Falls 7
Barns 1
Drowned 4
Suffocation 16
Cut throat 2
Pistol shot 2
Hanging 2
Run over by railway train 1
Wilful Murder 4
“Accident,” “Violence” 2
Total 41
With respect to the accidental or violent deaths it may be remarked that
the 16 from suffocation were of infants and due to “accident.” One of
the newly born infants was found in a box and another up a chimney; these
being, as were some of the others, the children of single women. On four
newly-born children the verdict of “murder” was found. In one case there
had been “exposure,” in a second the child was found dead, and in the
other cases the verdict was simply “wilful murder.” Of the four drowning
cases one was suicidal. By hanging, cut-throat, and pistol-shot all the
deaths recorded (two from each cause), were suicidal, making a total of
seven suicidal deaths during the year. The remaining deaths by violence
were accidentally caused.
Having carefully analysed the facts relating to these deaths as they
appear in the weekly returns of mortality, I submit the results, which
are, I think, worthy of attention. Of course the primary cause of an
inquest being held is the absence of a medical certificate showing the
cause of death. The reasons why certificates are not forthcoming, and
therefore why inquests become necessary, may be inferred from certain
particulars which appear in the returns, and may be summed up as
follows:—
Sudden Death 99
Found dead in bed (22) or otherwise (26) 48
Accident 3
Violence 15
Doubtful (none of the above reasons stated) 7
Total 172
It is to the deaths from disease that I would draw particular attention,
the bare facts appearing to point to a large amount of neglect of the
sick, which, without explanation, would seem to border on the criminal.
Fatal visceral diseases, it need hardly be said, present symptoms which
the most ignorant cannot altogether overlook—fever, pain, exhaustion,
&c.; and each disease has a more or less prolonged course, varying with
the importance of the organ affected, and with the amount of care
bestowed on the sufferer. It is not credible that any medical man would
be unable to diagnose the existence of such a disease, _e.g._ as
pneumonia, or would refuse to certify the cause of death of a patient who
had died under his care. We are driven to the conclusion, therefore,
that, in a great number of cases of disease, many of the victims being
infants, no effort is made to obtain medical advice for the sufferers,
and hence, when death ensues, an inquest becomes necessary, as there is
no medical certificate to show the cause of death. A post-mortem
examination is made, and then it becomes known that death was caused by a
disease that might have been cured, and that certainly must have had a
well-defined and often a lengthened course. Passing over such maladies
as apoplexy and heart disease, it is only necessary to mention, in
support of this view, such diseases as pneumonia, &c. (30 deaths); brain
diseases (15); convulsions—a symptom rather than a disease (8); scrofula
(5); syphilis (2); diarrhœa, diphtheria, &c. The question then arises,
in connection with such cases as these, whether it is sufficient to
record the cause of death? whether, in fact, some one should not be made
responsible for the neglect to provide medical advice for a child who
ultimately dies “suddenly” or is “found dead” as a consequence of an
attack of pneumonia, that may have extended over one, two, or three
weeks, or even a longer time? Not many weeks before this present writing
one of the “Peculiar People” was found guilty of manslaughter, having
neglected to provide medical attendance for his child, who died of
pneumonia, although it was admitted that every care, otherwise, had been
bestowed on the patient; and, notwithstanding the well-known fact that
with such care a very large proportion of the cases, especially if one
lung only is affected, will recover. It need scarcely be added that the
parents’ neglect had its origin in conscientious motives, however
mistaken and absurd. Can such a plea be made in all or many of the cases
to which I have here alluded: and should negligent parents escape without
punishment—without censure even?
True, the facts I have thus briefly brought under notice may be
explained—and they certainly need explanation; for as they baldly appear
in the returns of mortality they would seem to indicate an indifference
to life which is not only shocking, but may be in some degree the cause
of that terrible infantile mortality which all thinking persons deplore.
I will only add that it is notorious that medical men are constantly
called in to see children sick beyond the hope of recovery, in order that
no fuss may arise after death—the death certificate being all-sufficient.
No doubt in many cases, where the diagnosis is quite clear, the
certificate is given, although the practitioner may be conscious of the
neglect of the parents in applying for assistance when “too late;” and, I
dare say, that in some at least of the cases which come before the
Coroner the inquest has been brought about by the judicious refusal of
medical men to give certificates under such circumstances. I venture to
think, however, that a certificate should not be given in any such case,
and that not only should an inquest be held, but that the mere fact of
the responsible person in charge of the infant having failed to obtain
that medical advice and assistance which the poor may have for the
asking, should be regarded as establishing a _prima facie_ charge of
neglect, for which he or she should appear and answer at another tribunal
in the absence of exculpatory evidence.