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Bulletin of the History of Medicine 77.3 (2003) 736-737



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Frank Cullen. Cleansing Rural Dublin: Public Health and Housing Initiatives in the South Dublin Poor Law Union, 1880-1920. Maynooth Studies in Irish Local History, no. 40. Dublin, Ireland; and Portland, Ore.: Irish Academic Press, 2001. vii + 61 pp. Ill. $12.50 (paperbound, 0-7165-2738-3).

The South Dublin Poor Law Union, the subject of this short pamphlet, covered one of the most populous districts of Dublin together with an extensive suburban/rural hinterland. It was particularly afflicted by all the problems of urban development and poverty experienced at the end of the nineteenth century, its mortality rates being some of the highest in Ireland.

Poor Law Unions, created in Ireland 1838, had run a dispensary system attached to the workhouse since 1851. The workhouse dispensary carried out an essential pillar of Irish sanitary reform: smallpox vaccination. Workhouse infirmaries had also become a recognized part of the poor-law structure in Ireland by the late nineteenth century. The public health functions of unions were, however, considerably increased under the Public Health Act of 1878, which basically extended to Ireland the provisions of the Public Health Act of 1875 for England and Wales, adding the duty of sanitary inspection and the provision of clean water in rural districts. The organization of public health was further affected by the Local Government Act of 1898, which democratized local government and moved the responsibility for rural sanitary improvement to the county councils. So complex had Irish sanitary structures become by 1914—involving county councils, urban councils, and Poor Law Unions—that the need for their simplification was widely discussed.

Frank Cullen draws attention to one particular function of the Unions: the construction of homes for rural laborers. Acts were passed in 1883, 1885, and 1886 which allowed the Poor Law Unions to enforce housing improvement in private dwellings, and to actually construct cottages themselves and let them to agricultural laborers. There are some excellent illustrations of these "union cottages" in the pamphlet, many examples of which can still be seen today in what were, at that time, the Dublin suburbs. In national terms this housing reform was a great success: by 1900 the one-roomed mud cabin, familiar in the mid-nineteenth century, had become rare in rural areas. In contrast, the housing condition of the urban poor in Dublin was reaching crisis point.

The social effects of the housing reform—the relative improvement of the housing of the agricultural laborer as against that of many small farmers, the implications of making the Union (followed by the county council) a landlord—are all described here. It is, however, the public health impact of this housing reform that engages the attention of the author: can the decline in infectious disease in late nineteenth-century Ireland—TB being the exception—be linked to the improvements in sanitation and housing? To some extent it probably can, but there are still unresolved questions. Dublin's record in reducing mortality from the fevers in the late nineteenth century was not as good as that of other cities in the British Isles, and there were occasional but significant outbreaks of fever (typhus and smallpox). What housing improvements there were in rural [End Page 736] and suburban areas of the county of Dublin were not matched by improvements in urban housing.

Cullen points to two other engines of improvement brought about by the legislation: sanitary reform led to a greater public awareness of hygiene, and, in addition, created an expanded staff of sanitarians seriously committed to public health reform. However, he also notes the slowness and ineffectiveness of some projects. The effects of democratization on public health, and the related question of whether the values of the sanitary professional were shared to the same extent by the ordinary serving member of the poor-law board or county council, are not discussed.

Nonetheless, the case studies assembled by the author provide a detailed description of how sanitary improvement...

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