The changes made by this second or amended Fever Act were of a very extensive kind.  By the previous one medical relief was to be given through the guardians of the poor; by the Act as amended, the Board of Health was empowered to certify to the Relief Commissioners, the necessity of medical relief being afforded, in any electoral division in which there was a Relief Committee.  It was also to direct such Committees to provide fever hospitals, and every other thing necessary for the treatment of patients.  And further:  the Relief Commissioners, on the certificate of the Board of Health, were to issue their order to Relief Committees, to provide medical attendance, medicines, and nutriment, if necessary, for such patients as were not received into hospital, either because there was not accommodation for them, or because it might endanger their lives to remove them.  The Board of Health acted as little as possible upon this clause; holding that, under existing circumstances, it was impossible to treat patients with advantage in their own houses.  Those hospitals and dispensaries were managed by the Relief Committees, under the control of the Relief Commissioners, appointed to carry out the Act 10 Vic., cap. 7.  By the 16th clause of the amended Fever Act, provision is made “for the proper and decent interment of the deceased destitute persons who shall die of fever or any other epidemic disease in any electoral division or district, for which any Relief Committee shall have been constituted.”

Whilst this very extensive system of medical relief was established and carried out under the second Bill, the guardians of the poor continued to use the powers granted to them in the former Bill, of giving medical relief.  The returns from these two sources give, respectively, the number of fever cases received into their hospitals, but we have no authentic means of determining the number of persons who died of fever in their own houses, or on the highways and byways, as they wandered about in search, of food.  Such cases must have been very numerous.

Although fever or other epidemics did not arise to an alarming extent in 1846, still, that year showed a decided increase of them over previous years.  The following summary, derived from circulars issued, shows the origin and progress of fever in 1846.  “Fever began in Mitchelstown, County Cork.  It attacked equally those in good and bad health; but in some instances, as in Innishannon and in Cove, many, in the best health; while in Mitchelstown, the majority had previously suffered from privation.  Young persons appear to have been the subject of the epidemic, more than those of more advanced life.  The pressure from without upon the city [of Cork] began to be felt in October; and in November and December, the influx of paupers from all parts of this vast county was so overwhelming, that, to prevent them from dying in the streets, the doors of the Workhouse were thrown open, and in one week, 500 persons were admitted