London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1957

[Report of the Medical Officer of Health for London County Council]

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increasing importance—some parishes ceased to make any returns at all. In the appendix
it will be seen that recorded deaths were declining after 1832 when the population was
increasing. Ogle discusses this point and shows that only half the deaths were being
recorded by 1839. In defence of the Parish Clerks it should be pointed out that the Company
of Parish Clerks made several attempts during the mid-eighteenth century to
persuade Parliament to let them register births and deaths rather than christenings and
burials (Christie, 1893). The Company had been trying to arrange this as far back as
1661 and on 9 December, 1664, there was presented to the King a humble petition in
which they stated that they had faithfully endeavoured to carry out their duties, but
that they were conscious of the imperfection of their records (Brett-James, 1933).
Morris (1751) also criticised the lack of information in the Bills. He considered that
the age groups were not sufficiently divided in infancy and pointed out that ' one
month in the earliest infancy produces greater alterations, than several years in manhood.'
The diseases were not connected with the several ages. It was known of what
disease people died and it was known how old they were at death but it was not possible
to determine the ages for any specific disease. ' Whereas, by annexing to every disease
the number of persons of each age dying thereof, it would appear, from remarks upon
a competent series of years, to what diseases persons of every age were particularly
subject. From whence, if these bills were extended throughout the kingdom, the growth
or declension of every particular disease would be clearly discovered. This would furnish
a constant fund of instruction to the intelligent physician ; and at particular critical
junctures might suggest cautions, not unworthy the attention of the legislative body
of the kingdom ; at least, would make a faithful report to it of the state of the national
health, and of the annual increase or diminution of the people.'
He also wanted to differentiate the numbers dying from smallpox as to whether
they had been inoculated or not. He wanted to fine 'the master of the house when the
patient sickened for neglect'. This he considered 'would furnish ample conviction,
and remove female prejudices upon this subject'. Smallpox, which was the scourge of
the 18th century, will be discussed later.
He thought dissenters should also keep bills but that the religion itself should not be
noted. To substantiate his remarks and to show that his proposals were feasible he even
went so far as to design a form which could be completed by the parish clerks—an early
example of form design !
Nomenclature
Many of the causes of death listed in the old Bills make strange reading today and
an attempt has been made later, when deaths in certain selected years are compared,
to equate the archaic but expressive causes of the past like ' griping of the guts' and
' bloody flux ' with the more pedestrian dysentery of today.
A less easily resolvable difficulty is the estimation of the accuracy of the classification
which necessitates an explanation of how the cause of death was ascertained.
The
Searchers
According to Graunt (1676) ' When any one dies, then cither by tolling, or ringing :
of a bell, or by bespeaking of a grave of the sexton, the same is known to the searchers, 5
corresponding with the said sexton. The searchers hereupon (who are antient matrons,
sworn to their office) repair to the place where the dead corps lies, and by view of the
same, and by other enquiries, they examine by what disease or casualty the corps died.
Hereupon they make their report to the parish clerk, and he, every Tuesday night,
carries in an account of all the burials and christenings happening that week, to the
clerk of the hall. On Wednesday the general account is made up and printed, and on
Thursday published and dispensed to the several families, who will pay four shillings
per annum for them '. A general account for the whole year was issued on the Thursday
before Christmas Day.
An opinion of the searchers in 1759 was that though they were often of low capacity
and this has resulted in ' objections to the truth and justness of the bills', nevertheless,
' even the wisest person in the parish would be unable to determine the distempers from
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