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

fair rehearsal, that I may not go forth of my doors, as my servants
carry the entrails of beasts.” * * * *

“Concerning doing honour to the dead the consideration is not long.
Anciently the friends of the dead used to make their funeral oration,
and what they spake of greater commendation was pardoned on the accounts
of friendship; but when Christianity seized on the possession of the
world, this charge was devolved on priests and bishops, and they first
kept the custom of the world and adorned it with the piety of truth and
of religion; but they also ordered it that it should not be cheap; for
they made funeral sermons only at the death of princes, or of such holy
persons ‘who shall judge the angels.’ The custom descended, and in the
channels mingled with the veins of earth, through which it passed; and
now-a-days, men that die are commended at a price, and the measure of
their legacy is the degree of their virtue. But these things ought not
so to be; the reward of the greatest virtue ought not to be prostitute
to the doles of common persons, but preserved like laurels and coronets
to remark and encourage the noblest things. Persons of an ordinary life
should neither be praised publicly, nor reproached in private; for it is
an offence and charge of humanity to speak no evil of the dead, which I
suppose, is meant concerning things not public and evident; but then
neither should our charity to them teach us to tell a lie, or to make a
great flame from a heap of rushes and mushrooms, and make orations
crammed with the narrative of little observances, and acts of civil,
necessary, and eternal religion. But that which is most considerable is,
that we should do something for the dead, something that is real and of
proper advantage. That we perform their will, the laws oblige us, and
will see to it; but that we do all those parts of personal duty which
our dead left unperformed, and to which the laws do not oblige us, is an
act of great charity and perfect kindness.”—“Besides this, let us right
their causes and assert their honour:” * * “and certainly it is the
noblest thing in the world to do an act of kindness to him whom we shall
never see, but yet hath deserved it of us, and to whom we would do it if
he were present; and unless we do so, our charity is mercenary, and our
friendships are direct merchandise, and our gifts are brocage: but what
we do to the dead, or to the living for their sakes, is gratitude, and
virtue for virtue’s sake, and the noblest portion of humanity.”


_Necessity and nature of the superior agency requisite for private and
public protection in respect to interments._

§ 183. Having given a view of the evils arising from the existing
practice in respect to interments in towns, and an outline of what
appears to be justly desired as necessary objects to supply the wants of
the population, I now beg leave to submit for consideration the
information collected as to the practical means of obtaining them.

§ 184. The most pressing of the evils being physical or sanitary evils,
the first means of amendment required is the appointment and arrangement
of the qualifications, powers, and duties and responsibilities of an
officer of health, to whom the requisite changes of practice may be most
safely confided.

The functions of such an officer, as marked out by the evidence of
existing necessities, may be divided into the ordinary and the
extraordinary. The immediate necessities are those which arise from the
want of a trustworthy person who maybe looked up to for counsel and
direction to survivors in the event of a death, §§ 121, 122, 123, 124,
and guide a change of the practice of interment. It is only by an
arrangement that will carry a man of education, a responsible officer,
to the house of even the poorest person in the community, just at the
time when a competent and trustworthy person is most needed to give
advice, that the effect of ignorant or interested suggestions may be
prevented, and the beneficent intentions of the legislature, or the
salutary nature of any public arrangement for the general advantage can
be made known with certainty.

§ 185. The ordinary service of such an officer would consist of the
verification of the fact and cause of death, and its due civic
registration. From the exercise of these duties would follow the
extraordinary duties of directing measures of immediate precaution and
prevention, which it is to be feared whatsoever general sanitary
measures might be adopted would, at the outset, and for too long a
period, constitute ordinary and every-day duties. Out of the ordinary
duties of the officer of health, would arise extraordinary
jurisprudential duties of protecting the interests of the community in
cases of deaths which have occurred under circumstances of suspicion or
of manifest criminality.

§ 186. Assuming the necessity of the establishment of adequate national
cemeteries at proper sites, it is proposed that a body of officers
properly qualified by service, as in the example § 185, should have
charge of the material arrangements, and take the place of the
churchwardens and overseers in respect to all places of burial, and be
responsible for the control of the servants of the establishment, and
shall, moreover, be enabled to regulate and contract for supplies, at
reduced prices, of materials and service of the nature of those now
supplied by the undertaker. §§ 150, 153, 154, 155.

§ 187. In order that the officer of public health may be brought to the
spot, it is proposed that the last medical attendant on the deceased
should, on a small payment, be required to give immediate notice of the
death, in a form to be specified, or in case there happened to be no
medical attendant, it should then be incumbent on the occupier of the
house, or the person having charge of the body, to give the required
notice.

Before particularising the course of practice of such an officer, it
appears requisite to state other grounds on which intervention appears
requisite for the verification of the fact of death, and the mode of
death, by the inspection of the body previously to interment.

§ 188. It is admitted that some additional arrangements are yet wanting
for the complete attainment of the proper civic and technical purposes
of registration:—as depositaries of pre-appointed evidence of the fact
of death, to determine questions of private rights:—as depositaries of
evidence for purposes of medical science and public health, to show the
extent and prevalence of common causes of disease incident to different
occupations and different localities—and of the data for tables of
insurance, as well as for the recovery of sums assured, where the proof
of age is not admitted in the policy. Any one who is unknown to the
local registrar may go and register as a fact his own death, of which a
certified copy of the registry will, according to the 38th clause of the
Act, be evidence in a court of law. Cases of the registration of false
statements have already been detected; some have been made with the view
to successions and to the obtainment of property. False registrations
have been made amongst the labouring classes as to the place of death,
to gain interments in distant parishes at cheaper rates. Fictitious
deaths have been registered to defraud burial societies, and the
registrar’s certificate of such deaths have got in use by vagrants as a
means of obtaining alms. In Manchester a woman having obtained and used
one certificate of a fictitious death, soon after obtained another
similar certificate, and in order to deter parties from visiting the
house, she got the cause of death registered as “malignant fever.”

§ 189. On the continent, wherever the mortuary registers are well kept,
and arrangements are made for the protection of the public health, the
fact and time of death, and the identity of the deceased, is verified on
the spot, by inspection of the body by a competent responsible officer
of public health. Vide instance and effects at Geneva, stated in the
General Sanitary Report, p. 174.

§ 190. It is proposed that the verification of the fact of death, and
ascertaining its cause, by inquiry on the spot, should be confided to
the officer proposed to be appointed as an officer of public health. The
present local registrars might act as auxiliaries; the proposed
appointment would be an additional security for the accuracy of the
mortuary registration, and would improve that branch of the local
machinery for registration.

Postponing the consideration of other collateral grounds for the
appointment of a district officer of health, and to illustrate more
clearly the course of alteration of the practice of interments, we will
suppose the physician or officer of health brought by the proper notice
to the habitation where the body lies in the presence of the survivors.

§ 191. In visiting the habitations of the labouring classes, he would be
more careful to denote his office, profession, and condition, by his
dress, and in his address, even than with other classes. On his arrival
at the place of abode of a person of the working class, he would, after
announcing his office and duty, inspect the body, and then require the
name, age, occupation, and circumstances of the death of the deceased,
enter them, and take the attestations of witnesses present. If the death
occurred from any ordinary cause, he would, nevertheless, speak of the
expediency of the early removal of the body to the chapel or house of
reception, where it would be placed under proper care until the
appointed time of the attendance of the relations and friends at the
interment. The exercise of a summary power of removal in the case of
rapid decomposition of the corpse, or in case of deaths from epidemic
disease, for the protection of the living, is frequently suggested and
claimed by neighbours. On inquiry in Manchester as to the periods during
which the bodies of persons dying in the poorest districts were retained
in the rooms where they died, the superintendent-registrar, Mr.
Gardiner, observed, “they are not retained so long in these districts,
because the houses to which the rooms belong are generally inhabited by
several families, and those other families feel the inconvenience of the
retention of the body amongst them, and they press for an early
interment.” With females or survivors who cannot endure to part with the
remains, the exercise of a friendly will would sometimes be necessary,
and if properly exercised would generally be effectual. The name of an
officer of public health would carry with it very general voluntary
obedience to whatever he recommended, and in a majority of cases the
prostrate survivors would be glad that he should order everything, and
would feel it a relief if he were to do so. He would be prepared with a
tariff of the prices of burial, and with instructions as to the
regulations adopted for the public convenience, and for the more
respectful performance of the ceremony of interment, and should be
empowered and required, on the assent or application of the parties, to
carry them out completely, as he might do with very little inconvenience
or expenditure of time. He might be empowered to take such a course as
this. Speaking to the widow or survivor of the lowest class, he might
say—

“The inspectors of public health have been empowered to regulate the
practice and the charges for interment, and to contract for and on
behalf of the public to ensure the means of burial in a proper and
respectful manner for the highest, as well as for the most humble
classes. Formerly, the charge for the funeral of a person of the
condition in life of your husband was four or five pounds, but by the
new regulations, an equally respectable interment is secured to you for
little more than half the amount. You are, nevertheless, at liberty to
obtain the means of burial from any private undertaker. You may also, if
you prefer it, have burial in any private cemetery, or elsewhere.”

§ 192. It is anticipated that, except on private canvass, and that only
for a time, interment under the auspices of a public officer would be
preferred in the great majority of cases, if the business were conducted
with moderate care, in a manner really satisfactory, and if the minor
but really important conveniences of all classes were duly consulted.
For example, one frequent cause of the delay of interments amongst the
poorer classes in crowded districts, is the delay of notification of
deaths to distant relatives and friends, whose attendance may be
required. More than one-half of the poor cannot write, and many of all
classes who can write are unable to collect their thoughts even for a
simple announcement of the event. The poorer classes generally get some
one to write for them; and the regular payment for each letter is
fourpence and a glass of liquor, or sixpence, exclusive of paper and
postage. In the charges for funerals of the labouring classes in
Scotland, five shillings is set down as the item of expense of letters
of notification of the death of an artisan, and fifteen shillings for
the notifications of the deaths of persons of the middle ranks of life.
Under practicable regulations, such notifications might be prepared in a
manner suitable to persons of every condition, at the rate of threepence
per letter, or at one-half the ordinary rate of payment, paper, and
envelope, and postage stamp included. The service might be rendered at
an expense of a few minutes’ time to the officer in taking down a list
of the names and addresses of the persons to be sent to. This list he
would on his return to his office, hand to a clerk, by whom they would
be immediately prepared and despatched in proper and well considered
form. The Inspector might, therefore, add—

“If you will give me the names and addresses of those relatives and
friends who may be desired to attend the funeral, I will cause notice of
the time and places of attendance to be sent to them. Amongst the
highest classes it is now the practice to diminish the number of
followers to the grave, and to commit that duty only to a few; and it is
desirable, for the sake of preventing unnecessary expense, that too many
should not be invited. All the friends of the deceased who attend at the
national cemetery will have an opportunity of joining in with the
procession. Besides, the requests to attend, I can also, if you wish it,
and will give me the names and addresses, cause notifications of the
fact of the death to be sent to any persons in any part of the country.”

In the cases of illness amongst the survivors, or of a death from
epidemic disease, indicating an infected atmosphere, he might add—

“For the protection of your own health, and the health of your children
and of your neighbours, it is requisite that the body be immediately
removed to a place where it will be kept under the care of a physician,
and inspected until the appointed time of interment, when it will be
received by the friends and relations who attend.”

§ 193. It is considered that, in general, this course would be complied
with, but it is considered by physicians, that if it were found
necessary in the first instance, in the case of the poorest and most
ignorant and highly-excitable people, to concede the point, the officer
might give directions to have the body enclosed with cloth of a material
to resist the immediate escape of effluvia, and to be closed down, which
might be done at a few shillings extra expense. Mr. R. Baker, the
surgeon, who has paid great attention to the means for the improvement
of the sanitary condition of the population at Leeds, observes—

I believe that where persons die of epidemic diseases, there is not
much regard paid to the necessity of early interment. There is what
is called the making up of the body, which is often done very early
after death, and even in some cases of supposed contagion, before it
is absolutely necessary. But an application is used in coffins of
those whose friends can afford it which deserves naming, because it
is at once safe and economical, and renders any sanitary precautions
unnecessary, where there is a desire from any requisite family
arrangements to keep the body; it is to place the body in a deal
shell, and then to place this shell within the coffin, between which
and the shell are affixed at the sides and bottom, a few pieces of
circular wood about the thickness of two crown pieces, here and
there, to keep the shell and coffin apart, forming a considerable
interstice, which is filled in with boiling pitch. The lid of the
shell is then laid on, having a glass over the face, and over this
is poured more pitch till the shell is incased in a pitch coffin
between the wooden ones. The cost of this process, which is next to
that of embalming, is about 9_s._ 6_d._, and is easily paid out of
the seven or ten pounds which the club supplies. I would only add
that this experiment deserves well of every one’s consideration,
being far superior to lead, and equally useful, in all ordinary
interments, and admirable for the purpose of avoiding contagion,
while it admits the opportunity of keeping the body for any
arrangement that is required to be made. If this plan could be
enforced upon all occasions where death had occurred from contagious
disease, I look upon it, that a great benefit would be conferred
upon the community.

§ 194. In the cases where decomposition, as sometimes occurs, commences
even before death and proceeds with extreme rapidity after it, even an
immediate removal is not effected without producing depressing effects
on the bearers; and when there is an in-door church service, in some
districts in the metropolis, it is not unfrequently necessary to have
the body left at the church door, on account of the extremely offensive
smell which escapes from the coffin. These coffins are generally
constructed without knowledge, or care, or adaptation to the
circumstances of the remains, or to any sanitary service. Mr. W. Dyce
Guthrie, surgeon, who has paid much attention to some of the structural
means for the protection of the public health, specifies various modes
in which the evils arising before interment, as well as after, may be
prevented, at a cost so inconsiderable as not to be sensibly felt, even
by the poorest classes, and yet be as efficient as the most expensive
arrangements now in use. For example: “Coffins may,” he says, “be
rendered perfectly impervious to the escape of all morbific matter, at
an expense not exceeding 1_s._ 6_d._ or 2_s._ each, by coating the
interior over with a cement composed of lime, sand, and oil, which soon
sets and becomes almost as hard and resisting as stone. Pitch, applied
hot, would answer the same purpose as the compound I have mentioned, but
it would be more expensive.” In the cases of such rapid decomposition as
bursts leaden coffins, or renders “tapping” necessary, he recommends the
application, at a few shillings expense, of safety-tubes to the foot of
the coffin, so as to secure and carry away into a chimney flue, or a
current created by a chauffer, the mephitic matter. These are adduced as
instances of the detailed appliances of which the officer of health
would judge in each case on the spot and suggest to the survivors, and
if necessary write directions, or a prescription, for their appliance.

§ 195. A cause of the delay of interments might, it is stated, be
diminished by arrangements, under which coffins of every size being kept
prepared, one might be brought to the house, with the name of the
deceased, and his obituary duly inscribed on a plate, in about one-third
the time that is now usually employed for the purpose. By this service,
the rapid progress of decomposition, and the escape of noxious effluvia
would be arrested.

§ 196. Before leaving the abode of the deceased, the officer of health
would, in the case of death from diseases likely to have been originated
or precipitated by local causes, inspect the premises, inquire closely
as to the antecedent circumstances of the decease; and note directions
to be given in respect to the premises to officers having charge of
drainage or sewerage, or public works, for cleansing and lime-washing
the premises, at the charge of the owner, before renewed occupation.

In respect to the poorest classes, those who stand the most in need of
protection: the measure of prohibiting burial, except on a verification
of the fact and cause of death, by a certificate granted on the sight
and identification of the body at the place where the death occurred,
has its chief importance as being the means of carrying a person of
education into places rarely, if ever entered, by them, except by
accident. The functions of the officer of health when there are marked
out by instances of acts done by force of humanity and charity, which as
yet have no authority in law, or in administrative provision. For
example, in the following instance, of a house owned by a landlord of
the lowest class.

Shepherd’s-court consists of about six houses. It was notorious that
fever had prevailed to a great extent in this court; in the house in
question, several cases of fever had occurred in succession. The
house is small, contains four rooms,—two on the ground-floor and two
above; each of these rooms was let out to a separate family. On the
present occasion, in one of the rooms on the ground-floor there were
four persons ill of fever; in the other room, on the same floor,
there were, at the same time, three persons ill of fever; and in one
of the upper rooms there were also at the same time three persons
ill of fever; in the fourth room no one was ill at that time. It
appeared that different families had in succession occupied these
rooms, and become affected with fever; on the occasion in question,
all the sick were removed as soon as possible by the interference of
the parish officers. An order was made by the board of guardians to
take the case before the magistrates at Worship-street. The
magistrates at first refused to interfere, but the medical officer
stated that several cases of fever had occurred in succession in
this particular house; that one set of people had gone in, become
ill with fever, and were removed; that another set of people had
gone in, and been in like manner attacked with fever; that this had
occurred several times, and that it was positively known that this
house had been affected with fever for upwards of six weeks before
the present application was made. On hearing this, the magistrate
sent for the owner of the house, and remonstrated with him for
allowing different sets of people to occupy the rooms without
previously cleansing and whitewashing them; telling him that he was
committing a serious offence in allowing the nuisance to continue.
The magistrate further gave the house in charge to the medical
officer, authorizing him to see all the rooms properly fumigated,
and otherwise thoroughly cleansed; and said that, if any persons
entered the house before the medical officer said that the place was
fit to be inhabited, they would send an officer to turn them out, or
place an officer at the door to prevent their entrance. The landlord
became frightened, and allowed the house to be whitewashed,
fumigated, and thoroughly cleansed. Since this was done the rooms
have been occupied by a fresh set of people; but no case of fever
has occurred.[40]

This occurred seven years since, and on a very recent inquiry made at
this same house, it was stated that comparative cleanliness having been
maintained, no fever had since broken out, no more such deaths have been
occasioned, no more burthens had been cast upon the poor’s rates from
this house. The law already authorizes the house to be condemned, and
its use arrested, when it is in a condition to endanger life by falling;
if it be deemed that the principle should be applied to all manifest
causes of disease or death, or danger to life, then, instead of the
remote and practically useless remedy by the inspection of an unskilled
and unqualified ward inquest (Vide General Sanitary Report, p. 300), the
skilled and responsible medical officer, with such summary powers and
duties of immediate interference, as were successfully exercised in the
case above cited, should be appointed.

§ 197. It is proper to observe, that it occurs not unfrequently that