Chapter XIV: Appendix: Page (13)

§ 251. That for the avoidance of the pain, and moral and physical evil arising from the prolonged retention of the body in the rooms occupied by the living, and at the same time to carry out such arrangements as may remove the painful apprehensions of premature interments, institutions of houses for the immediate reception, and respectful and appropriate care of the dead, under superior and responsible officers, should be provided in every town for the use of all classes of the community. (§ 90 to § 101.)

§ 252. That for the abatement of oppressive charges for funereal materials, decorations, and services, provision should be made (in conformity to successful examples abroad) by the officers having charge of the national cemeteries, for the supply of the requisite materials and services, securing to all classes, but especially to the poor, the means of respectable interment, at reduced and moderate prices, suitable to the station of the deceased, and the condition of the survivors. (§ 186, § 115 to § 120.)

§ 253. That for these purposes, and for carrying out the physical arrangements necessary for the protection of the public health in respect to the practice of interment, officers of health qualified by medical education and special knowledge should be appointed. (§ 223.)

§ 254. That in order to abate the apprehensions of premature interment, § 92 to § 96, to bring responsible aid and counsel, and protection within the reach of the most destitute survivors, §§ 121 and 122 and § 198, to protect the people against continued exposure to ascertained and preventible causes of disease and death, the principle of the early appointment of searchers be revived, and no interment be allowed to take place without the verification of the fact and cause of death by the officer of health. (§ 123, 124, 125, 126, to § 216.)

§ 255. That in all clear and well ascertained cases of deaths from immediately removable causes of disease and death, the officers of health be invested with summary powers, and be responsible for exercising them, for the removal of those causes, and for the protection of strangers from continued exposure and suffering from them.

§ 256. That the expenses of national cemeteries should be raised by loans bearing interest.

§ 257. That the repayment of the principal and interest should be spread over a period of [thirty years?]—and be charged as part of the reduced expenses for future interments.

§ 258. That all burial fees and existing dues be collected on interment, and form a fund from whence be paid the compensations which Parliament may award to such existing interests as it may be necessary to disturb, including the payment of the establishment charges, and the principal and interest of the money expended for the erection of new cemeteries; and that any surplus which may thereafter accrue may be applied to the means of improving the health of the living.

§ 259. That, on consulting the experience of those cities abroad where the greatest attention has been given to the arrangements for the protection of health connected with interments, it appears that by the appointment of medical officers, unencumbered by private practice, as officers of health, and qualified by the possession of appropriate science for the verification of the fact and causes of death, and by committing to them the regulation of the service of interments in national cemeteries, the several defects above specified may be remedied, and that new and comparatively salubrious places of burial may be procured, together with appropriate religious establishments, wherein the funeral service may be better solemnized, and that the expense of funerals may be reduced, in the metropolis, at the least, to one-half of the existing amount, and full compensation be given to all who may have legitimate claims for compensation for losses on the alterations of the existing practice. (§ 219 to § 225.)

§ 260. That the agency of properly qualified officers of health necessary for abating the evils of the practice of interments would also serve powerfully to promote the application of those sanitary measures which in some districts would, there is reason to believe, save more than their own pecuniary expense, merely in the diminished numbers combined with reduced expenses of funerals, consequent on the practical operation of comprehensive measures of sanitary improvement. (§ 201.)

§ 261. The advantages which the measures proposed offer to the classes who now stand most in need of a beneficent intervention, may be thus recapitulated. To take the poorest class: the labouring man would (in common with the middle and higher classes) gain, on the occasion of his demise, protection for his widow and surviving children, that is to say;

Protection from the physical evil occasioned by the necessity of the
prolonged retention of his remains in the living and sleeping
room:

Protection against extortionate charges for interment, and against
the impositions of unnecessary, expensive, and unseemly funereal
customs, maintained against the wishes of private individuals and
families:

Protection and redress to his survivors or the living against any
unfair or illegal practices, should any such have led to the
death:

Protection against any discoverable causes of ill health, should any
have attached to his abode or to his place of work:

Protection from the painful idea (by arrangements preventive of the
possibility) of a premature interment:

Protection of the remains from profanation, either before or after
interment:

Protection such as may be afforded by the information and advice of
a responsible officer, of knowledge, and station, in the various
unforeseen contingencies that occur to perplex and mislead the
prostrate and desolate survivors on such occasions. (§ 191 to §
207.)

Added to these will be the relief from the prospect of interment, in a common grave-yard or charnel, by the substitution of a public national cemetery, on which the mind may dwell with complacency, as a place in which sepulture may be made an honour and a privilege.

§ 262. The advantages derivable to the public at large have already been specified, in the removal of causes of pain to the feelings of the living connected with the common burial places; they would also gain in the several measures for protection against the causes of disease specified as within the province of an officer of the public health to remove; and they would also gain in the steps towards the creation of a science of the prevention of disease, and in a better registration of the fact and the causes of death.

To use the words of a great Christian writer,—that all this, which constitutes the last office of the living, “to compose the body to burial,” should be done, and that it should be done well and “gravely, decently, and charitably, we have the example of all civilized nations to engage us, and of all ages of the world to warrant:—so that it is against common honesty, and public fame and reputation not to do this office.”

I would, in conclusion, beg leave to repeat and represent urgently that Her Majesty’s Government, should only set hands to this great work, when invested with full powers to effect it completely: for at present there appears to be no alternative between doing it well or ill; between simply shifting the evil from the centre of the populous districts to the suburbs, and deteriorating them; fixing the sites of interments at inconvenient distances, forming numerous, separate, and weak, and yet enormously expensive, establishments; aggravating the expense, and physical and moral evils of the delay of interment; diminishing the solemnities of sepulture; scattering away the elements of moral and religious improvement, and increasing the duration and sum of the existing evils:—there appears to be no distinct or practicable alternative between these results and effecting such a change as, if zealously carried out, will soothe and elevate the feelings of the great bulk of the population, abate the apprehensions of the dying, influence the voluntary adoption of beneficial changes in the practice of obsequies, occasion an earlier removal of the dead from amidst the living to await interment and ensure the impressiveness of the funeral service, give additional securities against attempts on life, and trustworthy evidence of the fact of death, with the means of advancing the protection of the living against the attacks of disease; and at a reduced expense provide in well arranged national cemeteries places for public monuments, becoming the position of the empire amongst civilized nations.

I have the honour to be, Sir,

Your obedient servant,

EDWIN CHADWICK.

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Footnote 1:

According to a memoir on this subject, read at the Royal Academy of
Sciences, by M. Cadet de Vaux, in the year 1781, “Le méphetisme qui
s’etoit dégagé d’une des fosses voisines du cimetière, avoit infecté
toutes les caves: on comparait aux poisons les plus subtils, à ceux
dont les sauvages imprégnant leur flèches meurtrières, la terrible
activité de cette émanation. Les murs baignés de l’humidité dont elles
les pénétroit, pouvoit communiquer, disoit on par le seul attouchement
les accidens les plus redoutable.” See Mémoires de la Société Royale
de Médecine, tom. viii. p. 242; also Annales de Chimie, tom. v. p.
158. As an instance of the state of the cellars around the grave-yard,
it is stated, that a workman being engaged in one of them put his hand
on the wet wall. He was warned that the moisture on the walls was
poisonous, and was requested to wash the hand in vinegar. He merely
dried his hand on his apron: at the end of three days the whole arm
became numb, then the hand and lower arm swelled with great pain,
blisters came out on the skin, and the epidermis came off.

Footnote 2:

Vide also, Traité des Maladies des Artisans par Patissier, d’après
Ramazzini, 8vo. Paris, 1822, p. 151, sur les Fossoyeurs: “Le sort des
fossoyeurs est très déplorable, leur face est livide, leur aspect
triste: je n’en ai vu aucun devenir vieux.” Also pp. 108–9, 137, 144.

Footnote 3:

Manuel du Tanneur et Corroyeur. Paris, 1833, p. 325.

Footnote 4:

In the course of some inquiries which I made with Professor Owen, when
examining a slaughterman as to the effects of the effluvia of animal
remains on himself and family, some other facts were elicited
illustrative of the effects of such effluvia on still more delicate
life. The man had lived in Bear-yard, near Clare-market, which was
exposed to the combined effluvia from a slaughter-house and a tripe
factory. He was a bird-fancier, but he found that he could not rear
his birds in this place. He had known a bird fresh caught in
summer-time die there in a week. He particularly noted as having a
fatal influence on the birds, the stench raised by boiling down the
fat from the tripe offal. He said, “You may hang the cage out of the
garret window in any house round Bear-yard, and if it be a fresh bird,
it will be dead in a week.” He had previously lived for a time in the
same neighbourhood in a room over a crowded burial-ground in
Portugal-street; at times in the morning he had seen a mist rise from
the ground, and the smell was offensive. That place was equally fatal
to his birds. He had removed to another dwelling in Vere-street,
Clare-market, which is beyond the smells from those particular places,
and he was now enabled to keep his birds. In town, however, the
ordinary singing-birds did not, usually, live more than about 18
months; in cages in the country, such birds were known to live as long
as nine years or more on the same food. When he particularly wished to
preserve a pet bird, he sent it for a time into the country; and by
repeating this removal he preserved them much longer. The fact of the
pernicious effect of offensive smells on the small graminivorous
birds, and the short duration of their life in close rooms and
districts, was attested by a bird-dealer. In respect to cattle, the
slaughterman gave decided reasons for the conclusion, that whilst in
the slaughter-house they lost their appetites and refused food from
the effect of the effluvium of the place, and not, as was popularly
supposed, from any presentiment of their impending fate. _Vide_
General Sanitary Report, p. 103, note, and p. 106.

Footnote 5:

On the evidence of individual cases the innocuousness of many poisons
and diseases might be proved. Individuals are sometimes found to
resist inoculation. It is a singular, and as yet unexplained fact,
that centenarians are often found in the greatest proportion in times
and places where the average duration of life of the whole population
is very low. It has been shown from an accurate registration of
centuries in Geneva, that as the average duration of life amongst the
whole community advanced, the proportion of extreme cases of
centenarians diminished. According to the bills of mortality there
were nearly three times as many centenarians in London a century ago
than at present. Out of 141,720 deaths within the bills of mortality
during the five years ended 1742, the deaths of 58 persons alone of
100 years and upwards of age are recorded; whilst out of 139,876
deaths which occurred in the metropolis as returned by the
registrar-general, during the three years which ended 30th June, 1841,
only 22 deaths of 100 years of age and upwards are recorded. The
average age of death of all who died was then 24 years; it is now,
judging from an enumeration made from the returns of 1839, about 27
years; and there appears to have been a considerable improvement in
all periods of life up to 90 years.

Footnote 6:

_Vide_ Appendix of the district returns of the Mortuary Registration.

Footnote 7:

In the medical profession examples are not rare of the attainment of
extreme old age; yet as a class they bear the visible marks of health
below the average. The registration of one year may be an imperfect
index; but the mortuary registration for the year 1839 having been
examined, to ascertain what was the average age of death of persons of
the three professions, it appears that the average age of the
clergymen who died in London during that year was 59, of the legal
profession 50, and of the medical profession 45. Only one medical
student was included in the registration: had the deaths of those who
died in their noviciate been included, the average age of death of the
medical profession would have been much lower.

Footnote 8:

An instance in exception of a barber having caught fever is
subsequently stated.

Footnote 9:

Two days in the week the London Fever Hospital is open to the friends
of the patients, who often spend a considerable time in the wards,
sometimes sitting on the beds of the sick; yet these visitors never
take fever themselves, nor are they ever known to convey it by their
clothes to persons out of the hospital. In like manner the persons
employed to convey the clothes of the fever-patients from the wards of
the hospital do not take fever, nor is there any evidence whatever
that typhus fever is, or can be, propagated merely by the clothes; yet
it is remarkable that the laundresses who wash the clothes, which
often contain excrementitious matters from the patients, or from the
dead, of an amount perceptible to the senses, rarely if ever escape
fever. It is inferred, that in this case the poison is by the heat put
in a state of vapour, which is inhaled, and being sufficient in
quantity, produces the disease.

Footnote 10:

In the Appendix will be found further particulars and exemplifications
of the facts, deducible from the mortuary registers, together with the
returns from the several registration districts in the metropolis, of
which the above is a summary.

Footnote 11:

Vide Appendix.—Paper on the Mortuary Returns.

Footnote 12:

Recently, April the 4th, at the Liverpool assizes, a woman named
Eccles was convicted of the murder of one child, and was under the
charge of poisoning two others, with arsenic. Immediately the murders
were committed, it appeared she went to demand a stated allowance of
burial money from the employers of the children.

Footnote 13:

Clarke _v._ Johnson, 11 Moore, 319.

Footnote 14:

Bligh’s 4th Parl. Reports, N. S. 194.

Footnote 15:

_Vide_ Appendix No. 12 for examples of undertakers’ ordinary bills for
funerals of different classes.

Footnote 16:

_Vide_ Return in the Appendix.

Footnote 17:

_Vide_ Appendix.

Footnote 18:

_Vide_ General Report on the Sanitary Condition of the Population, p.
443 and p. 395, for proximate estimates of the chief structural
expenses, _i. e._ main drains, house drains, annual supply of water,
water tank, and water-closet, and means of cleansing, and also an
exemplification of the practical rule for the distribution of the
expense, so as to render it coincident to the benefit.

Footnote 19:

In all cases the mortuary registries of 1839 are referred to; but the
data are varying, and are submitted, as they will be understood, only
as proximate estimates. I have every reason to believe them to be on
the whole below the truth.

Footnote 20:

A severe epidemic, by sweeping off the most susceptible cases, usually
diminishes the proportionate mortality from that cause during the
following year.

Footnote 21:

_Vide_ District Returns, Appendix.

Footnote 22:

On a question of fact as to the effect of the common funeral
arrangements on the imagination, the testimony of a poet, whose
accuracy of description is universally admitted, may be cited. The
Rev. Mr. Crabbe thus describes the effect of the funeral array:—

Lo! now what dismal sons of darkness come
To bear this daughter of indulgence home!
Tragedians all, and well arranged in black!
Who nature, feeling, force, expression lack;
Who cause no tear, but gloomily pass by,
And shake their sables in the wearied eye,
That turns disgusted from the pompous scene,
Proud without grandeur, with profusion mean!
The tear for kindness past affection owes;
For worth deceased the sigh from reason flows;
E’en well-feigned passions for our sorrows call,
And real tears for mimic miseries fall:
But this poor farce has neither truth nor art,
To please the fancy or to touch the heart.

* * * * *

Dark but not awful, dismal but yet mean,
With anxious bustle moves the cumb’rous scene;—
Presents no objects tender or profound,
But spreads its cold unmeaning gloom around.

* * * * *

When woes are feigned, how ill such forms appear;
And oh! how needless when the woe’s sincere.

_The Parish Register._

Footnote 23:

Amongst the higher classes the tendency is to reduce the number of
cases in which mourning is worn, and to diminish the time of wearing
it. It would be a great boon to persons in inferior condition and of
limited means, who are governed by the examples of those above them,
and who are put to ruinous expense for putting a whole family into
mourning, at a time when the expense can be the least spared, if the
custom could be further altered to the wearing of a piece of crape
only on the hat or on the arm, as in the army and navy; or by limiting
the wearing of full mourning to the head of the family, and using only
crape bands for the rest. Some conception may be formed of the
inconvenience incurred by the extent to which mourning is carried,
even amongst the poorest classes, if we suppose that on such occasions
it were necessary to clothe the whole of the men of the army and navy
in black. The very excess of deaths above a healthy standard in Great
Britain necessitates mourning to nearly forty thousand families per
annum. The extent to which custom has carried mourning appears to have
no Scriptural authority. Bingham, speaking of the primitive
Christians, states, “that they did not condemn the notion of going
into a mourning habit for the dead, nor yet much approve of it, but
left it to all men’s liberty as an indifferent thing, rather
commending those that either omitted it wholly, or in short time laid
it aside again, as acting more according to the bravery and philosophy
of a Christian. Thus St. Jerome commends one Julian (Hieron. Ep. 34 ad
Julian), a rich man in his time, because having lost his wife and two
daughters, that is his whole family, in a few days, one after another,
he wore the mourning habit but forty days after their death, and then
resumed his usual habit again, and because he accompanied his wife to
the grave, not as one that was dead, but as going to her rest.
Cyprian, indeed, seems to carry the matter a little farther; he says
he was ordered by divine revelation to preach to the people publicly
and constantly, that they should not lament their brethren that were
delivered from the world by divine vocation, as being assured that
they were not lost, but only sent before them: that their death was
only a receding from the world, and a speedier call to heaven; that we
ought to long after them and not lament them, nor wear any mourning
habit, seeing they were gone to put on their white garments in heaven
(2 Cypr. de Mortal., p. 164). No occasion should be given to the
Gentiles justly to accuse us, and reprehend us for lamenting those as
lost and extinct, whom we affirm still to live with God; and that we
do not prove that faith which we profess in words, by the outward
testimony of our hearts and souls. Cyprian thought no sorrow at all
was to be expressed for the death of a Christian, nor consequently any
signs of sorrow, such as the mourning habits, because the death of a
Christian was only a translation of him to heaven. But others did not
carry the thing so high, but thought a moderate sorrow might be
allowed to nature, and therefore did not so peremptorily condemn the
mourning habit, as being only a decent expression of such a moderate
sorrow, though they liked it better if men could have the bravery to
refuse it.” (Bing., book xxii. chap. 3, sec. 22).

Footnote 24:

Dr. Bently states, that “allowing for much of fiction, with which such
a subject must ever be mixed, there is still sufficient evidence to
warrant a diligent examination of the means of discriminating between
real and apparent death.” (_Ency. Prac. Medicine_, vol. iii. 316.) “As
respiration is a function most essential to health, and at the same
time the most apparent, the cessation of it may be considered as an
indication of death. But as in certain diseases and states of
exhaustion it becomes very slow and feeble, and so to the casual
observer to appear quite extinct, various methods have been adopted
for ascertaining its existence. Thus, placing down or other light
substances near the mouth or nose; laying a vessel of water on the
chest, as an index of motion in that cavity; holding a mirror before
the mouth, in order to condense the watery vapour of the breath; have
all been proposed and employed, but they are all liable to fallacy.
Down, or whatever substance is employed, may be moved by some
agitation of the surrounding air; and the surface of the mirror may be
apparently covered by the condensed vapour of the breath, when it is
only the fluid of some exhalation from the surface of the body. We
therefore agree fully with the judicious observations of Dr. Paris on
this subject:—‘We feel no hesitation in asserting, that it is
physiologically impossible for a human being to remain more than a few
minutes in such a state of asphyxia as not to betray some sign by
which a medical observer can at once recognize the existence of
vitality; for if the respiration be only suspended for a short
interval we may conclude that life has fled for ever. Of all the acts
of animal life, this is by far the most essential and indisputable.
Breath and life are very properly considered in the scriptures as
convertible terms, and the same synonym, as far as we know, prevails
in every language. However slow and feeble respiration may become by
disease, yet it must always be perceptible, provided the naked breast
and belly be exposed; for when the intercostal muscles act, the ribs
are elevated, and the sternum is pushed forwards; when the diaphragm
acts the abdomen swells. Now this can never escape the attentive eye;
and by looking at the chest and belly we shall form a safer conclusion
than by the popular methods which have been usually adopted.’”

The looking-glass and the feather have been the standing test for time
immemorial. When Lear enters with Cordelia dead in his arms, he says:—

“I know when one is dead, and when one lives;
She’s dead as earth.—Lend me a looking-glass;
If that her breath will mist or stain the stone,
Why, then she lives.

_Kent._—Is this the promis’d end?

_Edgar._—Or image of that horror?

_Lear._—This feather stirs; she lives! if it be so
It is a chance which does redeem all sorrows
That ever I have felt.”

_Shakespeare, King Lear, Act V. Sc. 3._

Footnote 25:

Vide Appendix.—Regulations and Plans of the Building, forming part of
the Institution.

Footnote 26:

In a paper read on the 2nd January last before the Academy of Sciences
at Paris, by M. le Baron Charles Dupin, on the increase of savings’
banks and their influence on the Parisian population, some most
startling facts are mentioned in the conclusion, showing the
deplorable moral condition of a large portion of that population. “Le
nombre proportionnel des indigents, au lieu d’augmenter, diminue,
ainsi que celui des bâtards, mais avec lenteur déplorable; au
commencement de l’époque dont nous résumons les progrès, le peuple de
Paris abandonnait chaque année 205 enfants sur 1,000 nouveau nés; il
n’en abandonne plus que 120: c’est beaucoup moins, et pourtant c’est
_cent vingt_ fois trop. Encore aujourd’hui, le _tiers_ du peuple vit
dans le concubinage ou dans le libertinage; un _tiers_ de ses enfants
sont bâtards; un _tiers_ de ses morts expirent à l’hôpital ou sur le
grabat du pauvre; et ni père, ni mère, ni fils, ni filles, n’ont le
cœur, pour dernier tribut humain, de donner un cercueil, un linceul,
au cadavre de leurs proches:—du côté des mœurs, voilà Paris, et Paris
amélioré!”—It may on this point of comparison be a relief to state,
the numbers who die in the workhouses in the British metropolis, do
not exceed 4000 for nearly double the population, and that of these,
on the average of the last ten years, not more than 293 have been so
given up or abandoned as to be applicable to the public service in the
schools of anatomy. The total number who are abandoned in all the
hospitals of London, for that service, has not, on the average,
exceeded 168 out of upwards of 2000 deaths per annum. The total number
of subjects requisite for teaching in the schools of anatomy would be
about 600. Notwithstanding that the prejudice against dissection has
much abated, the full number deemed requisite has never been obtained
of late years from all sources. In some instances, persons of
education set an example by giving up their own bodies for dissection;
in some other instances, the use of the remains is obtained by
persuasions, and the promises of more respectful interment afterwards,
than could otherwise be obtained. There are actually very few real
“abandonments” by relations, the greater proportion of cases being of
persons who have outlived near relations, of whom none, after due
enquiry, which is always made, can be found. In respect to
illegitimate births, it appears from the last parliamentary return of
the number of illegitimate children born in the several counties of
England (that of Mr. Rickman,) for 1833, that the proportion of
illegitimate to legitimate births, was in Middlesex, 1 in 38; and in
Surrey 1 in 40. This was most probably an understatement, but,
whatever may be the real proportions they are below any comparison
with the proportions in Paris. The highest proportion of illegitimate
to legitimate births given in the returns, were those of the county of
Pembroke, 1 in 8; and Radnor, where it is 1 in 7. It may be important
to state for the sake of the example, and in illustration of the
principle, as to the comparative economy of sanitary arrangements that
this excess of 7,000 miserable deaths and burials per annum in Paris,
at the least, might be saved by structural sanitary arrangements,
which would prevent the accumulation of human beings in winding
streets, (some of which are not more than eight or nine feet wide,)
under circumstances which render decency, morality, health, or
contentment impossible. The whole excess of deaths, as well as the
demoralization that arises from overcrowding, might in all probability
be saved even by the last vote of expenditure, five millions sterling,
(which, at English prices, of 100_l._ for a tenement for a family,
would have provided improved tenements, at improved rents, for fifty
thousand labourers’ families) for maintaining the war on the Arabs, or
by the interest of the money expended in building the immense wall and
fortifications round the dangerous population (kept “desperate,” as
Jeremy Taylor expresses it, “by a too quick sense of a constant
infelicity,”) which those works encircle in Paris. In a copy of a
report of the medical commissioners, appointed to examine the cholera,
with which I have been favoured by one distinguished member, M.
Villerme, and in which I have found powerful corroborative evidence on
the influence of structural arrangements on the health and moral, not
to speak of the political, condition of the population; they observe,
“Le fléau qui a pesé si cruellement sur la capitale s’est fait sentir
d’une manière particulièrement désastreuse dans les quartiers étroits,
sales et embarrassés de l’ancien Paris; n’y aurait-il pas lieu de
signaler ici quelques améliorations utiles à introduire dans ces
localités? Les raisons d’état ont souvent dominé les intérêts
matériels des villes; autrefois les voies étroites et tortueuses
appliquées même aux rues pouvait faire partie des moyens de défense à
l’usage de l’état: aujourd’hui des rues larges et droites deviennent
dans l’intérieur des villes un premier élément de sécurité publique
autant que d’hygiène; il y a donc double avantage à favoriser dans ces
conditions, soit des percements nouveaux, soit l’élargissement des
voies actuelles.” They give forcible descriptions of population
analogous to that found—happily in less proportions,—in the worst part
of our cities, and they also attest, from the examination of the
inferior population of that capital: “C’est une vérité de tous les
temps, de tous les lieux, une vérité, qu’il faut redire sans cesse
parceque sans cesse on l’oublie; il existe entre l’homme et tout ce
qui l’entoure, de secrets liens, de mystérieux rapports dont
l’influence sur lui est continuelle et profonde. Favorable, cette
influence ajoute à ses forces physiques et morales, elle les develope,
les conserve; nuisible, alors elle les altère, les anéantit, les tue.
Mais son action n’est jamais plus redoutable que lorsqu’elle trouve à
s’exercer sur une population entassée, quelle qu’elle soit d’ailleurs,
et voilà pourquoi l’on observe dans certains arrondissements une
mortalité plus grande; voilà pourquoi le germe des maladies s’y
développe plus constamment, pourquoi la vie s’y éteint plus
rapidement, enfin pourquoi l’on y compte habituellement un décès sur
trente-deux habitants, quand il n’y en a qu’un sur quarante dans les
autres.” They also indicate as part of the effects of the noxious
physical causes the moral depravity and the predominance of bad
passions which impede amendment. “Ces obstacles sont réels, ils ne
sauraient être méconnus, mais qui peut douter de les voir s’affaiblir,
si d’une part la classe aisée de la population, comprenant mieux les
intentions de l’autorité et ses intérêts véritables, se prête plus
aisément à l’action des règlements sur la propreté et la salubrité
publique, et si d’une autre part l’instruction, pénétrant dans cette
portion de la population qui doit une partie de ses vices et de sa
misère à l’ignorance, fait naître chez elle, avec des mœurs plus
pures, des habitudes plus régulières et plus en harmonie avec
l’hygiène publique?” But these representations of the Medical
Commissioners of Paris have not been heard by the classes appealed to,
and relief is sought by the mode of “giving vent” to the dangerous
passions in preference to the superior treatment recommended, of the
removal of the physical circumstances by which those passions must
continue to be generated. Thus it may be mentioned in illustration of
the important principle of the superior economy and efficiency of
structural means of prevention, that the expenditure of money on
Algiers appears to have been upwards of four millions sterling per
annum, during the twelve years of its occupation. The capital sunk on
the permanent structural arrangements for supplying London with water
being about three millions and a half, it may be safely alleged that
one year’s expenditure on Algiers would have sufficed for the
structural arrangements for a supply of water for the cleansing of
every room, and house, and street in Paris; or on the scale of the
expense of the works completed for supplying Toulouse with water, one
year’s expenditure on Algiers would have sufficed to supply one
hundred and fifty towns of the same size as Toulouse with the like
means of healthful, and thence of moral improvement; or such a sum
would have sufficed to have effected for ever the “percements et
enlargissements des voies actuelles,” and thence to have advanced the
health and achieved the comparative security of four or five such
cities as Lyons. One year’s cost of any one regiment maintained in the
war on the Arabs would suffice to build and endow a school, or to have
constructed between one and two miles of permanent railway. The total
amount of capital so applied exceeds nearly by one-fourth the amount
expended on the existing railroads in Great Britain. It may be
confidently averred that the cost of the forts detaches, or
_enceintes-continues_, said to be on a reduced scale upwards of ten
millions sterling, would, if properly directed, with the accessaries
of moral appliances in addition to such physical means as those
indicated by the officers of public health, suffice within the period
of the living generation, to renovate the physical and moral condition
of the great mass of the population in the interior of that capital.

Footnote 27:

Vide Appendix—Explanations of the District Mortuary Returns.

Footnote 28:

_Vide_ other instances cited in the Annales d’Hygiene.—Number 59, p.
153 to 159.

Footnote 29:

Vide Regulations at Franckfort and Munich, Appendix.

Footnote 30:

Vide Appendix for the list of burial places returned, and a view of
the spaces requisite on the preceding scale, § 145, and the relative
space occupied as burial ground by the chief religious denominations.

Footnote 31:

It is due to the medical profession to state, that they have always
discountenanced as injurious the practice of entombment in vaults
under churches. A Parisian physician had the following epitaph to his
memory:—

“Simon Pierre, vir pius et probus
Hic sub dio sepeliri voluit
Ne mortuus cuiquam noceret
Qui vivus omnibus profuerat.”

At Louvain, there is the tomb of a celebrated anatomist, with the
following:—

“Philippus Verhagen,
Med. Dr. et prof.
Partem sui materialem
Hic in cœmeterio condi voluit,
Ne templum dehonestaret
Aut nocivis halitibus inficeret.”

Footnote 32:

Perpetuities in burial grounds may be said to have been declared
illegal by Lord Stowell’s decision in the case of Gilbert v. the
Churchwardens of St. Andrew’s, Holborn, on the use of iron coffins.
His lordship, in his judgment in that case, remarked, that “All
contrivances that, whether intentionally or not, prolong the time of
dissolution beyond the period at which the common local understanding
and usage have fixed it, is an act of injustice, unless compensated in
some other way.”—Haggard’s Rep. v. 2, p. 353. _Vide_ statement of the
principle of this decision, in the extracts from the judgment given in
the Appendix, No. 12.

Footnote 33:

The neglect of the cemeteries at Paris, and especially of those
portions dedicated to the interment of the poorer classes, has been
the subject of public complaint, and means are now being taken to
redress them. A friend, who aided me with some inquiries in respect to
them, states,—

The English tourist in visiting Père la Chaise is attracted by
splendid monuments in the midst of cypress trees, and little
gardens filled with flowers planted round a majority of the tombs;
but the graves of the humbler classes lie beyond these, and to
them the stranger is seldom conducted. The contrast is painful.
When I last visited Père la Chaise, on a fine day in November, and
after a week of unusually fine weather for the season, I found the
paths quite impracticable in the poorer quarter of the cemetery,
and as I watched a man, in the usual blouse dress worn by the
working class, picking his way through the mud to lead his little
boy to pray over the grave of his mother, I could but deplore the
economy of an administration which had neglected to provide, at
least, a dry gravel path for the humble and pious mourner.

Footnote 34:

Vide Appendix for an exemplification of the excess of deaths and
funerals, and other losses incurred by setting aside Sir Christopher
Wren’s plan for the rebuilding of the city of London.

Footnote 35:

One of the twelve tables was in these words, “_Hominem mortuum in urbe
ne sepelito neve urito_.” Cicero, in one of his epistles, Epist. ad
Div. iv. 12, in which he describes the assassination of his friend M.
Marcellus, at Athens, mentions that he had been unable to obtain
permission of the Athenians that the body should be buried in the
city; they said that such permission was inadmissible on religious
grounds, and that it never had been granted to any one.

Footnote 36:

Bingham’s Christian Antiquities, b. xxiii. ch. 1, s. 2.

Footnote 37:

_Vide_ Leviticus, chap. xiv., verse 33 to 48, for early sanitary
measures of purification.

Footnote 38:

It is perhaps an important fact, that the great majority of burials in
some burial-grounds are stated by the undertakers who perform them to
be burials of persons who are not subscribing members of the
congregations who are reputed to be the owners of the grounds, and
whilst only one out of three of the parishioners of many parishes
choose burial in the ground belonging to their parish church, the
solemnization of the marriage ceremony being generally satisfactory to
the population, and all of them having the option to have the marriage
solemnized with or without the religious ceremony, only one out of
twenty-four in the metropolis prefer solemnization elsewhere than at
the established church. From the Registrar General’s Report it appears
that, in 1839, out of 18,648 marriages celebrated in the metropolis,
only 772 were not solemnized in the established church; and out of
124,329 marriages performed that year in the whole of England and
Wales, only 7,311 were performed out of the established church.

Footnote 39:

Bingham observes that St. Chrysostom speaks against those who use
excessive mourning at funerals, showing them the incongruity of that
with this psalmody of the church, and exposing them at the same time
to the ridicule of the Gentiles. For what said they are these men that
talk so finely and philosophically about the resurrection? Yes,
indeed! But their actions do not agree with their doctrine. For whilst
they profess in words the belief of a resurrection, in their deeds
they act more like men that despair of it. If they were really
persuaded that their dead were gone to a better life, they would not
so lament. “Therefore,” says Chrysostom, “let us be ashamed to carry
out our dead after this manner. For our psalmody, and prayers, and
solemn meeting of fathers, and such a multitude of brethren, is not
that thou shouldst weep and lament, and be angry at God, but give him
thanks for taking a deceased brother to himself.” St. Jerome also
frequently speaks of this psalmody as one of the chief parts of their
funeral pomp. He says at the funeral of the Lady Paula at Bethlehem,
which was attended with great concourse of bishops and clergy and
people of Palestine, there was no howling or lamenting as used to be
among the men of this world, but singing of psalms in Greek, Latin,
and Syriac (because there were people of different languages present)
at the procession of her body to the grave.” “And being so general and
decent a practice, it was a grievance to any one to be denied the
privilege of it. Victor Uticensis, upon this account, complains of the
inhuman cruelty of one of the kings of the Vandals. Who can bear, says
he, to think of it without tears, when he calls to mind how he
commanded the bodies of our dead to be carried in silence without the
solemnity of the usual hymns to the grave.” (Vol. vii. 335.)

Footnote 40:

Dr. Southwood Smith’s Report, Poor Law Commissioners’ Fifth Annual
Report, Appendix, p. 160.

Footnote 41:

Whosoever may feel inclined not to attach much weight to infantile
mortality on any such theory as that the “pressure of population” is
thereby diminished, may be requested to consider the evidence of the
fallacy, and proof that in the very districts where such mortality is
the greatest, so is the amount of births. Vide General Sanitary
Report, Note, p. 175; Tables, p. 182 and 183, et seq.; and the
subsequent corroborative evidence adduced in connexion with the
district returns of the proportions of deaths and funerals given in
the Appendix to this Report—Appendix.

Footnote 42:

Vide on the subject of defective registration of the causes of deaths:
a letter to the Registrar-general from Mr. Baker, coroner to
Middlesex, printed in the Minutes of Evidence on the practice of
coroners, given before a Select Committee of the House of Commons, p.
128 of paper 549, Sess. 1840.