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13
The nature of the deaths that are registered without medical certificate
gives this year fresh proof of the necessity for an amendment of the registration
laws in this respect. In two infants of the 15 cases the cause of death
is acknowledged to be "unknown"; in five other instances, without any
medical evidence, the cause of death is entered as "premature birth"; in
another infant " convulsions "; in another " malformation." It is clear that
the practice of accepting such statements of the cause of death deprives society
of an important safeguard against crime.
Again, deaths have been registered without medical certificate as occurring
from "disease of the liver," from "phthisis," from "inflammation of the
lungs," and from " bronchitis." No reliance whatever can be placed on these
alleged causes, and statistics of great importance are pro tanto damaged by the
reception of such uncertified entries. Their untrustworthiness is constantly
illustrated in the cases where inquests are held after registration (cases not
included in the fifteen above noted) where the cause of death certified by the
coroner has often turned out to be something very different from what had
been stated to the registrar.
Another evil result of the existing system is that some medical practitioners
knowing that it is optional whether a certificate of cause of death be
produced or not, are less disposed to be accurate in granting such certificates,
and occasionally do so in a very unsatisfactory manner. It is difficult to
estimate the importance of this consideration upon the correctness of the
death registers.
Inquests where held in 1864 on not fewer than 99 persons, the proportion
of inquests to population being larger in St. Giles's parish than in any
other parish of the district assigned to the Coroner for Central Middlesex.
Three of these inquests were on newly born children who had been murdered.
Forty of the inquests were on children under five years of age, most of them
only a few days or months old. The coroner's court throws great protection
over helpless children, whose parents are too apt to neglect them, sometimes
it may be feared even wilfully. An instance of the negligence through which
children come by their deaths is found in the fact that 18 infants suffocated
in bed became the subject of the Coroner's enquiry, and this negligence becomes
suspicious in its character when it appears that close upon half of these
children were illegitimate. Most of the inquests on persons over the age of
infancy were on cases of sudden death and accident—often brought about by
intoxication.
section vii.—On the Sanitary Work of 1864.
The amount of sanitary inspection carried out by the Inspector under the
supervision of the Medical Officer of Health does not differ materially from
that of previous years. Each month some four hundred or more visits are
paid to houses in the poor quarters of the district, especially in streets where
epidemic disease is prevalent, and the services of the Inspector are also
extended to any better class houses that appear to be in need of them.
Amendment of sanitary defects thus discovered has been procured in the vast
majority of instances upon the service of notice or as the result of warnings
conveved by the Medical Officer. Few persons have thought proper to neglect
altogether these notices, though there is still too much delay in complying
with their requirements. It has been needful to take proceedings before a
magistrate in five cases only. The following is an abstract of the sanitary
work done, showing in several important respects an advance upon the work
of other years.