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educated class. Reviewing the total of the insane, excluding idiots, it would appear that the educated are to the uneducated in the proportion of 100 to 61, and dividing the whole number according to occupations into ten classes, it further appears that no less than 404 belong to the professional class, which amount exceeds by a considerable number all the other classes specified, with the exception of the large agricultural one, giving rise to the remark that “this preponderance of mental disease among the professional and upper classes, shows how much more education and habits of thought tend to produce aberration of intellect than ordinary manual labour," qualifying the remark, as we believe truth requires, by prefixing unsound or ill-directed to education, and substituting irregular habits of life for habits of thought. Ireland now is honourably distinguished for the care taken of the insane, and for the many excellent asylums provided for them. It is a distinction, however, gained of late years; even no longer ago than 1817, according to a report of a committee appointed to examine into the state of the pauper lunatics—
“When a strong young man is thus afflicted, the only way they have to manage him is by making a hole in the floor of the cabin, not high enough for the person to stand up in, with a crib over him to prevent his getting out-the hole about four feet deep. They give the wretched being his food in it, and there he generally dies."
Of the last class of those labouring under permanent diseases, the lame and decrepit, the total number returned was 4375, of whom 2320 were males and 2055 were females. The class is too miscellaneous, judging from the remarks in the Report, to allow of any useful deductions, especially as the return of the persons so affected is described as incomplete.
To those whose attention is directed to paupers, workhouses, and hospitals, valuable information will be found in the Report on all these subjects, with copious statistics. It is curious to find that at a very remote period, anterior to the introduction of Christianity, buildings were set apart for the reception of the sick and wounded :
“We read (it is stated in the Report) that when the regal residences of Tara and Emania existed, there was attached to the latter 'the House of the Crimson Branch,' where the warriors of old hung up their arms and trophies; and near to this stood the Broin Bearg, or the House of Sorrow,' where the sick and wounded were provided for.”
It is also remarkable, as pointed out, considering how leper hospitals and monastic hospitals had been early established in Ireland, indicating unusual regard for the infirmities of our fellow men, that no record of any civil hospital in the capital of the country is found to exist previous to the eighteenth century,-a city now so amply provided with institutions of the kind, and with a medical school attached and dependent on them, of a high character and well-earned European reputation.
Of the great division, that of temporary diseases, of which the total has already been given—yiz., 104,495—the sources assigned are the following
Reported at home (rural) .. .... .... .... 41,836
(civic). ... . . . . . . . 6,455
(Sexes nearly equal.)
for the blind, aged, and infirm, &c., and hospitals of
(100 males to 77.65 females.)
(100 females to 84:54 males.) The tables given in the appendix to the Report on the status of disease are ample and instructive, considering them merely approximative, allowing for under-rating. Our limits forbid our dwelling on them. All that we can venture is to make a few selections. They are returned under two great heads—zymotic (epidemic, endemic, and contagious diseases) and sporadic diseases, and the latter are again subdivided into ten groups, according chiefly to the organs affected.
I. Zymotic diseases .............. 34,998
respiratory organs . . . . . . . . . . . 10,509
4,511 urinary organs . . . .
289 generative organs . . . . . . . . . . . .
693 locomotive organs. . . .
8,822 tegumentary organs . . .
7,167 , uncertain seat ...'
10,394 Accidental causes, such as burns, poison, effects of cold and starvation, &c. . . . . . . . . . . . . .
1,224 Causcs not specified . . . . . . . . . . . . .
General total. ... . 104,495 We shall select from these groups a few particular diseases for brief comment. As their localities will be one point of comparison, and this according to provinces, it may be right to state in limine the population of each, as determined by the Census. Of the four into which the whole of Ireland is divided, Leinster, forming a considerable portion of the eastern coast, had in 1851 a population of 1,672,738; Munster, constituting the southern portion, 1,857,736; Ulster, the northern portion, 2,011,880; and Connaught, the western, 1,010,031; the chief local difference, apart from direction of aspect, being that the province of Leinster possesses a smaller proportion of sea-coast than either of the others, and is almost entirely without those deep inlets of the sea for which the others are remarkable.
The diseases which were found throughout Ireland most to prevail on the night the reckoning was made were, as of old and in all times, those of the epidemic kind, especially fevers, dysentery, and diarrhea, amounting to 34,998, or one in three of the total sick.
“Great variety (it is remarked in the Report) existed in the provincial sum. maries for this class in proportion to the population; thus in Leinster and
Connaught one person in every 209 was returned as sick from some of the causes specified under the head of epidemic disease ; in Munster, as one in 106; whereas in Ulster the proportion was only one in 432."
“In examining more minutely into the distribution of the epidemic class of diseases, we find a remarkable difference in particular localities, being greatest in the city of Kilkenny and the counties of Clare and Kerry, the city of Waterford, and the town of Galway, in which localities the proportion varied from 1 in 55 to 1 in 54 of the population; and least in the counties of Antrim, Down, Armagh, Donegal, and Dublin, and also in Belfast town, showing in the former instance the effects of poverty and destitution in the production and maintenance of epidemic diseases, and in the latter of comfort, industry, and cleanliness, in maintaining a comparative immunity from diseases of an epidemic or contagious character.”
Amongst the sporadic diseases, those of the respiratory organs are conspicuous, and especially consumption. On the 30th of March, 4182 cases of this malady were returned, and, according to provinces, as follows: Leinster, 1326; Munster, 1260; Ulster, 1104; Connaught, 492; or, in proportion to the population in the first province, about 8 in every 10,000 of the inhabitants : in the second very nearly 7; in the third little more than 5; and in the fourth, Connaught, a little under 5, about 4.88. Taking certain counties in these provinces, as Mayo in Connaught and Kildare in Leinster, the proportional difference in the prevalency of the disease is even more striking-in the first little more than 3 cases occurring in 10,000 of the inhabitants, whilst in the latter there are as many as 9.7. On referring to the map, these counties are seen lying on the very opposite sides of the island Mayo projecting into the Atlantic, fully exposed to the west; Kildare, inland, lying low, the bog of Allen forming a part of it, yet at no great distance from the sea, and but little sheltered from the colder winds, the east and north-east. Besides difference of situation, difference of diet may be concerned in favouring more exemption from the disease in the western province and county than in the eastern. In the former it is probable that more fish is used, and generally a more plentiful diet than in the latter-sea-fish, which, containing iodine in iis composition, there is reason to believe, checks the formation of tuberoles and tends to keep under the low scrofulous diathesis. Other facts have come to our knowledge farourable to this conclusion. We shall mention one: it is the remarkable exemption of the island of Lewis from phthisis an island, the climate of which is peculiarly equables and the inhabitants of which consune little animal food, caempting sew fish, but of that a plenty,
Referring to the table of ages in the Census of persons labouring under consumption, it is curious to see the wide range of increase from infancy up to ten, and beyond up to twenty-five, when at about the maximum, and the diminution even more irregularly occurring with advancing years after twentr-fire; and it is worthy of remark that up to Native the proportional diminution is not considerable. Through the majority of ages especially after paberty and till an advanced period of time, the dispus shows a preponderance in the female sex,
being in the total in the instance of the male 1798, and in that of the female 2384. The latency and persistency of tubercles, indicated, we think, by the large proportion of elderly persons returned as labouring under phthisis, constitute a subject of inquiry which has not, we believe, received the attention it deserves. That such a state is not uncommon, we are satisfied; many a chronic catarrh we have known associated with tubercles in the lungs in those past the meridian of life; and many fatal cases suddenly fatal owing to accidental violence—have come under our observation, in which tubercles existed in these organs, without having been suspected, or sensibly impairing the general health.
The rarity of some diseases, as shown by the Census tables, is l'emarkable, such as ague (201 cases, probably a large proportion of them imported), delirium tremens (9), syphilis (824, chiefly occurring in garrison towns), gonorrhea (79, to which the same remark applies), stone (32), other diseases of the urinary organs (257), gout (51). The moderate prevalency of certain other sporadic diseases is not so remarkable, such as rheumatism (3953), ulceration (2616), itch (1193), scrofula (2654), dropsy (1464), and need no comment.
We pass now to the Analysis of Tables of Pestilences, and Tables of Deaths, and with a feeling of regret that the notices we shall have to offer must, in relation to the importance of the subjects, be commensurately short.
Of the total deaths returned for the decennial period between 1841 and 1851, amounting to 1,361,051, as many as 553,801 were owing to epidemic diseases, equal to 40-6 per cent. of the entire mortality-a circumstance not surprising, considering that the famine period is ineluded in the decennium, arising out of the destruction of the potato in 1846, and the following years. The most destructive of all these diseases were fever, dysentery, and diarrhoea, the almost invariable and dire accompaniments of famine. These together swept off 366,584 of the population-fevers 222,029, dysentery 93,232, diarrhea 41,323. The other diseases belonging to the zymotic or epidemic class next in degree of fatality were, cholera and small-pox, measles, scarlatina, hooping-cough, and croup. Cholera occasioned 35,989 deaths ; smallpox, 38,275; measles, scarlatina, hooping-cough, and croup conjointly, 100,141.: of these scarlatina, the least destructive, was fatal to 20,175.
Of the diseases or causes of death not belonging to the zymotic or epidemic family, but in part arising out of the famine, the more remarkable were those included under scurvy, infirmity, debility, old age, and starvation. The mortality from these reached the vast amount of 155,693, of which total deaths 21,770 were attributed to starvation. To these might be added 15,000 more, partly of like origin—viz., marasmus (6805), dropsy (662), ulceration (3634), mortification (3901).
Of the more ordinary diseases, pulmonary consumption, as usual, holds the highest rank as to fatality. The deaths from it are no less than 153,098—75,240 males, 77,858 females. The information respecting this malady contained in the several tables of mortality, accords, as nearly as could be expected, with that afforded in the tables already referred to of existing diseases, collected on the night of the 30th March. And making a like comparison as to localities, the results before obtained are tolerably confirmed. Thus, whilst the per-centage of deaths from phthisis in Connaught was only 7.6 of the whole mortality of that province, in Leinster it was 14:7; and whilst only 5.9 per cent. of the whole in the county of Mayo, it was as high as 19:8 per cent. in the county of Kildare.
Of deaths from other diseases, we shall mention only a few, and these—with the exception of one, convulsions, from their comparative unfrequency, not needing special notice, such as the following:-Gout, occasioning 272 deaths; diabetes, 158; stone, 35; aneurism, 187; empyema, 93; delirium tremens, 91; but convulsions, 43,167! In the instance of this last disease, it is worthy of remark that as many as 27,914 died under twelve months—viz., 16,017 males, and 11,897 females.
Deaths from violence, and sudden deaths, have received, as might have been expected, the careful attention of the Commissioners. In tabulating them, two divisions have been made-one including those on which inquests were held, the other those on which no inquests were held_taken from the police reports made to the Inspector-General of Constabulary. Under the first, 29,265 deaths are returned, 20,866 males and 8399 females. Under the second, 333—of whom 277 were males, 56 were females. The deaths on which inquests were held are subdivided into three classes : 1st, deaths by violence, neglect, evil intent or design, amounting to 2374–males 1589, females 785; 2nd, suicide, amounting to 841-males 573, females 208; 3rd, accidental deaths without design or intent, amounting to 12,717-males 9158, females 5021. The following excerpta are very significant, and are given as examples :
Suffocation cide, & exposure.
by limekilns. M. F.
M. F. Leinster ... 94+41=135 ... 50 ... 369 ... 191+85=276 ... 71+3= 74 Munster ... 127+44=171 ... 107 ... 52 ... 149 +66=215 ... 129*6=135 Ulster ... 22+ 6= 28 ... 123 ... 63 ... 165-783=248 ... 7+4= 11 Connaught 118+46=164 ... 60 ... 24 ... 687345102 ... 3+3= 6
The details recorded in the Census tables as to sex, age, locality, whether civic or rural, afford important data bearing on the history of man in his social relations, and the influences to which he is exposed. Merely considering the general numbers, we see in the return of deaths on which inquests have been held, how the male sex preponderates. The same preponderance, it is worthy of note, appears more or less marked in the tables of deaths from diseases of an acute kind: even in infancy it is shown under the head of convulsions. Is not the inference, then, fair, that in the male sex the tendency is to morbid action in excess, or to the sthenic diathesis, and that the opposite, or asthenic, rather belongs to the female sex l-as seems to be indicated, also, by the diseases to which they are in a higher ratio subject, such as phthisis