Wednesday, February 19, 2014

Old Athy Maladies

This week the Eye on the Past is given over to a short article written by Peter Behan, Professor Emeritus of Clinical Neurology and Senior Research Fellow in the University of Glasgow.  As will be seen from his opening paragraph, Professor Behan is an Athy man whose father, Patrick Behan, with his brothers Jack and Joe carried on business as house painters.  The Behan family lived in St. Joseph’s Terrace and the future university professor with his brothers Michael and Paddy attended the local Christian Brothers school.  Michael, whom I had the pleasure of meeting two years ago with his brother Peter, retired some time ago as Director of Personnel at Cleveland County, while Paddy, after leaving the local secondary school, went on to graduate with an engineering degree from  Trinity College Dublin.

Professor Behan who was Professor of Neurology at Glasgow University up to May 1999 is involved in researching the clinical and pathological features of fatigue states and the aetiology of multiple sclerosis.  Currently he is carrying out research on a rare neurological condition associated with multiple sclerosis with a Professor from Edinburgh University, whose family by coincidence also comes from County Kildare.  The condition called “the Mionaerach” which is commonly referred to in the Athy area holds a particular interest for the Scottish based professors and Professor Behan has been anxious to get data on “the Mionaerach” for some time past.

The following article which he termed “Old Athy Maladies” is of particular interest and perhaps will prompt readers of this column with information on “the Mionaerach” to send in data which might help Professor Behan and his colleague in their further research on the subject.

“Old Athy Maladies

My grandfather lived at 6 Chapel Lane, Athy, a small single-storey terraced house, in which he and his wife brought up 11 children. His main work was to take lime from the kilns near Hannon’s Mill with a horse and cart to the Curragh military camp. He had long been interested in animals and because of his work with horse had acquired a good knowledge and love of natural history. He certainly was often consulted by farmers about the diseases of their horses. I was as a schoolboy, at times, the conveyer of information to him from horse owners who brought their horses to be shod at one of the three blacksmiths that I passed each morning on my way to school. It must not be forgotten that whilst now, in the present time, any animal, including domestic cats or dogs, that become ill are brought to a qualified veterinary surgeon. As a small boy in Athy, at that time, I observed however that veterinary folk medicine was common in practice. I was also very aware that people with various diseases sought out and were treated too by unqualified practitioners of folk medicine. Two disorders and their treatments were of particular interest to me.

Athy in the 1930s and 1940s was a poor place. There was low employment, the best hope of a permanent job was to work in Captain Hosie’s Industrial Vehicles Ireland (IVI) Garage. Housing conditions were for the most part also primitive, despite the operation of the Slum Clearance Programmes. Tuberculosis was extremely common as we now know that the Irish have a particular susceptibility to contract it. I can remember many patients, including my sister, who died from this disease and others who spent a considerable part of their lives in a sanatorium. Indeed, several of my colleagues at school had inflamed suppurative cervical glands, almost certainly secondary to bovine tuberculosis infection. To try and eradicate the bovine tuberculosis, the police would come at irregular occasions and take samples from the milk vendor who sold milk from a large churn in the back of his ass-drawn car. In 1944, streptomycin was developed and had an enormous effect on the treatment of this devastating disease.

There were two other clinical conditions that I was able to study at first hand, which reflected at that time, the socio-economic conditions as much as any other barometer, namely the “Mionaerach” and the “fallen breast bone” disorder. The Mionaerach was relatively common and was usually diagnosed in the spring although it could occur at any time. The sufferers were usually teenagers or young people of both sexes, in which the cardinal symptom was lack of energy and protracted tiredness. This occurred for the most part after a virus infection. The patient would be unable to continue with his/her work, would have excessive sleepiness and often demonstrated a labile emotional state by continually bursting into tears on the merest provocation. Most people got better although some continued to be ill for years. I remember enquiring after a friend I had not seen for weeks to be told that she had the illness. It is now, of course, abundantly clear as to what these people suffered from but the condition was not understood at that time.

Clearly, such patients with the Mionaerach had a form of chronic fatigue syndrome, a real condition almost certainly, in the majority of cases secondary to a viral infection. Modern research, using sophisticated techniques, have now demonstrated in them subtle but definite neuroendocrinological abnormalities with aberrant steroid metabolism. The condition is usually sporadic but has occurred in epidemics, these epidemics giving rise to a rich nomenclature that has been applied in different countries. It is known, for example,, in Iceland as ‘akureyri’ disease or as Icelandic disease, in London as the ‘Royal-Free’ disease, or benign myalgic encephalomyelitis. Other names have been applied in different countries where epidemics have been recorded, as for example in Florida (USA), Europe, Australasia and South Africa. The condition has been recognised as genuine but it was not always thus, since several people considered these epidemics in schools, hospitals, factories to be a form of mass hysteria and the absence of diagnostic tests and clinical findings gave impetus for the disease to be characterised and classified as a purely psychological condition.

The Mionaerach (mineeart, lack of energy) has been reported from different parts of Ireland but particularly in and around Athy. Indeed, the mother of one of Kildare’s great heroes, Sir Ernest Shackleton, is said to have developed it.  John MacKenna in his recent biography of Shackleton wrote: ‘Henrietta, however, worn out by the birth of ten children, fell victim to a mysterious illness which left her without any energy. It was a sickness that Henry might have come across in Kilkea, where the locals would have described it as the Mionaerach, a disease that wouldn’t kill but debilitates the sufferer with little or no energy. Henrietta, so long the vital and good-humoured heart of the family, withdrew to her sick-room and rarely left it until her death in September 1926.’

The second condition, which was all the more serious, was that of the ‘fallen breast bone’ syndrome. Here, usually men were those affected and the condition was far from rare. I remember one woman who was said to possess the cure and lived near me, who saw her patients usually after 12 o’clock mass on Sunday. On reflection now, those men that I often studied entering her house were clearly and severely depressed. Her treatment was the lighting of a small candle, place it on a half crown on the patient’s chest, light the candle and cover it with a tumbler. When the candle went out, the tumbler was pulled off rapidly and the chest bone was supposedly restored to its normal position. Anatomically we know that the breastbone, i.e. the sternum, could not have been affected in this condition but such was the thinking at the time that possibly related to the hypochondrium and the symptoms depressed patients would have. Disorder of the chest, i.e. breastbone, was considered pathology. It is incredible now to think that people would be so silly as to submit to this form of country cure but, I suppose, their degree of depression was such that they would have done anything to try and help their state. Depression is the cause of more pain and misery than any other disease to which mankind has been afflicted. It has long been known that depression is often associated with obscure physical symptoms and whilst nowadays physicians would recognise the many forms in which it can present, in those far-off days there was little that could be done other than reassurance, which was all that could be offered by this primitive form of therapy.

Medicine, exploring predominantly contemporary stem-cell biology, looking at molecular subcellular events and dissecting the intricate DNA pathways that make up modern genetics make these observations of folk medicine hard to imagine. With the gaze of the future directed intensely at developmental and cellular biology, stem cells, which hold out the promise of curing most illnesses, you must not forget that it was only yesterday that lack of knowledge forced people to act in such a way. I am sure that by looking at country obscure ‘cures’ there are almost certainly many other illnesses that were the subject of such bizarre treatments. Holywells and sacred bushes (in which a piece of the garment of the sufferer was placed to rot on a thorn) are further examples of common methods of country cures.”

I remember a few years ago when Dr. Brian Maguire retired, he entrusted to me a sealed envelope in which I found a written description of a cure for “the Mionaerach”.  It had been given to him many years earlier by an old woman living in Plewman’s Terrace who on her death bed wanted the ancient cure to survive.  “The Mionaerach” is obviously not a condition peculiar to Athy, but presumably its prevalence in past times helped create an awareness of, and inevitably a folk cure for, the illness which contemporary medical practice could not diagnose or help.

If you have any information of any kind regarding “the Mionaerach” I would be delighted to pass it on to Professor Peter Behan.

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