It is easier to advise than to have or to retain a sense of proportion, especially when it is most needed. I have never known anyone genuinely comforted by the idea that others were worse off than he, which perhaps explains why complaint does not decrease in proportion to improvement in general conditions. And he would be a callow doctor who tried to console the parents of a dead child with the thought that, not much more than a century ago, an eighth of all children died before their first birthday.
Still, it is well that from time to time medical journals such as the Lancet should carry articles about medical history, for otherwise we might take our current state of knowledge for granted. Ingratitude, after all, is the mother of much discontent. To know how much we owe to our forebears keeps us from imagining that our ability to diagnose and cure is the consequence of our own peculiar brilliance, rather than simply because we came after so much effort down the ages.
A little article in the Lancet recently was written by two historians who are in the process of analyzing the results of 9000 coroners’ inquests into accidental deaths in Tudor England. It seems astonishing to me that such records should have survived for more than four centuries, but also that the state should have cared enough about the deaths of ordinary people to hold such inquests (coroners’ inquests had already been established for 400 years at the time of the Tudors). In other words, an importance was given to individual human life even before the doctrines of the Enlightenment took root: the soil was already fertile.
The article described the case of Dorothy Cawthorn who, in October 1559, got up, went into the kitchen of the house in which she was a servant, broke through the wall, and went into a five feet-deep pond where she drowned. The inquest found that she had been suffering from a fever, which had caused her to “behave herself as if demented, in so much as she did not know what she was doing or saying.” Probably she was desperate for water; the inquest proved that the concept of an organic confusional state was already known in the sixteenth century.
Pumped water was uncommon in those times, especially in the countryside where she lived, and drinking water was obtained directly from ponds and streams. About half of all accidental deaths were by drowning, people falling into rivers or down wells as they searched for water.
Traveling was dangerous, for carts and carriages overturned on the rough roads and crushed both passengers and bystanders. The care of horses was also dangerous, accounting for a tenth of accidental deaths, as was the care of other farm animals, even sheep sometimes causing deaths. A third of children who died between the ages of 7 and 13 did so from accidents at work, crushed for example by the sacks of grain that fell from carts.
I recalled an accident the aftermath of which I witnessed in East Africa. A badly maintained army truck carrying sacks of grain on top of which sat eighteen passengers tried to ascend a steep hill, but could not make it and began to roll backwards. The people fell off and then the sacks after them. All eighteen were suffocated or crushed to death, and by the time I arrived a mother and her six children, aged between three and eight, were laid out like organ pipes by the side of the road.
There was no inquest, of course. And, oddly enough, concern about accidents is inversely proportional to the likelihood of their happening. The local people explained the accident by the curse put upon the truck by spirits, rather than by the lack of maintenance of its brakes. Their fatalism was both admirable and infuriating.