Smallpox mortality and morbidity in late-seventeenth century Westminster

"Our current understanding of disease-specific mortality patterns in early modern London is largely based on the Bills of Mortality, a few parish burial registers that record cause of death and some family reconstitutional studies. However, there is an extant and underused source from the Westminster parish of St. Martin-in-the-Fields, which provides exceptionally rich mortality data: the sextons’ day books. Not only do the day books list the names of individuals buried in St Martin’s and their accompanying cause of death, but also which street, lane, court or yard the parishioners lived in; their familial status (whether man, woman, youth, maid or child); the burial or funeral fee; frequently the ages of the children who were buried; and occasionally the occupations of the deceased, or parents of the deceased. There are two surviving runs of day books: an intermittent one from 1685 to 1703, and then following a long hiatus, a second run from 1747. Focusing on smallpox, the first objective of this paper proposes to use the early run of day books (on the later run, see the accompanying paper in this session by Jeremy Boulton and Leonard Schwarz) in order to conduct a micro-examination of the mortality characteristics of an emerging and significant disease in late-seventeenth-century Westminster. Exploiting the detailed information listed above, familiar measures such as the seasonality and age-specificity of smallpox will be examined, plus more unusual factors such as the social class of a typical smallpox victim: the burial fee providing quantitative data to test the hypothesis that the disease killed irrespective of wealth and social status. The specific location of those who died of smallpox also allows the disease to be mapped so as to ascertain which regions of St. Martin’s were most severely affected. And when combined with the date of each of burial, it is possible to observe how smallpox might have spread across the parish. Was there a specific focal point from which the disease appeared to radiate or were there isolated and unrelated pockets of infection in different regions of the parish? Some of the day books data will be compared and contrasted with John Landers’ findings on smallpox from the Bills of Mortality and his family reconstitution of Quakers in Southwark and a few parishes lying in a north western quadrant outside the City walls. Another point of comparison will be the smallpox burials in the large extramural parish of St. Giles Cripplegate. The second objective is to examine the morbidity or incidence of smallpox. It will never be possible to determine exactly how many people in early modern London were infected with smallpox. However, a potential indicator of morbidity, at least for the poorest inhabitants of Westminster, comes in the form of the extraordinary payment lists within the overseers of the poor accounts. From a sample of three Westminster parishes of varying size, population and wealth – St. Martin-in-the-Fields, St. Clement Danes and St. Paul Covent Garden – all seventeenth-century references to those parishioners receiving monetary aid when sick of smallpox have been identified. Problems though arise over the inconsistent nature of the extraordinary payments lists, which vary from year to year, ranging from detailed descriptions as to the reasons for each disbursement to only citing the name of the recipient and nothing else. The sample nevertheless provides rare quantitative morbidity data which complements the mortality data from the sextons’ day books. Various measures will be conducted including a calculation of the case-fatality rate of smallpox through a nominal linkage with the Westminster burial registers."