They were “swollen” by the anasarca or general dropsy, which was reported from nearly all parts of Ireland as being, along with dysentery and diarrhoea, the prevalent kind of sickness before the epidemic fever became general in the spring of 1847. The same had been remarked as the precursor of the fever of 1817-18. In the end of March, Dr Jones Lamprey, sent by the Board of Health, found the parish of Skull “in a frightful state of famine, dysentery and fever.” Dysentery had been by far more prevalent than fever in this district, as in many others. “It was easily known,” says Dr Lamprey, “if any of the inmates in the cabins of the poor were suffering from this disease, as the ground in such places was usually found marked with clots of blood.” The malady was most inveterate and often fatal. It must have had a contagious property, for the physician himself went through an attack of it[508]. In the Skibbereen district the dead were sometimes buried near their cabins; at the town itself many were carried out in a shell and laid without coffins in a large pit[509]. Along the coast of Connemara for thirty miles there was no town, but only small villages and hundreds of detached cabins; this district is said to have been almost depopulated[510]. Besides the dysentery and dropsy, which caused most of the mortality in the winter of 1846-47, another early effect of the famine was scurvy, a disease rarely seen in Ireland and unknown to most of the medical men. It was by no means general, but undoubtedly true scurvy did occur in some parts: thus in the Ballinrobe district, county Mayo[511], it was very prevalent in 1846 for some months before the epidemic fever appeared, being “evidenced by the purple hue of the gums, with ulceration along their upper thin margin, bleeding on the slightest touch, and deep sloughing ulcers of the inside of the fauces, with intolerable foetor”--affecting men, women, and children. In some places, as at Kilkenny early in 1846, there was much purpura[512]. These earlier effects of the famine (dysentery and diarrhoea, dropsy, scurvy and purpura), were seen in varying degrees before the end of 1846 in most parts of Ireland. The counties least touched by them were in Leinster and Ulster, such as Down, Derry, Tyrone, Fermanagh and some others, where the peasantry lived upon oatmeal as well as on potatoes. But even these were invaded by the ensuing epidemic of fever, the only place in all Ireland which is reported to have escaped both the primary and the secondary effects of the famine having been Rostrevor, on the coast of Down, a watering-place with a rich population, which was also one of the very small number of localities that escaped in 1817-18. According to the following samples of admissions to the Fever Hospital of Ennis in the several months, the summers were the season of greatest sickness, a fact which was noted also in the epidemic of 1817-18: Year Month Patients