Strangling Angel

BookStrangling Angel

Strangling Angel

Diphtheria and Childhood Immunization in Ireland

Reappraisals in Irish History, 9


December 20th, 2017

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Winner of the 2019 NUI Publication Prize in Irish History. This book is the first comprehensive history of the anti-diphtheria campaign and the factors which facilitated or hindered the rollout of the national childhood immunization programme in Ireland. It is easy to forget the context in which Irish society opted to embrace mass childhood immunization. Dwyer shows us how we got where we are. He restores Diphtheria’s reputation as one of the most prolific child-killers of nineteenth and early twentieth-century Ireland and explores the factors which allowed the disease to take a heavy toll on child health and life-expectancy. Public health officials in the fledgling Irish Free State set the eradication of diphtheria among their first national goals, and eschewing the reticence of their British counterparts, adopted anti-diphtheria immunization as their weapon of choice. An unofficial alliance between Irish medical officers and the British pharmaceutical company Burroughs Wellcome placed Ireland on the European frontline of the bacteriological revolution, however, Wellcome sponsored vaccine trials in Ireland side-lined the human rights of Ireland’s most vulnerable citizens: institutional children in state care. An immunization accident in County Waterford, and the death of a young girl, raised serious questions regarding the safety of the immunization process itself, resulting in a landmark High Court case and the Irish Medical Union’s twelve-year long withdrawal of immunization services. As childhood immunization is increasingly considered a lifestyle choice, rather than a lifesaving intervention, this book brings historical context to bear on current debate.


'Strangling Angel is well written, interesting and thoroughly researched, drawing on a variety of new primary sources. It is not a history of immunisation in the British Isles, but differences in approach between progressive Ireland and Britain are highlighted. It will be useful to medical, political and social historians with an interest in infections and their prevention.'
William Dibb, British Society for the History of Medicine

'The documentary research in this book cannot be faulted. It includes painstaking examinations of wide-ranging archival materials as well as making extensive use of contemporary governmental, popular and scientific publications. ... Altogether, this is a promising first book from a talented scholar.'
Oisín Wall, Social History of Medicine

‘Michael Dwyer charts the history of diphtheria in Ireland with a strong focus on the controversies that arose when immunization was introduced in the early twentieth century […] Strangling Angel is among the most significant medical history monographs that has emerged from Ireland in recent years.'

Ian Miller, Journal of the History of Medicine and Allied Sciences 

‘Dwyer’s work comfortably takes its place among the timely and burgeoning international literature on the history of vaccination and immunization, along with that devoted to the broader development of public health policy and programs.'

J.T.H. Connor, Canadian Bulletin of Medical History

'Dwyer’s account of the history of diphtheria in Ireland not only provides us with a documented history of the disease for the island of Ireland but also highlights the issues that still surrounded the disease and its prevention.'
Anne Hardy, Bulletin of the History of Medicine

'Strangling Angel makes an important contribution to the history of health and medicine in Ireland. It will also be of interest to social historians concerned with the treatment of children in historical state-run institutions... Starting from a place in which diphtheria remained largely concealed in the historical record, Strangling Angel brings the disease to centre stage.'Alice Mauger, Irish Social and Economic History

Author Information

Michael Dwyer is Lecturer in the School of History at University College Cork.

Table of Contents

Table of Contents
Section TitlePagePrice
1. Aetiology of Diphtheria in Pre-independence Ireland23
The ‘Strangling Angel’ in Ireland26
Know Thine Enemy37
2. Diphtheria ‘Arrives’42
Diphtheria in Cork City46
Public Health Reform in the Irish Free State51
The Development of Antitoxin as an Anti-diptheria Prophylactic55
3. Anti-diphtheria Immunization in the Irish Free State61
Anti-diphtheria Immunization in Dublin73
J.C. Saunders Anti-diphtheria Intervention in Cork City80
4. Developing Burroughs Wellcome Alum-Toxoid87
Vaccine Trials in Cork City92
Further Vaccine Trials100
5. The Ring College Immunization Disaster111
Inquest at Ring120
Preparing for Battle130
6. O’Cionnfaola v. the Wellcome Foundation and Daniel McCarthy136
After Ring144
7. Towards a National Immunization Programme154
End of an Epidemic173