Part 18

§ 130. At Paris, interments are made the subject of a _fisc_; but a contract is made with one head to secure services and supplies to the private individual at reduced rates, and so far the system works advantageously to the public.

§ 131. The whole of the interments are there performed, and the various burial and religious dues collected and paid under one contract, by joint contractors for the public service at regulated prices, called the _Service des Pompes Funèbres_. This establishment annually buries gratis, upwards of 7000 destitute persons, or nearly one-third of all who die in the city. The funerals and religious services are divided into nine classes, comprehending various settled particulars of service, for which a price is fixed. The appointed service for any of these classes may be had on the terms specified in a tariff. This is found to be a great benefit to testators and survivors, as it enables them to settle the ceremonial with certainty, and without the possibility of any extortion. The first class of funerals are of great pomp: they include bearers, crosses, plumes, eighteen mourning coaches and attendants, grand mass at church, 120 lbs. of wax tapers, an anniversary service, and material of mourning cloth; and also the attendance of Monsieur le Curé, two vicars, twenty-one priests, six singers and ten chorister boys, and two instrumental performers, at a cost of 145_l._, for a funeral superior in magnificence perhaps to any private funeral in England. The charge for the service and materials of the ninth class, in which there is the attendance of a vicar and a priest, and of a bass singer or chorister for the mass, is about 15_s._ of English money. In the service ordinaire there is less religious service, and that is performed gratuitously. The only charge made is the price of the coffin, which is five or seven francs, according to the size: the coffin is covered by a pall, and carried on a plain hearse, drawn by two black horses. This funeral is conducted by a superintendent and four assistants, exclusive of the driver. The following is the scale of charges, and the numbers interred under each, during two years:—

─────────────────────┬──────┬──────┬──────┬──────┬───────┬────── │ │ │ │ │ │ │ 1st │ 2nd │ 3rd │ 4th │ 5th │ 6th │Class.│Class.│Class.│Class.│Class. │Class. ─────────────────────┼──────┼──────┼──────┼──────┼───────┼────── │ £. │ £. │ £. │ £. │£. _s._│ £. Religious Funeral │ │ │ │ │ │ Service │ 24│ 19│ 11│ 8│ 5 10│ 2 Anniversary Religious│ │ │ │ │ │ Service │ 26│ 20│ 12│ 9│ 6 0│ 3 Undertaker’s Material│ │ │ │ │ │ and Service │ 95│ 83│ 49│ 23│ 14 10│ 5 ─────────────────────┼──────┼──────┼──────┼──────┼───────┼────── Total Expenses │ 145│ 122│ 72│ 40│ 26 0│ 10 ─────────────────────┼──────┼──────┼──────┼──────┼───────┼────── Number of { 1839│ 23│ 52│ 138│ 256│ 828│ 1,457 Burials { 1841│ 30│ 47│ 188│ 201│ 816│ 1,655 ─────────────────────┴──────┴──────┴──────┴──────┴───────┴────── ─────────────────────┬──────┬───────┬──────┬────────┬──────────┬─────── │ │ │ │Total of│ │ │ 7th │ 8th │ 9th │the nine│ Service │General │Class.│Class. │Class.│Classes.│Ordinaire.│Total. ─────────────────────┼──────┼───────┼──────┼────────┼──────────┼─────── │ £. │£. _s._│ _s._ │ │ │ Religious Funeral │ │ │ │ │ │ Service │ 1│ 0 16│ 11│ │ │ Anniversary Religious│ │ │ │ │ │ Service │ │ │ │ │ │ Undertaker’s Material│ │ │ │ │ │ and Service │ 3│ 1 11│ 4│ │ │ ─────────────────────┼──────┼───────┼──────┼────────┼──────────┼─────── Total Expenses │ 4│ 2 7│ 15│ │ │ ─────────────────────┼──────┼───────┼──────┼────────┼──────────┼─────── Number of { 1839│ 2,523│ 141│ 530│ 5,958│ 14,087│ 20,045 Burials { 1841│ 2,377│ 78│ 715│ 6,107│ 14,185│ 20,292 ─────────────────────┴──────┴───────┴──────┴────────┴──────────┴───────

§ 132. On the number of burials in Paris for 1841, the gross income would be about 80,000_l._ per annum. Out of this sum the contractor pays the fixed salaries of the staff of officers, which consists of a chief inspector of funeral ceremonies, of 27 other directors besides, 78 bearers, one inspector of cemeteries and four keepers; officers chiefly appointed by the municipality. The total amount of the salaries which he pays is 5862_l._, English money. He keeps an establishment of 30 hearses and 76 carriages, with suites of minor attendants properly clothed, and inters the 7000 of the pauper class gratuitously. The last contractor paid annually to the municipality 17,000_l._, which sum was chiefly devoted to ecclesiastical objects. The large profits which he realized led to considerable competition, and a new contract was recently sealed for nine years, securing for public purposes an annual income of 28,000_l._

Besides this amount, there is a revenue of about 20,000_l._ per annum derived by the municipality from the sale of tombs, and from the tax on interments, which is twenty francs for the interment of every adult, and ten francs upon children under seven years of age. One-fifth of this revenue, or about 4000_l._, is devoted to the hospitals.

§ 133. The remains of those who die in the public hospitals in Paris, and are not claimed by their friends, are, after dissection, merely enclosed in a coarse cloth and deposited in the ground, without any funereal rites. This number amounts, as stated, to no less than 7000 annually. The total average deaths in Paris is from 28,000 to 30,000 annually. This, in a population of 900,000, gives about one burial to every thirty of the population annually, which is nearly as large a proportion of annual deaths and burials as that in Manchester. The deaths and burials in the British metropolis (though varying in different parts, from 1 in 28, as in Whitechapel, to 1 in 56, as in Hackney, chiefly according to the condition of the locality) average for the entire population of 1,800,000 inhabitants, one death or burial in every forty-two of the inhabitants, or one-fourth less of burials than at Paris in proportion to the population. In Paris the average number of inhabitants to every house is 36. If the mortality were there in the proportion of London there would be 7,000 fewer burials yearly. An assertion may be ventured, that more than this excess of mortality is ascribable to the still lower sanitary condition of the labouring population in Paris, which has its concomitant in a still lower moral condition than yet prevails amongst the population of our large towns.[26]

§ 134. In Paris the law requires that the dead shall be interred within twenty-four hours after the decease, but this law may be evaded by neglect to give notice of the death. The general practice, however, appears to be, that interments take place within two days.

§ 135. In America, the later regulations manifest the tendency of the general experience to connect the regulations of interment with the general regulations for the protection of the public health, and to do this by single, specially qualified, paid, and responsible officers, rather than by Boards, or by any unskilled and honorary agency. The revised statutes of Massachusetts introduce the alternative of the appointment of a single officer. Every town is empowered to appoint a Board of Health, “or a health officer:” and the Board so appointed may appoint “a physician to the Board.” The Board acting by such officer may destroy, remove, or prevent, as the case may require, all nuisances, sources of filth, and causes of sickness. “Whenever any such nuisance or source of filth, or cause of sickness shall be found on private property, the Board of Health, or health officer, shall order the owner or occupant thereof at his own expense to remove the same within twenty-four hours, and if the owner or occupant shall neglect so to do, he shall forfeit a sum not exceeding one hundred dollars,” c. 21, s. 10. In cases of the refusal of entry into private property, on complaint to a magistrate, the magistrate may thereupon issue his warrant, “directed to the sheriff, or either of his deputies, or to any constable of such town, commanding them to take sufficient aid, and being accompanied by two or more members of the said Board of Health, between the hours of sunset and sunrise, to repair to the place where such nuisance, source of filth, or cause of sickness complained of may be, and to destroy, remove, or prevent, the same, under the direction of such members of the Board of Health.” The cleansing of the streets and houses is in most cases included in the functions of the Board of Health, or of the health officer, who regulates the removal of all refuse. Sec. 14, c. 21.

Every householder, when any of his family are taken ill, is required, on a penalty of one hundred dollars,—and every physician in the like penalty, on ascertaining that any person whom he visits is infected with the small-pox, or other disease dangerous to the public health,—to give immediate notice to the officers of public health, and they may, “unless the condition of such person is such as not to admit of his removal without danger of life,” remove him at once to the public hospital, whatever may be his station in life. Sec. 43 and 44, c. 21.

I have been favoured by Dr. Griscom, the inspector of interments at New York, with the copy of a report on the sanitary condition of the population of that city; which points out the great extent of deaths that are preventible by the adoption of means similar to those recommended in the General Report for the improvement of the sanitary condition of the population in Great Britain. This report, revealing extensive causes of death in New York, of which a large proportion of the population must have been unaware, may be adduced in proof of the immense services derivable from such an office, when zealously executed, in guarding against evils more destructive than wars.[27]

§ 136. In Munich, and in other towns in Germany, the visits and verification of the fact of death as the warrant for interment, is felt to be an important public security, and is highly popular; but one cause of its popularity is the jurisprudential functions of the officer of health, as means of preventing premature interments, and the escape of crime; for comparatively little attention appears yet to have been given to the practical means afforded by the office of tracing out and removing the causes of disease. The difficulty appears to be in respect to the jurisprudential functions of the officers of health to satisfy the public anxiety for the exercise of solemn care in _every_ case of a multitude, where only one case in that multitude will, on the doctrine of chances, be a case calling for intervention; and where it is not provided, as it may and ought to be, that the discovery of that one shall be a matter of deep personal interest, instead of a mere source of trouble to the officer himself, his examinations may be expected to degenerate into a routine in which the intended security will fail in the less obvious cases.

In later times very comprehensive regulations as to the sites and management of cemeteries, and the service of officers of health, who have charge of the cemeteries, have been adopted throughout the Austrian dominions, and it is stated that they work very satisfactorily. On the occasion of every death by accident or violence, or of suspicion, a close inquiry as to the causes is made by the town physician. In Vienna a strict inquiry is made into every such death by the following officers, who all attend for that purpose;—namely, the town physician, the surgeon in chief, the professor of pathological anatomy, a lawyer, and in some cases, when analyses are required, a chemist. The results of their examinations are set forth in a “protocol,” a carefully prepared document, “_bien motivé_,” which sometimes takes two or three days in drawing up. The effect of this inquiry is the prevention, to a great extent, of crimes of violence, and the production of public confidence. It is stated to be highly popular.

§ 137. In Paris some cases have of late occurred, which have created much public uneasiness by the evidence they afforded of the defective organization of the service of the officers of health, and occasioned it recently to undergo an examination with the view to the adoption of better securities. It appears that, from a very early period, to satisfy the public solicitude, the law required the fact of the reality of a death to be verified by the personal visit and inspection of the Maire of the district of the city where the death had taken place. Subsequently, the Maires were allowed to delegate this duty to officers of their own nomination, persons qualified for the duties by a medical education, and who were called _Officiers de Santé_. But the appointments thus made by the Maires did not give public satisfaction; and in the year 1806 it was required that the persons appointed as “officiers de santé” by the Maires, should be chosen by them from amongst the doctors in medicine and surgery who were attached to the public hospitals. They appear, however, to have been mostly chosen without reference to public qualifications, from their own medical friends in private practice. This arrangement of appointing persons in private practice appears to have prevailed in other countries, and to have frustrated much of the benefits otherwise derivable from the institution. Thirty-five of these private practitioners are now appointed to perform the duty. Reports have gained ground that from negligent discharge of the duty, persons had even been buried alive, and that the verification had been given in cases of murder. On a recent commission of inquiry, the celebrated surgeon, M. Orfila, thus speaks of the necessity of the verification of the fact of the decease.

“It is possible to be interred alive! Interments may take place after murder, committed with the knife or by means of poison, without a suspicion being created that the death has been occasioned by violence. Ignorance or malevolence may attribute to crime deaths that have occurred from natural causes!”

After referring to ancient cases in which evidence was recorded of parties having been buried alive, he adduces the following recent instances of parties having been interred without due verification of the cause of death by the _Officier de Santé_:—

“We all know the case of the death of the grocer in the Rue de la Paix, who died of poison by arsenic. The interment took place after the verification of the death. In about a month afterwards I was called upon to examine the body as to the poison. Although the putrefaction of the corpse of the person who was of a very full habit had been much advanced, I was enabled to discover the presence of the arsenic by which the crime had been perpetrated.

“The widow Danzelle, of the Rue Beauregard, was found dead in her bed on the 1st of January, 1826. The certificate of the decease was given in due form to the relations to authorise the interment. In that certificate, given to M. le Commissaire de Police, the medical practitioner declared, ‘the death has taken place, and it appears that it has been occasioned by a commotion of the brain with hæmorrhage.’ ‘The deceased’ added he, ‘lived alone; she was found dead in her chamber, where she appeared to have fallen down.’ The municipal authorities caused the interment to be adjourned, and required a new examination of the body in the presence of the Commissioner of Police, assisted by two doctors in medicine. The result of the examination was, ‘that Madame the widow Danzelle had fallen under the blows of an assassin; the corpse bore five recent wounds in the neck, made with a cutting instrument, and the carotid artery had been divided.’

“In the month of July, a child of Dame Revel, Rue de Seine Saint Germain, died very suddenly. The authorities being informed that the child had been the subject of much ill-treatment on the part of the parents, ordered an inquiry and _une expertise medico-legale_. The examination of the body showed that the rumours as to the barbarous conduct of Dame Revel, the mother, were but too well-founded. Dr. Olivier testified to the fact, that the body bore twenty-seven recent contusions on the body and members, and a fracture of nearly five inches in extent, which almost entirely broke through one of the bones of the cranium.

“The death of this poor child, which was three years and three months old, awakened suspicions which had arisen on the death of its eldest brother, of eight years of age, which had been interred on the 28th of February preceding. The body was disinterred, and Dr. Olivier, to whom this second examination was confided, notwithstanding the length of time that had occurred since the death, found traces of numerous contusions on the body and members, and a wound above the right ear, with a fracture and disjunction of the bones of the cranium.”

And notwithstanding in this, as in the other case, the interment was effected without observations.[28]

After giving instances where the innocent were justified or suspicions were allayed by post mortem examinations, which proved that deaths suspected to have been from murder had occurred from natural causes, M. Orfila concludes by stating:—

“I do not believe that it often happens that persons are interred alive in Paris, though I must admit that such events may take place; but I am convinced that the earth has covered and continues to cover crimes without any suspicion being raised in respect to them.”

§ 138. Another report imputes the neglects of the “officiers de santé,” to the forgetfulness of duties, the force of habit or routine, the results of age and infirmities; and the chief remedy recommended, and now apparently in course of adoption in Paris, is the erection on the unsubstantial foundation of service by a number of private practitioners, of two additional stages as securities, namely, of three paid medical officers, who are to devote their time to the superintendence of the performance of the public duties by the private practitioners, and, secondly, a certain number of high honorary officers, who are to superintend both classes of paid officers. This is an example of one of those superficial alterations, in which, from want of firmness on the part of the legislature to compensate fairly and amply the interests which it is obviously necessary to disturb, and from not duly regarding and estimating the immense amount of pain and public evil which requires measures of alleviation of corresponding extent and efficiency; consequently from allowing that amount of pain and mortality to weigh as dust against local patronage and latent sinister interests,—that evil is only masked, and more widely and deeply spread by the intended remedy. Of a certainty the attention of every private practitioner, as he gains practice, whilst acting as a public officer, must every hour of the day be _from_ his public duties, and _with_ the means of adding to his emoluments. That the least possible time may be taken from them, the public duties are slurred over, conclusions are snapped from the readiest superficial incidents; extensive and removable, but latent causes of evil, the development of which would require sustained and laborious examination, are perpetuated, by being stamped authoritatively as “accidental” or arbitrarily classed under some general term assigning the evils as the results of some inscrutable cause. The three superior paid inspectors will not long be able to stimulate the thirty-five private practitioners to a close attention to their public duties against their paramount and ever-pressing interests, or will soon tire of doing so. The service will become one of mere routine and of short and easy acquiescence in all except the most extraordinary cases which present an appearance of danger to the officer himself if he overlook them. Under such arrangements, the functions of the office degenerates into a highly prejudicial form, protracting the evil, by creating an impression from the fact of the existence of the office, that all has been done in the way of prevention or remedy that can be done by such an officer. The admixture of private practice with important public duties in such cases, is attended with further evil in depriving the public of much volunteer service from the whole class of private practitioners, for many who would give information to advance science, or to aid the public service, can scarcely be expected to give cordial aid that may add to the credit and promote the interests of a rival. To the people themselves such services, from a locally connected private practitioner, are generally less acceptable than those of an independent and responsible public officer. The official service must, in time, fail to inspire confidence, for it must fail to elicit evidence to justify public confidence. The additional expense of the three additional officers will only have created an additional interest, in slurring over cases that may have been overlooked by the other class of officers, involving blame for remissness to the superior officers. When exposures do take place, these two classes of officers will only add to the means of perplexing public attention, and of dividing and weakening responsibility. If less than half the number of officers, devoting their whole time to the service, would be sufficient (as will be shown they would), for the efficient discharge of these highly important duties in London, less than one-third of the number would suffice in Paris.

§ 139. Except in the regulation of the expenses of the funerals, there appears to be nothing in the practice of interments in Paris, that deserves to be considered with a view to imitation. Indeed, the whole arrangements there are now under revision, and exertions are being made for their improvement. The little account that appears to have been at any time made of the feelings of the labouring classes, and the burial after dissection, of the poor dying in hospitals, without funereal rites, the almost total omission of any marks of sympathy or respect towards their remains,—cannot but have a most demoralizing effect on the survivors. The mode in which the evil of the retention of the corpse amidst the living is provided for by the law, which requires that interments shall take place within twenty-four hours after notice, must frequently oppress the feelings of the dying and of survivors, and harass them with alarms which the medical inspection provided, as we have seen, § 137, is not of a character to allay. The intermediate stage of removal provided at Franckfort and other German towns; the retention of the corpse in a separate room warmed and ventilated, and watched at all hours, and lighted during the night; the regular medical attendance and inspection, and other cares bestowed until there are unequivocal signs of dissolution, and the minds of all classes are satisfied, appears to be a superior arrangement, salutary in its effect and principle.[29] Beyond these benevolent arrangements may be commended the acts of real good will and charity by which the feelings of the labouring classes are consulted and satisfied by community of sepulture, and the benevolent care and spirit of good will in which it appears to be maintained.

_Experience in respect to the sites of Places of Burial, and sanitary precautions necessary in respect to them._

There appear to be very important questions connected with the consideration of the site of the place of burial to populous districts.

§ 140. The question of the distance of places of burial (irrespective of convenience of conveyance) appears to be dependent on the numbers buried,—on the composition and preparation of the ground,—on the elevation or depression of the place of burial,—and its exposure to the atmosphere and the direction of the prevalent winds for the avoidance of habitations.

§ 141. The extent of burial ground requisite for any district will be determined by the rate of decomposition.