliament, see: 11 & 12 Geo. III, c.23 (1771); 13 & 14 Geo. III, c.43 (1773); 15 & 16 Geo. III, c.31 (1775); 19 & 20 Geo. III, c.44 (1779); 23 & 24 Geo. III, c.29 (1783); 25 Geo. III, c.40 (1785); 25 Geo. III, c.39 (1785); 26 Geo. III, c.21 (1786); 39 Geo. III, c.17 (1799); Parliamentary register, iii, 10–12; Armagh Infirmary Minutes, August 1777 (A.C.M., MB 14, p. 261); British Privy Council register, 7 May 1772 (T.N.A., PC 2/116: 217); I.L.D.; Commons jn. Ire. (4th ed.), viii, 120, 515; ibid., ix, 29 , 64; Richard Lewis (ed.), The Dublin guide: or a description of the city of Dublin (Dublin, 1787), pp 181–2; The Times, 15 Mar. 1786; Morning Chronicle and London Advertiser, 6 Feb. 1786.

108 7 Geo. III, c.8 (1767).

109 I.L.D.; British Privy Council, Irish bills committee report, 20 Apr. 1768 (T.N.A., Privy Council Records, PC 1/9/18, f.4r); British Privy Council register, 19 Apr. 1768 (T.N.A., PC 2/113, p. 131).

110 17 & 18 George III, c.15 (1777); I.L.D.; Commons jn. Ire. (2nd ed.), xviii, 379; British Privy Council, Irish bills committee report, 13 May 1778 (T.N.A., Privy Council records, PC 1/11/80, f.3r).

111 36 Geo. III c.9 (1796).

112 Lloyd’s Evening Post, 8 Apr. 1791; Parliamentary Register, xii, 290–3; Commons jn. Ire. (3rd ed.), xxviii, pp 1102, 1131; minutes of Royal College of Surgeons, 5 Apr., 2 May 1791 (Royal College of Surgeons, minute books, RSCI/COL/1, pp 204–9); Kelly, ‘Infanticide,’ p. 20;Google ScholarGeary, Medicine and charity, p. 132.Google Scholar

113 15 & 16 George III c.31 (1775); ‘To amend an act passed in this kingdom in the 5th year of the reign of his present majesty, entitled, an act for erecting and establishing public infirmaries or hospitals in this kingdom’ (1795, failed); ‘To amend an act passed in the 5th year of the reign of his present majesty, entitled, an act for erecting and establishing public infirmaries or hospitals in this kingdom’ (1796, failed). For details of this legislation, see I.L.D.

114 This assertion is based on an examination of legislative promoters contained in the I.L.D., as well as biographical details of M.P.s in Johnston-Liik, History of the Irish Parliament. Details of initiatives which began life as parliamentary petitions have been taken from Commons jn. Ire. and Lords jn. Ire. For improving medical practitioners, see Barnard, Toby ‘The wider cultures of eighteenth-century Irish doctors’ in Kelly, and Clark, (eds), Ireland and medicine, pp 185, 187, 191.Google Scholar

115 See Grell, Ole Peter, Cunningham, Andrew and Jutte, Robert (eds), Health care and poor relief in 18th and 19th century northern Europe (Aldershot, 2002),Google Scholar and Grell, Cunningham and Roeck (eds), Health care in southern Europe.

116 For a list of voluntary hospital legislation, see Sneddon, Andrew ‘Institutional medicine and state intervention in eighteenth-century Ireland’ in Kelly, and Clark, (eds), Ireland and medicine, pp 157–62.Google Scholar For details of their content and passage through Parliament, see: I.L.D.; Commons jn. Ire. (4th ed.), xiii, 173; ibid., v, 29; ibid., xiv, 36; Lords jn. Ire., iii, 378–9; ibid., viii, 399, 410, 433–4, 452, 459; Stat. Ire., vii, 248–54, 836; Kirkpatrick, Steevens’ Hospital, pp 42–4;Google ScholarGeary, Medicine and charity, p. 17.Google Scholar

117 See Sneddon, ‘Institutional medicine’, pp 137–56;Google ScholarKelly, and Clark, ‘Introduction’, pp 11–12, 15.Google Scholar

118 For studies which place state intervention at the centre of a medical enlightenment, see Porter, Roy ‘Was there a medical enlightenment in eighteenth-century England?’ in British Journal of Eighteenth-Century Studies, 5 (1982), p. 53,Google Scholar and Gentilcore, David ‘“The golden age of quackery” or medical enlightenment? Licensed charlatanism in eighteenth-century Italy’ in Cultural and Social history, 3, no. 3 (2006), p. 257.Google Scholar For an article which questions the idea of an enlightened Ireland see, O’Brien, Gerard ‘Scotland, Ireland and the antithesis of enlightenment’ in Connolly, S.J., Houston, R.A., and Morris, R.J. (eds), Conflict, identity and economic development: Ireland and Scotland 1600–1939 (Preston, 1995), pp 125–34.Google Scholar

119 Bergin, John ‘The Quaker lobby and its influence on Irish legislation, 1692–1705’ in Eighteenth-Century Ireland, 19 (2004), pp 9–36, and Sneddon, ‘State intervention’.Google Scholar

* This article was researched and written using Wellcome Trust Grant number 088643MA. I would like to thank Stephen Scarth of the Public Record Office of Northern Ireland, and Dr Allan Blackstock, Professor Greta Jones, Dr Leanne McCormick and Professor James Kelly for their comments on earlier drafts.