Part 1

REPORT ON THE SANITARY CONDITION OF THE LABOURING POPULATION OF GREAT BRITAIN.

A SUPPLEMENTARY REPORT

ON THE RESULTS OF A SPECIAL INQUIRY INTO

THE

PRACTICE OF INTERMENT IN TOWNS.

MADE

AT THE REQUEST OF HER MAJESTY’S PRINCIPAL SECRETARY OF STATE FOR THE HOME DEPARTMENT,

BY

EDWIN CHADWICK, ESQ. BARRISTER AT LAW.

_Presented to both Houses of Parliament, by Command of Her Majesty._

LONDON: PRINTED BY W. CLOWES AND SONS, STAMFORD STREET, FOR HER MAJESTY’S STATIONERY OFFICE.

1843.

CONTENTS.

PAGE

Sources of information on which the Report is founded, § 1 1

Grounds of exception to the admitted necessities of the abolition of intra-mural interment examined, § 1 2

The evidence as to the innocuousness of emanations from human remains: negative evidence, § 2 4

The facts in respect to such alleged innocuousness incompletely stated, § 3 7

Positive evidence of the propagation of acute disease from putrid emanations, §§ 5 and 6 10

Specific disease communicated from human remains—positive instances of, §§ 8 and 10 14

Distinct effects produced by emanations from bodies in a state of decay and from bodies in a state of putrefaction, § 10 21

Summary of the evidence in respect to the sanitary question as to the essentially injurious nature of such emanations, &c., § 11 23

Difficulty of tracing distinctly the specific effects of emanations from burial-grounds in crowded towns, amidst complications of other emanations, § 13 23

Tainting of wells by emanations from burial-grounds, § 14 24

Danger of injurious escapes of putrid emanations not obviated by deep burial, § 21 28

General conclusions that all interments in churches or in towns are essentially of an injurious and dangerous tendency, § 23 30

_Injuries to the Health of Survivors occasioned by the delay of Interments._

The greatest proportion of deaths occur in the single rooms in which families live and sleep, § 25 31

Instances of the common circumstances of their deaths; and of the deleterious effects of the prolonged retention of the body in the living and sleeping room, from the western districts of the metropolis, § 26—from the eastern districts, §§ 27 and 28—from Leeds, § 34 31

Numbers of deaths from epidemic, endemic, and contagious disease; and consequent extent of dangers from the undue retention of the body amidst the living, § 38 43

Moral evils produced by the practice, §§ 41 and 42 45

The delay of Interments amongst the Labouring Classes in part ascribable to the difficulty of raising excessive Funeral Expenses, § 40 45

Evidence of undertakers on the funeral expenses and modes of conducting the funerals of different classes of society, §§ 43 and 44 46

_Specific effects of excessive Funeral Expenses on the economy of the Labouring Classes._

Extent of pecuniary provision made in savings’ banks and benefit societies for funeral expenses, §§ 53 and 55—Abuse of the popular feeling of anxiety in respect to interments; and waste and distress occasioned to them, §§ 56 and 57 55

Demoralizing effect of multiplied insurances for large payments for funeral expenses on the occurrence of deaths, §§ 60 and 61—Illegality of the practice. § 66—Case for interference for the prevention of crime, and measures for the reduction of the excessive expenses, §§ 69 and 71 63

_Aggregate Expenses of Funerals to the Public._

Small proportion of clerical burial dues to the undertaker’s expenses, § 74 69

Heavy proportion of funeral expenses in unhealthy districts, § 75—Efficient sanitary measures the most efficient means of diminishing the miseries of frequent interments, § 81 71

Failure of the objects of excessive expenditure on funerals—solemnity or proportionate impressiveness not obtained, § 84—and unattainable in crowded and busy districts, § 85—Increasing desertion of intra-mural burial-grounds, § 89 79

_Means of diminishing the evil of the prolonged retention of the Dead amidst the Living._

Obstacles to the early removal of the dead examined, § 89—Grounds for the apprehension of interment before life is extinct. § 90—Institution for the reception and care of the dead previous to interment formed in Germany, § 96—Success of, in abating the apprehensions of survivors, § 97—Practical evidence of the necessity of some such institution, and increasing use of inferior places for the same purpose in this country, §§ 101 and 10 84

_Proposed Remedies by the extension of separate Parochial Establishments in Suburban Districts examined._

Claims of the suburbs to protection from the undue multiplication of inferior burial-places in them, § 105 97

Instance of the trial of suburban parochial burial-grounds for the parishes of St. Martin-in-the-Fields and St. James, Westminster, §§ 166 and 108 97

Objections to the management of parochial boards stated by the Rev. William Stone, of Spitalfields, and others, § 109 100

Increased expense from numerous small and inefficient establishments, § 110 104

Unavoidable inefficiency of management by, § 111 105

Grounds for the conclusion that such establishments would ultimately rather extend than abate the evil, § 112 106

_Practicability of ensuring for the Public superior Interments at reduced Expenses._

Evidence of undertakers as to the practicable reductions in the expenses of funerals without any reduction in proper solemnity, §§ 113 and 115 to 120 107

Necessity of the provision of trustworthy responsible information to the survivors at the time of deaths as to what is necessary and proper, §§ 121, 122, 123, and 124 113

Objections to the abandonment of the necessities of the population in respect to burial as a source of profit to private and irresponsible trading associations, § 126 114

_Examples of successful Legislation for the improvement of the practice of Interment._

In America, § 127—in Germany, § 128—Mode of protecting the public from extortionate charges in Prussia, § 129—Regulations of funerals and application of the proceeds to public purposes, § 131—Excessive numbers of deaths and funerals consequent on the low sanitary condition of the Parisian population, § 133 119

Agency of superior officers of public health employed to superintend interments in America, § 135—in Germany, § 136—Example of the inefficiency of the agency employed at Paris, § 137—Consequences of mixing up private practice with public duties, § 138 125

_Experience in respect to the Sites of Places of Burial and Sanitary Precautions necessary in respect to them._

In regard to sites, § 140—to the time of the natural decay of bodies, § 143—to the depth of graves, § 144—to the space for graves; and the greater extent of space requisite for the same numbers of a depressed town population than for a healthy rural population, § 145—Data for the spaces requisite for the burials arising from the deaths in the metropolis, § 146 to § 150 127

Why careful planting requisite for cemeteries, §§ 151 and 152 131

_Extent of Burial-grounds existing in the Metropolis._

Summary of the extent of the burials by the chief religious communities, § 155—Disclaimer of private burial-grounds, § 156—Extent of cemetery companies’ estimates for burials, §§ 157 and 158—Diminution of public demand for burials in lead and in catacombs, § 160—Dangers to the living of ill-regulated burials, and legislation on, § 162—Improvements in all existing material arrangements for burials practicable. § 164—Defective arrangements in private cemeteries, §§ 165 and 166—Examples of improved ceremonial arrangements, §§ 169 and 171 133

_Moral influence of seclusion from thronged places, and of Decorative Improvements in National Cemeteries._

Statement by Mr. Wordsworth of the loss of salutary influence by burial in towns, § 172—Effects of careful visible arrangements on the mental associations of the population stated, § 173—Examples of the influence of cemeteries on the continent, §§ 174 and 175—Sir Christopher Wren’s plan for the exclusion of intra-mural burying places on the rebuilding of the City of London, § 176—Practice of the primitive Christians to bury outside cities, § 177 172

Superior agency of the _clerici_ employed in burial: and a special agency of public officers of health instituted in the east, § 177 148

Opinion of the Rev. H. H. Milman on the means of the re-investment of the funeral services with religious influences 150

Dispositions manifested in this respect amongst the lower classes, § 178 to 181 153

The duties in respect to honouring the dead, as stated by Jeremy Taylor 157

_Necessity and nature of the superior Agency requisite for private and public protection in respect to Interments._

Functions of an officer of health exemplified in respect to the verification of the fact and cause of death, §§ 184 to 190—Nature of his intervention and aid to the survivors, and the reduction of the expenses of funerals, § 191—For the protection of the survivors on the occurrence of deaths from infectious or contagious disease, §§ 193 to 200—Evidence of the acceptability of the visits of such officers to the houses of the labouring classes for the purpose of mortuary registration, § 201 163

Jurisprudential value of the appointment of officers of health in the prevention of murders and secret deaths, §§ 202 to 204 171

Service in supplying the want of coroners’ inquests in Scotland, 174

Advantages to science from the improvement of the mortuary registration, § 209—to medical science from bringing classes of cases, or common effects from common causes, under one view, §§ 212 to 215 179

_Proximate Estimate of the Reductions in Funeral Expenses practicable under National arrangements._

Total expenses of funerals in the metropolis, § 219—Economy of few large and inefficient as compared with many small and efficient establishments, §§ 221 and 222—Expenses of an adequate staff’ of officers of health, §223 185

Daily number of deaths and funerals in the metropolis and in provincial towns, § 224 189

Claims of existing interests to compensation, §§ 228, 229, and 230 191

Why payment of fees and expenses at the time of the funerals proposed to be retained, §§ 233 and 234 193

Applicability of conclusions from the metropolis to the provincial towns, § 235 195

Summary of conclusions:—

1. As to the evils which require remedies, § 237 197

2. As to the means available for the prevention or mitigation of these evils, § 248 199

APPENDIX.

PAGE

1. Regulations for the establishment of officers for the care of the dead and for conducting funerals at Franckfort, with plans of the houses of reception 205

2. Regulations for the examination and care of the dead at Munich 218

3. Examination of Mr. Abrahams, surgeon, registrar of deaths, on the defective arrangements for the verification, and on the effects produced on the physical and moral condition of children by the undue pressure of the causes of disease and death 223

4. Examination of Mr. Blencarne, medical officer of the City of London Union, on the extent to which the proportions of deaths are preventive by sanitary measures 226

5, 6, Extracts from the testimony of Dr. Wray, Mr. Porter, and & 7. Mr. Paul, medical officers of the city of London, on the same subjects 229–32

8. Extract from Dr. La Chaise’s account of population in the badly lighted and ventilated and badly cleansed districts of Paris 233

9. Note on the probable effects producible on the proportionate mortality and numbers of burials, of structural arrangements, such as those designed for the City of London by Sir Christopher Wren 234

10. Letter from the superintendent registrar of Stockport on cases of infanticides committed partly for the sake of burial money 235

11. Returns of the proportion of deaths to the population in each registrar’s district in the metropolis in the year 1839, the excess in number of deaths and funerals beyond a healthy standard, the average age of death of gentry, tradesmen, and artisans, and average years of life lost by premature deaths in each district, according to the Carlisle table of life insurance, and the proportion of deaths from epidemics, and the registrars’ returns of the chief causes of death in the lower districts 239

12. Examples of ordinary undertakers’ bills in the metropolis 267

Lord Stowell’s exposition of the law of England in respect to perpetuities in burial-grounds 269

13. View of the extent of intra-mural burial-ground provided as compared with the extent of extra-mural burial-ground required for the metropolis; and the comparative proportions of space occupied for the burial of persons of different religious denominations, and as trading burial-grounds 272

Return of the amount of burial fees received in some of the larger parishes in the metropolis 273

Returns of the number of burials in each of the burial-grounds in the metropolis 274

SANITARY REPORT.—SUPPLEMENT.

INTERMENTS IN TOWNS.

_To the Right Honourable Sir James Graham, Bart., &c., &c., &c._

SIR,

In compliance with the request which I have had the honour to receive from you, that I would examine the evidence on the practice of interment, and the means of its improvement, and prepare for consideration a Report thereon, I now submit the facts and conclusions following:—

It has been remarked, as a defect in the General Report on the evidence as to the sanitary condition of the labouring population, that it did not comprise any examination of the evidence as to the effects produced on the public health, by the practice of interring the dead amidst the habitations of the town population. I wish here to explain that the omission arose from the subject being too great in its extent, and too special in its nature, to allow of the completion at that time, of any satisfactory investigation in relation to it even if it had not then been under examination by a Committee of the House of Commons, whose Report is now before the public.

* * * * *

To obtain the information on which the following report is founded, I have consulted, as extensively as the time allowed and my opportunities would permit, ministers of religion who are called upon to perform funereal rites in the poorer districts: I have made inquiries of persons of the labouring classes, and of secretaries and officers of benefit societies and burial clubs, in the metropolis and in several provincial towns in the United Kingdom, on the practice of interments in relation to those classes, and on the alterations and improvements that would be most in accordance with their feelings: I have questioned persons following the occupation of undertaker, and more especially those who are chiefly engaged in the interment of the dead of the labouring classes, on the improvements which they deem practicable in the modes of performing that service: I have consulted foreigners resident in the metropolis, on the various modes of interment in their own countries: I have examined the chief administrative regulations thereon in Germany, France, and the United States: and I have consulted several eminent physiologists as to the effects produced on the health of the living, by emanations from human remains in a state of decomposition. I need scarcely premise that the moral as well as the physical facts developed in the course of this inquiry are often exceedingly loathsome; but general conclusions can only be distinctly made out from the various classes of particular facts, and the object being the suggestion of remedies and preventives, it were obviously as unbecoming to yield to disgusts or to evade the examination and calm consideration of those facts, as it would be in the physician or the surgeon, in the performance of his duty with the like object, to shrink from the investigation of the most offensive manifestations of disease.

§ 1. It appears that the necessity of removing interments from the midst of towns is very generally admitted on various considerations, independently of those founded on the presumed injurious effects arising from the practice to the public health. I believe an alteration of the practice is strongly desired by many clergymen of the established church, whose incomes, even with the probable compensation for the loss of burial dues, might be expected to be diminished by the discontinuance of _intra-mural_ interments. Exemptions from a general prohibition of such interments are, however, claimed in favour of particular burial-grounds, situate within populous districts, of which grounds it is stated that they are not over-crowded with bodies, and of which it is further alleged that they have not been known, and cannot be proved, to be injurious to the public health.

The statements as to the innocuousness of particular graveyards are supported by reference to the general testimony of a number of medical witnesses of high professional position, by whom it is alleged that the emanations from decomposing human remains do not produce specific disease, and, further, that they are not generally injurious. The practical consequences of these doctrines extend beyond the present question, and are so important in their effects on the sanitary economy of all towns, as apparently to require that no opportunity should be lost of examining the statements of facts on which they are founded.

The medical evidence of this class has generally been given in answer to complaints made by the public, of the offensiveness, and the danger to health which arises from the practice of dissection in schools of anatomy amidst crowded populations. The chief fact alleged to prove the innocuousness of emanations from the dead is that professors of anatomy experience no injury from them. Thus, Dr. Warren, of Boston, in a paper cited by M. Parent Duchâtelet, states, that he has been accustomed all his life to dissecting-rooms, in which he has been engaged night and day. “It has sometimes happened to me,” he observes, “after having dissected bodies in a state of putrefaction, to have experienced a sort of weakness and the loss of appetite; but the phenomena were never otherwise than transient. During the year 1829, the weather being excessively hot, decomposition advanced with a degree of rapidity such as I have rarely witnessed: at that season the emanations became so irritating, that they paralyzed the hands, producing small pustules and an excessive itching, and yet my general health was in nowise affected.”

Again, whilst it is stated by M. Duchâtelet that students who attend the dissecting-rooms are sometimes seriously injured, and even killed by pricks and cuts with the instruments of dissection, yet it is denied that they are subject to any illness from the emanations from the remains “other than a nausea and a dysentery for two or three days at the commencement of their studies.” Fevers the students of medicine are confessedly liable to, but he says it is only when they are in attendance on the living patients in the fever wards.

Sir Benjamin Brodie pointed out to me, that from the precautions taken, by the removal of such portions of the viscera as might be in an advanced state of decomposition, and from the ventilation of dissecting-rooms being much improved, the emanations from the bodies dissected are not so great as might be supposed; nevertheless, he observes:—

There is no doubt that there are few persons who during the anatomical season are engaged for many hours daily in a dissecting-room for a considerable time, whose health is not affected in a greater or less degree; and there are some whose health suffers considerably. I have known several young men who have not been able to prosecute their studies in the dissecting-room for more than three or four weeks at a time, without being compelled to leave them and go into the country. The great majority, however, do not suffer to that extent, nor in such a way as to cause interruption to their studies; and, altogether, the evil is not on a sufficiently large scale to attract much notice, even among the students themselves.

A writer on public health, Dr. Dunglison, maintains that “we have no satisfactory proof that malaria ever arises from animal putrefaction singly;” and as evidence of this position he adduces the alleged fact of the numbers of students who pass through their education without injury; yet he admits—