The 1807 report was not as wide ranging but notes that the catchment area of the hospital has been increased to include all areas south of the Liffey and within the Circular Road. The report also mentions that the majority of patients are women, which they state mirrors the population divide of the area. In 1808 the annual report states that there has been a decrease in the admissions of the indigent poor and as a consequence the admission of female servants was now permitted. The report notes that their masters were obliged by the laws of their country and god to take care of these servants. In practice, however, they were being dismissed from their positions on the outbreak of fever and forced to return to their homes where they were likely to spread the fever.
In 1811 the annual report stresses the need for cleanliness and they suggest that a printed notice be left at the houses of the patients giving basic sanitary advice. This advice was not intended only for the poor of Dublin. During that year children from a number of charitable institutions had been admitted and the committee felt the need to provide similar advice to those groups. The rich were not immune from criticism either. The living conditions of their servants were described as filthy and confined and conducive to the spread of contagion. The poor of Dublin was described as over thronged, depressed and debilitated by want of employment and by want of food. The report noted that it was rare to see a gleam of joy or the tranquil smile of a content well fed Dublin manufacturer. To add to the sense of doom and gloom whiskey’ that bane to industry, health and morals’ had become abundant and cheap. The ‘scanty stipend of casual labour, even the pittance bestowed by the hand of charity’ was being used to purchase this ‘poisonous liquor’. The mortality rate of both male and female patients was similar at approximately 1 to 11 for both with a slight decrease for female patients. This drew the comment that the habits of the lower class females seemed to be similar to that of lower class males in the abuse of spirituous liquors.
In 1814/1815 the physicians of the hospital seemed to despair at their own constant repetition of the causes of fever. Fever hospitals, they maintain can never hope to fully rid the city of disease but they call for a system of policing to finally instil a respect for cleanliness and to clear the ‘wretched receptacles’ in which the poor dwell. They also call for work for the unemployed, to discourage residence in cellars and to ‘excite industry, the parent of cleanliness and sobriety’. And to ‘rouse the passive brutified creature, from the torpor of sloth, vermin and rags into a confidence in his own exertions.’ This, they argue would raise the morale of the people and also raise their level of civilization.
Jacinta Prunty in her book Slums of Dublin, 1800-1825 provides perhaps the most detailed account of life in 19th century Dublin. As she observes the trustees of the new hospital soon found they were pursuing a dual mandate, on the one hand dealing with infection while on the other dealing with the causes of the infection. The causes of infection were not simply the lifestyle of the population. Basic sanitation not only was lacking, political will to improve it was equally absent. Whether the trustees ever realised the extent of the problem is debatable. In their previous forays into philanthropy, they do not appear to have donned the mantle of advocacy of the poor. Here however they found themselves confronting the local authority to clear drains and lobbying government for basic improvements in sanitation. The second Arthur Guinness who retired from active board involvement in 1823 could hardly have envisaged spending 21 years of his life involved in this hospital. His was not a passive role. He took an extremely active role in all its activities.
In 1822 Dr. T.C. Speer published his Inquiry into the Causes and Characters of the Diseases of the Lower Orders in Dublin. He discussed the situation in some detail and analysed the problem under four headings, Climate-Poverty-Population-National Character. His views on climate reflect the then widely held view on the transmission of fever and the advantages of Dublin over other cities. Poverty which he describes as a vast and overgrown state of pauperism is discussed but not its causes. The diet of the poor is however discussed. Potatoes, ‘always a favourite and easily obtained forms a great barrier to the ravages of hunger’, salt food-fish and bacon are favoured but fresh meat is rarely available. Tea is the favoured drink and is described as a panacea for many problems. While the benefits of whiskey are extolled, Dr Speer clearly enjoys a glass, its abuse is lamented. Whiskey is ‘a cure for all complaints and all weathers, in warm weather it allays their thirst, when cold it heats them, when wet it dries them, in sorrow they fly to it as a charm and a blessing, and in its intoxicating draughts their misery is forgotten.’
In 1826 a physician in the Cork Street Fever hospital, Dr Grattan, requested by the board to give a report on an outbreak of fever in the city described the prevailing circumstances,
“ …this is particularly the case at the present moment when poverty and destitution affect the wretched poor of our city to an extent sufficient to render it barely credible how human nature can support such continued and accumulated practices a total want of clothes-of food- of comfortable lodgings together with the absence of cleanliness” ( Minutes, 1826, p244 )
He went on to describe a visit to one house which he described as a garrett. There he found
“ a patient who lay in a remote corner on what is called on this side of the channel ‘a wad of straw’, on turning back a piece of old carpeting –the bed covering of this poor woman, her person was naked, only a tolerably thick tunic of dirt adhering to her skin; in the room no other article of furniture than part of a broken jug holding some liquid. “(Minutes, 1826 , p351)