Kate Brooks, Bath Spa University

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We may never know the exact number of deaths caused by this pandemic, not just because of Government obfuscation. Establishing a definitive cause of death is not as straight forward as it may seem, and the current debates about numbers can be read as yet another iteration of an almost 200-year old argument.

‘Death data’ – public records of causes of death – began in 1837, and almost immediately, caused an argument between sanitation campaigner Edwin Chadwick and pioneering statistician and epidemiologist William Farr.

In Christopher Hamlin’s fascinating article, he describes the debate between them: Chadwick  believed that key to the report was the disease- a person dies of cholera, he surmised, so cholera is the cause. Meanwhile, William Farr argued for including causes of the disease: what we would now call a more holistic approach, which took in environmental and economic factors, such as poverty or overwork.

In other words, for Chadwick, a person might die of heart failure; for Farr, it could be starvation. Both might be right, and both might apply to the same unfortunate person, but the latter is more contentious. To die of heart disease simply confirms there was something wrong with your heart. To die of ‘want of food’ becomes more overtly political: it implies something is wrong with society.

For Chadwick, defining cause of death by disease ensured a detailed, biological determinant at a time when medical practice was at pains to appear neutral, factual. Terms like ‘starvation’ were too wide, and open to interpretation. For Farr, noting economic inequality as a cause would provide necessary, statistical evidence, with which the medical profession could argue for an improvement in working conditions, particularly that of child workers. Farr’s own heart may have sunk to know such issues were still up for debate almost two centuries later.

In my research in the archives of a nineteenth century orphanage in Bristol, there are numerous accounts of parental deaths which reflect the precarious nature of life for working class Victorians. Orphans’ mothers most frequently die of phthisis, after the death of the father, usually the wage earner. The  dictionary definition of phthisis links it to tuberculosis. However the term has Greek origins, literally meaning ‘to waste away’, which infers malnutrition and starvation, something the nameless record keepers of the time may have been aware of. Such a term became, perhaps, a convenient means of resolving the ongoing Chadwick-Farr debate, a euphemistic shorthand for pulmonary diseases exacerbated by abject poverty and hunger.

However, one death in the archives, dated 1860, particularly stands out; the only one I’ve so far found to be recorded in Latin: res angusta domi.

Roughly translated, this means, ‘the severe pressure of straitened circumstances’. In other words, death by poverty. As with phthisis, one could surmise that the unnamed writer has taken Farr’s drive to write of the economic factors affecting an individual, but Chadwick’s desire to attribute a single cause. Yet this appears only once, and is the only death to be written in Latin. We could see such a presumably well-intentioned euphemism as maybe designed to protect the child left behind, or existing family members. It could be that even the translated phrase is still yet a euphemism, for suicide, death by despair: at the time, a sinful act.

More likely, however, it was to protect the ‘brand’ of the institution itself. This is an era obsessed with inheritance, and inherited traits – this entry is written the year after Darwin’s ground-breaking evolutionary theories were published, which his half-cousin, Galton, later reworked towards more eugenicist perspectives. The key purpose of the orphanage – as with similar institutions, such as reform and industrial schools, workhouses and asylums – was to turn these destitute ‘waifs and strays’ into disciplined, useful workers. Any hint of inherited ‘bad blood,’ of misery and madness, would perhaps affect the smooth operation of the institution’s fund-raising and apprentice-placing activities.

Then again, it could be an oblique criticism of the stark inequalities of nineteenth century England, in a roundabout and euphemistic way; a gentle, Latin riposte. The institution’s records were technically open to any curious visitor, inspector or benefactor. Such a phrase may have been something that an uneducated eye might sweep over on an institutional visit, or a like-minded, sympathetic reader might understand, acknowledge, or know not to mention.

Whatever the reason, whilst phthisis is used frequently, this Latin term seems not to appear again. Perhaps even this subtlety did not meet with official approval.

But we should pay heed to this anonymous record-keeper’s moment, nonetheless.

Firstly, because historically, this single entry represents the tensions of the Chadwick -Farr argument, written as it is, only two decades after this debate began, and when the infrastructure and convention of public health records were yet to be conclusively established.

Secondly, we need to note what it can tell us about the current situation. A notable theme in the early part of ‘lock down’ was the optimistic assumption that we are all ‘in it together’ in the fight to eradicate the disease. But recent studies into the geography of the virus have shown it is twice as likely to kill in economically deprived areas. Local research at Bristol University has similarly  linked mental health, suicide rates and the toll of lock down on vulnerable families and workers.

Like the obscure Latin phraseology, and the catch-all term phthisis, these studies can get overlooked, side-lined from news headlines and Government spin. But it is worth remembering that, despite their differences in ‘death data’ definitions, both Farr and Chadwick actively, publicly, campaigned for better conditions for the urban poor. And whatever the intentions of our writer, this description of death remains there in the records. We do not need any more euphemism and sidelining of how economic inequalities and social policy can affect mental and physical health, this writer may be saying to us now. To this, if anything, we must all, always, remain alert.

 

About the author: Kate Brooks is an Associate Lecturer in Education History at the University of Bath Spa. She is currently undertaking a doctorate in the history of children in care, and has worked as a foster carer for Bristol City Council.