A Century of Service - Eoin O'Brien

The Voluntary Hospital Movement and the Dublin School
Other methods of inducing counter-irritation included the use of rubefacients (such
as linaments or mustard poultices), setons (the placing of silk thread under the skin
to maintain a free discharge from an incision), moxas (a most painful technique
whereby an impregnated wick was allowed to burn slowly down to the skin to
produce a sore), pustulants (the application of croton oil or nitrate of silver to induce
an infected sore on the skin), and issues (the production of chronic suppuration by
placing a pea in a sore induced by caustic potash). 44 The most popular methods of
counter-irritation were dry-cupping and blistering, whereas the one causing the least
pain and injury was the method described by Corrigan in which a small flat iron
was heated and applied to the skin until redness was produced; the instrument used
for this form of counter-irritation was known as “Corrigan’s button” 45 and was
popular until the early part of the twentieth century. 46 Other antiphlogistic measures
consisted of blistering, purging with laxatives or emetics sometimes given to
maintain a state of continuous nausea, and finally starvation. 48
The drugs available were few and their actions poorly understood. Digoxin,
morphine and quinine, which are still in clinical use, were available in the nineteenth
century, but so also were strychnine and mercury, and there is evidence that all were
used to excess. 49 Doctors had not yet considered the concept of assessing the efficacy
of treatment by controlled studies.
Robert Graves
It was from this state of medical practice that the “Dublin school” was to arise. Is it
possible for us from this distance in time to detect its origins? A surprising feature
of the school is that its appearance was anticipated. Erinensis wrote of the beginnings
of a school as early as 1827. 50 He castigated the College of Physicians and the
University School of Physic for failing to establish a “national school of medicine”
by the joining together of medical and surgical interests. However, on reflection, he
despaired of any good coming from this ideal:
Scarcely less ridiculous is the idea of assisting by the new regulations the progress of
Dublin into a great school of medicine, with which they have at least been associated in
conversation. If by a multitude of pupils, cheap licences obtained without qualifications,
dear pathology and consequent ignorance, it is meant to establish a great school of
medicine, then, indeed, these measures are admirably adapted to produce such a happy
combination of circumstances; but such a great school would undoubtedly be, like a
great book, a very great evil. Dublin possesses some reputation in medical science; but
if it be contemplated to extend its fame, by converting it into a mart for the sale of
diplomas, like London and Edinburgh, then let Dublin remain as it is at present.
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