![]() In the St Martin in the Fields Sexton’s Day Books and the St Luke Old Street Parish Burial Registers, for example, the terms ‘Lunatick’ and ‘Lunacy’ appear to be interchangeable in defining the cause of death of the insane throughout the eighteenth and early nineteenth centuries (COWAC, SDB, 1747–1812 LMA, BBR, 1747–1812 LMA, BR, 1807–27). ![]() This is particularly apparent among the parochial burial records. Just as Andrews and Scull (2001:119–41) have identified that the wealthy could have the treatment of their insane family members and friends obscured to avoid any stigma or dishonour that the diagnosis of the insanity may have caused, we explore the extent to which those of the insane dead, or their friends and relatives who possessed greater wealth or social position, could often influence the reporting of cases of lunacy such that the cause of death was hidden or disguised.Ĭontemporary diagnoses and reporting of the death of the insane did not always distinguish between lunacy as a direct cause of death, and the death of a lunatic, whether caused by lunacy or some other illness ( Andrews, 1991: 502–3). Furthermore, it was the pauper insane and those who died in metropolitan institutions who were most likely (though not always) to be characterized as being insane at death, or their mortality being brought on by insanity. We argue that, to a significant extent, this misdiagnosis, and misreporting, was deliberate, in order to avoid the stigma of the dead being labelled ‘lunatic’ at the time of death, or the cause of death being ascribed as ‘lunacy’. ![]() Andrews (1991: 499–505) and MacDonald (1981: 145–6) have expressed the possibilities of confusion in the diagnoses and recording of the cause of death of the insane in the eighteenth century. It argues that the process of the reporting of the cause of death in the Bills of Mortality was vulnerable to outside influence, which in turn could determine what diagnoses would be recorded. This article addresses these contemporary fears of the under-representation of lunacy as cause of death in seventeenth- and eighteenth-century London and shows, initially, that insanity being ascribed as a cause of death had a distinctive chronology in this period. Lunatics, those clearly of unsound mind, were of course unable to make valid wills, and signs of mental incapacity were cited frequently in probate disputes by hopeful claimants ( Burn, 1767: 43, 45 see also: Bonfield, 1997 Houlbrooke, 1998: 80, 90, 218–19).Īlthough there is an extensive literature on the care of insane in the eighteenth-century metropolis, few scholars have investigated the concerns of Graunt and Black ( Andrews and Scull, 2001, 2003 Murphy, 2001a, 2001b Smith, 2007 Suzuki, 1991, 1992, 1998). Those making wills usually thanked God for being of sound mind, memory and understanding. Lunacy could disrupt a good deathbed performance through which the pious, and often impious, would prepare for salvation after death, though itself considered of diminishing importance in the eighteenth century ( Houlbrooke, 1998). 3 For Black, ‘many lunatick deaths in London are not reported, from their being interred in dissenting and unregistered burying grounds, or in other places of interment without the verge of the bills’, with some deaths from lunacy ‘intentionally suppressed’, and a ‘considerable remnant, perhaps as many more, sunk amongst the suicides and drowned’ ( Black, 1789: 128–9). Dr William Black, the London physician and medical statistician, believed that insanity was an equally unwelcome companion to death in the eighteenth century. Death by lunacy was included in his list of those ‘more formidable, and notorious diseases’, along with sudden death, seizures, epilepsy, and death on the operating table, of which ‘many persons live in great fear, and apprehension’ – conditions that would have prevented an adult meeting their maker in a suitable frame of mind ( Graunt, 1662). Dying mad was to be avoided in the seventeenth century. This reported under-representation of insanity as a cause of death may not have been surprising to Graunt’s contemporaries. 158 in 229250’ many cases, except those in the Bethlem lunatic hospital, were unreported or deliberately misdiagnosed for some other disease ( Graunt, 1662: 22 2). John Graunt, 1 the seventeenth-century statistician and one of the founders of modern demography, was highly sceptical of the veracity of the numbers of deaths caused by lunacy recorded in the London Bills of Mortality, observing they were ‘but few, viz. Introduction: lunatics in the London Bills of Mortality
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