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as not having been certified, either by a registered medical
practitioner or by a Coroner. None of them occurred in the
practice of unregistered male practitioners: three occurred in
the practice of midwives, the ages at death being 4 hours, 2
days, and 4 days respectively. The several deaths, with the
exception apparently of two of the midwives' cases, were duly
reported to the Coroner, who did not deem it necessary to hold
inquests. The causes of death, as registered, were premature
birth, in four cases; chest diseases, in three cases; convulsions,
in three cases; hemorrhage, in two cases; and old age, in one
case. In one case the cause of death, of a man aged 65, was
returned as "unknown" The ages of the deceased were 74,
73, 65, 52, 51, 48, 32, 14 months, 5 months, 28 days, 12 days,
4 days, 2 days, and 5 hours, respectively.
The attention of the Metropolitan Sanitary Authorities
was called, in 1887, to the subject of uncertified deaths, by
the Vestry of St. James, Westminster, that body being of
opinion that "no death should be registered unless the cause
thereof is certified either by a qualified medical practitioner,
or by the Medical Officer of Health for the District, or by
the Coroner upon inquisition." If it were meant that the
Medical Officer of Health should, as a part of his duty in
that capacity, inquire into and, if practicable, certify the
cause of death, I for one should respectfully prefer not to
come under any such obligation. It was stated that "at
present three to four per-cent. of the total deaths are not
certified at all." The proportion of deaths not certified, either
by registered medical practitioners or by coroners, had
steadily declined from 4.7 in 1879 to 2'7 in 1891. The percentage
varies within wide limits. In 1892 it was 09 per
cent. in London; 048 in Kensington; 2.7 in England and
Wales; ranging upwards to nearly 7 0 in Wales, where, probably,
certification is often impracticable, because, by reason
of the inaccessibility of the place of death, or remoteness from
a doctor's residence, medical attendance cannot be obtained.