A jab from the past
An Irishman’s Diary on a French view of Irish healthcare in the 1790s
“The chevalier’s epic walk, at an average of 22 Irish miles a day, also involved a stop at the Marble Arch caves, where he descended as far as anyone could at that time with only a candle, which then blew out, forcing him and his guide to shout for help from above ground.”
I see that today is the 265th birthday of Edward Jenner, who developed the world’s first vaccine and, in so doing, may have saved more lives than any other person before or since. We’ll return to that subject, but first a short detour via the Marble Arch caves in Fermanagh, where we left off yesterday.
When I visited them recently, it had been raining heavily, and the rivers that run through some of the caverns were still rising, so that I was just in time to get the last subterranean boat trip of the day.
A little later, water levels would be too close to the roof of the cave to allow river-borne entry to the complex. But happily, our group enjoyed the Stygian thrill of being ferried into the underground, and even of having to stoop under the lower parts of the rock ceiling, before disembarking and continuing on foot.
As the guide explained, it was only in 1895 that these watery caverns were first explored, although they were well-known locally for centuries, and had been a limited tourist attraction long before they were fully mapped.
But in fact I already knew this because, by coincidence, and thanks to Google’s digitisation project, I had lately been reading a travel book entitled A Frenchman’s Walk Through Ireland (1796-7), by a certain Chevalier de Latocnaye.
The author was a French royalist, who had fled the revolution, first to England and Scotland, and was now describing an Ireland itself on the brink of revolution – omens of which were everywhere he went, especially in Ulster.
Unsurprisingly, de Latocnaye had little enthusiasm for the United Irishmen. But he didn’t think much of Orangemen either. And in general he comes across as a fair-minded, enlightened, and affable individual, whose sense of humour rarely deserted him (except in Cork).
His epic walk, at an average of 22 Irish miles a day, also involved a stop at the Marble Arch caves, where he descended as far as anyone could at that time with only a candle, which then blew out, forcing him and his guide to shout for help from above ground.
Later, the Frenchman insisted on making a side trip, six Irish miles and back, to the reputed source of the Shannon. And as noted here yesterday, he needn’t have bothered, because we now know that the river’s true origins were in the same part of Fermanagh he’d just left.
But getting back to Jenner, it so happens that among the book’s many entertaining vignettes is de Latocnaye’s meeting, on a Mayo mountain road, with a “travelling inoculator”. The man had been born poor and was bound for the priesthood once until financial setbacks deprived him of the necessary education. So his fall-back plan had been to train himself in inoculating children against smallpox, then still a great scourge.
It wasn’t a lucrative living, he told the Frenchman, earning one £30 or £40 annually. So even apart from the question of medical ethics, he could not afford failures. Of 361 children he had treated that year, only one had died. But since the death of a patient meant that, first, he would not be paid and, second, he would be “beaten” by the child’s family, he took great care to avoid fatalities.
The chevalier was so impressed by this violence-based medical insurance scheme that he suggested – jocularly, I think – its adoption in urban areas where, as he complained, doctors tended to be paid even when they killed their patients, leading to a certain complacency. But joking aside, his meeting with the inoculator left him profoundly impressed both by the man and his patients. A running theme of the book is de Latocnaye’s defence of the Irish against denigration in Britain and beyond. Here, he eulogised their apparent willingness to embrace advances in medicine. It was far greater than in rural France, he suggested.
Even so, I’m reminded it was also in 1797, as de Latocnaye walked Ireland, that Edward Jenner first pioneered his smallpox vaccine, using the milder cowpox, and causing outrage at the idea of an animal disease being used to treat humans (his ultimate vindication is now immortalised in the very word vaccine, from the Latin for cow).
So de Latocnaye’s inoculator must have been using the variola virus itself, the older and much riskier procedure. And among the archives of the era, we also find reports about the high incidence of blindness in certain parts of Ireland, a fact blamed on the same itinerant paramedics. They were not all as scrupulous as de Latocnaye’s, and the people’s trust in medicine must often have been cruelly betrayed.