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a bare inspection' and hence 'there seems no other capacity in these searchers than
that of relating what they hear (Anon, 1759). Ogle quotes a writer of the article
'Bills of Mortality' in the 'Penny Cyclopaedia' (1835), in which it is shown that the
searchers demanded a fee of one shilling—sometimes they asked for more, and generally
got it—and sometimes even claimed as a perquisite the articles of dress of the deceased.
The writer concludes 'Such are the means at present employed in collecting mcdical
and political statistics in the Metropolis of England'. Charges had frequently been
levelled at the searchers and as early as 1665 John Bell came to their defence by pointing
out that they were selected by 'some of the eminentist men of the parish' and sworn to
their offices by a Justice of the Peace.
When the General Register Office was set up in 1837, steps were taken to revise the
system of registration of births, marriages and deaths which had remained the same
for the previous three hundred years. Lister, the first Registrar General, wrote in his
first Annual Report 'Long before the commencement of Registration, my attention
was turned towards an object admitted to be of great importance to the improvement
of Medical Science, namely,—to obtain a faithful statement of the cause of Death in the
column of the Register set apart for that purpose. It is obvious that such statements,
in order to obtain due credit, ought to be derived, whenever it is possible, from the
Medical Attendant of the deceased person '.
Although the searchers had disappeared it is of interest to note that it was not until
the Registration of Births and Deaths Act, 1874, that it became compulsory for all
death certificates to be signed by a medical practitioner.
Diagnostic
fashions
Graunt noticed that there were variations in the 'popularity of the various causes
of death from one year to another. For instance he commented on the fact that, in 1629,
2,596 deaths were classed as 'Chrisoms and infants' and only 52 as 'convulsions'.
In 1636 the number of deaths attributable to 'convulsions' had risen to 709 and the
number of' chrisoms and infants' dying had fallen to 1,895—as the difference between
the totals for the two years, 2,648 and 2,604 was so slight he concluded ' that this
difference is likely to be only a confusion in the accounts
He also wrote 'the tisick seems quite worn away; but it is probable the same is
entred (sic) as cough or consumption' and commented at length on the rising importance
of a new disease 'called by our bills, the stopping of the stomach' first mentioned in
1636, and on the fact that rickets was not mentioned until 1634, about which he posed
the question 'Whether that disease did first appear about that time or whether a disease,
which had been long before, did the first receive its name(p. 14). However, at the
end of a long disquisition he concluded by saying 'But of this let the learned physicians
consider, as I presume they have
From this account it is clear that even Graunt, writing contemporaneously, had
considerable difficulty in interpreting the Bills.
Calculation
of rates
Any comparison with the past, whether of mortality from all causes, or, if the
difficulties outlined earlier can be overcome, for specific diseases, can only be valid if
made in terms of rates and not absolute numbers. It is necessary therefore to ascertain
what population estimates are available for the varying areas covered by the Bills and
their reliability.
Estimates
Population
Graunt made a number of estimates of population, being prompted so to do when
finding it difficult to reconcile the numbers of deaths in the Bills with the assertion of
'one of eminent reputation' that there were 'in 1661 two millions of people more
than in 1625 before the great plague'. As he was hampered by not knowing the age
structure of the numbers dying he made his first estimate on the basis that the number
of child-bearing women might be double the births, 'since such women have scarce
more than one child in two years'. He found that the number of births was a little less
than the burials in those parishes where records were well kept and since there was on
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