The primary exciting causes were obvious, but seemingly irremovable. Schomberg had a great military reputation, but he was now over eighty, and it does not appear that he made himself personally felt in the camp, although he issued incessantly orders to inspect and report. As the mortality proceeded apace during the six or eight weeks of inactivity, murmurings arose against the commander. He was unfortunate in his choice of a camping ground, and in an unusually cold and wet season. The newly raised English troops seem to have been lacking equally in intelligence and in moral qualities. Their foul language and debauchery were the occasion of a special proclamation; their laziness and inability to make themselves comfortable called forth numerous orders, but all to no purpose. The regiment of Dutch troops were so well hutted that not above eleven of them died in the whole campaign; but the English would not be troubled to gather fern or anything else to keep themselves dry and clean withal: “many of them, when they were dead, were incredibly lousy.”
The camping ground not only received the drainage of the hills, but, strange to say, the rain would be falling there all day while the camp of the enemy, only a few miles farther inland, would not be getting a drop. On 1 October the tents on the low ground were moved a little higher up. On the same date there were distributed among the regiments casks of brandy—Macaulay says it was of bad quality—which appears to have been the trusted remedy against camp sickness, as in the Jamaica expedition of 1655. There were twenty-seven victuallers or other ships riding in Dundalk Bay; but the stores were bad, and the regimental surgeons had come unprovided with drugs that might have been useful in flux or fever. While the weather continued cold and wet, there was also a scarcity of firing and forage. On 14 October all the regimental surgeons were ordered to meet at ten in the morning to consult with Dr Lawrence how to check the sickness[426]. Several officers having died on the 16th and 17th, the camp was shifted on the 20th to new ground, the huts being left full of the sick. Gower’s regiment had sixty-seven men unable to march, besides a good many dead before or sent away sick. Story, the chaplain, went every day from the new camp to visit the sick of his regiment in the huts, and always at his going found some dead. He found the survivors in a state of brutal callousness, utterly indifferent to each other, but objecting to part with their dead comrades as they wanted the bodies to sit or lie on, or to keep off the cold wind. The ships at anchor had now received as many sick as they could hold, and the deaths on board soon became as many as on shore. On 25-27 October, the camp was again shifted, but the sickness continued apace. At length on 3 November, the Catholic army having dispersed to winter quarters, the sick were ordered to be removed to Carlingford and Newry. “The poor men were brought down from all places towards the Bridge End, and several of them died by the way. The rest were put upon waggons, which was the most lamentable sight in the world, for all the rodes from Dundalk to Newry and Carlingford were next day full of nothing but dead men, who, even as the waggons joulted, some of them died and were thrown off as fast.” Some sixteen or seventeen hundred had been left dead at Dundalk. The ships were ordered to sail for Belfast with the first wind, and the camp was broken up. There was snow on the hills and rain in the valleys; on the march to Newry, men fell out of the ranks and died at the road side. When the ships weighed anchor from Dundalk and Carlingford, they had 1970 sick men on board, but not more than 1100 of these came ashore in Belfast Lough, the rest having died at sea in coming round the coast of County Down. Such was the violence of the infection on board that several ships had all the men in them dead and nobody to look after them whilst they lay in the bay at Carrickfergus. An infective principle, once engendered in circumstances of aggravation such as these, is not soon extinguished. Belfast was the winter quarters, and in the great hospital there from 1 November, 1689, to 1 May, 1690, there died 3762, “as appears by the tallies given in by the men that buried them.” These numbers together make fully six thousand deaths, which agrees with the general statement that Schomberg lost one half of the men whom he had embarked at Hoylake in August. The Irish Catholic army began to sicken in their camp in the hills above Dundalk Bay just before they broke up, and they are said to have lost heavily by sickness in their winter quarters.
The war ended with the Treaty of Limerick, in 1691. The Seven Ill Years followed,—ill years to Scotland, in a measure to England, and almost certainly to Ireland also; but it does not appear that the end of the 17th century was a time of special sickness and famine to the Irish, and it may be inferred from the fact of Scots migrating to Ireland during the ill years that the distress was not so sharp there. The epidemiology of Ireland is, indeed, a blank until we come to the writings of Dr Rogers, of Cork, in some respects the best epidemiologist of his time, which cover the period from 1708 to 1734. His account of the dysentery and typhus of the chief city of Munster in the beginning of the 18th century will show that the old dietetic errors of the Irish, noted in medieval times, had hardly changed in the course of centuries.
A generation of Fevers in Cork.
Rogers is clear that typhus fever was never extinct, while the three several times when it “made its appearance amongst us in a very signal manner,” are the same as its seasons in England, namely 1708-10, 1718-21 and 1728-30[428]. His experience relates only to the city of Cork, and, so far as his clinical histories go, only to the well-to-do classes therein; and although those seasons were years of scarcity and distress all over Ireland, yet Rogers does not seem to associate insufficient food with the fever, and never mentions scarcity. The fevers were in the winter, for the most part, and were usually accompanied by epidemic smallpox of a bad type, which in 1708 “swept away multitudes.” Nothing is said of dysentery for the earliest of the three fever-periods; but for 1718 and following years we read that “dysentery of a very malignant sort, frequently producing mortification in the bowels,” prevailed during the same space; and that the winters of the third fever-period, namely, those of 1728, 1729 and 1730 were “infamous for bloody fluxes of the worst kind.” It is clear that the fever spread to the richer classes in Cork, for his five clinical histories are all from those classes. The following is his general account of the symptoms:
The patient is suddenly seized with slight horrors or rather chilliness, to which succeed a glowing warmth, a weight and fixed pain in the head, just over the eyebrows; soreness all over his flesh, as if bruised, the limbs heavy, the heart oppressed, the breathing laboured, the pulse not much altered, but in some slower; the urine mostly crude, pale and limpid, at first, or even throughout, the tongue moist and not very white at first, afterwards drier, but rarely black. An universal petechial effloresence not unlike the measles paints the whole surface of the body, limbs, and sometimes the very face; in some few appear interspersed eruptions exactly like the pustulae miliares, filled with a limpid serum. The earlier these petechiae appear, the fresher in colour, and the longer they continue out, the better (p. 5). The fixed pain in the head increasing, ends commonly in a coma or stupor, or in a delirium with some. Some few have had haemorrhage at the nose, a severe cough, and sore throat. In some he had observed a great tendency to sweats, even from the beginning: these are colliquative and symptomatic, not to be encouraged. In but few there have appeared purple and livid spots, as in haemorrhagic smallpox: some as large as a vetch, others not bigger than a middling pin’s head, thick set all over the breast, back and sometimes the limbs, the pulse in these cases being much below normal. The extremities cold from the 6th or 7th day, delirium constant, tongue dry and black, urine limpid and crude, oppression greater, and difficulty of breathing more. It is a slow nervous fever (p. 18).
Rogers believed that mere atmospheric changes could not be the cause of these epidemics: “they may favour, encourage and propagate such diseases when once begun; but for the productive cause of them we must have recourse to such morbid effluvia as above described [particles of all kinds detached from the animal, vegetable and mineral kingdoms]; or resolve all into the θεῖον τί so often appealed to by Hippocrates[429].”
But, as regards Cork itself, special interest attaches to the following “four concurring causes:”
“1st, the great quantities of filth, ordure and animal offals that crowd our streets, and particularly the close confined alleys and lanes, at the very season that our endemial epidemics rage amongst us.
2nd, the great number of slaughter-houses, both in the north and south suburbs, especially on the north ridge of hills, where are vast pits for containing the putrefying blood and ordure, which discharge by the declivities of those hills, upon great rains, their fetid contents into the river.