Part 14
One consequence of abandoning the rite of burial, as a trade and source of emolument to persons without instruction or qualification, who employ for important ministrations agents of the lowest class, § 51, is, that only the superficial, ceremonial, and profitable portions of the service are usually attended to, and that important private and public securities are lost. One of the proper ministrations after death, a purification or ablution of the body, is generally omitted. On inquiring, as to the effects produced amongst the lower class of Irish by the retention of the body amidst the survivors under circumstances of imminent danger, a comparative immunity has been ascribed to the practice which they maintain of washing the corpse immediately after death. Amongst the lower class of the English and Scotch population of the towns, this important sanitary rite is extensively neglected, and the corpse is generally kept (except the face) with the _sordes_ of disease upon it. The occurrence of such cases as have already been mentioned, § 31 and § 40, of the propagation by contact of diseases of a malignant character, may probably be sometimes ascribed to this neglect. The ablution, whether with tepid or cold water, as a general practice, is a protection against cases of protracted syncope or suspended animation. Besides these cases, there are others of a judicial nature which cannot be termed extraordinary amidst a population where deaths from accidents or one description of violence or other, a large proportion of them involving criminality, amount in England and Wales alone to between 11,000 and 12,000 per annum. Cases have occurred of violent deaths discovered on exhumation, and on judicial examination where marks of violence have been covered by the shroud, and where the coffin has been closed on _primâ facie_ evidence of murder.
Between the every-day dangers arising from the undue retention of the dead amidst the living, and all real dangers and painful apprehensions, a course of proceeding has been taken at Franckfort, and several cities in Germany, which has hitherto been perfectly successful as a sanitary measure, and highly satisfactory to the population.
§ 95. A case is stated to have occurred at Franckfort, where, on taking to the grave a child which had died immediately after its mother, who had been just interred, on opening her coffin the eye of the supposed corpse moved, and she was taken out and recovered. She stated that she retained sensation, but had utterly lost all power of volition, even when the coffin was closed, and she heard the earth fall upon it.
§ 96. This case, and some others which have undoubtedly occurred in Germany, led to the establishment of houses at Franckfort and Munich for the reception and care of the dead until their interment; and similar establishments have now been attached to a large proportion of the German cities, under regulations substantially the same. The State regulations of interments at Munich (translations of which, and of those at Franckfort, together with plans showing the construction of the houses of reception, I have given in the Appendix) have this recital:—
“Whereas it is of importance to all men to be perfectly assured that the beings who were dear to them in life are not torn from them so long as any, the remotest, hope exists of preserving them,—so death itself becomes less dreadful in its shape when one is convinced of its actual occurrence, and that a danger no longer exists of premature interment.
“To afford this satisfaction to mankind, and to preclude the possibility of any one being treated as dead who is not actually so; to prevent the spread of infectious disorders as much as possible; to suppress the quackeries so highly injurious to the health of the people; to discover murders committed by secret violence; and to deliver the perpetrators over to the hands of justice;—is the imperative duty of every wise government; and in order to accomplish these objects, every one of which is of the greatest importance, recourse must be had to the safety, that is to say the medical police, as the most efficient means, by a strict medical examination into the deaths occurring, and by a conformable inspection of the body.”
The regulations provide that, on the occurrence of the death, immediate notice shall be given to the authorities, who shall cause the body to be removed to the house of reception provided (which at Munich is a chapel where prayers are said) for its respectful care. At the edifice of the institution at Franckfort, an appropriate apparatus is provided for the requisite ablutions with warm or tepid water: the body is received, if it be of a female, by properly appointed nurses, who perform, under superior medical superintendence, the requisite duties. The spirit of the regulations of these institutions (vide Appendix) may be commended to attention; for if it be a high public duty, which is not questioned, to treat the remains of the dead with respect and reverence, it follows that public means should be taken in every stage of proceeding, to protect individuals against the violation of that duty; where private individuals are, as they almost always are and must be, especially in populous districts, compelled to call in the aid of strangers for the performance of such ministrations as those of purifying and enshrouding the corpse, such securities as are exemplified in these regulations should be taken that those duties are confided to hands invested with responsibilities, and having a character of respectability, if not of sanctity. At Munich, they are intrusted to a religious order of Nuns. At Franckfort a private room is appropriated for the reception of each corpse, where regular warmth and due ventilation and light, night and day, are maintained. Here it may be visited by the relations or friends properly entitled. On a finger of each corpse is placed a ring, attached to which is the end of a string of a bell,[25] which on the slightest motion will give an alarm to one of the watchmen in nightly and daily attendance, by whom the resident physician will be called. Each body is daily inspected by the responsible physician, by whom a certificate of unequivocal symptoms of death must be given before any interment is allowed to take place. The legislative provisions of the institution of the house of reception at Franckfort are thus stated:—
The following are the regulations regarding the use of the house for the reception and care of the dead, which are here made known for every one’s observance.
(1.) The object of this institution is—
_a._ To give perfect security against the danger of premature interment.
_b._ To offer a respectable place for the reception of the dead, in order to remove the corpse from the confined dwellings of the survivors.
(2.) The use of the reception-house is quite voluntary, yet, in case the physician may consider it necessary for the safety of the survivors that the dead be removed, a notification to this effect must be forwarded to the Younger Burgermeister to obtain the necessary order.
(3.) Even in case the house of reception is not used the dead cannot be interred, until after the lapse of three nights, without the proper certificate of the physician that the signs of decomposition have commenced. In order to prevent the indecency which has formerly occurred, of preparing too early the certificate of the death, the physician shall in future sign a preliminary announcement of the occurrence of death, for the sake of the previous arrangements necessary for an interment, but the certificate of death is only to be prepared when the corpse shows unequivocal signs of decomposition having commenced. For the dead which it is wished to place in the house of reception, the physician prepares a certificate of removal. This certificate of removal can only be given after the lapse of the different periods, of six hours; in sudden death, of twelve hours; and in other cases, twenty-four hours.
§ 97. A German merchant, now resident in London, who took great interest in the institution, informs me that he visited it in company with his friend, one of the inspecting physicians of this house of reception. His attention was there attracted by the corpse of a beautiful child:—that child turned out not to be dead, and he himself saw it alive and recovered. No such event is known to have occurred at Munich.
This gentleman, and Mr. Koch, our consul at Franckfort, who obtained for this Report the plans of the house of reception and the regulations for interment in that city, both attest from extensive knowledge of its population, that the effect of this institution, of which all classes avail themselves, is, on the part of the poorest and most susceptible classes, to allay all feelings of reluctance to part with the remains, and to create, on the contrary, a general desire for their removal from the private house early after death, that they may be placed under the care of skilful and responsible officers. The aggravation and extension of disease to the living is thus prevented; the protraction of the pain of the weaker and more susceptible of the survivors, arising from the undue retention of the remains, and the demoralizing effect of familiarity with them on the parts of the younger, and those of the least susceptible of the survivors, are equally avoided.
The following is an extract from an official report made for this inquiry through the English Ambassador, on the operation of similar regulations at Munich:—
“The arrangements made for the speedy removal of the body after death are considered highly beneficial in a sanative point of view, as tending to check the spread of contagious and unclean disorders, more particularly in the crowded parts of the town.
“At the same time the great care and attention paid to the bodies in the place where they are deposited, the precautions taken in cases of re-animation, and the ascertaining beyond a doubt the actual occurrence of death, are sufficiently satisfactory to the surviving relations.
“The examinations also which take place immediately after death have been found equally useful in detecting the employment of violent or improper means in causing death, as well as in discovering the existence of any contagious disease against which it is of importance to guard.
“There is only one burial ground for the whole city of Munich, on a scale sufficiently large for the population, and open to Protestants as well as Catholics, without distinction.”
§ 98. The practical means for the accomplishment of such an alteration of custom in the mode of keeping the remains of the deceased, preparatory to interment, in the towns of England, may be further considered in connexion with the remedial measures, for the reduction of the great and unnecessary expense of funerals.
Mr. Hewitt states the practical need of some such accommodation of survivors for the temporary reception of the dead in the crowded districts, independently of the high considerations on which the intermediate houses of reception at Franckfort and Munich and other parts of Germany were established.
The house in which my foreman lives is seldom unoccupied by a corpse. During the last week there were three at one time. The poor people speak of the inconvenience of having the corpse in their house, where they have only one room for their family. It is customary for me to say, “Very well, then, you may be accommodated; the body may be brought to our house, and kept until the time of the funeral, when you and your friends may come to the house and put on your fittings and follow the body to the ground.” This is done: men and women come to the house, put on hoods, scarves, coats, and hatbands, and follow the body to the ground. The body is sometimes removed under these circumstances from the room of the private house where the death has taken place, but it is most frequently done when the death of a poor person has occurred in an hospital, a workhouse, or a prison, and it is wished to bury them respectably, but where it would be inconvenient to remove them to the only room which the family have to live in. I believe that all the undertakers receive deceased persons in their houses and keep them for burial.
Judging from the particular instances coming within your own experience, do you believe that if arrangements of a superior order were made for the reception of bodies and keeping them under medical care previous to interment, the accommodation would be deemed a boon?—Yes; it would be a boon to a great many classes, especially the poorest. It would be a great accommodation also to many persons of the middle classes—shopkeepers, who only keep the under part of their houses and let off the upper parts. On the occurrence of a death these classes are as much inconvenienced by the presence of a corpse as are persons of the labouring classes. And yet there are few who like to have a burial take place in less time than a week. To such persons as these it would certainly be a very great accommodation to have an intermediate house of reception for the due care of the body until the proper time of interment.
Mr. Thomas Tagg, jun., an undertaker of extensive business in the city of London, states, that “besides the poorest classes who die at hospitals and are buried by their friends, and are sometimes taken to the undertaker’s premises, when more convenient to the relatives of the deceased than to be removed to their own houses, that respectable persons also from the country, who die at an hotel or inn, or in apartments, are occasionally removed to the undertaker’s until the coffins are made, and they can be conveyed to the residence of their family, or their vaults in the country.”
§ 99. Mr. Wild gives other examples of the practice; and states that instances sometimes occur of persons of respectable condition in life who cannot bear the painful impressions produced by the long continued presence of the corpse in the house, and who quit it, and return to attend the funeral.
§ 100. Mr. P. H. Holland, surgeon and registrar of Chorlton-on-Medlock, in Manchester, states an instance where a mother who had lost two of her children from small-pox (as she conceived, from the retention in the house of the corpse of a child belonging to another woman which had also died of the small-pox) stated that it would be a great boon to the poorer classes to provide proper places to receive bodies until the convenient time of interment. The extent of benefit which such a provision would confer, and which is attested by other witnesses of extensive experience, will indeed be sufficiently manifest on consideration of the circumstances under which they are placed.
§ 101. It is only submitted that suitable accommodation should be provided for the removal and care of bodies, and given, as it would be, as a boon. Confident statements are frequently made that the removal of the deceased from private houses to any public place of reception would be resisted; but it appears on an examination of the cases in which resistance was made, that in most of them the arrangements were really offensive, coarse-minded, and vulgar, and such as to prove that the feelings of the relations and survivors were little cared for by those who ought to have understood and consulted them. In some cases of the lowest paupers the retention of the body has been proved to have arisen from a desire to raise money, on the pretext of applying it to defray the expenses of the funeral long after it had been provided for; but the objection of the respectable portions of the labouring classes are objections not to the removal itself, but to the mode and sort of place in which it is commonly performed on the occurrence of a death from contagious disease, in a bare parish shell, by pauper bearers, to the “bone-house” or other customary receptacle for suicides, deserted or relationless, or, as they are sometimes termed, “God-forsaken people.” On the occurrence of the cholera little difficulty was interposed by any class to the immediate removal of the dead. The success of such a measure would depend entirely on the mode in which it is conducted.
§ 102. In reference to all such alterations, it may here be premised that very serious practical errors are frequently created by taking particular manifestations of feeling or prejudice, and assuming those prejudices to be impregnable, and assuming, moreover, that any or every prejudice pervades the entire population.
Not only does the extent of the prejudices which are supposed to stand in the way of regulations of the practice of interments, but the difficulties of overcoming them, appear, from an examination of the evidence, to be commonly much exaggerated; but it appears that the nature of the objections themselves is much mistaken: it appears, for example, that the prejudice against dissection often arises less from a desire to preserve the remains in their living form than to preserve them from profanation and disrespect. In no part of the country has a more intense feeling been manifested to preserve the remains of the dead from dissection than in Scotland, where the expense of safes made of iron bars, strongly riveted down, and of a watchman to watch it, forms a prominent item of the funeral charges. Yet when the studies of the schools of anatomy were allowed to depend chiefly on the supplies of subjects stolen from the graves, it is stated by practitioners who, whilst students, were themselves driven to that mode of procuring subjects, that their labours were frequently frustrated by the precautions the survivors had taken to render the use of the remains for dissection impossible, by putting quick lime into the coffin to destroy them. The same precaution has been known to have been sometimes taken for the same purpose in London; and yet by proper care and attention to the feelings of the survivors, the practice of post-mortem examinations has been extended, and the consent to the use of the remains even for dissection in the schools has been frequently obtained from the survivors. A witness of peculiar and extensive opportunities of experience in several thousand cases was asked on this point—
Have you had any reason to believe, that by careful and kind treatment of the labouring classes, their prejudices may be extensively overcome?—Yes, certainly. There was no prejudice stronger or more general than that to post-mortem examinations, or to any dissection; yet by care, and by the inducement of the allowance of a better funeral, that prejudice has been extensively overcome. The teachers of the medical schools, after dissection of a body, and its use for the advancement of medical knowledge, have made a liberal allowance for the interment of the remains; such sums as three or four pounds have been allowed for that service. When the relations of the poorest classes have expressed the common aversion to a pauper funeral, and their pain at having to submit to it on account of their necessity, I have told them if they would allow the remains to be taken to a medical school, and be examined, the teachers would allow them such a respectable funeral as they wish; I have sometimes added, “It is for the advancement of science; persons of the highest rank and condition in society have directed their remains to be examined, and I do not see what sound objection there can be to any of the poorest classes doing so.” Whenever I have made the offer under such circumstances it has generally been accepted.
Of course after the examination at the schools, the remains were properly and respectfully interred?—Yes they were, wherever the parties requested, whether in or out of the parish.—They frequently chose places of interment out of the parish, and in some instances places two or three miles distant, and almost always out of the town.
Why was the burial mostly chosen out of the parish?—Generally from a dislike to the places and mode in which paupers were buried; to their being put into a hole, where, perhaps, fifty others were, instead of having a separate grave. They frequently made it a main condition, that the remains should be buried out of the parish.
The means to ensure voluntary compliance with all salutary regulations for the better ordering of interments, are those which ensure real respect to the remains of the interred, and thus to the feelings of the survivors. The widows’ and the mothers’ feelings of reluctance to part with the corpse would, from such measures, receive appropriate alleviation.
_Proposed Remedies by means of separate Parochial Establishments in Suburban Districts._
§ 103. A set of remedies, as proposed in the Committee of the House of Commons, and agreed to, has been before the public, and the chief part of them embodied in a bill proposed to the House at the close of the Session of Parliament of 1842. All the evidence of disinterested persons which I have met with, all paid and experienced officers connected with parishes, whose interests would perhaps be the least disturbed by parochial establishments, concur in the conclusion that the measures proposed for creating such establishments would not diminish, but would rather diffuse, and might even aggravate the evils intended to be remedied.
By the first clause it was proposed to enact—
That the rector, vicar, or incumbent, and the church-wardens of every parish, township, or place in every such city, town, borough, or place respectively, shall form a parochial committee of health for every such parish, township, or place.
§ 104. The first observation which occurs on this proposal is, that it involves the formation of “a committee of health,” for the execution of a sanitary measure, requiring the application of a very high degree of the science applicable to the protection of the public health, and omits all provision of services of the nature of those which would be required from a well-qualified medical officer. A provision on a parochial scale would indeed preclude the regular application of such service, except at a disproportionate expense. As a remedy against undue charges on the smaller parishes, a power of forming unions for the purpose is provided by the clause.
Or it shall be lawful for the rectors, vicars, or incumbents and church-wardens of any two or more parishes, townships, or places therein, to form such parishes, townships, or places into a Union for the purposes of this Act; and in such cases the rectors, vicars, or incumbents, and church-wardens of each parish, township, or place so united, shall form a parochial committee of health for such Union; and all the powers hereinafter given to any such committee may be executed by the majority of the members of any such committee at any meeting.
It is agreed by the most experienced public officers, that even a compulsory power to form unions of two parishes, but leaving the union beyond that number optional, would be equivalent to a provision, that two and _no_ more shall unite; but that a merely permissive power to unite would be nugatory, except perhaps in the case of the smallest parishes: in other words, since there are in the district to which the enactment would apply, in the metropolis, upwards of 170 parishes, it would imply the establishment of upwards of 100 places of burial in such places as the following clauses would enable the parishes to provide.