ILL.
What do emigration and low wages do to Irish health? Social conditions result in an extraordinary percentage of tuberculosis and lunacy, and in a baby shortage in Ireland. Individual propensities to sexual excess or common crime are, incidentally, responsible for little of the ill health in Ireland.
Ireland's tuberculosis rate is higher than that of most of the countries in the "civilized" world. Through Sir William Thompson, registrar-general of Ireland, I was given much material about tuberculosis in Ireland. An international pre-war chart showed Ireland fourth on the tuberculosis list—it was exceeded only by Austria, Hungary, and Servia.[1] During the war, Ireland's tuberculosis mortality rate showed a tendency to increase; in 1913, her death list from tuberculosis was 9,387 and in 1917 it was 9,680.[2]
Emigration is heat to the tuberculosis thermometer. Why? Sir Robert Matheson, ex-registrar-general of Ireland, explained at a meeting of the Woman's National Health Association. The more fit, he said, emigrate, and the less fit stay home and propagate weak children. Besides, emigrants who contract the disease elsewhere come home to die. Many so return from the United States. Numbers of the 50,000 annual migrants from the west coast of Ireland to the English harvests return to nurse the tuberculosis they contracted across the channel. Dr. Birmingham, of the Westport Union, is quoted as saying that in September a disease known locally as the "English cold" is prevalent among the young men who have been harvesting in England. Sometimes it is simple bronchitis. Mostly it is incipent phthisis. It is easily traced to the wretched sleeping places called "Paddy houses" in which Irish laborers are permitted to be housed in England. These "Paddy houses" are often death traps—crowded, dark, unventilated barns in which the men have to sleep on coarse bags on the floor.[3]
The Irish wage causes tuberculosis to mount higher. Dr. Andrew Trimble, chief tuberculosis officer for Belfast, comments on the fact that the sex affected proves that economic conditions are to blame. Under conditions of poverty, women become ill more quickly than men. Dr. Trimble writes: "In Belfast and in Ireland generally more females suffer from tuberculosis than males. In Great Britain, however, the reverse is the case…. In former years, however, they had much the same experience as we have in Ireland … and it would be necessary to go back over twenty-five years to come to a point where the mortality from tuberculosis among women equalled that now obtaining with us. It would seem that the hardships associated with poor economic conditions—insufficient wages, bad housing and want of fresh air, good food and sufficient clothing—tell more heavily on the female than on the male, and with the march of progress and better conditions of living … tuberculosis amongst women is automatically reduced."[4]
The Irish wage must choose a tuberculosis incubator for a home. Ireland is a one-room-home country. In the great "rural slum" districts, the one-room cabin prevails. Country slums exist where homes cannot be supported by the land they are built on—they occur, for instance, in the rocky fields of Galway and Donegal and in the stripped bog lands of Sligo. Galway and Donegal cabins are made of stones wrested from the ground; in Mayo, the walls are piled sod—mud cabins. Roofing these western homes is the "skin o' th' soil" or sod with the grass roots in it. Through the homemade roofs or barrel chimneys the wet Atlantic winds often pour streams of water that puddle on the earthen floors. At one end of the cabin is a smoky dent that indicates the fireplace; and at the other there may be a stall or two. The small, deep-set windows are, as a rule, "fixed." Rural slums are rivaled by city slums. Even in the capital of Ireland the poor are housed as badly as in the west of Ireland. Looking down on the city of Dublin from the tower of St. Patrick's cathedral, one can see roofs so smashed in that they look as if some giant had walked over them; great areas so packed with buildings that there are only darts of passageways for light and air. In ancient plaster cabins, in high old edifices with pointed Huguenot roofs, in Georgian mansion tenements, there are 25,000 families whose homes are one-room homes. Dublin's proportion of those who live more than two to a room is higher than that of any other city in the British Isles—London has 16.8; Edinburgh, 31.1; Dublin, 37.9.[5] In one-room homes tuberculosis breeds fast. A table from the dispensary for tuberculosis patients, an institution built in Dublin as a memorial to the American, P.F. Collier, shows that out of 1,176 cases 676 came from one-room homes.[6] As a type case, the report instances this: "Nine members of the W—— family were found living in one room together in a condition bordering on starvation. Both parents were very tubercular. The father had left the Sanatorium of the South Dublin Union on hearing of the mother's delicacy. He hoped to earn a little to support the family that had been driven to such a state through illness that, houseless, it had had to sleep on stairs. The only regular income was $1.12 a week earned by the eldest girl, aged 16, in a factory. Owing to want of food and unhealthy surroundings, she was in so run down a condition that it seemed certain she would become tubercular if not at once removed."
The Irish wage can't buy the "good old diet." Milk and stirabout and potatoes once grew rosy-cheeked children. But bread and tea is the general diet now. War rations? Ireland was not put on war rations. To regulate the amount of butter and bacon per family would have been superfluous labor. Few families got even war rations.[7] Charitable organizations doubt if they should give relief to families who are able to have an occasional meal of potatoes in addition to their bread and tea. In a recent pamphlet[8] the St. Vincent de Paul Society said: "A widow … who after paying the rent of her room, has a shilling a day to feed herself and two, three, four or even more children, is considered a doubtful case by the society. Yet a shilling a day will only give the family bread and tea for every meal, with an occasional dish of potatoes. By strict economy a little margarine may be purchased, but by no process of reasoning may it be said that the family has enough to eat, or suitable food." The Irish wage would have to be a high wage to buy the old diet. For that is not supplied by Ireland for Ireland any more. When Ireland became a cow lot, cereal and vegetable crops became few. But milk should be plentiful? The recent vice-regal milk commission noted the lack of milk for the poor in Ireland. Why? The town of Naas tells one reason. Naas is in the midst of a grazing country, but Naas babies have died for want of milk, because Naas cattle are raised for beef exportation. The town of Ennis tells another reason. Ennis is also in the center of a grazing country. Until the Woman's National Health Association established a depot, Ennis poor could not get retailed pitchersful of milk, for Ennis cows are raised to supply wholesale cansful to creameries which make the supply into dairy products for exportation.[9]
Bread-and-tea, and bread-and-tealess families get on the calling list of tuberculosis nurses. "The nurses often found," writes the Woman's National Health Association, "that a large number of cases committed to their care were in an advanced stage of the disease … in a number of cases families have been found entirely without food. This chronic state of lack of nourishment … accounts in part for the fact that there are two and sometimes three persons affected in the same family."[10]
Has mental as well as physical health been affected? Lunacy is extraordinarily prevalent in Ireland. In the lunacy inspectors' office in Dublin castle, I was given the last comparison they had published of the insanity rates in England and Wales, Scotland and Ireland. English and Welsh insanity per 10,000 people was 40.8; Scottish, 45.4; Irish, 56.2. The Irish rate for 1916 showed an increase to 57.1.[11]
Emigration, remark lunacy experts, fostered lunacy. Whole families withdrew from certain districts. Consanguineous marriages became more frequent. Weak-minded cousins wedded to bring forth weaker-minded children.
And Irish living conditions are a nemesis. They affect those who go as well as those who stay. Commenting on the fact that the Irish contribute the highest proportion of the white foreign-born population to the American hospitals for the insane, as well as filling their own asylums, the lunacy inspectors write: "As to why this should be, we can offer no reasoned explanation: but just as the Irish famine was, apart from its direct effects, responsible for so much physical and mental distress in the country, so it would seem not improbable that the innutritious dietary and other deprivations of the majority of the population of Ireland must, when acting over many generations, have led to impaired nutrition of the nervous system, and in this way have developed in the race those neuropathic and psychopathic tendencies which are precursors of insanity."[12]
Babies don't like mentally and physically worn-out parents. Babies used to be thought to have special predilection for Ireland. But as a matter of fact, they come to the island less and less. Ireland has for some time produced fewer babies to the thousand people than Scotland. During the decade 1907-1916 Scotland's annual average to every thousand people was 25.9;[13] Ireland's was 22.8. From 1907 to 1917 Ireland's total number of babies fell from 101,742 to 86,370.[14]
But as was said in the beginning, it is not to individual excess that most of the ill health in Ireland is due. It was not until recently that venereal disease as a factor in Irish ill health has been a factor worth mentioning. In 1906 a lunacy report read: "The statistics show that general paralysis of the insane—a disease now almost unknown in Ireland—is increasing in the more populous urban districts. At the same time the disease is still much less prevalent than in other countries, and in the rural districts it is practically non-existent. This is to a large extent due to the high standard of sexual morality that prevails all over Ireland."[15]
Nor do the Irish suffer from the violence that accompanies common crime—for there is little crime under the most crime-provoking conditions. As the Countess of Aberdeen said: "In the past annual report by Sir Charles Cameron, the medical officer of health for Dublin, there are again some figures that tell a strange tale of poverty so widespread, of destitution so complete, of housing so unsanitary, of unemployment so little heeded, that one is amazed by the fact that no combined effort on the part of more fortunate citizens has been made toward bringing about a wholesome change, and this amazement is only lessened by the extraordinary freedom we in Dublin enjoy from robberies, peculations, from crimes of violence and other misdeeds that would sharpen our perception of miseries now borne with a fortitude and a self-restraint that cannot but appeal strongly to any who, either from personal experience or philanthropic reading, know how crime and vice are associated elsewhere with conditions not more distressing and often less long-lived than ours."[16]