Death: 18thC Living Conditions, Part 7

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Perceived causes of death within the Bills of Mortality

Although the London Bills of Mortality are perhaps the best known and most complete set of records relating to death and disease we have from the 18th century, they were also compiled in many other towns, for example, Chester, Warrington, Dublin. They were initially begun in 1592 in order to document outbreaks of plague and other diseases in each parish, were compiled by the parish clerks and published on a weekly basis. Eventually, these were collected together and published as annual volumes.

The information in these Bills was obtained by searchers, elderly female pensioners with no medical training, who would look at the bodies and then decide the cause of death, either by their appearance, or the information they had been given by doctors or relatives of the deceased. A correspondent, writing to the Gentlemen’s Magazine in 1799 deplored the fact that:

John Graunt, one of the first British demographers, made scathing criticisms concerning the veracity of the searchers in his magnum opus, “Natural and Political Observations Made upon the Bills of Mortality” published in 1662. He suspected that the reason so few deaths appeared to be caused by venereal disease was because the searchers had been bribed, or of course, they may have just been particularly reticent about mentioning the subject. From the table below, we can see that there were only 81 recorded deaths from the French Pox, or syphilis.

Despite Graunt’s misgivings, the Bills of Mortality remain an important contribution to our knowledge concerning the death and disease of this period.

Although many of these forms of death such as, horshoehead, headmouldshot and purples look strange to us, they obviously had meaning for contemporaries, whilst others, for example, convulsions, consumption, teeth and worms could cover a multitude of different ailments. Graunt, of course, was under no misapprehension that many of the diagnoses made by the searchers were wrong, but it is highly likely that the medical profession would have been no more accurate. Even today it is thought that some 25% of death certificates are inaccurate. However, outside London, the cause of death was recorded in only a small number of parish registers, for example, Leeds and Selby in the West Riding of Yorkshire.

London Bills of Mortality – Diseases and Casualties for the years 1783 and 1784

 17831784 17831784
Abortive and Stillborn636528Mortification211136
Apoplexy and Suddenly219207Rash00
Asthma and Phthisic199377Rheumatism38
Bleeding34Rising of the Lights00
Bloody Flux51Scald Head00
Bursten and Rupture517Scurvy54
Cancer6743Small Pox15501759
Canker 2Sore Throat226
Chicken Pox13Sores and Ulcers813
Childbed144133St Anthony’s Fire10
Cholick, Gripes and Twisting of the Guts  378Stoppage in the Stomach610
Cough, and Hooping Cough268467Thrush8565
Dropsy864830Vomiting and Looseness142
Fever, Malignant Fever, Spotted Fever, and Purples23131973Bit by a mad Dog02
Fistula04Broken Limbs13
French Pox4932Burnt1314
Gravel, Stone, and Strangury4335Drowned11097
Grief43Excessive Drinking48
Headmouldshop, Horshoehead, and Water in the Head1915Found Dead45
Inflammation308198Killed by Falls and several other Accidents7539
Itch00Killed themselves2623
   Total Buried1902917828

We must remember that for people living in the18th century death was never far away. A simple cut or broken bone could lead to blood poisoning, sepsis, and ultimately, without the benefit of modern antibiotics, death.

Infantile deaths – natural or infanticide?

The number of infant deaths as recorded in the London Bills of Mortality during this period was absolutely staggering. The total number of all deaths in 1783, was 19,029 and of this, 6,632 were infants under the age of two, i.e. 34.85%, whilst the figures for 1784 were hardly any better, 5,729 infant deaths out of a total of 17,828, i.e. 32.13%. What was the reason for these deaths? Apart from the diseases mentioned above, a far more sinister cause could have been infanticide.

As well as straightforward murder or abandonment, there is good reason to believe that the wet nursing profession was responsible for many infant deaths in both this and the following century.

The wet nurses and foster mothers, the “angel makers”, who were responsible for looking after babies in their charge, deliberately neglected them, especially if illegitimate, and if they were not, often at the behest of their natural mother, thereby causing an early death. According to Malcolmson there were very few indictments for infanticide during the second half of the eighteenth century in Britain. However, that is not to say that there was a failure to investigate cases of sudden death. As Jackson says:

Perhaps we should not be surprised at these low figures, and with so many children dying at birth it would be difficult to prove that death was intentional. Even today, it can be notoriously difficult to distinguish between infanticide and genuine cot deaths. It was well known that the smothering of babies by their mothers was a common occurrence, and contemporary commentators were damning in their criticism, as can be seen from a pamphlet published in 1757 by George Burrington:

It is interesting to note that nearly all those accused of infanticide were unmarried women. The stigma attached to having an illegitimate child must have been more than some women could bear, especially as this could mean instant dismissal from their jobs, and if the infant lived, not only would they lose their employment, and endure public shame, but would most probably be unable to support themselves and the child.

Hoffer in “Murdering Mothers: Infanticide in England and New England 1558-1803”concludes that: “married women were not accused of murdering their newborn babies.” Documented cases of married women being accused are exceptional. Perhaps the reason for this was that “child-murder or murderous neglect by married people was surprisingly widely condoned, virtually impossible to police, and rarely punished.” It would appear from the evidence throughout Europe that infanticide was viewed by a good proportion of the population as one of the means that parents used to save their other children from starvation.

It was to try and stop this situation that various individuals and philanthropic organisations set up foundling hospitals where unwanted children could be looked after and cared for. The 18th century saw an explosion of such hospitals, but tragically, the death rate was staggering. Nearly 80% of children into the Rouen hospital during the mid-eighteenth century died, and by the end of the century this had risen to the astounding figure of 95%. Between the years 1700-1800, the Madrid foundling hospital had a mortality rate of 75%, the Dublin hospital, one of 89%, and by the end of the century very few hospitals had a rate of under 60%.

It would seem that the main reason for this was the gross overcrowding these institutions had to contend with. In the 18th century, overcrowding on a huge scale was invariably accompanied by high rates of infectious disease. Many of the babies had come from the countryside and therefore had little or no resistance to urban diseases. Sanitation was, at the best, basic in the extreme, and this encouraged diseases such as infantile diarrhoea, and smallpox was always waiting in the wings, ready to strike. Finding enough wet-nurses to cope with all the infants must have posed an insoluble problem, and the children were farmed out to rural wet-nurses. When none could be found, babies were fed on pap or cow’s milk, and in the days before sterilization, this was a virtual death sentence.

Causes of death listed in the Bills of Mortality which are particularly relevant to infants

Abortive and Stillborn636528
Cough and Hooping Cough268467
Headmouldshot, Horshoead and Water in the Head1915

In the next article: The Medical Profession.

In this series:

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