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

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.

And be it enacted, that every such committee may provide a
convenient site of land for the burial of the dead of the district
for which such committee shall be formed, which land shall not be in
or within the distance of two miles from the precincts or boundaries
of the city of London or Westminster, or the borough of Southwark,
or in or within one mile of any other city, town, borough, or place;
and no land which shall be purchased for such purpose shall be
within 300 yards of any house of the annual value of 50_l._, or
having a plantation or ornamental garden or pleasure-ground occupied
therewith (except with the consent in writing of the owner, lessee,
and occupier of such house).

An undertaker who has an extensive business, states that he has for some
time been desirous of purchasing a piece of ground for interments in the
suburbs of the metropolis, as a private speculation of his own, and that
he had been three years in looking out for a plot that was suitable and
purchasable, but has hitherto been unable to procure one. Other
witnesses, on similar grounds, doubt the practicability of parishes
procuring land, unless at enormous prices.

Supposing it were possible to procure separate plots for all the
parishes which will require them in the suburbs, there are preliminary
objections to the plan which relate to the suburbs themselves.

§ 105. The suburbs, it may be submitted, not only require careful
protection on their own account, but on account of the population of the
crowded districts of the metropolis, which are relieved by the growth of
the suburbs. The progress of the new increments to towns is, therefore,
as a sanitary measure, entitled to favourable protection. But the
appropriation of vacant places, without reference to any general plan,
must create very frequent impediments to the regular or systematic
growth of the suburbs, and can scarcely fail ultimately to deteriorate