My district is of the better description, inhabited either by the higher classes or by respectable working men, in which cases of deaths from crime are not very likely to occur; yet suspicious cases have from time to time happened (say six or eight annually in my district), to which I have thought it necessary to call the attention of the coroner. In one case, for example, a father, a labouring man, came to me to report the death of his infant child, stating the cause to be sickness and purging; there was then no cholera prevalent, and the rapidity of the disease was unusually great. My suspicion was excited as to the cause of the death, of which the father could give no clear account, and I sent word to the coroner that I thought the case was one which required inquiry. An inquest was held, and it turned out that the child had taken arsenic. The jury were of opinion that the death was entirely accidental,—that there had been no criminal intention. Had not the cause of the accident been developed by the inquiry, others of the family might have suffered in the same way. The other cases, which had escaped inquiry, have been chiefly those of accident, in which the death occurred at long periods subsequently, such as five or six weeks. I have found that it is a common practice to represent children as “still-born,” who were born alive, it not being necessary to register still-born children. By passing them off as still-born, burial is obtained for a smaller fee. But by this means cases of infanticide might be concealed. The fact of a married woman having been pregnant, and no proof existing as to the issue may hereafter be of legal importance. I have heard of many suspected cases of the wilful neglect of children, on whose deaths sums were obtainable from different burial societies. I cannot doubt that by inquiring much infantile death, which occurs from ignorance and incorrect treatment, would be prevented.
Inspection on the spot would, I consider, operate much more powerfully in prevention than in detection of crime. It would also occasion the stoppage of many existing but unsuspected causes of death. I have had reason to believe in the existence of a large amount of the preventible causes of death, with respect to which I have had no means of inquiry.
I was, during four years, apothecary to the Chorlton-on-Medlock Dispensary, during which time cases of sickness occurring in houses unfit for healthful habitation were constantly coming under my observation; many particular localities, affording far more than their due proportion of disease, owing to imperfect drainage and ventilation. Any one who had gone to inspect the body on the occurrence of death in those places, with powers to enforce sanitary measures, such as the removal of the survivors, the drainage and cleansing and ventilation of the premises, would, undoubtedly, have had the means of preventing much mortality.
§ 204. Mr. Leigh, the surgeon, whose testimony has already been cited, acts as one of the registrars of Manchester, and adverts to one source of mortality amongst infants which appears to be widely extended in the town districts. It is a practice with mothers who go to work to leave their children in the care of the cheapest nurses, who commonly neglect the infants, and have recourse to Dalby’s Carminative in large quantities to quiet them. It is his opinion that a large number of them fall a sacrifice to this and other improper modes of treatment. For example, says Mr. Leigh,
There is one evil of the extent of whose existence I had no conception, till I had for some time held the office of registrar. In decrying this, I would beg distinctly to disavow any private professional feeling. I allude to the great number of cases in which either no medical treatment at all, or what is nearly as bad, improper medical treatment, had been resorted to. I think, in nearly one-fourth of the deaths of infants reported to me, on inquiry I find that the little patients had been attended by incompetent and unqualified practitioners, chiefly retail druggists. Cases of croup and inflammation of the lungs which are eminently benefited by medical treatment, and in which prompt and decisive measures often preserve life, are treated by them, and I have reason to know by inquiry into the details of the cases that bleedings, calomel, and the remedies absolutely requisite in such cases are never, or very rarely, employed, whereas, under proper medical treatment, most of such cases would recover. Under these circumstances, these men themselves become fertile sources of mortality to the young.
In a subsequent communication, he states—
I find that in the month of January just passed I registered the deaths of 33 children under 4 years of age, of these 9 were attended by druggists; I believe all by one who has received no medical education: this is at the rate of 108 per annum. Three of the children had no assistance at all, making 12 out of 33 that might possibly have been saved. This number 33, however, is below the average of the year, for in the three months preceding there died in the district, of children under 4 years, 133, or 44 per month; and during the quarter ending 30th September, 1842, 169, or 56 per month; and the general number of those having no attendance, or being attended by druggists, is fully one-third, so that 100 per annum is much below the truth. I some time ago requested Mr. Bennet, the registrar for the Ancoats district, to make similar notes on the cases reported to him, and on inquiry from him I have reason to believe that the evil exists to as great an extent in his district as in mine.
I find that in most of the cases no efficient medical treatment was adopted. Cases of pneumonia are seldom or never bled, or proper remedies applied: the disease is probably not recognized, and if it were, the treatment and extent to which it should be pursued is not known to the parties prescribing.
A similar practice appears to be prevalent also in the mining districts of Staffordshire and Shropshire. (Vide Reports of the Sub-Commissioners for inquiring into employment in Mines, vol. I., pp. 22, 23; articles 182–6; and pp. 38, 39; pp. 305 to 315, and the recent report respecting the employment of children at Nottingham.) In the course of some recent inquiries by Dr. Lyon Playfair he found the increasing sale of opium in the manufacturing towns was ascribable to the increasing use of it in the form of carminative, or as it was named “quietness” for children, and that the consumption of opium by adults had diminished. On inquiring from the druggists who sold the opium what was the cause of the diminished consumption by the adults, the uniform answer was, the “distress of the times,” which compelled them to dispense with luxuries. He however ascertained clearly that from this terrible practice great numbers of children perish, sometimes suddenly from an overdose, but more commonly slowly, painfully, and insidiously. He was struck, however, with the fact of the increased proportions and rapidity of the births in the places where this infantile mortality was prevalent. It was remarked by the people themselves. So that there was no diminution of the numbers of children, but a woeful diminution of their strength and a proportionate increase of their burdensomeness. Those who escaped with life, became pale and sickly children, and it was very long before they overcame the effects arising from the pernicious practice; if indeed they ever did do so.[[41]]
The most serious consequences, arise from the omission of proper administrative securities for the safety of life in Scotland. On these Dr. Scott Alison states:—