Dearth, diet, and disease in Ireland, 1850: a case study of nutritional deficiency.

DEATH and disease are no strangers to underdeveloped economies. At best, nutritional standards are poor: diets are inadequate in calories, protein, and vitamins. At worst, adverse weather conditions or pestilence or war can devastate the main food supply causing famine, disease, and death. These scourges are still familiar in Asia and Africa; in the western world such disasters have faded into the annals of time. Ireland experienced one of the last major famines to occur in Western Europe. Between 1845 and 1849, the potato crop failed three times, leaving about three million people destitute. In these years, both infectious diseases such as typhus, relapsing fever, and dysentery, and nutritional deficiency diseases were rife. Yet little has been written about the nutritional and medical aspects of Ireland's Great Famine. There is one very old study of scurvy in Ireland written at the time of the Great Famine,2 and a more recent general investigation of diseases prevalent during the Famine,3 but little else. This paper focuses attention on one particular nutritional deficiency disease xerophthalmia. Xerophthalmia is an eye disease caused by lack of vitamin A, and manifest by dryness and ulceration of the cornea. In the first half of the nineteenth century, famines occurred in Ireland frequently. "In the three decades before the great famine one in every three years saw serious famine in some part of the country."' Intense distress was suffered in 1817, 1822, 1831, 1835-37, 1839, and 1842, culminating in the Great Famine. All these famines were caused by the failure of the potato crop, and in the case of the 1845-49 crisis a fungus disease, phytophthora infestans, more commonly referred to as potato blight, was the culprit. Since the potato was the main food, indeed often the only food, in the diet of the Irish labourers during the early decades of the nineteenth century, the effect of this pestilence was catastrophic for one-third of the population. The course of the Great Famine has been well documented. The potato failure was only partial in 1845,5 but the destruction of the crop was general and more widespread