Report on the sanitary conditions 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 online

which would exist, if that system were universally acquiesced in,
and all our parishioners were brought for interment to our parochial
burial grounds. To say nothing of the inability of many parishes to
provide adequate grounds, there could not be an adequate supply of
clergymen or of churches. Indeed, it has always seemed to me, that,
in practice, this _has been_ admitted; for, in London, that
considerable and important part of the burial service which is
performed within the church, unless specially desired and paid for,
has, from time almost immemorial, been left out; and I think that
the highest ecclesiastical authorities could hardly have introduced
or sanctioned such an anti-rubrical omission, had it not served some
more popular or more necessary purpose than that of merely raising
the fees of the church. From this consideration, added to the
frequent inconvenience of my burial services, I have been led to
regard the fees for the in-church service, like the payments for the
erection of monuments and tablets in our churches, as a kind of
necessary preventive duty. And certain it is, that unless our burial
services were limited by some such restrictive system, they would be
not only overwhelmingly laborious, but absolutely impracticable and
incompatible with our other professional engagements. How, for
instance, could the densely-built parish of Christchurch,
Spitalfields, yielding a clerical income less than 380_l._ a-year,
possessing one burial-ground, and one church attached to that
burial-ground, accommodate, in any enlarged sense of the word, an
_interrable_ population of 23,642, with the addition of the many
proprietors of our vaults and graves, who must always be resident at
a distance? Even now, with our present very scanty demand for
interment, I sometimes find, as I have intimated, extreme
inconvenience from this part of my duties. For obvious reasons the
working classes make choice of Sunday for their burials; the very
day, above all others, when the clergy and the church are almost
wholly pre-engaged for other purposes. No wonder, then, that one
purpose should often clash with another—that burials _in_ church
should clash with burials _out_ of it—that clergymen should be
hurried, discomposed, and exhausted—and mourners kept waiting in a
cold, damp burial-ground, so as to verify the old objection urged by
the Puritans against our service there, that “in burying the dead we
kill the living.” On other days, too, the clergy have other
engagements, so as to render it necessary to appoint burials for a
particular hour—an appointment, however, often more necessary to the
clergy than agreeable to the undertakers and their employers. And
yet, with every precaution, the clergyman is most seriously
incommoded; for, however he may try to accommodate, by allowing
parties to fix their own hour of burial, his time and patience are
fearfully encroached upon. Burials are very seldom punctual. They
arrive from 20 minutes up to an hour and a half after the hour
fixed. Mourners linger at home over their cups. The undertaker
pleads that he “couldn’t get them to move.” Sometimes he has another
“job” in hand elsewhere—nay, an undertaker has had two “jobs” in my
own burial ground—he has fixed them for the same hour; yet, after
having, with my assistance, completed one of them, he has coolly
left me to wait till he could fetch the other; so that, what with
wasted time, exhausted patience, and trials of temper owing to
incivility and other annoyances from such persons as a clergyman is
thus brought into contact with, he has, to say the least, as much
inconvenience as the public have to complain of.

Among the inconveniences which the necessities of our parochial
system impose upon the working-classes, may be mentioned the
practice just now alluded to, viz., the omission of the _in_-church
service in all cases where it is not specially paid for. Looking at
my parishioners in a religious light, and at a moment when all ranks
and conditions are literally levelled in the dust, I feel this to be
an invidious distinction between rich and poor; and I think it but
natural that the poor should prefer burial in places where such a
distinction is less strongly marked.

In another part of his highly important communication, he observes—

In the course of my remarks I have adverted to our inadequate
parochial provision for the burial of the dead in populous places,
and to the consequent inconvenience which has placed the churchyard
in unfavourable contrast with the dissenting ground. There is
another inconvenience, however, which attaches to both, and which is
inseparable from the burial of the dead in a crowded population: I
mean the impossibility of maintaining a due solemnity on such an
occasion.

If the working-classes of a populous city are less awfully affected
by the sight of death, from an unavoidable familiarity with it in
their own homes, it is to be feared that they and others meet with
much to prevent or impair a wholesome sensibility upon it in public;
for there the touching associations of a burial, and the sublime
spirituality of our burial office are broken in upon by the
exhibition of the most vulgar and even ludicrous scenes of daily
life.

The eastern end of my parish ground, for instance, abuts upon
Brick-lane, one of our most crowded and noisy thoroughfares, and at
one corner stands a public-house, which, of course, is not without
its attraction to all orders of street minstrels. In performing the
burial service, I have left the church, while the organ has been
playing a beautiful and impressive requiem movement, and proceeded
to the grave, where it was purely accidental if I did not hear the
very inappropriate tune mentioned by my medical friend.

Indeed, as my church extends along one side of another crowded
street, I have had most inappropriate musical accompaniments, even
during that part of the burial service which is performed _within_
the church. My burial ground is partially exposed to the street at
the west end also; and there, as at the east, it is liable to be
invaded by sounds and sights of the most incongruous description.
Boys clamber up the outside of the wall, hang upon the railing, and,
as if tempted by the effect of contrast, take a wanton delight in
the noisy utterance of the most familiar, disrespectful, and
offensive expressions;—of course, all attempts to put down this
nuisance from within the burial ground serve only to aggravate it,
and nothing _could_ put it down but a police force ordered to the
outside every time that a burial takes place. To this
wilful disturbance is added the usual uproar of a crowded
thoroughfare,—whistling, calling, shouting, street-cries, and the
creaking and rattling of every kind of vehicle—the whole forming
such a scene of noisy confusion as sometimes to make me inaudible.
On all these occasions, indeed, I labour under the indescribable
uneasiness of feeling myself out of place. Amidst such a reckless
din of secular traffic, I feel as if I were prostituting the
spirituality of prayer, and profaning even the symbolical sanctity
of my surplice. And yet, the exposure of my burial-ground is but
partial, and is little or nothing compared with that of many others.
The ground is hardly less desecrated by the scenes within it; on
Sundays, especially, it is the resort of the idle, who pass by the
church and its services to lounge and gaze in the churchyard. It is
made a play-ground by children of both sexes, who skip and scamper
about it, and, if checked by our officers, will often retort with
impertinence, abuse, obscenity, or profaneness. I generally have to
force my way to a grave through a crowd of gossips, and as often to
pause in the service, to intimate that the murmurs of some or the
loud talk of others will not allow me to proceed. I hardly ever
witness in any of these crowds any indication of a religious
sentiment. I may sometimes chance to observe a serious shake of the
head among them; but, with these rare exceptions, I see them
impressed with no better feeling than the desire to while away their
time in gratifying a vulgar curiosity. On the burial of any
notorious character,—of a suicide, of a man who has perished by
manslaughter, of a woman who has died in child-birth, or even of a
child who has been killed by being run over in the street, this
vulgar excitement rises to an insufferable height. If, in such a
case, the corpse is brought into my church, this sacred and
beautiful structure is desecrated and disfigured by the hurried
intrusion of a squalid and irreverent mob, and clergyman, corpse,
and mourners are jostled and mixed up with the confused mass, by the
uncontrollable pressure from without. I will not, indeed, venture to
say that, on these occasions, the mourners always feel and dislike
this uproar, for I believe that among the working classes they often
congratulate themselves upon it. There is an éclat about it which
ministers to the love of petty distinction before alluded to; but,
whether through the operation of this feeling or the many other
abominable mischiefs attending the burial of the dead in populous
places, there is much to counteract or impair the solemn and
impressive effect of religious obsequies.

§ 89. The feeling of a large proportion of the population appears to be
dissatisfaction with the intra-mural parochial interments, less on
sanitary grounds than from an aversion to the profanation arising from
interment amidst the scenes of the crowd and bustle of every-day life.
This feeling is manifested in the increasing numbers who abandon the
interments, even in parishes where the places of burial are neatly kept,
where, if there be nothing to satisfy, there is nothing to offend the
eye, where the service is solemnly and attentively performed, and where
the amount of the burial fees cannot be supposed to influence the
choice. The increasing feeling of aversion is indeed manifested by acts
less liable to error than any verbal testimony, by the increasing
abandonment of parochial family-vaults by the gentry and middle classes
of the population, by payments from the labouring classes, even of
increased burial dues for interments in places apart from the
profanation of every-day life. The feeling manifested may be stated to
be a national one, and to call for measures of a corresponding extent
and character.


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

The most predominant of the physical, if not of the moral evils which
follow the train of death, to the labouring classes, being the long
retention of the corpse in their one room, the means of altering this
practice claims priority in the consideration of remedies.

§ 90. The delay of interment, it has been shown, is greatly increased by
the expense of the funerals; but in a considerable proportion of cases,
where the expense is provided for, the delay still occurs, chiefly from
feelings which require to be consulted,—the fear of interment before
life is extinct.

§ 91. It has been proposed by an arbitrary enactment, without
qualification or provision of securities, to forbid all delay of
interments beyond a certain number of hours. Such a provision would, in
the shape proposed, and without other securities, run counter to the
feelings of the population, and standing as a self-executing law it
would have but little operation.

The proposed compulsory clause stood thus in the bill of the session of
1842 without any qualification:—

“And be it enacted, That from and after the First day of October,
One thousand eight hundred and forty, if any dead body shall
continue unburied between the First day of May and the Thirty-first
day of October, both days inclusive, more than hours, or
between the First day of November and the Thirtieth day of April,
both days inclusive, more than hours, the executors or
administrators to the estate and effects of such deceased person, or
the friends or relatives of the same, or any one of such friends or
relatives present at the burial, or the occupier of the house from
which such dead body shall be removed to be buried, shall forfeit
the sum of Twenty shillings for every Twenty-four hours after the
expiration of such respective periods.”

From the closeness of the rooms in which the poorer classes die, and
from large fires being on such occasions lighted in them, decomposition
often proceeds with as much rapidity in winter as in summer. The mental
sufferings from the prolonged retention of the body amidst the living,
§§ 26, 3, 39, and the moral objections to it also, § 42, would be as
intense in the winter as in the summer, or more so.

§ 92. In several of the continental states, about half a century ago,
similar enactments were passed; but it was found necessary to accompany
them with various securities; and where these securities, such as the
medical inspection and certificate before interment, have been loose,
events have occurred which have convinced the public of the necessity of
strengthening them. In a recent report on the subject at Paris, by M.
Orfila, he adduces an instance.

“In October, 1837, M. Deschamps, an inhabitant of la Guillotière, at
Lyons, died at the end of a short indisposition. His obsequies were
ordered for the next day. On the next day the priests and the
vergers, the corpse-bearers and conductors of funerals, attended. At
the moment when they were about to nail down the lid of the coffin,
the corpse rose in its shroud, sat upright, and asked for something
to eat. The persons present were about to run away in terror, as
from a phantom, but they were re-assured by M. Deschamps himself,
who happily recovered from a lethargic sleep, which had been
mistaken for death. Due cares were bestowed upon him, and he lived.
After his recovery he stated that in his state of lethargy he had
heard all that had passed around him, without being able to make any
movement, or to give any expression to his sensations. * * * It is
fortunate for M. Deschamps that the funeral, which was to have taken
place in the evening, was deferred until the morning, when the
lethargic access terminated, otherwise he would have been interred
alive.” * *

In the last number of the Annales d’Hygiene, the following recent
instances are cited, as proving the necessity of a regular verification
throughout the kingdom of the fact of death:—

A midwife of the commune of Paulhan (Hérault) was believed to be
dead and was put in a coffin. At the expiration of twenty-four hours
she was carried to the church and from thence to the cemetery. But
during its progress the bearers felt some movement in the coffin,
and were surprised and frightened. They stopped and opened the
coffin, when they found the unfortunate woman alive! she had merely
fallen into a lethargy. She was carried back to her home, but in
consequence of the shock she received she only survived a few days
the horrible accident.

It is stated from Bergerac (Dordogne), of the date of the 27th of
December, 1842, that—

An individual of the Commune d’Eymet, who suffered from the
continued want of sleep, having consulted a medical practitioner,
took on his prescription a potion which certainly caused sleep; but
the patient slept always, and the prolongation of the repose created
great anxiety, and occasioned his being bled. The blood flowed
feebly, drop by drop. Then he was declared to be dead. At the
expiration of a few days, however, the potion given to the patient
was remembered, and an uneasy sensation that it might have been the
cause of an apparent death, caused the exhumation of the body. When
the coffin was opened the horrible fact was apparent to all present
that the unfortunate man had really been buried alive; he had turned
round in the coffin! His distorted limbs showed that he had long
struggled against death.

In the “Journal des Débats,” bearing date February 21, 1843, a letter is
given from Caen of the 17th February, informing us “that Madame * * *
dwelling in the Rue Saint-Jean, appeared, after a long sickness, to
expire on Tuesday evening. The sad functions of preparing her for the
tomb were performed during the night. On the Thursday morning the coffin
was brought, and as the two men were about to lay her in it, she moved
in their hands, and woke up from the profound lethargy in which she was
plunged. Madame * * * is in a state of health which leaves little hope.
We shudder to contemplate the horrible end which awaited her if the
trance had continued some hours longer.”

§ 93. I am informed of one case, which occurred in a private family in
this country, of a disentombment, made under very similar circumstances
to those of the case related from Bergerac, which revealed a similarly
horrible event, the body being found turned in the coffin. The belief of
the occurrence of such cases in this country is sometimes founded on
statements of the bodies being found out of their proper position in the
coffins; but nothing is more probable than the discomposure of the body
from its recumbent position, by jolting at the time of its removal down
steep and narrow staircases. Sir Benjamin Brodie observes:—“Mistakes
such as these here alluded to must be very rare, and can be the result
only of the grossest neglect. The movements of respiration are always
perceptible to the eye, and cannot be overlooked by any one who does not
choose to overlook them, and there is no doubt that the heart never
continues to act more than four or five minutes after respiration has
entirely ceased. But it is not always easy to say what is the _exact
moment_ at which death hath taken place, as in some instances the
inspirations for some time previously are repeated at very long
intervals. Thus I have watched a dying person, and supposed that he was
dead, when, after a minute’s interval, there has been a fresh
inspiration; then one or two more presently afterwards; then another
long interval, and so on. I have no doubt that persons in this condition
are often sensible, and even hear and understand all that is said.

“It may be doubtful whether sensibility is always immediately
extinguished when the heart has ceased to act. In persons who have died
of the Asiatic cholera convulsive movements of the body have been
observed even several hours after apparent death. If the nervous system
has remained in such a state as this implies, who can say that it did
not retain its sensibility? There is no account of persons in whom such
convulsions (after apparent death) have taken place having recovered;
but this occurrence, even without chance of recovery, forms a strong
argument against the immediate burial of persons who have died of the
cholera.”[24]

§ 94. The extreme ignorance and terror of the lowest class of the
population on the occurrence of a death which they may never have
witnessed before, must be expected to stand in the place of gross
neglect. Of the lower class of officers in public establishments, when
unsuperintended by well qualified and responsible persons, the
occurrence of gross neglect must be anticipated. Cases have recently
occurred, and have at other times, though rarely, occurred, where the
sick are laid out for dead, who have afterwards recovered. “To the
skilful medical practitioner,” says Dr. Paris, (Paris and Fonblanque’s
Medical Jurisprudence, vol. ii., p. 44,) “we apprehend such signs must
ever be unequivocal, but we are not prepared to say that common
observers may not be deceived by them.” And he adduces instances where
they have been. He cites the testimony of Howard, who, in his work on
prisons, says, “I have known instances where persons supposed to be dead
of the gaol fever, and brought out for burial, on being washed with cold
water have shown signs of life, and have soon afterwards recovered.”

* * * * *

Dr. Paris also states that—

At the period when the small-pox raged with such epidemic fury, and
physicians so greatly aggravated its violence by their stimulating
plan of cure, there can be no doubt but that many persons were
condemned as dead who afterwards recovered; amongst the numerous
cases that might be cited in support of this opinion, the following
may be considered as well authenticated:—the daughter of Henry
Lawrens, the first president of the American Congress, when an
infant was laid out as dead, in the small-pox; upon which the window
of the apartment, that had been carefully closed during the progress
of the disease, was thrown open to ventilate the chamber, when the
fresh air revived the supposed corpse, and restored her to her
family; this circumstance occasioned in the father so powerful a
dread of living interment, that he directed by will that his body
should be burnt, and enjoined on his children the performance of
this wish as a sacred duty. We can also imagine, that women after
the exhaustion consequent on severe and protracted labours may lie
for some time in a state so like that of death, as to deceive the
by-standers; a very extraordinary case of this kind is related in
the Journal de Savans, Janvier 1749.

Dr. Gordon Smith, in his work on Forensic Medicine, has observed,
that in cases of precipitancy or confusion, as in times of public
sickness, the living have not unfrequently been mingled with the
dead, and that in warm climates, where speedy interment is more
necessary than in temperate and cold countries, persons have been
entombed alive. We feel no hesitation in believing that such an
event _may be possible_; but the very case with which the author
illustrates his position is sufficient to convince us that its
occurrence would be highly culpable, and could only arise from the
most unpardonable inattention: “I was,” says Dr. Smith, “an eye
witness of an instance in a celebrated city on the continent, where
a poor woman, yet alive, was solemnly ushered to the margin of the
grave in broad day, and whose interment would have deliberately
taken place, but for the interposition of the by-standers.” If the
casual observer was thus able to detect the signs of animation, the
case is hardly one that should have been adduced to show the
difficulty of deciding between real and apparent death.

Although the chances may be as millions to one against such a horrible
occurrence, yet the existence of the painful feeling of the possibility
of such an event, even if the apprehended possibility were utterly
unreal, is as valid ground for the adoption of measures to prevent and
alleviate the painful feeling, as if the danger were real and frequent.
A large proportion of the population, especially in Scotland, are deeply
impressed with the horror of being buried alive. Amongst the
working-classes the feeling is sometimes manifested in a dying request
that they may not be “hurried at once to the grave.”

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.