Bills of Mortality
BILLS OF MORTALITY
WILLIAM A. BREND, M.A., M.B., B.Sc.
[Reprinted from Transactions of the Medico-Legal Society,
BAILLIÈRE, TINDALL AND COX
8, HENRIETTA STREET, COVENT GARDEN
BILLS OF MORTALITY.
The custom of recording births, marriages, and deaths is of very ancient origin. In Genesis v. and xi. are given the births, ages, and deaths of the descendants of Adam to the birth of Noah, and from Noah to the twelve patriarchs. Moses counted the Israelites, and recorded the numbers of each of the tribes. Nehemiah, after the return from the Captivity in Babylon, says: "I found the book of the genealogy of them which came up at the first" (vii. 5).
In Rome, a register of deaths (ratio Libitinæ) was kept in the temple of Libitina, the goddess of the dead, and a regulation, ascribed to Servius Tullius, required that for every death a piece of money, known as the lucar Libitinæ, should be deposited in the temple. Marcus Aurelius ordained that all free persons should give notice of a birth within thirty days, and a record of these was kept in the temple of Saturn.
In medieval times, registers appear to have been kept in France as early as 1308, but not much can be learned about them. In Spain, Cardinal Ximenes in 1497 ordered registers to be kept in every parish, in order to terminate the disorders arising from the marriage of persons between whom there was spiritual affinity.
Parish registers in England were first instituted by Thomas Cromwell in 1538. In the churchwardens' accounts of the parish of St. Margaret's, Westminster, for that year is the following item:
"Paid for a Book to registre in the names of buryals weddings and Christenings 2d."
Local registers had, however, been kept by various churches and religious houses long before this date.
The parish clerks of London, who were responsible for the registers, were licensed as a guild as far back as 1232 under the name of "The Fraternity of St. Nicholas." This was dissolved and reincorporated by Henry VIII. James I. gave them a charter which required that only such as were "able to sing the Psalms of David and to write" should be elected members. By a charter of Charles I. were enjoined to make weekly reports of the christenings and burials within their respective parishes, one copy whereof was required to be sent to the King and another to the Archbishop of Canterbury. A report for the whole year, complied from the weekly returns, was issued in December. These reports are the Bills of Mortality.
Bills of Mortality were prepared for isolated years long before they were issued annually. The early Bills are, however, of extreme rarity, and is is probably impossible to determine when they were first drawn up. All the usual books of reference give 1592 as the date of the first, but this is clearly an error, for there were at least three earlier than that. Among the Egerton Manuscripts in the British Museum is the following very interesting document, which has hitherto, so far as I am aware, escaped notice. It is undated, but is believed by the Museum authorities to be of the year 1532.
"The Extime of Courses Beryed of the Plage wtin the Citie of London
"Syns the xvith day of Novēbre vnto the xxiii day of the same moneth ys deed in the citie & fredom yong and old thes mayny folowyng of the plag and oder dyseases
S buttolls wthout bysshopsgate i corse
S nycholas flesshamuls i of ye plag
S peturs in cornell i of ye plag
Mary Wolnorth i corse
All halowes barkyng ii corses
Kateryn colman i of the plag
Mary Aldmanberg i corse
Michaels in cornell iii of ye plag
All halowes ye moor ii i of the plag
S gyles iiii cors iii of the plag
S Dnstons in ye west iiii of y plag
Stevensin colman strete i corse
All halowys lmbert strete i corse
Martens owute whiehe i corse
Mergett moyses i of the plag
Kateryn erechurche ii of the plag
Martens in ye vyntre ii cors
Buttolls wthout algate iiii corses
S Olav in hert strete ii corses
S Andros in holborn ii of ye plag
S peters at powls wharff ii of ye plag
S ffeythes i corse of ye plag
S Alphes i corse of the plag
S Mathews in fryday strete i of the plag
Aldermary ii corses
Sepulcres iii cors i of the plag
S thoms appostells ii of the plag
S leonerds faster lane i of ye plag
Michaels in ye ryall ii corses
S Alborowes i corse of the plag
Swytthyns ii cors of ye plag
Mary somsetts i corse
S bryde v cors i of the plag
S benetts powls wharff i of the plag
All halows in ye wall i of ye plag
Mary hyll i corse
sm of ye plag xxxiiii ᵱsons
sm of oder sekenes xxxii ᵱsons
the holl sm iiixx & vi
and ther is this weke clere iiixx and
It is evident from this manuscript that a considerable number of parishes were at this time issuing weekly Bills.
The next Bill of Mortality appears to have been for the year 1562, and the occasion of its preparation is thus given in Maitland's "History of London," 1754:
"In the year 1562 a grievous Pestilence raged in this City; therefore, in order to know the Increase or Decrease of the same 'twas judg'd necessary to take an Account of the Number of Burials; which being the First of the Kind that was ever taken in London, it commene'd on the ﬁrst of January Anno 1562, and ended the last of December 1563, Whereby it appears that the Number Total buried within the City and Suburbs in that Year amounted to 23,630, whereof of the Plague 20,136."
This Bill is quoted by Stow, but I have not been able to ﬁnd any instance of the original.
In the Hall of the Parish Clerks, Wood Street, City, is a well-preserved Bill of Mortality for the year 1582. This is probably the oldest Bill now extant. Walford (Transactions of the Royal Historical Society, 1878) mentions it, but no other writer on the subject seems to have been aware of its existence. It runs as follows:
"The nvmber of all thosc that hath dyed in the Citie of London and the liberties of the same from the 28 of Dcecmber 1581 vnto the 27 of December 1582, with the Christenings. And also the number of those haue dyed of the plague of euery parish particulerly.
"Reuela, 14 chap.—Blessed are the deade that die in the Lorde euen so sayth the spirite for they rest from their labours.
|"There is deade this yeare, that is to say frō the 28 of December 1581 unto the 27 of December 1582 within the Citie and liberties of the same||viMDccccxxx|
|Of the plague||iiiMLxxv|
|Parishes cleere of the plague||v|
|Of the plague||CCxxxix|
"Here followeth the parishes with their numbers that hath buried of the Plague.…"
Bills of Mortality were not again kept until the plague years, 1592–1594, and these are the Bills which are usually stated to have been the first. There is no copy of these or of any of the foregoing Bills in the British Museum, Guildhall, Record Ofﬁce, or Somerset House.
The ﬁrst year in which the Bills of Mortality were issued to the public was 1594. Walford is of the opinion that this was done in order to frighten people from settling in the Metropolis, for Queen Elizabeth was seriously alarmed at the rapid growth of the city.
The area within the first Bills of Mortality consisted only of the city parishes, but in 1605 six contiguous parishes in Middlesex and Surrey were added, and in 1626 the City of Westminster, making the total area 5,875 acres. In 1636, Hackney, Islington, Newington, Stepney, Poplar, Bethnal Green, and Rotherhithe were included, bringing the area up to 22,538 acres. St. Peter ad Vincula was added in 1729, "but a contest arising between the Inhabitants of the Tower Liberty without and those within the Tower, whether the Church of St Peter ad Vincula was Parochial or not, the Merits thereof were try'd in the Court of King's-Bench at Westminster in the Year 1730, when it was determin'd in the Negative, which occasion'd its being left out of the Bill of Mortality soon after" (Maitland).
Particulars of diseases and casualties were ﬁrst included in the Bills in 1629, and the burials of males and females were then given separately. It was at ﬁrst feared that the publication of the causes of death might give offence, and for some years two sets of Bills were printed, one with and the other without this information. But in 1660 the Bills were remodelled, and henceforth only one Bill was issued. The list of casualties and diseases from the Bill for 1665—the year of the Great Plague—is here given as an illustration of the terminology in use at the time:
|Abortive and Stilborne||617|
|Ague and Feaver||5,257|
|Appoplex and Suddenly||116|
|Bloudy Flux, Scowring and Flux||18|
|Burnt and Scalded||8|
|Cancer, Gangrene, and Fistula||56|
|Canker and Thrush||111|
|Chrisomes and Infants||1,258|
|Cold and Cough||68|
|Consumption and Tissick||4,808|
|Convulsion and Mother||2,036|
|Dropsie and Timpany||1,478|
|Flox and Smal-pox||655|
|Found dead in streets, fields etc.||20|
|Gout and Sciatica||27|
|Griping in the Guts||1,288|
|Hangd and made away themselves||7|
|Headmouldshot and Mouldfallen||14|
|Kild by severall Accidents||46|
|Meagrom and Headach||12|
|Murthered and Shot||9|
|Overlain and Starved||45|
|Rising of the Lights||397|
|Shingles and Swine Pox||2|
|Sores, Ulcers, broken and bruised Limbs||82|
|Spotted Feaver and Purples||1,929|
|Stone and Stranguary||98|
|Stopping of the Stomack||332|
|Teeth and Worms||2,614|
In all 9,967
In all 97,306
|Of the Plague|
|Increase in the Burials in the 130 Parishes and at the Pest-house this year||79,009|
|Increase of the Plague in the 130 Parishes and the Pest-house this year||68,590|
In 1728 the ages at death were included, and the Bills were embellished with an ornamental margin of skulls and crossbones, which was further elaborated in 1747 by the addition of hour glasses. These features are seen in the accompanying reproduction of the Bill for the year 1801.
Despite their rudimentary character, the Bills of Mortality were frequently the subject of investigation and analysis during the seventeenth and eighteenth centuries. The earliest work of this nature is that by Captain John Graunt, entitled "Natural and Political Observations made upon the Bills of Mortality," first published in 1661, and subsequently much enlarged by Sir William Petty. This singularly interesting volume is the ﬁrst instance of the application of statistical methods to the phenomena of human society. Its merits were immediately recognized, and the Royal Society promptly elected the author a Fellow, and bore the expense of printing and publishing his book.
Captain Graunt gives the following account of the manner in which the Bills were compiled:
"When any one dies, then either by tolling, or ringing of a Bell, or by bespeaking of a Grave of the Sexton, the same is known to the Searchers corresponding with the said Sexton.
"The Searchers hereupon (who are ancient 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 Accompt of all the Burials and Christnings happening that Week to the Clerk of the Hall. On Wednesday the general Accompt is made up and printed, and on Thursday publifhed and dispersed to the several Families who will pay four Shillings per annum for them":
"That there be a special care to appoint women searchers in every parish such as are of honest reputation, and of the best sort as can he got in this kind; and these to be sworn to make due search and true report to the utmost of their knowledge whether the persons whose bodies they are appointed to search do die of the infection, or of what other diseases, as near as they can."
"That no searcher during this time of visitation be permitted to use any public work or employment, or keep any shop or stall, or be employed as a laundress, or in any other common employment whatsoever."
It will scarcely be believed that the functions and character of the searchers continued unchanged until they were swept away by the Registration Act of 1836. John Tilley, Clerk to the Parish Clerks, in giving evidence before the Select Committee on Parochial Registration in 1833, states that "the ofﬁce of searcher is conﬁned to two old women, generally paupers, who are legally entitled to ask a fee of fourpence, and on their hearing from the parish clerk that there has been a death in any house, they go and demand a sight of the body. Being very needy people they are open of course to any fee that may be given them to dispense with their office altogether. Instead of fourpence if they get one shilling or half-a-crown they go away without looking at the body."
Information collected in such a manner was, of course, bound to be highly inaccurate, and the Bills are unfortunately of very little value for modern statistical purposes. Apart, moreover, from error arising from the ignorance and venality of the searchers, there is evidence that the ﬁgures were at times deliberately falsiﬁed by the parish clerks in order to conceal the ravages of epidemics. De Foe, for instance, asserts that for weeks after the pestilence had commenced, the deaths were ascribed to other causes, and, when further concealment became impossible, they were systematically understated. He and others estimate that the total number who died of the plague was above 100,000, whereas, according to the Bills, it was but 68,590. The searchers and parish officers were frequently bribed in order to avoid the shutting up of the house, which was compulsory where a death from plague had occurred. The truth of this statement is borne out by the enormous increase which the Bills show of deaths from causes other than the plague. Occasionally, also, a clerk failed to make his weekly return, for which offence he was liable to be fined by the Lord Mayor the sum of one shilling.
It must be noticed that the record is of christenings, not births; hence the ﬁgures do not include the births of Quakers, Dissenters, Jews, Roman Catholics, etc. Even those who were "half-christened"—i.e., without sponsors—were not included, and Graunt mentions that many persons failed to notify a birth, chiefly for the reason that a small fee had to be paid.
Captain Graunt was well aware of the inaccuracy of the Bills, but did not consider that his observations were vitiated thereby. He says, for instance: "In case a man of seventy-ﬁve years old died of cough (of which, had he been free, he might possibly have lived to ninety) I esteem it little errour (as to many of our purposes) if this Person be in the Table of Casualties, reckoned among the Aged, and not placed under the Title of Coughs." And again, "if one died suddenly, the matter is not great whether it be reported in the Bills, Suddenly, Apoplexy, or Planet-strucken, etc." He ascordingly made a thorough analysis of the Bills which were at his disposal, and many of his deductions are in agreement with modern knowledge. He estimates the population within the area of the Bills to be 384,000, among whom are 24,000 "teeming" women. He ﬁnds an excess of births of males over females in the proportion of fourteen to thirteen. lie notes the higher moxtality of males in the somewhat unhappily-chosen words "Physicians have two Women Patients to one Man 3 and yet more Men die than Women." He observes that after a visitation of the plague the population of the city is always restored within two years; that 7 per cent. die of age; that abortives and stillborn are to those that are christened as one to twenty; that a disposition in the air towards the plague doth also dispose women to abortions; that every wedding one with another produces four children; that in the country but about one of fifty dies yearly, but in London one of thirty over and above the plague; that London is not so healthful now as heretofore, which may be due to the burning of sea-coal; and that the unhealthy season is Autumn. He deplores the seemingly small mortality from "French pox" (syphilis) in view of the great frequency of the disease, as he fears that the publication of such figures is likely to encourage immorality, and "forasmuch as it is not good to let the World be lulled into a security and belief of impunity by our Bills, which we intend shall not be only as Deaths-heads to put men in mind of their Mortality, but also as Mercurial Statues to point out the most dangerous waics that lead us into it and misery." He is at pains therefore to show that the number is understated, that some of such deaths are recorded under "Ulcers" and "Sores," and many others under "Consumption" for "the old-women Searchers after the mist of a Cup of Ale, and the bribe of a Two-groat fee, instead of one given them, cannot tell whether this emaciation or leanness were from a Phthisis or from a Hectick Fever, Atrophy etc., or from an Infection of the Spermatick parts."
The next writer on Bills of Mortality was Edmund Halley, the astronomer. Using the Bills of Breslau, in Silesia, in which the ages at death were recorded, he constructed, in 1693, the ﬁrst life-tables which have any pretensions to scientiﬁc accuracy.
A later account of Bills of Mortality is given in Strype's "Stow." The christenings in 1729 were—of males, 8,736, and of females, 8,324; 28,000 die annually, of whom 10,000 are children under two years of age, and about 2,500 more under five years of age. The population of the city, including the out-parishes of Middlesex and Surrey and the City of Westminster, is estimated to be 1,045,075, and a description of the method of arriving at the ﬁgures from the annual mortality is given. Mention is also made of other attempts to estimate the population from the number of houses in the city. The number of oxen killed annually, 60,000 or 70,000; the quantity of coals burned, 400,000 chaldron; and the amount of strong beer and ale brewed, 1,200,000 barrels.
Corbyn Morris, in 1751, made an analysis of the burials and ehristenings in his "Observations on the Past Growth and Present State of the City of London." His tone is pessimistic. He con. siders that the population is decreasing, and, among other reasons for this unhappy state, he gives the following:
"The discouragemcnt to matrimony in London is a grand operating cause of the diminution of the christenings and consequently of the excess of the burials. The unmarried ladies and gentlemen in this city of moderate fortunes, which are the great bulk, are unable to support the expense of a family with any magnificence, and therefore cannot intermarry together without retiring from high life, and submitting to relinquish those pleasures of the town to which their appetites have long been raised; they therefore acquiese in celibacy; each sex compensating itself as it can by other diversions. Persons also of inferior situation in London have their taste for pleasures inﬂamed, and avoid with caution the marriage state with their equals.… But above all the present increasing diminution of the christenings in London beneath the burials with many other evils is particularly to be attributed to the enormous use of spirituous liquors. For it is beyond all dispute that such liquors are become the common drink, and even the food too if it may be so termed of these peeple."
Some interesting information concerning the Bills of Mortality is given by William Maitland in the "History and Survey of London," 1760. When searching for the earlier records he found that "the Register belonging to the Company of Parish Clerks commencing only in the year 1664, the ﬁrst Part thereof being lost, the Company are of Opinion that the same was lent to Mr. Graunt to enable him to write his Natural and Political Observations but by some Accident never return'd." Maitland points out that many important burial-grounds, such as those of St. Paul's Cathedral, Westminster Abbey, the Temple Church, the Rolls and Lincoln's Inn Chapels, the Charterhouse, and various hospitals, though belonging to the Church of England, are not included in the Bills "whereby the Number of Persons that die within this City and Suburbs is greatly diminished to the no small lessening the grandeur of London in the Eyes of the World in respect to the Number of its Inhabitants!" Everywhere mortality was regarded as an index of population, and a low death-rate derogated from the dignity of the city. A series of elaborate calculations gave Maitland the ﬁgure 725,903 as the number of inhabitants of the City of London.
In 1771, Dr. Richard Price published his "Observations on Reversionary Payments," and this and subsequent papers were of great value in calling attention to the inadequate data upon which several recently-formed beneﬁt and insurance companies were relying. It is curious to notice that when the Equitable Society of London, founded in 1762, applied for a charter, it was refused by the law officers of the Crown, on the ground that the success of the scheme depended upon the accuracy of certain tables of life and death "whereby the Chance of Mortality is attempted to be reduced to a certain standard. This is a mere speculation. never tried in practice" ("Encyclopædia Britannica"). Dr. Price's tables based upon the Northampton Bills of Mortality were subsequently employed for calculating Government annuities. This writer also deplores the decline in the population, in language which has a curiously modern ring. He says: "In consequence of the easy communication lately created between the different parts of the kingdom, the London fashions and manners and pleasures have been propagated everywhere, and almost every distant town and village now vies with the capital in all kinds of expensive dissipations and amusement. This enervates and debilitates; and together with our taxes raises everywhere the price of the means of subsistence, checks marriage, and brings on poverty, dependence and venality."
Another writer about this period makes the curious statement that, owing to the multiplication of chapels, it was no uncommon thing in some parts of the country for christenings (and some. times burials) to be registered twice over—ﬁrst in the chapel register, and afterwards, for greater security, in that of the mother-church.
In 1773 Dr. Thomas Percival made an extensive investigation into the vital statistics of Manchester and adjacent places. He ﬁnds that each marriage produces about four and three-quarter children, and, unlike most of his contemporaries, comes to the conclusion that the population is increasing. He suggests that fertility has been promoted by the general use of tea, or possibly pepper and other spices.
Later writers on the Bills of Mortality were Dr. Mann-Burrows, in 1818, and Dr. Cleland, in 1836.
A few words must now be said concerning the names of diseases employed in the Bills of Mortality. These seem to have been selected with but little regard for even such scientiﬁc and medical knowledge as there was at the time. Ill-deﬁned phrases and popular names abound. Though many of the terms soon became obsolete, yet, on comparing the two Bills given, it will be seen that very few changes were made during the period covered by the Bills. Much was left to the discretion of the searchers. "Aged" and "infant" for instance, had no ﬁxed limit in years, but depended upon the opinion of the "ancient matron"; a chrisome, however, was a child under the age of one month.
Some of the affections cannot now be identiﬁed with certainty, and they even puzzled contemporary writers. Graunt, for instance, says: "There seems also to be another new Disease called by our Bills The Stopping of the Stomach, first mentioned in the year 1636, the which Malady, from that year to 1647, increased but from 6 to 29; Anno 1655 it came to 145. In 57 to 277. In 60 to 314. Now these proportions far exceeding the difference of proportions generally arising from the increase of inhabitants, and from the report of Advenæ to the City shews there is some new Disease which appeareth to the Vulgar as Stopping of the Stomach. Hereupon I apprehended that this Stopping might be the Green-sickness, forasmuch as I find few or none to have been returned upon that account, although many be visibly stained with it. Now, whether the same be forborn out of shame I know not: For since the World believes that Marriage cures it, it may seem indeed a shame that any Maid should dye uncured when there are more Males than Females, that is an overplus of Husbands to all that can be Wives. In the next place I conjectured that this Stopping of the Stomach might be the Mother, forasmuch as I have heard of many troubled with Mother-fits (as they call them), although few returned to have died from them; which conjecture, if it be true, we may then safely say, that the Mother-fits have also increased. But I was somewhat taken off from thinking this Stopping of the Stomach to be the Mother, because I ghessed rather the Rising of the Lights might be it. For I remembered that some Women troubled with the Mother-fits did complain of a choaking in their throats." In the end he is obliged to leave the question to be fought out by the physicians, having, however, provided us with a vivid picture of the confusion and uncertainty which existed.
"Mother" is given by Murray and other lexicographcrs as an hysterical malady, accompanied by feelings of suffocation. Mair states that it was a disease of women, but this is presumably an error, for Shakespeare makes King Lear say:
"O, how this mother swells up toward my heart!
Hysterien passio! down, thou climbing sorrow!"
It was clearly of a convulsive nature, and possibly was epilepsy.
The "lights" were the lungs. "Rising of the lights" is variously given as heartburn, choking feeling in the throat, and globus hystericus. Probably it was applied to any condition accompanied by dyspnœa.
An "imposthume" was an abscess; "calenture," sunstroke; "planet-struck," paralysis; "livergrown," rickets (Graunt); "evil" and "King's evil," tuberculosis; "headmouldshot" and "horseshoehead," hydrocephalus; "ﬂux," dysentery; and "swine-pox," chickenpox. "Despair" and "grief" we should now call melancholia.
It will be readily understood that a system of registration so highly defective as the Bills of Mortality was frequently and vigorously assailed by members of the medical profession. Many proposals were put forward to improve the Bills and to give them a more scientiﬁc character, but for various reasons these all came to naught. The fate of an attempt which was made in 1754 illustrates the kind of prejudice which was apt to be encountered. A group of physicians, in conjunction with the parish clerks, presented a Bill to Parliament requiring that all the parishes in England should be obliged to keep exact registers of births, deaths, and marriages, instead of christenings and burials only, and that an annual general Bill should be prepared for the whole country. At the same time the list of diseases was revised, and many obsolete terms were proposed to be deleted. The Bill was at ﬁrst received with favour, and was ordered to be printed; but, unfortunately, a clause which required that the people should be numbered aroused hostility on religious grounds. "Sin of David!" became the cry, and in the end the Bill was defeated by a large majority (vide Gentleman's Magazine, 1754). In this connection it is interesting to recall that the civil registration of births in the Act of 1836 met with considerable ecclesiastical opposition on the ground that baptism and naming of the child were separated. It was feared that having registered the birth and named the child, parents would fail to celebrate the rites of baptism.
One point more may be mentioned. It will be noticed that a discrepancy appears in the Bills between the number of executions and the burials of executed persons. Most of the bodies unaccounted for went to the dissecting-rooms, in pursuance of the sentence "that you be hanged by the neck until you are dead, and that your body shall afterwards bc dissected and anatomized." The fate of the bodies of traitors is indicated by the following sentence (vide case of Walcot I. Eng. Rep, p. 89): "Quod … ibidem super bigam ponatur, et abinde usque ad furcas dc [Tyburn] trahatur, et ibidem per eollum suspendatur, et vivens ad terram prosternatur, et quod secreta membra ejus amputentur, et interiora sua extra ventrem suum capiantur et in ignem ponantur, et ibidem ipso vivente comburantur, et quod caput ejus amputetur, quodque corpus ejus in quatuor partes dividatur, et illo ponantur ubi Dominus Rex eas assignare voluit." The places usually selected were the gates of cities, and in London, London Bridge and Westminster Hall. This sentence was not completely abolished until 1870.
The first of the Registrar-General's reports under the Births and Deaths Registration Act of 1836 was published in 1839, and thereafter Bills of Mortality cease to have any interest. They continued to appear, however, in an abbreviated form until 1850, when the yearly Bills were abolished, and in 1859 the making and returning of the weekly Bills was ordered by the company to be discontinued. From ﬁrst to last, the Bills had covered a period of over three centuries.