James McDonnell

James McDonnell 1762-1845

The Founder of the Belfast Medical School

From a paper by Samuel Simms published in the Ulster Medical Journal 1932 vol1 p34.

The Belfast Medical School had its origin as a direct result of the well-laid plans of one James McDonnell, the son of the owner of a little property in the Antrim Glens, where he was born in 1762, about a quarter of a mile from Cushendall on the road to Red Bay.

In 1780 McDonnell's father died, and a few years later he proceeded to Edinburgh, then the medical Mecca of Great Britain, where he graduated in 1784. His thesis was "On the Drowned." He discussed the various methods then known of resuscitation, and suggested as a last resort, transfusion of blood. He then settled in Belfast, where he gradually built up a large practice. The population of the town was about 17,000, and there were about ten physicians in practice, chief of whom was Dr. Halliday, the friend of Lord Charlemont.

The last ten years of the eighteenth century in Belfast were years of crowded life, political and intellectual, and it was during this period that the philanthropy, the foresight, and the enthusiasm of McDonnell succeeded in laying the foundation of the Medical School by the establishment of the Belfast Dispensary. Previous to this the only medical relief in the town to the indigent was rendered by the Belfast Charitable Institution in Clifton Street, which, however, was limited in proportion to its means and accommodation. As a consequence, many of the poor received no medical treatment at all, and to remedy this was the aim of the founders of the Dispensary. In the words of Malcolm, the historian of our Hospital: "Amongst this noble band of philanthropists it cannot now be considered invidious to distinguish the name of one who may, without exaggeration, be considered to have represented this end throughout his active life, all the energy and zeal which animated and cherished this charitable movement—James McDonnell, M.D., of, whom it will be sufficient at present to state that in times of the greatest apathy towards his favourite project, and when almost unassisted by an encouraging hand, he continued to tend and watch over it with fostering care and unabated interest, until it had reached a vigorous maturity." The prospectus was issued on 13th April: £50 only was asked for the initiation of the scheme. The first general meeting was held on the 19th, and the medical officers, Dr. McDonnell and Dr. White, were appointed on 16th May. A house was taken in West Street (off Smithfield), and the infant charity started forth on its way. Its aim was to supply free medicine and free medical attendance to the indigent poor, and also to visit them in their homes when occasion required. The days of attendance were Mondays, Wednesdays, and Fridays at 10 a.m., and the Dispensary was open till 3 p.m. The charity was popular with the class for whom it was established, and in a little over four years 2,406 patients had received medical or surgical advice, and medicine valued at £120 per annum, which is at the rate of 4s. 4d. per person, or £21. 13s. 4d. per hundred. Of these, 1,740 were cured, 336 relieved, 50 reported as incurable, and 280 died or made no report.

In the years following 1792 there is little evidence of Dr. McDonnell's movements. It is known, however, that he was occupied with the Dispensary and with his private medical practice.

A further step was taken in 1797, on the incentive of Dr. McDonnell, to found a public hospital. He was long convinced that it was necessary to have a hospital where fever cases, which were very prevalent amongst the poor, could be properly attended. Typhus was a great scourge of the town for many years, and it was impossible to control the infection and nurse these patients in their own homes. On 14th April this idea was publicly adopted by a Committee, and on the 17th a dwelling-house was taken in Berry Street at a rental of £20 per annum. Six beds and other requisites were ordered. A nurse was appointed, and on the 27th the physicians and surgeons of the Dispensary were asked to attend at the new institution. The new hospital—the first hospital in Ireland for fever—was thus inaugurated. It was reported on the 1st June that ten patients had been received into the hospital, cured, and discharged.

This new institution, The Belfast Fever Hospital and Dispensary, was in this way established, and the future expansion and foundations of the Medical School can be traced to this small hospital of six beds, opened in May, 1797. The first appeal for public assistance was issued on 6th October. It stated that sixty patients had then been admitted to the hospital, with only one death, and the importance of this work to the community was stressed. The original subscriptions for the hospital had amounted to £58, and at the date of the appeal nearly £53 had been expended on the sixty patients.

In a printed letter of John Templeton (1766-1825), the Belfast naturalist, dated September, 1797, it is stated: "Our benevolent friend, the doctor, willing to do every service in his power to mankind, lately set on foot a fever hospital; the institution was certainly good, but it has proved what many people prognosticated—'a seminary for diseases,' since it has only been three months established, the housekeeper, the apothecary, the dispensing surgeon, Alexander McDonnell, and Dr. Boisragon, also the doctor himself, had all caught the fever by their attendance. They are all happily recovered, but the last-mentioned, and he is also convalescent." This incident perhaps was a factor in the temporary abeyance of the charity, as the extreme infectiousness of typhus and its mode of propagation was not then understood.

In September, 1799, a meeting was held to revive the hospital, and £113 was collected by means of a charity sermon of the Rev. William Bristow. Three houses in West Street at the corner of Smithfield were taken, and turned into a hospital. Dr. James McDonnell was appointed physician, and Mr. Bartholomew Fuller as surgeon. From this time forward for the next eighteen years, the Belfast Hospital and Dispensary increased in importance and in the affections of the people of the town. The guiding hand was that of McDonnell, who devoted his time, his services, and his talent to making the Hospital a success. From December, 1799, to October, 1800, 148 patients were admitted, with 12 deaths, and from that date to 8th August, 1801, 249 were admitted, with 18 deaths. Thus in a little over a year and a half, there were 398 cases, mainly of typhus. For many years the only cases that the hospital could receive were those of fevers, their urgency generally excluding medical and surgical cases. Up to the year 1807 the hospital and dispensary was entirely supported by voluntary contributions, but in that year the Irish counties were enabled by Act of Parliament to grant certain sums for maintenance of these charities. The sum granted in this year amounted to £193. 7s. 6d., and the progress of the hospital was so assured that at the close of the year the question of extension was considered, but temporarily abandoned.

In 1810 the first decisive step was taken towards the erection of a new hospital building. A portion of ground was selected in Frederick Street, a lease obtained by Dr. McDonnell, Wm. Clarke, and Wm. McS. Skinner from the Marquess of Donegall, and a Building Fund was commenced. In the following year the Building Fund was increased by means of Charity Sermons, and the labours of collectors, and on 5th June, 1815, the first stone of the new building was laid by the Marquess of Donegall. The foundation stone has a long inscription beginning with Hoc nosocomium aegrotis et arti medicae sacrum.

Dr. McDonnell now became the leading physician of Belfast, a position which he maintained for over thirty years, until ill-health forced him to retire. He was clearly the leader in the foundation of the new hospital, and his activity was everywhere visible. The years 1816 and 1817 were pre-eminently "hard years," and they were associated with a revival of the dreaded typhus. The building of the hospital was pushed on, and at length the wards were opened on 1st August, 1817. The epidemic was at its height, the patients were transferred from the old hospital, "though the walls were wet and the staircases scarcely secure," and no application from town or country was refused. This hospital of one hundred beds was further taxed in 1818 by the admission of 1,530 patients, and in 1819 by 1,258. From 1817 till 1821 no patients were admitted to the hospital except fever cases; it was probable that in these epidemics a fourth of the population was infected. It was the intention from the foundation of the hospital that its advantages should not be confined merely to the inmates. "The physicians and surgeons of Belfast should be invited to place their pupils there, to acquire experience by observing its practice, and in the course of a few years it might become a school of physic and surgery of no trifling importance to the young medical student of this neighbourhood and of the Province of Ulster." This, however, was not adopted until January, 1820, when the Committee recognised that pupils should be admitted into the hospital, and that each of the medical attendants might introduce one pupil to act as clerk or dresser. The first registered medical student of the hospital was Mr. B. Bingham, who was registered on 21st December, 1821; from that date up to 1850 over four hundred students passed through the hospital. In 1822 "The Belfast Medical Society" was revived by four physicians, one of whom was Dr. McDonnell. The original Society founded in 1806 had lasted to 1814, when it was dissolved, it was now again revived, a valuable medical library was collected and located at the hospital. In process of time, this Society became the parent of the Ulster Medical Society, which to-day possesses its original Minute Book. For some years many pupils attended the hospital, but the question of promoting systematic clinical lectures only became prominent at the close of 1826. Dr. McDonnell, however, had advocated in 1824 that the hospital should provide the nucleus of a medical school. In 1827 it was decided that such lectures would be a great advantage to the pupils and to the hospital, and on 3rd June the senior physician, Dr. James McDonnell, gave the first clinical lecture on "Systematic Medicine." The Belfast School of Medicine had started on its way. Its author had now reached the summit of his medical career: he had come to Belfast many years previously, he had founded a Dispensary, he had founded a Hospital, and in the lecture-theatre he had become a teacher of his profession. The full fruits of his plans were not yet matured, but some years later (1836), before his death, the Medical School was completed by the establishment of a medical department in the Academical Institution. The Medical School of Belfast was founded in the old General Hospital, improved by the formation of the medical department of the Academical, and completed in 1848 by the establishment of the Medical Faculty in the Queen's College.

Feeling that the time had arrived when he should retire from his active duties, he resigned, and was appointed to the consulting staff of the hospital in 1828. In the same year, on l8th April, he was presented with a service of plate, valued at £700, inscribed as follows: "To James McDonnell, Esq., M.D., who during a period of nearly forty years has devoted his time and eminent talents to the work of humanity, whose gratuitous advice has always been at the service of the poor, and to whose exertions this town has been principally indebted for that invaluable institution, the Fever Hospital and Dispensary, this service of plate has been presented by the nobility, Ladies and Gentlemen of Belfast and its vicinity, as a tribute of their respect and esteem. A.D. 1828." This testimonial was a proof of the high position he occupied in the minds of the community, and it was certainly well deserved. For many years after this he still continued to practise his profession and to take an active part in scholarly work. His residence throughout his long life was No. 13 Donegall Place. He was of medium height, and his countenance was open, impressive, and cheerful. He was quick and able in speech, and had a good style of composition. In medical science he was against the practice of employing wet nurses, and urged that children should be nursed by their own mothers. He was interested also in the various phenomena associated with irregularities of the pulse, and was skilled in the treatment of fevers.

He survived until 5th April, 1845, when he died in his eighty-second year. He was then the oldest member of the profession in the city. His funeral was attended by the Mayor and members of the Corporation. It left Belfast at 9 a.m. for the journey to the churchyard of Layde, about one mile north of Cushendall, where his remains rest amongst those of his illustrious ancestors. A beautiful Celtic cross was erected to his memory, which cannot ever be forgotten (Si monumentum requiris circumspice), for to his foresight we are indebted to-day for the Belfast Medical School.