Headstones and Causes of Death

By Professor R. S. J. Clarke

Causes of death are rarely mentioned on gravestones, apart from violent and sudden deaths. Gravestones round the coast record shipwrecks, Drumbeg records a death in the Charge of the Light Brigade and many record deaths of those connected with the 1798 rising. However, several commemorate deaths from diseases now rarely seen in Europe, but common in the poor and overcrowded conditions of Ireland in the past.

Cholera

This is an inflammation of the intestines causing painless watery diarrhoea which increases in severity, leading to collapse and death, perhaps within twenty-four hours. It is caused by an organism, spread by sewage-contaminated water and has largely disappeared in countries where pure water is available. Treatment consists in water and salt replacement, which in former times was exclusively by mouth, but now is more often by intravenous infusion.

Epidemics usually started in the Far East and it was therefore known as "the Asiatic Cholera". Ireland was struck repeatedly in the eighteenth and early nineteenth centuries, but most severely in 1832, when about 3,000 people in Belfast were infected and about 500 died. An isolation block was opened behind the Fever Hospital in Frederick Street and large plots for burial of paupers were set aside in Clifton Street and Friar`s Bush Graveyards. These areas were used again for victims of the Great Famine and now form green spaces to remind us that in the past infectious diseases, both in epidemics and isolated cases, were the main cause of death. There was another outbreak of cholera in 1848-9, and further cases throughout the century as argument raged over the need for improved sanitary arrangements. Deaths from local outbreaks are specifically recorded in graveyards in Annahilt, Ardglass, Ballymore (County Armagh), Larne, Moira and Mullaghglass (County Armagh), and deaths abroad are often noted on gravestones here.

'Fever' and Typhus

The term "fever" is nowadays applied to any condition associated with a raised temperature, but historically in Ireland it covered a number of infectious diseases often accompanying famine. They were all spread by organisms carried by the louse and spread from person to person, when weakened by starvation, living in overcrowded conditions and incapable of even the most basic personal hygiene. There were, in fact, three different fevers which commonly occurred. These were the mildest or trench fever, later associated with the First World War. More serious was the episodic relapsing fever, which was often accompanied by jaundice and was known in Ireland down the years as the Buidhe Conaill (or Pestis Flava in old texts). Most dangerous of all was typhus fever which produced a swollen, blotchy appearance, severe delerium, gangrene and death. Since these diseases were spread by direct contact with infected patients, doctors and clergy were frequent victims, for example Dr Alfred Anderson of the Belfast Fever Hospital, the Rev John Montgomery of Banbridge, the Rev Robert W Toler of Annalong, the Rev Bernard Dorrian, parish priest of Lisburn and the Rev Patrick McEvoy, parish priest of Kilbroney, county Down, all in the 1845-7 period. As with cholera, these fevers did not end with the Great Famine and deaths were common in Ireland into the twentieth century, when the understanding of the causes and the mechanism of spread made them less likely.

Typhoid and Enteric Fever

This was never common in Ireland, even during the Famine and the only case, recorded on a gravestone in Downpatrick, occurred at Kasauli, India.

Influenza

The influenza epidemic of 1918 is reputed to have killed more people that World War I. It clearly decimated the Taylor family of Ballywalter, taking John Taylor, aged 42, and his three sons aged 15, 17 and 20. It is not clear why this epidemic was so severe in its effects, when it is now rarely fatal, except in babies and the frail elderly.

Scarlatina or Scarlet Fever

This childhood fever was very common in the 19th and early 20th centuries, but isolation of infected children gradually reduced the number of cases. I also became less severe in its course, for reasons unknown. It must have killed thousands of children, but is only mentioned on two gravestones, in Ardglass and Knockbreda, and in the Knockbreda stone the words "of scarlatina" were later erased, perhaps because of a perceived stigma.

Yellow Fever

This tropical fever, particularly associated with jaundice, has always been particularly common in Central America. It is caused by a virus transmitted by the mosquito and has been virtually eliminated by campaigns against the insect. It was a particular scourge during the building of the Panama Canal.

Sunstroke

This is probably the least likely cause of death to be found in Ireland and the two cases recorded on gravestones were in Fiji and the USA.

Tuberculosis

Tuberculosis or phthisis, as it was sometimes called, killed more people in Ireland than all the above together, but it is rarely, if ever, mentioned on a gravestone as the cause of death. Again the reason was a reluctance to admit that anyone in the family suffered from the disease.