WAITING MORTUARIES.
OF all the various methods that have been suggested or introduced for
the prevention of premature interment, none has been attended with such
satisfactory results as the erection of mortuaries (Leichenhäuser) in
Germany. These structures, described in pp. 294 _et seq._, ought to
be provided, as far as practicable, in every parish, and certainly
in every Sanitary District in the United Kingdom, and by the Boards
of Health in the United States, and adapted to the requirements of
the population. They should be of chaste and elegant design, well
ventilated; their atmosphere made antiseptic with living plants and
flowers, and by plenty of light; provided with baths and couches, and
a skilled attendant--edifices where both the dead and the apparent
dead can be deposited pending burial, cremation, or resuscitation.
Separate compartments are necessary for cases where death has been due
to accidents and for those who have succumbed to infectious diseases.
Every modern appliance should be introduced for the restoration of
such as may exhibit signs of returning consciousness, and of those in
whom, after sufficient time had elapsed, no sign of putrefaction was
observable. The temperature of the room should be kept at eighty-four
degrees, as suggested by Sir Benjamin Ward Richardson, and no
interment, cremation, _post-mortem_, or embalming should be permitted
until a medical examination by one or more experienced physicians
showed unequivocal signs of putrefaction. Perhaps the Royal Humane
Society, which during the last one hundred and fifty years has done
such splendid work in restoring the drowned and asphyxiated, might
be willing to extend the field of its benevolent operations to other
neglected forms of suspended animation where intelligent direction and
supervision is so much required.
A writer in the _British and Foreign Medico-Chirurgical Review_, 1855,
vol. xv., p. 75, says:--“The earliest movements in the direction of
means for the prevention of premature interments originated with
Winslow in France, followed by other well-known writers upon the signs
of death. It was Madame Necker, however, who embodied their suggestions
in a practicable form as submitted to the National Assembly, in
1792, by Count Berchshold. In the ninth year of the first French
Republic (1801) a project was entertained for the erection of six
‘temples funeraires’ in Paris, but came to no good, as attendant evils
preponderated. To Germany belongs the credit of having executed these
designs in such wise that they should not prove the positive sources
of more danger to the living than could be counter-balanced by the
occasional preservation of an individual from the risk of premature
interment. Believing that this risk had been prodigiously diminished
since the establishment of these institutions for the reception of
cases where doubt of the reality of death has existed, Hufeland, in
Weimar, devised the plan that Frankfort-on-the-Maine incorporated
with its reform in sepulture and establishment of extra-mural
cemeteries, in 1823. Hufeland’s plans have subsequently been adopted
and carried out in many other German States.... As a sanitary measure
the separation of the dead from the living, especially from among
the crowded poor, would be, apart from the not less important point
of verification of death, an incalculable benefit.... It behoves us
in this matter to learn another lesson from our neighbours, and to
take measures to prevent the occurrence of catastrophes too fearfully
horrible to contemplate in thought, too dreadful for the most vivid
imagination to realise. Science can hold out no token by which to
recognise the certainty of death. Sanitary police, at least in England,
is indifferent about the risk of a few burials alive, and thinks it
superfluous to prevent their occurrence.”
[THE GERMAN SYSTEM.]
That the people have a right to protection by the State against
preventable sources of danger, all civilised nations have acknowledged,
by the making of laws that guard their citizens from the invasion of
diseases of domestic or foreign origin, as well as many other perils.
But the German-speaking countries have gone further than any other
in this humane direction _by recognising apparent death as a special
peril to be guarded against by law_, in order to prevent living
burials. For this purpose they have established mortuaries connected
with cemeteries, in which the apparently dead are placed, under the
observation of physicians and attendants. Here the bodies are placed
upon tables, dressed in their ordinary clothes, amidst light, warmth,
and ventilation, surrounded by plants and floral tributes. Thus they
are kept from forty-eight to seventy-two hours, unless decomposition
sets in earlier, or the death was due to an infectious disease. Further
delay is allowed on application by the attending physician, or by some
member of the family interested. Cords connected with an alarm bell are
attached to the fingers, under the conviction that the least movement
of the body would arouse the attendant in an adjoining room. No doubt
these mortuaries have saved a certain number from being buried alive;
but the system can be improved by extending the observation until
such time as death is certain, for experience shows that no stated
limit of time can apply to all cases of trance and catalepsy, which
are the chief causes of apparent death. Some of these continue for
a week, and cases of even longer duration are not unknown. It often
happens that returning vital activity consists merely in scarcely
perceptible movements of the eyelids or the mouth, a change of the
complexion, slight moisture on the face, or a faint action of the
heart, or a warmth in that region, or feeble thoracic movements--all
of which might escape observation until the allotted time had expired,
and no contrivance, however delicately adjusted, could announce their
presence. Time alone will test the existence of life or death in such
cases.
The extensive literature on this subject shows that the struggle to
bring about the existing mortuary system in Germany was kept up for
many years before it obtained its measure of success. It was legalised
about the year 1795, after the physicians of Germany, France, and
Austria had shown the absolute necessity for it.
Mortuaries have continued in high favour with the people wherever they
have once been properly established; none, so far as the author has
been able to learn, have ever been abolished. At the present time the
city of Munich is constructing a mortuary at the Southern cemetery upon
a costly scale, surpassing in sumptuous accessories anything of the
kind before attempted in Germany. It will be not unworthy of the public
buildings of the city. This is an emphatic endorsement of the necessity
of the system by a people that for more than fifty years has given it a
thorough trial; and it is a strong argument for its adoption elsewhere.
The question suggests itself here: Why should not the English-speaking
peoples accept the long experience of a philosophical, painstaking,
clear-minded people like the Germans, supported as it is by many
sanitary and medical authorities in France, England, and the United
States, and establish these institutions in connection with existing
cemeteries, with such modifications as national habits, local tastes,
and customs may dictate?
The following practical suggestions are from a paper in the _Medical
Times_, vol. xvi., No. 415, p. 574, September 11, 1847, entitled, “On
the construction of houses for the reception of the dead; and on the
means to be used for the recovery of those who are only in trances or
fits, or in whom life is only impassive,” by Robert Brandon, Esq.,
Great Russell Street, Bloomsbury:--
“_DUBIÆ VITÆ REFUGIUM_; OR, ASYLUM FOR DOUBTFUL LIFE.
[ASYLUM FOR DOUBTFUL LIFE.]
“The building should be large enough to provide means for
resuscitation, and have room enough for the deposition of bodies
when epidemics are prevalent. There should be hot baths, for these
often are alone enough to recall the vital spark; and a kitchen to
prepare nourishment for those who are recovered, and for the porter
and other officers who would live on the building. The room for the
deposit of the bodies should communicate with the porter’s room by
means of a glass door, and every body should have a wire fixed to
the feet and hands, in communication with a bell, which bell must
ring in the porter’s room, in order to warn him should there be any
motion in those thought to be dead. There should be men and women on
the premises to use friction, a galvanic machine, and the implements
necessary for transfusion and artificial respiration. As the usual
and accepted signs of death are not signs to be relied on, so is
decomposition a true sign, and none should be buried until this be
present; but as the presence of decomposed animal matter would be
injurious, not only to the inmates of houses, but to the surrounding
inhabitants, and as it is inconvenient to the poor man who has but one
room to keep a body in that room, where he and his family eat, drink,
and sleep, asylums for the reception of those thought to be dead
should be constructed, and are absolutely necessary. Nor is it enough
to wait for decomposition, but we should endeavour to prevent this
by endeavouring to restore vitality by means of hot baths, external
heat, artificial respiration, galvanism, or transfusion; the first of
these is oftentimes enough. Now, I think it probable that many persons
would be recovered, thought to be dead, for, out of a number of those
reputed dead, a certain number have recovered--some by the sticking of
the pins into them which fixed the shrouds, some under the surgeon’s
knife, some from delays in the burial, and others from the accidental
overturning of the coffins, as we learn from a paper published on
premature burials. Some time since a woman was kept above ground for
a considerable time, as medical men could not decide if she were dead
or no. And at Constantinople a sailor the other day was attacked with
apoplexy, and a vein was opened in his arm; no blood came, and the
man was thought to be dead, but on the road to the grave blood began
to flow, and the supposed dead man recovered. There is now living in
Brussels a man who escaped from the grave; and another built a house
at Cologne to commemorate his escape. These cases will be enough to
show that we have no certain sign of death but decomposition; and,
if this be true, we must have asylums for the reception of bodies
previous to decomposition, and for the application of means which can
do no harm, and may do much good, such as those before indicated.
Medical men think that the absence of respiration and want of heart’s
action, with loss of motion and sensation, are signs of death; but
this is not the case, for many bodies which have been drowned have all
these signs present and yet recover. Again, infants are often born
without any action of the heart or lungs, and yet are recovered by
very simple means, such as the hot bath; and I myself have recovered
persons by stimulants who were thought to be dead. Many may be
recovered by transfusion (first introduced into this country by the
celebrated Dr. Blundel) when the heart still palpitates, but the
brain is insensible; or by stimulants given at that period; or by
hot bath, and the external application of heat; by galvanism, where
other means have failed; and these can do no harm. Since the brain
is insensible there can be no suffering; and many lives will be saved
by perseverance, and the skilful application of means which have
succeeded in isolated cases. Buildings for the reception of those
thought to be dead should be placed in cemeteries.
“I divide life into active and passive. Life is active when man is
in the enjoyment of all his faculties, intellectual and moral; when
the various organs necessary for circulation and respiration are in
play; when there is sensation, perception, and motion; and when the
sphincters are not relaxed. Passive life is that state hitherto called
death; but, according to me, death is decomposition.
“Nor should we despair at any period previous to this, since we
can give motion by galvanism; blood by transfusion; respiration by
artificial respiration; heat by this and the external application
of caloric; and by stimulants we can keep up that action which has
been excited by other means. Nor must we despair if we do not at once
succeed in our endeavours to recall life, for perseverance often
accomplishes that which at first sight seems impossible.
[MR. ROBERT BRANDON’S SUGGESTIONS.]
“Men have recovered from simulated death after being in the sea twenty
minutes, and I see no reason why, after disease, men may not also be
recovered from a state resembling death. Many who are left as dead
are only in fainting fits, some are in trances; and graves have been
opened where the buried man has been found to have eaten portions of
his own flesh, which of course he could not have done unless recovery
had taken place. How horrible to think that we may awake up in our
graves tormented with the pangs of hunger, unable scarce to breathe,
and finding all escape from our narrow cell impossible; the prisoner
in his grave has nought to do but to commend his soul afresh to his
Maker, and lay himself down to die! May not much of this be prevented
by asylums for doubtful life, by the application of reagents, and by
building vaults in our cemeteries instead of graves? I earnestly hope
that the day has arrived when we see these things in the proper light;
when our church-yards will be no longer overloaded with the remains
of those who, perhaps, might have lived had they been left a little
longer above ground--had they been transfused, or even buried in
vaults instead of graves, with a guardian to watch over their mortal
remains! Life may exist, but not be evident; but the non-evidence
of life is no proof of death, as many have been recovered in whom
life was only latent--in whom there was no action of the heart,
no respiration, no motion, no sensation. This has happened after
drowning, in infants born asphyxiated, in women after flooding, and
would happen much more often were the proper means applied in all
cases to recall life, and to ascertain those who may be recoverable.
Simple inspection is not enough to decide if a man be dead or not,
because persons are often only in trances or fainting fits when they
are thought to be dead; and I wish to insist on the fact that there is
no sign of death but decomposition, and that, therefore, none should
be buried until this sign be present, nor until an attestation of the
presence of decomposition be given by some surgeon.”
Referring to the universal fear of burying relatives alive, the
_Lancet_, September 20, 1845, vol. ii., p. 321, observed:--“It is
but little use to descant upon an evil without pointing out a remedy.
In Frankfort, Munich, and in various other towns, houses, properly
situated, have been fitted up for the temporary reception of the
dead. Corpses are there deposited immediately after death, and taken
care of until the signs of decomposition have become unequivocal,
medical assistance being at hand should symptoms of vitality manifest
themselves. By this simple plan all the objections which attend on the
retention of the dead in the dwellings of the poor may be obviated, and
at the same time their dread of burying their relatives whilst still
alive respected. This plan is evidently much preferable to that which
is followed in France. In the latter country, in the large towns, there
is in every district a medical inspector of the dead. The inspector
is informed of the death as soon as it has taken place, and within
a very limited time is bound to inspect the body and give a formal
certificate. This guarantee having been obtained, the inhumation of
the deceased is enforced by law within two or three days of the death.
Notwithstanding this precaution, cases have occurred, even during the
last few years, which appear to prove that inhumation has taken place
before life was quite extinct. We doubt, also, whether such early
interment could under any circumstances be enforced in our own country.
Some modification of the German plan is evidently what we must look
for in any system of legislation which may hereafter be decided on.”
These admirable suggestions from the leading medical journal were made
more than half a century ago; since that time, every year has brought
to light cases of living burial, and confirmed the urgent need of
reform; but nothing has been done until quite recently to awaken public
attention to their importance. The subject is of such a gruesome,
unpleasant, and depressing character that few people care to have
their names associated with a movement of this character, beneficent
though it is, and certain to save thousands of unfortunate people,
particularly women and children (who are more especially liable to
various forms of suspended animation), from such tragic occurrences.
The _Undertakers’ and Funeral Directors’ Journal_, August 22, 1895,
referring to the fact that in 1892 thirty-one thousand eight hundred
and ninety-two inquests were held in England, and to the urgent
necessity for the erection of mortuaries, says:--
[EVERYWHERE NEEDED.]
“The bountiful, or private enterprise, should provide these
mortuaries. But once let their necessity be recognised and the scheme
approved,--fashion leading the way,--then undertakers would readily
supply what was wanted. If not, then the local authority should take
the initiative. Mortuaries are sadly needed almost everywhere for
present purposes, as newspapers constantly affirm. In providing them,
care should be taken to build with an eye to future requirements when
it shall become customary if not compulsory to remove the dead from
among the living within a reasonable time after death.
“It is merciful sometimes to be inexorable, and what a lot of willing
and unnecessary discomfort and risk would be saved were it possible
and the practice to find a temporary resting-place for our departed
friends till we are ready to carry them befittingly to the tomb.”
MORTUARIES OF LONDON.
Each of the sanitary districts in the Metropolis is supposed to have
a mortuary of some kind for the reception of bodies from hospitals,
infirmaries, hotels, private houses, as well as from the river and
streets, or in transit to and from foreign countries, where they are
kept without charge for about five days, unless the public health
requires earlier interment. Hospitals, hotels, and families are
thus relieved of the presence of corpses, for convenience, and for
purposes of inquest. The mortuaries are nearly all plain, gloomy, and
depressing structures of brick. The best of them comprise a coroner’s
courtroom, coroner’s private room, the caretaker’s rooms, waiting
room, _post-mortem_ room, chapel, and viewing room connected. There is
no physician in attendance, and no autopsies are performed except by
surgeons upon their own cases, or for purposes of inquests. There are
no appliances or conveniences for resuscitation, as all the bodies are
regarded as dead, having been, for the most part, certified as such by
a medical practitioner, the exceptions being such as are taken from the
water or street by the police, or left there for inquest. The buildings
are usually well lighted, and some of the rooms contain fire-places,
but they are devoid of taste or ornamentation of any kind. The bodies
are kept in coffins, which, if there is any odour proceeding from them,
are screwed down. Permission is afforded for inspection by doctors or
by any of the family of the deceased on application to the keeper.
These mortuaries are kept clean, and decent and respectful treatment of
the bodies is enforced by regulations.
[THE LONDON MORTUARIES.]
The London County Council issued a return (No. 157) dated March 9,
1894, in pursuance of the Public Health (London) Act, 1891, relating to
coroners’ courts, mortuaries, etc., from which it appears that there
were fifty-one mortuaries in the sanitary districts of London up to
September 30, 1893. In most of these the accommodation is described
as “sufficient,” “good,” “well arranged,” “excellent,” “convenient.”
Others are of an opposite character. The one attached to the Town
Hall, Holborn district, is reported as “very small (about nine feet by
nine feet), inconvenient, and badly situated.” In the Poplar district
the mortuary “is an old crypt, quite unfit for the purpose, and has
no convenience for _post-mortems_.” At Ratcliffe, in the Limehouse
district, the mortuary “consists of a railway arch, and is very
unsuitable.” “There is a very small mortuary in the church-yard” at
Shadwell. The mortuary under the church-yard of St. Martin’s Church
(St. Martin’s-in-the-Fields) is reported “very imperfect.” The one in
the Southern Coroner’s district is situated under a railway arch, and
there is no mortuary-keeper. At St. Paul’s, Deptford, the mortuary
contains only one room, which serves for mortuary and _post-mortem_
room. Plumstead is possessed of an underground mortuary in the
church-yard, reported as “unsatisfactory.” The Lewisham district
has an “unsuitable” mortuary at the cemetery. Rotherhithe has “an
inadequate mortuary in the old burial-ground.” At St. George the
Martyr (Southwark) the mortuary is reported to be “inadequate and
unsuitable.” In the Strand district there is “no proper mortuary, but
a small dead-house attached to the Savoy Chapel is used.” Eltham,
Lea, and Kidbrooke, in the Plumstead district, have no mortuaries.
The part of Lambeth, S. and S.E., up the Clapham and Kennington Park
roads, is without a mortuary, and _bodies awaiting inquest are kept in
private houses_. Nor are there any mortuaries in the Greenwich district
(Hatcham), Wapping, or Mile End Old Town. Arrangements are reported to
be in progress for the enlargement of some of these establishments and
the erection of others.
No resuscitations are reported from any of these places, except in
the case of Ernest Wicks, a boy two years old, who was found lying
on the grass in Regent’s Park apparently dead, and resuscitated in
St. Marylebone Mortuary (after being laid out on a slab as dead) in
September, 1895, by the keeper, Mr. Ellis, assisted by Mrs. Ellis.
When the doctor arrived, the child was breathing freely, though still
insensible. The child was taken to the Middlesex Hospital, and was
reported by the surgeon to be recovering from a fit.
[HOSPITAL MORTUARIES.]
The London mortuaries stand well in the estimation of the authorities,
medical practitioners, and the people, on account of their usefulness
and convenience in relieving hotels and private houses of the dead
pending funerals, and in cases of deaths from infectious diseases, as
well as from accidents and acts of violence (amongst which suicides are
included) which require investigation. In consequence of this, there is
a disposition on the part of the authorities to enlarge and improve the
older and smaller ones, and to introduce the later conveniences. Those
in St. Marylebone and St. Luke’s are the latest examples, and could,
with comparatively little outlay, be rendered creditable and useful
establishments. First of all, they require the means of resuscitation,
such as are in use at the Royal Humane Societies’ Depôts, and at
the German mortuaries; also baths, couches, plants, flowers, and
mural ornaments, with a skilled nurse or caretaker, and a medical
practitioner either on the establishment or within telephone call. A
fundamental regulation should be added to the standing orders that,
when there is no sign of decomposition, bodies should be treated not
as dead but as sick needing attention, and to be kept under careful
observation. Such simple and inexpensive alterations, gradually
introduced by County, Parish, and District Councils, would, in the
course of time, bring about a greater respect for the dead, with proper
consideration for the apparently dead, besides increasing the feeling
of the sanctity of human life. In the course of time these improvements
would educate the public, and lead to the erection of new and handsome
structures of beautiful design, with appropriate artistic decorations,
such as are to be found in Munich and other parts of Germany.
The _Medical Times_, September 5, 1896, p. 569, says:--
“In a recent issue of the _Nursing Record_, there is an interesting
article on hospital mortuaries by a special commissioner.... At
Guy’s the mortuary only contains room for one body. There is a bier,
covered by a cradle and a red and white washing pall, and over this
is a shelf, on which are placed a cross, fresh flowers, and candles.
At St. Bartholomew’s the mortuary itself is certainly not a place
where one would care to find one’s dead. The bare, white-washed
walls, the sloping floor, the black lidless shells, covered by
white sheets, would depress most people even if they had no special
interest in them. That this is felt to some extent by the hospital
authorities is evident from the fact that, when a member of the
staff dies, they do their best to make other arrangements for the
disposal of the body until it is removed from the hospital. There
is an hospital not named [continues the _Medical Times_] where the
only place available as a mortuary is the wash-house. It would appear
that the managers of metropolitan hospitals do not believe in the
reality of death-counterfeits, and therefore make no arrangements for
resuscitation.”
MORTUARIES IN THE PROVINCES.
With the object of ascertaining the utility of these establishments,
the author wrote to the clerks or other officials in all the larger
towns in the United Kingdom, fifty in number, requesting copies of
the regulations, reports, etc. To these communications twenty-four
replies were received. Of these, only three sent copies of reports,
furnishing particulars of the number of bodies received, and the number
of inquests and _post-mortems_; three sent copies of regulations;
and the remainder do not publish either reports or regulations. One,
however (Poplar), states that the by-laws in use are approved by the
Local Government Board. The Chief Constable at the Town Hall, Salford,
writes, July 26, 1896--“There are three mortuaries in the borough, but
a separate record of the bodies laid in the mortuaries is not kept, and
no papers exist respecting them.” Mr. Hagger, the Vestry Clerk of the
Parish of Liverpool, says--“I know of no public mortuary in Liverpool
which is considered to be of such importance as to call for anything
in the shape of periodical reports.” Mr. R. Davidson, Governor of the
City Parish Poorhouse, Glasgow, writes, July 27, 1896--“I have never
had any reports relating to the mortuary here.” Mr. J. Jackson, Chief
Constable, Sheffield, writes, July 29--“We have never had papers or
reports connected with it (the mortuary), except the ordinary rules and
regulations for preserving decency, cleanliness, etc.” Similar replies
were received from Manchester, Swansea, Scarborough, Wigan, Bristol,
St. Mary’s (Islington), Dundee, and Catford. Mr. Robert Clinton, Master
of the Bethnal Green Workhouse, writes, July 30--“That their mortuary
has not been the subject of any reports,” and continues, “The subject
of persons being buried alive is a very important one, and should
arouse the interest of every intelligent person. Some method ought
certainly to be devised that will prevent anyone being subjected to so
horrible a fate.”
IRELAND.
The following extracts are from the report by Dr. J. E. Kenny, M.P.,
Coroner for the City of Dublin, received in January, 1894:--
[BURIAL CUSTOMS IN IRELAND.]
“There are no local laws in Dublin or in Ireland relative to the mode
of disposal of the dead, but the Sanitary Acts, which refer to the
United Kingdom of Great Britain and Ireland, can be availed of when
necessary to compel the burial of the dead within a reasonable period,
on the ground that an unburied body is a nuisance dangerous to public
health. There is, however, no fixed period. Among Roman Catholics it
is customary to bury the dead on the third or fourth day after death,
but there is no hard-and-fast rule.... The local burial authorities
usually require a medical certificate of death before opening the
grave, but there is no legal sanction for this, and it is merely the
custom. The coroner’s order for burial where an inquest is held does
away with the necessity of such certificates as those above referred
to, but _post-mortem_ examinations in these cases are the exception,
not the rule. A good many, however, are held on those who die in
local hospitals when the consent of the relatives or friends can
be obtained. I have not heard of any case of cremation in Ireland,
and earth-burial is the universal practice. Occasionally, when so
ordered by the will of the deceased, a body is removed to England
for cremation. I am myself rather in favour of cremation as a more
scientific and safer method of disposing of the dead.
“There are no chambers (mortuaries) of the kind referred to in this
question in Dublin, nor, so far as I know, in Ireland. I know of no
law as to the signs of death which must be recognised to exist before
burial is permitted, nor is there any officer on whom is thrown the
duty of ascertaining or deciding whether such exist or not.
[REFORMS URGENTLY NEEDED.]
“If cremation be generally adopted, it ought not to be performed
earlier than the third day after death, or perhaps not until some
unmistakable sign of decomposition has set in. I think this rule of
some such sign of decomposition setting in ought to apply to all
methods of disposal of the dead. Whenever well-marked warmth of the
body exists after apparent death, burial of any kind ought not to take
place until after a full and exhaustive examination by a competent
authority. In all doubtful cases I would suggest the application of
either a hot iron to some sensitive part of the body, or that a small
incision should be made over the course of some small artery, a person
being left to watch the result for some time in the latter case, so as
to take proper precautions against hæmorrhage, should the person be not
really dead. It might perhaps with advantage be made the law that in
every case of death or supposed death the body should be viewed by a
medical man, who, having satisfied himself that death had taken place,
would sign a certificate to that effect. If I understand rightly, such
is the law in France. I would, however, be opposed to any law making an
autopsy necessary in every case. The existence of such a public officer
as a coroner is undoubtedly of advantage in reference to cases of
sudden death or supposed death, as it is among such cases that mistakes
are most likely to occur. I can see no objection to the establishment,
at the public expense, of chambers for the reception of dead bodies
under certain circumstances.”
In reply to a similar inquiry Sir Charles A. Cameron, Superintendent
Medical Officer of Health, writes, August 10, 1896--“There is no public
mortuary in Dublin, but we are taking steps for the establishment of
one.”
It need hardly be said that the mortuaries described in these reports
have little in common with certain _Leichenhäuser_ of Germany or
the _Mortuaires d’ Attente_ urgently called for by various writers
of France, and proposed to be erected. The English mortuaries may
more appropriately be described as _morgues_ or depositories for
the homeless and neglected dead--useful for this purpose, but in no
respect fulfilling the requirements of the present day. Without skilful
attendants and scientific appliances for the restoration of suspended
life, to which all are liable, the apparently dead, if deposited
in such chilling establishments, would, through neglect, be more
likely to lose what spark of life remained than to have it kindled
into a flame and recover. The erection of mortuaries for the sake of
death-counterfeits, and in order to give peace of mind to doubting
friends, would no doubt be opposed chiefly on the ground of expense.
The outlay must come from the pockets of the rate-payers, who have been
accustomed to accept the cursory inspection of “the corpse” and the
certificate of the doctor as a satisfactory solution of any misgivings
as to the actuality of death. Under the circumstances it would not
be surprising if the unreflecting majority preferred to take what
they would consider to be an infinitesimal risk rather than to incur
the expense of the necessary outlay. This volume has been written to
remove such apathy, and, if possible, to arouse public attention to
the subject; and if the facts are, as the author believes, absolutely
true, and the danger real, other and abler contributions furnishing
the results of wider and more extensive investigations may be expected
to follow. It is believed that the expense of constructing tastefully
designed mortuaries in all populous districts could be met by a rate of
from a farthing to a penny in the pound, and in the smaller or thinly
populated districts groups of parishes could unite in providing such
useful institutions. At present, under existing customs, probably ten
times the amount required is annually expended in funeral trappings,
mourning habiliments, costly wreaths, and ornamental monuments (mainly
for the purpose of ostentatious display) than would provide temporary
resting-places for the real and apparently dead in every part of the
United Kingdom. The erection of such establishments, where the fact
of death in every case could be unequivocally demonstrated before
burial or cremation, would remove an ever present and consuming load of
anxiety from the hearts of thousands of sensitive souls.
CONTINENTAL MORTUARIES.
[CONTINENTAL MORTUARIES.]
The author is indebted to a “Treatise on Public Health,” by Albert
Palemberg and A. Newsholme, London, 1893, for the following details:--
BRUSSELS.
“This city possesses two mortuaries to which bodies are conveyed from
confined houses. One of these, within the town, only receives the
bodies of persons not having died of an infectious disease; all others
are conveyed to the mortuary at the Evère Cemetery....
“In times of epidemic the removal of corpses to the mortuary is
compulsory, and so also in other cases where the medical health
officer decides that it is necessary. No corpse, without special
permission, can be kept in the mortuary more than forty-eight hours
after death, but this interval can be shortened or lengthened by
special order.”
PARIS.
“By a decision of July 21, 1890, the Municipal Council of Paris has
decided to establish a mortuary in each of the cemeteries of the east
(Père La Chaise) and the north (Montmartre).... The mortuaries are
not available for the bodies of persons having died from infectious
disease.
“Bodies are only admitted to the mortuary--(1) On the written
application of the head of the family or some other persons competent
to undertake the funeral. (2) On the production of a certificate of
death from the doctor who attended the patient, stating that the death
was not caused by infectious disease.
“Up to the present time (1893) these mortuaries do not appear to have
been of great service, owing to the unwillingness of families to part
with their dead before the time of interment.
“‘La Morgue.’--This establishment only receives bodies on which a
_post-mortem_ examination is required, and the bodies of unknown
persons, placed there for recognition. In the hall where the bodies
are exposed, the temperature is kept several degrees below zero by a
system of refrigeration, thus retarding putrefaction. This system
would, in consequence of the low temperature, greatly retard or
prevent the revival of persons who may only be in a state of torpidity
from submergence, or of trance or catalepsy, who could be resuscitated
if warmth and other proper means were promptly applied to them.”
BERLIN.
“In some of the cemeteries mortuaries have been built, which are
placed at the disposal of the public by the authorities, with the
understanding that the corpses shall be taken from them as soon as
possible.
“The bodies of the poor are first placed in the depository of the old
cemeteries, within the city enclosure, whence they are removed by
night in carriages kept for the purpose to the mortuary in the large
cemetery outside the city, to be buried the next day. The Jews have
built a mortuary chapel in their new cemetery at Weissensee, which
fulfils all the conditions required by modern hygiene, and contains
everything necessary for washing, isolating, and enveloping the bodies.
“A new establishment, which answers its purpose perfectly, has
been built in the old cemetery--Charité--and is used for inquests,
_post-mortem_ examinations, etc., also for the exhibition of bodies
of unknown persons. The bodies are preserved from putrefaction by an
apparatus in which refrigeration is produced by ammonia and chloride
of calcium, as the Morgue in Paris.”
VIENNA.
“There is a mortuary in each district of the city to which are brought
corpses belonging to families who have imperfect accommodations.
“The district doctor must decide whether removal is necessary, as it
is his duty to register deaths and their causes. He should at the same
time examine into the state of the dwelling from a sanitary standpoint.
“In cases of sudden death, and when the cause of death is not
apparent, a _post-mortem_ examination must be made.
“The bodies of persons who have died from infectious disease must not
be taken to the common mortuaries, but to one built in the common
cemetery.
“Bodies must not be buried in the city. The principal cemetery is at
Kaiser-Ebersdorf, north-west of the city, and cost four millions of
marks.”
STOCKHOLM.
“Every parish possesses a mortuary vault. According to the regulations
of the Health Commission, bodies must not remain there more than
forty-eight hours in the hot season, and seventy-two in the cold
weather.”
The first modern mortuary was opened at Weimar, Germany, in 1791.
In a “Handbook for Travellers in Europe” for 1890, by W. Pembroke
Fetridge, p. 622, is the following description of the model mortuary in
Weimar:--
“The New Church-yard is a sweet place of its kind. Here may be seen
an admirable arrangement to prevent premature burials in cases of
suspended animation. In a dark chamber, lighted with a small lamp,
the body lies in a coffin. In its fingers are placed strings, which
communicate with an alarm clock; the least pulsation of the corpse
will ring the bell in an adjoining chamber, where a person is placed
to watch, when a medical attendant is at once supplied. There have
been several cases where persons supposed to be dead were thus saved
from premature burial.”
The _Middlesborough Gazette_ of 11th October, 1895, says:--
“Those who have visited burying grounds in some parts of the South
of England are well aware that tombs made in the shape of ‘waiting
rooms’ are largely in vogue with the well-to-do classes. One in a
little church-yard in Sussex was elegantly fitted up. The coffins were
placed on one side of the well-lighted vault, while on the opposite
side was a couch, chairs, and a table, together with books. The
relatives of the deceased--eccentric they may have been, we are not
prepared to say--visited the vault, access to which was gained by a
flight of steps, and there passed much of their time in reading, the
ladies doing needle work. But this sort of thing is only for the
rich. The poor must be protected from being buried alive by other and
more economical methods--namely, by stricter attention to the actual
and unmistakable evidences of death, and by careful registration on
medical certificates only.”
It would appear by the following announcement, that an effort is being
made to supply one of the several properly fitted mortuaries needed in
the French capital:--
“The _Pall Mall Gazette_ of September 21, 1895, announces a decided
novelty in the way of limited liability companies--the Mortuary
Waiting-room Company, which, it says, is on the point of being floated
in the French capital. Our contemporary says that the amount for
subscription is stated to be £20,000, and dividends at the rate of at
least 100 per cent. may, it is claimed, be confidently looked for. The
company undertake to provide separate waiting-rooms, of two classes,
in a large mortuary building. The alleged corpse will be comfortably
deposited there upon a couch, and carefully looked after till the
fact that it is a corpse shall have been established beyond question.
The waiting-rooms will be tastefully decorated, with everything about
them to welcome the revived tenant agreeably back to life. It is
interesting to hear that no shareholder’s heirs will be allowed to
visit him.”
Some sanitarians and funeral reformers urge with much reason that the
presence of the dead should not be allowed to endanger the health of
the living, and recommend that if death has occurred from infectious
disease, the body should be covered with charcoal and conveyed at once
to a mortuary chamber; and others advise early burials for all as soon
as possible. If, however, this volume has not demonstrated the danger
of such early burials, except where decay of the earthly vesture is
visible, it will have been written in vain.
The following recommendation from a well-known physician and surgeon
appears in _London_, p. 613, September 27, 1894:--
“Coroners’ Courts and Mortuaries,” a paper read at the Hygiene
Congress at Buda Pesth, by W. J. Collins, M.D., M.S., B.Sc., D.P.H.
(Lond.), L.C.C.
“I therefore hold that every inducement should be held out to the
poor by local authorities, by the provision of decent, suitable, and
attractive mortuaries, to allow their dead to be removed from danger
to the living to a place where sentiment shall be respected and
sanitation satisfied.”
THE UTILITY OF MORTUARIES.
[THE MAYOR OF MUNICH’S OPINION.]
During the discussion on Premature Burials in the press, the erection
of mortuaries (chambres mortuaires d’attente) has been objected to
(1) on the ground of expense to the rate-payers; and (2) because the
results by way of resuscitation of those constructed in Germany have
not justified the cost of their erection and maintenance, and that
if they had not already been in existence they would not now, it is
said, be established. The most recent investigations on this subject
have been made by Monsieur B. Gaubert, the results of which appear in
his work, “Les Chambres Mortuaires d’Attente,” a volume of 308 pages,
published in Paris, 1895. The author shows by the citation of facts
that both in France and Germany numerous cases of resuscitation of
persons certified as dead, and deposited in mortuaries, in spite of
many drawbacks connected with their management, have occurred, and that
their continuance is amply justified on the ground of utility. In the
report of the Municipal Council of Paris for 1880, No. 174, p. 84, is a
letter from Herr Ehrhart, Mayor of Munich, May 2, 1880, who says:--“The
lengthy period during which these establishments have been utilised,
the order which has always prevailed, the manner in which the
remains are disposed and adorned, _the resuscitation of some who were
believed to be dead_, have all contributed to remove any sentimental
objections to these establishments. The bodies are transported to the
Leichenhäuser twelve hours after death, without the least opposition on
the part of the relatives.” The expense of these institutions would, no
doubt, in the aggregate be a considerable sum, but not nearly so large
as that voted for the erection and maintenance of public libraries,
now so common; but in the presence of so serious and real a danger
as that of living burial, to which any of us is liable, it is hardly
worth considering. For peace of mind the cost of such insurance would
be cheerfully paid by thousands, and ought to be provided for the poor
and for those who would in time come to value it. This is a matter that
might appropriately be taken up by the County, District, and Parish
Councils and Boards of Guardians, under the powers granted to them by
the Local Government Act of 1894.
Dr. Josat, in his treatise “De la mort et de ses caractères,” shows
by numerous arguments and examples that, as there is an interval or
condition provided by nature between disease and health known as
_convalescence_, and the transition between the one and the other
is preceded by a variety of phenomena known as a _crisis_, so there
is an interval between the termination of a fatal malady and real
death (erroneously described as the agony), the symptoms which denote
intermediate or apparent death. But while the result of an error may
be of little moment in the first case, it may in the other become
disastrous, by abandoning the dying before absolute death. It is during
this interval, between (so called) death agony and absolute death,
which sometimes has been known to last a week, that the transfer to a
suitable mortuary should be made.
The following may be cited as typical illustrations of the utility of
mortuaries in discovering the existence of life after apparent death.
[AND CASES OF RESUSCITATION.]
H. L. Kerthomas in “Dernières Considérations sur les Inhumations
Précipitées,” Lille, 1852, p. 17, relates that--
“At a hospital in Liege two house-surgeons were at the ‘Salles des
décades’ in pursuance of their anatomical studies, when hearing at
one side of them a noise like stifled breathing great was their fear!
Still they coolly finished their examination, and then discovered the
supposed corpse moving convulsively amongst his dead companions; but,
thanks to efficient help, he was completely restored to health.” (The
above occurred in 1847.)
M.B. Gaubert, in “Les Chambres Mortuaires d’Attente,” records the six
following cases:--“On the 25th of January, 1849, the _Journal des
Débats_ recorded a fact somewhat similar to that which lately disturbed
the town of Perigueux:--
“‘MUNICH.
“‘A young man who was asphyxiated by charcoal had been declared dead
by the doctor. After they had been watching the body twenty-four hours
at the mortuary chamber, the family caused it to be carried to the
church, where it passed the night without the customary caretaker. The
next morning “the corpse” was found bathed in its own blood, and the
floor of the church was stained. Restored to consciousness during the
night and not having any help, the poor young man had succumbed to
hæmorrhage, brought on by the incisions which they blindly practised
on the body of the supposed dead one to make sure of his death.’
“‘The mother of a family had just lost her child, aged five years. She
carried to the Leichenhäuser a heart broken by grief, cherishing the
vague hope in the depth of her love that this separation would not
be the last. According to habit the families of Munich exposed the
corpse in a mortuary chamber amidst flowers and trees, and surrounded
by a circle of light. The Leichenhäus then appeared to have lost its
habitual funereal character--for it had quite a festive air. The
poor mother passed the night amidst tears and prayers, waiting with
anxiety and hoping for the arrival of the good news. The next morning
a workman of the Leichenhäuser knocked at the door of the house with
a large bundle which he carried in his arms; a few seconds after, the
mother pressed to her heart the resuscitated child which she was told
she had just lost. The transports of joy she experienced were so great
that she fell down dead. The child had come to life in the mortuary by
himself, and, when the keeper saw it, it was playing with the white
roses which had been placed on its shroud.’ (P. 179.)
“The same recent writer quotes the following on the testimony of the
surgeons Louis and Junker:--
“‘SALTPÉTRIÈRE.
“‘A young country girl,’ said Surgeon Louis, ‘strong and vigorous,
twenty-five years old, left on foot from the Hotel Dieu, Paris, where
she had been resting the night before, and came to Saltpétrière. The
fatigue of the journey induced an attack of syncope on her arrival.
They put her on the bed, and with cordials and warmth she revived,
but at the end of an hour she had another attack. They thought she
was dead, and carried her to the mortuary. After leaving the body--it
had remained there some time--they carried it to the amphitheatre.
The next morning a young surgeon said he had heard plaintive cries in
the amphitheatre, and his fear had prevented him from coming to tell
me. I went into the amphitheatre, and saw with sorrow that the poor
girl, who had vainly struggled to free herself from the sheet which
enveloped her, was now quite dead. She had one leg on the floor, and
an arm on the seat of the trestle of a dissecting table. I here recall
the feelings of horror with which I was agitated on this occasion.
I doubt if there ever was a sadder or more touching spectacle than
this.’ (P. 187.)
“BERLIN.
“‘A Berlin apothecary wrote to me lately’ (says Dr. Lénormand) ‘in this
town to the effect that during an interval of two years and a-half, ten
people stated to be dead had been recalled to life. I shall quote only
the following:--
“‘SOLDIER OF THE GUARD.
“‘In the middle of the night the bell of the vestibule rang violently.
The caretaker, who had only entered on duties within a few days, much
startled, ran towards the mortuary. As soon as he opened the door he
found himself confronted with one of “the corpses” enveloped in his
shroud who had quitted his bier and was making his way out. He was a
soldier of the guard believed to be dead, and he was able to join his
regiment five days later.’ (_Ibid._, p. 180.)
“FRANKFORT-ON-THE-MAINE.
“Dr. Josat said that during his sojourn in Germany, Herr Schmill,
director of the mortuary at Frankfort, related to him a case of
apparent death which occurred under his own eyes.
“‘In the year 1840, a girl of nineteen years died of acute
pleuro-pneumonia. Her body, during very hot weather, was exposed
in the mortuary for a period of eight days in a state of perfect
preservation. Her face retained its colour, the limbs were supple,
and the substance of the cornea transparent, whereas in ordinary
cases decomposition shows itself on the third day. The parents could
not reconcile themselves to have their daughter buried, and found
themselves much troubled. Finally on the ninth day the supposed dead
suddenly awoke without any premonitory indications of life.’ (_Ibid._,
p. 180.)
“BELGIUM.
“There was a case at Brussels in January, 1867, of a person who
returned to life just as the bearers arrived at the mortuary.
“‘A workman of the suburbs, employed by a firm of carriers, fell ill,
and in a few days died. This suddenness of the death caused doubts
as to its reality, and after the usual delay he was taken to the
mortuary connected with the cemetery. The body was left for a few
days’ observation. As soon as they arrived a noise escaped from the
coffin, and arrested the attention of the people present. At once they
hastened towards the coffin, and tried to restore him, and in a short
time he came to life. The same evening he was able to return to his
home. On the following day he went himself to the authorities to annul
the record of his supposed death.’” (P. 182.)
M. Gaubert continues:--“We have collected in Germany fourteen cases of
apparent death followed by return to life in mortuaries, in spite of
all that has been done for the prevention of such occurrences.” (P.
182.)
CASSEL.
“Dr. E. Bouchut, in ‘Signes de la Mort,’ 3rd edition, p. 50, relates
that an apothecary’s assistant had an attack of syncope, which
continued for eight days, when he was apparently dead, and was removed
to the mortuary of the Military Hospital, Cassel, where he was covered
with a coarse wrapper and left amongst the dead. The following night
he awoke from his lethargy, and, on recognising the horrible place
where he was, dragged himself to the door and kicked against it. The
noise was heard by the sentinel, aid arrived, and the patient was put
in a warm bed, where he recovered. Dr. Bouchut says that, if he had
been swathed in tight bandages, his efforts at release would have been
futile, and he would have been buried alive.”
LILLE.
The Paris _Figaro_, March 31, 1894, on the authority of the _Progrés du
Nord_, April 2, 1894, reports that:--
“M. Vangiesen, aged eighty-one years, awakened from supposed death on
the flagstones of the mortuary at the Charité Hospital at Lille.”
The _Undertakers’ Review_, January 22, 1894, reports that Lena Fellows,
aged twenty-two years, a servant in the employ of A. R. Knox, of
Buffalo, fell dead, as was thought, while at work on December 8.
The remains were taken to the morgue in a coffin, but next morning
when morgue-keeper McShane began to lift the supposed corpse into
the refrigerator he found that the woman was alive. It was a case of
catalepsy.
The case of a child found apparently dead in Regents’ Park, London,
and carried to the Marylebone Mortuary, where it subsequently revived,
has already been noticed. The incident caused a good deal of comment,
and suggested, doubtless, to the reflective reader that other cases of
suspended animation might have a less fortunate issue.
[NEED OF CAREFUL SUPERVISION.]
It is quite impossible on the Continent for an enquirer, as the author
knows from experience, to obtain reliable information with regard
to what takes place within the walls of mortuaries, because of the
numerous officials and others who are interested in covering up any
errors of previous death-certification that may come to light in
them. These comprise the health authorities, and the police in places
where the latter regulate funerals, as well as the physicians, whose
credit is at stake, and the nurses and undertakers. In many districts
in Germany the original object of the mortuaries--the prevention of
premature burial--advocated by Hufeland and others, has not been kept
in view, but the edifices have rather been used for the convenience
of the undertakers and their assistants, the bodies in many cases
being removed before actual dissolution was established by evidence
of putrefaction. This will need to be guarded against by more careful
supervision.