The prison medical service and the treatment of Thomas Ashe.
By Ciara Breathnach
On 7 September 1917, Gregory Ashe wrote the following letter to his son Thomas following his recent incarceration for sedition.
Dear Thomas,
I received your letter am sorry that you are under lock and key again however be cheerful Keep a stout heart am not troubled because of you but always pray for you the people were anxious to know the result of your trial and see what it would have come to but yet we have not heard the result all are making inquiries regarding you north south east and west and sure I am they even pray for you.
An amount of corn not cut yet such weather I never remember and the potato crop is in danger of not keeping sound be cheerful and courageous I shall we pray
Gregory Ashe Kinard Lispole Co Kerry
(NLI MS 44,611 [7])
This melodic stream of consciousness with its cadences of the everyday—neighbourly concerns, weather and harvest yields—is poignantly unaware of the tragedy that was about to unfold. What might Gregory Ashe have written to his son had he known about his ambition to achieve political-prisoner status, the dangerous means he would use to realise it and the terrible risks he would take in putting his body through the rigours of starvation while on hunger strike and, ultimately, in placing his health in the hands of a prison medical service (PMS) that gave republican prisoners short shrift?
Sources
Using files held at the National Archives of Ireland (NAI) and the Chief Secretary’s Office Registered Papers (CSO/RP), this article revisits the circumstances surrounding the death of Thomas Ashe from the perspective of the PMS. To mark the centenary of his death, in September 2017 CSO/RP/1918/2000 is being conserved and digitised in preparation for becoming the ‘document of the month’, a popular feature on the NAI website. The CSO/RP indices are not for the fainthearted; they can be difficult to negotiate and relate to an enormous body of records dealing with all aspects of Irish life, from schooling to prisons and public works. Unfortunately, owing to the fire in the Public Records Office in 1922, the weighty indices offer tantalising details of a partially extant archive.
CSO/RP/1918/2000 is less of a document and more of a three-part folder documenting the minutiae of the series of events that led to Ashe’s death, his funeral, and the Crown’s response to the eleven-day inquest that ensued. It also contains correspondence with the Office of the Censor and the attorney general over whether or not newspapers should be prohibited from publishing a letter penned by Bishop Buckley of Killaloe, who accused the British administration of ‘the slow murder of Thomas’.
According to telegrams and other messages in the CSO/RP file, Ashe’s movements were carefully monitored that summer. When he addressed a public meeting at Ballinalee, Co. Longford, on 25 July 1917, his proclamation that ‘if he had his chance again and that England was overpowered he would call out his men again as he did in Easter week’ had inevitable consequences. He was sentenced to two years’ hard labour in August 1917 for sedition. This time it led him to Mountjoy Prison, which held ‘criminal prisoners’, a class with whom Ashe and his comrades refused to be placed on a par. Together with other republican inmates, he demanded special category status, which has been subject to careful study by William Murphy. Acts of insubordination on their part in September 1917 were followed by a series of punishments—deprivation of exercise, which was standard, but culminating in the removal of bed, bedding and boots for those involved in the series of protests. It was under such circumstances that Ashe and 39 others began to refuse food on 20 September. Murphy points to the forbearance and collusion of sympathetic prison warders in the earlier stages of the protest, but once it reached the remit of the PMS, which was the case for those on hunger strike, their ability to assist in the republican campaign was curtailed.
Dr Raymond Granville Dowdall
According to the rules for convict and local prisons, the medical officers were responsible for the physical and mental health of inmates. The actions of Dr Raymond Granville Dowdall, medical officer at Mountjoy Prison, with respect to the 1917 hunger strikes has received some attention from Murphy, and more recently from Ian Miller. But the extent of Dowdall’s lineage in the field of ‘artificial feeding’ in the prison context is deserving of more detailed examination. He was appointed to the General Prison Board (GPB) medical service in 1895 and it was not long before he was ‘artificially feeding’ inmates at Grangegorman Female Prison. In an article I published in 2014 I argued that prison medical officers (PMO) saw themselves as integral to prison discipline, or what Michel Foucault termed the ‘modulation of the penalty’. There I described the case of Ellen Shea, who was a prostitute and serial offender from the Waterford area, where she had spent time in prison for petty crimes. Ellen Shea was found insane and incapable of pleading at the City Commission in 1889. Recalcitrant and boisterous, she was eventually sent to Grangegorman in March 1893 from the Central Criminal Lunatic Asylum, and during her nearly two-year stay she was insubordinate and disruptive in every possible way. For instance, in accordance with the prison rules she availed of her entitlement to change her religion from Roman Catholicism to the Protestant faith and then back again. Her behaviour routinely sent her to the punishment cells, at which point she was placed under the auspices of the PMS. It is unclear whether in 1895 she was refusing food or whether her mental health was called into question, but Dr Dowdall’s actions are documented. He subjected her to purges, feeding through an oesophageal tube and rectal alimentation. Although it was not uncommon to ‘artificially feed’ inmates in prisons and asylums, from her medical sheet it appears that Dowdall was using her body, which he pushed to the limits of its endurance, as a site of experimentation. Although Ashe refused to be placed on a par with petty criminals like Ellen Shea, in December 1895 she too was discharged on ill-health grounds. Dowdall’s report to the GPB that year was perfunctory and made no mention of his ‘management’ of Shea. Without a death on his premises, he was not bound to report on the finer ‘everyday’ details of how the PMS functioned.
Having served in the PMS for 22 years, in Mountjoy for twenty, Dowdall in 1917 was without doubt one of the most experienced PMOs in Ireland. Indeed, his expertise and that of his colleagues in the ‘artificial feeding’ of prisoners was brought to bear in 1912 at the height of suffragette activity in Ireland and Britain. On 14 September 1917 a strategic decision was taken by John Boland, deputy governor, not to implement ‘diet stoppage’ as a punishment for republican prisoners lest it provoke hunger-strike action. With only twelve single cells at its disposal, the scale of the hunger strike in 1917 was not something with which the PMS could physically cope. It was further complicated by the fact that, as Murphy has described, the PMOs were subject to death threats and intimidation outside the prison walls.
Dr William Lowe
Additional space was allocated to the PMS, and Dowdall was permitted to employ the services of locums. Dr William Lowe, who had a practice in nearby Amiens Street, was a surgeon with no prior experience in artificial feeding, so by way of a tutorial on 25 September Dowdall fed six republican prisoners in his presence and watched while Lowe conducted four. Dowdall was then called away to a telephone call, leaving Thomas Ashe in Lowe’s inexperienced hands. On his return, Dowdall by chance met in the corridor with Ashe, who stated that he was feeling a bit weak. His cyanosed lips and cold extremities caused Dowdall to place him under close observation in the PMS that day. With his deterioration on 25 September, Dowdall, under prison rules 138 and 172, was prompted to write that ‘the illness of prisoner Thomas Ashe may terminate fatally within a brief period and before the termination of his sentence’.
In the fullness of the inquest that followed, all sorts of arguments were made by experts about Ashe’s ‘fatty heart’. The inquest concluded that there was a presence of oedema or excess fluid in the lungs, which was considered secondary to his heart condition. That Dr Lowe botched the ‘artificial’ feeding of Thomas Ashe is evidenced by the immediate effect and later through his slow deterioration. The CSO/RP file shows correspondence between the CSO, the attorney general, the city coroner, Dr Louis A. Byrne and the GPB, exhibiting how the authorities choreographed official responses during the inquest. The intricate details of CSO/RP/1918/2000 provide a sharp contrast to the annual report of the GPB for 1916–17; no mention is made of Thomas Ashe. Instead, the report contained a summary of the legal view of the GPB’s responsibility in the case of sane prisoners arrested under the Defence of the Realm Acts if they resorted to hunger strike. The following year Dr Dowdall suffered a breakdown and died. Ironically, he too was subject to the selectivity of GPB reporting mechanisms and, despite his seniority and years of dedicated service, he was not memorialised in the annual reports like his colleagues who were killed on active service in France and Palestine.
ACKNOWLEDGEMENTS
I am grateful to Niamh McDonnell, NAI, and James Harte, NLI, for their assistance.
Ciara Breathnach lectures in history at the University of Limerick.
FURTHER READING
C. Breathnach, ‘Medical officers, bodies, gender and weight fluctuation in Irish convict prisons, 1877–95’, Medical History 58 (1) (2014).
M. Foucault, Discipline and punish: the birth of the prison (London, 1991).
I. Miller, A history of force feeding: hunger strikes, prisons and medical ethics, 1909–74 (London, 2016).
W. Murphy, Political imprisonment and the Irish, 1912–1921 (Oxford, 2014).