There can be little doubt that there was a pressing need for a fever hospital. There was extreme poverty, in the immediate vicinity of the proposed hospital. Survey after survey and the hospital’s own records paint a grim picture of an inner city society whose living conditions were appalling. Whitelaw’s survey conducted in 1798 and published in 1805 provides an early insight into the living conditions of the time. Referring to the inner city as the ancient part of the city he describes the population of the numerous lanes and alleys as being ‘crowded together to a degree distressing to humanity.’ The rent of a single apartment was so onerous that two, three and even four families often shared the accommodation to lighten the rent. On his early morning rounds, conducting the survey, Whitelaw often came across ten to sixteen people, of both sexes, sharing a room ‘not fifteen feet square, stretched on a wad of filthy straw squirming with vermin and without any covering save the wretched rages that constituted their wearing apparel.’ An ‘intelligent clergyman’ of the Church of Rome had assured him that no.6 Braithwaite Street had once contained one hundred and eight souls. In 1798 only fifty six souls were found. In Plunkett Street 917 people were living in thirty two houses, an average of 28.7 to each house. To add to the misery of these teeming streets, filth and rubbish was strewn in the back yard of these houses. As there was no organised rubbish collection, Whitelaw, found ‘a degree of filth and stench, inconceivable except by such as have visited these scenes of wretchedness.’ It was not uncommon to find rubbish heaped to the level of the window of these houses from where it was seldom removed. In School House Lane he found a house where the entire side wall had fallen, killing some cows. The thirty tenants remained living in this situation for some months and the ‘humane’ landlord had continued to collect the rent. In the south inner city he counted 15.683 inhabitants in 1179 houses, an average of 13.3 per house. Additionally a number of dairies were operating and ‘vast quantities of dung continued to accumulate by neglect.’ Whitelaw was also concerned at the number of cemeteries in the area and the burial practices which were spreading disease.
Reverend James Whitelaw was Rector of St Catherine’s Parish in Dublin. Ironically, he himself died of fever, in 1812, when he and a Doctor Lynch, from Cork Street Hospital contacted fever from the same patient, while discharging their respective duties, ‘their anxiety for the interests of a stranger inducing them to lose sight of caution’.
The initial impetus for establishing the fever hospital came, apparently, from a group known as The Dublin Society for Promoting the Comforts of the Poor. In 1800, a sub committee of this group reported the advantages of the city, the temperance of its climate, the adjacent sea, the elevated position of its principal streets and the supply of wholesome provisions. They also noted its negative features, the closeness and filthiness of the streets where the poor lived, their low situation and want of proper sewers and the wretched and general insanitary condition of the homes of the poor. These were most pronounced in the liberties of St Sepulchre, Thomas Court and Donore. This society had among its committee six people who subsequently became trustees of the fever hospital.
At that first meeting in minutes 1801 to promote a fever hospital, the group declared their objective was to provide relief for the ‘sick poor’ of Dublin and their subsequent annual reports contain many references to the poverty encountered by the hospital’s staff.
In 1801 their annual report outlines the necessity for the hospital and quotes from examples of other cities. Their opening preamble contains a quote from a publication of the House of Industry on Dublin’s north side.
‘Contagious disease is the most formidable shape under which the almighty manifests his displeasure to the poor of every country a dreadful scourge- to the poor of this, the more afflicting, if we consider that among the labouring classes in Ireland, from neglect of early habit of industry, the maintenance of six or seven children solely depends on the health of the parent, and that his inability to labour consequently exposes a whole family to want in this metropolis. Fever in all its forms, is the great bane of domestic comfort among the lower order of the people.’ (Laurence Geary, Medicine and Charity in Ireland, 1718-1851,(Dublin, 2004))
In 1806 their annual report noted Whitelaw’s survey and the population of each parish in their catchment area is stated by Whitelaw as St James, 6104, St Catherine’s, 10,176, St Audeon’s, 5191, St Luke’s 7241, St Nicholas Without, 12506, Part of St Michaels 2579, St John’s, 1191, St Peters 2438. This apparently gives a population density of 249 per acre compared to 169 in some parishes on the south side of the Liffey. From their own records they estimate that in the Liberties area, the average occupancy per room is six. The annual report goes on to state that the majority of the lower classes live in lanes and back yards where privies are either not provided or are choked up. The lanes therefore were being used to deposit all manner of rubbish and filth, and as they were rarely if ever cleaned they depended on scavengers to bring some kind of order to the resultant squalor. As a consequence the air itself is tainted and the constant respiration of this air weakens the ability of the inhabitants to fight disease. The dwellings of the poor are stated to be extremely miserable. Lodging houses attract major criticism. The shared stairwell being used to deposit waste which they state accumulates like a dunghill causing effuvia, a smell intolerable to all but the occupiers of these houses who appear oblivious to its effects. Each floor of these houses contains one or more families, the roofs and walls frequently let in the rain. Very often there are no beds in these rooms; the rooms are badly ventilated and filthy. Where beds do exist they often consist of straw strewn on the ground while bedclothes consist of a blanket if at all. The blanket rarely washed while the clothes worn by the poor during the day are often the only bed cover available. The poor, the report states, often sleep many to a bed, thus encouraging the spread of fever. They rarely have a change of clothes and often work as manufacturers in the same room that they live in. They are described as extremely unclean in their person and in their habits. Their food is described as scarce and of poor quality and incapable of providing sufficient strength to ward off contagion.