Through the Archives: Community Doctors of the Past
In the final post in this series, Simone Doyle, a student on UCD's MA in History of Welfare & Medicine in Society, explores the career of Dr Neil John Blayney (1874-1919) using the archival material in our collections. You can read the previous post in this series here.
Doctors in Obscurity
Several notable figures tend to dominate our discussions of doctors in the past – Hippocrates, Joseph Lister, Louis Pasteur, John Snow. In Ireland, Francis Rynd (inventor of the hypodermic syringe), and fellow Wexford man, Arthur Leared (inventor of the binaural stethoscope), are arguably our most famous medical men. But what of the lives of the less prominent doctors who served their communities, counties, and country, upheld their Hippocratic oath and were respected members of the medical community? Thanks to material donated to the archives of the Royal College of Physicians of Ireland (RCPI), as well as the work of academics and students studying the history of medicine, and avid amateur historians, many formerly forgotten members of the medical profession are now being rescued from obscurity and having their stories told. This blog post will discuss one such doctor, Neil John Blayney (1874-1919), and his career in Maryborough County Infirmary, Queen’s County (now County Laois), made possible due largely to the archival material donated to the RCPI by his grandson, Neil Brennan.
|Dr Neil John Blayney (NJB/1/4)|
The County Infirmary
Maryborough County Infirmary was established in 1808. By 1836 it housed 868 patients, well above its original capacity of fifty-five. Maryborough was something of an institutional town as it comprised not only the Queen’s County Infirmary and dispensary but a district lunatic asylum (now St. Fintan’s Hospital) and a county gaol (now Portlaoise Prison) that contained eight prison wards (six for men, two for women), nine solitary cells and a prison infirmary.
Neil John Blayney (often referred to as “N J” in newspaper entries for the period) assumed the position of Surgeon and Physician in 1900, after working as the resident surgeon in the Mater Hospital in Dublin and the Mater Infirmorum, Belfast between 1897 and 1899. His appointment was complicated by a local conflict surrounding the previous Physician, a Dr David Jacob’s retirement and his replacement by his son, Dr W.G. Jacob. This appointment was challenged by the Infirmary management, and, after a lengthy campaign, W.G. Jacob was dismissed by the Queen’s County Board in October 1899 and replaced by Blayney. W.G. Jacob challenged this decision in the courts, with Blayney named as co-defendant in the proceedings that ran until 20 February 1900, after which he was confirmed as the surgeon and physician for the Infirmary. Blayney in 1904 described this situation as ‘a period of exceptional difficulty and excitement’.
References from his colleagues prior to his appointment in Maryborough are glowing: ‘he was remarkable for diligence, good conduct and ability’; ‘a highly qualified and competent surgeon … deserving of any position of public trust’; ‘he will, I am confident, be found eminently suitable and give entire satisfaction’. Blayney seems to have lived up to the reputation that preceded him. Father Connolly, a member of the Infirmary Board claimed that ‘nobody could be more attentive or successful than Dr Blayney…in his treatment of them’. At least one of his clients (Major J. Duffield) can be seen to concur, writing to personally thank Dr Blayney and his staff for their swiftness in dealing with ‘the child of a widow…in my charge … who contracted scarlatina … thus preventing the spread of the infection’. As a show of gratitude, Major Duffield donated funds towards the running of the Infirmary.
|Postcard of Queen's County Infirmary, Maryborough (NJB/1/4)|
“Body-snatching”, Suicide and Strychnine
Blayney’s position carried with it a slew of responsibilities, some similar to the work of a modern GP, along with additional duties more conventional for the time. Of the latter, there was his involvement in the training of Voluntary Aid Detachment Nurses during the First World War, giving classes for groups associated with the Irish Volunteers, Cumann na mBan and the Irish Red Cross, and his work on promoting information around the fight against tuberculosis (see below).
His more traditional responsibilities included being attendant to the last moments of many locals and people in surrounding areas, as documented in reports of coroners’ inquests. He assisted a workhouse doctor, Dr McCann in Mountmellick in attempting to save a farmer who had attempted suicide by ‘slicing his own throat’ according to news reports. He gave testimony in the case of Matthew Costigan, a man who died of apparent alcohol-related injuries whose body had been returned to the family by police without the Coroner’s permission, an action which could have resulted in imprisonment for the person blamed for wrongful removal.
Perhaps the most curious of these reports is that on the death of twenty-one-year-old Mary McEvoy. Mary, who had been in apparently good health, died with such suddenness that Dr Blayney at first suspected she may have been poisoned and suggested that the Coroner order a post mortem. At the inquest, however, Blayney changed his opinion, deciding that ‘the only poison could have been strychnine, and since then I have concluded that it could not have been strychnine’. Nevertheless, a post mortem was ordered, performed by Blayney and Dr W.G. Jacob, his one-time opponent. In the end, a brain haemorrhage was cited as the cause of Mary’s death.
Given Dr Blayney’s surgical background, it is no surprise that he was among those who advocated for the addition of a proper operating theatre to the infirmary. Management Committee reports reflect just how long and arduous this process was. The first request for funds from the public appear in 1905; by 1907, the probable cost of £200 had yet to be raised, and the theatre remained unsatisfactory (Blayney reportedly said he would ‘be ashamed to show the place to another surgeon’); and the final payment for the work on the theatre was made in April 1911.
Welcome Home Sanatorium
The late nineteenth century and early decades of the twentieth century saw a marked rise in tuberculosis cases. This epidemic had a higher mortality rate than that from other diseases at the time and was attributed to one in every 8.5 deaths in Ireland. The establishment of sanatoria in Germany in the mid-nineteenth century for the treatment of tuberculosis signalled the beginning of a movement of specialised sanatoria building worldwide in the late nineteenth and early twentieth centuries, which had migrated to Ireland by the 1890s.
By the time the Queen’s County Sanatorium opened in April 1911, Dr Blayney had already been very involved in providing the public with advice and information. In 1909, during a lecture he delivered at Maryborough, he impressed upon the attendees the dangers of spitting, how decaying teeth could leave people vulnerable to tuberculosis, and advised them to support new legislation around the inspection of dairies. It appears that immediately following the Sanatorium’s opening, Dr Blayney provided his services free of charge. However, by 1912, developments under the provisions of the Prevention of Tuberculosis (Ireland) Act required a full-time Superintendent to be appointed. At a meeting in June 1912, concerns were raised by the Infirmary Committee that it could not afford to pay a full-time doctor dedicated to the sanatorium at the suggested salary of between £300 and £500 per annum. The discussion also raised the question of whether or not Dr Blayney could be allowed to hold both his current role and that of Sanatorium Superintendent; Dr W.G. Jacob had been removed and replaced by Dr Blayney for holding multiple positions, and so it was felt that Dr Blayney would have to give up his private practice in order to be eligible to fill the role at the Sanatorium. The discussion concluded without any decision reportedly being reached. As shown in material in the RCPI Collection, Blayney continued his education in tuberculosis treatment throughout July of that year, attending multiple postgraduate lectures on the subject, including one organised by the Women’s National Health Association. Just four months later, in November 1912, Dr Blayney was officially appointed as the Superintendent of Queen’s County Sanatorium, running unopposed and voted in unanimously, making his recent postgraduate activities particularly timely. Unfortunately, his stewardship was cut short when the Sanatorium was destroyed by a fire later that month and never rebuilt.
|Opening of the Queen's County Sanatorium |
Career Conflicts – Local to National
Dr Blayney’s professional outlook seems to have been defined by two things – practical diligence and strong opinions. As a result, he was involved in his share of professional conflicts.
In 1908, a dispute was reported between Dr Blayney and other members of the Management Committee over the appointment of nurses. After the resignation of the two former infirmary nurses some months prior, an advertisement was published to fill the vacant positions. Dr Blayney had, without notifying the Board, changed the advertisement’s wording so that it required nurses to have ‘the necessary certificates, as directed by the Local Government Board’. When pressed on why this was necessary when many nurses in private institutions were able to practice without these certificates, Dr Blayney was reported to have said that ‘for the status and dignity of the institution, no nurse should be under the standard laid down by the local government boards’, and that if possible, he would prefer an even higher standard. The Committee Chairman in particular pushed back against this and argued that they should proceed to elect new nurses based on the previous, unaltered advertisement. Despite Dr Blayney’s protest, the election of new nurses was postponed, and the advertisement re-printed with his qualification clause removed.
A larger conflict emerged between Dr Blayney and some other doctors in the area – including Dr T. F. Higgins, the county Coroner, who was a rival applicant for the Medical Advisership position Dr Blayney eventually took up (under the Insurance Act of 1911) in July 1913. On 30 July, Higgins and ten other area doctors co-signed a letter expressing their dissatisfaction with Blayney taking up the post: ‘We express the strongest disapproval of … Dr. Blayney … accepting Medical Advisership … and we call on said doctor to resign, and failing to do so, we decline to have any medical consultations with these officials until they have resigned.’ This caused some severe issues for Dr Blayney – the doctors refused to send patients to the Infirmary, or to supply assistance to him on operations, leading to their cancellation. One patient, according to members of the Management Committee, was kept in hospital ‘and fasting’ for a week without being sent for operation because Dr Blayney could not get any of the doctors to assist him. The gravity of the matter was summed up by one of the Committee Members: ‘they have a grievance in legislation, and they want the poor, infirm and suffering people of the county to suffer by that’.
The biggest conflict of Dr Blayney’s career came in November 1903, when he resigned from the Queen’s County Branch of the Irish Medical Association. In a letter to Dr Dunne of the Queen’s County Medical Association, printed in the Leinster Express and elsewhere, Dr Blayney affected his resignation by harshly criticising the Association’s motives for demanding £200 per year for all dispensary medical men and four guineas a week for locums, claiming it showed an ‘evident tendency … by … the association to try and drag the dispensary system into the control of the Civil Service’. He further criticised the Association’s election policy for dispensary doctors, citing a case in Ballyroan in which of the two candidates who presented, only one was qualified for the position. He seemingly insinuated that this candidate was prevented by the Association from presenting himself and warned that if this were allowed to happen elsewhere ‘we would have medical men, appointed by the guardians more or less against their will, who might not be suitable to fill their position, nor might their election be approved of by the majority of the people’. Dr Blayney finished by saying:
It does not resound to the credit of … the association … when we find them trying to prevent the representatives of the people from exercising the authority vested in them.
The version published in the Leinster Leader was accompanied by commentary that suggests Dr Blayney’s letter was ‘bound to exercise a profound influence on the course of the medical controversy’. This certainly seems to have been the case, considering the level of backlash towards Dr Blayney from his colleagues.
In the 14 November issue of the Leinster Express, Dr Higgins criticised Blayney’s worries about dispensaries being put in control of the Civil Service by directly referencing his ascension to the position in Maryborough: ‘Under the civil service system, the best man should be appointed … according to merit. Is that objectionable to Dr Blayney? If so, it means that gratitude to those, who, under a different system, placed him in the County Infirmary, has prejudiced his mind.’
Blayney’s act of protest was dealt a further blow by a letter to the Irish Times from Secretary of the Irish Medical Association, Dr Thomas Gick (reprinted in the Express). The letter stated that despite Dr Higgins’ claim that he had been crucial in formulating the policies of the Queen’s County Branch, Dr Blayney had never actually been a member of the Irish Medical Association, and therefore ‘could not resign that which was not in his possession’.
This piece of information served to make for even more cutting responses. Dr L.F. Rowan laid into Dr Blayney with particular vitriol, criticising his ‘mental attitude’, calling his resignation from a position he did not hold a ‘rare psychological phenomenon’ and suggesting his letter contained ‘a profound degree of mental torpor or hibernation that almost disarms criticism’. Dr Rowan even went so far as to mock Blayney’s actions in quitting over policy for dispensary doctors: ‘It is a pity he is not a poor dispensary doctor, because he can never have opportunity of showing the faith that is in him by resigning himself.’
That Dr Blayney’s career and relationship with his colleagues, particularly Dr Higgins, continued to operate successfully after these clashes suggests that the assessment of Blayney by his peers, infirmary colleagues and patients as an upstanding and consummate professional was almost certainly an accurate one.
MA in History of Medicine & Welfare in Society, UCD
 Samuel Lewis, A Topographical Dictionary of Ireland (London, 1837), Accessed at: https://www.libraryireland.com/topog/M/Maryborough-East-Maryborough-Queens.php
 Lewis, A Topographical Dictionary of Ireland.
 Neil J. Brennan, Opening Dusty Boxes: The Life of a County Surgeon in Edwardian Ireland (Carrigtohill, 2019), 27-8.
 Nationalist and Leinster Times, 1 October 1904.
 M.A. Boyd to N.J. Blayney, 11 November 1898 (RCPI Archive - NJB/1/2/1); Charles Coppinger to N. J. Blayney, 20 November 1898 (RCPI Archive - NJB/1/2/1); Daniel McDonnell to N.J. Blayney, 30 November 1899 (RCPI Archive - NJB/1/2/1).
 Nationalist and Leinster Times, 1 October 1904.
 Leinster Express, 30 March 1912.
 Leinster Express, 2 June 1917; Brennan, Opening Dusty Boxes, 52.
 Westmeath Independent, 25 Nov 1911.
 Leinster Express, 27 April 1912.
 Leinster Express, 22 March 1902.
 Nationalist and Leinster Times, 28 October 1905; Leinster Express, 1 December 1907; Nationalist and Leinster Times, 1 April 1911.
 Alan Francis Carthy, The Treatment of Tuberculosis in Ireland from the 1890s to the 1970s: A Case Study of Medical Care in Leinster (PhD Thesis, National University of Ireland Maynooth, 2015), 1.
 Carthy, Treatment of Tuberculosis, 25, 49.
 Leinster Express, 2 February 1909.
 Leinster Express, 29 June 1912.
 RCPI Archive - NJB/1/4/3.
 Leinster Express, 9 November 1912.
 Leinster Express, 3 October 1908.
 Brennan, Opening Dusty Boxes, 44.
 Dr E.F. Hogan, Dr T.F. Higgins et al to N.J. Blayney, 30 July 1913 (RCPI Blayney Collection, Item 42).
 Leinster Express, 31 January 1914.
 Leinster Express 7 November 1903.
 Leinster Leader 7 November 1903.
 Leinster Express, 14 November, 1903.
 Leinster Express, 14 November 1903.
 Leinster Leader, 14 November 1903.
 Leinster Leader, 14 November 1903.
I would like to thank the following people:
Dr Catherine Cox for her support, kindness, and guidance throughout my studies. To Dr Elizabeth Mullins for inviting me to lecture sessions and talks relevant to my research. Mr Neil Brennan for his insightful talk about his grandfather Dr Blayney. To Ms Harriet Wheelock of RCPI for supplying me with the archival material. To Dr Alice Mauger for editing, notes and advice on the piece. And finally, to my partner and my mother for their constant support over the course of my studies.