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 numbers of students who pass through their education without injury;
yet he admits—

In stating the opinion that putrefaction singly does not occasion
malarious disease, we do not mean to affirm that air highly charged
with putrid miasmata may not, in some cases, powerfully impress the
nervous system so as to induce syncope and high nervous disorder; or
that, when such miasmata are absorbed by the lungs in a concentrated
state, they may not excite putrid disorders, or dispose the frame to
unhealthy erysipelatous affections. On the contrary, experiment
seems to have shown that they are deleterious when injected; and
cases are detailed in which, when exhaled from the dead body, they
have excited serious mischief in those exposed to their action.
According to Percy, a Dr. Chambon was required by the Dean of the
Faculté de Médecine of Paris to demonstrate the liver and its
appendages before the faculty on applying for his licence. The
decomposition of the subject given him for the demonstration was so
far advanced, that Chambon drew the attention of the Dean to it, but
he was required to go on. One of the four candidates, Corion, struck
by the putrid emanations which escaped from the body as soon as it
was opened, fainted, was carried home, and died in seventy hours;
another, the celebrated Fourcroy, was attacked with a burning
exanthematous eruption; and two others, Laguerenne and Dufresnoy,
remained a long time feeble, and the latter never completely
recovered. “As for Chambon,” says M. Londe, “indignant at the
obstinacy of the Dean, he remained firm in his place, finished his
lecture in the midst of the Commissioners, who inundated their
handkerchiefs with essences, and, doubtless, owed his safety to his
cerebral excitement, which during the night, after a slight febrile
attack, gave occasion to a profuse cutaneous exhalation.”

An eminent surgeon, who expressed to me his belief that no injury
resulted from emanations from decomposing remains, for he had suffered
none, mentioned an instance where he had conducted the post mortem
examination of the corpse of a person of celebrity which was in a
dreadful state of decomposition, without sustaining any injury; yet he
admitted, as a casual incident which did not strike him as militating
against the conclusion, that his assistant was immediately after taken
ill, and had an exanthematous eruption, and had been compelled to go to
the sea side, but had not yet recovered. Another surgeon who had lived
for many years near a churchyard in the metropolis, and had never
observed any effluvia from it, neither did _he_ perceive any effects of
such emanations at church or anywhere else; yet he admitted that his
wife perceived the openings of vaults when she went to the church to
which the graveyard belonged, and after respiring the air there, would
say, “they have opened a vault,” and on inquiry, the fact proved to be
so. He admitted also, that formerly in the school of anatomy which he
attended, pupils were sometimes attacked with fever, which was called
“the dissecting-room fever,” which, since better regulations were
adopted, was now unknown.

§ 2. In proof of the position that the emanations from decomposing
remains are not injurious to health at any time, reference is commonly
made to the statements in the papers of Parent Duchâtelet, wherein he
cites instances of the exhumation of bodies in an advanced stage of
decomposition without any injurious consequences being experienced by
the persons engaged in conducting them.

At the conclusion of this inquiry, and whilst engaged in the preparation
of the report, I was favoured by Dr. Forbes with the copy of a report by
Dr. V. A. Riecke, of Stuttgart. “On the Influence of Putrefactive
Emanations on the Health of Man,” &c., in which the medical evidence of
this class is closely investigated. In reference to the statements of
Parent Duchâtelet on this question, Dr. Riecke observes—

When Parent Duchâtelet appeals to and gives such prominence to the
instance of the disinterments from the churchyard of St. Innocens,
and states that they took place without any injurious consequences,
although at last all precautions in the mode of disinterring were
thrown aside, and that it occurred during the hottest season of the
year, and therefore that the putrid emanations might be believed to
be in their most powerful and injurious state, I would reply to this
by asking the simple question, what occasion was there for the
disinterment? Parent Duchâtelet maintains complete silence on this
point; but to me the following notices appear worthy of attention.
In the year 1554, Houlier and Fernel, and in the year 1738, Lemery,
Geoffroy, and Hunaud, raised many complaints of this churchyard; and
the two first had asserted that, during the plague, the disease had
lingered longest in the neighbourhood of the Cimetière de la
Trinité, and that there the greatest number had fallen a sacrifice.
In the years 1737 and 1746 the inhabitants of the houses round the
churchyard of St. Innocens complained loudly of the revolting stench
to which they were exposed. In the year 1755 the matter again came
into notice: the inspector who was intrusted with the inquiry,
himself saw the vapour rising from a large common grave, and
convinced himself of the injurious effects of this vapour on the
inhabitants of the neighbouring house.[1] “Often,” says the author
of a paper which we have before often alluded to, “the complexions
of the young people who remain in this neighbourhood grow pale. Meat
sooner becomes putrid there than elsewhere, and many persons cannot
get accustomed to these houses.” In the year 1779, in a cemetery
which yearly received from 2000 to 3000 corpses, they dug an immense
common grave near to that part of the cemetery which touches upon
the Rue de la Lingerie. The grave was 50 feet deep, and made to
receive from 1500 to 1600 bodies. But in February, 1780, the whole
of the cellars in the street were no longer fit to use. Candles were
extinguished by the air in these cellars; and those who only
approached the apertures were immediately seized with the most
alarming attacks. The evil was only diminished on the bodies being
covered with half a foot of lime, and all further interments
forbidden. But even that must have been found insufficient, as,
after some years, the great work of disinterring the bodies from
this churchyard was determined upon. This undertaking, according to
Thouret’s report, was carried on from December, 1785, to May, 1786;
from December, 1786, to February, 1787; and in August and October of
the same year: and it is not unimportant to quote this passage, as
it clearly shows how little correct Parent Duchâtelet was in his
general statement, that those disinterments took place in the
hottest seasons of the year. It is very clear that it was exactly
the coldest seasons of the year which were chosen for the work; and
though in the year 1787 there occurs the exception of the work
having been again begun in August, I think it may be assumed that
the weather of this month was unusually cold, and it was therefore
thought the work might be carried on without injurious effects. It
does not, however, appear to have been considered safe to continue
the work at that season, since the report goes on to state that the
operations were again discontinued in September.

Against those statements of Parent Duchâtelet, as to the
innocuousness of the frequent disinterments in Père La Chaise,
statements which are supported by the testimony of Orfila and
Ollivier, in regard to their experience of disinterments, I would
here place positive facts, which are not to be rejected. “I,” also
remarks Duvergie, “have undertaken judicial disinterments, and must
declare that, during one of these disinterments at which M.
Piedagnel was present with me, we were attacked with an illness,
although it was conducted under the shade of a tent, through which
there was passing a strong current of wind, and although we used
chloride of lime in abundance, M. Piedagnel was confined to his room
for six weeks.” Apparently, Duvergie is not far wrong when he states
his opinion that Orfila had allowed himself to be misled by his
praiseworthy zeal for the more general recognition of the use of
disinterments for judicial purposes, to understate the dangers
attending them, as doubtless he had used all the precautions during
the disinterments which such researches demand: and to these
precautions (which Orfila himself recommended) may be attributed the
few injurious effects of these disinterments. It, however, deserves
mentioning, that, if Orfila did undertake disinterments during the
heat of summer, it must have been only very rarely; at least,
amongst the numerous special cases which he gives, we find only two
which took place in July or August, most of the cases occurred in
the coldest season of the year. I cannot refrain from giving, also,
the information which Fourcroy gained from the grave-diggers of the
churchyard of St. Innocens. Generally they did not seem to rate the
danger of displacing the corpses very high: they remarked, however,
that some days after the disinterment of the corpses the abdomen
would swell, owing to the great development of gas; and that if an
opening forced itself at the navel, or anywhere in the region of the
belly, there issued forth the most horribly smelling liquid and a
mephitic gas; and of the latter they had the greatest fear, as it
produced sudden insensibility and faintings. Fourcroy wished much to
make further researches into the nature of this gas, but he could
not find any grave-digger who could be induced by an offered reward
to assist him by finding a body which was in a fit state to produce
the gas. They stated, that, at a certain distance, this gas only
produced a slight giddiness, a feeling of nausea, languor, and
debility. These attacks lasted several hours, and were followed by
loss of appetite, weakness, and trembling. “Is it not very
probable,” says Fourcroy, “that a poison so terrible that when in a
concentrated state, it produced sudden death, should, even when
diluted and diffused through the atmosphere, still possess a power
sufficient to produce depression of the nervous energy and an entire
disorder of their functions? Let any one witness the terror of these
grave-diggers, and also see the cadaverous appearance of the
greatest number, and all the other signs of the influence of a slow
poison, and they will no longer doubt of the dangerous effects of
the air from churchyards on the inmates of neighbouring houses.”

After having strenuously asserted the general innocuousness of such
emanations, and the absence of foundation for the complaints against the
anatomical schools, Parent Duchâtelet concludes by an admission of their
offensiveness, and a recommendation in the following terms:—

“Instead of retaining the ‘debris’ of dissection near the theatres
of anatomy, it would certainly be better to remove them every day:
but as that is often impracticable, there ought, on a good system of
‘assainissement,’ to be considered the mode of retaining them
without incurring the risk of suffering from their infection.”

After describing the mode of removing the “debris,” he concludes—

“Thus will this part of the work be freed from the inconveniences
which accompanied and formed one of the widest sources of
‘infection,’ and of the disgust which were complained of in the
theatres of anatomy.”

§ 3. The statements of M. Duchâtelet respecting the innocuousness of
emanations from decomposing animal and vegetable remains, observed by
him at the _chantiers d’équarrissage_, or receptacle for dead horses,
and the _dépôts de vidange_, or receptacle of night soil, &c., at
Montfaucon, near Paris, are cited in this country, and on the continent,
as leading evidence to sustain the general doctrine; but as it is with
his statements of the direct effects of the emanations from the
grave-yards, so it is with relation to his statements as to the effects
of similar emanations on the health of the population; the facts appear
to have been imperfectly observed by him even in his own field of
observation. In the Medical Review, conducted by Dr. Forbes, reference
is made to the accounts given by Caillard of the epidemic which occurred
in the vicinity of the Canal de l'Ourcq near Paris in 1810 and
subsequent years:—

In the route from Paris to Pantin (says he), exposed on the one side
to the miasmatic emanations of the canal, and on the other, to the
putrid effluvia of the _voiries_, the diseases were numerous, almost
all serious and obstinate. This disastrous effect of the union of
putrid effluvia with marsh miasmata, was especially evident in one
part of this route, termed the Petit Pont hamlet, inhabited by a
currier and a gut-spinner, the putrid waters from whose operations
are prevented from escaping by the banks of the canal, and exposed
before the draining to the emanations of a large marsh. This hamlet
was so unhealthy, that of five-and-twenty or thirty inhabitants I
visited about twenty were seriously affected, of whom five died.

In the carefully prepared report on the progress of cholera at Paris,
made by the commission of medical men, of which Parent Duchâtelet was a
member, it is mentioned, as a singular incident, that in those places
where putrid emanations prevailed, “le cholera ne s'est montré ni plus
redoutable ni plus meurtrier que dans autres localities.” Yet the
testimony cited as to this point is that of the Maire, “whose zeal
equalled his intelligence,” and he alleges the occurrence of the fact of
the liability to fevers which M. Duchâtelet elsewhere denies.

“I have also made some observations which seem to destroy the
opinions received at this time, as to the sanitary effect of these
kinds of receptacles; for,

“1st. The inhabitants of the houses situated the nearest to the
depôt, and which are sometimes _tormented_ with fevers, have never
felt any indisposition.”

§ 4. To prove the innocuousness of emanations from human remains on the
general health, evidence of another class is adduced, consisting of
instances of persons acting as keepers of dissecting rooms, and
grave-diggers, and the undertakers’ men, who it is stated have pursued
their occupations for long periods, and have nevertheless maintained
robust health.

The examination of persons engaged in processes exposed to miasma from
decomposing animal remains in general only shows that habit combined
with associations of profit often prevents or blunts the perceptions of
the most offensive remains. Men with shrunken figures, and the
appearance of premature age, and a peculiar cadaverous aspect, have
attended as witnesses to attest their own perfectly sound condition, as
evidence of the salubrity of their particular occupations. Generally,
however, men with robust figures and the hue of health are singled out
and presented as examples of the general innocuousness of the offensive
miasma generated in the process in which they are engaged. Professor
Owen mentions an instance of a witness of this class, a very robust man,
the keeper of a dissecting room, who appeared to be in florid health
(which however proved not to be so sound as he himself conceived), who
professed perfect unconsciousness of having sustained any injury from
the occupation, and there was no reason to doubt that he really was
unconscious of having sustained or observed any; but it turned out, on
inquiry, that he had always had the most offensive and dangerous work
done by an inferior assistant; and that within his time he had had no
less than eight assistants, and that every one had died, and some of
these had been dissected in the theatre where they had served. So,
frequently, the sextons of grave-yards, who are robust men, attest the
salubrity of the place; but on examining the inferiors, the
grave-diggers, it appears, where there is much to do, and even in some
of the new cemeteries, that as a class they are unhealthy and
cadaverous, and, notwithstanding precautions, often suffer severely on
re-opening graves, and that their lives are frequently cut short by the
work.[2] There are very florid and robust undertakers; but, as a class,
and with all the precautions they use, they are unhealthy; and a master
undertaker, of considerable business in the metropolis, states, that “in
nine cases out of ten the undertaker who has much to do with the corpse
is a person of cadaverous hue, and you may almost always tell him
whenever you see him.” Fellmongers, tanners, or the workmen employed in
the preparation of hides, have been instanced by several medical writers
as a class who, being exposed to emanations from the skins when in a
state of putrefaction, enjoy good health; but it appears that all the
workmen are not engaged in the process when the skins are in that state,
and that those of them who are, as a class, do experience the common
consequences. The whole class of butchers, who are much in the open air
and have very active exercise, and who are generally robust and have
florid health, are commonly mentioned as instances in proof of the
innocuousness of the emanations from the remains in slaughter-houses;
but master butchers admit that the men exclusively engaged in the
slaughter-houses, in which perfect cleanliness and due ventilation are
neglected, are of a cadaverous aspect, and suffer proportionately in
their health.

Medical papers have been written in this country and on the continent to
show that the exposure of workmen to putrid emanations in the employment
of sewer cleansing has no effect on the general health; and when the
employers of the labourers engaged in such occupations are questioned on
the subject, their general reply is, that their men “have nothing the
matter with them:” yet when the _class_ of men who have been engaged in
the work during any length of time are assembled; when they are compared
with classes of men of the same age and country, and of the like periods
of service in other employments free from such emanations, or still more
when they are compared with men of the same age coming from the purer
atmosphere of a rural district, the fallacy is visible in the class, in
their more pallid and shrunken aspect—the evidence of languid
circulation and reduced “tone,” and even of vitality—and there is then
little doubt of the approximation given me by an engineer who has
observed different classes of workmen being correct, that employment
under such a mephitic influence as that in question ordinarily entails a
loss of at least one-third of the natural duration of life and working
ability.

The usual comment of the employers on the admitted facts of the
ill-health and general brevity of life of the inferior workmen engaged
in such occupations is, “But they drink—they are a drunken set;” and
such appears frequently, yet by no means invariably, to be the case. On
further examination it appears that the exposure to the emanations is
productive of nervous depression, which is constantly urged by the
workmen as necessitating the stimulus of spirituous or fermented
liquors. The inference that the whole of the effects are ascribable to
the habitual indulgence in such stimuli is rebutted by the facts
elicited on examination of other classes of workmen who indulge as much
or more, but who nevertheless enjoy better health, and a much greater
average duration of life. It is apt to be overlooked that the weakly
rarely engage in such occupations, or soon quit them; and that, in
general, the men are of the most robust classes, and have high wages and
rather short hours of work, as well as stimulating food. A French
physician, M. Labarraque, states in respect to the tanners, that,
notwithstanding the constant exposure to the emanations from putrid
fermentations, it has not been “remarked” of the workmen of this class
that they are more subject to illness than others. A tanner, in a manual
written for the use of the trade, without admitting the correctness of
this statement, observes: “Whatever may be the opinion of M. Labarraque
on this point, we do not hesitate to declare the fact that this species
of labour cannot be borne by weakly, scrofulous, or lymphatic
subjects.”[3]

§ 5. So far as observations have been made on the point (and the more
those reported upon it are scrutinized, the less trustworthy they appear
to be), workmen so exposed do not appear to be peculiarly subject to
epidemics; many, indeed, appear to be exempted from them to such an
extent as to raise a presumption that such emanations have on those
“acclimated” to them an unexplained preservative effect analogous to
vaccination. That one miasma may exclude, or neutralize, or modify the
influence of another, would appear to be _primâ facie_ probable. But it
is now becoming more extensively apparent that the same cause is
productive of very different effects on different persons, and on the
same persons at different times; as in the case mentioned by Dr. Arnott
of the school badly drained at Clarendon Square, Somers’ Town, where
every year, while the nuisance was at its height, and until it was
removed by drainage, the malaria caused some remarkable form of disease;
one year, extraordinary nervous affection, exhibiting rigid spasms, and
then convulsions of the limbs, such as occur on taking various poisons
into the stomach; another year, typhoid fever; in another, ophthalmia;
in another, extraordinary constipation of the bowels, affecting similar
numbers of the pupils. Such cases as the one before cited with respect
to the depôt for animal matter in Paris, where the workmen suffered very
little, whilst the people living near the depôt were “tormented with
fevers,” are common. The effects of such miasma are manifested
immediately on all surrounding human life (and there is evidence to
believe they are manifest in their degree on animal life[4]), in
proportion to the relative strength of the destructive agents and the
relative strength or weakness of the beings exposed to them; the effects
are seen first on infants; then on children in the order of their age
and strength; then on females, or on the sickly, the aged, and feeble;
last of all, on the robust workmen, and on them it appears on those
parts of the body that have been previously weakened by excess or by
illness. Whilst M. Parent Duchâtelet was looking for immediate
appearances of acute disease on the robust workmen living amidst the
decomposing animal effluvium of the Montfaucon, I have the authority of
Dr. Henry Bennett for stating that he might have found that the
influence of that effluvium was observable on the sick at half a mile
distant. “When I was house surgeon at St. Louis,” says Dr. Bennett, “I
several times remarked, that whenever the wind was from the direction of
the Montfaucon, the wounds and sores under my care assumed a foul
aspect. M. Jobert, the surgeon of the hospital, has told me that he has
repeatedly seen hospital gangrene manifest itself in the wards
apparently under the same influence. It is a fact known to all who are
acquainted with St. Louis, that the above malady is more frequent at
that hospital than at any other in Paris, although it is the most airy
and least crowded of any. This, I think, can only be attributed to the
proximity of the Montfaucon. Indeed, when the wind blows from that
direction, which it often does for several months in the year, the
effluvium is most odious.” As an instance of a similar influence of
another species of effluvium, not observed by the healthy inhabitants of
a district, it is stated that at a large infirmary in this country, when
the piece of ornamental water, which was formerly stagnant in front of
the edifice, had a greenish scum upon it, some descriptions of surgical
operations were not so successful as at other times, and a flow of fresh
water has been introduced into the reservoir to prevent the miasma.

The immediate contrasts of the apparent immunity of adults to
conspicuous attacks of epidemics, may perhaps account for the persuasion
which masters and workmen sometimes express, that they owe an immunity