The Launch of William Whitla’s Medical Institute: Undercurrents and Outcomes

Introduction

Although the launch of the new Medical Institute took pride of place, the unveiling of the Dr William Smyth Memorial Window by the Countess of Dudley was a highlight of the day. Surprisingly, as we shall see, the launch involved considerable political undercurrents. Also, the paths subsequently taken by three of the launch’s main participants had some strange twists.

An Occupational Disease of Irish Doctors

Dr William Smyth died of Typhus, which has been something of an Occupational Disease of doctors. Howard Ricketts and Stanislaus von Prowazek, the doctors for whom the causative agent Rickettsia prowazekii is named, both succumbed to it.¹ It is well accepted that the eruption of Mount Tambora in the Philippines in 1815, thanks to its adverse weather effects, caused ‘The Year without a Summer’ in 1816.² That year, Mary Shelley created Frankenstein on a washout holiday beside Lake Geneva. It also led to the Ireland’s Typhus epidemic from 1816-19, with 1.5 million cases and 65,000 deaths, most notably in 1817. Mortality was higher in doctors and clerics³ because “They had less or no immunity, were older, male, came into contact with cases through their calling, and therefore suffered a high mortality”.

Dr George Gillichan of Dundalk died in December 1817 aged just 28 years,⁴ “During a Contagious Fever with which Providence was pleas’d to afflict this Country”, and:

Under his directions a system of medical police was established, and a hospital on an ample scale provided, which he gratuitously attended, and which the inhabitants liberally maintained. From the time the fever began to rage, he declined visiting the rich, that the poor might have his undivided attention.

Barker and Cheyne proposed control measures, one of which was the prohibition of Wakes,⁵ which was prescient, given that the disease’s vector, Pediculus humanus corporis, leaves its host not only when fever takes hold but when the body cools after death.

Typhus returned with a vengeance during the Great Famine of the 1840s. MacArthur⁶ noted that, as in the earlier Typhus epidemic, people were not only hungry but cold because it was too wet to ‘win’ turf. Traditional Irish hospitality was also problematic because when starving people went on the road, they were invariably taken in, and congregating at soup kitchens facilitated disease transmission. MacArthur differentiated between ‘Typhus in the Peasantry’ and ‘Typhus in the Gentry’. In the former group there was transmission within the family (source: fresh louse faeces), with a low mortality (high resistance, younger victims, previous exposure). In the latter, there was no transmission within the family (source: inhaled, dried louse faeces), with a high mortality (low resistance, older victims, no previous exposure).⁶ Doctors fell into this group in what was a reversal of the general social class gradients of disease. In ‘Black 47’ in Munster alone, 48 doctors died, mainly from Typhus, and of the 473 medical doctors appointed by the board of health to special fever duty, one in every fourteen died at his post.

Dr William Smyth

William Smyth was born at ‘Stonepark’, Mountcharles, Co Donegal, on 30^th March 1859, the eldest son of Samuel Smyth, the local Dispensary Doctor.⁷ Smyth junior attended the Royal School, Raphoe in Co Donegal and afterwards read Medicine at Trinity College Dublin (TCD), where he survived Smallpox, and was awarded his Licentiates in Medicine and Surgery from TCD and the Royal College of Surgeons of Ireland, respectively, in December 1880.⁸ His ‘MD’ was celebrated in Mountcharles with bonfires when, “a lighted barrel on poles” was carried and placed in front of the family’s hall door, whereupon Smyth emerged to deliver, “a neat and appropriate speech”. “The assembly then amused themselves [sic] to a late hour with music and dancing.”⁹

That year he was appointed as a Dispensary Doctor in Ardara,¹⁰ moving to the Dungloe/Burtonport Dispensary district in the Rosses, which included Arranmore Island, in October 1882 after the death of Dr John Spencer from Typhus. The outbreak seems to have been caused by migratory workers (spailpín) returning from harvesting in Scotland,¹⁰ or from imported second-hand clothes.⁷

Smyth took up residence at Roshine Lodge, since demolished, just outside Burtonport. He married Esther Keown, five years his junior, in April 1883 (see Figure 1).¹¹ She was a daughter of William Keown, formerly of Ardglass, Co Down,¹² whose brother had been brought by Lord George Hill in 1846 to run the Corn Store at Bunbeg.¹³ Just before Christmas 1900, there was an outbreak of Smallpox and Smyth vaccinated around 700 people at Lettercaugh in a fortnight.¹⁴

Figure 1.

Wedding photograph of William and Esther Smyth, 1883.

Courtesy: Anthea Smith

In October 1901 there was an outbreak of Typhus on Arranmore Island.¹⁴ Typhus was always a threat to doctors in the Rosses: we have already discussed John Spencer’s demise,¹⁰ and Dr Charles Doherty died from the disease in 1887,¹⁵ and at least two deaths had occurred from Typhus in local doctors earlier that century.^16,17 Smyth was “summoned” to Arranmore on 13^th October to treat the Gallagher family. In a fashion reminiscent of George Gillichan, Smyth took over the sole care of the family and decided to move the husband, wife and three children to the hospital in Glenties.¹⁴ The family was not keen to leave their cottage (see Figure 2) as it was feared it might be burnt by neighbours, so strong was the dread of the disease, but they finally consented. An ambulance was arranged for the mainland but the problem was to find a suitable boat. He failed to borrow one because of fear of infection, so had to buy an old one which had been out of the water for two years.¹⁴

Figure 2.

The Gallagher’s cottage on Arranmore Island, which survived their departure. Reconstituted watercolour by FD How

Smyth had no one to crew for him, but help arrived in the shape of Dr Brendan MacCarthy, the Medical Officer of Health for Co Donegal. The pair successfully rowed the family across the three miles of sea to the waiting ambulance. This took them to hospital where they all made a good recovery. The boat, on the other hand, sank after a few hours,¹⁴ or according to the BMJ,¹⁸ after five minutes. Smyth then decided to visit the Glasgow International Exhibition (see Figure 3), and sailed directly there from Burtonport on 6^th November, but he soon started to feel ill and returned home. He died from Typhus on 19^th November and is buried in St Crone’s Church of Ireland cemetery in Dungloe, along with six of the couple’s 14 children.¹⁴ There is a fine monument to him inside the church (see Figure 4).

Figure 3.

Postcard of the Glasgow International Exhibition, 1901. Source: Author’s collection

Figure 4.

Memorial Plaque to Dr William Smyth. St Crone’s Church of Ireland, Dungloe

A Hero of Donegal

Smyth’s death caught the public’s imagination, and a fund to support his family was established a month after Smyth’s death, chaired by the Duke of Abercorn, the Lord Lieutenant of Co Donegal, with Smyth’s old college mate, Thomas Myles, serving as a trustee.¹⁹ An editorial in the BMJ declared:¹⁸

But such a man as William Smyth is a glory to the whole profession, and his death in the prime of manhood … must be counted more heroic than a death in battle. Soldiers die for their country in the fierce joy of combat; William Smyth died for his fellow men with nothing to cheer him on but the sense of professional duty.

The following year, Frederick Douglas How published a ‘Memoir’ entitled, ‘A Hero of Donegal’. How’s initial literary excursion was a biography of his father, Bishop Walsham How, in 1898.²⁰ He comes across as a high-minded, Anglican hagiographer who specialised in ‘uplifting’ moral tales for boys and girls. Smyth’s death had featured heavily in the English press and How spotted a vehicle for his talents. He was a gifted watercolourist who illustrated his own books. He visited the Rosses in early 1902 when he commented on the idleness, “…there is enough and to spare”, and disapproved of the local blacksmith being still in bed at 9.15 am!⁷

It seems, however, that How had blundered into something that he did not fully understand, and no one saw fit to enlighten him. It is a valuable little book, although it is only told from one perspective. The Derry Journal carried a critical review:²¹

The memoir is a friend’s tribute to a friend gone before and in this character is appropriate and sympathetic. We cannot help, however, expressing regret that the author goes into other matters that in our judgement had much better – certainly with much nicer taste – have been left out, and that, as it seems to us, jar somewhat on the spirit of graciousness and appreciative kindly good-will so markedly in evidence during the promotion of the testimonial fund subscribed to in splendid generosity and cordiality by all sections of the public.

No clue is given as to the nature of the “other matters” which “nicer taste” should have omitted. There are a number of possibilities, including the fact that Smyth was a “strong Loyalist”… [who] “did not hide his loyalty under a bushel,”¹¹ and the district was “‘Nationalist,’ almost to a man”. Smyth had even been captain of the Burtonport cricket team,²² however unlikely that sounds, but the Herdmans of Sion Mills, where cricket reigned supreme, had a longtime connection with the Rosses.²³ During the Boer War, Smyth, “…raised a sum of £20 in Burtonport—a strong pro-Boer locality—for the widows of those who were killed in South Africa”.²⁴

No, it is undoubtedly the six-month sea voyage that Smyth embarked upon in the autumn of 1889²⁵ – “a six months’ [sic] trip to Australia for the benefit of his health”.²⁶ This was on the advice of the eminent Dublin-based Physician,²⁷ James Little, with whom How corresponded.²⁸ James Little had befriended Smyth during a sporting holiday in Donegal.²¹ Little reported that Smyth had suffered from a persistent cough, “…and feared he was going into consumption”.²⁵ Incidentally, Little’s name was on the guest list for the Institute’s launch in 1902, but he doesn’t seem to have attended.²⁹

Little’s diagnosis lies uneasily with the description of Smyth given by How: he was six feet two inches tall, “As fine a man as you’d see coming into a fair,” and, “…he came to weigh fifteen stone, but there was never an ounce of superfluous flesh upon him”.¹⁰ There was also Brendan MacCarthy’s description of Smyth at the Annual Dinner in the new Medical Institute:³⁰

Of splendid physique, a fearless horseman, an all-round athlete, as well as a man thoroughly grounded in the work of his profession. He was fully appreciated by the people among whom he worked. Though differing widely from them in many things considered of importance, he was recognised as a true man, and was respected and loved by all.

He was also a highly accomplished sailor, winning a cup outright at the Rosses Annual Regatta on 8^th August 1889, just ten weeks before his world circumnavigation for the “benefit of his health”.³¹ Smyth was plainly not a man to be cowed by anything, or anybody, so what exactly was going on?

The Land War

In Ireland in the 1870s, some landlords such as the Marquis of Downshire had massive estates (115,000 acres) along the east coast, while the Duke of Abercorn owned 76,000 acres in Tyrone and Donegal; more than half the land was owned by less than 1,000 landlords. In contrast, in 1851 over half of tenants had less than 15 acres.³² Despite Gladstone’s Land Acts, which aimed to break up the estates, the return of famine in 1879 saw the foundation of the Irish National Land League by Michael Davitt and others, which resulted in the Land War. This led to tenants withholding rent, and multiple evictions.³²

It was replaced from 1886-91 by ‘The Plan of Campaign’, which involved a more focused version of agitation and called for withholding rent when owners refused to reduce them by 20-40%.³³ Donegal had witnessed the Derryveagh Clearance of 1861 when the Landlord, John George Adair, evicted 45 families. By the late 1880s Wybrant Olphert’s estate of just over 18,000 acres at Falcarragh had become a political hotbed.³² Tenants who joined the Plan would hand over their rent, less the reduction, to a trustee – in this case to James McFadden, “The Patriot Priest of Gweedore”.¹³ This resulted in many evictions with battering rams to the fore.³⁴ McFadden was jailed for his activities for six months in 1888.¹³

The Murder of District-Inspector Martin

On his release, McFadden blithely continued as before, but when his re-arrest was bungled on 3^rd February 1889, McFadden’s angry parishioners bludgeoned the RIC’s District-Inspector Martin to death with paling posts and stones.¹³ Ten people, including McFadden, were charged with murder and a further 13 with conspiracy. Their trial began at Maryborough (Port Laoise) on 17^th October,³⁵ but collapsed on 26^th, partly thanks to stark photographs of the peasantry’s living conditions (see Figure 5). They were taken by James Glass, a Derry photographer, and commissioned to inform the defence in the trial, which may have helped soften the attitude of a hostile jury.³⁶ McFadden, who pleaded guilty to obstruction, was immediately released. Several others received relatively light sentences, and they all were released when the Liberals were returned to power in 1892.³⁵

Figure 5.

A Derrybeg extended family, photograph by James Glass, 1889. Source: Author’s collection

Dr William Smyth’s Sea Voyage

According to How,²⁸ James Little confirmed that Smyth had consulted him about his health in 1888 or 1889. The upshot was that Smyth sailed to Quebec from Moville on the Parisian,³⁷ departing on the day the Maryborough Trial began. That August he had received permission for six months’ leave of absence from duties,³⁸ and in September he was presented with an Address and a bag of sovereigns by friends.³⁷ He left nine days after his son – and second child to survive – was born (three previous children had not survived their first day).

It seems highly probable that Smyth departed just as the Trial started because he was considered a reprisal risk. So, was Smyth involved in the Land War? He had been made a Justice of the Peace for Co Donegal by its Lord Lieutenant, the Duke of Abercorn, the previous year when just 29 years old.³⁹ He undoubtedly presided at Petty Sessions, but records have not survived. A merchant in Dungloe had been boycotted but Smyth strongly supported him, and he was warned not to fraternise with an RIC Inspector in Dungloe.²⁸ A glimpse of Smyth’s antipathy to the Land War is given by his support for District-Inspector Markham at his Court Martial. Markham may have been a scapegoat for the mishandled arrest of Father McFadden that February, because, although Markham was found guilty, he afterwards returned to duty.⁴⁰

Questioned by Markham in April 1889, Smyth stated:⁴¹

Dungloe district was disturbed some time after your arrival there. The peace of the district has been well preserved during your time. From my intercourse with the people I believe the fear you instilled into them, and the prompt manner in which you met warlike rowdyism and riot, was the means of deterring them from coming into Dungloe after sunset lest they came into contact with the police.

Thus, it seems highly likely that Smyth had created animosities which the Maryborough Trial was going to further inflame, so it was considered prudent for him to go abroad. If so, why did he leave his wife and children behind? One contemporary authority noted that, “…maiming of women and children – have never dishonoured the county”.⁴² It seems, therefore, that his family were thought to be safe, but he may have been considering a new life elsewhere. He set sail for Australia and England from Victoria, BC, on the Dochra,²⁵ at the end of December, no doubt having heard that the Trial had collapsed. He arrived in Liverpool on 29^th April 1890,⁴³ to return home “… in a wonderfully improved state of health”.²⁵

The Impact of Two Donegal Murders on Public Opinion

Writing in 1899, Stephen Gwynn observed: “Two murders in Donegal – this one [Martin’s] and that of Lord Leitrim – have had a wide-spread notoriety”.⁴² Lord Leitrim had been murdered in an ambush on Fanad in April 1878 over land disputes.⁴⁴ Martin’s murder sparked a Loyalist ‘Indignation Meeting’ in Belfast’s Ulster Hall on 14^th February,⁴⁵ addressed by Sir Edward Harland, and the Reverend Hugh Hanna, where ‘Partition’ was very much in the air. One newspaper referred to, “…the half-civilised peasants of Gweedore”.46 In view of such polarization, the friendship and respect shown towards Smyth by Brendan MacCarthy is heartening: whereas Smyth was a staunch Loyalist, Brendan had an impeccable Nationalist background. His father was Denis Florence MacCarthy, who, like Oscar Wilde’s mother Speranza, wrote for Thomas Davis’ Nationalist paper, The Nation.⁴⁷

In September 1895, a request was made by John St. Clair Boyd,⁴⁸ a Fellow of the Ulster Medical Society and first President of the Gaelic League, to hold Irish classes in the Society’s rooms – the application was, “…not entertained”.⁴⁹ Sir William Whitla himself was a staunch Loyalist, signing various Covenants.⁵⁰ In 1909, when Sir William was President, the handbook prepared for the British Medical Society’s AGM in Belfast didn’t even mention ‘Ulster’, alluding instead to “Belfast and North-East Ireland”.⁵¹ Probably to Sir William’s consternation, the Burroughs Wellcome handbook, produced by Henry Wellcome for the AGM, was entitled “Medicine in Ancient Erin”⁵² and dripped with Celtic iconography.

Fresh Departures

As mentioned, some of the main players at the launch developed new interests. Sir William would have been concerned that the Earl of Dudley, a Conservative, and therefore hostile to the Liberals’ ‘Home Rule’ rhetoric, later “…developed strong Nationalist views, much to the annoyance and amazement of his own political party”.⁵³

Sir Thomas Myles, who had received his knighthood with Sir William, took a more bizarre diversion. He was a huge man, an accomplished athlete and boxer, who used to spar with John L Sullivan, the pugilist, and even fought a three-round bout with him.⁵⁴ In 1886 he became a founding member of the short-lived Protestant Home Rule Association, and often spoke on Home Rule at public meetings. He was also a keen yachtsman, so thanks to his commitment to Home Rule, and his concern over the Ulster Volunteer Force’s arming in 1914, he agreed to assist Erskine Childers in acquiring arms for the Irish Volunteers. In his steam yacht, Chotah, he met Childers in the Asgard, transferred rifles and ammunition, and landed them at Kilcoole, Co Wicklow, on the night of 1st August 1914.54 Years later he exclaimed to a young Volunteer who questioned his commitment, “I brought you those guns to show that bloody Craig that two could play his game”.

The Countess of Dudley was born Rachel Gurney in 1868, the daughter of a Quaker banker, who ran into financial difficulties. To survive, she and her sister helped their mother to run a millinery shop, but it went badly. She was noticed for her beauty and singing by the Duchess of Bedford and became her protégée (see Figure 6). She was wooed by the second Earl of Dudley, and the couple married in 1891. The Earl’s family was not that pleased and sometimes referred to her as the “shop girl Countess”.⁵⁵ The couple came to Ireland as Viceroy and Vicereine in August 1902 and stayed until December 1905.⁵⁶ She became acutely aware of poverty in Dublin city, although people there had access to doctors and charities, but during holidays in Connemara she was shocked at the destitution of the poor.⁵⁷ The Countess wrote to the newspapers to raise money for her ‘Lady Dudley Nursing Scheme’ covering the entire west coast.⁵⁸ Up to its launch in April 1903, there were only four certified district nurses in the west of Ireland.⁵⁹

Figure 6.

Rachel, Countess of Dudley in 1891, © National Portrait Gallery, London

The Scheme’s First Annual Report in 1904 observed:⁶⁰

The Island of Aranmore [sic] and district of Burtonport, Co. Donegal came next in order of selection, and Nurse McMahon (see Figure 7) was appointed to this district on March 3^rd [1904]. From this remote locality, familiar to the ear of most Irishmen, comes the echo of a name which yet endures, that of Dr. Smyth of Burtonport, who nursed the sick on the Island of Aranmore during an epidemic of typhus, eventually dying himself of the same disease.

Figure 7.

Nurse MacMahon, the eighth Dudley Nurse appointed, on the strand at Arranmore Island in 1904. Source: Second Annual Report, 1904. Courtesy of the National Library of Ireland, Dublin

The Burtonport Priest wrote thanking her ‘EXCELLENCY’ because, until then, it had not been possible for “…the dispensary doctor to reach the island in stormy weather” so that the sick were “…left to the mercy of the winds and waves”. The Scheme co-operated with the Congested Districts Board until 1923, and ended in 1974.⁶¹

From 1908-11 the couple were in Australia when the Earl became the country’s fourth Governor General. In 1909 the Countess launched her Bush Nursing Scheme, which faltered through lack of funding,⁶² but eventually became a forerunner for the famous ‘Flying Doctor’ service.⁵⁷ She also established the Countess of Dudley’s Polo Challenge Cup, which is still contested today.⁶³ Sadly, despite the couple’s seven children, the Earl was a philanderer whose ‘Concupiscent Capers’⁶³ led to the couple’s separation with a hush hush financial settlement in 1918. In June 1920, the Countess, then aged 51, had just arrived in Galway on holiday, when she drowned while swimming in the sea, watched by her maid, who “…was powerless to assist”.⁵⁵

The Whitla Medical Institute

In 1946 cracks began to appear in the Institute and doors were inclined to jam. This was traced to the enlargement of the old Police Barrack on the east side of the Institute to make a Merchant Seamen’s Club. A hike in the Rates was also a headache.⁶⁴ During the 1950s there were wrangles with the Club about liability, but eventually incomplete compensation from the Club was received. Costs of publishing the Journal were also soaring, and as more problems were arising, the Institute was sold to Inst in 1965. Eventually new accommodation was made available in the new Whitla Medical Building, which was opened in May 1976, but it was not until 1982 that all the details were ironed out.⁶⁵ It provides a fitting home for the Smyth Memorial Window, and other important ‘legacies’ from the old building.

Conclusion

Frederick Douglas How had no grasp whatsoever of the real reason for the long voyage which William Smyth embarked upon in the autumn of 1889, but Sir William, and the Trustees of the Smyth Fund, certainly had. Its Chair, the Duke of Abercorn, would have been well aware of Smyth’s previous history. Indeed, the fact that Smyth might have been a potential target of the same political forces that led to the murder of District-Inspector Martin, perhaps added to the poignancy of his tragic death, and the window represented a token of defiance against these political forces. In this much, at least, it was itself driven by political forces. In any case, the subsequent direction taken by the Countess was uplifting. She had witnessed destitution in Co Galway, but perhaps her noble initiative was triggered by the shining example of Dr William Smyth?