§ 135. In America, the later regulations manifest the tendency of the general experience to connect the regulations of interment with the general regulations for the protection of the public health, and to do this by single, specially qualified, paid, and responsible officers, rather than by Boards, or by any unskilled and honorary agency. The revised statutes of Massachusetts introduce the alternative of the appointment of a single officer. Every town is empowered to appoint a Board of Health, “or a health officer:” and the Board so appointed may appoint “a physician to the Board.” The Board acting by such officer may destroy, remove, or prevent, as the case may require, all nuisances, sources of filth, and causes of sickness. “Whenever any such nuisance or source of filth, or cause of sickness shall be found on private property, the Board of Health, or health officer, shall order the owner or occupant thereof at his own expense to remove the same within twenty-four hours, and if the owner or occupant shall neglect so to do, he shall forfeit a sum not exceeding one hundred dollars,” c. 21, s. 10. In cases of the refusal of entry into private property, on complaint to a magistrate, the magistrate may thereupon issue his warrant, “directed to the sheriff, or either of his deputies, or to any constable of such town, commanding them to take sufficient aid, and being accompanied by two or more members of the said Board of Health, between the hours of sunset and sunrise, to repair to the place where such nuisance, source of filth, or cause of sickness complained of may be, and to destroy, remove, or prevent, the same, under the direction of such members of the Board of Health.” The cleansing of the streets and houses is in most cases included in the functions of the Board of Health, or of the health officer, who regulates the removal of all refuse. Sec. 14, c. 21.
Every householder, when any of his family are taken ill, is required, on a penalty of one hundred dollars,—and every physician in the like penalty, on ascertaining that any person whom he visits is infected with the small-pox, or other disease dangerous to the public health,—to give immediate notice to the officers of public health, and they may, “unless the condition of such person is such as not to admit of his removal without danger of life,” remove him at once to the public hospital, whatever may be his station in life. Sec. 43 and 44, c. 21.
I have been favoured by Dr. Griscom, the inspector of interments at New York, with the copy of a report on the sanitary condition of the population of that city; which points out the great extent of deaths that are preventible by the adoption of means similar to those recommended in the General Report for the improvement of the sanitary condition of the population in Great Britain. This report, revealing extensive causes of death in New York, of which a large proportion of the population must have been unaware, may be adduced in proof of the immense services derivable from such an office, when zealously executed, in guarding against evils more destructive than wars.[[27]]
§ 136. In Munich, and in other towns in Germany, the visits and verification of the fact of death as the warrant for interment, is felt to be an important public security, and is highly popular; but one cause of its popularity is the jurisprudential functions of the officer of health, as means of preventing premature interments, and the escape of crime; for comparatively little attention appears yet to have been given to the practical means afforded by the office of tracing out and removing the causes of disease. The difficulty appears to be in respect to the jurisprudential functions of the officers of health to satisfy the public anxiety for the exercise of solemn care in every case of a multitude, where only one case in that multitude will, on the doctrine of chances, be a case calling for intervention; and where it is not provided, as it may and ought to be, that the discovery of that one shall be a matter of deep personal interest, instead of a mere source of trouble to the officer himself, his examinations may be expected to degenerate into a routine in which the intended security will fail in the less obvious cases.
In later times very comprehensive regulations as to the sites and management of cemeteries, and the service of officers of health, who have charge of the cemeteries, have been adopted throughout the Austrian dominions, and it is stated that they work very satisfactorily. On the occasion of every death by accident or violence, or of suspicion, a close inquiry as to the causes is made by the town physician. In Vienna a strict inquiry is made into every such death by the following officers, who all attend for that purpose;—namely, the town physician, the surgeon in chief, the professor of pathological anatomy, a lawyer, and in some cases, when analyses are required, a chemist. The results of their examinations are set forth in a “protocol,” a carefully prepared document, “bien motivé,” which sometimes takes two or three days in drawing up. The effect of this inquiry is the prevention, to a great extent, of crimes of violence, and the production of public confidence. It is stated to be highly popular.
§ 137. In Paris some cases have of late occurred, which have created much public uneasiness by the evidence they afforded of the defective organization of the service of the officers of health, and occasioned it recently to undergo an examination with the view to the adoption of better securities. It appears that, from a very early period, to satisfy the public solicitude, the law required the fact of the reality of a death to be verified by the personal visit and inspection of the Maire of the district of the city where the death had taken place. Subsequently, the Maires were allowed to delegate this duty to officers of their own nomination, persons qualified for the duties by a medical education, and who were called Officiers de Santé. But the appointments thus made by the Maires did not give public satisfaction; and in the year 1806 it was required that the persons appointed as “officiers de santé” by the Maires, should be chosen by them from amongst the doctors in medicine and surgery who were attached to the public hospitals. They appear, however, to have been mostly chosen without reference to public qualifications, from their own medical friends in private practice. This arrangement of appointing persons in private practice appears to have prevailed in other countries, and to have frustrated much of the benefits otherwise derivable from the institution. Thirty-five of these private practitioners are now appointed to perform the duty. Reports have gained ground that from negligent discharge of the duty, persons had even been buried alive, and that the verification had been given in cases of murder. On a recent commission of inquiry, the celebrated surgeon, M. Orfila, thus speaks of the necessity of the verification of the fact of the decease.
“It is possible to be interred alive! Interments may take place after murder, committed with the knife or by means of poison, without a suspicion being created that the death has been occasioned by violence. Ignorance or malevolence may attribute to crime deaths that have occurred from natural causes!”
After referring to ancient cases in which evidence was recorded of parties having been buried alive, he adduces the following recent instances of parties having been interred without due verification of the cause of death by the Officier de Santé:—
“We all know the case of the death of the grocer in the Rue de la Paix, who died of poison by arsenic. The interment took place after the verification of the death. In about a month afterwards I was called upon to examine the body as to the poison. Although the putrefaction of the corpse of the person who was of a very full habit had been much advanced, I was enabled to discover the presence of the arsenic by which the crime had been perpetrated.
“The widow Danzelle, of the Rue Beauregard, was found dead in her bed on the 1st of January, 1826. The certificate of the decease was given in due form to the relations to authorise the interment. In that certificate, given to M. le Commissaire de Police, the medical practitioner declared, ‘the death has taken place, and it appears that it has been occasioned by a commotion of the brain with hæmorrhage.’ ‘The deceased’ added he, ‘lived alone; she was found dead in her chamber, where she appeared to have fallen down.’ The municipal authorities caused the interment to be adjourned, and required a new examination of the body in the presence of the Commissioner of Police, assisted by two doctors in medicine. The result of the examination was, ‘that Madame the widow Danzelle had fallen under the blows of an assassin; the corpse bore five recent wounds in the neck, made with a cutting instrument, and the carotid artery had been divided.’