by Eugenie Scott, Ulster University
Until the mid-nineteenth century, Belfast was a small market town. However, from the 1840s factories and mills sprang up. The growing town soon became known for its linen industry and shipbuilding. At the time, many British doctors blamed industrialisation for the spread of non-infectious diseases including cancer. Often, their writings provided a commentary on rapidly changing social conditions as well as medical diagnosis. Many believed that incidences of some diseases were on the rise in ‘civilised’ (or industrialised) towns where inhabitants had departed from ‘natural’ ways of living. The environments, diets and fast pace of living introduced by urbanisation and industrialisation was responsible for creating a host of medical issues: the so-called ‘diseases of civilisation’.
Nineteenth-century doctors often linked cancer to civilisation, imagining that it was caused by the rush and whirl of modern life, which somehow incited pathological growth in the body. British cancer expert William Rodger Williams perceived a connection between progress and cancer. In 1894, he commented: ‘Cancer mortality has coincided with progressive population, increased national wealth and marked improvement in the general well-being.’ Williams feared that industrialisation had been a great environmental change that upset the balance of the human body. He further remarked that ‘Ireland, the only part of the United Kingdom that has during the last half-century remained comparatively un-progressive, is also the only part in which there has been no great increase of the cancer mortality’. Cancer rates might well have been comparatively low in Ireland but there was an exception to this rule: industrial Belfast.
Smoky emissions filled Belfast’s streets, fuelled on coal, the common energy source of the day used for running factories and machines. Factories produced a contaminated environment of thick black smoke which polluted the air and harmed the population’s health. Working conditions in Belfast’s linen industry involved long hours in hot, damp and overcrowded factories lacking fresh air. Workers were exposed to the omnipresence of dust. In consequence, ill-health, particularly tuberculosis and bronchitis, was widespread among mill workers. Greta Jones argues that ‘it is possible that some bronchitis, emphysema and lung cancer were diagnosed as tuberculosis and vice versa.’
Image: Sarcoma of the Upper Face Bone. Andrew Charles, Cancer, A Handbook for the Lay Reader (Dublin: Society for the Prevention and Relief of Cancer Ireland, 1922). Image courtesy of the National Library of Ireland.
Cancer in the Hospitals
Where was cancer treated? With various dispensaries throughout the city, Belfast has been described as having ‘a very efficient health service’ in the Victorian era. A cancer sufferer in the 1830s might have visited the Belfast General Dispensary on Frederick Street, a three-storey high building with two windows at the front situated down a narrow street in a busy part of town. They would have waited to be seen by a doctor in either the kitchen, a back room or the stairs. The Dispensary was said to have a good supply of delicate and expensive medicines such as morphine, then used to alleviate the pain of cancer.
With limited knowledge of how to treat cancer, hospitals were reluctant to occupy beds with patients deemed incurable. Those with chronic diseases received less help because general hospitals, as they became more sophisticated and curative, began to deny access to ‘chronics’ on the grounds that medicine could do little for them. Beds were usually reserved for those who might benefit from medical treatment.
Surgery has been described as ‘the earliest therapy established for cancer.’ The use of the knife for cancer treatment increased during the course of the eighteenth century. However, many physicians saw surgery as an ineffectual procedure unlikely to bring permanent cure. Without a safe and effective anaesthesia until the 1840s, the pain involved would have been intolerable. Cancer sufferers were known to steer away from the knife as long as possible unless their torment had become unbearable.
As the efficacy of pain relief gradually improved, surgeons were able to operate for extended periods of time and perform more intrusive surgeries. Chloroform was first used as an anaesthetic in Belfast General Hospital in 1850. From mid-century, demands grew for a hospital in which it was safe to perform surgery without the risk of contracting infectious diseases from other patients. From hereon, fever was no longer treated at the hospital, enabling surgery in the Belfast General Hospital to grow and develop. Between 1859 and 1862, thirteen successful cases of excision of the breast were recorded along with six operations for the cancer treatment in 1869.
Image: A Fifty-Year-Old Irish Labourer who was Admitted to Mercer’s Hospital for the Removal of a Large Tumour from the Back of the Neck. E. Stamer O’Grady, Notes of Surgical Cases (Dublin: John Falconer, 1875). Image courtesy of the National Library of Ireland.
The Belfast workhouse opened in 1841 on Lisburn Road (where City Hospital stands today). Initially intended for use by the destitute poor, workhouses became important places of medical relief. The services available would have been of little aid to the cancer patient but might have at least provided accommodation, food and basic care. The workhouse differed from voluntary hospitals as it really had to take in all who appeared at the doors. Unsurprisingly, the workhouse was a place to which ‘cases of recurrent, incurable and ‘inaccessible’ cancer were prone to gravitate’. Census statistics similarly suggest that far higher numbers of cancer patients could be found in workhouses rather than hospitals, and that the intake of cancer cases rose throughout the century. Between 1851 and 1861, nineteen cancer sufferers were boarded in the Belfast workhouse. This greatly increased in the next decade. Between 1861 and 1871, eighty-one deaths logged as cancer occurred in the Belfast workhouse.
Folk Cures and Remedies
Alongside orthodox medicine existed a tradition of folk cures and remedies still used in nineteenth-century Ulster. It is plausible that cancer patients consulted a mixture of orthodox and non-orthodox physicians in the hope of being cured, all of which would have been entirely ineffective in curing cancer, although they might have provided comfort and relief from pain. However, these would have been appealing with no other option available, made sense according to non-orthodox medical theories and traditions and at least provided some degree of comfort in the absence of a cure.
Belfast was said to have its own cancer healer: Dr Broom. In an adverts in the Belfast Telegraph, Broom wrote: ‘The very remarkable cures of cancer and sores, or diseases of every kind which have been performed by Dr Broom in Belfast and its vicinity, and through the greater part of Ireland, can be disputed by no person whose eyes are open to conviction’. Another advert described Broom as ‘perhaps the only gentleman known, who has performed the cure of cancer, without any operation or sufferings to the patient. The cure is performed by medicine, which is so very safe. Patients in the very last stage of the disease…may be completely cured.’ Medical advertising claims of this nature had been commonly published in newspapers since the early eighteenth century for a range of ailments. These notices were often nothing more than attempts by frauds with no legitimate medical expertise offering false promise for their own financial gain.
Image: Sixty-Year-Old Widow who was Admitted to Mercers Hospital for a Large Tumour Located on her Face and Neck. E. Stamer O’Grady, Notes of Surgical Cases (Dublin: John Falconer, 1875). Image courtesy of the National Library of Ireland.
Overall, options available for cancer patients usually involved the workhouse where they lived out their final months or years with the most basic medical aid, if any. Alternatively, some would have been nursed by family and friends or turned to quack doctors such as Broom. While Dr Broom’s existence is questionable, irregular medicine was commonplace in the nineteenth century medical marketplace and it is likely that such therapies were offered in Belfast. A cancer specific hospital was not established in either Belfast or the province of Ulster, until the opening of the Thompson House Hospital in Lisburn, just outside Belfast, in 1885. The hospital was purpose-built specifically for incurables and included a spacious cancer ward. The facility was founded by a local family, the Thompsons, who had compassion for those living in poverty with conditions with no hope of cure. The hospital is still open today however and is now used for nursing brain injuries.
© The Author(s) 2021. Published by the Epidemic Belfast team on behalf of Ulster University.
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 Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer (New York: Scribner, 2011), p. 44.
 William Rodger Williams, A Monograph on Diseases of the Breast (London: John Bale, 1894), p. 282.
 Peter Thorsheim, Inventing Pollution: Coal, Smoke, and Culture in Britain since 1800 (Athens, OH: Ohio University Press, 2006), p. 193.
 David Lyons Armstrong, ‘Social and Economic Conditions in the Belfast Linen Industry, 1850-1900,’ Irish Historical Studies, 7: 28 (September 1951), p. 245.
 Greta Jones, ‘Captain of All These Men of Death’: The History of Tuberculosis in Nineteenth and Twentieth Century Ireland (Amsterdam: Rodopi, 2001), p. 69.
 David H. Craig, ‘A History of the Belfast City Hospital’, Ulster Medical Journal, 43:1 (1974), pp. 1-14.
 Royal Commission on the Condition of the Poorer Classes in Ireland, First Report, Appendix (A), Supplement; Appendix (B), Medical Relief, Dispensaries, Fever Hospitals, Lunatic Asylums; Supplement, Parts I. and II. (Appendix B) House of Lords, Vol. 6, 1836, p. 200.
 George Weisz, Chronic Disease in the Twentieth Century: A History, (Baltimore, MD: John Hopkins University Press, 2014), p. 7.
 For a recent overview of cancer treatment, see Agnes Arnold-Forster, The Cancer Problem: Malignancy in Nineteenth-Century Britain (Oxford: Oxford University Press, 2020).
 Craig, ‘History of Belfast City Hospital’.
 Sixth Report of the Medical Officer of the Privy Council, House of Lords, 1864, p. 705; O’Sullivan, ‘Short History of the Treatment of Cancer’.
 Richard S. Clarke, ‘From Factory Row to the Grosvenor Road,’ Ulster Medical Journal, 67 (June 1998), pp. 8-11.
 Arthur Newsholme, ‘The Question of the Increase of Cancer’, British Medical Journal, i:1725 (1894), pp. 161-162.
 The Census of Ireland for the Year 1861, Part III: Vital Statistics. Vol II: Report and Tables Relating to Deaths, p. 99.
The Census of Ireland for the Year 1871. Part II. Vital Statistics. Vol. II. Report and Tables relating to Deaths, p. 147.
 Belfast Newsletter, 8 March 1833.
 Belfast Newsletter, 26 October 1827.
 Louise Penner, Victorian Medicine and Popular Culture (London: Routledge, 2016), 12.