physicians were of the priestly or Druidic caste, their
traditions being handed down orally from remote
antiquity. In many Irish and Welsh tales, Druids appear
as healers. The Druid physicians, called liaig
(2) or, if they were women,
banliaig, were greatly skilled in surgery,
trephination (opening the skull to reduce pressure or
remove brain lesions) and amputations. They also healed
through herbs, healing stones, medicated baths, sweat
houses and thousands of secret verbal charms passed
orally down through the ages. Centuries before the
traditional stethoscope was invented, they used a horn
for assessing the heart beat. Every Irish chieftain was
accompanied into battle by his personal liaig,
and not a few owed their lives - following near-fatal
spear or sword injuries - to the skills of their Druid
physicians (Berresford Ellis 1995: 213-214).
BC, King Nuadr, the leader of the Tuatha de Danaan, lost his hand at the
First Battle of Moytura (Mag Tuired) against the Firbolgs. He
was given a silver replacement made by the silversmith Credne
Ceard under the direction of Dian Cécht, who was believed to be
the Irish god of healing (Fleetwood 1983: 2).
(3) Dian Cécht’s daughter, Airmid,
was equally renowned for her prowess as a physician and is
credited with identifying over three hundred healing herbs. His
son, Miach, was reputed to be a better physician than his
father, so much so that Dian Cécht slew his son in a fit of
jealousy (Berresford Ellis 1995: 213).
times little provision was made for the treatment of those who
were sick and poor. Even in ancient Greece, the seat of
democracy, there was no system of medicine and healthcare that
was available to all, regardless of their position in society.
In most European societies at the time the wealthy and powerful
had their own physicians while the sick poor and elderly were
often put to death as the ultimate solution to their ills.
hospital in Europe was founded by the Roman matron Saint Fabiola who died in 399 AD, near
Rome as a hospice for the sick poor (Berresford Ellis 1995:
214). However, according to legend, the first hospital in
Ireland was founded six centuries earlier, when Queen Macha Mong
Ruadh (who died 377 BC) established a hospital called Broin
Bherg (the House of Sorrow) at Emain Macha (Navan).
Certainly, by the Christian period there were hospitals all over
Ireland, many of which were leper houses, often in the
monasteries that sprang up all over the island (Berresford Ellis
Under the Brehon
laws, the code of great antiquity now recognised as the most
advanced system of jurisprudence in the ancient world, medicine
began to be formalised into a sophisticated system. There were
free hospitals for the sick poor, maintained free of taxation,
with compensation for those whose conditions worsened through
medical negligence or ignorance. Medical treatment and
nourishing food was made available for everyone who needed it,
and the dependents of the sick or injured were maintained by
society until he or she recovered. Each physician was required
by law to maintain and train four medical students and
unqualified physicians were prohibited from practicing. It was
also seen to be important that physicians had time to study or
travel so that they might acquaint themselves with new
techniques and knowledge, and that the clans to which they were
attached made provisions for this. Under the Brehon laws, women
were also eligible to be physicians (Bryant 1923).
The period from
the fifth century until the coming of the Normans in the twelfth
century was, in effect, the Golden Age of ancient Gaelic
medicine, as noble Irish families surrounded themselves with
entourages of learned men, including physicians. Every Irish
lord had his own physician. Physicians, like poets, historians
and musicians, had a high status in Gaelic Ireland, the highest
position being ollamh leighis, or official physician to a
king, chieftain or Irish lord. They were awarded hereditary
tenure of lands for the medical services they rendered. Medicine
was the preserve of a select number of families, father passing
his medical knowledge to son and sometimes to daughter or
kinsman, forming renowned families of hereditary physicians (Nic
Dhonnchada 2000: 217-220).
Phlebotomical Chart from an Irish manuscript,
in antient Erin,
London: Burroughs Wellcome, 1909)
Royal College of Surgeons in Ireland
Among the famed
medical families were the Ó Caisides (Cassidys) and Ó Siadhails
(Shiels) of Ulster, Ó hÍceadhas (Hickeys) and the Ó Lees of
Connaught, and the Ó Callanains (Callanans) of
Munster, to name just a few.
Their medical schools, such as that of Tuaim Brecain (Tomregain
in County Cavan) founded in the sixth
century, Aghmacart (in County
Laois), and the medical schools
at Clonmacnoise, Cashel, Portumna, Clonard and Armagh were famed throughout
Europe. (4) Famed
hereditary physicians in Scotland, like the MacBeathas, or
Beatons, who provided medical services to generations of
Scottish kings, originated in Ireland, and Scottish students
studied at the medical school at Aghmacart (Mitchell: 2008).
One of main
functions of the ancient Irish medical schools was the writing
and translation of medical texts into Irish, such as Galen’s
commentary on the Aphorisms of Hippocrates translated
into Irish in 1403 by the Munster medical scholars, Aonghus Ó
Callanáin and Niocól Ó hÍceadha. (5)
A vast body of medical texts exists, written in Irish or
translated from Latin into Irish. Some were of Arabic origin,
thus making available to Irish physicians a wealth of new
medical knowledge and techniques influential in new schools of
Arabic medicine in Europe. These works, together with the books
of the old medical families written in Irish and handed down to
succeeding generations, such as the Book of the O’Lees,
compiled in 1443; The Lily of Irish Medicine, compiled by
the O’Hickeys, physicians to the O’Briens of Thomond, compiled
in 1352; (6) Book of the O’Shiels,
hereditary physicians to the MacMahons of Oriel, and the many
manuscripts written by the O’Cassidys, physicians to the
chieftains of Fermanagh, constitute the largest collection of
medical manuscript literature, prior to 1800, existing in any
one language (Nic Dhonnchadha 2000: 217-220).
were famed throughout Europe and had connections to the great
European medical schools of the time, such as those of Louvain,
Bologna and Padua, forging links
between Continental Europe and Ireland (Dunlevy 1952: 15). The
ancient Irish medical schools existed from before the tenth
century to the end of the sixteenth, when an Irish medical
education and a continental one were regarded as equal. The
Flight of the Earls in 1607 after the Battle of Kinsale marked
the decline of the old Gaelic tradition. Along with the Brehon
laws and the Irish intelligentsia, the medical schools of the
ancient medical families of Ireland were abolished under English
rule, and many of the Gaelic-speaking Irish physicians were
forced to migrate to Europe where they were held in high regard.
Formal Medical and Surgical Education in Ireland to 1900
From the Middle
Ages, medical practitioners in Europe organised themselves
professionally in a pyramid with physicians at the top and
surgeons and apothecaries nearer the base, with
non-medically-trained healers, vilified as ‘quacks’, on the
periphery (Porter 1998: 11). The sick, especially the sick poor,
were treated in monasteries. Surgery, or ‘surgerie’,
bloodletting and the extraction of teeth was delegated to the
monastery lay servants, the barbitonsores, who attended
to the tonsures, involving as it did the shedding of blood.
Thus, surgeons became part of the medieval guild of
barber-surgeons, whose emblem was the red and white pole still
seen outside barber shops today. Only surgeons belonging to the
guild had a right to practice (Widdess 1989: 3).
education in Ireland dates from 18 October 1446 when the Guild
of St Mary Magdalene, to which the Dublin barber-surgeons
belonged, was established by charter of Henry VI, and was the
first medical corporation in Great Britain and Ireland to
receive a royal charter. (7) The
second charter of the barber-surgeons guild in Ireland was
granted by Elizabeth I in 1577. In 1687 the third charter of the
Dublin barber-surgeons was granted by James II, in which
barbers, surgeons, apothecaries and wig-makers were united. Many
surgeons in Dublin, however, did not wish to associate
themselves with barbers. Finally, in 1704, surgeons who were
independent of the barber-surgeons guild called upon the Irish
parliament to separate surgeons from barbers, and apothecaries
from wig-makers. In 1721 the independent surgeons of Dublin
formed a society of their own. The apothecaries were
incorporated separately as the Guild of St Luke by charter of
George II in 1745 (Widdess 1984: 4-5).
eighteenth and early nineteenth centuries, physicians and
surgeons were educated separately, surgeons being considered of
lower medical and social status than physicians who belonged not
to a guild, but to a fraternity. The Fraternity of Physicians
was formed in Dublin in 1654, and later incorporated into the
Physicians of Ireland.
University medical school was established in 1711. However, few
medical degrees were conferred for the first thirty years of its
existence and only medicine, or ‘physick’, was taught, no
provision being made for the study of surgery.
In 1745 the
Lying-in Hospital (now called
the Rotunda Hospital) was opened. At the time midwifery was regarded by physicians as a
degrading occupation which was practiced by surgeons who bore
the title ‘surgeon and man-midwife’. The same year, a hospital
was founded for the mentally ill, St. Patrick’s Hospital, by the
will of Jonathan Swift, Dean of the St. Patrick’s Cathedral in
Dublin and author of Gulliver’s Travels, who left his
entire estate for that purpose (Widdess 1984:158).
(8) Among the hospitals to emerge in
Dublin in the nineteenth
century were the Fever Hospital
in 1804, Sir Patrick Dun’s and St. Vincent’s in 1834 and the
Misericordiae founded by Catholic nuns in 1861. Also established
were a number of new maternity and children’s hospitals, small
hospitals for the diseases of the skin, and the Adelaide
Hospital with its Protestant charter (Lyons 2000: 63).
there was no systematic training of surgeons except by
apprenticeship. This was a form of indenture for an agreed
number of years, normally from five to seven, the quality of
which depended on the knowledge of the master, the degree to
which he was willing to impart his knowledge and the degree to
which the apprentice was willing to apply himself. There were no
examinations or curricula of required courses. The apprentice
was not paid during the years of his apprenticeship, but was
required to pay a fee to his master who, in turn, provided him
with lodging, usually in his own house, food and clothing.
Sometimes sons were apprenticed to their own fathers, as was the
renowned Dublin ophthalmologist of the nineteenth century,
Arthur Jacob. (9)
anatomy and other allied subjects in this period was haphazard
or non-existent. Anaesthetics were unknown. If a patient
survived a surgical procedure, his or her wound was in danger of
becoming infected, and death from septicaemia often resulted.
Surgery was confined to amputations, removing exterior tumours,
extracting teeth and blood-letting. Little invasive surgery,
except the extraction of bullets and kidney stones, was
attempted, since death from septicaemia was almost always
Royal College of Surgeons in Ireland circa
1830, by W. H. Bartlett
(Wright, G. N., Ireland Illustrated, London: Fisher,
Son & Jackson, 1833)
In 1780 the
Dublin Society of Surgeons was formed, having finally broken
away from the barber-surgeons guild to which Catholic Irish had
been refused membership (Widdess 1989: 2). On 11 February 1784,
it received its royal charter, and the Royal College of Surgeons
in Ireland was founded under its first president, Sylvester
In its early
years the Royal College of Surgeons granted two kinds of
diplomas: the Letters Testimonial or Licence, and surgeoncies to
the army, of which there were two grades: surgeons and surgeons’
assistants. Later, in 1797, examinations for naval surgeons were
instituted. It can be claimed that one of the chief motives for
the foundation of the Royal College of Surgeons in Ireland was
to provide surgeons for the British army or navy, a purpose
which was, in fact, expressed in the original Charter (Widdess
1989: 50). Apprenticeship, by which a student was apprenticed to
a member of the College, was a requirement until 1828, after
which it became optional, and ultimately was abolished in 1844 (Widdess
from the Royal College of Surgeons who wished to further his
medical education had to take a post-graduate diploma in
Medicine by going abroad to Europe or to
Edinburgh or London, for it was not until 1886 that a joint
diploma of the Irish Colleges of Physicians and Surgeons was
From 1804 on, in
the time of the Napoleonic Wars, some seventeen privately-owned
medical schools in Ireland were founded to meet the demand for
medically-trained men. At most of these establishments
facilities for teaching were minimal and in the absence of
conventional dissecting and lecture rooms, stables were used.
Many of the schools existed only for a short time, the need for
surgeons for Wellington’s army diminishing at the end of the
Napoleonic Wars (Widdess 1989: 101).
For all students
of medicine or surgery, knowledge of anatomy was deemed the font
of medical knowledge and this knowledge was acquired through
dissection of human corpses. Following hangings, bodies of
criminals would be carted straight to the dissecting rooms of
medical schools, normally by a back entrance. Despite the high
crime rate in Dublin, there were not sufficient bodies to
satisfy the demand, and a brisk trade in grave-robbing emerged.
The grave-robbers, or ‘resurrection men’, working at night at
burial grounds of the poor and destitute, dragged the
recently-buried corpses from smashed coffins, removed the grave
clothes which they replaced in the empty coffin and put the body
in a sack for delivery to the designated medical school.
(11) Soon the ‘resurrection men’
were supplying the medical schools in London and Edinburgh with
bodies illegally exported in crates as ‘Pianos’ or ‘Books’ (Widdess
1989: 34-38). With the passing of the Anatomy Act in Britain in
1832, permitting the medical profession access to ‘unclaimed
bodies’ - in effect, the poor and destitute without families who
died in workhouses -, grave-robbing came to an end (Porter 1998:
The Académie Royale de Chirurgie, Paris
education in Ireland was influenced by medical institutions in
France, one of which, the famed Académie Royale de Chirurgie
in Paris, was founded by the son of an Irishman. Georges
Mareschal was born in
1658. His father, John Marshall, was an Irish émigré who arrived
in France in the mid-seventeenth century serving as an officer
in a cavalry regiment until his sword arm was amputated
following a serious wound. Orphaned at twelve years of age,
Georges Mareschal was befriended by a local barber-surgeon which
decided his future career. In 1677 he entered the Collège de
St. Cosmé in Paris, the first College of Surgeons in Europe,
which had been in existence since 1255. His skill as a surgeon
was quickly recognised and he became first surgeon to Louis XIV.
Under Louis XV, the Académie Royale de Chirurgie was
founded, becoming the prototype for all future surgical
colleges, including the Royal College of Surgeons in Ireland,
with Georges Mareschal as its first President (Widdess 1989:
12-13). One of its future graduates was Michael O’Gorman who
became the one and only protomédico of the Viceroyalty of
the Río de la Plata and the father of modern medicine in
Catholic University Medical School
In 1845, under
the administration of Robert Peel during the reign of Queen
Victoria, the Queen’s colleges were founded in Cork, Galway and
Belfast with view to placing higher education on a secular
basis. They were known throughout Ireland as ‘the Godless
colleges’. The Catholic hierarchy viewed such a system as
dangerous to faith and morals and held that Ireland’s future
doctors should have access to a medical education in a Catholic
medical school and not be compelled to enter non-denominational
schools or study abroad. Despite the fact that the founder of
the Royal College of Surgeons, Sylvester O’Hallaran, was
Catholic, as well as eleven of its presidents, by far the
majority of the licentiates, judging by their names, were
Protestant. The only way to obtain a medical degree in Ireland
was from Trinity
College which until 1793 discriminated against Catholics. When
Catholics were admitted in 1845, they were not eligible for
In 1854 the
medical school of the Apothecaries’ Hall in
Dublin was purchased in the name
of Andrew Ellis, a licentiate and fellow of the Royal College of
Surgeons - and a Catholic. Thus, the Catholic
School was founded with John Henry Newman, an Englishman and a recent convert
to Catholicism, as rector. Smaller than the medical faculties of
each of the Queen’s Colleges in 1880, by 1900 the
School outperformed all other Irish medical schools, even
College and the Royal College of Surgeons, to become the largest medical school
in Ireland. It was
eventually incorporated into University College Dublin when the
National University was founded in 1909 (Froggatt 1999: 60-90).
reputed to be the second city of medical importance in the then
British Empire, second only to Edinburgh. The reign of Victoria
marked the Golden Age of medicine in Ireland. Physicians and
surgeons such as Abraham Colles (1773-1840), Robert Adams
(1791-1875), Arthur Jacob (1790-1874), John Cheyne (1777-1836),
William Stokes (1763-1845), Robert Graves (1796-1853) and Sir
William Wilde (1815-1876) were pioneers in their fields, giving
their names to symptoms and diseases such as Stokes-Adams
syndrome, Graves’ disease, Jacob’s membrane, Colles’ fascia and
Cheyne-Stokes respiration (Lyons 2000: 63-7).
The Royal College of Surgeons in Ireland
(Susan Wilkinson, 2000)
There were, until
the latter years of the twentieth century, Catholic hospitals
and Protestant hospitals where the medical and nursing staffs
were of one religion or the other, just as schools and
universities were separated along religious lines. Happily, that
situation has ended as Ireland has moved towards secularisation
in medicine and education. In recent years Ireland has been
enriched by the mingling of many diverse cultures, philosophies
and religions. Nowhere is this internationalism more strongly
reflected than in its medical schools where more than half the
student body is from abroad, both from developing and developed
countries. These schools have formed links with many countries
of the world in medical training.
Many of the
graduates from the Royal College of Surgeons in Ireland and
College were surgeons of renown in the armies that fought for South American
Independence. In their own way they contributed to the birth of
the new republics now forming
Latin America. Still more,
throughout the nineteenth century, offered their expertise to
the new republics of Latin America, some preferring to practice
in small towns and communities where doctors were desperately
needed, while others attained renown in cities. Many of the
early boticas, or pharmacies, were established by men
such as the Carlow-born brothers Edmund and William Cranwell,
who had studied at the famed Apothecaries’ Hall in Dublin.
Others, like the nineteenth-century physician Robert S.D. Lyons,
who obtained his medical education at the Catholic
School, also in Dublin, risked their
lives in the study of epidemics like yellow fever that
periodically ravaged Iberia, Latin America and the Caribbean. All formed a valued and respected part of the medical community at
large, giving their knowledge gained in
or Continental Europe to the benefit of their adopted countries.
the Irish doctors and pharmacists who, for various reasons, went
to Latin America and the Caribbean in the eighteenth and
nineteenth centuries, present-day physicians in the region and
the hospitals and academies that Irish physicians helped to
found can rank with their counterparts all over the world.
1 Without the help of Mary O’Doherty,
Medical Essayist and Senior Librarian (Special Collections and
Archives), of the Mercer Library at the Royal College of
Surgeons in Ireland, much of the research for this article could
not have been easily obtained, if at all. I wish to thank her
for her help and suggestions in writing this article and for the
insight she gave me into many of the Irish physicians and
surgeons, past and present, whose names are forever linked with
Ireland’s medical schools.
2 The word liaig means
‘leech’, an archaic term for a doctor or healer. The term is
often used for a Druidic doctor in ancient texts.
3 This is the earliest reference to
the fitting of an artificial limb in Western European
4 For a list of hereditary medical
families and the ancient Irish medical schools, see ‘Medical
Writing in Irish, 1400-1700’ by Aoibheann Nic Dhonnchadha,
Irish Journal of Medical Science, 169 (2000), pp. 217-20.
5 Trinity College Dublin MS 1318,
6 Practica seu Lilium medicinae,
comprising seven volumes of diseases of the body, was written by
the French physician Bernard of Gordon in 1305, and was one of
the best-known medical texts of the Middle Ages.
7 The barber-surgeons of London and
Edinburgh were not incorporated until some years later.
8 This was an entirely enlightened
approach to treating mental illness, as the norm at that time
was to incarcerate the mentally ill in lunatic asylums.
9 The Jacobs were a famous medical
Quaker family in Ireland for four generations. After his
apprenticeship, Dr Arthur Jacob, born in 1790, studied in
Paris before returning to Ireland where he eventually taught at
the Royal College of Surgeons.
10 Sylvester O’Halloran
(1728-1807), was a distinguished
surgeon and a Catholic, who studied at the Universities of
Leiden and Paris. He was one of the few Irish Catholics to reach
the top of the medical profession in eighteenth-century Ireland.
11 To steal a body was a
misdemeanour, while the theft of garments was a felony,
punishment for which was transportation or hanging.
Ellis, Peter. The Druids (Grand Rapids, Minnesota:
Eerdmans Publishing Company, 1995).
- Bryant, Sophie.
Liberty and Law Under Native Irish Rule
(London: Harding & More Ltd., 1923).
- Coakley, Davis
and Mary O’Doherty (eds.). Borderlands: Essays in Literature
and Medicine in honour of J.B. Lyons (Dublin: Royal College
of Surgeons in Ireland, 2000).
- Doran, Beatrice
M. ‘Reflections on Irish medical writing (1600-1900)’ in Davis
Coakley and Mary O’Doherty (eds.) Borderlands: Essays on
Literature and Medicine in honour of J.B. Lyons (Dublin:
Royal College of Surgeons, 2002).
- Dunlevy, M.
‘The Medical Families of Mediaeval Ireland’ in Doolin, William
and Oliver Fitzgerald (eds.) What’s Past is Prologue: A
Retrospect of Irish Medicine (Dublin: Monument Press, 1952).
- Fleetwood, John
F. The History of Medicine in
(Dublin: The Skellig Press, 1983).
- Froggatt, Sir
Peter. ‘Competing Philosophies: The ‘reparatory’ Medical Schools
of the Royal Belfast Academical Institution and the Catholic
University of Ireland, 1835-1909’ in Greta Jones and Elizabeth
Malcolm (eds.) Medicine, Disease and the State in
(Cork: Cork University Press, 1999).
- Lyons, J. B.
(ed.). 2000 Years of Irish Medicine (Dublin: Eirinn
Healthcare Publications, 2000).
- Lyons, J. B.
Brief Lives of Irish Doctors (Dublin: The Blackwater Press,
- Medicine in Ancient
(London: Burroughs Wellcome & Co., 1909). Royal College of
Surgeons in Ireland archives.
- Mitchell, Dr
Ross, Celtic Medicine in Scotland, available online
9 September 2008.
- Nic Donnchadha,
Aoibheann. ‘Medical Writing in Irish, 1400-1700’ in Irish
Journal of Medical Science, Vol. 169 (2000).
- Nic Donnchadha,
Aoibheann. ‘Medical Writing in Irish’ in J. B. Lyons (ed.)
2000 Years of Irish Medicine (Dublin: Eirinn Healthcare
- Porter, Roy.
The Greatest Benefit to Mankind (New York: W. W. Norton,
J. D. H. The
College of Surgeons in Ireland and its Medical School, 1784-1984
(Dublin: Royal College of Surgeons in Ireland, Publications
Department, 1984). 3rd Ed.