Chapter III: Appendix: Page (2)

George Higinbottom, an undertaker, was employed to remove in a shell
the corpse of a woman who had died of typhus fever in the London
Fever Hospital. In conveying the body from the shell into the
coffin, he observed that his left hand was besmeared with a moisture
which had oozed from it. He had a recent scratch on his thumb. The
following morning this scratch was inflamed; in the evening of the
same day he was attacked with a cold shivering and pain in his head
and limbs, followed the next by other symptoms of severe fever; on
the fourth day there was soreness in the top of the shoulder and
fulness in the axilla; on the fifth the breast became swollen and
efflorescent; on the seventh delirium supervened, succeeded by
extreme prostration and coma, and death took place on the tenth day.

A lady in the country received a basket of fish from London which
had become putrid on the road. In opening the basket she pricked her
finger, and she slightly handled the fish. On the evening of this
day inflammation came on in the finger, followed by such severe
constitutional symptoms as to endanger life, and it was six months
before the effects of this wound subsided and her health was
restored.

Among many other cases, Mr. Travers gives the following, as
displaying well the minor degrees of irritation, local and
constitutional, to which cooks and others, in handling putrid animal
matter with chapped and scratched fingers, are exposed:—A cook-maid
practised herself on a stale hare, for the purpose of learning the
mode of boning them, in spite of being strongly cautioned against
it. A few days afterwards two slight scratches, which she remembered
to have received at the time, began to inflame; one was situated on
the fore-finger and the other on the ring-finger. This inflammation
was accompanied with a dull pain and feeling of numbness, and an
occasional darting pain along the inside of the fore-arm. The next
day she was attacked with excruciating pain at the point of the
fore-finger, which throbbed so violently as to give her the
sensation of its being about to burst at every pulsation. The
following morning constitutional symptoms came on; her tongue was
white and dry; she had no appetite; there was great dejection of
spirits and languor, and a weak and unsteady pulse. After suffering
greatly from severe pain in the finger, hand, and arm, and great
constitutional derangement and debility, the local inflammation
disappeared in about three weeks, and she then began to recover her
appetite and strength.

2. It is proved by indubitable evidence that this morbific matter is
as capable of entering the system when minute particles of it are
diffused in the atmosphere as when it is directly introduced into
the blood-vessels by a wound. When diffused in the air, these
noxious particles are conveyed into the system through the thin and
delicate walls of the air vesicles of the lungs in the act of
respiration. The mode in which the air vesicles are formed and
disposed is such as to give to the human lungs an almost incredible
extent of absorbing surface, while at every point of this surface
there is a vascular tube ready to receive any substance imbibed by
it and to carry it at once into the current of the circulation.
Hence the instantaneousness and the dreadful energy with which
certain poisons act upon the system when brought into contact with
the pulmonary surface. A single inspiration of the concentrated
prussic acid, for example, is capable of killing with the rapidity
of a stroke of lightning. So rapidly does this poison affect the
system, and so deadly is its nature, that more than one physiologist
has lost his life by incautiously inhaling it while using it for the
purpose of experiment. If the nose of an animal be slowly passed
over a bottle containing this poison, and the animal happen to
inspire during the moment of the passage, it drops down dead
instantaneously, just as when the poison is applied in the form of a
liquid to the tongue or the stomach. On the other hand, the vapour
of chlorine possesses the property of arresting the poisonous
effects of prussic acid; and hence when an animal is all but dead
from the effects of this acid, it is sometimes suddenly restored to
life by holding its mouth over the vapour of chlorine.

During every moment of life in natural respiration a portion of the
air of the atmosphere passes through the air vesicles of the lungs
into the blood, while a quantity of carbonic acid gas is given off
from the blood, and is transmitted through the walls of these
vesicles into the atmosphere. Now that substances mixed with or
suspended in atmospheric air may be conveyed with it to the lungs
and immediately enter into the circulating mass, any one may satisfy
himself merely by passing through a recently painted chamber. The
vapour of turpentine diffused through the chamber is transmitted to
the lungs with the air which is breathed, and passing into the
current of the circulation through the walls of the air vesicles,
exhibits its effects in some of the fluid excretions of the body,
even more rapidly than if it had been taken into the stomach.

Facts such as these help us to understand the production and
propagation of disease through the medium of an infected atmosphere,
whether on a large scale, as in the case of an epidemic which
rapidly extends over a nation or a continent, or on a small scale,
in the sick chamber, the dissecting room, the church, and the
church-yard.

Thus it is universally known that, when the atmosphere is infected
with the matter of small-pox, this disease is produced with the same
and even with greater certainty than when the matter of small-pox is
introduced by the lancet directly into a blood-vessel in
inoculation.

It is equally well known that, when the air is infected by particles
of decomposing vegetable and animal matter, fevers are produced of
various types and different degrees of intensity; that the
exhalations arising from marshes, bogs, and other uncultivated and
undrained places, constitute a poison chiefly of a vegetable nature,
which produces principally fevers of an intermittent or remittent
type; and that exhalations accumulated in close, ill-ventilated, and
crowded apartments in the confined situations of densely-populated
cities, where little attention is paid to the removal of putrefying
and excrementitious matters, constitute a poison chiefly of an
animal nature, which produces continued fever of the typhoid
character. There are situations in which these putrefying matters,
aided by heat and other peculiarities of climate, generate a poison
so intense and deadly, that a single inspiration of the air in which
they are diffused is capable of producing almost instantaneous
death; and there are other situations in which a less highly
concentrated poison accumulates, the inspiration of which for a few
minutes produces a fever capable of destroying life in from two to
twelve hours. In dirty and neglected ships, in damp, crowded, and
filthy gaols, in the crowded wards of ill-ventilated hospitals
filled with persons labouring under malignant surgical diseases or
bad forms of fever, an atmosphere is generated which cannot be
breathed long, even by the most healthy and robust, without
producing highly dangerous fever.

3. The evidence is just as indubitable that exhalations arise from
the bodies of the dead, which are capable of producing disease and
death. Many instances are recorded of the communication of small-pox
from the corpse of a person who has died of small-pox. This has
happened not only in the dwelling-house before interment, but even
in the dissecting room. Some years ago five students of anatomy, at
the Webb-street school, Southwark, who were pursuing their studies
under Mr. Grainger, were seized with small-pox, communicated from a
subject on the dissecting-table, though it does not appear that all
who were attacked were actually engaged in dissecting this body. One
of these young men died. There is reason to believe that emanations
from the bodies of persons who have died of other forms of fever
have proved injurious and even fatal to individuals who have been
much in the same room with the corpse.

The exhalations arising from dead bodies in the dissecting room are
in general so much diluted by admixture with atmospheric air,
through the ventilation which is kept up, that they do not commonly
affect the health in a very striking or marked manner; and by great
attention to ventilation, it is no doubt possible to pursue the
study of anatomy with tolerable impunity. Yet few teachers of
anatomy deny that without this precaution this pursuit is very apt
to injure the health, and that, with all the precaution that can be
taken, it sometimes produces such a degree of diarrhœa, and at other
times such a general derangement of the digestive organs, as
imperatively to require an absence for a time from the dissecting
room and a residence in the pure air of the country. The same
statements are uniformly made by the professors of Veterinary
anatomy in this country. The result of inquiries which I have
personally made into the state of the health of persons licensed to
slaughter horses, called knackers, is, that though they maintain
their health apparently unimpaired for some time, yet that after a
time the functions of the nutritive organs become impaired, they
begin to emaciate, and present a cadaverous appearance, slight
wounds fester and become difficult to heal, and that upon the whole
they are a short-lived race.

The exhalations arising from dead bodies interred in the vaults of
churches, and in church-yards, are also so much diluted with the air
of the atmosphere, that they do not commonly affect the health in so
immediate and direct a manner as plainly to indicate the source of
these noxious influences. It is only when some accidental
circumstances have favoured their accumulation or concentration in
an unusual degree, that the effects become so sensible as obviously
to declare their cause. Every now and then, however, such a
concurrence of circumstances does happen, of which there are many
instances on record; but it may suffice for the present to mention
one, the particulars of which I have received from a gentleman who
is known to me, and on the accuracy of whose statements I can rely.

Mr. Hutchinson, surgeon, Farringdon-street, was called on Monday
morning, the 15th March, 1841, to attend a girl, aged 14, who was
labouring under typhus fever of a highly malignant character. This
girl was the daughter of a pew-opener in one of the large city
churches, situated in the centre of a small burial ground, which had
been used for the interment of the dead for centuries, the ground of
which was raised much above its natural level, and was saturated
with the remains of the bodies of the dead. There were vaults
beneath the church, in which it was still the custom, as it had long
been, to bury the dead. The girl in question had recently returned
from the country, where she had been at school. On the preceding
Friday, that is, on the fourth day before Mr. Hutchinson saw her,
she had assisted her mother during three hours and on the Saturday
during one hour, in shaking and cleansing the matting of the aisles
and pews of the church. The mother stated, that this work was
generally done once in six weeks; that the dust and effluvia which
arose, always had a peculiarly fœtid and offensive odour, very
unlike the dust which collects in private houses; that it invariably
made her (the mother) ill for at least a day afterwards; and that it
used to make the grandmother of the present patient so unwell, that
she was compelled to hire a person to perform this part of her duty.
On the afternoon of the same day on which the young person now ill
had been engaged in her employment, she was seized with shivering,
severe pain in the head, back, and limbs, and other symptoms of
commencing fever. On the following day all these symptoms were
aggravated, and in two days afterwards, when Mr. Hutchinson first
saw her, malignant fever was fully developed, the skin being burning
hot, the tongue dry and covered with a dark brown fur, the thirst
urgent, the pain of the head, back, and extremities severe, attended
with hurried and oppressed breathing, great restlessness and
prostration, anxiety of countenance, low muttering delirium, and a
pulse of 130 in the minute.

In this case it is probable that particles of noxious animal matter
progressively accumulated in the matting during the intervals
between the cleansing of it; and that being set free by this
operation and diffused in the atmosphere, while they were powerful
enough always sensibly to affect even those who were accustomed to
inhale them, were sufficiently concentrated to produce actual fever
in one wholly unaccustomed to them, and rendered increasingly
susceptible to their influence by recent residence in the pure air
of the country; for it is remarkable that miasms sometimes act with
the greatest intensity on those who habitually breathe the purest
air.

The miasms arising from church-yards are in general too much diluted
by the surrounding air to strike the neighbouring inhabitants with
sudden and severe disease, yet they may materially injure the
health, and the evidence appears to me to be decisive that they
often do so. Among others who sometimes obviously suffer from this
cause, are the families of clergymen, when, as occasionally happens,
the vicarage or rectory is situated very close to a full
church-yard. I myself know one such clergyman’s family, whose
dwelling-house is so close to an extremely full churchyard, that a
very disagreeable smell from the graves is always perceptible in
some of the sitting and sleeping rooms. The mother of this family
states that she has never had a day’s health since she has resided
in this house, and that her children are always ailing; and their
ill health is attributed, both by the family and their medical
friends, to the offensive exhalations from the church-yard.

Dr. Lyon Playfair states as follows in his communication—

There are two kinds of changes which animal and vegetable matters
undergo, when exposed to certain influences. These are known by the
terms of “decay” and “putrefaction.” Decay, properly so called, is a
union of the elements of organic matter with the oxygen of the air;
while putrefaction, although generally commencing with decay, is a
change or transformation of the elements of the organic body itself,
without any necessary union with the oxygen of the air. When decay
proceeds in a body without putrefaction, offensive smells are not
generated; but if the air in contact with the decaying matter be in
any way deficient, the decay passes into putrefaction, and putrid
smells arise. Putrid smells are rarely if ever evolved from
substances destitute of the element nitrogen.

Both decaying and putrefying matters are capable of communicating
their own state of putrefaction or of decay to any organic matter
with which they may come in contact. To take the simplest case, a
piece of decayed wood, a decaying orange, or a piece of tainted
flesh is capable of causing similar decay or putrefaction in another
piece of wood, orange, or flesh. In a similar manner the decaying
gases evolved from sewers occasion the putrescence of meat or of
vegetables hung in the vicinity of the place from which they escape.
But this communication of putrefaction is not confined to dead
matter. When tainted meat or putrescent blood-puddings are taken as
food, their state of putrefaction is frequently communicated to the
bodies of the persons who have used them as food. A disease
analogous to rot ensues, and generally terminates fatally. Happily
this disease is little known among us, but it is of very frequent
occurrence in Germany.

The decay or putrefaction communicated by putrid gases or by
decaying matters does not always assume one form, but varies
according to the organs to which their peculiar state is imparted.
If communicated to the blood it might possibly happen that fever may
arise; if to the intestines, dysentery or diarrhœa might result; and
I think it might even be a question worthy of consideration, whether
consumption may not arise from such exposure. Certainly it seems to
do so among cattle. The men who are employed in cleaning out drains
are very liable to the attacks of dysentery and of diarrhœa; and I
recollect instances of similar diseases occurring among some
fellow-students, when I attended the dissecting-rooms.

The effects produced by decaying emanations will vary according to
the state of putrefaction or decay in which these emanations are, as
well as according to their intensity and concentration. Thus it
occurs frequently that persons susceptible to contagion may be in
the vicinity of a fever patient without acquiring the disease. I
know one celebrated medical man who attends his own patients in
fever without danger, but who has never been able to take charge of
the fever-wards in an infirmary, from the circumstance of his being
unable to resist the influence of the contagion under such
circumstances. This gentleman has had fever several times. This
shows that the contagion of fever requires a certain degree of
_concentration_ before it is able to produce its immediate effects.
A knowledge of this circumstance has induced several infirmaries
(the Bristol infirmary, for example) to abolish altogether
fever-wards and to scatter the fever cases indiscriminately through
the medical wards. Owing to this distribution, cases in which fever
is communicated to other patients or nurses in the infirmary are
very unfrequent, although they are far from being so in those
hospitals where the fever cases are grouped together.

I consider that the want of attention to the circumstance of the
concentration of decaying emanations is a great reason that the
effects of miasmata in producing fever is still a _questio vexata_.
Thus there may be many church-yards and sewers evolving decaying
matter, and yet no fever may occur in the locality. Some other more
modified effect may be produced, according to the degree of
concentration of the decaying matter, such as diarrhœa or even
dysentery; or there may be no perceptible effects produced, although
the blood may still be thrown into a diseased state which will
render it susceptible to any specific contagion that approaches. It
must be remembered that decaying exhalations will not always produce
similar effects, but that these will vary not only according to the
concentration, but also according to the state of decomposition in
which the decaying matters are.

The rennet for making cheese is in a peculiar state of decay, or
rather is capable of a series of states of decay, and the flavour of
the cheese manufactured by means of it varies also according to the
state of the rennet. Just so with the diseases produced by the
peculiar state or concentration of decaying matters or of specific
contagions. When the Asiatic cholera visited this country many of
the towns were afflicted with dysentery before the cholera appeared
in an unquestionable form. In like manner the miasmata evolved from
church-yards may produce injurious effects which may not be
sufficiently marked to call attention until they assume a more
serious form by becoming more concentrated. But notwithstanding the
absence of marked effects, it is extremely probable that constant
exposure to miasmata may produce a diseased state of the blood. Thus
I had occasion to visit and report upon, amongst other matters, the
state of slaughter-houses in Bristol. These are generally situated
in courts, very inefficiently ventilated, as all courts are. I
remarked that the men employed in the slaughter-houses had a
remarkably cadaverous hue, and this was participated in a greater or
less degree by the inhabitants of the court. So much was this the
case, that in a court where the smells from the slaughter-house were
so offensive that my companion had immediately to retire from
sickness, I immediately singled out one person as not belonging to
the court from a number of people who ran out of their houses to
inquire the object of my visit. The person who attracted my
attention from her healthy appearance compared with the others, had
entered this court to pay a visit to a neighbour.

§ 11. That conclusions respecting such immensely important effects can only be established by reasonings on facts frequently so scattered over distant times and places as to require much research to bring them together; that those conclusions are still open to controversy, and have hitherto been maintained only by references to statements of distant observations, whilst regularly sustained examinations of the events occurring daily in our large towns might have placed them beyond a doubt; may be submitted as showing the necessity of some public arrangements to ensure constant attention, and complete information on these subjects, as the basis of complete measures of prevention.

§ 12. The conclusions, however, which appear to be firmly established by the evidence, and the preponderant medical testimony, are on every point, as to the essential character of the physical evils connected with the practice of interment, so closely coincident with the conclusions deduced from observation on the continent, that from Dr. Riecke’s report (and to which a prize was awarded by an eminent medical association), in which the preponderant medical opinions are set forth, they may be stated in the following terms:—

“The general conclusions from the foregoing report may be given as follows:

“The injurious effect of the exhalations from the decomposition in question upon the health and life of man is proved by a sufficient number of trustworthy facts;

“That this injurious influence is by no means constant, and depends on varying and not yet sufficiently explained circumstances;

“That this injurious influence is manifest in proportion to the degree of concentration of putrid emanations, especially in confined spaces; and in such cases of concentration the injurious influence is manifest in the production of asphyxia and the sudden and entire extinction of life;

“That, in a state less concentrated, putrid emanations produce various effects on the nerves of less importance, as fainting, nausea, head-ache, languor;

“These emanations, however, if their effect is often repeated, or if the emanations be long applied, produce nervous and putrid fevers; or impart to fevers, which have arisen from other causes, a typhoid or putrid character;

“Apparently they furnish the principal cause of the most developed form of typhus, that is to say, the plague (_Der Bubonenpest_). Besides the products of decomposition, the contagious material may also be active in the emanations arising from dead bodies.”

§ 13. Such being the nature of the emanations from human remains in a state of decomposition, or in a state of corruption, the obtainment of any definite or proximate evidence of the extent of the operation of those emanations on the health of the population nevertheless appears to be hopeless in crowded districts. In such districts the effects of an invisible fluid have not been observed, amidst a complication of other causes, each of a nature ascertained to produce an injurious effect upon the public health, but undistinguished, except when it accidentally becomes predominant. The sense of smell in the majority of inhabitants seems to be destroyed, and having no perception even of stenches which are insupportable to strangers, they must be unable to note the excessive escapes of miasma as antecedents to disease. Occasionally, however, some medical witnesses, who have been accustomed to the smell of the dissecting-room, detect the smell of human remains from the grave-yards, in crowded districts; and other witnesses have stated that they can distinguish what is called the “dead man’s smell,” when no one else can, and can distinguish it from the miasma of the sewers.

In the case of the predominance of the smell from the grave-yard, the immediate consequence ordinarily noted is a head-ache. A military officer stated to me that when his men occupied as a barrack a building which opened over a crowded burial-ground in Liverpool, the smell from the ground was at times exceedingly offensive, and that he and his men suffered from dysentery. A gentleman who had resided near that same ground, stated to me that he was convinced that his own health, and the health of his children had suffered from it, and that he had removed, to avoid further injury. The following testimony of a lady, respecting the miasma which escaped from one burial-ground at Manchester, is adduced as an example of the more specific testimony as to the perception of its effects. This testimony also brings to view the circumstance that in the towns it is not only in surface emanations from the grave-yards alone that the morbific matter escapes.

You resided formerly in the house immediately contiguous to the
burying-ground of —— chapel, did you not?—Yes I did, but I was
obliged to leave it.

Why were you so obliged?—When the wind was west, the smell was
dreadful. There is a main sewer runs through the burying-ground, and
the smell of the dead bodies came through this sewer up our drain,
and until we got that trapped, it was quite unbearable.

Do you not think the smell arose from the emanations of the sewer,
and not from the burying-ground?—I am sure they came from the
burying-ground; the smell coming from the drain was exactly the same
as that which reached us when the wind was west, and blew upon us
from the burying-ground. The smell was very peculiar; it exactly
resembled the smell which clothes have when they are removed from a
dead body. My servants would not remain in the house on account of
it, and I had several cooks who removed on this account.

Did you observe any effects on your health when the smells were
bad?—Yes, I am liable to head-aches, and these were always bad when
the smells were so also. They were often accompanied by diarrhœa in
this house. Before I went there, and since I left, my head-aches
have been very trifling.

Were any of the other inmates of the house afflicted with illness?—I
had often to send for the surgeon to my servants, who were liable to
ulcerated sore throats.

And your children, were they also affected?—My youngest child was
very delicate, and we thought he could not have survived; since he
came here he has become quite strong and healthy, but I have no
right to say the burying-ground had any connexion with his health.

§ 14. In the course of an examination of the Chairman and Surveyor of the Holborn and Finsbury Division of Sewers, on the general management of sewers in London, the following passage occurs:—

“You do not believe that the nuisance arises in all cases from the
main sewers? (Mr. Roe)—Not always from the main sewers. (Mr.
Mills)—Connected with this point, I would mention, that where the
sewers came in contact with church-yards, the exudation is most
offensive.

“Have you noticed that in more than one case?—Yes.

“In those cases have you had any opportunities of tracing in what
manner the exudation from the church-yards passed to the sewer?—It
must have been through the sides of the sewers.

“Then, if that be the case, the sewer itself must have given
way?—No; I apprehend even if you use concrete, it is impossible but
that the adjacent waters would find their way even through cement;
it is the natural consequence. The wells of the houses adjacent to
the sewers all get dry whenever the sewers are lowered.

“You are perfectly satisfied that in the course of time
exudations very often do, to a certain extent, pass through the
brick-work?—Yes; it is impossible to prevent it.

“Have you ever happened to notice whether there was putrid matter in
all cases where the sewer passed through a burial-ground?—The last
church-yard I passed by was in the parish of St. Pancras, when the
sewer was constructing. I observed that the exudation from it into
the sewer was peculiarly offensive, and was known to arise from the
decomposition of the bodies.

“At what distance was the sewer from the church-yard where you found
that?—Thirty feet.”

Mr. Roe subsequently stated—

“Mr. Jacob Post, living at the corner of Church-street, Lower Road,
Islington, stated to our clerk of the works, when we were building a
sewer opposite Mr. Post’s house, that he had a pump, the water from
the well attached to which had been very good, and used for domestic
purposes; but that, since a burying-ground was formed above his
house, the water in his well had become of so disagreeable a flavour
as to prevent its being used as heretofore: and he was in hopes that
the extra depth of our sewer would relieve him from the drainage of
the burying-ground, to which he attributed the spoiling of his
water.”

Professor Brande states that he has “frequently found the well-water of London contaminated by organic matters and ammoniacal salts,” and refers to an instance of one well near a church-yard, “the water of which had not only acquired odour but colour from the soil;” and mentions other instances of which he has heard, as justifying the opinion, that as “very many of these wells are adjacent to church-yards, the accumulating soil of which has been so heaped up by the succession of dead bodies and coffins, and the products of their decomposition, as to form a filtering apparatus, by which all _superficial_ springs must of course be more or less affected.” Some of the best springs in the metropolis are, fortunately, of a depth not likely to be considerably affected by such filtration. In Leicester, and other places, I have been informed of the disuse of wells near church-yards, on account of the perception of a taint in them. The difficulty of distinguishing by any analysis the qualities of the morbific matter when held in solution or suspension in water, in combination with other matters in towns, and the consequent importance of the separate examination already given to those qualities, may be appreciated from such cases as the following, which are by no means unfrequent. In the instance of the water of one well in the metropolis, which had ceased to be used, in consequence of an offensive taste (contracted, as was suspected, from the drainage of an adjacent church-yard), it was doubted whether it could be determined by analysis what portion of the pollution arose from that source, what from the leakage of adjacent cesspools, and what from the leakage of coal-gas from adjacent gas-pipes. In most cases of such complications, the parties responsible for any one contributing source of injury are apt to challenge, as they may safely do, distinct proof of the separate effect produced by that one. Popular perceptions, as well as chemical analysis, are at present equally baffled by the combination, and complaints of separate injuries are rarely made. If, therefore, the combined evil is to remain until complaints are made of the separate causes, and their specific effects on the health, and until they can be supported by demonstration, perpetual immunity would be ensured to the most noxious combinations.

The effects of unguarded interments have, however, as will subsequently be noticed, been observed with greater care on the continent, and the proximity of wells to burial-grounds has been reported to be injurious. Thus it is stated in a collection of reports concerning the cemeteries of the town of Versailles, that the water of the wells which lie _below_ the church-yard of St. Louis could not be used on account of its stench. In consequence of various investigations in France, a law was passed, prohibiting the opening of wells within 100 metres of any place of burial; but this distance is now stated to be insufficient for deep wells, which have been found on examination to be polluted at a distance of from 150 to 200 metres. In some parts of Germany, the opening of wells nearer than 300 feet has been prohibited.

§ 15. Where the one deleterious cause is less complicated with others, as in open plains after the burial of the dead in fields of battle, the effects are perceived in the offensiveness of the surface emanations, and also in the pollution of the water, followed by disease, which compels the survivors to change their encampments.

The fact is thus adduced in the evidence of Dr. Copeland:—

“It is fully ascertained and well recognized that the alluvial soil, or whatever soil that receives the exuviæ of animal matter, or the bodies of dead animals, will become rich in general; it will abound in animal matter; and the water that percolates through the soil thus enriched will thus become injurious to the health of the individuals using it: that has been proved on many occasions, and especially in warm climates, and several remarkable facts illustrative of it occurred in the peninsular campaigns. It was found, for instance, at Ciudad Rodrigo, where, as Sir J. Macgregor states in his account of the health of the army, there were 20,000 dead bodies put into the ground within the space of two or three months, that this circumstance appeared to influence the health of the troops, inasmuch as for some months afterwards all those exposed to the emanations from the soil, as well as obliged to drink the water from the sunk wells, were affected by malignant and low fevers and dysentery, or fevers frequently putting on a dysenteric character.”

§ 16. In the metropolis, on spaces of ground which do not exceed 203 acres, closely surrounded by the abodes of the living, layer upon layer, each consisting of a population numerically equivalent to a large army of 20,000 adults, and nearly 30,000 youths and children, is every year imperfectly interred. Within the period of the existence of the present generation, upwards of a million of dead must have been interred in those same spaces.

§ 17. A layer of bodies is stated to be about seven years in decaying in the metropolis: to the extent that this is so, the decay must be by the conversion of the remains into a gas, and its escape, as a miasma, of many times the bulk of the body that has disappeared.

§ 18. In some of the populous parishes, where, from the nature of the soil, the decomposition has not been so rapid as the interments, the place of burial has risen in height; and the height of many of them must have greatly increased but for surreptitious modes of diminishing it by removal, which, it must be confessed, has diminished the sanitary evil, though by the creation of another and most serious evil, in the mental pain and apprehensions of the survivors and feelings of abhorrence of the population, caused by the suspicion and knowledge of the disrespect and desecration of the remains of the persons interred.

§ 19. The claims to exemption in favour of burial-grounds which it is stated are not overcrowded would perhaps be most favourably considered by the examination of the practice of interment in the new cemeteries, where the proportion of interments to the space is much less.

§ 20. I have visited and questioned persons connected with several of these cemeteries in town and country, and I have caused the practice of interments in others of them to be examined by more competent persons. The inquiry brought forward instances of the bursting of some leaden coffins and the escape of mephitic vapour in the catacombs; the tapping of others to prevent similar casualties; injuries sustained by grave-diggers from the escapes of miasma on the re-opening of graves, and an instance was stated to me by the architect of one cemetery, of two labourers having been injured, apparently by digging amidst some impure water which drained from some graves. No precedent examination of the evils affecting the public health, that are incident to the practice of interment, appears to have been made, no precedent scientific or impartial investigation appears to have been thought necessary by the joint-stock companies, or by the Committees of the House of Commons, at whose instance privileges were conferred upon the shareholders: no new precautionary measures or improvements, such as are in use abroad, appear consequently to have been introduced in them; the practice of burial has in general been simply removed to better looking, and in general, better situated places. The conclusion, however, from the examination of these places (which will subsequently be reverted to) is, that if most of the cemeteries themselves were in the midst of the population, they would, even in their present state, often contribute to the combination of causes of ill health in the metropolis, and several of the larger towns.

§ 21. It has been considered that all danger from interments in towns would be obviated if no burials were allowed except at a depth of five feet. But bodies buried much deeper are found to decay; and so certain as a body has wasted or disappeared is the fact that a deleterious gas has escaped. In the towns where the grave-yards and streets are paved, the morbific matter must be diffused more widely through the subsoil, and escape with the drainage. If the interments be so deep as to impede escapes at the surface, there is only the greater danger of escape by deep drainage and the pollution of springs.

Dr. Reid detected the escape of deleterious miasma from graves of more than 20 feet deep. He states—

In some churchyards I have noticed the ground to be absolutely
saturated with carbonic acid gas, so that whenever a deep grave was
dug it was filled in some hours afterwards with such an amount of
carbonic acid gas that the workmen could not descend without danger.
Deaths have, indeed, occurred occasionally in some churchyards from
this cause, and in a series of experiments made in one of the
churchyards at Manchester, where deep graves are made, each capable
of receiving from 20 to 30 bodies, I found in general that a grave
covered on the top at night was more or less loaded with carbonic
acid in the morning, and that it was essential, accordingly, to
ventilate these grave-pits before it was safe to descend.

This I effected on some occasions by means of a small chauffer
placed at the top, and at one end of the grave a tube or hose being
let down from it to the bottom of the grave. The fire was sustained
by the admission of a small portion of fresh air at the top, and the
air from the bottom of the grave was gradually removed as the upper
stratum was heated by the fire around which it was conveyed; and
when it had been once emptied in this manner a small fire was found
sufficient to sustain a perpetual renewal of air, and prevent the
men at work in the grave-pits from being subject to the extreme
oppression to which they are otherwise liable, even when there may
be no immediate danger. A mechanical power might be used for the
same purpose; and chemical agents, as a quantity of newly slaked
lime, are frequently employed, as they absorb the carbonic acid.
From different circumstances that have since occurred, it appears to
me probable that numerous examples of strata or superficial soil
containing carbonic acid may be more frequently met with than is
generally suspected, and that while in churchyards the presence of
large quantities of carbonic acid may be frequently anticipated, its
presence must not always be attributed solely to the result of the
decomposition of the human body.

The amount of carbonic acid that collects within a given time in a
deep grave-pit intended to receive 20 or 30 bodies, is much
influenced by the nature of the ground in which it is dug. In the
case referred to, the porous texture of the earth allowed a
comparatively free aerial communication below the surface of the
ground throughout its whole extent. It was, in reality, loaded with
carbonic acid in the same manner as other places are loaded with
water; it was only necessary to sink a pit, and a well of carbonic
acid was formed, into which a constant stream of the same gas
continued perpetually to filter from the adjacent earth, according
to the extent to which it was removed. From whatever source,
however, the carbonic acid may arise, it is not the less prone to
mingle with the surrounding air, and where the level of the floor of
the church is below the level of the churchyard, there the carbonic
acid is prone to accumulate, as, though it may be ultimately
dispersed by diffusion, it may be considered as flowing in the same
manner in the first instance as water, where the quantity is
considerable.

Again, where the drainage of the district in which the church may be
placed is of an inferior description, and liable to be impeded
periodically by the state of the tide, as in the vicinity of the
Houses of Parliament, where all the drains are closed at high water,
the atmosphere is frequently of the most inferior quality. I am
fully satisfied, for instance, not only from my own observation, but
from different statements that have reached me, and also from the
observations of parties who have repeatedly examined the subject at
my request, that the state of the burying-ground around St.
Margaret’s church is prejudicial to the air supplied at the Houses
of Parliament, and also to the whole neighbourhood. One of them,
indeed, stated to me lately that he had avoided the churchyard for
the last six months, in consequence of the effects he experienced
the last time he visited it. These offensive emanations have been
noticed at all hours of the night and morning; and even during the
day the smell of the churchyard has been considered to have reached
the vaults in the House of Commons, and traced to sewers in its
immediate vicinity. When the barometer is low, the surface of the
ground slightly moist, the tide full, and the temperature
considerable—all which circumstances tend to favour the evolution of
effluvia both from the grave-pits and the drains—the most injurious
influence upon the air is observed. In some places not far from this
churchyard fresh meat is frequently tainted in a single night, on
the ground-floor, in situations where at a higher level it may be
kept without injury for a much longer period. In some cases, in
private houses as well as at the Houses of Parliament, I have had to
make use of ventilating shafts, or of preparations of chlorine, to
neutralize the offensive and deleterious effects which the
exhalations produced, while, on other occasions, their injurious
influence has been abundantly manifested by the change induced in
individuals subjected to their influence on removing to another
atmosphere. No grievance, perhaps, entails greater physical evils
upon any district than the conjoined influence of bad drainage and
crowded churchyards; and until the drainage of air from drains shall
be secured by the process adverted to in another part of this work,
or some equivalent measures, they cannot be regarded as free from a
very important defect.

The drainage of air from drains is, indeed, desirable under any
circumstances; but when the usual contaminations of the drain are
increased by the emanations from a loaded churchyard, it becomes
doubly imperative to introduce such measures; and if any one should
desire to trace the progress of reaction by which the grave-yards
are continually tending to free themselves of their contents, a very
brief inquiry will give him abundant evidence on this point. My
attention was first directed to this matter in London ten years ago,
when a glass of water handed to me at an hotel, in another district,
presented a peculiar film on its surface, which led me to set it
aside; and after numerous inquiries, I was fully satisfied that the
appearance which had attracted my attention arose from the coffins
in a churchyard immediately adjoining the well where the water had
been drawn. Defective as our information is as to the precise
qualities of the various products from drains, church-yards, and
other similar places, I think I have seen enough to satisfy me that
in all such situations the fluids of the living system imbibe
materials which, though they do not always produce great severity of
disease, speedily induce a morbid condition, which, while it renders
the body more prone to attacks of fever, is more especially
indicated by the facility with which all the fluids pass to a state
of putrefaction, and the rapidity with which the slightest wound or
cut is apt to pass into a sore.

Mr. Leigh, surgeon and lecturer of chemistry at Manchester, confirms the researches made by Dr. Reid in that town, and observes on this subject—

But the decomposition of animal bodies is remarkably modified by
external circumstances where the bodies are immersed in or
surrounded by water, and particularly, if the water undergo frequent
change, the solid tissues become converted into adipocire, a fatty
spermaceti-like substance, not very prone to decomposition, and this
change is effected without much gaseous exhalation. Under such
circumstances nothing injurious could arise, but under ordinary
conditions slow decomposition would take place, with the usual
products of the decomposition of animal matters, and here the nature
of the soil becomes of much interest. If the burial-ground be in
damp dense compact clay, with much water, the water will collect
round the body, and there will be a disposition to the formation of
adipocire, whilst the clay will effectually prevent the escape of
gaseous matter. If on the other hand the bodies be laid in sand or
gravel, decomposition will readily take place, the gases will easily
permeate the superjacent soil and escape into the atmosphere, and
this with a facility which may be judged of when the fact is stated,
that under a pressure of only three-fourths of an inch of water,
coal gas will escape by any leakage in the conduit pipes through a
stratum of sand or gravel of three feet in thickness in an
exceedingly short space of time. The three feet of soil seems to
oppose scarcely any resistance to its passage to the surface; but if
the joints of the pipes be enveloped by a thin layer of clay, the
escape is effectually prevented.

If bodies were interred eight or ten feet deep in sandy or gravelly
soils, I am convinced little would be gained by it; the gases would
find a ready exit from almost any practicable depth.

§ 22. He also expresses an opinion concurrent with that of other physiologists, that the effects of these escapes in an otherwise salubrious locality, soon attract notice, but their influence in obedience to the laws of gaseous diffusion, developed by Dalton and Graham, is not the less when scattered over a town, because in a multitude of scents they escape observation. In open rural districts these gases soon intermix with the circumambient air, and become so vastly diluted that their injurious tendency is less potent.

Other physical facts which it is necessary to develope in respect to the practice of interment may be the most conveniently considered in a subsequent portion of this report, where it is necessary to adduce the information possessed, as to the sites of places of burial, and the sanitary precautions necessary in respect to them.

§ 23. From what has already been adduced, it may here be stated as a conclusion,

That inasmuch as there appear to be no cases in which the emanations from human remains in an advanced stage of decomposition are not of a deleterious nature, so there is no case in which the liability to danger should be incurred either by interment (or by entombment in vaults, which is the most dangerous) amidst the dwellings of the living, it being established as a general conclusion in respect to the physical circumstances of interment, from which no adequate grounds of exception have been established;—

That all interments in towns, where bodies decompose, contribute to the mass of atmospheric impurity which is injurious to the public health.

_Injuries to the Health of Survivors occasioned by the delay of
Interments._

In order to understand the state of feeling of the labouring classes, and the general influence upon them, and even the effects on their health, of the practice of interment, it will be necessary to submit for consideration those circumstances which immediately precede the interment, namely, the most common circumstances of the death.

§ 24. In a large proportion of cases in the metropolis, and in some of the manufacturing districts, one room serves for one family of the labouring classes: it is their bed-room, their kitchen, their washhouse, their sitting room, their dining room; and, when they do not follow any out-door occupation, it is frequently their work room and their shop. In this one room they are born, and live, and sleep, and die amidst, the other inmates.

§ 25. Their common condition in large towns has been developed by various inquiries, more completely than by the census. As an instance, the results may be given of an inquiry lately made, at the instance and expense of Lord Sandon, by Mr. Weld, the secretary of the Statistical Society, as to the condition of the working classes resident in the inner ward of St. George’s, Hanover Square, and in the immediate vicinity of some of the most opulent residences in the metropolis. It appeared that 1465 families of the labouring classes had for their residence 2175 rooms, and 2510 beds. The distribution of rooms and beds was as follows:—

─────────────────────────┬─────────╥─────────────────────────┬───────── DWELLINGS. │Number of║ BEDS. │Number of │Families.║ │Families. ─────────────────────────┼─────────╫─────────────────────────┼───────── Single rooms for each │ 929║One bed to each family │ 623 family │ ║ │ Two rooms for each family│ 408║Two beds to each family │ 638 Three rooms for each │ 94║Three beds to each family│ 154 family │ ║ │ Four rooms for each │ 17║Four beds to each family │ 21 family │ ║ │ Five rooms for each │ 8║Five beds to each family │ 8 family │ ║ │ Six rooms for each family│ 4║Six beds to each family │ 3 Seven rooms for each │ 1║Seven beds to each family│ 1 family │ ║ │ Eight rooms for each │ 1║Dwellings without a bed │ 7 family │ ║ │ Not ascertained │ 3║Not ascertained │ 10 │ —————║ │ ————— Total │ 1,465║ Total │ 1,465 ─────────────────────────┴─────────╨─────────────────────────┴─────────

Out of 5945 persons 839 were found to be ill, and yet the season was not unhealthy. One family in 11 had a third room (and that not unoccupied) in which to place a corpse. This, however, appears to be a favourable specimen. From an examination made by a committee of the Statistical Society into the condition of the poorer classes in the borough of Marylebone, it appeared that the distribution of rooms amongst the portion of population examined showed that not more than one family in a hundred had a third room.

No. occupying part of a room, 159 families, and 196 single persons.
No. occupying one room 382 families, and 56 single persons.
No. occupying two rooms 61 families, and 2 single persons.
No. occupying three rooms 5 families, and 7 single persons.
No. occupying four rooms 1 families, and 0 single persons.

§ 26. Mr. Leonard, surgeon and medical officer of the parish of St. Martin’s-in-the-Fields, gives the following instances of the circumstances in which the poorest class of inhabitants die, which may be adduced as exemplifications of the dreadful state of circumstances in which the survivors are placed for the want of adequate accommodation for the remains immediately after death, and previous to the interment:—

There are some houses in my district that have from 45 to 60 persons
of all ages under one roof, and in the event of death, the body
often occupies the only bed till they raise money to pay for a
coffin, which is often several days. They are crowded together in
houses situate in Off-alley, the courts and alleys opening from
Bedfordbury, Rose-street, Angel-court, courts and alleys opening
from Drury-lane and the Strand, and even in places fitted up under
the Adelphi arches; even the unventilated and damp underground
kitchens are tenanted. Of course the tenants are never free from
fevers and diarrhœa, and the mortality is great. The last class
live, for the most part, in lodging-rooms, where shelter is
obtained, with a bed or straw, for from 2_d._ to 4_d._ per night,
and where this is not obtainable, the arches under the Adelphi
afford a shelter. In the lodging-rooms I have seen the beds placed
so close together as not to allow room to pass between them, and
occupied by both sexes indiscriminately. I have known six people
sleep in a room about nine feet square, with only one small window,
about fifteen inches by twelve inches; and there are some
sleeping-rooms in this district in which you cannot scarcely see
your hand at noon-day.