BO S T O N
M
EDI CAL
LI BRARY
A S S O C IA T I O N
S e c t io n
GI
V EN
.
S h elf
.
m
E
DE
SU DDE
BY
MD
A B G RANV I LLE,
.
.
.
.
D
L
N
O
(
,
)
NI T F SE E RAL RDE R S AUT R F S T PE TE R S UR
R A URNE RU SS A
S PA S F ERMAN
S PA S F E N LAND
I SS IN E N T REA T I SE N PRU SS I C A CID
E TC E TC E TC
ASS CIAT E R C RRES P NDIN MEM E R F
IMPE RIAL AND R AL
A CADE MIES F S C IENCES AND S C E T IES F PAR I S ERL I N S T PE T ERS UR RU SSE L S
DRESDE N NN TURIN NAPLES F L RE NCE E N I CE E TC
K
O
,
JO
GH
Y
V
O
To
T HE
I
K
HO
O
O
O
O
O
,
BO
G
O
O
.
,
G
O
O
G,
B
.
Y ; T HE
G
G
.
O
O
.
,
B
O
I
,
,
T HE
O
,
B
O
,
OY
,
V
G, B
B
.
,
,
.
L O ND O N
J O HN
C H U R C H I LL
(E s tablished
,
NEW BU
R LI N G T O N
in P r i nces S tr eet, S oho ,
MD C C C L I V
.
R
ST E ET
.
,
I
NEV E R
m any c as e s o f s udde n
Within t en d ays I h ave had
inq uir e int o O n e c o n st ab l e
b efo r e had
de ath as at pre s e nt
t h i rt y o n e c as e s t o
al o n e s ent m e n o t ic e
.
-
,
M
r
.
Coroner
t
Wakley
aS ipend iary
,
so
of
fi ve
c as e s
at t he inques
Magi t at
s r
,
.
e,
t
on
”
.
t
t he lae
who was fo und d ead ,
J R us sell , Es q
.
Ma
.
h1 0 1 851
rc
.
C ONTE N T S
ARK S PR ELI
RE M
I
.
II
.
III
IV
V
VI
.
.
.
.
RECOLLE CTI
TH E
RE GI
D EAT
H-S
N
O S
.
MI NARY
.
ST RAR GENE RAL
-
.
TAT I ST I CS
FR EQU E N CY
OF
.
N
O
SUD D
OF
EN
LI FE
N
O
.
I N
ENGLAND
D EAT H — Fact s
S UD D EN D EAT H ?
I S
CON CLU SI
.
— The Co ns ult at ion-Room
EARLY D E ST RU CTI
WHAT
.
.
.
M
R E ARKS PRELI
MI NARY
.
adopted M
r Wa
kley s em
phatic and official declaration as a text for
writing a b o ok but as a s uitable introduction
to one which I have long been preparing from
practical observations and extensive inquiries
into a subject the importance o f which is
sufficiently enunciated in the title page
2 C lass diseases as we may term them
have of late years received great attention in
this as well as in foreign countries
The
great progress recently achieved in physio
logy and animal chemistry was of itself
likely to induce a m o vement t o wards a better
I H AV E
’
no t
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E MI N ARY
E MARKS
R
X
PR LI
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acquaintance with and sounder treatment o f
any group o f diseases which are known to
affect alike the higher and the easier not less
than the humbler and the industrial classes
of society A ccordingly we have suffered
from no lack of treatises on stomach com
plaints on affections of the lungs and o n
diseases of t he heart E ach o f these classes
in fact of disturbed functions known to im
plicate important organs as the centres of
those functions has received a large share o f
consideration from the medical profession
N o r have their e ff orts and researches bee n
received and accepted with less eagerness and
encouragement by a discriminating public
head diseases has pro
3 The class o f
bably attracted less serious attention U n
uestionably
their
treatment
has
never
in
q
this country been made the subj ect of many
v olum es D rS C o oke K ellie C lutterbuck
—
Abercrombi e Todd and C opland the latte r
in his admirable articles on head affections
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REMA R KS
P
REL IMI N A RY
xi
.
—
are the
in the D icti onary o f
principal authorities referred to in o ur days
in questions connect ed with especial diseases
A lt hough far fro m agreeing with
e brain
Of t h
nother either in t heory o r practice their
one a
wo rks will always command respect and be
co ns ulted with advantage
Their writings
however by their ve ry nature and form are
n ot calculated (like m any of those wh ich re
late especially t o any o f the three class es o f
disease s previously mentioned) to invite and
secur e public attenti on generally A nd ye t
wer e the imp o rtance of the subj ect o f head
dis eas es t o be measured by the good which
the public would derive from at tending more
clo sely t o it the consid erati o n and study of
dis eases that snap the thread of life asunder
abruptly might be expected to com mand a
ram o unt in t er es t o n the par t o f the e ner al
a
p
g
reade r b efore any which relates s im ply to
the s tomach the he art o r the or gans of
spiration
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xii
4
RE MARKS
.
REL I MI NA RY
P
A nother and more recent publication
,
by an hospital physician to which I shall
again revert on a future occasion might be
alluded to in this place But that work does
not treat exactly of the same subject matter
as the present which refers principally to t he
most formidable of the affections of the head
I t confines its investigation rather to the con
sideration of apoplexy and partial paralysis
consequent o n diseases of the heart a s ubj e ct
handled wit h considerable ability
But it
says nothing of t he tremendous consequences
t reated of in the following pages arising from
disturbed vascular action in the head no
matter how and from that alo ne N o r does
it bring the powerful aid of death statistics
to b ear upon the propositions laid do wn as
tests at once and in corroboration of their
truth and importance Y et nothing can be
more interesting than the whole question s o
viewed N o r is anything more essential to
its full development and the us eful inferences
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RE MA RKS
x iv
REL IMI NARY
P
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scarcely consider t heir introduct ion worthy
the acceptance of t he profe ssion and the
public But vital statistics have a nobler and
loftier purpos e as will be noticed in the
s e quel ; and in tha t light they have be e n
viewed and adopted in the pursuit of the
present inquiry
6 That i nquiry I have purpos ely divided
into two branch e s The one popular stat is
tical and philosophical relates to matt ers of
fact and occurre nce in connexion with sudde n
death apopl exy and paralysis whichhave
not been duly notice d o r appreciated before
The other medical and practical embracing
an e xt e nde d vi ew of t he causes increasing
frequ ency (e sp e cially among comparatively
young people) treatme nt and prevent ion Of
those formidable disorders together with a
section on longevity or death from old age
The present volume is intended to exhibit a
full d evelopment of the first branch of the
inquiry I t is s o writt e n that it may form
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R
E MA RKS
P
REL IMI N A RY
XV
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independent work The second branch
will form the subj e ct o f another volume to
follow soon aft er t he present
I n it t he
r eader will be put in possession of cert ai n
plain physiological principle s relating to the
circulation of t he blood in the head with an
account and description of the consequences
t hat must and do in e vitably follow any d e
v ia
t io n from the normal condition o f that cir
culation with the delineation o f the cor
responding ill e ffects produced on the nervous
system lastly with the e numeration of those
measur
e s by w hich the stealthy
Ii
a
l
ro fe s siO
p
advanc e s of t he disorde r of death (as it
m ay justly be called) b eing once d etected
m ay be diverted and stopp e d
7 I n its dry and I nsulated character the
investigation I am about to ent er upon could
not boast of nov elty but for the manner in
which it has bee n treated and the many cu
The subj ect of
rions facts brought forward
S U D D E N D E A T H that o f apoplexy that o f pa
an
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xvi
RE MARKS
REL I MI NA RY
P
.
has
each
had
many
able
and
distin
y
h
u
i
d
e xpositors from the very earli e st
s
e
e
g
p
r io d s of medical science do wn t o our o wn
days But conjointly and in reference t o
o ne another and as aff e cting vital statistics
and in fact as a comple x question interest
—
ing to all in these times it will probably be
admitted that t he subject has been handled
in a novel y et practical manner I have done
my best th ough not the best O thers will
c ome after me who will do better for there is
ample room for it ; and the successful ad
vances which each collateral scientific inquiry
c onnected with the question of life may be
expect e d to make in future years will be so
much h elp towards the production of a fa
r
superior performance
8 I n the meantime the present attempt
with its succeeding volume will I trust effect
s ome go od by preserving many lives that
now fall victims t o unsuspected affections of
the head ; as well as by p ointing o ut to all
l
ra
s is ,
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RE M ARKS
REL I MI NA RY
P
xvii
.
the means Of pro tecting themselves from ner
vous injuri es which when no t immediately
des tructi ve of life tend t o impair the s enses
o f sigh
t an d o f hearing and o f l o c om otion
and, not unfrequently the faculties of the
mind als o ; thus ren dering a prol onged life
alm ost a burthen
n O f my pres ent wo rk sim
9 I n the pla
l
i
i
c
t
h
a
s
b
een
my
o
b
j
ect
have
endea
I
p
y
v o ured s o to divid e and arrange its s ubo rd i
t alth ough bear
t e pa
rts a
na
nd s ect io ns th a
ing a d ue r elation o ne t o the othe r each may
be taken and conside red separately with pen
O f notes and qu otati ons
feet indep endence
that serve O ftener t o perplex and confuse
rathe r t han illustrate or explain the text I
have been very sparing But where asser
tions o r facts are bro ught for ward of s o start
ling a nature that it could hardly be expected
they should be accepted o n a mere statement
o f my o wn I have n o t failed t o c o rro b o rate
them by suitable references t o s uperi o r and
unquesti onable auth o rities
6 9
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xviii
10
RE MARKS P REL IMI NARY
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A nd thus the present volume is s ent
.
into the world as a respectful tribute of accu
m ulat e d professional experience due by m e
to the public from whom I have received
every encouragement during a career of
thirty fi ve years in t he me trop olis I ven
ture to think that my professional brethre n
will thereby become acquainted with a mul
t it ud e of facts and correlative views worthy
that actuaries and all
O f their consideration
such as are engaged in estimating the value
of human life may consult it with advantage
and lastly (and this is not the least I mp ortant
point) that the religiously inclined will find
in these pages themes pregnant with the
m ost serious and soul inspiring reflections
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1 , C aree r»
S tr eet ,
May F @ 3
J une 2 0 th, 1 8 54
17
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I
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’
RE C OLLE C TI ON S
R
C ON S U LTATI ON - OO
THE
Mn
o
cabinet
tr ente m ille
.
d es
a
m es
tions
cons ulta
M
.
me
ra
r te
o
pp
”
P
ro
said
to
me
the
late
f
fe s s o r H allé o f Paris when in a m o ment Of
dyspeptic
hurried on the l ot h o f
August 1 8 1 6 from my hotel in the Rue d u
C olombier to his house near the E cole de
Médecine at which he used to d eliver an
lly a c o urse o f
nua
Phys ique M
éd icaie et
r
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Hygiene
”
.
H allé had acquire d by his writings a great
,
,
reputati o n as a physi ologist ; but he was a
man o f b ooks an d n ot Of experience as I
so o n dis c overed ; like many a counsello r
,
,
,
B
RE CO LLE C TI ONS
2
.
”
learned in the law whose chambers in the
Temple y ou seek with case and fee in hand
t o s ave yourself the trouble o f poring over
the statutes at large o r even the more useful
v olumes o f Welshy and Beavan digests and
n opinion or a condensed view of the
s o get a
law
The Profess or was c onsul ted fro m far and
near o n account o f his extensive reading and
prodigious medical er uditi on
H e used to
receive his p atients o n three days in the
week as early as at half past seven o clock in
the morning and his cabinet was gener ally
t hr o nged with peopl e o f t he bett er and higher
class es chiefly dys peptic hipped and hypo
,
,
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’
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l;
a
c
chond ria
,
I
taking leave t he patient dropped as
he went by his thr ee or four écus on the
mantelpiece of t he chim ney and s eldoI n re
turned again I t is curious that this oracle
wh om t he class es of patie nts I have just
named were especially eager t o interrogate
On
,
,
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'
,
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,
4
R
r
escrip
ions
t
,
p
E C O LLE C T I O NS
.
aft er the fashion
of
many of his
countrymen
Before this oracle of the Parisian faculty
then did I on the 1 0 th of A ugust o f the
y ear before m entioned present myself t he
condemned of all the higher practitioners of
—
L ondon the Baillies the Farquhars the Pem
bertons the Blanes the S cudamores carrying
with me in their Opinion a declared diseas e
of the heart with p a
lpitations of such vio
lence and so palpably evi d ent that H all é
counted them without feeling my pulse The
stethoscope was not then in existence and I
was destined t o be present at its discovery
by L ae nnec and t o assist at its birth M
y
inward conviction was that I might drop
down dead at any o ne moment so intense
was the disturbance of the circulation and its
internal comm otion
My visit to Hallé proved reciprocally un
productive H e declined to receive any r e
m unera
t io n fo r his advice from a confr er e
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TH E CONS U LT A TI ON R OO M
5
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while I derived no benefit fro m his counsels
.
The boldest suggesti o n he ventured t o o ffer
me was that of my drinking plentifully of
what he called eau de cafe o r a largely
diluted coffee infusion Still he encouraged
me by his conversation apparen t sincerity
and I felt better for my visit t o him during
the three or four follo wing days
This system of consultation at h ome is an
agreeable as well as lucrative arrangemen t
for a medical man no r is it less c onvenient
o r ec onomical to the patient
A late b aro net
President of the C ollege of Physicians enjoy
ing as a practitioner a greater share o f no
t o riet y in this country han even the late
t
French Pr ofessor enjoyed in P aris yet not
equal to him as a consulting physician bade
me o ne day remark how seldom and with
what diffic ulty now a—days a L ondon physi
n succeeded in attaining that degree o f
cia
an almost oracular renown which enables
him t o remain at home in the m orning until
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RE CO LLE CTI ON S
6
.
!
”
a late hour in the receipt o f business
f
r
o
(
”
In this respect
s uch were his expressi o ns)
II
have b e en very fortunate ; but
s aid he
see how far m ore lucky are the dentists the
o culists the ins erters o f b ougies (a favourite
practice in th o se days) and they who syringe
the ears fo r they are the m ountain that never
g o es to M
ah omet whereas M
aho met mus t
needs g o t o the mountain
L o ok at a certain
famed o dontologist not far from Burli ngton
V ehicl es of all de scription thr ong
G arde ns
the stre et in front o f his residence The
barking o f his kn o cker is lo ud and incessant
The breathless p orter has n o soo ner delivered
a card and a mes sage to his master and
slipped int o his o wn poc ket a propit iat ory
half a—cr own e r a shilling than he receives
another and a third and a fourth in quiet
succession pr om isi g t o all parties priority
nd apportioning their station
o f intr o ducti o n a
for waiting acco rding t o the weight of their
int o my
U pstairs downstairs
argum ents
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TH E C O NS U LTATI O N R OO M
7
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lady s chamb er are t he anxi ous patients led
t o war ds their d oo m until at las t no t a niche
is left fo r a new c omer This is doing busi
n es s
n d d o ing it t oo in a very
a
lea
ant
s
p
’
’
,
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’
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,
ma
nner
“
,
”
.
A lively and Very clever accoucheur
“
,
t OWn,
”
inthis
c o ntinue d t he courtI y Baro net wh o has
wo n many friends and g olden opinions for the
space of upwards of twenty five years and
wh o during that peri o d held the public at
his b eck Oft en obs erved t o me that m ore than
half o f his daily earm ngs poured int o his
ho use in the c ourse o f the m orning with very
little or n o trouble to himse lf O ften in his
present dignified retirem ent do es he l ook
back with satisfaction t o th ose o racular days
when in t he enj oyment o f a w ell merited
and unb ounded confiden ce o n the part o f t he
public he excha
nged with them his valuable
d icta and medical re cipe s for th eir n ot leSs
valuable notes willingly given I s ay there
m la
fore again qua
cr os um
m d ulce qua
“
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RE C O LLE C TI ONS
8
.
o f quoting L atin
T
the
Baronet
was
fond
o
)
(
do business in this way how delightful to
all parties !
ll b e asked can
s ha
But what relation
these reminiscences bear t o the subj ect of
7
My answer I s the most direct
my book
fo r that which led me to Professor H allé s
c onsultation ro om was the commencement o f
that series o f successive indications o f a con
l disturbance in the equilibrium be
s tit ut io na
t ween the circulation and nervous act ion
w hich after t h
e lapse o f twenty years ter
m inat e d in establishing a permanent liability
to the two formidable disorders and to sud
den death o f which I purport treating in the
following pages
O nce the attenti on o f a physician has
been called t o the existence within himself
o f a train o f symptoms which threat e n t o
destroy life however S light o r transient such
symptoms may at first appear he fails not to
watch their every m o vement ; t o discriminate
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TH E CONS U L T ATI ON R OO M
9
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between the s everal m o dificati o ns th ey may
undergo to judge o f the real imp ortance to
be attached t o each to infer from their mo
d ificat io ns the treatment they r equire ; and
finally to dr aw just and available c onclusions
from the results Of his meditatio ns A nd all
such experience thus gaified by the phys i
n through observati o ns made o n himself
cia
and his own sufferings applied ud iciously
and deliberately to the management o f similar
contingencies occurring in other people would
e nable him t o comprehend master and m o r e
successfully treat diseases thence arising
The record t herefore o f the author s o wn
case I n the present instance might so far be
d e em e d auseful not less than asuit abl e pre
liminary to a treatise o n diseases with which
he has himself been threatened and which he
has afterwards had frequent opp o rtunities to
watch and treat in a vast number of other
individuals H ence all pers onal recollecti ons
likely t o thro w light o n the questi o n in hand
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B
5
REC O L LEC TI
10
ONS
.
c onsid ered as so much admissible
With
evi d e nce in its supp ort or illu s trat io n
this I shall pro ceed with m y n
arrative ; and
there may be found perchance no t a few
among my re aders who will recognise s om e
o f t he symptoms and co rresp ondi ng sense
tions ab out t o be describe d as s imilar to
thos e they have themselves experience d at
peri o d of their lives and s o apply t o
t heir o wn case my s eve ral c o nclus i ons
I t is no w near up o n t hirt y s even years
sinc e that m o st extra
ordinary of all the
Italian cantatr ici t he celebrated and nu
equalled C atalani was in her z enith and at
tracted univers al admirati o n in this c ountry
D uring her resid enc e in Lo n don th ough but
a y oung physI CI an at the time I had been
honoured with her c onfidence in medical
matters I was standing b efore her one day
full of healt ln giving her s ome directions at
parting c oncerning s ome slight indisp ositi on
under which she was s uffering when she sud
b
ma
e
y
.
.
,
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e
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RE CO LLE C TI ONS
12
.
n
w
o
upright and firmly from the house M
y
fortunately was only a few hundred yards
distant and I reached it at last looking all
along eagerly at the r ails t o support m e
should I fall but I fell not
A fri end o f mine the late Professor A T
Thomson then living near me being sum
moued arrived immediately when I requested
him to bleed me largely from the arm In
considerate as the measure might have been
—
deemed by many practitioners such was the
feeling of securit y which the performance of
that operation had given me as contrasted
with that o f alarm produced by the sudden
ness not less than the violence o f t he attack
that after a fe w days I had the operati o n r e
d
O
f
course
other
remedial
agen
s
e
a
t
e
t
p
were had recourse to at the s ame t ime for
in the course of a couple of days many of t he
most eminent men I n practice whose friend
ship I enjoyed had either assembled or had
come separately to my house t o advise on
the case
,
.
,
,
,
,
.
.
,
.
,
,
,
,
.
,
,
,
,
.
,
,
,
,
.
THE
C ONS U L T A TI ON R OO M
A t this distance
13
-
of
.
time with the safer
guide of many yea
rs experience I recogni se
that t he free use o f the lancet in the manner
I directed it to b e employed in opposition to
the opinion o f mo st of my more expert medi
cal friends was injudicious True there was
an almost overwhelming sense o f suffocation
at the heart as if the entire mass o f venous
blood were rushing into its chambers pro
dacing at the same time great confusi o n in
the head and pulsations against the ribs b oth
in front and under the shoulder blade re
semblingthe loud str okes o f a hammer and
the s udden diminution o f the fluid mass by
venesection might fairly be expect ed to cause
a corresponding mitigation of ii s alarming
tumult But it was n ot so The palpitations
c ontinued unmodifi e d the intermissions of t he
pulse remained unchanged and with thes e
there super vened e xtreme re al
s ympt o ms
weakness as well as an unm itigated s tate of
dysp ep s ia I shall have occasi o n t o dwell
,
’
,
,
,
.
,
,
,
,
,
,
,
-
,
,
,
I
r
.
.
,
,
.
.
,
REC OLLEC TI ON S
14
.
this latt er c onse quence of large
bleedings as a very impo rtant point for con
repente d n ot that I had
s till I
s iderati o n
My impression from
fr eely o pened m y veins
the very ons et of the attack having b een that
apoplexy must inevit ably ensue unl es s by t he
abstractio n of bl oo d I prev ent ed the impetus
and pres s ure fr o m withn t o bur st asunder
the c oats of s ome of t he weaker vessels in the
brain I t was a s o urce of im mediate c om fort
and eas e t o my mind t o b elieve that I had
baffl ed such afatal result by t he measur e I
had adopted
N everthele ss t he c o ntinua
nc e of t he cardiac
sympt oms unacco mpanie d h o wever by any
S ign o f disturb a
nce in the head (which ha d by
thi s time com pletely cease d) induced t he
hereafter
on
,
,
,
,
.
,
,
,
,
i
,
.
,
.
.
,
,
,
,
,
that I was lab ouring under a dis eas e of
the heart ; with which co m forting d elib era
tio n the s ufferer was left t o shift fo r him s elf
T wo m onths elaps e d before I could venture
clud e
.
THE
CO N SU LTA TI ON OO M
-R
15
.
a carriage, and a little
late r fo r a walk which was n eces sarily sh ort
since every exertio n pro duce d a painful sh ort ness of bre a
th and a fe eling o f suffocati o n
A t t he end of the third mont hI t ransferre d
l
a
r
ys
e
f
g
eeab
l
t
o
a
la
l
o
ng
b
fore
n
s
e
t
m
e
y
p
tl ed t o Paris with m y wife an d three young
ch
ildren fo r a couple of years
The int en
ti on was to plu
nge at o n ce int o all s or t s o f
m e ntal o ccupation s and pr o fessional s tudie s
in t he hopes o f diverting my th o ughts from
the co nsi d e rati o n o f m y o wn wretched fe el
ings which had at last r eached a degree of
sis that threatened at t imes to
hyp o cho ndria
lead to some disastrous result I carried in
my mind t he sentence of thy brethren in
Englan d and their co ndemnati o n and I felt
within m e b y night an d by day and at every
hour of m y wakeful exist enc e those dr eadful
sensati o ns whichse em e d t o attest t he ac cur acy
of their s enten ce
I hav e a
lready menti oned how m y case was
fo r an airing in
out
,
,
z
,
.
v
,
,
,
‘
.
,
,
.
,
,
~
,
,
,
,
.
.
—
“
,
'
,
,
,
.
,
RE CO LLE C TI ONS
16
.
viewed and tre at e d by the first eminent pro
fossor to whom I fl ew for some comfort im
m e diately o n my arrival in the F rench capi
tal The experiment had n o t proved very
encouraging nor did the opinions of Chaus
sier Pariset M
o ntegre M
agen die Breschet
and Orfila with whom I presently became
acquainted by attending their respective
courses of lectures afford me better encou
O
ne
symptom
in
particular
I
used
r a em ent
g
to urge them in m e rcy to relieve and that
was a positive feeling of strangulation not at
the windpipe but at the gullet just b elow
the pharynx (probably what D r M
arshall
H all has since denominated trachelismus)
which came on half an hour after every re
past no matter how trifling The s ensation
was t hat which might be suppos e d to be pro
d u ce d by a hard pressure o r a squee z e rath e r
of the part between finge r and thumb and
was accompanied by intense pain I t seemed
t o last as long as the process of digestion in
,
.
,
,
,
,
,
,
,
,
.
,
,
,
,
.
,
.
,
,
,
,
.
TH E CONS U L T A TI ON R OO M
-
t he
17
.
stomach lasted and then entirely disap
red
r
e
a
N
one
but
what
proved
me
e
pallia
p
t iv es we re rec o mme nded and those chie fly of
the class o f antispasmodics
A gainst the
violent beatings o f the heart they had n othing
to suggest bette r than hir ud ines in ano ; but
I had bled quite enough and declined the
application
My nights were passed in a continued state
of agitation ; for in whatever p o sition I laid
m yself the loud tones o f my heart and the
throbbing pulses in every part o f the body
rm it t e d no ne but a feverish and agitated
e
p
sleep The days were spent in going from
—
hospital to h o spital from one le cture t o
—
another and in assisting at as many aut op
sies o f patients who had di ed suddenly or
had succ umbe d to supposed diseases o f the
—
h
heart as I could ear o f that I might le arn
my own fate I n the vortex even o f all these
various occupations the one obtruding thought
would ever be pres ent that such immense
,
.
,
.
’
,
.
,
,
,
‘
.
,
s
-
,
,
.
,
,
18
R E CC LLE C TI ON S
.
o f t he circulati o n as t hen existed
disturbance
within m e c ould only terminate in death
A nd yet while examining the many un
fort unate victims of r eal dis eas es o f the heart
which the clinical wards of La Char ité af
f or ded me o pp o rtunities of daily witnessing
in c ompany with the distinguished physician
o f that h o spital
the late Professor L eroux
m
the
im
ediate
success
o
r
t
o
C
orvisart
and
(
)
C lo quet his principal assistant I w o uld often
persuade myself that my o wn symptoms dif
fered fro m th o se which t hese patients had
while many of t he most
e xhibited in life
pr ominent S igns by which their cases had
been distinguished were n o t t o be found in
,
.
»
,
,
,
,
,
,
,
I t had likewise struck me that alth ough
sei z ed at times s uddenly with abs olute suffo
while standing or s itting still I yet
c ati o n
found myself s ometimes running fast t o pre
vent my b eing t oo late at a lecture ; o r
m ounting a s taircase quickly fo r the s ame
,
,
,
RE CO LLE C TI ONS
20
.
own case to the consideration of another
French phy s I C I an
It was L aennec s habit when examining a
newly admitted patient labouring u nder pec
toral disorder to percute him (as I had seen
invariably done in the Clinique of La Char ité
also) in every part o f the chest both in front
and at the back as well as on either side
After which he would apply the ear to any
part which had resounded badly or imper
fe ct ly
O ne day (it was the 1 3t h of S eptem
ber 1 8 1 6 for I took a note of it) L aennec
seemed d is s atis ed with the result of his pe r
cus s io n and direct auscultation in an interest
m g but obscure case before him
when turn
ing round to the circl e o f pupils around the
bed Why said he should we not avail
ourselves o f the help which acoustics yield to
7
us of making distant sounds more audible
The speaking trumpet enables the dull of ear
to hear the faintest whisper ; the ascending
tube in a wareh ouse conveys to the upper
.
’
,
,
,
,
,
,
.
.
,
,
,
,
”
,
,
,
,
-
THE
CC N S U LTATI ON
R OO M
21
.
stories in audible sounds the muttered d ir ec
tions of t he master below ; the ticking of a
watch placed at the end o f a long beam I S
heard loudly by the ear applied to the other
e xtremity ; a tube
therefore applied over
the lungs o r to the chest over the heart
ought to instruct us more plainly through
o ur ears
with the movements and sounds
going on within and forthwith snatching the
hier d es uis ites from the hands of the nearest
ca
u
elece inter ne and rollin
it
lengthwise
to
g
p
the shape of a cylinder havm g a perforation
through it s axis he applied it first to one side
of the chest then to the other and again t o
the back between and below the shoulder
blades and declared (what we all I ifio w to be
true) that he could make o ut with greater
distinctness than with the naked ear applied
over the parts their inward c ondition from
their respecti ve sounds which he then de
,
,
,
,
,
,
,
,
,
,
,
,
,
,
'
,
,
Such was the birth of that fam o us
,
inst ru
RE CO LLE C TI ONS
22
.
ment at first den ominated by its invent o r
ning its way
sl
o
wly
w
in
t
r ilo ue which
e
c
o
p
q
from the humble hospital bearing the name
o f its founder the unlucky mini ster of L ouis
X V I t o every corner o f EuI Ope and to the
new world has laid open t o the medical m en
in almost every instance, the scenes of disease
enacted within the thorax, which before baf
fl ed detection The invention o f the steth o
scope simple and a ccidental as it m ay have
been marks a striking era in the history o f
m edicine and is second only in import ance o f
results t o the disc overy made by t he imm ortal
,
,
,
,
,
,
,
,
.
,
,
,
,
O n the foll owing
Why Lae nn ec
d ay
Laennec had pro
s e dit i o n o f t he wo rk
n no un c e d t he i nvent i o n s h o ul d h a
in wh ic h he a
ve
change d the s c ene o f it s fi s t applicat i o n f o m t he
wa
r d o f ah o s p i t a
l t o the ch amb er o f afai p at i ent is
n o t ve y i nt e ll i i bl e t o m e exc ep t o n t he sc o re o f
g
F r en ch yallant i
My own not e s t ak en down at the
t im e a
n d o n t he s p o t a
re l i a
bl e t o no m is c o nc ep t ion
,
in his fi r t
,
,
r
r
r
r
,
,
er e
.
,
,
.
TH E
—
CONS U L TA TI O N R OO M
23
.
cured proper cylinders made of a thick paste
b o ar d (to which he not long after s ubstituted
hard wood) eight inches lo ng and o ne and a
half inch in diameter perfectly smooth with
an even perforati o n in it s centre through o ut
it s axis
It had the two en ds somewhat hol
lo wed o ut so that the o ne which was applied
to the convex parts of t he chest as well as
the opposite end t o whi ch the ear o f the exa
miner was applied fitt ed admirably for both
purposes
S uch an instrument as this I
brought t o E ngland in N ovem ber 1 8 1 7 (that
is a year aft er its invention) when I first
settled myself down in pract ice in S aville
R ow and I well remem ber how most o f my
c ontemporaries t o who m t he in
s trdrh
e nt was
e xhibit ed and expla
ined m ade them selves
merry at the cre d ulit y o f French doct ors and
my own
i
But returning t o o ur do ings at t he R a
p
ssed in the daily
taZ N ecker ; some m o nths pa
is new expl oring inst ru
empl oyment of th
,
,
,
,
.
,
,
,
.
'
,
,
,
.
,
,
,
.
,
.
RE CO LLE C TI ONS
24
.
ment brought to light so many instances of
the most extraordinary accuracy in the diag
n o sis which it had enabled the professor to
pronounce that I determined at length t o
submit my own chest t o the explorations of
that sagacious practitioner
The leading
features of my case I had already mentioned
t o him as well as my motive for seeking
amidst the many miserable objects o f disease
which encumbered the wards of the h o spital
som e cases that S hould resemble my own
H e took some days to form his judgment
,
,
,
,
.
,
,
,
,
.
,
examining the action o f the heart as well as
every phasis of the function o f my lungs at
different periods o f the day and under vari
able circumstances when at length he pro
,
,
an opinion which t o this very day
I have had reason to consider a just o ne
and which put me in the way o f distinguish
I n
f
b
e
tween
dis
o
rders
the
circulation
that
o
g
directly affect the heart without sensibly
affecting the head and vice vers a; while it
no unce d
,
,
,
,
,
,
,
TH E CO NS U L T A TI ON R OO M
25
-
.
opened my eyes t o a third class o f disturb
ances o f the circulation in which both t he
heart and the head are alternat ely and som e
times si multaneously affected
O f the most distressing symptom s I was
lab o uring under he found the principal cause
t o have been the too large quantity o f b lood
I had lost H e justifie d the principle o f
blood le tting in the outset of such an alarm
ing attack as I originally had had and which
I described to him ; but he disapproved o f
the repetition of that operation and e ven
igh number of ounces of blood
o f the too h
”
I had lost on the first occasion
C ontinue
e ssor
added
the
experienced
prof
to
study
)
(
both in these wards and in those o f La
Uhar ité more especially devoted t o the ex
amination and treatment o f diseases of t he
heart and you will see reasons as well as a
number of examples suffici e nt to convince
u of the correctness o f my assertions
o
y
A nd truly the impression left o n my mind
,
,
,
.
,
.
-
,
—
,
,
,
,
,
,
”
.
,
,
0
RE CO LLE C TI ONS
26
.
by the contemplation o f the examples in
question while it has perfectly satisfied me
o f the truth o f L aennec s d o ctrine it has als o
S erved t o direct my attention in subsequent
years much more closely t o those con diti o ns
o f the circulation whi ch endanger life by
involving its two most important organs the
brain and the heart By watching those
con ditions and bringing timely and suitable
remedies to bear upon them I firmly believe
that under Providence death has m ore than
once been averted in my o wn as well as in
the case of many o f my patients
To these conclusions the present personal
recollections were intended to lead and to
that end t hey have been introduced in this
place They are the text o f my book and
no t inappropriately fo rm its commencement
A s to what became o f all the various and
anomalous symptoms by which I was inces
nt ly tormented in the midst of all my self
sa
imp o sed occupations during my prolonged
,
’
,
,
,
,
.
,
,
,
,
,
.
.
,
.
II
.
R E GI S TR AR -GE N E R AL
T HE
.
is in t he very heart of the metr o
polis and beneath the loftiest and most
magnificent o f its palatial structures a huge
cemetery in which stripped o f all their o r
a
n
i
c
e
lements
and
of
every
particle
f
what
o
g
renders ordinary intramural sepultures hurt
ful t o the living the dead of all E ngland for
the last sixteen years have been lying in
t orred not covered with earth indeed but
in black cerements Their number is legion
Five milli o ns nine hundred and thirty two
th ousand three hundred and seventy three
names of human beings o f all classes and
ages wh o ha ve departed this life during the
THERE
,
,
,
,
,
,
,
,
,
.
.
-
,
-
,
,
,
,
TH E RE GI S T R AR GE NER A L
29
-
above -n amed
.
period may be read in these
sepulchral vaul ts with the same cas e as he
who strolls through the maz es o f K ens al
C emet e ry can scan the names o f the beings
there entombe d
Thus while the last census tells us that
the previo us half century has adde d ten mil
lions to the population o f E ngland ; the re
cords of death kept at S omerset H ouse
h
e
roclaim
t
equally
a
tested
fact
tha
nearly
t
t
p
six t enths of an equal amo unt o f hum an
beings have disappeared from among the
living in less than half the time which has
been occupied in doubling o ur population
s ince 1 8 0 1
The R egistrar General s O ffice a depart
ment destined to yield hereafter re sults
which the philosophy o r sagacity of t he
present generation can scarcely predicate
but of the high importance o f which there
cannot be a moment s doubt was located
when I visited it last year in Somerset
,
,
,
.
,
,
,
-
,
.
’
-
,
,
,
,
’
,
,
,
TH E RE GI S T R AR GE NER AL
30
-
.
Place I t has since been transferred to an
other part of S omerset H ouse t o that formerly
occupied by the R oyal A cademy But my
description o f its sepulchral recesses and ar
rangements applies to the former locality and
distribution to which likewise is referable
the account gi ven of its nature by the ofli cials
o f the department
in o ne o f their annual
reports
as well as the more romantic
delineati on o f its use and peculiarities in
s orted in o ne o f the numbers o f a weekly
miscellany stamped with the inspiration o f
.
,
.
,
,
,
,
D ick ens a
L
It was indeed important that in the pursuit
o f my inquiry into the number and prevalence
o f cases o f sudden death apoplexy and para
lysis which I had undertaken and for which I
had been c ollecting notes and facts for the last
twelve years I should not omit to inspect the
,
,
,
,
,
,
,
S ee Annu al R ep o rt
r
App en d
r
l
is
r -G en er a fo r
t he R e g tra
ix p age 59
H o u s eh o ld Wo d s v o l i p age 3 30
r 1 8 39
t he ye a
’
Of
.
,
”
,
.
.
.
RE GI ST RA R E NE R AL
T HE
-G
3I
.
returns o f all deaths sent in every M
o nday to
this department by the many hundred regis
t rars and sub registrars established all over
E ngland and Wales I s h o uld thus be quite
c ertain o f com ing t o the knowledge o f posi
tive d ata enabling me to form a correct cal
culati on o f the total number o f deaths und er
the three heads o f causes already name d
The result o f such an examination would im
part a degree of precisi o n to the conclus ions
I might draw from it which neither private
nor public experie nce c ould pretend to attain
e ven by way of approximatio n
T ruly as regards sudden death I had
another source of info rmation t o which I
—
might have recourse the returns fr om the
But I was soon discouraged from
C oroners
looking to that quarter by the tenor o f a
r
letter dated O ctob er 3 l st 1 8 52 from M
C oroner Wakley to whom I had addressed a
request to be permitted to have access to t he
registers of his court ; and still more so by
,
,
-
,
.
,
,
,
.
”
,
,
.
,
,
,
,
.
THE RE G I S T R A R GE NE R AL
32
-
.
the ill success of a motion made and carried
in the H ouse of C ommons on the 2 0 t h of
D ecember 1 8 52 by the H onourable M
e m ber
for A shton That gentleman had moved for
and carried an A ddress for the opposite
returns
These returns however were never made
to t he H ouse or inde e d were asked for o f
,
,
,
.
,
,
,
,
,
the several C oron ers in E ngland o r if asked
they were never complied with and thus a
series of highly interesting data which such
returns were l ikely to afford was denied to
the public
It was then that I addressed myself to the
R egistrar G eneral for permission to have ao
cess to the documents in his custody stating
the object for which I required that permis
—
si o n namely to collect such additional and
authentic information respecting sudde n death
apoplexy and paralysis as would render what
I already possessed not o nly more valuable
but more available for mathematical cal
,
,
,
,
.
-
,
e
,
,
,
,
,
,
R E G I S T R A R GE NE R AL
THE
“
m
«
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S G
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E
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:
.
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34
THE
RE G I S T R AR GE NE R AL
-
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36
T HE
RE GISTR AR GE NE R AL
-
.
great department (since M ajor Graham in
t ro d uce d the method and regularity which
no w preside over the many i nt ricate opera
tions performed in it) that t here is hardly
another branch of the public service where
information appertaining to it can be mor e
readily o r so fully obtained Thi s is espe
lly the case in what is called the Statistical
cia
S ection and here I had the good fortune o f
falling into the hands o f D r F arr the head
o f that divisio n whose name needs no eulogy
from me and of M r Tho rnton o ne of his co
adj ut or s in the calculation o f the nu
merical
r eturns
D ay by day for many months at such
hours as my other e ngagements would permit
me and under such auspices d id I attend at
this offi ce from D ecember 1 8 52 till J uly
1 8 53 and again in O ctober and N ovember
of the latter year F o r three o r four hour s
at a time I pr oceeded to the examination o f
some hundreds of huge folios going over
,
,
,
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,
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,
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,
,
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,
,
,
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,
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,
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,
,
THE RE G ISTR AR GE NE RA L
-
.
every name inserted therein and picking out
and noti ng down in tabular fo rms already
pr epared all the cases which had direct re
feren ce to the threefold obj ect o f my in
,
,
a
,
I
the subterranean and vaulted chambers
then of the R egistrar Gener al s O ffice did I
take my station in a compartment d estined
for the p r eservation of death records ever
since the commenceme nt of the establishment
The very aspect of the structure
in 1 8 3 8
and its atmospher e war med by steamed air
in which a
n o il lamp str uggled to disperse
darkness tended to add to that feeling of
awe and solemnity which the natur e of the
i nqui ry was of itself calculated to inspire
A ll around against the walls large p r esses
are erected o n the many shelves of which one
beholds regularly arranged an immens e num
ber of volumes fourteen inches in length
twelve inches wide and from two to three
and even four i nches in thickness
Their
n
’
-
,
,
,
-
.
,
,
,
,
,
,
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,
,
,
,
,
,
.
THE RE G IS TR AR GE NE R AL
38
-
.
sable binding massive and secured in front
by strong straps and buckles is relieved o n
the back by the laco nic word D E ATH S
stam ped in large gold letters A s the eye
ranges r ound the vaulted chamber this solemn
mo nosyllable o ffers itself r epeated a hundr ed
and hundred times until the very number
sickens the spirit
Within these huge folios are registered the
names age sex and state in li fe o f the de
ceased the disease o f which he d ied and in
many cases it s duration the date o f death
and whether o r no t it is certified by a medical
ma
n but almost always attested by o ne or more
persons present o n the occasion F rom no t
fewer than six hundred and twenty three dis
t rict s i nto which all E ngland is divided for
registration purposes are the returns of these
several facts obtained and here transferred
after a proper examinatio n of the documents
s o received
The information thus obtained
amounts in every quarter to twenty five o r
,
,
”
,
.
,
,
,
.
'
,
,
,
,
,
,
,
,
,
.
-
,
,
,
,
.
,
-
,
THE RE G ISTRAR GE NE RA L
39
-
.
twenty six such volumes the metropolis alone
o ccup m g five o f them with its suburbs
I
f
y
the same amo unt has bee n obtained since
1 83 8 the year o f the first operation o f this
office t he particulars collected o f the deaths
o f all who have departed si nce then must
occupy about sixt een hundred and sixty four
such volumes as wer e displayed before me in
the sombre caves o f S omerset Place I n what
direction will these caves proceed to yield
room for the forthcoming twenty six folios in
every quarter during the next half century 9
What will the space be which will be o ccu
pied by the progressive accumulation o f these
—
death s registers population and mortality
increasing at the same time 2
The aspect o f these vaults and their re
echoes
d
o f death no t unaptly suggest a
a
e
t
e
p
visit t o L a M orgue in Paris or to the resting
chamber of the dead one finds in connexion
with the great cemeteries at Frankfort and
Munich There the very bodies are laid out
-
,
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,
,
,
-
,
.
,
-
-
’
’
’
,
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,
,
.
,
THE RE GISTR AR GE NE R AL
40
-
.
either for recognition o r momentary observa
tion but nothing of their history is suggested
H ere o n opening these fatal
t o the observer
volumes you behold at o ne vie w the whole
—
n
i
i
i
n
n
group of bei gs mpl cated o e death the
dyi ng the certifying doctor and the attendant
witness each to attest by his signature the sad
event no t omitting when necessary the result
n i nte rnal i nvest igatio n into the par ticular
of a
nature o f each case
H ow is it that no such minute details and
particulars are r equir ed o n the coming into
as are demanded o n the goi ng o ut of the
world o f the meanest no t less than of the
?
i
n
i
I n the latter case those
i
h ghest d vidual
who remain behi nd expect to know how and
wherefore the departed have quitted them
no r will they t r ust to the me r e missing of a
n
individual o r to his abrupt absence fr om the
busy scenes o f earth and rest satisfied that
he has taken his flight to another and more
lasting life
.
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.
THE RE GISTR AR GE NE R A L
41
-
A s I ran down the
.
these sable
volumes so pregnant with informatio n how
glari ngly the great truth stared me in t he
face that in death all distinction ceases I Be
t he nam e ill us t rl o us or of the m ost degraded
into these colum ns that of every dead o ne
must come at last and often in the closest
I n the
approximatio n
suburban burial
grounds the patrician or the citizen vain of
his wealt h or civic ho nours i nsists, eve n be
yond the grave to keep aloof from the general
herd N ot so within these unr ele nting co
lum ns of registered deaths
H er e the lofty
and the humble the powerful and the weak
the C roesus and the L azarus the hap ght y and
the meek all all are confounded together in
o ne co nt inuous processio n of mi ngled bei ngs
who had occupied very different stations when
in life but who are no w placed o n an equality
O fte n the most exalted name of o ne who is
reported to have died suddenly by the visi
is immediately prece ded by
t at io n of G o d
co l um ns o f
'
,
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,
i
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,
.
,
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,
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,
,
,
.
,
q
”
,
42
THE
R E G IS T RAR GE NE R A L
-
.
that o f a criminal who was executed for
so runs the cause o f death in his case '
I n a nother part we fi nd
M aria O stler A slett
—
aged thirty six a gentlewo m an who died of
ovarian dropsy and next to her M aria M
an
ning aged twe nty eight year s o f whom it is
recorded that she was hanged 3 0 t h of
N ovember 1 8 4 9 What a lesson o f humilia
tio n !
A s if in mockery of such a lesson the
chambers o f the dead wer e placed between
those o f the registers of births and the r e
n
i
rs o f marriages
i
The
former
clad
s
t
e
g
cheerful red the emblem of joy ; the latter in
a green colour the hue of hope and expec
t at io n perhaps o f j ealousy no t unaptly lo
ca
t ed in this manner between reproductio n
and destruction
I f we open any o f the volumes of these two
divisio ns contiguous to that o f death we soon
—
perceive how simple each operation is t he
birth o r the marriage which they record The
”
,
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,
.
44
THE
R E GI S T R AR GENE RAL
-
.
toxication none but strangers near him to
bid God speed to his soul 1 9t hof N ovember
1 84 6
I turn into a house in R obert street
C helsea o ne C hristmas day o f the same year
and ther e see the wife of a lighter man o ne
o f a me rry party sudde nly become i ndispo s ed
I hear t he
nd expire in t en mi nutes
vomit a
wailing of a distracted father as I approach
his dwelling in a str eet near the S trand o n a
particular day in 1 8 4 9 at the self infl ict ed
instantaneous death of his s on a young phy
n who had quaffed a dose of prussic acid
s icia
H ere in Hound s d it ch Alfred Thomas Gr iffith
a young and inexperie nced chemist dies
suffocated from accide ntally inhaling a large
quantity of ether o n the 1 5th of N ovember
I n the same month and yea
1 8 51
r o ne o f
the attestingwitnesses leads me into awret che d
room at N o 4 5 Greek str eet S oho the abode
of despair where Mary Ann Blake the wife
of a music pri nter has inflicted a deadly
wound in the throat of her infant three months
in
,
!
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THE R E G ISTR AR GE NE R AL
45
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.
old and then with t he same instrument a
carving knife severs her o wn head from the
body and falls by the side of her babe I An
o l d lady has accide ntally broke n a ba
s 1n while
washing and with the edges of the fragments
inflicted a wound o n her person Erysipelas
ensues and she is snatched away in three
days though previously in robust health I
am sudde nly transported o n the 5t h of O cto
ber 4 9 into the baggage warehouse at the
L ondon D ock and witness the opening o f a
n unknow n aged aboutfor ty
ca
sk in whicham a
five years 1s found dead J ohn W elch a you ng
policeman j ust come o f age enters coura
o n the 1 2 t h of the sam e mo nth the
eo us l
g
y
K enilworth sewer o ut of whichthree labourers
the youngest 2 2 years of age had just been
dragged dead H e hoped to save others and
is followed by a young surgeon H enry W ells
equally eager to rende r assistance : they never
I could fancy that I beheld the tre
r eturned !
m ul o us hand stretched upward s to clutch the
,
,
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THE R E GIS TRAR GE NE RA L
46
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.
rope o f the gate bell o f H omerto n workhouse
o f the poor wretch o f whom it is recorded
that she expired o n that spot o n the 2 9t h o f
A ugust 1 8 4 9 from neglect and star vation
befor e the call was answered A nd oh how
grievous how deeply painful the r eflections
which suggest themselves when o n running
over the list of those who are reported to have
died in workhouses whither sheer want and
absolute wretchedness had driven them One
r eads such des ig natio ns as the following o f
the beings so sheltered
widow of a gen
a housekeeper
for
an author
t l em an
”
merly independent
a coach manufacturer
a coach herald painter
a b r ewer
a
an officer in the army
builder
a clerk
W e readily can picture t o ourselves the mise
rable feelings of desolation and abandonment
by which death in these unfortunate cr eatures
must have been embittered !But attention
is soo n diver ted to a much more horrid sight
—
by these relentless records a sight at the
,
,
”
,
,
,
.
,
,
,
,
.
2)
(c
”
(c
,
,
,
”
“
,
,
”
cc
,
”
”
,
,
”
“
,
.
,
R E G IS T R AR GE NE R AL
T HE
47
-
.
iron works o f D o wlay M erthyr Ty dfil where
we almost fancy we hear the yells o f a child
scarcely eleven years o ld a straight ener o f
iron who o n t he 6 t h o f J anuary 1 8 51 while
employed at his task misses his aim and dies
his belly pierced by a red hot bar o f iro n
— t he victim o f utilitarian
ism and of that
greediness for labour so rife in these d ays
which sets a mere child to straight en glowing
bars o f iro n
But here is a crowd in o ne o f the st reets
1 8 51 around a
o n the 2 8t h of N ovember
poor higgler J ohn Watts aged 2 0 years A
runaway horse threatened to knock him do wn
To avoid it he suddenly turns round and in
so doing has run agai nst the hea
d of a post
with his belly which has actually burst and
he has expired !
Who cannot see as if enacted before him
the following scene t aken from the death
records of J uly 1 8 51 The second mat e o f
,
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48
THE
R
E GISTR AR GE NE R AL
-
.
”
the C ity of Boulogne steame r enters the
inside of the paddl e wheel box to insp ect it
The wheel suddenly revolves and he with it
The shock produced congestion of the brain
and the unfortunate mariner di es apoplectic
in three hour s
I n another case y o u fancy you behold the
V ery i nfe rnal act pe rpet r ated o n the 2 4t h o f
M arch 1 8 4 9
A female infant newly born
and alive is taken from the mother s side and
laid o n the burning coals
But enough !
the heart sickens at these
dreadful spectacles of human infirm it ies of
body immorality insanity and crime O ften
as I went o n scanning these ste rn and truth
ful details the scenes themselves so fo rciblv
nd appeared
r ecorded were b r ought befo r e a
—
to confront me until the very air o f the sub
terranean chambers in which I was writing
in the doubtful twilight o f an expiring day
seemed reeking with cadaverous effl uvia and
,
-
.
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,
,
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.
,
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”
,
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,
THE RE G IS T R A R GE NE R AL
49
-
.
the
rat t ling o f bones was heard along the
dark vaulted passages which co nnected the
o ne with the other compartments !
I n fact the m or al no t less than the m or tal
history of o ur population may be traced in
t hes e s o m br e register s in which no t an hu n
dred but thousands upon thousands o f similar
and ev e n more affecting examples appear
—
i
f
illustrat ve o both histories the latter quick
—
keen r elentless the former dark indifferent
crim inal yet always consiste nt in its results
It is not however eithe r for very sensitive
people o r romantic them es that these black
books are s o carefully and like a treasure
I t is for the more worldly
preserved N o !
purposes of law of testam entar y inquiries o f
inheritance perhaps o f legitimization o f issue
and other such objects
Into the head of
searcher s after these obj ects no such sacred
ideas feelings or suggestions will ever e nter
as I experienced myself and have e ndeavoured
feebly to po rtray
,
,
,
’
,
,
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,
THE RE GISTR AR GE NE R AL
50
-
.
those worl dl y purposes therefore I shall
an ex
devote the
no t yet
tended stat
ician o n
been b
the c
o f death
I have chose
om this in
quiry I trust t o
ct such par
t icular and ge neral co nclusio ns as will es ta
blish the truth o f my proposition that sud
d o n death apoplexy and paralytic diseases
are both very prevalent in our time and affect
much younger indivi duals than is generally
”
considered in society
F or political o r politico economical pur
poses statistics have been found useful by
some by other s faulty and defective as evi
de nce The same has been thought o f them
when applied to fr ee t rade But there is no
tampering with death returns and life ave
rages ar e much more certain than those of
bread stuffs which have been viewed by many
as capricious uncertain and not trustworthy
To
,
,
,
,
,
,
,
.
-
,
,
.
-
.
-
-
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,
,
,
.
DEATH STAT IST ICS
52
-
.
as far as I have been able to obt ain them at
the R egistrar s Office And lastly the total
number o f the same kind o f deaths as have
taken place exclusively in the M etropolitan
D ivision during the same period distinguish
This M etropolitan D ivision is
ing the sexes
the first o f the eleven d iv1s10 ns into which
all E ngland and W ales are at present divided
fo r registratio n purposes and co ns is t s o f thirty
six districts comprising a part of the counties
nd K ent
L ondon proper has
o f S urr ey a
twenty fi ve districts Surrey supplies nine and
K ent two districts namely G reenwich and
L ewisham
O ne o f the proclaimed objects of t he pre
sent work is to prove tha sudden dea
t
apoplexy and above all paralysis are no t
exclusively still less emphatically the o r
dained mode of death o f the aged but that
o n the c
ontrary, a larger proportion o f such
deaths take place before m an has reached the
age of sixty five years and that it is chiefly
’
,
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,
DE AT S TA T IST ICS
H
53
.
among the younger class of lives that there
is
an increasi ng fr equency o f such deaths
Wi th these views I shall introduce in a table
drawn up from informat ion obtained in the
manner previously described a general state
me nt o f the respective ages at which the
three forms of death in question have occur
red both in males and females taking fo r
t his purpose three o r four o f the years of the
last decennium promiscuously in order to
show t hat the same rule obtains in any o ne
year and not especially in any o ne particular
se ries o f year s S howing in fact that the
principle I e nunciat e is the rule and no t the
exception
O ccasionally I shall present the annual r e
turns divided i nto tri monthly periods in
order to see if any useful practical i nfer ences
nce th t may
n
i
ff
n be drawn from a
d
ere
ca
y
be remarked in different quarters o f the year
as to the amount o f its share of mortality
But all these consideratio ns would be in
.
,
,
,
,
,
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,
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,
a
.
DE A TH S TATIST ICS
54
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.
sufficient to invest t he main question with its
proper degree o f interest were the s tatus in
life o f the patient not taken equally into the
account F o r the profession handicraft o r
occupatio n of the individual exercises more or
less a certain influence in each case
These
particular s therefore will be stated as I shall
likewise endeavour to mentio n the average
length of time which elapsed as far as I shall
have been able to ascertain it in cases of
apoplexy and paralysis bet ween the first
“
seizure and d eat b fi
Ther e is another branch of the present in
i
n
i
n
which
must
be
passed
over
vest i a
n
o
t
t
o
g
silence and the natur e of which is alike in
t er es t ing to the philanthr opist and the public
authorities namely the frequent occurr ence
of sudden death (as it is r epresented in
the o flicial returns) o f children within the
,
.
,
,
,
.
,
,
,
,
,
,
,
,
,
,
,
”
b een d e em e d advis ab l e t o r e s erve t h is
las t co n s ider at io n fo r avo l um e o n t he p ract ical p ar t
o f t h is qu es t io n t o a
pp e ar h er eafter
I t has
,
.
DE A TH S TAT IST ICS
55
-
.
first year o f t heir exist ence N ot until I eu
t ere d into this painf ul inquiry had I any idea
that the early sacrifice o f human life in cer
tain large towns and cities o f E ngland and
Wales reached to t he extent I found regis
t ere d in the subterranean vaults of S omerset
H ouse Professe dl y we do not (as the C hinese
have been sometimes represented t o do with
theirs) commit t he exuberance o f o ur i nfant
population to the depth o f a canal or river
in a wicker bask et
But we certainly co n
t riv e to disembarrass ourselves o f such exu
—
berance by modes little less equivocal as
far as the returns to be read in the great
ledgers of death so often alluded to do testify
I shall develope more circumstantially this
branch of the subject farther o n when we
shall have had before us the ast ounding nu
m erals representi ng the early extinctio n o f
human life in E ngland and Wales
N ext in importance to the preceding part
of the subject is that of the large number o f
.
,
'
,
.
,
.
,
,
,
.
.
D EAT H S TA T IS T ICS
56
-
.
”
i ndividuals found dead
I n the majority
n i nvestigatio n r e
o f such cases there I S a
corded with occasio nally a p os t m or tem ex
aminatio n, the resul t o f which is presumed
t o explain the immediate cause of the awful
occurr ence But it is in r eality the effect
producing death which is mostly ascertained
o n such occasio ns a
nd no t the cause when
the internal appearances afte r death are taken
into account This observation applies equally
to the p os t m or tem examination o f a great
many other cases o f pr emature death F or
example a female unknown is found dead o n
the steps of a door in St Pancr as o n a par
She is examined
t icular day in J u ne 1 8 51
and water was fou nd in the p ericar d ium and
accordingly it is stated in its proper column
in the register that she died o f water in that
sac But the wa
ter must ha ve been the effect
of inflammatio n o r sudden congestion of the
cor onary vessels of the heart which in reality
had ind uced dea
th The same may be said
.
,
,
,
,
.
,
,
,
.
.
,
.
,
.
,
,
,
,
,
,
.
,
,
.
,
,
DE ATH S TA T I ST ICS
57
-
.
of
a great many inst ances of sudden death
in which it is asserted after exam ination
that they had been caused by an effusion of
either blood o r serum on the surface o f the
brain o r within it s ventricles I say the cause
o f death was that which p roduced the effusio n
This is no idle quibbling abo ut a word ; her e
after in speaking o f prevention and cure with
reference to any o f the three classes of death
treated in these pages the importance of the
above distinction will become manifest
When o n examination o f the body of a
person who died suddenly we find reco r ded
in the register such remarks as in the fol
lo w mg cases we readily asse nt to the opinio n
therein expressed that the i m me diate cause
o f deat h was the o ne actu
ally detected and
described A lawyer s clerk sixty years o f
age is found dead in Hyde Park, o n the 1 2 t h
1 84 9
o f D ecember
O n examinatio n his
stom ach and oesophagus are found crammed
full to the throat with undigested food
,
,
,
,
.
.
,
,
,
.
,
,
,
,
’
.
,
,
,
,
.
”
.
D
5
DEA TH S T ATI ST ICS
58
-
.
the 8t h of S eptember of the same year
a labourer died suddenl y in the district o f
C amberwell after t e n months s uffering un der
some unk n own dis eas e
H is body is ex
am ine d an d a large tumour is found ad her
ing t o the insi de wall of the chest whi ch had
compressed the lungs an d displaced the heart
an d thus caused su dden death
I n a third
cas e that of a child two years o l d who like
wise had died s uddenl y about the same time
it was as ce rtained t hat he had been choked
by numer ous w arts gr owing in the ins ide of
Ther e is no doubt as t o the
t he laryn x
dir ect caus e of death in these cases
Perhaps in the foll owing ver di ct returned
by a jur y under the direct ion of Mr C oroner
T Barn ett of C heltenham in the case of a
child no t quite five years old whose death
had tak en place on the l 6 t h o f D ecember
i p o f We st d ean
1 8 51 a
t O ld Cr os s t ownsh
el
t
es
it
would
puzzle
my
readers
W
s h co u
n
i
)
(
to dete rm ine whi ch was the cause and whi ch
On
,
,
’
,
.
,
,
,
,
.
,
,
,
,
.
.
,
,
.
.
,
,
,
'
,
,
,
,
6O
DE A TH STA T I S T IC S
-
TA BLE
I
.
.
An nual D e ath s fro m all cau s es in all E n gl an d an d
Wal e s (b o t h s exe s in clu d e d) an d annu al P o pul at io n
b etwe en t he las t C en s u s e s o f 1 84 1 and 1 8 51
,
.
C ens us
P p l ati n
o
.
1 841
1 842
1 84 3
1 84 4
1 84 5
1 84 6
1 84 7
1 84 8
1 8 49
1 8 50
1 8 51
T tal d ath t y
I c a f p p lat i
en
s
e
o
n re se o
o
u
u
o
.
8 24
ea
rs
o n 1n
t en
y
a
e rs
A glance at the same decennial period
,
in
reference to t he metropolis furnishes us W1t h
the following det ails The popula tion o f the
metropolis was
,
.
I n 1 84 1
I
Wh il e
t he m
An d t h at
of
n 1 8 51
l y in t he fo rm er ye ar was
lat ter year
o rt a it
t he
DE A TH-STAT IST ICS
A nd
if
61
.
look at the intervening years be
t ween the two the progressive annual in
crease o f the metropolitan populat ion with
the real number o f deaths corresponding
thereto is found to be as set down in the
annexed Table
we
,
,
.
T A BL E
rs
Y ea
.
I I
D ead w
aes and e aes
Ml
POP‘fl afi o n
‘
.
Fml
.
1 84 2
1 84 3
1 844
1 84 5
1 84 6
1 847
1 84 8
1 84 9
1 8 50
1 8 51
I
n
r
contemplating the two preceding t ables
,
S eventh Annual R ep o rt p age 1 1 1
S e e E ighth An nu al R ep o rt p age 1 6 7
1
0
3
i
r
a
e
h
A
l
p
p
g
n
t
n
n
u
a
R
e
o
t
e
e
N
S
1
S e e T ent h Annu al R ep o rt p age 1 7 7
#
1 S ee B r o ad s h eet o f L o n d o n M o rt al it y p ub l is h e d
S ee
.
,
.
,
,
,
.
.
,
DE ATH S T AT IS T ICS
62
-
.
what reader will no t be struck by the re
markable fact that whether as regards the
total number o f deaths in all E ngland or
the total number o f deaths in the metropolis
only the large increase which appears l n the
year of t he cholera
is followed in the
succeeding year
by a most striking
diminutio n in the amount of deaths ? so
much so as to bring that year s mortality
co nsiderably below the average number o f
deaths o f the years preceding the cholera
year Thus in Table I for all E ngland and
W ales the deaths o f that year were
being the largest amount in any o ne year
since the census of 1 8 4 1 But 1n the year
following that of the cholera
the
number of deaths fell to
being not
only
less than 1n the cholera year
but even less than the number of deaths of
the year preceding that of the cholera by as
many as
The same observatio ns
apply to the metropolitan deat hs which in
,
,
,
’
,
.
,
.
,
,
.
,
,
”
,
D
E ATH STAT IST ICS
-
63
.
the cholera year were
whilst in the
succeeding year they o nly reached
79 a
difference o f
N o r is this all for o n
comparing the number o f deaths o f 1 8 50
withthat of each of the three years preceding
the year of the cholera it is found to have
been infer ior to them all whereas accord
ing to the yearly incr ease o f the population
the relative proportion o f deaths should in
crease also N o w there must be something
more than a simple coi ncidence or chance
in these singular devi a
tions from ordinary
events
A gr eat epidemic malady sweeps
over the country carrying away its thousands
of victims raising the ordinary average o f
deaths to a very high figure and i n the next
year we find death slacking its fatal scythe
to an unusual degr ee o f moderation I s not
the unerring hand o f a compensating Pro
?
A ccordingly if we take
v id ence in all this
t he deaths of the t wo years together which
preceded t he cholera and st rike t he mean ;
,
,
,
,
,
.
,
-
.
,
,
,
.
,
,
D EATH S TA T IS T ICS
64
-
.
treat the year of t he cholera and the
compensating year that follows in the same
manner we shall find that the four years
present nearly the same average
Thus
the mortality of all England was
and
,
,
,
.
I n 1 84 7
I n 1 84 8
—Aver
T o get h er
I
n 1 8 4 9,
I
n 1 8 50
To
And
h o l er a
year
ge t h
of c
—Aver
er
.
for the metropolis the mort ality was
I
n 1 84 7
I
n 1 84 8
—Aver
T o g e t h er
I n 1 8 4 9,
I
.
year
.
h o ler a
of c
n 1 8 50
— Aver
T o g et h e r
S o that
,
r
e
a
t
e
g g
.
reality it is found when the ag
of the four years is taken either for
in
,
,
,
—
DEATH ST AT IS T ICS
65
.
the whole o f E ngland or for the m etropolis
o nly that no greater number o f people died
in t hose years because o f the cholera i nt er
v enin
n
i
f
h
tha
the
cholera
d
n
visited
us
a
o
t
g
It were well that those philant hr o pl s t s who
are running the whole hog to use a verna
onlar exp r ess io n with the ir theo ry o f cholera
being the o ffspring o f filth and insalubrious
localities r equiring large measures o f Govern
ment interfe rence expensive Boards of H ealth
and extramural interme nts shoul d reflect o n
these statistical facts and the co nclusio ns t o
which they lead
The sudden inroad and presence o f a great
plague that for a season chokes the grave
yards and fills the streets with funeral pro
cessions leaving behind it a high number o f
the victims fallen o n the great registers are
ordained from o n H igh as a solemn warning
to us all that we may put ourselves and our
houses in order But it is no t sent to de
populate whole counties or to destroy m an
,
,
.
,
,
,
,
,
,
,
.
,
,
,
,
,
“
.
DE ATH ST AT IST ICS
66
-
.
for
whe
the
great
plague
has
p
a
ssed
n
3
away and o n the following years the tribes
are again numbered fewer than usual o f the
people ar e found to have died l n that year
that the mass o f living flesh may co n
S uch is the D ivine covenant
ue the same
t in
A R eport from the G e neral Board o f
Health dated W hitehall 4 t h J a nuary 1 8 54
has just been p resented to both H ouses o f Par
liam ent which as regards the mortality from
cholera in E ngland during the year 1 8 4 9
may be looked upon as an extraordinary d o
O n grounds no t specified the re
cum ent
orte
r s fi r st throw discredit o n the retur ns o f
p
the R egistrar G eneral adopted as accurate
no t accu
in these pages but described as
9“
—
by the reporters and then deliver
rate
their O pinion founded o n p r o bability !
the
(
kind
,
”
,
,
”
“
.
.
,
,
,
,
,
,
,
,
,
.
-
,
,
”
,
h
I t is kn o wn t at t
r
at e
5
r
”
,
“
&c
hes e
r et urn s
were n o t accu
.
I t is
pr o b abl e
forth (p age s
5 an d
”
,
&c
“
.
,
it is
e s t im
at e d
”
,
an d
so
DEATH S TA T IS T ICS
68
-
.
accuracy of whi ch as far as it is attainable
there cannot be a doubt) and transferred to
these page s will co nvince every reader that
the statements ust referred to are a pure
and u nm itigated exaggeratio n which must
have escaped the attention of the head of the
Board
A simple numerical propositio n will prove
this The total number o f deaths in all
E ngland and Wales in the three years pre
ceding the cholera and in that o f the cholera
itself amounted to
The average
yearly deaths therefore were
But
in the year o f the cholera there died in
E ngland from all caus es
being an
—
r
excess ove the average o f
and
such and not
was p r o bably the total
number o f deaths caused by choler a
This
number however as I have already shown
was more than compensated by a diminished
mor tality in the two following years in which
the average number of deaths instead o f
,
,
,
,
,
.
.
,
,
,
,
,
,
,
,
,
.
,
,
,
,
,
DEATH ST A T IST ICS
69
-
.
as 1n the above case was only
n
f
r
n
o
o
givi
g
us
a
dimi
utio
the
n
3
—
more t hat enough
di nary mort ality
and o d d deaths
to make up fo r the
by cholera which had taken place two years
previously Why the n frighten the world
nd
o ut o f its propriety thus u nnecessarily a
gratuitously ? W e may rest assur ed that the
sanitary movement like every other human
undertaking can o nly benefit by the help of
truth
Having now set forth the total num ber o f
deaths fr om all causes in all E ngland gene
rally and in the metropolis especially during
the decennial period in question we will now
turn to the number of those who in t he course
have died sud
o f the sam e pe riod of years
d enly o r from apoplexy o r paralysis whether
in E nglan d gener ally o r in the metropolis
separately I exclude from this number the
sudden deaths o f infants under o ne year o f
—
age which 1s to form a separate considera
t ion in anot her par t of t he volum e
,
,
.
,
,
,
,
.
'
,
,
’
,
,
.
.
,
,
,
,
.
.
DEATH S TAT IST ICS
70
-
T A BLE
I I I
.
.
S ud d en D e at h s an d
fro m Ap o p l exy and
Paralys is fo r all E n glan d an d Wal e s dur in g t he fi ve
ye ars fo ll o win g b o t h s exe s inclu de d
N u m b er
of
,
,
,
,
.
,
Y ears
.
Sudd
en
Apopl exy
.
Pa aly i
r
.
s s
.
1 847
1 84 8
1 84 9
1 850
1 8 51
To t al s
F rom this large sum total of death s under
the three forms we will no w eliminate those
which especially appertain to the M
et r o p o
litan D ivision in order that we may see ho w
large a shar e (and in pr oportion to its po pu
lation how much larger a share than properly
belongs to it) that division has had in the
ge neral mortality from the three causes I n
this case am enabled by reference to the
documents in the R egistrar General s office
to present a table embracing the eleven years
,
,
.
,
-
’
,
DEA TH S TAT IST ICS
71
-
.
preceding the last census our means of com
parison are thereby increased
.
T A BL E
mb e
I V
.
fr o m Ap o plexy an d
Pal s y t h at h ave o ccurr e d in t he M etr o p o lis b etween
t he t wo l as t cen s u s e s m a
l es an d fe m al e s
Nu
r of
S u d d en D e at hs an d
'
,
,
/
.
,
Y e ars
S u dd
.
1 84 2
1 84 3
1 844
1 845
1 84 6
1 84 7
1 84 8
1 84 9
1 8 50
1 8 51
T
ot
al s
en
8 70
668
592
532
422
6 74
590
714
6 76
51 6
.
Ap pl xy
o
e
814
92 5
T t al
o
.
s.
7 76
8 51
895
8 86
.
1
The influence of seasons o n the occurrence
of deaths of the nature we are conside ring is
r ati ng i nto four
s ufli cient l
evi
ced
by
sepa
n
y
groups o r quarters of the year the several
totals recorded in each class in the precedi ng
,
,
,
DE AT S TAT IST ICS
72
H
table ;
tions
when we find
.
the following propor
S ud
.
Apo
Pa
r
.
.
rt er s
T o t al in t en Wint er q ua
S prin g
S um m er
Autum n
O r combining the general total o f
deaths by the three causes their occurrence
in each quarter stood thus
,
,
Wint er
.
Sp ing
r
Sum m
.
er.
m
Aut u
n
.
Two great facts may o n a first n ew be
deduced from the preceding tables The
first that deaths by apoplexy and paralysis
have eoeter is p ar ibus been generally o n the
increase The population of the metropolis
in 1 8 51 being
and that o f 1 8 4 1
the difference is
or a
little more than the fourth of the population
of 1 8 51 The number of fatal cases of palsy
therefore should have increased s ome what in
,
,
.
,
,
,
.
.
,
,
DE A TH STAT IST ICS
73
-
.
—
whereas
the same proportio n and be 93 9
it amounted in reality to
But the
case 1s still stronger as regar ds apoplexy the
number of deaths from which having bee n
8 6 6 in 1 8 4 1 shou ld have increased only to
in 1 8 51 whereas the number reached
— showi ng the progr essively increasing
frequency of the complaint as before stated
If we turn our attention to the mortality
fr om the thr ee causes throughout E ngland
and Wales during the same period we see
the truth of the preceding assertion still more
str o ngly illustrated I will quote only o ne or
two examples in support of the fact Take
the number o f d eaths from apoplexy and pa
*
ra
ly s is in 1 8 4 2 which stand at 53 6 1
and
respectively according to the criterion
4
ofpopulatio n which in 1 8 50 was
— the number of
and in 1 8 4 2 was
deaths from apoplexy should have been
96
and fr om par alysis
in 1 8 50
But ste rn
,
,
,
,
,
,
.
,
,
,
.
.
,
,
,
,
.
S ee
S ixt h Annu al R ep o rt p age
,
94
E
.
DE A TH S TA T I S T ICS
74
-
.
reality shows us instead
deaths from
apoplexy and
deaths from paralysis
o n the o ne hand
being an excess o f
and o f
o n the other !
The second great fact is that a manifest
i nfluence is exercised by the season o n the
occurrence of premature deat hs H ence in
looking at the distribution o f the t otal num
ber of deaths in Table IV according to sea
sons it appears that the winter and autumn
quarters are more prolific o f such deaths
—
than the spring o r summer the last being the
least productive o f such results This is more
remarkable in the case o f apoplexy than in
sudden death o r paralysis and yet profes
s io na
lly speaking o ne would have expected a
contrary result inasmuch as independently
of coup s ole s o leil so nearly allied to apoplexy
heat is known to favour the development of
*
the disease
,
,
,
,
.
.
,
,
,
,
,
.
,
,
,
,
,
,
.
>
6
t ive p ro p o rt io n s o f d e a
t hs
On c
om pa
r in g t h e s e r el a
acco r d in g t o
s ons ,
s ea
wit
h th o s e
in T ab l e I V
.
of
t he
DE A TH ST A T IS T ICS
76
-
.
the practice to consider the latter as more
e xposed to such deaths
I am aware that mere stat istical calcula
tors will object to my assertion that at the
periods o f life to which I r efer the greater
frequency o f premature deaths a larger num
ber of indivi duals exist at those ages than are
living at the same time of a more advanced
age That fo r example the percentage of
those who are living at any age between
thirty and sixty—five upon every
of
all living is larger than the percentage of
tho s e who ar e older ; and that therefor e it
is no t surprisi ng if premature deaths are mor e
frequent among the former than among the
latter A ssuming such to be the fact mathe
lly it cont r overt s no t the other fact
m at ica
that while life is at that period when o ne
would expect it to endure lo nger than t ha
to f
older people it is seen o n the contrary (within
t he last thirty years at least ) t o be destroyed
oft ener by the three causes already m en
.
,
,
,
,
.
,
,
'
,
,
,
.
,
,
,
,
,
t ione d
.
DE A TH ST AT IST ICS
77
-
N or is this a peculiar
.
exclusive charac
t eris t ic of human life in this country only
A s far as I have had t he means o f learni ng
by conversation with hyg1en1c physicians of
other nations and by the perusal o f foreign
statistical r ep o rt s the same observations have
been made in all countri es where ver great
and sudden political commotions o r gigantic
commer cial speculations and in fact wher ever
all those events of a public natur e are o f fre
quent occur re nce which tend to exalt de
press irritate or vex the character and Spirit
n whether through ambitio n o r d is a
of m a
p
pointment persecution o r te rro r the pursuit
—
of riches or the love o f renown in o ne word
through any and all of those hum an passio ns
which are antagonistic to the enjoyme nt of
an unruffl e d temper and an eve n state of
mind
A s however the present is intended to be
a section o nly and no t a volume o n death
statistics I shall not inflict o n my readers any
or
.
,
‘
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.
,
,
,
,
,
DE A TH S T A T IST ICS
78
-
.
large numbers of elaborate tables from F rance
Germany o r Belgium to prove the preceding
assertions But I happen to have at hand an
ua
r
o ld number of the B r itis h a
nd F o r eign Q
ter ly M
ed ical R eview in which a
n article is
i nserted o n a subject o f a kindred nature to
my o wn and which had been proposed as the
theme o f prize essays in Italy in the year
1 83 4
The article in question gives a suc
cinct account o f two ofthose essays the same
which had obtained the prize ; the o ne by
D octo r Giuseppe F errario intitled S tatis tica
,
,
.
,
,
-
,
.
,
,
d elle m or ti imp r o uuis te,
l
ess ia
a
o
p
,
uella
by D octor
Uittad i
Mila
no ;
r
e
p
the other
intitled Monogr afia
both published in Milan
To m m as io ,
d elle m o r ti r ep entine,
in 1 8 3 4
epa
r tico la
r m ente
.
The researches o f these writers exte nd
from 1 7 50 to 1 8 33 and the r esult p r oves the
increased frequency o f sudden death
S up
posing all sudden deaths to have been de no
m inat e d apoplexy it would appear that their
,
.
,
DE A TH S TA T IS T IC S
80
-
.
fatality of that disease is governed by mathe
ma
C uriously enough he calcu
t ical laws
lates what should be the rate of such fatality
from birth to t en years of age and so o n fr om
dece nnium to decennium up to the last be
,
.
,
,
,
tween ninety and a hundr ed years o f age
and by comparing the actual obse r vations o r
fatal occurr ences with his calculatio ns he
n fi nd o nly a t r ifli ng diff e r ence betwee n
ca
the two
O ur observations in this country do no t
coincide in their results with those made at
M ilan 3 no r is it to be wondered at for o ur
male populatio n between twenty fi ve and
—
sixty five years of age which exhibits a very
large proportion o f sudden and apoplectic
deaths is much mo r e exposed to exciting
and influe ncing causes mental social as well
as physical by which those deaths are pro
S uch exciting o r influencing causes
d uce d
scar cely ever ruffl e the tempe r or the even
tenour of the circulation in steady old gentle
,
,
,
.
,
-
,
,
,
,
,
,
.
,
DE A TH STAT IST ICS
-
81
.
have reached and passed t he scri p
tural three score and t en
With respect t o the greater liability to
apoplexy in males than in females the o bser
M r F arr
va
t io ns in both countries co incide
in the S eco nd A nnual R eport o f the R egis
trar General for 1 83 8 page 7 3 states that
women have less chance o f dying suddenly
than m en in the proportion o f t en to eightee n
And a little farther o n he remarks that o f
sudden deaths registered by coroners
were males and
including apoplexy
females ; so that out o f
males
th or apoplexy while
6 5 died o f sudde n de a
o f the females 5 1 o nly died
—
r r F arr s state
A s r egards sudden death M
ment may be accepted as uniformly accurate ;
but with r espect to apoplexy I am inclined
to think that a greater num ber o f data than
he could have had in the first year o f the
registering Operatio ns in his department o h
t aine d in the last t welve years will have
m en, who
-
.
,
,
.
.
-
,
,
,
”
.
,
,
,
,
,
.
,
.
’
,
,
,
,
E
5
DEATH STA T IST ICS
82
-
.
shown him that the statement o f an invariable
superiority in the number of deaths in males
over that o f females demands certain m o d ifica
tions especially in r eference to females in very
advanced life F or example in the year 1 8 4 9
the number o f females who died o f apoplexy
between t he ages of sixty five and o ne hundred
was l n the first second and third quart ers
great er than that o f males 3 and the total
numbers for the year at the above period o f
life were 2 2 7 females to 1 9 4 males
Be this as it may with regard to apoplexy
there can be no doubt of the greater liabi
lit y of females to paralysis
A ccordingly if
we look to the column o f deaths by paralysis
in all E ngland and Wales during the five years
previous to and inclusive of that o f the last
census in the table hereinafter annexed t he
relative proportions of the two sexes in each
year s tot al amount of paralyt i c cases will be
found to stand t hus
,
,
.
-
,
,
,
,
,
,
.
,
,
.
,
,
,
,
’
,
DE ATH S TA T I S TICS
84
-
T A BL E
T ab l e
.
VI
xh ibit in g by co un t ie s the Gr e ater Liab il it
F e m ale s o v er M ale s t o fat al cas e s o f Paralys is
e
,
,
.
M
.
M
cludi g
L d
p p big
th I t D i i i
f
th G
al R gi t y
f E gla d
I D D LE S E X , in
on
on
e
s
e
e ne r
ro
e
.
6
Wes t
.
o
4 27
o
Mid land
Gl u c t hi
H f d hi
Sh p hi
St aff d hi
W c t
Wa w ick hi
e n
er,
M
.
n
v s on
n
o
F
n
93
26
45
92
44
84
re
s
s
ro
s r
.
re
es er s
ere or
D iv
re
or
re
s
or es er
2 S o uthE astern D ir
S y
K t
Su x
Ham p hi
B k hi
.
1 83
1 40
67
83
54
urr e
"
en
s se
s
er
s
re
re
M
3 S o uth
i d l an d D ir
ert fo r s ir e
in a
for s ire
N o rt a t o n
n in
on
e fo r s ir e
a r i eshire
.
H dh
B u ck gh m
Ox d h
h mp
Hu t gd
B d dh
C mb dg
4
E as ter n D ivis ion
.
E x
Suff l k
N f lk
or o
5 S o u th Wester n D ir
Wil t s ire
h
h
ll
D or s e t s ir e
D evons ire
o rn w a
C
Sm
o
erset
42
44
59
Ch h
Rd g
d g
N hRd g
10
17
.
82
354
.
200
53
34
N o r ther n D ivis ion
u
es
11
er
n
10
ore
.
WelshD ivision
WA LE S
.
62
80
h mb land
Cumb la d
W t m land
er
61
31
21
93
02
.
c i
Y ork D ivision
We st i in
Eas t Ri in
o rt
i in
7
67
62
46
.
.
.
47
8 N o r th Wes ter n D iv
e s i re
Lan ashre
9
.
23
112
72
79
v
c
h
u d
c h
gh m
by h
N o rt
58
Mid land D i
Lei e st er s ire
R t l an
Lin oln s ire
N o t t in a
D er s ire
3O
25
49
59
94
o
h
.
.
s se
.
7 N or th
.
21
27
33
50
re
s
r
.
.
202
p er io r it y o f m al e s o ver fem al e s in t h is
r ge n um b er o f p en s io n er s dyin g o f p a
ra
i s d u e t o t he l a
at G r eenwich
T he
su
.
DE ATH S TAT IST ICS
85
-
.
—
males
is o n the side of the
albeit the differ
ence is very trifling But in the other thi rty
six counties as well as in W ales the reverse
is the case and the difference in many places
is considera ble
This will appear manifest
in the opposite T able calculated for the
year 1 8 4 9 3 but still m o re s o in Table VII
p 87
N ext t o the influence o f the sex in the
consideration o f our three sources o f death
that o f the age at which the death of the
patients occur is the most interesting
A s I before stated it is the common o pi
r e liable to die
nion that no ne but old people a
of apoplexy o r paralysis o r sudde nly This
may have been the case at very r emot e pe
r io d s o f society whe n there did no t e xist that
degr ee of progress in civilization of which we
at present boast albeit but of ut ilit arl ani s m
and self aggrandisement and no t o f solid in
t elle ct ua
l acquirements the principal of which
certainly belong to earlier ages I t is how
ever not so in o ur days for we shall per
.
,
,
,
,
,
,
,
.
,
’
.
.
,
.
,
,
.
,
“
,
.
,
,
,
,
-
,
,
.
,
,
DEATH STATI STI CS
86
-
.
from the citation o f a few examples
th at the middle period o f life supplies an
equal and at times eve n a greater number o f
s uch deaths than mere old age
F or this purpose I shall select the years
1 8 4 7 1 8 4 8 1 8 4 9 and 1 8 50 as the four years
the records of which I have been able more
minutely to study di ssect and analyz e in the
vaults o f S omerse t H ouse
L et us examine the n the returns o f those
years and adopt a form best calculated t o
bring o ut in a promine nt manner the various
fact s which they present to us so as to im
part authority for the inferences to be de
d uce d from them
This has been effected in the opposite Table
i
N
o
VII
from
wh
ch
it
appears
that
thi
w
i
n
)
(
the short space o f four years in England
individuals o r
males and
females perished either suddenly o r
from two forms o f head diseases apoplexy
and palsy
W e will now class this large number o f
ceive,
,
,
,
.
,
,
,
,
,
,
,
,
.
,
,
,
,
,
,
.
.
.
,
,
,
,
,
”
,
.
—
DEATH ST AT ISTICS
88
.
deaths under o ne year of age and deaths at
unkno wn ages the amount of both of which
is included in the prece ding Table
,
,
.
T A BLE
S dd
en
M
F
u
P
erio
d
s.
.
A
C
.
.
Th
P id
ree
er o
s
V
III
.
.
F
.
M
.
.
A ND
12 1 0 1 0 54
1 8 94
7 56
6 66
3 1 96 2 34 2
87 30
6 922
7 1 75
36 4 11
1 392 12 7 6
4 793
5792
7 022
2 4 90 7
154 1 7
1 34 7 0
1 57 98
s
F
.
74 0 6
6 8 7 24
H ere then we see that fr om
x
to
manhoo d or mature age the deaths fro m the
three causes are the fewest in number that
nearly double the number of m e n d ie sud
d enly o r fr om apoplexy at a mature (B )
than at an o ld age (C ); that women and
,
infancy
,
’ ‘
,
,
,
b efo re m ent io ne d all de at h s un der o n e year
u
i
of a
a
r
e e x clu d e d fr o m t h e s e ca
c
a
t
o
n
l
l
h
y
e
s
a
s
t
e
g
w ill b e co n s id er e d s e p a
ra
ft e r in the S e ct io n
t ely h ere a
o n t he E a
rly D e s t ruct io n o f Life in E n gl a
nd
As
,
,
,
,
.
DE
89
.
almost equal numbers either sud
d enly or of apoplexy in the two periods of
life B and C : and lastly that the only
marked differ ence which the two latter pe
rio d s o ffe r with regard to males as well as
females is observa
ble in the number of deaths
by paralysis The latter d isease will inva
r ia
bly be fou nd to be more destructive in
females t han in males I t is esse ntially the
disease of women fr om fifty to ninety five
years of age I n the years 1 8 4 7 1 8 4 8
1 8 4 9 and 1 8 50 the total number of wome n
who d ie d fro m paralysis was
com
par ed to that of males
But this
ex cess begins to be observed only at the age
of sixty years and so o n for e vei ys ucce ed ing
year o f life
Tested in the same manne r the mortality
of the metropolis fro m o ur three causes of
death exhibits precisely similar r esults The
truth of this will be made manifest by the
annexed Table N o I X in which are pre
m en
die
A TH—S TAT IS T ICS
in
,
,
,
,
,
,
.
.
-
.
,
,
,
,
'
,
'
'
,
.
,
,
.
,
,
.
.
,
DE ATH—S T AT IS TICS
90
.
sented the number o f males and fem ales who
died suddenly o r from apoplexy o r paralysis
at different ages duri ng the years 1 8 4 7 1 8 4 8
and 1 8 4 9 classed in groups at o nce ac
cording to the formula of Table VIII
,
,
,
,
,
,
,
.
T A BLE
IX
.
M etro p o lis
.
Ap pl xy Pa aly i
o
M
.
A
.
B
E
e
F
.
.
.
r
s s
F
B
.
F
.
ot
h
x
s e es
.
.
2 83
2 17
356
1 24
6 97
14 6 4
7 51
46 3
16 6 7
1291
344
7328
6 71
4 87
17 90
2 27 1
4 54 8
8 874
H ere we have presented to us a grand t otal
of
deaths exclusive of those under o ne
year of age and o f ages unknown from three
o f which belong to the
causes only
second period of life
N ow this large number ofpremature deaths
whether in all E ngland or in the metropolis
in people of the age when mankind is sup
1
,
,
.
,
,
,
DE ATH S T A T IST ICS
92
-
.
R egistrar-G eneral has pr oved himself to be
,
will take care to secur e it for the use of the
public in all futur e years A t the same time
it would be well to give to the A nnual R eports
that u niformity of subjects treated in them
and regularity in the di stribution of matte r
without which refer ence is r ender ed both dif
fi cult and defective
That all these necessary
perfections have not yet been attained in
M ajor Graham s depar tment is neither his
fault no r the co nsequence of any unwilling
ness o n his par t or that of his ve ry able
—
subordinates but the natural r esul t of a m is
taken parsimony o f the Government in
granting such a number of working hands as
shall be commensurate with the yearly in
creasing magnitude and importance of this
highly interesting and natio nal establish
*
ment
.
,
,
.
’
,
,
,
,
.
F ir s t Annu al R ep o t o f the R e gis t
G en e al an d at p age 7 8 w e fi n d t h e s e w o d s
t he ca
u s e o f d ea
t h b e co rr e ct ly ins ert e d (in the
I n t he
r
,
r
,
r
r
ar
I f
re
DE ATH S TA T IST ICS
93
-
.
Grouping then the deaths from all causes
,
,
into periods A B C according to ages as we
have done with r egard to sudden death and
from apoplexy and paralysis 3 but excluding
all deaths under o ne year o f age o r from
lfo rm at l o n p rem atur e births o l d age un
ma
known ages and the deat hs from o ur o wn
three particular causes we have a disposable
total o f
deaths from all causes which
group themselves as l n Table X
The first remark to be made o n that
Table is that the deaths fr om all caus es
during the period of mature age B taken
together form very nearly o ne third o f the
whole whe r eas in the case o f sudden deaths
,
,
,
,
,
,
~
,
,
,
,
,
.
,
,
~
,
,
,
h er e will exis t t h en cefo rwar d p ubl ic do cu
r iv e d a m o e a
b
e
d
e
m e n t gfr o m wh e n ce m a
c
c
u
r
a
t
e
y
kn o wl e dge n o t o nly o f t he co m p ar at ive p r eval e nce o f
vario u s m o rt al dis e as e s as e gard s t he wh o l e o f
l e s but al s o o f t he l caliti s in wh ich
nd a
n d Wa
E n gl a
il an d t he s ex age an d co n
t h ey r e s p ect iv e ly p rev a
d iti n f lif e wh ich e ach pr in cip ally affe ct s
rs t
i
e
s
t
g
)
,
,
r
,
r
o
,
,
e
,
,
”
o
o
.
DEATH ST AT IST ICS
94
-
T A BLE
T o t al
X
.
.
b er o f D eath s fr o m All C aus e s
d ivid e d int o T hr e e Perio d s o f Life
num
in 184 7 ,
,
.
P i dC
er o
.
F
M
.
98 5
1 89
44
T t al mal
o
T tal f mal
es,
o
e
es ,
from apoplexy and paralysis as we
have seen the proportion during the same
period B is as 1 to
o f the whole ; co n
firming my assertio n that such forms o f death
are more prevalent during the vigour than in
the decline of li fe
The second im portant though only an in
l observation is that the death s of
cid ent a
fe males in each group B and C are more
and
,
,
,
,
.
,
,
,
,
,
DE A TH STA T I S TICS
96
-
.
we find in this case also that a large
numbe r of comparatively you ng people in all
E ngland both males and females who at o ne
mome nt were seen in the full enj oyment of life
were at the next cold and inanimate I have
drawn up a Table showing the pr oportion of
sudden deaths in each county duri ng the year
in questio n distinguishi ng the sex and as
signing to each county the amount of popu
lation which we may suppose to have existed
in 1 8 4 9
F r om notes taken of the diffe r ent
age s at which such deaths have occurred as
they appear in the M S returns at S omerset
House I am enabled to s t at e t hat no t fewer
than four hundr ed and fifty fiv e of them (that
is o ne eighth of the whole ) occurr ed between
the ages of twenty and forty years Sur ely
x
the sudden extinction of life in so large a
,
,
,
,
,
,
.
,
,
“
.
,
.
’
,
,
-
-
.
’
‘
b er o f th e s e cas e s wo uld h ave b e en
gre atly incre as e d an d t h at o f ap o p le ct ic cas e s p r o p o r
t io n a
t el y d im inis h e d had I add e d as m ight h ave b e en
le git im at ely d o n e al l s u ch in st an ce s o f d e at h by ap o
T he
n um
,
,
,
,
DEATH ST AT IST ICS
97
-
.
umber o f young people in the course of a
twelvemo nth is a fact suggestive of serious
considerations
But we shall d o well to analyse the follow
ing Table a little farther i n o r der to elicit all
t he information it is capable of s upplym g us
with respecti ng the i nflue nce o f localities in
the recurrence o f the three forms o f death
under consideration Thus when com paring
the m et r o po lihwith the north western divi
sion of E ngland we see tha t although the
populatio n o f the latter at the last ce nsus
n
.
,
,
.
,
-
,
,
,
p l exy s o r ep o r t e d r e s p e ctin g wh ich n o dur at io n is
n d wh ich m a b e p r e s um e d t o h a
a
s s ign e d a
v
e ha
p
y
p ene d s u ddenly An d th ere w er e ales m any cas e s o f
alit is r ep o r te d in t he r e g is t er s in wh ich the att ack
cep h
is s t at e d t o h ave l as t e d s o s h o r t ap er io d as t o b e a
lm o st
co n s id er e d a s u dd e n d e a
Finally t h ere are t he
th
ca
s es of
co n vu l s io n s
wh ich fr e qu ent ly t erm in at e in
afew m o m ent s an d m igh t h ave b e e n co unt e d as s u d
d e n d e ath s
B u t all t h e s e I h ave purp o s ely exclu d e d
fro m m y co m p ut at io n o f s u dden death s wh ich has
n everth e l e s s e xt en d e d t o v ery l a
r g e fi gures
,
,
-
.
.
,
”
,
.
,
,
,
.
F
bl xhibiti g th mb f D ath ff m Ap pl xy Paaly i a d S dd
di t i g i hi g th x a d with
i
ach c u t y f E gla d a d Wal
c p di g p pulat i 1 84 9
a
n
e e
n e
n
o
on
orr es
e nu
o
n
o
n
er o
n
o n,
e
n
o
o
s
s
es,
e
r
,
n
n u s
s s,
e se
o
Mid dl
o unt y .
ese
M
.
x
Su y
K t
Su x
Hamp hi
B k hi
H t f d hi
Bucki gham hi e
Oxf d hi
N thampt
Hu ti gd hi
B df d hi
Camb idg hi
E x
Suff l k
N f lk
Wilt h i
D
t hi
D
hi
C nwall
S m t hi
Gl uc t hi
H f d hi
Sh p hi
St aff d hi
W c t hi
Wa wick hi
L i t hi
Rutla d hi
Li c l hi
N t ti gham hi
D b y hi
Ch h i
La ca hir
W t Ridi g
E R id i g 8 Y k
N th Ridi g
D ham
N t h m b la d
C m b la d
W t m la d
M m u t h hi
S uth Wal
N t h Wal
rre
en
sse
re
s
er
re
s
er
re
s
or
n
or
r
s
re
s
on
or
ons
n n
or
e
re
re
s
re
es
r
s se
o
or o
s
re
or se s
re
e vo n s
re
or
o
re
er s e s
o
re
e s ers
ere o r
ro
re
s
re
s
or
re
s
o r e s er s
r
re
s
re
e ce s ers
re
n
re
s
n o ns
o
er
es
n
re
n
s
s
a
re
re
re
e
s
n
es
n
.
or
t
n
or
ur
or
u
es
on
o
or
u
er
er
n
n
ore
o
n
s
es
es
re
es ,
en,
u
n
.
Ap pl xy Pa aly i S dd
C
n
1 06
e
.
r
s s
F
.
.
u
e n.
T tal
o
.
DE A TH S T A T IST ICS
100
-
.
the mortality fr om the thr ee caus es does not
—
i
n
a tta (by o ne tenth) the third o f the morta
lit y o f the met r opolis
O n the other hand whe n we turn t o single
counties we obser ve W estmo reland t o be the
freest fr om the disease in question as com
pared with the metropolis 3 for with a po pu
lation o ne fortie th o f that of London its m o r
tality fr om the thr ee causes was only equal
C am
t o o ne fi ft iet h o f that of the m et r o plis
brid ge shir e is o f bad repute with r egard to
salubrity 3 and o ne is inclined we hardly
know wherefore t o think quite differently o f
—
O xfo r dshire both counties forming parts o f
t he south midland divisio n
But o n com
paring numbers we fi nd that as regards
sudde n deaths apoplexy and paralysis the
last nam ed county with a populatio n
less than that of the firs t named county has
had 2 3 2 such deaths agai nst 1 7 4 which o c
curred in C amb ridgeshire I f we next com
par e Gloucester shir e with Warwickshire, the
.
,
,
,
-
,
,
-
.
,
,
-
.
,
,
,
,
,
,
-
,
,
-
,
’
,
.
DEATH S T AT IS T ICS
10 1
-
.
amount of whose respective populat io ns at
the last census was
to
we find that the number of fatal cases from
t he three causes s o often me ntio ned was
larger in the county with the smallest po pu
lation being 6 1 9 t o 4 6 0 L et the t wo huge
counties L ancashire and t he W est Riding be
compar ed together for a similar purpose
The former having a population o ne third at
leas t larger than the latter its mortality
from the three causes co nj ointly should have
been
whereas it has amounted t o
showing a very mark ed inferiority in
t he healthiness of L a ncashi r e as co ntrasted
A nd in this manner we
with Y o rkshire
might proceed with our parall el sTn the cas e
of many o f t he othe r counties
If we turn no w to what ar e denominated
l n the R egist r ar G e neral s Bla ck L edgers t h
e
dist ricts of the metropolitan division of which
—
there are thirty six and comp are the o ne
with the other (inequalit ies o f populatio n
‘
,
‘
.
,
,
,
.
-
,
,
.
'
.
’
-
,
,
,
DE ATH ST AT IS TICS
102
-
.
b eing t ak en int o account at the same t ime) a
notable d i fference is at o nce detected in the
degree o f 1m m unity o f some dist rict s and
that of the rest from the three forms o f death
But such an inquiry interesting and fo r me
d ical pu rposes useful though it m ight be
would lead me too wide o f the scope of my
present investigation I m ust ther efor e leave
it to futur e inquirers and a future period
whe n a less par simo ni ous T r easury ali ve t o
the immense value which will hereafter be
lo ng t o eve ry research em anating from t he
R egistrar G e n eral s d epar tment shall have
supplied its chief with t he means o f carrying
o ut t o the full his i nte ntions of r e nderi ng his
A nnual Reports mor e perfect
O ne subordinate branch o nly o f the inves
t igat io n I would neve rtheless lightly touch
upon in this place as se rving t o thr ow ad
d it io nal light o n the influence o f localities
in p r oducing sudde n deaths and deaths fr om
apoplexy and paralysis I have already stated
,
.
,
,
,
,
,
,
.
,
,
,
,
,
’
’
-
,
,
,
.
,
,
,
,
.
DE ATH S TA T IST ICS
10 4
-
T ABLE
XI I
.
.
C o m p arat ive H e alt h in e s s o f cert ain
an d C it ie s in E n gl an d 1 8 4 9 in r e fer en ce
t h r e e ca
l ity
u s e s o f m o r ta
T ab l e
of
,
,
.
-L
o
.
o
n E n
.
8
Co
un ty
P o p ula
n
To w
.
9
ti n
o
.
83
5
:
.
1 851
3
1
.
3
0
M
E
.
8
E3
a S5
.
igh t n
I
l
hnt
Ha tin g
f W i gh t
I l
Lym in gt n
S uthampt n
W in h t
E dm n t n
Middl
H nd n
H t
H tf d
Et n
Bu k
O
n
O f d
C amb idg
1C amb i dg
E y
C amb idg
Wi b a h
W t Ha
E
Mald n
Suff lk
Sud u y
I
wi h
wi h
N
N f lk
E p in gh am
A yl h am
F
h
W aylan d
Wi
Wi t
gP w y
H nit n
D
n
3P lym ut h
E
t
n t
i ad
C n wal l
St G man
l
S m t B at h
B idg w at
it l
Gl
h
C h lt nh am
La
n a hi
ht n
ld ham
S
Han t
K nt
Su y
Hant
Br
o
P o r t s eaI s l an d
I s e of T a e
us sex
s
e
r re
s
s
s
7
2 l , 2 14
s e o
o
o
o
c
esex
es er
o
o
er s
e
o
er
or
c s
o
x or
xo
r
e
r
e
e
r
l
c
e
s
m
es
s sex
o
b
o
r
c
ps
or o
or
c
6 8, 1 96
r
s
o re
oe
l t on
s
o
ev o
x e er
N ewt o
L
Ab b o
sk e
o s t e rs
.
Br
e
s o
e
c s
re
As
O
60
e
o
15
s
er s e
r
I
1
1
r
er
.
‘
30
o
o
or
18
se
e
o
10
er
2
1
2
88
I
68
1
1
86
T o wn s
t o t he
D EAT H ST A TIS T ICS
-
105
.
ns of
the
populatio
(
either being nearly equal) are these
1 A poplexy and paralysis male and female
more fr equent in counties than in cities
2 S udde n deaths more freque nt in cities
t han in counties
The real numbers for 1 838 stand thus
A nnual R eport page
1 62
,
,
,
,
.
.
.
T A BLE
D is eas e s
males
x1113
°
.
Cit i
es
.
C
o unt ie s
.
Cit i
es
3 58
30 3
1 79
H er e ag ain is am
.
Cu
o
nt ie s
.
C
.
6 95
337
34 1
108
2 74
2 82
1 20
o unt ie s
valu able arrangem ent in
at abu l ar fo rm ad o p t e d in t he S e co n d Annu al R ep o r t
in wh ich im p o r t a
n t info r m a
t l o n l n a cl e a
n d co n
r a
nn er is given
cis e m a
a
n
d
f
r o m wh ich t he a
b
o ve
(
T ab l e is e xt r act e d) t h at has n o t b ee n r et ain e d in any
s u b s e qu en t R e p o r t
Why n o t o n e m ay in quire ?
S o m eth n g lik e t he s am e in fo r m at io n un do ubt e dly
ma
b
f
e
a
t
r
r
m
r
r
m
ta
g
h
d
f
h
f
bl es in o ne
e
e
o
o
t
e
o
o
s
y
o r t wo
but n o t al l s ub s e qu en t R ep o r t s 3 b ut t he
ma
tt er t h er e i s d il ut e d ext en de d a
n d no t e a
s ily
co m p a
ra
ble
F 5
,
,
o st
,
,
,
,
,
,
.
,
i
,
,
,
,
.
,
DEATH —ST AT I S T ICS
10 6
.
The last point in co nnexio n with d eath
statistic s which I shall int roduce as far as
my researches at the R egist rar General s
have enable d me so to do is the co nsidera
tion o f the influence which the profession
occupatio n or s tatus of the patie nt may be
supposed t o have exercised in the pr oduction
o f the eve nt
Ther e is no other means of
obtaining such information except by go i ng
over o ne by o ne all t he cases of sudde n
death apoplexy and paralysis which occur
o n the Gre at R egiste r s a
nd write o ut the e n
tire report o f each case The published do
cum ent s do no t put us in possessio n of the
particular s r equir ed of the s tatus in life o f
the deceased no r of the time that his attack
lasted before death both important feature s
in an investigatio n like the o ne I have un
I the r efor e patiently selected all
d e rt ak en
the cases of the M etropolitan D ivision that
had any relation to that investigation
choosing for the purpose the two years 1 8 4 6
,
,
’
-
,
,
,
.
,
,
,
,
,
,
.
,
,
.
,
DE ATH S TATI S TI CS .
10 8
-
tion had also dir ected their atte nti on to the:
i nflue nce o f p rofessions in deaths by apo
plexy 3 when it appeared that out of
of each class those who had fallen victims
wer e in the following propor tio ns
,
,
Agent s Farm er s
Phys ician s an d S u ge o n s
Paint e s an d E ngrave s
M er ch ant s
V ictu all e s an d I n n k e ep er s
C ivil E ngine e s Acco unt ant s
M as o ns
B r o k er s ,
,
4 80
r
r
32 9
r
2 56
2 55
r
r
,
&c
168
.
,
list is a more exte nsive o ne as
will be seen in the annexed Table N o X I V
The two Tables however are no t com
parable togethe r inasmuch as the Italian
reckons the number o f apoplectic deaths in
each calling out of a known number of i ndi
ls of that calling then living 3 whereas
v id u a
o ur Table simply states the number of those
of each calli ng o r s tatus in society who had
fallen victim s to apoplexy paralysis or sud
d en death duri ng the t wo years selected
Our
o wn
,
.
,
,
,
,
,
,
,
.
DE ATH S T A TI STI C S
109
-
T A B LE
O f t he C o n d i t i o ns
XI V
.
.
in Life and o f t he d ifi er ent Pr o
fe ssi o ns and O ccup at i o ns o f t ho s e who d i e d fro m
t he c au ses herein n a
m e d in the ye ars 1 8 4 6 an d
1 8 5] w it h the n um b e r o f s u ch d e at hs in e ach c l as s
o f Pa
t i en t s
'
,
,
.
f
.
o
y
x
.
s
r
e
e
s
s
b
ME TR OPO LI S
a
ml
e
l
p
.
o
uC
p
A
N
l
I
H
N
Noblemen gentlemen independent
93
Ofli
in the arm y a d na y and East India
12
Com pany s ser ice
Clergymen medical men lawyers
25
Ladies
wi dows of gentlemen spinsters 1 31 1
d aughters o f gentlemen
Widows o f artisans tradesmen labourers ser
30 3 3
ants 8 m
Married women of artisans and all i d t ial 291 2
classes and unmarried daughters of ditto
grooms cabmen postboys port rs me
1 28 1
housemaids charwomen
g
Barbers hairdressers
1
House p aint ers plumbers slaters plasterers 122 1
stonemasons bricklayers lab urers
}
Carpenters upholsterers cabinetmakers oin
ers b hm ak
wheelwrights ship
55
”
,
,
n
cer s
’
0
0
5
#
!
O
O
,
v
,
,
,
,
,
,
,
,
,
v
)
v
.
n us r
,
'
4
‘
,
,
e
,
s e n er s,
,
,
,
-
,
,
,
11
ers ,
,
workers gunmakers cutlers coppersm iths
Licensed ictuall ers hotel and innkeepers
publicans brewers fi house keepers
ll
b
Butchers pork and tripe sell ers p o l terers
,
,
12
,
,
rus
,
,
o
,
,
10
,
V
27
,
,
,
'
,
eerse
13
,
co
ee -
,
ers
,
29
o
,
u
7
D EAT H
1 10
ME T ROPOLI S
.
rocers milkmen dairym en cheesemongers
F shm ongers
Bakers confectioners millers
Tail o s boot and shoemakers hatters
N dl w m
mill iners dressmakers haber
dashers
Merchants ad merchants clerks acco ntants
commercial tra ellers
House agents auctioneers and brokers
Artists architects sur eyors musicians
teachers schoolmasters
Stationers publishers printers booksellers
bookbinders newsmen
Watchmakers g ol d and sil ersmiths j ewell ers
Coopers turners and other artisans brush
makers car e s
C a hm ak
coach painters saddl ers harness
makers leather cutters
Horse dealers carters waggoners draym en
carriers stabl men
Po licemen watchmen sol d iers sail ors and
their wi es ; waterm en C ustom House
fli
Pensioners mal e and femal e
Paupers mal e and femal e
V arious other occupations or whose conditions
in life is unknown
Prostitutes
Prisoners
Wea ers and their wi es m ercers haber
dashers
All persons co ect d with gar d ening or agri
cul tural operations
All pro fessions
G
,
,
,
i
,
r
,
,
,
e
ee
en,
o
,
,
’
n
u
,
,
v
-
,
,
,
v
,
,
,
,
,
,
,
,
,
v
,
,
,
,
v r
,
o
,
-
er s ,
c
,
,
-
,
-
,
,
,
e
,
,
,
,
,
v
o
,
,
cers
,
,
,
v
v
nn
e
,
,
E A RLY DE S TR UC TI O N
112
IV
or
.
D ES T R U C TI O N O F L I F E IN
EAR LY
E N GL A ND
.
perit pres d u quart des enfans pendant
la prem i ere
observes a modern foreign
I
L
writer o n T ectology and he goes o n to ex
press his surprise at such a fact His feel
ings would not be greatly different were he
to scan o ur annual reports from S omerset
H ouse since the commencement o f their esta
.
blishm e nt
.
We open the very first
of
these valuable
volumes containing a set of tables giving
,
D
r
.
F R l E D L AN D E R ,
ah
E d ucat io n P hysiqu e d es
L I FE
IN
E N G L AND
113
.
deaths registered from J u
ly 1 1 83 7
to J une 3 0 1 8 38 both days inclusive and
there we find the following facts
1 I n the first or M etropolitan D ivision
havi ng at the time a population of
o ut o f the total n
umber of registered deaths
in that year about one fift hwere those of in
fauts under one year of age A t that time
E ngland and Wales were divided into twenty
five divisions for registering purposes instead
of eleven as is at present the case
By consult ing the table of each of t hes e
divisions we learn (speak ing in round num
bers for s trict mathematical prec1s 10 n 1s not
needed in medico political computation) that
the early destruction o f hum an life went on
s t ra
ct s o f
,
,
,
,
,
.
.
,
,
,
,
-
,
.
.
,
.
,
,
-
fi
at about the following rates in every
registered deaths
in M anchester and its
2 M ore than
suburbs
3 N early the same i n Liverpool West
D erby and its suburbs
.
.
,
.
,
.
E ARLY
1 14
STR UCTI ON
DE
or
5
A t Lee ds m ore than
I n Birm ingham near
6
I n M i d dlesex (London exclusive) H ert
4
.
.
,
.
fo r d shire,
7
Bedfordshire and Buckinghamshire
,
I n K e nt,
.
e
,
Surrey S ussex Berkshire
,
,
,
and H ampshire
,
I n D orset shire
and Wiltshire less than
9 I n D evonshire a littl e more than
ll
ditto
1 0 I n C ornwa
1 1 S om ersetshire
ditto
1 2 I n Es sex
ditto
1 3 I n N orfolk and Suffolk more than
1 4 I n S outh Lincolnsh
ire H untingdon
1
shire and C ambridgeshire m ore than : 7
1 5 I n N or th Lincolnshire Rutland D erby
N ottinghamshire Leicestershire and No rth
am pt o ns hir e more than i
1 6 I n O xfordshire Gl o uce stershire Wo r
ces t e r War wickshire Birmingham excepted)
(
a lit tle more than a
1 7 I n the mining parts of S t afi o rd shir e
and Shropshire considerably more than i
8
.
.
.
.
.
.
.
.
.
,
.
,
,
.
,
.
,
,
,
,
,
,
,
.
,
,
,
'
'
.
,
.
A
11 6
E ARL Y DE ST R UC TI O N
of
or
males not fewer than 3 0 6 are of infants
under one year of age
But I will put the subject in a clearer point
o f vie w by constructing a T able out of those
supplied by t he offi cial Report showing the
pr o portion of those who have died under one
year of age in every
registered deaths
distinguishing males and females and class
I n
h
em und er the separat e divisions of the
t
g
county as before enumerated
,
.
,
,
‘
,
,
'
.
,
T A BLE
N
u
m ber o f deaths under
3
year
o
f
a
g
e
1
3 g
"
IE
5
O t o f 1 0 0 0 O t of 1 0 00
%
z
ma
l d at h female deaths
<4
I
.
Num ber of deaths under
5
,
.
4’
:
e_
1
2
3
4
5
6
7
e
13
s
.
.
of
1 00 0
Out
of
1 0 00
male deaths fem ale deaths
.
20 2 96
26 9 2 6
30 6 2 7
24 0 38
2 0 90 2
8
9
10
11
12
Out
u
u
2 0 31 7
20 79 1
1 96 6 6
2 56 7
2 56 50
2 44 0 9
2 1 6 70
1 89 6 3
1 6 9 55
1 6 0 56
1 6 4 55
1 86 6 9
1 6 31 9
1 78 9 8
2 0 0 83
2 33 6 3
2 99 6 7
2 332 2
1 856 1
280 9 5
1 92 90
246 6 4
221 1 1
24 0 1 4
1 96 99
16 6 4 7
1 95 54
1 521 2
.
L I FE I N E NGL AN D
’
11 7
.
T he preceding T able gives for the year
a proportion little short o f i for the
males and
for the female deaths within
the first year of life o ut of the whole number
o f re gistered deaths
1 838
}
7
,
,
,
.
With the aid of the tables contained in the
—
2
S econd Annual Report (pages 3
57)
tables which it is to be regretted have not
been continued in precisely the same form in
—
w e can
ev ery succeeding A nnual Report
push our investigation into this early destruo
tion o f life, even to within the first month o f
existence in both sexes From the informa
tion therein marshalled we shall gather some
extraordinary facts
What is professed to be given I n the fol
lowing T ables is an abstract of deaths male
and female for all E ngland under one year
of age subdivided into months the popula
tion o f E ngland being taken at
A s compared wit h the deaths of the pre
vl o us year the rate o f increase in the number
,
,
,
.
,
.
‘
,
,
,
,
,
E ARLY
118
D E s TR U CTI ON
T A BLE
D e at hs
in
I I
or
.
1 838
.
Total s
Age
.
.
Under 1 month
1 and und r 2
M
.
e
F
.
Total
.
deaths in 1 8 3 8 was as 2 1 8 5 is to 2 1 4 1 9
males and females T his point is best eluci
dated by a reference to similar T ables for
each o f four other successive years By com
bining afterwards the five together and co n
t ras t ing the result with the m ortality of the
year prece di ng those we have selected we
can draw inferences which will surprise m ost
of my readers
We see at once a very striking dif
ference in this early destruction of human
life between male and females ; the latter
of
.
“
.
,
,
,
,
.
,
E ARLY DE STR UC TI O N OF
12 0
T A BLE
V
.
D e at hs in 1 8 4 1
Males
.
Totals
.
Bi ths
r
.
Under 1 month
1 a d under 2
.
M
.
n
2
3
6
9
F
Total
12
Total under 1 y
r
.
.
A BLE
T
VI
.
D e at hs in 1 8 4 2
Age
.
Males
.
Females
.
.
.
Totals
Under 1 m nth
1 a d under 2
.
M
o
.
n
2
3
6
9
F
.
Total
12
.
being less sufferers in the proportions of 1 6 6
to
difference 4 4 5 N ow as such a
,
,
.
,
L I FE I N
E
NG L AND
T A BLE
T he F ive Y e ars
VI I
12 1
.
.
c o mb ine d
.
Under 1 m onth
1 and under 2
12
Total under 1 yr
.
disparity o f relation between the two sexes
in death is considerably higher than that
which exists between them at birth the latter
being only 1 0 0 females to 1 0 5 males in
E ngland we must conclud e t hat so m e phy
l reaso n exists for the favour o f compara
s ica
tive exemption shown to females supposing
o ne and the sam e cause to act in both sexes in
pro ducing death either under one month o r
within the first year What is that reason
‘
,
,
‘
v
,
,
,
‘
~
.
O f co urse the prop o siti o n is thus put
G
on
the
E ARLY
D
.
E S T R U CTI ON
or
belief that there is fair play (of which I have
some doubt) in all these numerous deaths o f
newly born babes from which I should have
before stated the still born and t he prem a
t ure births have been totally excluded What
,
-
,
,
-
r
,
,
that reason is remains t o be discovered
We next n otice I n the preceding T ables the
fact that of the total number o f deaths males
.
,
,
,
and females within the first year o f life nearly
,
third Of them occurs before o r at t he ex
i
i
n
ra
of
the
first
month
t
o
p
A gain if we se ek in the aggregate of the
five Tables for the lowest m o rtality withi n the
ye ar we find it at the ninth tenth and
eleventh months ; the proportions being
1 8 5 the former under o ne m o nth the
3 82
latter between the eleventh and twelfth
m onth bothmales and females
I n the same manner the co mbined T able
sh ows that the relative rates o f mortality in
the several m onths o f the first year com
pared with the whole m or tality o f that peri o d
o ne -
,
‘
.
,
'
,
,
,
,
,
,
.
,
.
,
E ARLY DE STR UC TI O N OF
12 4
more marked in the latter districts than in
certain other large cities o r even the metro
polis Finally that it prevails l n the most
is
,
.
,
frequented sea port towns over that of the
surrounding towns or cities unconnected with
either seafaring life mining o r manufactories
I n fact that wherever classes o f careless un
educated idle dissipated beggarly and god
less people of both sexes live there the early
destruction of life is t he greatest
I t will not be superfluous in this place to
add that nearly the whole o f the number Of
infant deaths within the first m onth and of a
large proportion also Of those which occur
subsequently within the first year o f age
2
suddenly
As
take place as reported
s um ing that they are so reported correctly
had I in cluded their number in the total o f
the sudden deaths I have recorded in the
—
section on D eat h Statistics the aggregate
am ount of the latter would have acq uired still
m ore extra
ordinary proportions But I deli
-
,
,
,
.
,
,
,
,
_
,
,
,
.
,
,
,
‘
,
,
_
,
-
,
.
L I FE I N E NGL AND
125
.
excluded the m from my records of
adult sudden deaths that we might deal
separately with the former in the present
section as a subject callin
g for a distinct and
berat ely
,
,
serious considera
tion
We assume then that these infant deaths
are sudden ; and as the mind o f man im
pressed with the conviction o f the infinite
goo dness o f the C reator revolts at the idea of
s o much human life being quenched nearly
—
as soon as it is called int o being we are
-
,
,
,
,
‘
,
,
made to look for an explanation o f so unna
tural a pheno menon to the evil pass ions of
man and lis t en wit h doubt t o such verdicts
as the following extracted from the registers
professing to account fo r each sudden and
fatal event after some sort of investigation
1 Found dead accidentally suffocated
2 Found dead in a cradle suffocated
3 S udden ins ufiicl e nt inflati o n o f the lungs
4 A ccidentally suffocated wh ilst in bed
with the mother
,
‘
,
,
,
.
,
.
,
.
.
.
.
,
,
.
'
.
.
‘
E ARLY DE S T R UC TI ON O F
12 6
5
.
S uffocated whilst in the arm s
mother
6
.
of
the
.
A ccidentally o verlaid
.
Found dead by the side o f the m other
8 Found dead lying close against the
m other
9 Found dead in bed suffocated by pres
s ure how caused unkn o wn
1 0 S uffocated instantly lying between t he
m other and the father
1 1 S uffocated by being accidentally turne d
over and laid o n by another child in bed
1 2 S uffocated by slipping o ff the pillo w
o f a be d o n t o his face being laid there on
7
.
.
.
,
.
,
.
,
.
,
.
.
.
.
,
to sleep
.
from taking an over quan
tity o f the mother s milk she having fall en
asleep while the child was s ucking durati on
uncertain
1 4 ; Found dead in bed with her parents
and t wé other children
1 5 S uffocated by being accidentally p r
esse d
13
.
S ufi b cat io n
’
,
.
.
.
E ARLY DE S TR UC TI O N O F
12 8
these to account for infants dying at a few
h ours d ays o r weeks after birth : un
”
kn own no medical attendant no r any c or o
,
,
,
.
,
In
’
ner s inquest
.
the subdistrict
Of
C hep
stow for example as many as five deaths o f
m ale infants are recorded in that manner
betw een the 2 l s t o f J une and the 2 9th of
J uly 1 8 51 o ut Of sixteen deaths fr om all
causes registered in that district A nd in M
on
mouth the deaths o f four female infants under
o ne year o f age are registered in an equally
O ut o f 3 51 deaths
unsatisfactory manner
from all cause s registered at Abergavenny
during the first qua rter O f 1 8 51 as many as
fift y six cases O f deaths o f infants under o ne
year o f age are recorded without any satis
factory reason assigned
H ere is evidence enough (and a great deal
m ore might be adduced from the same I I I d I S
u
a
l
t
b
sources
to
lead
one
to
pause
before
e
p
)
he concludes that all such early and p rema
ture deaths are what o ne of the coroners
'
,
,
,
,
,
.
,
.
,
,
-
,
.
'
,
:
L I FE
IN
E N G L AND
12 9
.
frequently afi xes t o his returns o f Similar
”
deaths natural
What is the meaning o f
such a definiti o n ? T he o nly natural death
I admit is that o f Old age But the same
c or o ner has O ften r ep orted t he sudden death
o f an infan
t thus N atural found dead in
”
1
bed I s it natural to find a dead babe in bed
O thers of the ver dicts I have enumerated
convey explanations of the death not a whit
less singular Let us take an Instance
verdict N O 1 2 T his was the case O f a male
infant at nine months who died suddenly on
the 1 9th o f S eptember 1 8 4 6 at N O 4 4
Lower M arsh Lambeth What can such a
verdict mean ?and how I s t he fact w
hich it
implies possible with a child nine months
O ld ? T ake aga
in N O 13 A male infant
nin e Weeks Old s o n o f a basketmaker in
C r o ss Street Whitechapel is found dead in
bed o n the 13 th of J anuary 1 8 4 6 H ow
did t he c o roner come t o the co nclusion t hat
nt c o ntinu ed sti cking and what is
the infa
.
,
,
.
,
,
’
.
“
’
.
.
.
,
,
,
.
,
.
,
‘
,
,
.
.
,
,
,
,
,
,
,
.
~
'
'
,
G
5
E ARLY DE S T R UC TI ON O F
1 30
the quantity o f t he moth er s milk t hat will
destroy achild nine weeks o ld
I n ver dict NO 1 1 the coroner was obliged
ccept t he statement o f the father residing
to a
t 2 3 G reat E xeter S treet o n the 2 7t h o f
a
D e cember 1 8 4 6 as a legitimate evidence that
t he d eath o f his in fant was brought ab o ut
’
.
,
,
,
,
,
,
,
ild
there described A ch
ly ing at full length o n the back o f an oth er
wh o had his face downward until death is
pro duced in the latter is to say the least an
extraordinary Occurrence
V erdict N o 9
refers to a female infant four m onth s o ld
found de ad o n t he 5t h o f April 1 8 51 I t
was an illegitim ate child
What sort Of pres
sure could it be that caused her death ? N et
a hug o f affe ction fr om the mother I trow
in the m anner
.
.
,
,
,
,
.
.
,
,
.
,
.
,
!
ead verd ict 1 7 and hear the a ddi
se (whi ch o ccurred o n
l fact of the ca
t io na
the 2 5t h of August 18 51 in Ge orge Street
So uthwark) that the infant was only six
A gain
r
,
‘
,
,
,
,
weeks
Ol d ,
and
the O ffspring
of
illegitim acy
E ARLY DE S T R UC TI O N
s ingle
or
woman is taken dead o ut Of a bucket
while a fourth
e 1 7 th Of O ctober 1 8 51
on t h
i nfant newly born and which had breathed
was discovered in a cigar box in O ctober
1 849
I n all such cases the truth O f the
verdict is palpable though it e xplains no t
the manner nor the motive Of the act neither
d oes it attempt to designate who the perpe
t rat o r s of the act had been or t o discover if
the act were wilful o r accidental
T hus far then the i nvestigation c o nducted
before the coroner s court thro ws n o light o n
t he m o r e im po rt ant p art Of the great question
namely what are the causes o f the early
?
destruction o f life in E ngland N umerous as
these verdicts are which o ne meets at t he
termination of every m o nt h o r quarter in the
great ledgers at S omerset Place they are not
more decisive Of the question than the sixteen
o r seventeen forms O f such verdicts I have
just brought forward in illustratio n A nd yet
it is precisely upon occasi ons such as present
,
,
,
,
,
-
.
,
,
.
,
.
,
.
,
,
’
,
'
,
,
'
,
.
L I FE
E N GLAND
IN
1 33
.
themselves before c o roners in the cases s pe
e O f their ver
cifi e d in those several formul a
dicts that if ever the difficult yet imp o rtant
point can be solved what is the real agency
to which We are t o ascribe the truly appalling
frequency o f the premature death of infants
A t present such f ormul a
e of verdicts as the
coroners adopt o r suggest to their juries are
almost an encouragement so to speak to a re
—
petition Of infanticide whenever the perpet rat iOn o f such a dreadful act has been v en
t ure d upon on t he chance O f its beI ng att ri
buted to mere accidents if I nqu I r e d into aft er
wards And if not an encouragement for re
petition they would pr o ve such for imitation
When two unwedded parents steeped in
wretchedness as in brutalizing drink have
squeez ed their unwelcome infant intruder be
t ween them t o d eat h and they hear t he jury
declare as the whole final solution and r e
Found dead in bed
Sponsibility O f the case
between mother and father supposed t o have
,
,
,
“
.
,
,
,
,
e
,
,
,
.
.
,
,
,
k
,
,
,
,
E A RLY DE STR UC TI O N
134
or
c
be en accidentally overlaid
verdi
t
N
O
(
burthened
1 7)
o r when a single woman
.
,
with the infant fruit o f her illegitimate pas
si o n o r involuntary seduction is summ o ned
,
by the c or o ner t o explain how it happened
that it had suddenly died and finds her own
tem ent accepted as suffi cient explanati on
st a
that the babe died suffocated by being acci
dentall y pressed t o o closely to her breast
”
whilst suckling (verdict N O 1 5) when all
such s ententious verdicts are uttered I say
where is the juryman O f c omm o n sense who
,
,
,
a
.
,
,
d o es not perceive at once tha t such his d et o say the le st are not likely t o
cisions
deter the parties in questi on or any other
equally ill minded parties bent on imitating
a pro ceeding so safe fro m appearing before
him o n a similar gr ound again
I t is my str o ng c o nvicti o n co me to after
the perusal o f a considerable mass o f verdi cts
O f the same stamp o n the sudden d eaths of
very young infants as are to be seen in these
a
,
s
,
,
,
-
,
,
,
,
,
E ARLY DE ST RU C TI O N
136
or
”
are called the attesting witnesses t o the
death Of such young infants as are recorded
in the Registrar General s v olumes can sup
ply us with m o re explanat o ry o r c onvincing
gr ounds for this early extincti o n O f human
life in this country Let us see in fact
to what causes have been ascribed these
deaths O f babes under o ne m o nth ;
and O f
deaths Of infants under o ne
year O f age which have taken place in the
sh o rt space O f five years viz from 1 838 t o
’
-
,
'
.
,
,
,
.
,
1 842
,
.
A s in the case
Of
the c o ro ners verdicts
s o in the present instance I shall marshall
the various causes to which the death of in
fauts o ccurring naturall y has been attribut ed
by the attesting witness I S ha
ll give them
as c ollect ed fro m the great registers
A
general reader will be puzzled at s ome of
these a
llegations ; pr ofessional readers will
perhaps smile at the pompous display O f af
fe ct e d physi ological penetrati o n in s ome o f the
’
,
,
,
,
,
.
.
,
,
L
I FE
E N GL AND
IN
137
.
Reports ; but all will be Impressed thereby
with the tru th that the too frequent o ccur
rence of death at the earliest peri o ds Of life
is a mysterious fact t o be witnessed o nly in
highly civilized nations and am ongst the m
chiefly in thos e luxurious cities the residence
Of courts o r in huge towns the dwelling
place O f gold coining manufacturers in both
O f which the two antagonistic states m o stly
prevail Of excessive wealth and the m o st ah
j ect and squalid misery
,
,
,
,
,
,
,
,
-
,
,
.
O f the causes assigned for the de ath
of
young infants under o ne month the following
are among the most frequent
1 Low vitality
2 Want o f vitality
3 D ifficult vitality
4 Want Of de velopment
,
.
.
.
.
.
.
.
.
.
I m perfect development
6
.
7
.
8
.
Want o f power
Imperfect respiration
Inanition
.
.
.
.
E ARLY DE S TR UCTI ON O F
1 38
Want of natural nutriment And when
t he child is farther advanced
1 0 Want O f sufficient nourishment
1 1 D ry nursing
1 2 S ome few cases are s et down as a seven
”
m onths child to acco unt for their decease
I n certain o ther cases we have m o re learned
explanations
1 3 I mperfectly C italiz ed
A nd in a particular infant born in Breck
n o ck Place C amden T own 2 7thOf J uly 1 8 51
the death was ascribed to
1 4 L o w vital tenacity o r debility fr o m
birth
T here are however s ome causes assigned
for this early destruction of life which if not
s o profound o r mystical are not the less un
intelligible as for example in the case of a
baby three weeks: O ld who died S eptember
1 8 51 at West E nd H ampstead from
”
15
S tr enuous cachexia from birth
O r where a little girl Louisa Barker by
9
.
.
.
.
.
.
“
.
’
,
.
.
,
,
,
,
,
.
,
,
,
,
,
,
,
,
,
,
,
,
,
,
.
.
,
,
E ARLY DE S T R UC TI ON O F
1 40
o ccur under
month o r between o ne and
two and between two and three m o nths are
n ot no w given T heir total number I s at
present classed in one c olumn only represent
ing all t he deaths which take place fro m birth
to the third month collectively
S uch an
arrangement deprives at o ne stroke the two
sorts of Rep o rt namely those previously and
th o se subsequently to 1 8 4 7 o f one immense
o ne
,
,
,
.
,
,
,
.
,
,
,
advantage T hey have ceased to be compar
able the o ne with the other and therefore
all statistical computations c onnected with
the earlier period of human existence which
not
be
O
f
use
to
actuaries
but
are
Of the
ma
y
utmost importance to the naturalist and the
philosopher not less than to the practical
physician cannot now be based as they might
have been o n a mass o f continuous reports
for a period O f nearly eighteen years T hey
must be Split int o two distinct computations
each embracing only a comp a
ratively sh o rt
period
.
,
,
,
,
,
,
,
,
,
,
.
,
.
L I FE I N E NGL AND
It was not possible
of
141
.
course from the
begl nnI ng o r even in the course o f the first
few years o f the establishment O f this great
department o f civil administration so to pre
arrange the manner in which its numerous
,
,
,
,
facts should be c onveyed to the public as
never after to require any alteration Yet
how important nay essentially necessary it
I s that when once cases fo r calculations have
been determined forms o f tables selected
denominations o f causes adopted and the
signification o f terms fixed t he same should
continue and never vary if each successive
A nnual Report is to be a help to the o ne that
preceded it and of equal assistance to the
?
Researches also by
o ne that is to follow
‘
,
.
,
,
,
,
,
,
,
,
,
,
,
,
curious and interested readers of such A nnual
Reports would thereby be facilitated and
reference for the sake of comparative infor
mation Obtained with ease and c ertainty I
may appear fanatical on this subject ; but
,
,
.
such is my reverence for this prodigious
eu
E ARLY DE S TR UC TI O N O F
1 42
of
vital and political statistics which the
Registrar General and his principal subo rdi
nates so ably conduct that I wo uld wish t o
see those large A nnual Repo rts so replete
wit h informati o n o f the highest standard and
value religiously maintained within one uni
fo rm arrangement Of subj ects embracing if
y o u please as m any imp o rtant points o f c o n
genial inquiries as it may be deemed neces
sary to intr o duce yet always under t he same
form and with the same den ominations
T hen it is that we shall be able t o draw
large c o nclusi ons and inferences from t he
mass O f information c omm unicated to the
public which cannot fail in many ways to
redound t o the benefit o f manki nd T wo o r
three m o re heads might advantage ously be
added t o the present printed returns I mean
”
first D isease and A ges next D iseases and
”
Professions t ogether with the population o f
the latter fo r the sake O f c omputation and
lastly The l owest and highest average d u
w
e
g
,
-
,
,
,
,
,
,
,
.
,
,
,
.
.
,
,
,
,
,
,
,
E ARLY DE S T R UC TI O N O F
144
this S ection but rather that it is o n the in
crease and that in some parts of E ngland
the manufacturing towns t o wit such as
M anchester A shton Preston Leeds &c
this early mortality may be rightly called
frightful C ompared with that O f the metro
polis it is almost unacc ountable
T he highest number o f deaths under o ne
year Of age both male and female in all
E ngland and Wales quoted in T ables 3 4
5 6 occurred in the year 1 8 4 2 when it
amounted to
But in the following
T ables we shall find that in about fi ve years
from that date the number in question had
become
and that in t wo years more
it reached the figure o f
of
which
(
or m ore than the half were deaths
under three months) being an excess in that
year Of
infant lives lost A nd as the
average total births male and fem ale was in
t hat year
it foll ows that every sixth
child born died befo re o ne year o f age Of
,
,
,
,
,
,
,
.
,
,
.
.
,
,
,
,
,
,
,
,
,
.
,
,
,
,
,
LI FE I N E N GL AND
1 45
which latter number every third child never
1
n
attai ed it s third month of existence
T A BLE
V
III
.
nfant s und er t hree m o nt hs b et ween t hre e
an d s ix m o nth s an d b e tw ee n S I X an d t w el ve
m o nt hs fo r all E n gl an d afi d Wal es Mal es an d
F e m al e s ; d urin g t he ye ars fo ll o win g :
D eaths
of
I
,
,
,
,
Under one
month
.
M
.
1 847
F
.
M
F
.
.
5
1 84 8
1
1 84 9
g
I t is thus demonstrat ed that -da t he course
O f three years there perished more than a
quarter O f a m illi on or
infants be
fore they reached the first year Of their life
Surely s o large a mortality calls for s om e
Serious investigation into its origin and causes
With the view O f affording s ome clue t o
H
,
,
,
,
.
.
1 46
E A R LY
E T R UC TI ON O F
D S
“
such origin and causes I have collected as
before stated a similar amount of informati on
respecting the deaths of infants occurring in
the metropolis during the same number of
years and an equal amount also respecting
those deaths whi ch have taken place among
infants in three large sections of the country
where the most laborious as well as the wo rst
paid and fed and the least educated of the
W o rking cla
r e c ongregated
If we should
ss es a
discover that in such lo calities the number of
infant deaths is larger than the amount of
population o r any physical peculiariti es o f
the place O r district would warrant (agree
ably to the laws that regulate this species Of
m ortality in other places) we shall hav e but
o ne c o nclu sion to draw from that fact
A nd
let the legislator and the m oralist look t o it
For as sure as there is in any nation a hidden
tampering with infant life whethe r frequent
o r o ccasio nal s ystematic o r accidental a
s in
the cases of the p ois onings in E ssex or the
,
,
,
,
,
,
,
.
'
,
.
"
.
,
,
,
,
E ARLY DE S TR UC TI ON
1 48
or
vice and poverty in which compared with
their population the number of infant chil
dren who die annually under three months
,
,
,
,
or under o ne year is disproportionately
large
T hus for example Shoreditch which in
1 8 4 7 had 2 96 deaths of males under o ne
year in 1 8 4 8 had 3 4 5 and in 1 8 4 9 357
and the proportion O f such deaths to the
t otal deaths Of the district have been on an
average more than o ne in four In Poplar
again there were 1 54 male infant s deaths out
total male deaths in 1 8 4 7 g1v1ng
o f 56 0
,
.
,
,
,
,
,
'
,
,
,
.
,
’
,
,
pretty nearly a proportion of two children in
every seven deaths Of all ages dying under
o ne year O f age
and inasmuch as o ut O f
that number O f 1 54 not less than 8 4 were
under three months the extinction o f very
y oung male life in the district went o n at
the rate of 56 per cent c ompared with that
o f infants under o ne year o f age
Let us take Lambeth next in 1 8 4 7 and
,
,
,
,
,
.
.
,
,
L I FE
1 8 48
IN
E NGL AND
14 9
.
I n that period there was an aggre
.
gate Of deaths Of all ages
males not
fewer than 7 4 5 o f which wer e infants under
o ne year O f age ;
consequently more than
one in three died at that age during t hose
Stepney within
t wo years in that district
t he s ame period l ost
males O f all ages
o f which 6 0 7 were infants under one year of
age that is one in four and so o n through
the several districts O f Bethnal G reen White
chapel and R o t herhit he fi I need hardly state
that the female side o f the problem is not
more encouraging
On the other hand let us look at o ne of
the districts at t he west end o f t he t own
St G eorge s H an o ver S quare for instance in
1 8 4 7 and 1 8 4 8
H ere we find an amount
O f d eaths at all ages
males and females
and that o f infants under o ne year o f
,
,
.
,
,
‘
,
,
,
,
,
.
,
,
.
’
.
,
,
,
.
,
,
age,
I t follows that the
the latter was to
t he
former as
m o rtality
,
o ne
'
to
of
E ARLY
D
E S T R U CTI O N O F L I FE
.
just half the m ortality Of infant life in La
m
?
beth D oes not this call for inquiry
Can
s uch a
f
f
s
rep
o
ster
o
u
di
erence
between
o
n
e
p
d ist rict and an o ther in the same city he
.
,
,
simply ascribed t o differences o f positi on
ngus ta
water aspect drainage and the r es a/
,
,
d om i
,
,
?
the less fortunate inhabitants
Is
there nothing else ?
T he reader however may seek out fo r
himself any further informati o n o n t he sub
in
the
metrop
o
li
and
any
o f the three
e
c
s
t
j
other great s ections of E ngland to which I
have alluded — as I put him in poss ession of
rs relating to this grave
t he s everal parti cula
uestion
in
r
e
ference
t
o
these
localities
n
i
q
—
Tables drawn up for the purpose co nfining
m yself however t o the years 1 8 4 7 and 1 8 4 8
in order t o avoid any interference whi ch the
deaths by ch oleramight exercise in our Cal
cula
t ions if we admitted int o them the re»
turns for the year 1 8 49
of
,
,
,
,
,
,
i
,
,
,
,
.
E ARLY DE S TR UC TI ON OF
1 52
A
ng ular and I believe an unprecedented
phenomenon occurs in reference to the gene
ral mortality at all ages and from all causes
which I have inscribed opposite each O f t he
fo ur preceding divisions in order that a co m
Si
,
.
,
,
,
r1s o n m a be made with the
a
p
y
contemporaneous
mortality o f infant life in the same localities
O n contrasting the year 1 8 4 8 with the pre
ceding year in each of the four selected cases
it will be seen that the general mortal ity in
s tead Of increasi ng in the proportion of the
increased p opulation actually diminished
being less than the mortality O f 1 8 4 7 by
in the cas e of the metropolis by
in t he case Of the sixth divI SI On by
in
the case o f the ninth or York division an d by
I
no less than
( )in the case Of the eight h
N o r is t his dimi
o r N o rth Western division
nut io n less s triking in t he gen eral aggregate
O f deaths at all ages for E ngl and and Wales
in 1 8 4 8 when compared with the aggregate
m ortality of the year preceding For I n
.
,
,
,
,
,
,
,
,
,
,
-
.
,
.
,
L I FE
IN
EN
GL AN D
1 53
.
that m ortality was
whereas
in 1 8 4 8 it was only
D ifference
— a num ber o f beings s are d to make
p
up for the victims that were t o fall unde r
the inflicti o n Of ch olera in the succeeding
1 8 4 7,
,
,
,
,
.
I t is no t p o ssible to disc o urse
s o griev
O us a subj ect as the extinction of infant life
with out referring to what has been taking
place in o ne O f th o se m o nstrous con gregati ons
o f spinning and weaving mills yclept manu
fact uring towns with which Lancash ire is
studded and where for a period o f seven or
eight m o nths a dogged though peaceable re
v olt Of lab our against c apital has been car
ried o u I allude o f c o urse to Prest o n I ts
strike and its lo ck o ut which began in the
autumn O f 1 8 53 and ended only a short time
since need n o t excite surprise when it is
co nsidered that the t o wn continues much in
the same unenviable condition in which I foun d
on
,
,
,
,
,
,
.
.
,
.
,
-
,
,
,
it in
1 84 1 ,
,
when I paid t o it a professional
H 5
E ARLY
1 54
D Es TR U CTI ON
or
i it the result of which I gave to the pfibiic
in o ne Of my fo rmer w o rks entitled t he
”
Spas o f E ngland
un de r the head of
Preston ?
D uring the m ore rec ent unfo rtunat e pe
r io d evidence in elucidation O f the gene ra
l
prop os itio n of the e arly extinction O f life was
exhibited by t he classes o f pe ople I refer to
o f such a degree that even the most ind if
ferent l ooker o u o r staunches t O pt imist, m us t
be startled by it
T he r eturns re cently Obtaine d at S omer
s et Ho use fr o m that b o ro ugh s how Su ch an
increased mortality among child ren under
five year s und er o ne year o f age and unde r
as to dem onstrate One of W m
one month
things or b oth e ither t hat the s elf paup eris
ing effect Of the w o rkmen s strik e by starving
the mother deprived the infants of their na
tural sustenan ce and s o c au s ed the d est ruc
tion Of a vast number O f such c hildr en o r
V s
,
,
,
“
a
,
,
,
-
,
.
,
,
,
,
-
'
,
’
'
,
,
,
.
V 0 1 i p age 34 4 , 5
.
.
.
E ARLY DE STR U CT I ON
1 56
or
they will lie abed till four O cl o ck in t he
”
afternoon and exist on but o ne meal d aily
I magine in the midst of these miseries
wive s lying ih bringing forth in miserabl e
rooms already occupied by a large family
fresh mouths calling for part Of t he susteu
anc e O f the mother o f her life blood in fact
with which she was so ill provided for want
O f food !I s it a marvel then that we should
?
read of babes dying by hundreds
N or is there any evidence o r t he t race Of
it (in the returns of the registrars received
at the Registrar General s O ffice) that mere
d been the cause o f the vast and
disease ha
rapid extinctl on o f infant life I n a very large
number o f instances the entry in the great
ledgers runs thus disease unkno wn
no
me dical attendan t
and generally the onl y
attendant or witness in all the other cases
was either the father o r the m other and no
A great many such cases are not
one else
'
’
-
.
,
~
,
,
-
,
"
,
,
,
-
"
’
-
,
‘
.
,
”
,
,
,
,
,
.
S p ec tat o r
”
,
J anu ary 1 8 54
.
I E
L F
IN
E NGL AN D
1 57
.
”
even certified that is t o say the father o r
m other rep orted t o the district o r b o rough
registrar or the undertaker that the child
”
was dead and the child was buried
C on
”
”
debility are the o nly two
vuls io ns
or
t erms employed to des ignate a disease as the
cause of death whenever a cause has been
assigned which is not often the case and
“
,
,
.
,
,
.
,
,
,
,
,
then the cause is generally assigned with out
any medical certificate but simply o n the
statement of one Of the parents
That the latter were o f the number of the
misguided victims Of those ill designing ring
leaders to whose instigation the recent strike
at Preston is due may be inferred from their
-
,
,
callings o r o ccupati ons as set down in the
registries T hose callings I have been at
pains to select and here report as fo rming
the complement of that statistical informa tion
which I am enabled t o lay before my readers
and without which the philanthropist would
,
.
,
,
,
in
v
ain attempt t o form a c o rrect n oti o n o f
,
E ARLY DE STR UC TI ON
1 58
DE
ll the d is
esent in it s pro per aspect a
astrous res ults o f the Prest o n s trike
ng ed a
ccordi ng t o the fre que ncy w
Arra
ith
or repr
;
,
.
r o f age occurr ed in refe r ence
yea
ss o f oper a
tive s t heir
t o e ach particular cla
or der st oo d thus : weave rs wo o lcom bers
nd er
u
o ne
,
,
e
lo o m ers , fram e
s-
,
,
tenters packers fl ax —
d re ss ers
-
,
,
,
als o been frequent d eat hs
of
t he same
kind in
families o f sh o em aker s t ailo rs and labourers
It is a fact wo rthy o f r em ark that in t he maj O
rity o f cas es where t he p arents we re re co veraor
employed in any sub o r d inate Operatio n of t he
th s o f t he
t he d ea
co tto n spinning pro ces s
infant s have tak en plac e at t he v ery e arlim t
pe rio d Of life varying fro m one day t o one
n d seld om o l d er
T he
t wo or thre e weeks a
number O f th ese in the shor t p er iod o f t ime
alluded t o amounte d t o 2 1 9 I will no w
,
.
,
,
‘
-
,
,
,
,
,
.
.
,
ive
the
facts
t
y
s
and
a
h
e
t
s
g
,
record e d at S 0
‘
“
2
1 60
E A RLY DE STR UC T I O N
‘
T ABLE
X
"
or
.
D e ath s at al l
Age s an d o f
D e at h s un d er F ive Y e ar s o f Age in e ach o f t he t hr e e
h alf ye ars fo llo win g M ale s an d F em al e s in the
b o r o u gh o f Pr e s t o n
R eturn
the n um
of
b er
of
,
,
-
,
,
.
Ma
r.
31, 1 853
.
S pt
e
Ma
r
.
.
30 , 1 854
.
T tal
s.
o
T tal d ath
o
e
s
d
D eat hs un
5 years
er
l
594
587
4 97
lous co ndition of parent al exist ence as pre
vailed during six out o f the fifteen mont hs
owing to the strike m ight have had o n t heir
children o f a tend er er age I sought t o as
certain the number o f deaths that had occur
red among i nfants from a day old and month
by month up t o the complet ion of the eleventh
month o f their life
A s the informat io n I required for my pur
pose is not yet t abulated in t he Ofli ce o r
likely to be soon published I was permit ted
to have access t o what are called the M S
,
,
,
,
,
,
.
,
,
.
L I F E IN E NGLAND
1 61
.
heet s appert aini ng t o t he boroughof Prest on;
and by patiently picking out and not i ng
the d eaths o f infant s as they oc curred I o b
t aine d the followi ng results
O f the tot al number o f deaths at all ages
males and females l n the borough of Presto n
during the fifteen months in quest ion amount
9 1 1 were of
ing as before stated t o
i nfants under o ne year of age 2 1 9 of who m
had not reached o ne mo nth
C ompared
therefore with the general mort ality of the
borough during the same period the propor
s
,
,
,
,
,
,
.
»
,
tions of infant death stood thus
U n d er 5 ye ar s
ye ar
1
1 m
o nt
of
age 1 in 2
age
of
h
,
,
or
50 p er
cent
.
1 in 3 ,
1 in
or
1 0 in 1 2 5
.
I f we now look at the R et urns o f the
G eneral M ort ality in all E ngland for a series
“
of y ears say from 1 8 3 9 to 1 8 4 4 i we notice
,
S e e E ight h and N inth
G en e al p
t ra
r-
r
,
.
2 14
.
Annual R ep o rt o f
R e gis
E A R LY
162
D ESTR
UCTION
o r
that t he ordi nary
proportions of infant deaths
to the who le mor tality were very differe nt
r
U nd er 5 ye ars
1
ye ar
1 m
of
of
on t
h
age
age
1 in
or
3 6 p er
1 in 5,
or
20
1 in
or
cent
.
1 0 in 1 55
.
om pari ng t he two ret ur ns it is seenat
once that in the case of Prest on t he ex
t inction of i nfant life in the period So often
referred to has pro ceeded at an incre ase d
rate es pe cially in i nfants under o ne year a
nd
under one month ; the exce ss as regards the
former age being 1 3% per cent and as xc
gards the latt er 2 0 per cent
This large sacrifice of infant life during the
strike and for a few months previously is
rendered s till more glaring and suspicious
ng t o the particular period) whe n we
looki
(
contrast it with the ordinary mortality in the
very same locality during any other year in
which its unfortunat e populatio n we r e no t in
F or this pur
t he same exceptio nal state
On
'
c
,
,
,
,
,
,
.
,
,
.
,
,
,
,
“
.
pose we shall again select the year
1 8 4 7,
and
E ARLY DE S T R UC T I O N
1 64
or
reatures succumbed at each successivemonth
of their lives males and females
"
c
‘
.
,
Mal
es
U nder l
At 1
m
onth
.
F mal
1 24
at
re
es
.
34
35
27
24
l
t ota
mal
es
Age
At 6
95
98
30
31
27
G
e
m
F mal
ont
hs
20
28
29
24
20
10
11
and fe aes, 911
.
G ivi ng as before reported a total
,
,
31
22
24
28
23
28
38
8
ml
es .
e
.
of
aths
de
91 1
of infants under o ne year o f age
nearly the half of whom peris hed before t hey
were three months old
I n the F ifth A nnual R eport t here are some
wery judicious remarks of the R egistrar Gene
ral respect ing certai n erroneous deductio ns
often made when deaths un der five years of
age are compar ed with the t otal deaths instead
o f the bi r ths in the precedi ng year s
I trust
the remarks will not be found applicable to
the deductions I draw from the comparative
statement of the total number of deat hs at
,
.
-
”
,
,
.
L I F E I N E NGL AN D
1 65
.
all ages and that o f t he childre n under five
o r u n der o ne year o f age throughout these
pages A ll I wish to show in my case is
that a certai n total number of people o f all
ages have died in o ne year in any o ne locality
and t hat a cert aincompo ne nt portio n o f t hat
total consisted o f infant s of the tender ages
The larger or the smaller pro
in questio n
portion which that comp onent p o r tion bears
to the total being assumed to have been o c
ca
s io ne d by some u nusual causes requiri ng
c o nsideration
The subj ect I have so painfully dwelt upon
connecting itself as it naturally does with
the unus ual occurrence of a state such as I
,
,
,
.
,
,
.
,
,
.
,
,
,
ha
ve alluded t o in the case o f Presto n is cal
cula
t e d to suggest how necessary it was o n
the part of our rulers t hat they should have
looked with corresponding vigilance to the
events there transpiring But the gover n
ment o n the contrary throughout the period
appears to have considered t he whole affair
,
,
,
.
,
,
,
E ARLY DE ST R UC TI ON
166
or
as a mere question of labour and profit to be
settled bet ween operatives and their employ
ers likely to subside and settle itself (as m
deed it has since done) after some heavy
pecu niary losses and nothing more It never
was dreamt or imagined that a much severer
—
loss that o f human life at its tenderest
—
age would be incurred (as I have shown o n
i ncontrovertible evide nce) which ought t o
have be en foreseen and guarded against
D id it never occur t o o ur rulers that there
would be another account of these dark trans
actions to be settled as between them and
the Giver o f life fo r neglecting to watch with
a s crutinizing eye over the existence of the
y ounger offspring o f those whom they go
whil e placed in a situation o f un
v erne d
para
lleled difficulties certai n to lead eit her
to an obvious or to a less nat ural increase
o f pre m at ure deat hs 9
I n seeking far ther among these sad regis
t ers for e vide nce eit her o f t he early dest ruo
e
,
,
.
,
,
.
e
,
,
,
,
,
’
,
E ARLY DE ST R U CTI O N
1 68
or
gr eat (D r Gr anville) but as little is known
o f the diseases of intra uterine life
r em a
p
tnr e bir th should be employed (by the rers
n e ntering
i
ra
i
s
every
case
of
death
t
g
)
occurring between the seve nth and ninth
months o f pregnancy Pr em atur e bir th must
be the result of the mother o r child s malady
which should be written und er
o r i njury
premature birth
F or the information of such of my readers
as may be u nacquainted with the fact I may
observe that the above are quotatio ns from
the general instructions given t o the regis
t rars and others as t o the meaning o f the
nam es o f diseases to be employed in register
ing the causes of death and the order in
which they should be entered
N ow as in considering the laws o f vitality,
there is a great difference between a child
nd o ne d i ng a
no t yet come to maturity a
y
few hours o r days after birth at its full period
l
t
t
it
would
seem
desirable
via
i
c l en a
b
i
é
d
n
f )
(
.
-
,
z
.
’
,
’
.
,
,
,
,
.
,
,
’
,
L I FE
E NGL AN D
IN
169
.
tha
t the t wo t erms o r causes with their cor
responding number of victims should be kept
distinct and fo r t he two followi ng reasons
F irst because the number of
amo ng others
—
still born children which bears a certai n pro
port ion to the tota
l number of births must
necessarily be included u nde r the head of
premature births since they ar e not r e
“
corded separately anywhere in the r epo rt f
and cannot possibly fall U nder the head of
debility
S econdly because in the case of
p r emature births we have to look fo r a
cause according to the R egistrar G ener al s
,
,
,
,
.
,
,
,
”
,
”
,
.
,
”
“
,
’
'
-
,
I
pp o s e t h at the s till bo rn ar e s im p ly
r e ck o n e d wit h o u t
any re fer en ce t o p em atur birt h
d o f die d unde r o n e m o nth fo r ho w
u n d e r the h e a
s ne v er
ca
n a ch ild d ie u n d e r o n e m o n th which wa
b orn al ive 2
t
I
ca
nn o t
-
su
r
,
e
,
“
'
,
‘
3
Aft er th is n o t e an d the t ext t o wh ich it r efers
o
r e no t a
w er e p int e d I l e arn th at t he s t ill b o rn a
count e d o r n o t ice d b y t he r e gis t r a
rs
Th is is ap ity ;
as t he t o t al n um b e r o f b irth s give n cann o t r ep r e s e n t
t he wh o l e
d uct ive fo rce o f fe mal e s in E n gl and
m
a
r
-
,
.
.
fir m
—x m
5,
m
x
W
M
M
»!
E ARLY DE S T R UC TI ON OF
i nstructions to two distinct parties concerned
the mother and the child o r both toge ther 3
whereas in the case of debility o ne party
only viz the child can supply the cause of
I t is evident ly incongruou s to
it s death
am algamate two such distinct contingencies
I think I can prove the inconvenience of
this amalgamation by the e xampl e of my
o wn present investigatio n
I n co nsidering the p r odigious extinction of
human life in its earliest periods after giving
the total number o f infants who died under
o ne mo nth which as I have just observed in
a not e cannot be meant to embrace children
still born o r born b efore their tim e and dead
shortly after
prematur e birth
I nat u
rally feel de sirous to add the total number of
lives lost to t he world under the two latter
special circumst ances
But as neither of
them is dis tingul shed from the other in the
general table of causes both being o n the
cont rary mixed up with the deaths from de
,
,
,
”
,
,
.
,
,
.
.
.
,
,
,
,
-
,
- a
.
E A RLY DE ST R U C T I ON OF
1 72
as are set d own in the Annual R eport s I fall
into the error o f substracting als o a cert ain
unknown aggregate num ber O f infants born
after mature gestation and dead before the
expiratio n o f o ne month
U nder these statistical difficulties the ta
bular information in farther illust ration o f
the proposition treated o f in the present sec
tio n which I am about to brI ng forward of
the number o f premature births for t he years
1 8 4 7 1 8 4 8 and 1 8 4 9 in all E ngland and t he
metropolis separately (cont rasting the lat t er
with those that took place in three other large
nd during t he same period)
divisions o f E ngla
must be receive d with all the above salvos
and reservations
The opposite Table teaches us t hat in all
nd a
nd W ales in the s ac e of three
E ngla
p
years only
creatures came into the
world and died as soon as they saw the
light o r there about since they are no t reck
o ned in t he R egistrar G e neral s books am ong
“
,
,
.
,
,
,
.
‘
,
,
,
,
,
.
,
,
"
,
"
,
,
-
’
E ARLY
1 74
number
the
’
S T R UC TI ON OF
DE
w
those ho died under o ne
m o nth or of those under o ne y ear of age
O f this large amount of premature births
—
rather say very p r em atur edeaths L ondon
o r the F ir st D I V I S I O n p r oduced the smallest
—
share ; while the N orth W ester n D ivision
ng world agai n
the
ma
n
ufacturi
co
tributed
n
(
)
e largest
A lthough its population is only
th
o ne ni netee nth mo r e than the popul a
tio n of
the M etropolitan DivI S I On the share of pr e
mature births (deaths) it contributed was
nd a quarte r tim e gr eater than that of
o ne a
—
fi r st division A gain therefore I ask why
should human life in it s earliest stage s be S O
largely decimated beyo nd the ordinary limits
and fair ave rage of other parts o f the coun
t ry in districts where thousands of opera
t iv es o f the least educate d class mal es and
females are huddled together for many hours
of s ix days in the week occupied solely in
pr ocuring worldly benefit for their master s
fo r a limited hire which is too ofte n s quan
of
.
,
”
,
,
,
,
,
.
-
,
”
.
,
,
,
,
,
,
,
,
1 76
E ARLY DE S T R U C TI O N OF
dark ness that renders t heir condition t enfol d
more pitiable and dangerous ; for wher e the
soul is shu t o ut from the cont emplation o f
heavenly subjects owi ng t o the want Of know
ledge of God and His la w s in this world and
the next t he thing which is call ed cons cience
nd the abse nce o f that i nwa
exi s ts no t a
rd
m o nitor judge and punis he r l eav es to the
individual being so bereft t he fear of t he
human laws o nly to restrain him from t he
Ho w feeble that bar
commissio n of crimes
r ie r
is all know too well who peruse the
daily recqr d s of vice and crime exhibited in
nd police
and who
o ur courts o f justi ce a
will have read also the official and un deniable
testimonies co ntained in thes e pages of the
appare nt car eless say reckl ess m anner in
which infant life appear s t o be t reated among
cert ain of the lower classes o f o ur population
A nother cont emporary writer in allusion
to these fact s remarks that unquestionably
there are crimes which are peculiarly rife
"
,
,
,
'
,
,
,
,
,
,
.
,
,
,
,
.
,
,
L I FE IN E N GLAN D
1 77
.
amo ng t he
lower classes
There appe ars
to be growing up in E ngland a large and in
crea
s m g i ns ensibility to t he sight o f su ifer
of
n
I n
The
n
atural
i
n
sti
ctive
hor
or
r
g
blood the reverential sense o f the sacre dne ss
of human life see m s to becoming ext inct
9:
amo ng the humbler classes
I t is refreshing to those whose resear ches
have plunged them in the midst o f scenes
where such feat ur es o f class character in it s
brut e state are displayed in this country to
find here and there among its gigantic M anu
fact uring E stablishme nts thanks t o the e ffort s
Of their owners most honour able and heart
cheering exceptio ns brought about by c r eating
precisely an opposite conditio n o f characte r
in their depe ndents through religious and
worldly education administered judiciously
and in suit able degrees and no more and
with the additio nal help Of almost paternal
kindness and consideration fo r their welfare
a
”
'
,
,
.
-
,
,
,
,
,
,
,
s
,
,
,
,
,
,
'
.
M o rn in g C hr o nicl e l eading
”
>
<
x
,
] 8 54
.
art icl e
I
,
5
May 2 4
,
E ARLY DES TR UC TIO N OF
1 78
"
n o ne s uch
tha
exception 3 and it were we ll if the propriet ies
mes
o f society pe r mitted the d ivulgat io n of na
and special instances not many miles fr om
M anche ster from A shton fr om L ee ds fr o m
Wakefield an d some other places
They
would se rve as examples t o o t hers to do the
like provi ng to them at the same time that
in such manner and no other can the brutal
izing effect o f vice and the pauperis ing re
sult of strikes be pr eve nted or swe pt clear
of t he land ; as the individuals to whose ex er
tio ns I refer have driven them from t heir own
prem is es and neighbourhood
I t would be an insult t o m y readers were
I t o imagine that this long mo ral digression
i ntroduced in this place required a
n apol ogy
fo r it s app earance
I feel it impossible to
disco nnect the consideration of pr emature
death which is the main s ubject of my
volume fr om the reflections which suggest
themselves at the same time with refere nce
I
am acquaint e d wit h more
“
,
,
,
,
.
,
'
,
,
,
,
”
,
,
,
.
,
,
.
,
,
,
,
E ARLY DE S T R UC TI O N OF
1 80
”
,
the neighbourho od o f being go od people
stamped the charac t er o f such a fire side
h owever humble ho wever limit ed t he means
it possessed fo r daily s upport Their younger
o ffspring was fr ee fr om formidable diseas e
and death r arely visited its early cradle fo r
the mother was able to supply its wants she
che rished its existence fl e w fo r succour t o
the nearest medical charity to save it when
thr eatened and with her husband looked
upo n it as on e destined t o be to them a
blessing
—
r
n
N ot so wit hi some ga rets back attics or
under ground floors where the pains and dif
fi cult ie s O f travail had summo ned me profes
s io na
lly t o a charity pat ie nt who lying o n a
single thin m at tr ess laid on the bare floor
scar cely covered by a soiled blanket or some
tattered garment was awaiting in e x cruciat
i ng agonies the relief which nature de nied
and art alo ne could procure
H er e everything
de noted intense unmitigated wret chedness
“
-
,
,
.
,
,
,
,
,
,
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,
,
-
a
,
,
,
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,
.
,
,
L I FE
IN
E N G L AN D
1 81
.
the effect not o f want of employment on the
f
h
n
a
o
f
c
s
rt
husband
but
ne
er
ea
i
g
t
e
o
v
p
dissipation during t he hours o f rest from
labour especially o n the sabbath day which
“
-
,
-
,
,
ll its comforts
bared the dwelling of a
one by one t o s u
l
int
o
icati
g
liqu
o
rs
t
o
x
n
pp y
himself and not unfrequent ly to his partner
— t he Whole group pre
and to his childre n
senting the spectacle o f a perfect abr utiss e
m ent such as a traveller c ould expect to find
only among the wilds o f back C affraria o r in
the settlements o f the Ot cheWo I ndians
N or is this an exaggerated o r a solitary
picture T he like scenes I h a
ve repeat edly
witnessed and altho ugh for many years past
my functions to Such chariti es have ceased I
hear enough from those o f my younger bre
thren Who follow in the same track that no
—
—
great change indeed no change at all has
b een taking place in subsequent years for t he
N either will such a change for the
better
better take place unt il the curse of inebriety
had
‘
’
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!
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,
,
E ARLY DE S T R UC TI O N
1 82
or
'
parent of all vi ces shall have been driven
from the land I call upo n th os e wh o may
be s ceptical o n the subj ect to open a v olume
entitled History and Progress o f the T em pe
”
rance Reformat ion just published by J ames
Silk Buckingham and peru s e the facts as well
as the argum ents in reference to int o xi cation
which the author th ere in adduces to show
where the evil lies as well as where the
,
.
,
,
,
'
,
,
,
,
,
remedy against it is to be found Quotati ons
also in support o f those arguments will be
read in tha
t volume fro m a recent rep ort of
T he British and Foreign Te mperance S o ciety
which assert that more than on e half of the
madness in thi s country appears to be occa
that no less than
s io ne d by drinking
pers ons were t aken into custody by
the p olice in one year f o r drunkennes s alo ne
and that four fift hs o f all the crimes in
E ngland hav e b een estimated t o be c o m mit
ted under t he ex ci tement o f liquor am ong
tingly include
which I unhesita
.
,
,
,
,
”
,
-
-
'
E ARLY DE S T R U C TI O N
1 84
L I FE
or
.
dence that such p rem atur e labours never hap
pened to t erminate successfully fo r the child
,
,
whatever m a
be
the
fate
o f the mother
A
ll
y
such and oth er similiar facts might certainly
be retorted upon the better by t he less favoured
classes o f people and it is painful to be o b
lige d to admit that in su
ch instances there is
"
no denying the truth o f t he allegat io ns fi
But what does such a retaliation as this
go to prove except that a m ore strict and
more vigilant as well as effectual guard
against the perpetrators o f such iniquities
whether in high or low life ought to be insti
stituted by the Legislature ? It is t o that
great consummation therefore that all my
remarks and arguments point it is t o show
it s absolute necessity that voluminous pr o ofs
of its imp o rtance have been collecte d in t he
present S ecti o n
.
,
,
,
,
,
,
,
‘
,
,
.
c o mes
it , t h at at er t he m agist rat e
s d e cl a
rat i o n t hat the c ase d em an d ed and sho ul d h ave far
t her inv es t i gat i o n n o o t her n o t ice a e a
re
h
d
f
o
t
at
pp
ini qui to u s t rans ac t i o n
H ow
f
,
,
’
V
FRE QU E N C Y
OF
S U DD E N D E AT H
FAC T S
.
.
THE appalling
declaration o f the coroner
—
that recorder o f premature deaths with which
these pages were introduced would suffice o f
itself to arrest attention S o fl eeting ho w
ever are the impressions produced by mere
ny o f those
general assertions that few if a
who happen to read dwell o n them with that
seriousness and gravity which a question so
immediat ely connected with o ur individual
existence would seem to command
F AC T S alone possess the magic power o f
effecting m ore vivid and lasting im pressions
,
,
.
,
,
,
,
,
,
,
.
FREQUE NC Y
186
0F
and in no considerations partaking alike o f a
physical moral and religious character is
this assertion truer than in that one which
engages our present attention involving as
it does our best and dearest interests
T he minis ter o f t he word of G od may
from his pulpit descant with all the eloquence
o f an inspired prea che r of the G ospel t o a
devout congregation on the uncert ainty and
—
the short span of human life he may endea
Y o ur to impres s on them ho w life is b ut vanity
and an empty name by allusions to an in
—
nt a
s ta
ne o u s deat h
but what co uld his pious
efforts produce compared with the im pres
sion which the discovery o f o ne of the wora
shi ppers l n t he congregation having dropt
from his seat and Suddenly e xpired would
leave on the mind of all thos e who had on
that day o ined with hi m l n solemn prayer t o
,
,
,
,
,
,
,
.
,
,
,
,
s
,
,
.
the C reator ? T hat o ne fact coul d never be
obliterated from the memory of those who
had been witnesses of it but whose r ecollec
,
1 88
FRE QU E NCY
or
enjoyment) ceased o n t he m oment to exist
as if struck by lightning !A nd such are t h
e
facts the increasing frequency of which I
propo se to demonstrate by references to t he
ordinary chronicles o f the days as I have
done with the stati stics I have produced
Looking only to the most conspicuous ex
amples among the cases o f sudden death
which have come to my knowledge in the
brief s pace of little more than the five years
before mentioned from the middle o f 1 8 4 9
I find nearly one hundred o f them rec o rded
in the publi c j ournals as having occurred
among people o f consequence
T here are
periods indeed in which those awful visi
t at io ns seem to occur as it were in quick
succession T hen comes a brief lull to be
followed by another e qually rapid procession
o f fatal cases
I t is painful to have to usher in our necr o
logical list with the name o f one whose pri
vate friendship we had the good fortune t o
,
,
,
,
,
.
,
,
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,
,
,
,
.
,
.
-
SUDDE N DE AT H
1 89
.
enjoy To lo ok at his st out frame or to
follow him through the endless labours he
.
,
had carved o ut for hims elf o ne would have
an ticipated a long career t o H orace T wiss
But H orace T wiss while sitting in a b oard
r o om o f o ne o f t he companies o f which he
,
.
,
’
was
a director and in the act of addressing
the members ceased t o live early in May
,
,
,
,
18 4 9
A
few months before this a similarly awful
occurrence had been witnessed at the O riental
C lub in the person o f M r T raill an I ndian
gentleman who had for som e time been um
d ergo ing the hydropathic treatment at an
institut ion in the Regent s Park Sir Nicholas
Fit z Simmon I nspector G eneral o f Priso ns in
,
.
,
,
,
’
.
'
‘
-
-
,
I reland was meeting the same fate o n the 3 1 s t
,
—
forty two
J uly at the early age
years
From Florence and from Paris not long
after tidings reached this co untry o f the
equally sudden disappearance from am ong
t he living o f t wo fair countryw o men wh o
of
of
,
.
,
,
‘
,
,
,
FREQUE NC Y OF
1 90
4
each in her exalted circle
,
had
been the centre
conviviality and wit H arriett Lady Pell ew
expires in her carriage on the drive at t he
726 ; whilst the popular C ountess of Bles
0 6230 5
sington re turning home fro m dining at t he
D uchess de G ram m o nt s is seized with apo
plexy and dies the following m o rning the
4 t h of June
T hat same month saw an exemplary mini
ster o f the G ospel the Rev Philip T histle
”
th waite Strong die very suddenly at his
rectory in C olchester ; and M aria widow of
the late Lieutenant G eneral C ope expire as
suddenly at Weym outh 3 while J ohn Phil
pot l ate MP for Gloucester is nex t an
no unce d as having
died in an o m nibus in
”
the Regent C ircus
of
.
,
’
:
,
,
,
.
,
,
,
-
,
,
”
,
.
,
,
.
I n t he suc ceeding months we have t he an
tes s M
nounce m ent that the D o wager C oun
or
ton wa
s found dead in bed 3 that the R ev
Luke Yarker vicar of C hillingham while
cr ossing a street at Spittal whither he ha
d
i‘
”
.
“
,
,
,
REQU E NC Y
1 92
F
or
where while they were preparing a draught
for him he fell o ff the chair and expired in
a fe w minutes
I n that same year death had m arked as
his o wn three important foreign personages in
no less sudden a manner ; Bo ut ourlin auth or
”
La C ampagne des Russes en France
of
cousin of G eneral Nicho lai Bout ourlin at
wh o se country house at Tro sk o i near M osc ow
I had m et and enjoyed his highly intellectual
society in J uly 1 8 4 9 only a few weeks before
the fatal event died in afew hours T he
lady o f the well known diplomatist N essel
rode I saw depart from St Pe tersburg in
Ju ne 1 8 4 9 overflowing with health S he
was in the following August at Gastein
using those strong baths which s ome one ha
d
T he coun
i mprudently recommended to her
tess was Certainl y not a fit subj e ct fo r such a
remedy She died there instantaneously
T he third case to which I shall refer is o ne
in which I am s omewhat medically concern ed
‘
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,
,
SUDDE N DEAT H
1 93
.
to the parti culars o f which therefore I
shall again allude when we come to treat of the
causes of sudden death and the means of pre
venting it in another volume At present the
fact alone is imp o rtant T he Grand D uke
Michael only s urvw m g brother of the E mperor
Nicholas a prince of gigantic frame like his
imperial relative starts at the head of a superb
train o f artillery for the frontier of Hungary
—
ches Warsaw
fifl l o f life in J uly 1 8 4 9 rea
and while in the act of reviewing his troops
is seen to fall from his horse is caught and
carried to his quarters where not many hours
aft er he expires, on the 9th of S eptember
I have alluded to the occasional sudden
cessation of life in the person Br ami nister
while preaching to his congregat ion T he
year 1 8 50 ushers in the not less awful fact (in
the pers on o f the Rev M r Francis of C ocker
hill C hapel) o f a minister in the A rchdeacon s
C ourt o f A sht o n under Lyne no m l nat ing his
and
,
,
.
.
,
,
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,
'
,
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,
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,
,
.
.
.
,
.
’
-
,
-
,
FREQ UE NC Y O F
1 94
churchwarden and after uttering the last
syllable sinking on the floo r and expiring
T he death of the lady o f an eminent author
and representative of a N orthern C ourt in
E ngland in an equally sudden manner and
that of a young banker at Brighton J H
Bo rr er came in quick succession N o r did the
month close without adding another remark
able s udden death to the list in the person o f
a most liberal and patriotic citi z en Sir Felix
B o oth Bart wh ose m unifi cent gift in further
ance o f o ne of the arctic expe ditions secured
him an imperishable mement o o n the utmost
northern confines o f A merica
O f M r Boothby o f T wyford A bbey near
E aling a director of the N orth Western Rail
way o n which line many a time and o ft we
had met in j ollity the demise was not less
awfully sudden H e expired in the last week
in O ctober 1 8 50 in the act of ge tting o ut ef
bed
,
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.
,
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.
FREQUE NC Y OF
1 96
—
fro m I ndia all disappear from this world
without a warning I
I must rise instantly o r I shall be s uffo
”
uttered the amiable and youngest
ca
t ed
sister of a noble earl and the cherished wife
of a wealthy banker well known for his be
nevo le nce and the pi ous use he makes of his
fortune H er ladyship had but just laid her
self down to rest on the 8 th of J uly in this
year
at T rent Park She rose quickly
rushed to the window which she threw open
to inhale fresh air I t was the last breath
she took in for she fell a c orpse
T wo only o f the many examples that oc
curred in this same year among foreign not
ables I shall quote as illustrat ive fact s relat
ing as they do to two remarkabl e persons
Audin a great literary character born in
1 7 93 died at fi fty eight years of age in his
carriage while travelling from M ars eilles to
A vignon H e was the auth o r o f several his
l works o f merit relative to Luther
t o rica
,
,
,
,
.
‘
,
.
,
,
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’
.
!
,
,
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,
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-
,
,
,
.
,
,
SU DDE N
D
E AT H
1 97
.
apublisher by
C alvi n and Henry
,
profession H err C arl S ander one of the
most celebrated surgeons of G ermany ex
r e d suddenly while seated at his desk in
i
p
t he act of writing a treatise on anatomy
But we are entering upon a much more
disastrous year with the a
ccession of 1 8 52
Among the many noted persons for high sta
tion sounding names sterling reputation o r
other striking characteristics in whom a sud
den seizure was followed by speedy death in
this year we shall find the Great C aptain of
the age From that very circumstance the
year 1 852 will be for ever aft er as memorable
as t he year 1 7 6 9 l n which the hero who was
t o share with N apole on the Gr eat the glory
of their generation and the admiration of
posterity first saw the light as had done the
mighty opponent himself whom he was des
,
.
,
,
.
,
.
,
,
,
,
,
.
,
‘
‘
,
,
tined to overthrow
I look at my collected notes o f this year
and disregarding the minor o r less striking
.
,
“
FREQUE N C Y
1 98
or
cases I find the N ew Year s day darkened
by the sudden death o f Sir C harles Wager
’
-
,
Watson of West wratt ing Park
O n that
m orning this gentleman in his usual health
and spirits mounted to meet the S uffolk fox
h ounds A t two o clock he was riding at a
brisk rate by the side o f a friend when sud
d enly he seemed to reel on his horse and fell
O n coming to his assistance he was
o ff
found dead
I t was proved that he had
been seized with a fit
Baron Kemeny the representative of Kos
s uth in London was listening o n the 5t h of
J anuary to a letter which the S ecretary of
the H ungarian C ommitte e was reading to
him at his residence in Foley Place when he
suddenly fell and expired ; Luigi D onati
professor of languages while in the act o f
giving a lesson at the C lergy Or phan S chool
St J ohn s Wood had his life cut short in a
manner not less sudden
Few t here are wh o do not remember the
,
.
,
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’
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,
,
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.
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,
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,
,
,
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’
.
,
.
.
FREQ UE NC Y OF
200
for dinner O n entering his private apart
ments t he Prince complained to his attendant
t hat he felt very ill notwithstanding which
he proceeded to wash himself The atten
dant left the apartment while the Prince was
wiping his face and had but just closed the
door when hearing something fall heavily
he t urned back and found his master lying
senseless on the floor T he Prince never
rec overed his senses and breathed his last at
a litt le before six o clock that is to say o ne
hour after the first seizure
I n the protracted discussion on the supply
o f water to the met r
opolis and the best
mode of drainage for t his unmanageable
4
Babylo n
a ques tion which has hi t herto
baffl ed all who have been engaged in it and
seems to appal S ecretaries of S tate as well as
—
S anitary C ommissioners the public heard
much of an eminent engineer M r Frank
Forster the p r o tege and associate of Robert
St ephenson
Since his connexion with the
.
,
’
.
,
,
,
,
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’
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,
,
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,
.
.
S UDDE N DE AT H
20 I
.
M etropolita
n C o m m l s sm ners o f S ewers, his
health had been much impaired by the ha
rassing fatigue and anxieti e s o f offi cial duties
not in the least lighten ed by much cordiality
on the part o f his c olleagues
H e was in
the act o f writing a letter on the 1 3t h of
A pril when he was struck with a
poplexy
and almost immediately expired
O n the 2 5t h o f May died equally sud
den the H on C hetwynd T albot Recorder of
Winds or and n ot l ess instantaneously L ord
A bercromby in S co tland in the following
m onth ; an ev ent succeeded o n the l 0 t h of
August by the d eath as s udden of G eneral
Sir T homas D owm an C o m m amiant o f the
Royal A rtillery at Woolwich
T he vagaries and mischievous doctrines of
her son (who se name when the Italians shall
have won for themsel ves an honourable po si
tion among the c onstitutional royalties of
E urope will hold up as a warning a
ains
t
g
t he delusion s o f s o cialisti c republicans)have
,
.
,
,
”
.
,
,
,
.
,
,
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,
‘
,
,
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,
.
,
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,
,
x
5
202
FR
EQU E NC Y O F
‘
given t o the mother of M az zini an imp o rtance
which the obscurity of her descent would have
denied to her T his lady o f wh om report
spoke favourably d ied suddenly o n the 9t h
of the same m onth in V enice
N ext on the funeral list appears the name
of o ne wh o from a scenic draftsman and an
indifferent Protestant became the leader of a
sect of G othic masons and a convert to R 0
manism T o his efforts it is said E ngland
owes the fifty R omish temples which we have
seen rising around us as if by magic in the
“
,
.
,
.
,
,
,
,
,
.
,
,
,
,
last twenty years While throughout E ng
land and within a few miles only of t he
m etropolis district churches for the true
worship and the religious comfort of thou
sands of benight ed people are lingering o n in
their tardy c onstruction through periods of
five six or seven years nay many more
—
years as yet incompleted for lack of that
zeal just patronage and aid which the more
earnest and eager followers o f the PO e hav e
p
~
.
,
,
,
,
,
,
,
,
,
,
,
,
,
,
FRE QUE NC Y
204
or
direction Pressure by congesti o n or effusm n
was at work 3 and in that awful state was the
illustrious patient watche d by relatives and
m edical m en t hro ut
t he brief spac e o f six
o r seven hours which the dreadful blow had
occupied in destroying life o n the 1 4t h of
S eptember
H is Grace had retired to rest
o n the previous night apparently quite well
Less imp ortant yet as connected with the
nce of the first N apoleon s ugges
remembra
tive of the quenching of another meteoric
genius was the death o f D r Stokoe which
happened in a public refreshment room in
York on the 1 3t h of S eptem ber 1 8 52 as he
was preparing to continue his ourney to
Lon do n from the north H e had j ust been
t o visit the grave of his daughter J ane in
t err e d in the York C emet ery five years before
when t he dea dl y blow at once felled him to
t he ground
H e had served as surgeon in
t he British Fleet at the battle of T rafalgar
and was appointed medical attendant to
.
,
~
,
,
:
.
,
,
,
,
,
.
-
,
,
,
.
,
,
.
,
SU DD E N DE ATH
205
.
Bonaparte d uri ng the last y ears of his
exile
D r S tokoe I believe was the last surviving
actor in that great politico tragical drama
which for a perio d of S I X years was enacted
on the rock of St H elena A ll all that took
apart in that disgraceful perform ance includ
ing it s unenviable manager have since quitted
t his worldly stage unkn own and u ncared for ;
Whilst the ashe s o f the impe rial victim lie
entombed under the panoplied dome of a
t emple which proclaims his glorious achiev e
ments
D r Stokoe often spoke to me wit h
feelings of honest indignation at what he had
,
.
.
,
,
-
,
.
.
,
,
,
,
!
.
,
been doomed to witness of t he m is erable and
petty vexations heaped on t he fallen hero
O ften have I heard him in this town d escan t
—
f
in the presence o the ex king J os eph Napo
leon s eldest brother on the many excellent
private qualities exhibited by the E mperor
in his daily intercourse w ith those around
him Stokoe was not c m hom m e d e p lum e
,
.
,
,
’
,
”
.
,
EQU E NCY
206
FR
or
.
unfortunately his recollections h o wever wer e
vivid and his veracity undoubted
But death is hurryin g o n and refuses to
linge r behind S uddenly it cuts o ff t he ex
is t ence o f a young lady barely sixt een years
o f age o n the 2 6 t h o f the same fatal month
M iss S elina A nn T urner was visiting with
some friends the S urrey Z oological Gardens
and making remarks o n some of the animals
when she fell down and died At C ambridge
the M aster o f J esus C ollege D r French is
suddenly seiz ed with paralysis after transact
ing business an d being previously in the en
o m ent o f his usual good health and dies
j y
forty eight hours aft er
O nly a fe w days subsequently in Lond on
—
the s o n in law of o ne o f the most eloquent
advocates o f the day suddenly ceased to live
—
at his father in law s o n the 2 9t h of N ovem
ber and the first week in D ecember prove d
equally and as instantaneously fatal to J ane
Sanders o f S t oke Ferry N o rfolk aged fo rty
,
.
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~
FREQU E NC Y
20 8
OF
A scene even more awful was about the
,
same time taking place at the G eorge and
”
Blue Boar in H olborn where M r William
M orris while in the act of patting a horse in
the yard sudd enly dropped down in a state o f
unconsciousness Being immediately picked
up and conveyed to King s C ollege H ospital
t he resident physician ascertained that life
was extinct
T he name o f Gioberti will be fo r ever re
vered by those so ns of Italy whose aspira
tions are for the spontaneous emancipation of
the whole of their fatherland ust as that
portion was spontaneously made free (under
t he inspiration of that gifted and patriotic
mini ster ) by C harles Albert of S avoy its chi
Gioberti
lr ous but ill supported sovereign
va
—
was n ot a practical statesman still less so
for times of national struggles against ex ter
nal foes and int ernal treacherous friends
But he prepared the way for another states
man more equal t o the task who was to
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SU DDE N DE AT H
209
.
succeed him and who by his judgment dis
int erested pat riotism great tact and c o nci
liat o ry eloquence in the senate has secured
for himself in the history of his beloved
country a twin page on which t he name of
A zeglio will shi ne by the side of that of
Gioberti T his excell ent man died suddenly
in Paris in the night of the 2 5t h to the 2 6 t h
of O ctober in the year we are recording
He was born in T urin in 1 8 0 1
Gioberti was incessantly at work read
generally twelve hours a day and had taught
himself G erman E nglish mathematics and
H is ner vous system had
t he natural sciences
be en greatly shaken by t he polit ical events
in the midst of which he had not l o ng befo r e
been plunged and by all the immense head
labour he had undergone H e was frequently
attacked with illness during which (observes
his biographer) I l tombait facilement en d e
lire
T he fact is he was subject to att acks
in the head fo r it is mentioned that he c ould
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FREQU E NC Y
2 10
or
not bear the weight o f his hat o n the head
H e lived in a constant state of apprehension
that he would die suddenly
We thus close the eventful and sorrowing
year of 1 8 52 T he succeeding one has been
but little less prolific in s t riking ex am pl es o f
the same awful description ; and it is with
the record of the death of an eminent physi
cia
n on the 2 0 t h of J anuary that the black
catalogue begins D r Pereira a popular
lecturer and writer on Materia M edica had
just recovered from the effect s of an accident
O ne evening after playing a game at d o m l
noes with his daughter as usual in his cheer
.
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,
ful manner he retired to rest but awoke not
long after feeling unwell
S ome one was
summoned to his bedside when upon turning
himself on his right side he exclaimed plac
ing his hand at the same time on his heart
I have broken a blood vessel here !
and ex
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Four days aft er news reached town that
,
REQUE NC Y
F
OF
prime minister Bu ol preparatory t o his pro
R
a
cee d in
to
I
taly
to
succeed
the
veteran
g
d et s ky and he had recently returned hom e
and ret ired to rest wh en just after midnight
b e summoned his servant d esiring him t o
bring a glass of water When the ser vant
,
,
e
,
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,
.
returned his master was gasping for breath
and soon after ceased to be At the bare
mention of this soldier s name the very hair
st ands erect from in dignation at the memory
o f his countless atr o citi es ?But he is now
5
beyond human retribution and we are to
hope that his soul ere it quitted its mortal
dwelling had made its peace with the eternal
J udge before whom he had been so suddenly
summoned !
,
.
’
’
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,
,
O n the same night an E nglish gallant sol
dier Lieutenant General Sir E dward Kerri
son was foun d dead in bed
N ot many days after death was striking a
distinguished victim in the stree ts of C open
hagen
Vice A dmiral Z art hm ann was re
-
,
’
,
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,
-
.
SUDDE N DE AT H
2 13
.
turning one evening early in April from a
visit to a friend on foot in co m pany with
t he colonel of the Guards and was q uietly
discours ing with him on the debates in
the D iet when being seized suddenly with
vertigo he exclaimed
Support me I am
very giddy and leaned on his friend With
these words he sank to the ground H e was
immediately transferred to the nearest house
M edical aid was procured but the A dmiral
expired in an hour
T here is something very melancholy in the
simple statement of the following case fur
ni s he d me by a competent authority
Mr
Nich olson the architect o f Woodhall S pa
near Lincoln attends one d a
the
h
h
o
u
t
j
y
middle of A pril with the trustees t o look
over the works H e agrees to meet o n t he
follo wing day a builder to arrange pla
ns for
important future operations ; returns to his
hotel at Boston by railway and while medi
tating on the best m o de o f carrying out t he
intended works drops d o wn dead
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FREQUE NC Y O F
2 14
T he month of April however was to be
,
,
signalised by a more important example of
sudden death in that of the Rev G eorge
Butler D ean o f Peterborough and for a
quarter o f a century the highly respected
H ead M aster of H arrow S chool where his
name is justly revered D r Butler was
s eated at table on the 3 0 t h o f A pril with his
family when all at o nce he became insen
sible and after ten minutes passed away al
most without a struggle
—
M r T D ay S eni or Taxing M aster to the
C ourt of E xchequer had only five days be
fore the last mentioned date quitted this
world in a manner no less sudden H e had
discharged the duties o f his office o n t hat
day and had walked into the city when
upon reaching the M ansion H ouse he was
sei z ed with a fit and expired
T he lad y o f the Braz ilian M inister in Lon
don is brought to bed of a dead child on S a
t ur d ay evening the 1 1 t h o f J une
O ne
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REQUE NC Y
2 16
F
M
uls at
or
H ow true
From
p
the humble lodging o f a poor curate it visits
next the more sumptuous dwelling of the
D anish Minister and simultaneously almost
the not less comfortable apartments of a
M ember of Parlia
ment M D e Bille had
attended the Queen s drawing room on
T hursday the 1 8t h of J une and was o ut as
usual on the Friday at two o clock O n S a
It is not a little
t ur day morning he expired !
remarkable that his predecessor at our C ourt
C ount R event lo w died in a similar manner
two years before while on a tour through
o r e cequo
e
e
d
p
.
,
,
,
,
.
.
’
-
,
,
’
.
,
,
,
,
S c otland
.
T he eldest son
”
of
the late Liberator o f
I reland M r M aurice O C o nnell had one
T hursday evening appeared in his usual
health in the H ouse of C ommons ; on the
Friday at midnight he breathed his last in
H alf M oon Street Piccadilly
We are still in J une and we are hurried
through the sad list o f friends and acquaint
’
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,
,
SUDDE N DE AT H
217
.
ances
departing prematurely from amongst
us T homas J ohnson of Lincoln s I nn Fields
o ne o f the sons of our late esteemed colleague
D r J ames J ohnson died suddenly on the 3 rd
of June C aptain Graves drops down dead
while on parade a
t York ; and next occurs
Bransby C O OpC r s in stantaneous death at his
club N ot less sudden or awful was the de
parture of Sir Frederick A dam T he gallant
G eneral had been o n a visit to his brother
Sir C harles at Greenwich and had just en
t er e d one of the carriages of the G reenwich
Railway o n his return to London when he
was suddenly struck with death
A nd so
were Sir J ames T homson K C Physician
G eneral who died of apoplexy while presiding
at the medical board on the 2 5t h o f A ugust
and Roger J ohnson Smyth MP and a ma
ra
i
s
t
e
at
the
age
of
thirty
ei
ht
years
on
t
g
g
the 1 9th of S eptember and C aptain D alling
of the Royal Navy at E arsham H ouse N o r
folk o n the l 0 t h of O ctober
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FREQUE NC Y
2 18
or
N ot quite three weeks aft er the Rev Wal
,
.
ter Bury had reached the railway terminus
at C oventry on a visit to his brother the
surgeon in that city when he dropped life
less ; while o n the 8 th o f the same month
di
N
ovember
obias
Wallis
S
turge
es
very
T
(
)
suddenly at his residence Linden Villa
Leatherhead o f whom it is recorded that his
remains were conveyed for burial to the C c
”
m et ery of the S ociety of
Friends fo llo wed
by their car r iages without any farther notice
of the deceased s good qualities
T wo young peeresses are next st ruck down
— t he o ne in I reland at A ll o a H ouse by a
”
sudden and unexpected death after long
suffering
the other in S cotland at E glinton
C astle by a no less sudden dissolution
and thus fell the C ountess of Mar o n t he
1 5t h and the C ountess o f E glinton o n the
1 6 t h o f D ecember
N ow let us hasten t o the c o nclusion o f this
too long and sad review of the many who
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FREQ UE NCY
220
or
to the last moment had been engaged in the
examination o f students and candidates for
fellowships recently vacant at his college
C aptain Warner he o f t he long range and
whose destructive inventions were just about
having their application in a good cause fails
us at the very 11c of time snatched away
by that insta
ntaneous d eath whichhe had
compassed all his life against the enemies o f
his country
H e expired suddenly o n the
5t h o f D ecember
Peaceably and tranquilly yet not less in
sta
nt a
neo us ly
departed this life o n the
1 5t h the second surviving daughter o f t h
e
late G eorge Ward o f N orthwood Park Isle
of Wight who in the times when Lord Robert
S eymour the N ashes and the Wards fl ou
rishe d in that isle as we recollect used t o be
called the King of C owes
T o him and to
another excellent gentleman was d ue the in
t ro d uct io n of the firs t steamer that made a
regular passage between C owes and South
ampton
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”
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'
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SU DDE N DE A T H
'
.
22 1
O n the Sunday preceding the last men
-
t io ne d
decease the following impressiv e scene
was taking place not very far from the last
m ent l o ne d city
A stout and healthy middle
aged yeoman was cr o ssing O ving ton Park on
his way to evening church which he never
!
r
reached Returning f o m d ivine service the
park kee pers found him seated with his back
to a tree his hat on his umbrella under his
arm D E AD i it h no appearance o f co nvul
sion o r previous struggle
T he 2 9t h o f D ecember Louis N apole on
decreed t hat there should be an imperial co m
mission to superintend the construction of the
l
reat
edifice
po
r
e x po s it io n universelle
u
g
des produits de l agricult urem de J ind us t rie
presided over by the H eir
e t des beaux ar t s
presumptive to the throne
Viscont i the
eminent archite ct son o f the late still more
eminent antiquari an received o n that day
his nomination as a member of that commis
s ion
H e attended its first meeting o n the
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FREQUE NC Y
222
or
aftern o on of the 3 ot h o r following day at th e
P alaz s N atl onal and was returning thence
home at five o clock in his carriage O n
reaching the house and the door o f the car
r ia e being opened Visc o nti was found dead !
g
H ow little in acco rd with a season of fe sti
v it ies is the intrusion o f death
Yet the gay
season o f 1 8 4 5 at C heltenham witnessed in
the very vortex o f a bachelors ball at the
A ssembly Ro o ms R Leicester E s q of C am
bridge Villas seiz ed with vertigo expi ri ng i n
ten minutes o n the 3 rd o f February
A nd the following month brought its o wn
contribution to the registry of sudden deaths
by recording that o f the fourth son o f t he
R ev J S D S erres of E asebourne near Mid
hurst at the age o f twenty seven years at
C alais and again equally instantaneous
t hat of a young naval lieutenant son of a
noble and wealthy marquess which took place
on the 2 1 s t whilst he was stepping on
board his vessel ready to sail for the scene of
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FREQUE NC Y OF
224
bar at Stafford were witness t o their bel oved
leader s elevation to the bench I n the mids t
o f his duties o n a circuit which he held for
t hirt een years and while actually speaking
for the defendant to a special jury M r
’
S erjcant Talfo ur d received the C hancellor s
letter conveying to him the great rewa
rd of
his honourable life and substituting for the
toils and excitement o f advocacy comparative
repose in a higher sphere o f duty E ngaged
in that more dignified vocation o n M o nday
last in the same court in the presence of the
same groups o f men who had reason to love
and admire him a more awful summons bore
M r J ustice Talfo urd away !H e passed to a
higher judgment seat to receive we may
humbly hope a reward far brighter and mor e
enduring than any which human lips or han ds
”
can offer
That such should
be the end was the will o f G od ; and never
did robed o r ermined judge in an open court
in the fulfilment of his duty meet a death so
’
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SU DDE N DE AT H
225
.
like that o f a hero With Talfourd s name
the memory of his last hour can never cease
to live I t will remain o n earth and be a
fruitful source o f good and there is a pause
i n sorrow when we think that it will be r e
”
membered too in he aven !
A brother J udge M r Justice C oleridge
addressing in a si m ilar m anner the Grand
J ury at D erby a few days later o n this
”
awfully sudden death as he call ed it ex
pressed himself in a not less feeling manner
H e was sitting as I d o now discharging the
sa
me duty in which I am engaged and in t he
act of addressing t he Grand J ury when in an
instant that eloquent t o ngue was arrested by
the hand of death and that gene rous heart
was cold Surely no thing can exemplify more
strikingly the unc ertainty of life
People
were trembling at the thought o f coming be
fore him but in a minute his function was
over and he was gone to his own account
O ur recollecti o n suggests but o ne other
’
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5
FRE QU E NC Y
22 6
or
case though of remoter date whi ch less in
solemnity was much m ore awful in reality
considering the scene of its enactment and
t he great mass of people who were witnesses
on t he occasion I allude to the fat e o f the
highly popular actor PALMER whilst repre
senting the character of the Stranger in
Kotzebue s well known drama o n the Liver
pool boards
T here is another and a better
world he had just exclaimed and he dropped
lifeless I
But I must hasten to a conclusi on o r I
shall be o vertaken by many more of such
calamitous accounts ere the ink o f my pre
sent narrative is dry T he obituaries in the
public j ournals have recorded no t fewer than
”
eleven cases of very sudden d eath among
people of c onsequence in the lapsed month
o f M ay alone the majority of wh o m were no t
yet fifty years o f age Frederick H odgson
Es q late MP for Barnstaple while d ressing
for di nner to meet a large party o f invited
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228
of
FREQ UE NC Y OF S U DDE N DE AT H
t hem
.
to tell if once you enter on the dis
?
mal subject
From every quarter o f the
country from families wh
om you knew to be
in the full blo om o f health o f indi viduals who
were deemed vigorous and in the flower o f
manhood we hear as we meet in our daily
intercourse of some o ne o f them having s ud
d enly disappeared from among the living !
I
r
s hrink not fr om the responsibility of d ecl a
ing that in a large proportion of these cases
the fatal event should not have taken place
the truth o f which assertio n will be made
manifes t when I come to speak; in a future
v olume of the manner by which impending
blows o f thi s kind may be s een coming, and
may be averted
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VI
.
W HA T I S S U DD E N D EA T H
BEFORE a reply can be giv en to such a
questi on another and much more important
—
should first be resolved What is life
O n no other topics perhaps have physio
l ogis t s o f all ages differed m ore widely than
in their definition of life
A medical attendant who has Wi t nes sed
the last throes o f travail in his patients s ud
d enly find s in his hands an exquisitely formed
and perfect creature ust launched into the
w o rld
T here it lies momentarily cryles s
breathless motionl ess the symb ol of s o me
imitation of the human fo rm by art She in
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WH AT
2 30
I s
?
SUDDE N DE A T H
whose womb it was thus fashioned has ceased
to be linked to it T heir union has been
severed H er offspring is become an in d e
pendent being it is come to take its place on
i
!
the earth yet it breathes not it cries not
it moves not !Its eyes are closed its lips
are sealed ; and but for the warmth its
shapely mass imparts to the hand it might
be a mere produce of the chisel Quickly
the vigilant attendant breathes int o its n o strils
and into its mouth and gently press es the
soft and tender breast and lo a d eep sigh
—
and a cry the first cry that s e ems the har
binger o f suffering to c ome ann ounces that
the statue lives S o we say But what and
?
I s it the breath from t he
who gave it life
lungs o f the attendant that set t he m achinery
of life o n its ourney like the o ne gentle t a
p
ping at t he pendulum o f a well m ounted
horologe which s et s it and the machinery it
regulates on the ir intended performance o f
”
motion ? If s o th en breath is life else
,
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W HA T
2 32
I s
S UDDE N
?
DE ATH
possessed for example o f thirty pounds of
blood as his o rdinary share o f life may ad d
to it two thr ee nay four o r five pounds m ore
o f that desirable co m modity by food a
nd
e xerc ise u nder favourable circumsta nces ?
O n the p rinciple that blood is life how i s
sudden death to be defined and explained ?
I t is evident that such a doctrine is no t
sui ted for o ur purpose
The blood is no t life The embryo m an
while being fas hioned in its mother s womb
has blood circulating through its organs ft
is the mother s blood It adds t o the size and
the development of those o rgans but gives
them no life C uvier says The foetus up t o
the very moment o f it s birth and as long as
it has no life of it s o wn but partakes of that
o f its pare nt is no t a bei ng but a germ f
M ovement o nly is what the heart o f the
m other impart s and exte nds to the o ffspri ng
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H is t o ri e N atur e ll e d e s
duct io n
.
Anim aux
,
”
vol
.
i intr o
.
W H AT
I s
S U DDE N DEE T H
’
1
2 33
as it extends it equally to t he remotest end
o f her other limbs 3 fo r in its infra uteri ne
state her o ffsprl ng is o nly another of the
mother s limbs subj ect like the res t t o all
and every o ne of the organic a ctio ns peculiar
But this movi ng mass o f flesh
to
and blood within her is no t insti nct with life
L ins t ant o u l o foetus comme nce aexister
1
cu il
observes
Bichat
est
presque
m
me
e
e
(
)
est concn mais cette existence do nt chaque
j our aggrandit 1a sphere n est poi nt 1a meme
que celle dont i1 jouira quand i1 aura vu la
lumiere
On a
A nd a little farther o n we read
1e
comparé anu sommeil profo nd l etat
foetus se trouve C ette comparais on est infi
-
,
’
,
,
,
r
.
’
,
’
,
,
”
.
,
’
.
I am
n o t u n co
att e m p t e d t o b e
gniz an t
s e t up
of
in the
an e w fan gl e d
ro o m
do ct
o f s o un d
r
r in e ,
i
h
s
o
p y
l o gy th at the m o th er an d foetu s are ind ep en dent o f
ch o t h e r a
s fa
r a
t io n o f t he b l o o d a
n d in
ea
s ci cul a
wa
T he d o ctr in e run s co unt er t o fact s
r d m o ve m ent s
,
r
,
.
and
co m
m o n s en s e
.
WH A T
2 34
I s
SU DDE N
?
DE ATH
dele dans le s ommeil la vie animale n est
qu en partie suspendue : chez le foetus elle
nea
nt ie
ou plus t ot elle n a
e st ent ier em ent a
”
nous pouvons j e cr 0 1s
pas commen cée
conclure avec assurance que dans le foetus la
vi e animale est nulle et que tous les actes a
t
tach es acette age so nt dans la dependance
de
Y et in these se ries o f o r
actio
n
s
which
e
n
d
u
re
for
forty
weeks
n
a
i
c
g
the blood performs a pr incipal part though it
imparts no life
O ne o f the most indust rious compilers o f
physiological writings of the present day
whom the whole category of medical stude nts
in this count ry ah I and o f their se niors also
may co nsult with advantage and be thankful
has e ndeavoured to enunciate an opinion of
his o wn in two separate works enJoym g much
consideration respecting the natur e of life
A fter animadverting in o ne of those works o n
’
’
’
,
,
,
.
,
,
.
,
,
,
,
,
”
“
,
.
h
S ur l aV ie
ge 1 1 6
r I b id p a
B ic at ,
‘
.
.
et
la
M o rt p age
”
,
108
.
WH AT
2 36
Is
SU DDEN D E AT H ?
facts in physiology that vital force can only
manifest itself through those peculiar arrange
ments of matter which are distinguished as
niz ed s tr uctur e since this alo ne exhibits
o rga
that assemblage of material conditio ns which
is requir ed to concur with the dynamical
agency that is the active principle o f t he
whole for the production o f the phenome na
M augr e its italics reader s will be
o f life
puzzled to comp rehend this passage I t c er
t ainly would be diffi culty t o co nstruct out o f
such a definition o f life a proper reply t o the
3
questio n What is sudde n death
Le t us see if others among pop u
lar E nglish
writers o f no very old date have been more
successfu
l in their expositio n of the two great
questions under consideration
What say
D arwin and A ndr ew C ombe
D arwin p r eceded the last named author
rk
r i nciples of Physiology
W
hose
W
o
P
has
(
been sold in untold numbers both here and
in A me rica) by many years as he did m any
,
,
,
,
,
”
,
.
,
,
’
”
,
.
”
“
,
,
,
WH A T
I s
SU DDE N DE A T H
7
237
more wri ters both E nglish and foreign with
his V l eW o f the important question o f life
I n precedi ng them he likewise anticipated
them though i n a somewhat exagge rated o r
poetica
l manner in those sounder principles cf
ysiology
whic
h
are
n
w
co
n
s
i
dered
as
the
o
h
p
discovery o f more recent times A ccording
to D arwi n all the phe nomena o f life the fa
culty o f thinking even inclusive ar e the r esult
of an app r opriate movement in the organic
matter o f m an p r oduced by irr itation co n
sequent o n the application of certai n s timuli
t o that mat ter : the nervous system o f course
as l n the case of his predecessor s view (D r
C ullen s) playi ng the p rincipal and essential
part in the phenome na
O n the other hand A ndrew C omb e co n
siders the blood to be the sour ce of life
The blood says he is peculiarly the vital
fluid
To all such writers as m al nt am that
life resi d es in the blood (no r is t his a mere
idle question about words to be settled) it is
,
,
.
,
,
,
.
,
,
,
,
,
,
’
.
’
,
.
,
.
”
,
“
,
,
?
WH A T I S SUDDE N DE AT H
238
incumbent
to prove that life consists l n the
—
i
two characterist cs o f blood namely m ove
in other wor ds
m ent and nutr ibility ; o r
that life is cir culatio n of the blood from
the heart and s upp ly of nutr im ent with in
crease o f the body through digestion and
respiration This is precisely what Andre w
C ombe tries to prove but he as well as
every other writer holding the same doctrine
has signally failed in his expositio n
E xperimentalphysiologists such as F lourens
S erres R olando Berlinghieri E dwar ds Tied
mann &c have shown that movement o r ao
tion of the heart will co ntinue for some time
aft e r death I will state my reasons for ad
hering to such a propositio n
I n the course o f some exper iments I m ade
with prussic acid in 1 8 2 2 confirmed by
others r epeated o n the 5t h o f A pril 1 8 2 4
at the W estminster G e neral D ispensary in
the presence of D r R obert L ee D r C hi
chester of C heltenham and M essrs Par sons
!
,
,
,
,
,
,
,
.
,
,
.
,
,
,
,
.
,
,
,
,
,
.
.
,
,
,
,
,
,
.
,
,
.
.
WH A T
2 40
S U DDE N DE AT H
I s
?
I shall in this place proceed t o introd u ce the
notes o f my expe riments as I fi nd them e u
t er e d o n the self same sheet in which I set
them down at the time
A str ong and stout puppy had about
twenty drops of Garden s hydrocyanic acid
put o n its tongue The pulse in the femoral
artery was just before sixteen distinctly
O n the acid touchi ng the to ngue the dog
nd be
stretched itself the pupils d ilated a
came fixed I t yelled deep and long and the
pulsations i ncr eased t o twenty thirty forty
fifty in p ropo rtio n as the respiration of the
animal became slower and was r educed at
last t o mer e sighs with great intervals be
tween them By the time the respiration
had wholly ceased the pulsations had become
so rapid and so irregular that I could not
count them The animal was at last prostrate
nd to all appearance dead
The
o n it s side a
pulsatio ns soon after became again slower
and distinct but no t at regular int ervals
,
-
.
’
.
,
,
.
,
,
.
,
,
,
,
,
,
,
,
.
,
.
,
.
.
WHA T
S U DDE N DE A T H
I s
’
2
241
The che st being open at this mome nt the
movement o f the auricular and ventricular
cavities was obse rved very distinctly and I
then noticed also that the auri cular pr eceded
by a s altus time o nly t he ve ntri cular move
ment ; and that i mmediately after that o f
the vent ricle the pulsatio n unde r my fi nge r
at the femo r al art er v was felt als o These
progressive pulsations we r e equally noticed
o n dividing the p ri n cipal mammar y ar tery
fo r the blood was see n to spi r t p er s altum
each time immediately after the vent ricular
moveme nt and no t while either the auricular
ce
o r ve nt r icular move m e nt was taking pl a
A second dog exhibited the same phe no m ena
under p recisely the same t rea
t niénf
The description of the preceding e xperi
ments will r emind many of my professio nal
readers of those much mor e sanguinary
which the late D r Wilson Philip had pub
lishe d shortly befor e the date of my own ;
ted (contrary to
and in which he demo nst ra
,
,
,
-
'
,
.
”
”
,
”
.
‘
,
,
’
,
.
WH A T
2 42
I s
SUDDE N DE AT H
?
asser tion) that even after the fo r
cible and mechanical dest ructio n of the brain
and spinal marrow o f a quadruped the move
ments o f the heart and the circulatio n co n
tinned for som e minutes
Sir B Brodie in his C roonian L ecture fo r
1 8 1 0 had already come to the same co nclusio n
namely that the i nflue nce of the brai n is no t
directly necessary to the actio n of the heart
—an opinio n which he co nfirms by a nother
series o f experiments to ascertain the mode
by which poisons act o n animals
If it be true according to Professor S erres
celebrated researches o n the development of
the brain in the four classes of vertebrated
animals that the nervous system developes
itself in the intra uterine creature from the
cir cumference to the centre and that the
lateral nerves of the head the trunk and t he
pelvis are already formed Whilst the spino
cereb ral struct ure is still in a liquid state
and the b rain it self is as yet incomplete (prov
Legallo is
’
,
,
.
,
.
,
,
,
,
.
’
,
,
,
-
,
,
,
,
,
WH A T I S S UDDE N DE AT H
2 44
?
emarkab le work o n the principle o f life
mo r e especially o n the movements o f the
heart (evidently and wr o ngly co nnecting them
with life) thr ough a series of well conducted
an d varied experiments e nd eavour ed to co n
vince physiologists of the co rr ectness o f his
Legallo is having thus settled the
views
questio n that the nervous or br ain power
and the heart power were intimately asso
cia
t e d in maintaining life e nded by defining
the latter to be the effect of the impression
m ade by arterial blood o n the b r ain and
spinal marrow while death was the cessatio n
of that impression
Th1s i s evide ntly an
error ; and the experiments I have detailed
demo nstrate it A rterial blood was see n in
them to spirt out in its wonted manner
through an Opening made i nto a vessel co n
n ect e d with the outwar d ci r culat io n of the
heart l ong after the disappearance of every
nd the autopsy of
s ig n of l ife in the a nimal a
it s body
r
,
-
,
,
.
-
,
,
,
-
,
,
’2
.
.
,
,
,
.
?
DE A T H
WHA T IS SUDDE N
2 45
A s a nother favou rable opportu nity of pub
lis hing the
few r emai ning collateral facts which
we r e derived from the same series of e x per i
m ents m av no t p r ese nt itself ; and as I co n
sider those facts to bear o n some impo r tant
points o f juridical medici ne in cases of poiso n
ing with prussic acid I tr u
st the reade r s will
exc us e thei r intr oduction in this place I
continue to transcribe the original notes
A nother fact (obser ved in p r evious ex
r il
rmed
n
e rim ent s
was
co
n
fi
amely
the
b
p
)
liant and scarl et like appear ance of the lungs
and the apparently total abse nce o f ve nous
—
blood from any of their vessels the lungs
ese
nt ing o ne u nifo r m ver millio n colou r ex
r
p
I nter nally the br o nchi W er e quite
t ernally
pale o r rather white and the blood vessels
unifo rmly gorged with blood m or e b rilliant
in colour than the arterial blood of the same
,
,
.
.
,
,
-
’
“
=
.
-
,
,
of
The r e was no coagul um in either cavitie s
the heart The blood was fluid t hr ough
.
WH A T
2 46
I s
SUDDE N DE AT H
?
out the body ; but coagulated immed iat ely
The stomach
o n bei ng take n away fr om it
of both dogs was distended brimful with large
morsels o f cheese bread and meat mixed
with a po rridge like liquid o f yellowish clay
colour
The three distinct forms o f peristaltic
motion of the intesti nes noticed in forme r
experime nts with grown up cats were o b
served likewise on the present occasion and
thus far that striking fact was confirmed
The motions co ntinued all the time that
those of the heart lasted The bladder in
both cases emptied itself with str o ng ej ec
tion and so completely t hat by the contrae
tion it s parietes fo rmed almost a har d solid
pyriform body I n o ne of the dogs the rec
tum deposited its contents
N o traces of
prussic acid could be detected in the se cre
tions by the ordinary means of a nalysis
W ell then if circulat io n o f the blood fr om
—
the heart be no t identical with life no more
.
,
,
,
-
”
.
,
-
,
,
,
,
.
,
.
,
,
,
,
.
.
”
.
,
WHAT I S S U DDE N DE A T H
248
?
.
of time to multiply refe rences to other Br itish
writers who assuredly have n o t come neare r
to the truth than any of their predecessors
W e next look among o ur near est neigh
bour s o n the other side of the channel fo r
o ne o r two of t hei r g reatest autho rities o n
physiology o r medicine to tell us what life
,
.
e
,
,
Bichat first p resent s himself a ge nius in
every way r emarkable of whose labour s the
F re nch school of me dicine is justly pro ud
Within the sho rt compass o f a thirty year s
existe nce eleven of which had bee n l uces
nd phy s io l o
nt ly devoted to anatomical a
sa
i
nclusi ve of the exam inatio n o f
i
l
i
stud
es
ca
g
sever al hundr ed bodie s in a single winte r
this modern Boerhaave laid the foundation of
,
,
.
’
,
,
~
,
P A
.
tom
.
.
ll e
L at r e i
ii
.
p
.
24
:
C u vie r M ém o ire s
d e P ar is an 7
,
.
n t er n e
d es I
n s e ct e s ,
.
L e s in s e ct e s
,
O r gan is at io n I
.
’
n o nt
au cu n ag en t d e
d e l a S o ciét é
d
’
cir cul a
t io n
”
.
H is t m r e N at u r ell e
“
WH A T
S UDDE N DE AT H ?
I s
code of anatomical and phy
s io l o ica
i
i
n
ed
c
e
which
coupled
with
h
l
m
e
t
g
new doct rine of animal chem istry applied to
the functio ns of the human body s ubs e
an
entirely
n ew
,
,
(
2 49
,
quently i ntr oduced by L i ebig may be deeme d
to constitute o ur p r esent most intelligible
comprehensive and r ational system of the
natural history of m a
n
O f thr ee m emo rable wo rks which th is
young vete ran autho r published within two
year s of his dea th at the comme ncement of
the p resent century the o ne entitled Phy
l
r ches o n L ife a
n
d
R
esea
D
eath
sio l o ica
l
a
g
r eady quoted is u nquestio nably the m ost r e
markable
What then is his defi nitio n of
?
—
L a v ie
life what that of sudden d ea
th
est l ens em ble des functio ns q ui r esistent a
la mort Bichat might as w ell have uttered
and with equal emphasis the t ruis m that life
?
is no t death Who could have denied it
But a little further o n this ens em ble o r com
binat ion of functio ns does no t seem to co n
,
,
,
.
'
,
,
,
”
,
,
,
.
,
,
’
”
.
,
,
.
,
,
,
M5
WH AT
2 50
I s
SUDDE N DE A TH ?
life for after declaring that all living
beings ar e constantly subject to the action of
external objects which tend to destroy life
he proceeds to say that they are likewise
possessed of a permanent p r incip le o f re
action within themselves respecting which
the author t ells us that ce principe e st celui
”
de la vie
Bichat admits at the same time that the
is p r incip le is unknown and can
nature of th
only be appr eciated by its pe culiar pheno
mena the principal of which is the habitual
s t it ut e
,
,
,
,
,
.
,
,
,
act ion and react ion between the external
—
destructive agents and the living body an
alternat e contes t the intensity o f which is in
the inverse ratio (according to Bichat) of t he
age o f the individual Thus in children the
ction
hence there
r ea
ction surpasses the a
is superabundance o f life in childr en There
is equilib rium be tween the two actions in
adult s while in old age the o ffendi ng action
of external o bjects continuing the same the
e
,
.
,
,
.
,
,
,
WH A T
2 52
SUDDE N DE AT H
I s
?
qui distingue éminemment les animaux et les
ux de tous les au t r es co r ps de la nature
veget a
c est L A V I E : mouveme nt interi eur do nt l a
cause est i nco nnue m ais dont l e s effets sont
faciles aper cevoi r
To this we reply that
n body
if an interio r movement in the hum a
b e life its cause is no t u nk nown} The ex
ample o f the new born babe with its suddenly
acquir ed inwar d movement th rough the im
parted b reath explains la caus e inconnue
To this d ay we meet with autho r s and lec
t ur e r s who maintain the doct rine of what is
called innervatio n meaning the r eby the in
fl uence which the nervous portio n of the ani
l frame exe r ts over the rest and which
ma
they consider as the re al source of life;
Wh ole volumes have b een written to develope
and prove the t ruth of this doctri ne ; and
many inge nious exper iments have been de
vised and executed in illustration of it s prin
ci l e s
r e st r o ng r easo ns for be
A
s
the
e
r
a
p
lievi ng that the great ce ntre of the nervous
,
’
,
’
,
.
,
-
,
,
”
.
,
,
,
‘
.
»
W H AT
Is
S UDD
EN
DE AT H
?
2 53
syst em t he brain, i s the seat and agent of
volition and thought
s ens at io n pe r c eptio n
Which so eminently char acterise human life
e ven whe n moveme nt gr owth developme nt
and many other animal functio ns o r op era
—
r
n
tio ns are checke d o suspe ded it was a very
w t hat the n e rves of
natu r al i nfere nce to d ra
the body and a ce rtain supposed fluid circu
lating through them constitute life
U nfortunately facts again start up before
us to upset all such foregone conclusio ns
Ther e is har dly an anatomical museum in
Europe that does no t p r esent a number of
acephalous childre n mostly well formed and
completely constituted in all other respects ;
The history o f som e of them Wi fe have lived
in t hat state is well known an
d duly aut hen
I will allude esp ecially to o ne only
t icat e d
r emar kable i nstance o f a ch
ild born wit ho ut a
head and co nsequently without brain de
scr ibed by M r L awrence the eminent surgeon
of St Bartholomew H ospital in the fifth
,
,
,
,
,
,
,
,
,
,
,
’
,
,
.
,
,
.
'
,
,
'
.
'
‘
L
,
,
.
,
~
‘
.
,
WH A T
2 54
I s
SUDDE N DE AT H ?
volume of the M edico C hirurgical Trans ac
tions The peculiarities were these There
was no b rain nor cranium
Its basis o r
r athe r a part which should have formed its
basis was covered by t he common int egu
ments except over the great opening into
the spine where a small soft tumour equal
in size to the e nd of a thumb projected
about an inch and was covered by a thin
membrane which was woven in with the sur
rounding integuments This small soft tu
mour was the terminatio n of the medulla
spinalis swelled out into a small bulb when
the latter was pressed general convulsio ns
ensued
The child was perfectly formed in all its
nd had attained it s full siz e
i
r ts
a
a
t
p
breathed naturally was no t deficient in
warmth took a litt le food by the hand and
performed the t wo principal functio ns of the
kidneys and intestines in the usual manner
while he lived from the Sunday (the day o f
-
.
.
,
,
.
,
,
,
,
,
,
,
.
.
,
,
,
,
,
,
WH A T
2 56
Is
SUDDE N
?
D E ATH
mal and has nothing to do consequently wit h
life I t is to the pr esence of the spinal chord
that the formation and developme nt of the
diver se par ts of the body in their perfect
s tate are due a
nd it is owing to the same
prese nce that their r espective functio ns are
executed The b rain has never been found
without the spinal chord fo r the former is
the pr oduct and termination of the latter
which may exis t as we have just seen, with
out the pr esence o f the other
The b r ain and the nervous structur e of
animals are no t in themselves sufficie nt t o
account fo r o r explain what life is and co n
sequently to throw light o n the other qu es
tio n of prematur e death But their exist
ence and the manner in which they have
bee n supposed to act deduced fr om many
phenomena observed in the course of m any
ably conducted ingenious experime nts have
led many to assume that there is something
circulating thr ough every po rtio n of the ner
,
.
,
.
,
,
,
.
,
,
.
'
,
,
,
WH AT
S U DDE N DE ATH
I s
”
2
2 57
vous structure t o which the name of ner
vous fluid has bee n give n and this is co n
s id e r e d by them to be th
e s o ur ce o li e
f f
C uvier who prese nts himself like a giant
amidst all such a
utho rities a
dmits the exist
ence of a nervous fluid which he parad o xi
cally considers to be at one and the same
time secreted and co nducted by the m e d nl
lary substance o r nerve matter yet he does
no t ascribe the
ri
ciple
of
life
to
it
H
is
n
p
definitio n o f life is both infelicitous and u ni n
Life he says co nsists in the
t elligibl e
faculty which certai n o rganic bodies have
of enduring fo r a time and under a dete r
mined fo rm attracting unceasingly within
themselves parts of the sur rou nding matter
and yielding up at the same time t o the
elements por tio ns of their o wn substance
A ssuredly this is a descriptio n of the act of
living and no t of life A n o rganic body en
dowed with life is capable o f pe rfo rming the
operations described by C uvier because it is
,
”
.
,
,
“
,
,
,
-
.
.
“
.
,
,
,
,
,
,
,
,
”
.
,
"
,
.
,
WH A T
2 58
S UDDE N DE A T H
I s
living for were it no t so the operations could
no t be performed
L ife must p r ecede t he
operations no t the operations life which
must have been the case were they the
parents o f li fe The ope ratio ns are in fact
the prese rvers o r maintainers of life and
n othi ng else
and there it is where the great
“
anatomist erre d fi
A n ingenious theory has bee n lately
hazar ded in o ne of the medi cal journals by
a r espectable physician who anxious to r e
vive the system o f the chem ico physiologists
first assumes that electricity and nervou s
influe nce must be ide ntical o r mean t he
sam e thi ng
and seco ndly that as nothing
n be more
ca
certain than that there is
scarcely a tissue in the animal system less
apt or likely to originate electricity than the
substance o f which the brain and Spinal mar
—
n be co n ductor s o nly
r o w co nsist
nerves ca
,
,
.
,
,
.
,
,
,
,
,
,
-
,
,
,
-
,
C uv ier
I nt r o d u ct io n
“
H is t N at ur ell e d e s
.
,
.
,
An im aux
’
,
vo l
.
i
.
WH A T
2 60
IS
S UDDE N
D
E AT H
?
s1st of affe rent and effer ent fib rils it follows
that they must and indeed they have been
p ro ved to be the co nductor s of elect ricity
S uch I believe and as far as I can com
pr ehend them are the views of the writer in
question to which I make two simple ex cep
tio ns if his theo ry is brought fo rwar d as the
theory of life I n the int ra uterine existence
o f the animal there is no tr ansmutat io n of
ar terial into venous blood ; and before such
a trans mutatio n can take place in it s extra
uterine life some other act must be per
formed as w e have see n in the case of t he
—
n ewly bo rn What p r oduces that act there fo r e
is the life and n o t any subseque nt chemical
change o r evolved electricity which can o nly
begin after life has been e s tablished Elect ri
city may exist (and I co nfess D r Strachan s
theory of it is s im ple and inviting) nay it may
be inst rumental in maintaining life,as indeed
,
,
"
i
,
,
,
a
,
,
,
,
-
.
,
,
.
,
,
,
,
.
’
.
,
,
,
D
of
t he
S tr ach an
On
N e rv o u s I nfl u e n ce
r
.
g
t he O r i in an d
,
”
.
S ee
,
C ir cu l atio n
L an ce t ,
”
1 8 54
.
W HAT
?
SU DDE N DE AT H
I s
261
special function or produce in the living
animal contributes to that great result but
they do no t constitute life no r does death
e nsue when any o f them ceases to act My
second exceptio nis that as in many i nferior
animals there e x1st s none o f the elect ro pro
nd vei ns
dh
ct iv e arrangeme nts of arte ries a
o n which l ife is made to depe nd by D r
Strachan s theo ry we should be obliged to
adm it that the r e is mo r e than o ne so r t o f
life to account fo r the existe nce of such beings
—an evident absur dity
This very theory of ele ctricity being the
analogous rep r ese ntative of what is called the
ne rvous fluid has fou nd favour with a modern
Italian philosopher far mo r e illus t rious than
the wri ter just commented upon ; I mean
Professor M at teucci His view of the mode
of action o f the ner vous system (as it ap
i
m
r e d in a pape r laid by h
before
the
e
a
p
A cademy o f S ciences of Paris in 1 8 4 7
ever y
,
.
,
,
-
“
,
.
’
,
.
,
,
.
,
through D umas)
is
this
he admits the ex
,
WH AT
2 62
I s
SUDDE N DE AT H
?
a nervous fluid says it is analogous
to electricity and he derives its origin from
the muscular tissues where it is cr eat ed o r
excited by the chemical action of their free
acid o n the alcaline principles o f the blood
M atteucci considers that the fluid thu s pro
d uce d is carried along the nerves as co ndu e
tor s to the mass of the brain whence by the
i nfluence o f volition it is distributed t o the
muscular system agai n for the purpose
deter mining contraction
of
S e no n e
vero &c
A n i nge nious living lecturer o n electro
biology (whose definitio n of life by the bye is
a mere truism) has laid it down that the me
nis m of a double voltaic circuit represe nts
cha
perfectly what animal life is The analogy
between the t wo he says is perfect Granted
for t he sake o f argument W e then inquire
whence the electro galvanic fluid in the ani
mal
Where is the double galvanic circle
W e have just seen what D r S trachan said as
is t ence
of
,
,
,
.
,
,
,
,
.
”
,
.
-
-
.
,
,
.
.
,
-
.
WH AT
264
I s
S UDDE N DE A T H
?
This law D r Barbier p r etends has bee n
overlooked because the name natur e or
that of vital force has been given t o it
By some it is co nsidered as the same thing
as the soul ; by other s it is looked upo n as
the result o f innervation the produce o f ner
vous centr es the brain the medulla the
But the biogenic law proper is
ganglia
n o n e of those for it ne ithe r impar ts to the
;
animal the faculty of feeling no r tha
t of mo
tion I t is only o rganization
A gai n the biogenic law is co ntempor ary
with the organized being It takes posses
sion of that being the mome nt it begi ns it s
development in it s mother I t exe r cises it s
power over it eve n while in its r udimentar y
state while in fact it is yet a germ The
latter detaches itself from the body that has
pr oduce d it at a fixed period only and when
all t he co nditions that are r equisite to e nsu re
The
it s in dividual existence are p r esent
biogenic law follows the new cr eature and
.
”
,
,
”
.
,
,
,
,
,
.
,
”
“
.
.
,
,
r
.
.
,
,
.
,
.
,
.
,
WHA T I S SU DDE N DE A T H
?
265
’
h o lds it under its sway to the end and thus
D r Barbier defines life
D eath especially
sudde n death is even m ore simply explained
.
.
,
,
Physicians (sa
ys he) occasio nally see
p er sons dying without being able to detect
the existence o f any lesio n or the smallest
alte ra
tion or deviation in their organizatio n
The body of the victim attentively s cruti
ny
nise d presents no material disturbance in a
The failure o f life cannot be at
o f its parts
tributed to any morbid modification of the
nervous centres i nasmuch as the se nsat io ns
perceptio ns the will and the intellect have
continued intact to the last The muscular
movements have be en perform ed with regu
l arity
N evertheless life is extinguished o n
all points The circulation is performed more
slowly r espiration becomes painful inco m
l
et e
n
n
i
all
the
fu
n
ctio
s
which
co
st
tute
l
i
e
f
p
are gradually suspended animal heat de
creases and death supervenes
The bio
N
'
,
.
.
,
,
,
.
.
.
,
~
,
‘
,
.
.
WH A T
266
S U DDE N DE AT H
law has ceased to animate such a
n
i
e
e
g
body
I s
?
”
.
This investigatio n as to the nature of life
it would be easy to extend much fii rt her by
referring to the several opinions held by other
philosophers and sages o f all nat ions many
o f whom have treated this i m portant questio n
from the earliest times But such references
would no t better enable us than all the doc
trines hitherto set forth to answer the ques
tion placed at the head o f the present S ec
tio n
There are however,o ne or two references
which I m ay be permitted t o introduce t he
o ne te nding t o throw some side light o n eer »
tain funct ions of life the other invol ving an
att empt to set up the heart as an ind epen
dent agent and t he representative o f life
through the nerves I will dispose o f t he
latter first I n a recent com munication to
the R oyal S ociet y there is an alleged demo n
s t ra
t io n by a livi ng physician o f a nervous
,
,
,
.
,
.
,
:
.
.
,
,
WH AT
268
S UDDE N DE AT H
I s
’
3
to m e in MS six years after in Paris
while I was in the enjoyment of the inti macy
nd historical persona e
o f that remarkabl e a
g
w ho was the n in his ninety seco nd ye a
r of
age in the fullest power of his intellect and
that same wit which had made him at one
time the favourite of L ouis X V
The main
object o f the expe riments (which I believe
were neve r published) w a
s to test the t ruth
o f the r ece ntly p r oclaim ed do c
trine of Gall
that the cir cumvolutions o f the br ain were
the exclusive seats of the intellectual faculties
nd the will
the passions a
The experiments
w er e m ad e o n r abbit s co ck s and sheep a
nd
led to conclusions diametrically opposed t o
the views o f D r Gall D iffere nt po rt iOns o f
the br ain m at ter wer e removed down to the
ventricles varying the size, place and extent
of the a blations and noting t he effect o n the
cr eatures when it was proved that the animal
retained his senses the apprehensions of d an
ger the volitio n t o escape from it (when set
nica
t ed
.
,
,
,
‘
-
-
,
,
.
,
,
'
,
,
.
.
,
,
,
,
,
,
,
WH A T
SU DDE N D E AT H
I s
?
2 69
free) and the p ower of motio n even after the
removal of co nsiderable portio ns of brai no n
both sides Showing that while the seat o f
the sense s was in the i nferior strata of the
brain that o f its inst incti ve faculties was cer
t ainly no t in its supe r ior co nvolutions
I n a rece nt and very T em zirk abl e work
said to be from the pen of a lady entitled
THE P R O T O PL AST there occur s a passage s o
clearly explanatory of what I have alw ays
held to be the only correct view of the nature
nnot
o f life abstractedly co nsidered that I ca
resist the satisfaction of quoting it H aving
previously stated —that two things which ought
to be kept distinct have nevertheless been too
much confounded together nanreiy organi
the fair author goes o n to say
z a
t io n and life
that o rganl z atio n is the arrangeme nt move
ment and adaptatio n of the part icles o f mat
while life is the communication o f an
t er
immaterial p rinciple L ife o r the living es
se nce forms no part of organizat ion it simply
,
,
.
,
‘
,
.
,
,
,
”
,
,
.
,
,
”
,
,
,
,
,
.
,
,
2 70
W HAT
I s
.
S U DDEN DE ATH ?
uses it as it finds it as a m achine subordinat e
”
to it s will
The last t hree lines especially
I would wish t o press int o my service They
b ring at once before us the C reator s greates t
act o n the sixth day of H is m i ghty work
when H e breathed life into the co mp letely
n
niz ed animal m a
They are co nfirmed
o rga
by the example of t he new born infant
But if the theory of life propounded by so
many wise m en does no t lead (as it should
do) to a natural explanation o f what is m eant
by t he awful word s
we
S udden d eath
m igh t possibly find in t he writings of so m e
o f thos e authors or o t hers a direct d efi nition
,
,
,
,
.
.
’
,
.
-
”
,
,
,
,
of that m eani ng Let us refer then t o afew
such authors taken at random and s ee if w e
shall be m ore fort unat e in o ur research
I t is a startling subject I have undertaken
t o examine
o t m ore s tartli ng t h
e
a
t
n
n
y
m any o f the fact s i nferences and conclusi ons
appertaini ng to it which will successively de
velo e t hemse lves a
n
n
t
n
d
il
l
be
e
ed
m
i
n
w
i
o
p
.
,
,
,
,
.
,
,
,
,
,
,
:
W H A T IS S U DDE N DE A T H
2 72
other o r mo re modern authority Bichat; de
clares that the great differe nce which exis ts
between la mort de vieillesse and that
which is l effet d un coup subit is that in
the o ne case life begins gradually to be ex
t inguis he d in every par t of the body and
—
n
n
fi ally e ds in the heart death exer cising
its i nfluence from the cir cumfere nce to the
cent r e ; whilst in the other case
la vie
s e t e int da ns l e c oeur e t ensuite dans toutes
les parties C est d u centr e ala circo nfer ence
que la mort enchaine ses pheno m enes
T his Opinio n of the illustrious Parisian ana
t o m is t is gr ounded o n his peculiar system of
h
n
sm log
r
adopted
si
ce
by
the
g
r
e
te
a
p y
y
numbe r of the F r ench medical schools o f the
—
day and in which the various functions co n
r e divided i nto a nimal
s t it ut ing life a
and
n
n
d
or a
i
c o r i nte rn al a
exter
n
al
The
f
mer
o
r
g
acting from the cir cumfe rence to the centr e
whilst the actio n of the latter extends from
the centre to the C i rcumfere nce
,
,
”
'
,
’
’
,
,
,
,
,
’
’
.
”
.
'
_
,
,
,
\
.
,
.
?
WH AT IS SUDDE N DE AT H
Bichat moreover maint ai ns that sudde n
dea
t h no matter of what k i nd always begi ns
wit h o ne of the principal organs the heart
the lungs or the brain and he explains how
life is gradually extinguished in each organ
according as it has first began to cease in
9
»
,
,
,
,
\
2 73
,
,
,
,
M ilne E dwards definition o f death is more
laco nic than satisfactory
L orsque l espece
de tourbillo n qui determi ne le renouvelle
ment des m at eriaux dont le corps est com
i
r itio n
rr et e sa ns
o
s
n
r
d
n
u
t
a
e
n
o
e
w
s
o
p
)
(
retour cc corp s
ards as
and E dw
tritio n therefore what Bichat
cribes to n u
ascribes to circulation
But it Would be apure was t e o f time after
having giventhe deliberat e opinion of t wo such
authorities as M orgagni and Bichat o n the
”
ning o f t he term
m ea
sudden deat
to re
produce inthis place t he d icta o f many more
writers o f lesser note M ost o f them do but
’
’
'
.
”
'
’
'
,
,
,
,
.
,
.
l
‘
“
,
'
,
.
E l em en s d e Z
.
l gi e p age 3
oo o
”
,
.
Par
N
is,
5
1 8 54
.
W H AT
2 74
I s
S
U DDE N DE A T H ?
repeat what their predecessors had said be
fore them while a fe w among them all lim it
their inquiries simply to t he question a
s to
wh eth er s udd en death m eans d eath in three
ys The
minut e s o r three ho urs or thr ee da
reviewer of two It alian w o rks o n sudden
death to which espe cial refere nce was m ade
"
,
.
,
,
,
the Se ction
tisti cs
D eath S ta
mpre
he nds und er that denom inati on all cases that
term inat e fatally in l ess than three days after
the attack Such a d efinition woul d embrace
apoplexy and p a
lysis which often do not
ra
n th
d e stroy t he pat ient in less t im e tha
ree
o r mo re days
I adm it that t hey t erminate
generally in sp eedy death; but I cannot view
se s
as strictly sud d en any other tha
n those ca
o f death in whi ch a
n ind iV idua
l W hilst in
the act apparently of performing in t he m o st
n ormal ma nner po s sible h
is vit al funct ions
ceases instantaneously to live and suchare
all those which I have detaile d in the S ectio n
ent itled F acts wi t h o nly a veryfew except ions
in
on
-
,
co
.
,
.
.
,
,
,
,
,
.
W H A T IS S UDDE N
2 76
’
1
D E ATH
”
foudr oyante o f the F rench Such a pre
tended i nference is an error N 0 such p he
no m e no n occurs in nature unless t hrnugh
accident o r from violence U nder Natur e s
laws ther e is no s uch a thing as sudden death
This will be demonstrated in a S ection of a
future volume o n the causes of the event
which has received that denomination It
will be seen that in every case whe re death
has abruptly cut short the thr ead of life there
had been a pr eparation mo r e or less ant ece
dent to the occur rence which must inevitably
have led to it unless interfer ed with by a
timely and successful watching o n the part of
a medical attendant
The death may have occurred u nexpecte dl y
and in the opinio n of fri e nds and bystanders
the victim may have seemed to ha
ve been
st ruck down dead as if by lightning But
in reality the eve nt was o nly the natural
te rmination of an inward state of things
which insidiously and unsuspectedly was pre
-
.
.
,
’
.
.
,
,
.
,
,
,
,
,
,
-
.
,
,
,
.
,
,
,
W H AT IS SU DDE N DE ATH ?
2 77
all cases o f sudden death
n oppo r tu nity has bee n
s d call ed in which a
nd closer i nvestiga
or d e d for a farther a
nfi
tion Sufi cient cause has bee n detec t ed and
cle arly made o ut to co nvinc e us that the in
nt a
ne o us clo smg o f life was me r ely the
sta
n atural terminatio n o f a trai n o f morbid ope
tions Which had been going o n within fo r a
longer or shorter period of time 3 and that
/s uch a ki n d o f death was in no way
s o fa
n
dissimil ar from that which follo ws the termi
natio n o f a long ill ness
I n t he mids t of life we are in d eath
The antithesis of these solemn and thrilling
words heard o n the brink o f an open grave
as it receives the body of a d epa
rted friend
is well calculated t o convey to our minds the
idea o f human existence suddenly quenched
I t also bespeaks the ins ignificance of that ex
is t ence both in value and time
F or what
7
is life
it is even a vapour t hat appeareth for
a litt le time and the n vani shes a
way
It
r
g
h
e blow
n
t
i
a
p
I
.
n
,
,
,
,
,
.
”
.
.
,
,
“
.
.
.
”
.
WHA T
2 78
I s
SUDDE N DE A T H ?
us o f the uncertai nty o f o ur end that we
may al ways be prepared
Be ye also ready
for the S o n o f m an comet h at an hour when
”
we think not
T hese and other passages from the Book
o f K nowl edge , may have been suggested to
their respect ive writers by the numerous ex
am ple s of i nst ant aneous deat h re corded in
cred writ ings
the Sa
I t is satis factory t o know that in the opi nio n
intained in thes e pages respect ing what
ma
should be called sudden d eath I am supported
r
by the views entert ained on t he subje ct by M
t
rr of the Regis rar G enerals d epartm ent
Fa
No d efinitio n observes t hat s agaci ous wri t er
c
of t h
e sense in wh
ich s udd en d eathis pra
tically und ersto o d by coroners has be en
The writ ers even 0 n medi cal
given
j uri sprudence do not stat e With any s tri ct
nes s what t h ey m ean by sud d en d eat h
whether it be d eath in t en m inutes t en
hours or t en days 3 but it is generally apa
t ells
,
,
.
.
,
”
.
,
.
.
.
,
,
.
“
.
,
”
,
,
;
,
5
”
,
.
,
,
,
,
,
,
2 80
WH A T IS SUDDE N DE AT H
7
whilst the lungs had ceased their functio ns
with a last prolonged exp ir ation, following
after many seconds the last deep insp ir ation;
whe n death ensues And such appears to
be the close of life so far resembling its open
With
ing as described early in this S ection
a first deep inspiration life awakens with a
last and long expiration life sleepeth On
the coming of sudden deat h the last crown:
ing symptom of danger is a check ed halting
and suffocating respirat ion
,
,
.
,
.
,
.
,
,
,
.
,
C O N C LU SI O N
.
the course o f a long and eventful life
the half of which has bee n spent in pro fes
sioual labours o ne thing has struck me as
most si ngula
r
I t is the indiffere nce with which people
ge nerally hear the news o f the sudde n death
nd
s heard a
ny o ne forget it as s o on a
of a
careles sly o g o u in their o wn mode of livi ng
without asking themselves these t wo simple
—
questions W hat can have b r ought about t his
sad event é A m I living in such wise as to
rende r myself liable to the like fate 2
A nd yet there are many who while thus
I
N
,
-
,
,
,
,
u
,
b
-
,
’
’
,
C O NC L USI O N
2 82
.
”
indifferent o f to morrow are actually un
der the insidious and unsuspected working o f
those inward changes which sooner o r later
will send t hem to swell the number o f t he
cases I have brought together in the F ifth
S ection With the history o f not a few of
those cases I was well acquai nted ; and t he
individuals to whom they r elate w ere known
by me to be so threat e ned Thei r well nu
d ers t oo d c onstituti on their per sonal appear
ance their family antecedent s their m ode of
living and when by chance visited profes
lly their ordi nary state of pul se a
s io na
nd
respiratio n—t oget her with their confession of
—
certain peculiar inward sensations all tended
t o impress m e with t he conviction that their
death whenever it happene d would be
-
:
,
;
,
?
‘
.
‘
.
,
,
,
~
,
,
,
,
a
"
,
,
dd en
Many such are even now t o be seen pre
am bulating the t horoughfares of t he m et ro
polis freque nt i ng t heir clubs or are t o be
m et a
r d perfectly uncon
t t he fe st ive bo a
su
.
v
,
»
,
,
,
”
C O NC L USI O N
2 84
.
F ir s t
that in o ur days apoplectic seizures
paralytic threate nings and actual stro k es
are more common than in fo rmer times
rly
S econd ly, that ne ither youth no r e a
manhood goes fr ee but rather the contrary
from such calamities
Thir d ly that these calamities are no t con
fined mer ely to the larger masses but reach
the home of the better and most exalted
F o ur tldy that the proportio ns of such
calamitous deaths to the gener al mortality of
the country is fast increasing
Las tly that as r egards the sudden death
of infants especially circumstances have bee n
found to accompany it o f a startling nature
which the present inquiry has in a great
measure b r ought to light but which demand
a larger investigation fi o m the public aut ho
,
,
,
,
.
,
,
.
,
,
.
,
.
,
,
,
,
,
,
,
'
rit ies
.
Should the perusal O f the truths cont ained
the preceding pages no t fail of its main
—
obj ect that of producing a wholesome fear
in
C O NC L USI O N
2 85
.
sudden death and p r ove a warni ng also
agaI ns t the stealthy app r oaches o f those de
rangements o f the circulation somet im es Slo w
d sometimes i nstantaneous which lead to
an
—
apo plectic fits and paralysis the end I had
r ese nt volume will
I n v1e w l n publishi n
the
p
g
of
,
,
,
,
,
,
accomplished
S uch rea de r s as may co nsider themselves
liable to the peri ls enumerated in the course
pared to under
of these S ectio ns will be pr e
stand and avail themselves o f the contents of
another se ries I purpose (D V ) to publish
in co nti nuatio n at the e nd of the present
year and in which the causes o f sudde n death
4t he t r ue natu r e of apoplexy a
nd par alysis
the t r eatment and prevention Of t ho s e fo r
m id abl e disorders by remedies by diet by
—
change of air and by m I neral waters the
—
philosophy o f sudden death the par entage
o f i nsanity t r aced t o the same causes that
—
give r ise to t he two former diseases and
fi na
lly the dyi ng o f Old age or as it has
be
.
,
'
‘
.
.
,
,
,
'
-
‘
,
,
,
”
,
,
,
C O NC L USI O N
2 86
.
”
been call ed lo ngevity will receive a full
popular and practical development and co n
“
,
,
,
,
SI
d erat ion
.
Thus shall we be put in possession o f t he
means Providence perm its us to employ
against the coming of that form o f dissolu
tion which must be viewed as an awful visi
ta
t io n ; sinc e it has bee n coupled with two
o t her still more awful whe n in t hat beauti
f ul K Y R I E of plaints and supplications t o G od
we are t aught to say
FR O MBATT LE AND MURDE R
z
AN D F RO M S U D D EN DE AT H
G OO D LO RD D EL IV ER US
,
,
,
,
,
’
,
”
.
THE EN D
.
L O N D ON 2
G
.
J
.
PA L
ME R
,
S A V OY
S T R EE T , S TR A N D
.