Part 6

§ 22. He also expresses an opinion concurrent with that of other physiologists, that the effects of these escapes in an otherwise salubrious locality, soon attract notice, but their influence in obedience to the laws of gaseous diffusion, developed by Dalton and Graham, is not the less when scattered over a town, because in a multitude of scents they escape observation. In open rural districts these gases soon intermix with the circumambient air, and become so vastly diluted that their injurious tendency is less potent.

Other physical facts which it is necessary to develope in respect to the practice of interment may be the most conveniently considered in a subsequent portion of this report, where it is necessary to adduce the information possessed, as to the sites of places of burial, and the sanitary precautions necessary in respect to them.

§ 23. From what has already been adduced, it may here be stated as a conclusion,

That inasmuch as there appear to be no cases in which the emanations from human remains in an advanced stage of decomposition are not of a deleterious nature, so there is no case in which the liability to danger should be incurred either by interment (or by entombment in vaults, which is the most dangerous) amidst the dwellings of the living, it being established as a general conclusion in respect to the physical circumstances of interment, from which no adequate grounds of exception have been established;—

That all interments in towns, where bodies decompose, contribute to the mass of atmospheric impurity which is injurious to the public health.

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

In order to understand the state of feeling of the labouring classes, and the general influence upon them, and even the effects on their health, of the practice of interment, it will be necessary to submit for consideration those circumstances which immediately precede the interment, namely, the most common circumstances of the death.

§ 24. In a large proportion of cases in the metropolis, and in some of the manufacturing districts, one room serves for one family of the labouring classes: it is their bed-room, their kitchen, their washhouse, their sitting room, their dining room; and, when they do not follow any out-door occupation, it is frequently their work room and their shop. In this one room they are born, and live, and sleep, and die amidst, the other inmates.

§ 25. Their common condition in large towns has been developed by various inquiries, more completely than by the census. As an instance, the results may be given of an inquiry lately made, at the instance and expense of Lord Sandon, by Mr. Weld, the secretary of the Statistical Society, as to the condition of the working classes resident in the inner ward of St. George’s, Hanover Square, and in the immediate vicinity of some of the most opulent residences in the metropolis. It appeared that 1465 families of the labouring classes had for their residence 2175 rooms, and 2510 beds. The distribution of rooms and beds was as follows:—

─────────────────────────┬─────────╥─────────────────────────┬───────── DWELLINGS. │Number of║ BEDS. │Number of │Families.║ │Families. ─────────────────────────┼─────────╫─────────────────────────┼───────── Single rooms for each │ 929║One bed to each family │ 623 family │ ║ │ Two rooms for each family│ 408║Two beds to each family │ 638 Three rooms for each │ 94║Three beds to each family│ 154 family │ ║ │ Four rooms for each │ 17║Four beds to each family │ 21 family │ ║ │ Five rooms for each │ 8║Five beds to each family │ 8 family │ ║ │ Six rooms for each family│ 4║Six beds to each family │ 3 Seven rooms for each │ 1║Seven beds to each family│ 1 family │ ║ │ Eight rooms for each │ 1║Dwellings without a bed │ 7 family │ ║ │ Not ascertained │ 3║Not ascertained │ 10 │ —————║ │ ————— Total │ 1,465║ Total │ 1,465 ─────────────────────────┴─────────╨─────────────────────────┴─────────

Out of 5945 persons 839 were found to be ill, and yet the season was not unhealthy. One family in 11 had a third room (and that not unoccupied) in which to place a corpse. This, however, appears to be a favourable specimen. From an examination made by a committee of the Statistical Society into the condition of the poorer classes in the borough of Marylebone, it appeared that the distribution of rooms amongst the portion of population examined showed that not more than one family in a hundred had a third room.

No. occupying part of a room, 159 families, and 196 single persons. No. occupying one room 382 families, and 56 single persons. No. occupying two rooms 61 families, and 2 single persons. No. occupying three rooms 5 families, and 7 single persons. No. occupying four rooms 1 families, and 0 single persons.

§ 26. Mr. Leonard, surgeon and medical officer of the parish of St. Martin’s-in-the-Fields, gives the following instances of the circumstances in which the poorest class of inhabitants die, which may be adduced as exemplifications of the dreadful state of circumstances in which the survivors are placed for the want of adequate accommodation for the remains immediately after death, and previous to the interment:—

There are some houses in my district that have from 45 to 60 persons of all ages under one roof, and in the event of death, the body often occupies the only bed till they raise money to pay for a coffin, which is often several days. They are crowded together in houses situate in Off-alley, the courts and alleys opening from Bedfordbury, Rose-street, Angel-court, courts and alleys opening from Drury-lane and the Strand, and even in places fitted up under the Adelphi arches; even the unventilated and damp underground kitchens are tenanted. Of course the tenants are never free from fevers and diarrhœa, and the mortality is great. The last class live, for the most part, in lodging-rooms, where shelter is obtained, with a bed or straw, for from 2_d._ to 4_d._ per night, and where this is not obtainable, the arches under the Adelphi afford a shelter. In the lodging-rooms I have seen the beds placed so close together as not to allow room to pass between them, and occupied by both sexes indiscriminately. I have known six people sleep in a room about nine feet square, with only one small window, about fifteen inches by twelve inches; and there are some sleeping-rooms in this district in which you cannot scarcely see your hand at noon-day.

How long is the dead body retained in the room beside the living?—If the person has subscribed to a club, or the friends are in circumstances to afford the expense of the funeral, it takes place, generally, on the following Sunday, if the death has occurred early in the week; but if towards the end of the week, then it is sometimes postponed till the Sunday week after, if the weather permit; in one case it was twelve days. In the other cases I have known much opposition to removal till after a subscription had been collected from the affluent neighbours; and in some instances, after keeping the body several days, I have been applied to to present the case to the relieving officer, that it might be buried by the parish. Amongst the Irish it is retained till after the wake, which “_is open to all comers_” as long as there is anything _dacent to drink or smoke_; but I must bear witness, also, to the frequent exhibition, in a large majority of the poor, of those affectionate attentions to the mortal remains of their relatives, which all are anxious to bestow, and which, notwithstanding the danger and want of accommodation, make them loth to part with them.

In what condition is the corpse usually, or frequently, retained?—Amongst the Irish, it does not signify of what disease the person may have died, it is retained often for many days, laid out upon the only bed, perhaps, and adorned with the best they can bestow upon it, until the _coronach_ has been performed. Thus fevers and other contagious diseases are fearfully propagated. I remember a case of a body being brought from the Fever Hospital to Bullin-court, and the consequences were dreadful; and this spring I removed a girl, named Wilson, to the infirmary of the workhouse, from a room in the same court. I could not remain two minutes in it; the horrible stench arose from a corpse which had died of phthisis twelve days before, and the coffin stood across the foot of the bed, within eighteen inches of it. This was in a small room not above ten feet by twelve feet square, and a fire always in it, being (as in most cases of a like kind) the only one for sleeping, living, and cooking in. I mention these as being particular cases, from which most marked consequences followed; but I have very many others, in which the retention of the body has been fraught with serious results to the survivors.

Will you describe the consequences of such retention?—Upon the 9th of March, 1840, M—— was taken to the Fever Hospital. He died there, and without my knowledge the body was brought back to his own room. The usual practice, in such cases, is to receive them into a lock-up-room, set apart for that purpose in the workhouse. I find that upon the 12th his step-son was taken ill. He was removed immediately to the Fever Hospital. Upon the 18th the barber who shaved the corpse was taken ill, and died in the Fever Hospital, and upon the 27th another step-son was taken ill, and removed also.

Upon the 18th of December, 1840, I—— and her infant were brought, ill with fever, to her father’s room in Eagle-court, which was ten feet square, with a small window of four panes; the infant soon died. Upon the 15th of January, 1841, the grandmother was taken ill; upon the 2nd of February the grandfather also. There was but one bedstead in the room. They resisted every offer to remove them, and I had no power to compel removal. The corpse of the grandmother lay beside her husband upon the same bed, and it was only when he became delirious and incapable of resistance that I ordered the removal of the body to the dead-room, and him to the Fever Hospital. He died there, but the evil did not stop here: two children, who followed their father’s body to the grave, were, the one within a week and the other within ten days, also victims to the same disease. In short, five out of six died.

In October, 1841, a fine girl, C——, died of cynanche maligna: her body was retained in a small back room. Upon the 1st of November another child was taken ill, and upon the 4th two others were also seized with the same disease.

Upon the 2nd of February, 1843, H——, in Heathcock-court, died of fever. I recommended the immediate removal of the body from the attic room of small dimensions, but it was retained about ten days, the widow not consenting to have it buried by the parish, and not being able to collect funds sooner: their only child was seized with fever, and was several weeks ill.

Upon the 3rd of March, 1843, B—— died of a fever in Lemontree-yard; the body was retained some days, in expectation of friends burying it, but in the mean time a child of B——, and one of a lodger in the same house, were infected.

Upon the 13th March, 1843, I saw a family in Hervey’s-buildings, which is more open, and the rooms of a better class than those in some other situations. I found there the corpse of a person who had died of a fever; the father and mother were just taken ill, and a child was taken ill soon after. The foot of the coffin was within ten inches of the father’s head as he lay upon his pillow. I caused it to be removed as soon as possible, and the three cases terminated favourably. In the case in Bullin-court, mentioned before, the girl Wilson was affected with nausea vertigo, general prostration of strength, and trembling, the usual symptoms in these cases. Soon after her removal, the mother of the deceased was seized with typhus, and is now only so far recovered as scarcely to be able to go about and attend to another son, who is at present ill of the same disease. These are a few cases only in which serious evils followed on retention of the body. I could multiply them, if necessary; but they will suffice to show that there should be power of removal to some recognized place of safety given to the district medical officer for the benefit of the individuals concerned and the public at large. The rooms are often most wretched in which these cases occur; the neighbourhood is badly ventilated and drained, or often not drained at all, and if the medical officer were responsible for his acts, and bound to report regularly, there would be a sufficient guarantee that no unnecessary harshness would be exercised in the performance of a duty absolutely required for the preservation of the public health, and the safety of those dearest to the sufferers themselves.

Comparing the effects of the practice of retaining the bodies before interment, with the effects of emanations from the dead after interment, when buried in crowded districts, which appears to you to be the most pernicious practice?—When a body is retained in a small room, badly ventilated, and often with a fire in it, the noxious gases evolved in the process of decomposition are presented to persons exposed to them in a highly concentrated form, and if their health is in a certain state favourable to receive the contagion, the effect is immediate. In crowded burial-grounds in which I have never seen a body at a less depth than three feet from the surface (allowing for the artificial building up of the ground to give apparent depth to the grave), the gases having this thickness of earth to penetrate, arrive at the surface in a divided state, and by small quantities at a time mix so gradually with the atmosphere, that it becomes comparatively harmless by dilution, and is scarcely perceptible. In confined situations, where the ground is limited in extent, the long continuance of gradual evolutions of noxious matter would, doubtless, be a cause of debility to surrounding inhabitants; but such instances, I think, are rare. I have made inquiry in the immediate neighbourhood of grave-yards, and I form my opinion from the result. There can be no doubt whatever as to the propriety of burial beyond the limits of towns, and if the corpse of the poor man could be deposited at a distance, without entailing a greater expense upon him, I think it would improve the health of our large towns very much; but I believe the retention of the corpse in the room with the living is fraught with greater danger than that produced by the emanations from even crowded grave-yards.

§ 27. The condition in which the remains are often found on the occurrence of a death at the eastern part of the metropolis are thus described by Mr. John Liddle, the medical officer of the Whitechapel district of the Whitechapel Union.

What is the class of poor persons whom you, as medical officer, are called upon to attend to?—The dock labourers, navigators, bricklayers’ labourers, and the general description of labourers inhabiting Whitechapel and lower Aldgate.

On the occurrence of a death amongst this description of labourers, what do you find to be the general condition of the family, in relation to the remains. How is the corpse dealt with?—Nearly the whole of the labouring population there have only one room. The corpse is therefore kept in that room where the inmates sleep and have their meals. Sometimes the corpse is stretched on the bed, and the bed and bed-clothes are taken off, and the wife and family lie on the floor. Sometimes a board is got on which the corpse is stretched, and that is sustained on tressels or on chairs. Sometimes it is stretched out on chairs. When children die, they are frequently laid out on the table. The poor Irish, if they can afford it, form a canopy of white calico over the corpse, and buy candles to burn by it, and place a black cross at the head of the corpse. They commonly raise the money to do this by subscriptions amongst themselves and at the public-houses which they frequent.

What is the usual length of time that the corpse is so kept?—The time varies according to the day of the death. Sunday is the day usually chosen for the day of burial. But if a man die on the Wednesday, the burial will not take place till the Sunday week following. Bodies are almost always kept for a full week, frequently longer.

What proportion of these cases may be positively contagious?—It appears from the Registrar-General’s Report (which, however, cannot be depended on for perfect accuracy, as the registrar’s returns are very incorrect,—I do not think I have been required to give a certificate of death upon more than three occasions), that in the year 1839, there were 747 deaths from epidemic diseases which formed about one-fifth of the whole of the deaths in the Whitechapel Union.

Have you had occasion to represent as injurious this practice of retaining the corpse amidst the living?—I have represented in several communications in answer to sanitary inquiries from the Poor Law Commission Office, that it must be and is highly injurious. It was only three or four days ago that an instance of this occurred in my own practice, which I will mention. A widow’s son, who was about 15 years of age, was taken ill of fever. Finding the room small, in which there was a family of five persons living, I advised his immediate removal. This was not done, and the two other sons were shortly afterwards attacked, and both died. When fever was epidemic, deaths following the first death in the same family were of frequent occurrence. In cases where the survivors escape, their general health must be deteriorated by the practice of keeping the dead in the same room.

Do you observe any peculiarity of habit amongst the lower classes accompanying this familiarity with the remains of the dead?—What I observe when I first visit the room is a degree of indifference to the presence of the corpse: the family is found eating or drinking or pursuing their usual callings, and the children playing. Amongst the middle classes, where there is an opportunity of putting the corpse by itself, there are greater marks of respect and decency. Amongst that class no one would think of doing anything in the room where the corpse was lying, still less of allowing children there.

Mr. Byles, surgeon, of Spitalfields, states, that the above description is generally applicable to the condition of the dwellings of the labouring classes, and to the circumstances under which the survivors are placed on the occurrence of a death in that district. He observes, moreover—

In the more malignant form of fever, especially scarlatina, the instances of death following the first case of death are frequent. The same holds good in respect to measles, and in respect to small-pox in families where vaccination has been neglected. I have also known instances of children who had been vaccinated becoming the subject of fever apparently from the effluvia of the body of a child who had died of the small-pox. I have often had occasion urgently to represent to the parish and union officers the necessity of a forcible interference to remove bodies. Coffins have been sent and the bodies removed and placed in a vault under the church until interment, and the rooms limewashed at the expense of the parish.

Were such removals resisted?—Not generally; they were in some few instances.

§ 28. Mr. Bestow, a relieving officer of the adjacent district of Bethnal Green, who is called upon to visit the abodes of those persons of the labouring classes, who on the occurrence of death fall into a state of destitution, thus exemplifies the common consequences of the retention of the corpse in the living and working rooms of the family:—

Is the corpse generally kept in the living or in the working room?—In the majority of cases the weavers live and work in the same room; the children generally sleep on a bed pushed under the loom. Before a coffin is obtained, the corpse is generally stretched on the bed where the adults have slept. It is a very serious evil in our district, the length of time during which bodies have been kept under such circumstances. I have frequently had to make complaint of it. We are very often complained to by neighbours of the length of time during which the bodies are kept. We have very often had disease occasioned by it. I have known, in one case, as many as eight deaths, from typhus fever, follow one death; there were five children and two or three visitors whose illness and deaths were ascribed to the circumstance.