Part 6
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.
In January, 1837, a man named Clark, in George Gardens, in this parish, having been kept a considerable length of time unburied (I was informed beyond a fortnight), I was directed to visit the case, and I found the house consisted of two small rooms, wherein resided his wife and seven children. I remonstrated with them upon the impropriety of keeping the body so long, and offered either to bury, or to remove it, as it was then becoming very offensive. I was informed it would be buried on the following Sunday, as it would not be convenient for the whole of the relatives to attend the funeral earlier, and I understood a very great number did attend. I find that on the 30th of the same month (January) I was called again to visit Ann Clark, one of the family, in the same miserable abode, who was lying upon some rags, very ill of fever. I had her removed, but she ultimately died; and I again remonstrated with the family remaining in the same house, and offered to take them into the workhouse, which was declined, stating, it was their intention to remove in a few days to another house. And on the 20th of February, my attention was called to the same family, who had then removed to No. 3, Granby Row, not far from their former abode, and here I found the mother and the whole of the children (as I had predicted to them, if they persisted in their habits), all ill of fever without much hopes of their recovery. I had five removed to the London Fever Hospital immediately; but out of seven who were affected, two died. My attention was shortly afterwards directed to Henry Clark, of Barnet Street, who was a relative, and had taken fever (it was stated) by having attended the funeral of his friend; he, it seems, communicated it to his wife and two children, one of whom died; next followed Stephen Clark, of Edward Street, who, having visited the above-named relative, and attended the funeral of their infant shortly afterwards, had fever; also his wife and three children, one of whom died also. In August, 1837, I was called to visit the case of Sarah Masterton, No. 11, Suffolk Street, whose husband lay dead of fever; she was with two children in the same room, and the corpse not in a coffin. They were in the most deplorable condition, and so bad with fever that none of the neighbours would venture to enter the room with me. I had the dead body removed in a shell to our dead-house, and the woman and children to the infirmary in the workhouse. Two of them ultimately recovered; one died. In the same house, and in the upper room, I next found Robert Crisp, with a wife and child, upon whom I could not prevail to leave the place, and my urgent entreaties were treated with contempt and bad language. Ultimately, however, his child died, and not until then could I persuade him to get another place, neither would he have the infant removed, or come into the workhouse himself.
William Procktor, residing in a miserable hut in Camden’s Gardens, of only one room, with a wife and two children, when visited, was found badly affected with fever, of which the wife died, and the body was kept in the same place wherein all the family resided and slept, for more than a week. The man was next attacked, and then the children; and for a considerable time they were attended by our medical officer, but I believe they all ultimately recovered.
His report book contained frequent instances of cases of the like description.
§ 29. Mr. T. Abraham, surgeon, one of the Registrars for the City of London, who has had much practice as a parochial medical officer, was asked upon this subject—
In the course of your practice, have you had occasion to believe that evil effects are produced by the retention of the corpse in the house?—Yes; I can give an instance of a man, his wife, and six children, living in one room in Draper’s Buildings. The mother and all the children successively fell ill of typhus fever: the mother died; the body remained in the room. I wished it to be removed the next day, and I also wished the children to be removed, being afraid that the fever would extend. The children were apparently well at the time of the death of the mother. The recommendation was not attended to: the body was kept five days in the only room which this family of eight had to live and sleep in. The eldest daughter was attacked about a week after the mother had been removed, and, after three days’ illness, that daughter died. The corpse of this child was only kept three days, as we determined that it should positively be removed. In about nine days after the death of the girl, the youngest child was attacked, and it died in about nine days. Then the second one was taken ill; he lay twenty-three days, and died. Then another boy died. The two other children recovered.
By the immediate removal of the corpse, and the use of proper preventive means, how many deaths do you believe might have been prevented?—I think it probable that the one took it from the other, and that, if the corpse of the first had been removed, the rest would have escaped, although I, of course, admit that the same cause which produced the disease in the mother might also have produced it in the children. I believe that, in cases of typhus, scarlatina, and other infectious diseases, it frequently happens that the living are attacked by the same disease from the retention of the body.
Mr. Blencarn, surgeon, one of the medical officers of the City of London Union, was asked—
Have you observed any evil effects following the practice of the long retention of the corpse in the house amidst the living?—Yes; I have observed effects follow, but I cannot say produced by them, though they were perhaps increased by them. In those cases which I have had, where there has been a succession of cases of fever in the same family, after a death it has generally occurred that the parties affected have complained two or three days before that they felt very unwell. Generally this has been the case. I have in such instances ordered them medicine immediately. Since the Union has been established, we have immediately removed all fever cases to the fever hospital.
The retention of the corpse amidst the living, under such circumstances, must aggravate the mortality, must it not?—There cannot be a moment’s doubt about it.
§ 30. Mr. Barnett, surgeon, one of the medical officers of the Stepney Union, thus exemplifies the effects of the practice in his own district. After speaking of the prevalence of nervous depression, ascribable to the contiguity to a crowded grave-yard, he says:—
Similar symptoms are observable when the dead are kept any length of time in crowded apartments. I well recollect a child dying, during the summer months, of scarlet fever, and the parents persisted in keeping the corpse for a considerable period, notwithstanding the entreaties of the rest of the inmates to the contrary, all of whom complained of being ill therefrom. The result was the production of several cases of typhoid fever and much distress. A short time ago, I was requested to attend a family consisting of five persons; they resided in a room containing about 500 cubic feet, with but little light and much less ventilation. One child was suffering from small-pox, and died in a day or two: the corpse was allowed to remain in the room. The two other children were soon attacked by the disease, as well as a child belonging to a person residing in the same house, who was imprudent enough to bring it into this apartment, though cautioned not to do so. The stench arising from the living and dead was so intolerable that it produced in myself severe head-ache, and my friend, who accompanied me, complained of sudden nervousness. The parents of these children (one of whom is since dead) are suffering great debility.
The similarity of symptoms produced in these cases might perhaps lead us to the conclusion that the cause was probably the same in all; consequently, whether this poison be diluted or concentrated, it should, at all times, be carefully avoided. For this purpose, I should recommend the early removal of the dead from such apartments, and a check to be put to the baneful practice of burying the dead so near the surface in crowded districts.
§ 31. The accounts given by the medical practitioners and persons who are chiefly in attendance on the parties before death, are corroborated by the evidence of undertakers and others engaged in providing goods and services for the performance of the last rites for artisans of a condition to defray the funeral expenses.
Mr. Wild, an undertaker, residing in the Blackfriars Road, London, who inters between 500 and 600 bodies annually, of which about 350 are of the working classes, states, that the time during which the corpse is kept in the house varies from five to twelve days.
The greater proportion of the working men in London live and sleep in one room only, do they not?—Three-fourths of the rooms we have to visit are single rooms; the one room is the only room the poor people have.