INQUESTS.
A large proportion of deaths form the subject of enquiry in the Coroner’s Court. Last year the number was 172, viz., 152 in the Town sub-district and 20 in Brompton, equal to 6.4 per cent. of the total deaths. One hundred of the subjects of enquiry were below the age of five years, 80 being less than a year old, mostly in fact infants of a few hours, days, or weeks. Forty-eight inquests were held on persons between the ages of 5 and 60, and 24 on persons above the age of 60. The great majority of the deaths were due to disease. Thus of the 99 sudden deaths the causes of death as found by post mortem examination (and post mortem examinations were made in 154 out of the total of 172 cases) were as follows:—
Various diseases were specified in other six cases in which the deaths were not returned as “sudden.” Death was found to be caused by disease in many of the cases in which the deceased were “found dead,” either in bed or otherwise, viz., from
| Lungs, Diseases of the | 6 |
| Heart „ „ | 6 |
| Convulsions | 4 |
| Brain, Diseases of the, 2; Apoplexy 1 | 3 |
| Laryngitis 1; Spasm of the Glottis 1; Scrofula 1 | 3 |
| “Found Dead,” &c. | 4 |
| Total | 26 |
The accidental and violent deaths were caused as follows:—
| Falls | 7 |
| Barns | 1 |
| Drowned | 4 |
| Suffocation | 16 |
| Cut throat | 2 |
| Pistol shot | 2 |
| Hanging | 2 |
| Run over by railway train | 1 |
| Wilful Murder | 4 |
| “Accident,” “Violence” | 2 |
| Total | 41 |
With respect to the accidental or violent deaths it may be remarked that the 16 from suffocation were of infants and due to “accident.” One of the newly born infants was found in a box and another up a chimney; these being, as were some of the others, the children of single women. On four newly-born children the verdict of “murder” was found. In one case there had been “exposure,” in a second the child was found dead, and in the other cases the verdict was simply “wilful murder.” Of the four drowning cases one was suicidal. By hanging, cut-throat, and pistol-shot all the deaths recorded (two from each cause), were suicidal, making a total of seven suicidal deaths during the year. The remaining deaths by violence were accidentally caused.
Having carefully analysed the facts relating to these deaths as they appear in the weekly returns of mortality, I submit the results, which are, I think, worthy of attention. Of course the primary cause of an inquest being held is the absence of a medical certificate showing the cause of death. The reasons why certificates are not forthcoming, and therefore why inquests become necessary, may be inferred from certain particulars which appear in the returns, and may be summed up as follows:—
| Sudden Death | 99 |
| Found dead in bed (22) or otherwise (26) | 48 |
| Accident | 3 |
| Violence | 15 |
| Doubtful (none of the above reasons stated) | 7 |
| Total | 172 |
It is to the deaths from disease that I would draw particular attention, the bare facts appearing to point to a large amount of neglect of the sick, which, without explanation, would seem to border on the criminal. Fatal visceral diseases, it need hardly be said, present symptoms which the most ignorant cannot altogether overlook—fever, pain, exhaustion, &c.; and each disease has a more or less prolonged course, varying with the importance of the organ affected, and with the amount of care bestowed on the sufferer. It is not credible that any medical man would be unable to diagnose the existence of such a disease, e.g. as pneumonia, or would refuse to certify the cause of death of a patient who had died under his care. We are driven to the conclusion, therefore, that, in a great number of cases of disease, many of the victims being infants, no effort is made to obtain medical advice for the sufferers, and hence, when death ensues, an inquest becomes necessary, as there is no medical certificate to show the cause of death. A post-mortem examination is made, and then it becomes known that death was caused by a disease that might have been cured, and that certainly must have had a well-defined and often a lengthened course. Passing over such maladies as apoplexy and heart disease, it is only necessary to mention, in support of this view, such diseases as pneumonia, &c. (30 deaths); brain diseases (15); convulsions—a symptom rather than a disease (8); scrofula (5); syphilis (2); diarrhœa, diphtheria, &c. The question then arises, in connection with such cases as these, whether it is sufficient to record the cause of death? whether, in fact, some one should not be made responsible for the neglect to provide medical advice for a child who ultimately dies “suddenly” or is “found dead” as a consequence of an attack of pneumonia, that may have extended over one, two, or three weeks, or even a longer time? Not many weeks before this present writing one of the “Peculiar People” was found guilty of manslaughter, having neglected to provide medical attendance for his child, who died of pneumonia, although it was admitted that every care, otherwise, had been bestowed on the patient; and, notwithstanding the well-known fact that with such care a very large proportion of the cases, especially if one lung only is affected, will recover. It need scarcely be added that the parents’ neglect had its origin in conscientious motives, however mistaken and absurd. Can such a plea be made in all or many of the cases to which I have here alluded: and should negligent parents escape without punishment—without censure even?
True, the facts I have thus briefly brought under notice may be explained—and they certainly need explanation; for as they baldly appear in the returns of mortality they would seem to indicate an indifference to life which is not only shocking, but may be in some degree the cause of that terrible infantile mortality which all thinking persons deplore. I will only add that it is notorious that medical men are constantly called in to see children sick beyond the hope of recovery, in order that no fuss may arise after death—the death certificate being all-sufficient. No doubt in many cases, where the diagnosis is quite clear, the certificate is given, although the practitioner may be conscious of the neglect of the parents in applying for assistance when “too late;” and, I dare say, that in some at least of the cases which come before the Coroner the inquest has been brought about by the judicious refusal of medical men to give certificates under such circumstances. I venture to think, however, that a certificate should not be given in any such case, and that not only should an inquest be held, but that the mere fact of the responsible person in charge of the infant having failed to obtain that medical advice and assistance which the poor may have for the asking, should be regarded as establishing a prima facie charge of neglect, for which he or she should appear and answer at another tribunal in the absence of exculpatory evidence.