A freak accident

In March 1827 The London Medical Repository and Review included a short report of an inquest which had been held a couple of weeks earlier. The deceased was a small child, whose name is not revealed – and since children were often referred to at this date as ‘it’, it is not even possible to establish whether it was a boy or a girl. The child, whose parents lived in Bagshot in Surrey, had died in highly unusual circumstances. The mother, Hannah Pattison, gave this statement to the inquest:

My husband and I were travelling for work, and the deceased, who was about three years and a quarter old, was with us. Yesterday, about one o’clock in the afternoon, we were all three coming through the entry leading from Slaney-street to Snow-hill. As we were going along the entry the child caught his foot upon a brick which had broken out, and fell down on his face. I lifted him up, but the child was senseless, and died before we reached Mr. Knowles’s, which is only across Snow-hill. The child did not fall down any steps; the child was very healthy from its birth. We came to Birmingham on Saturday.

She was evidently illiterate, since her statement concludes with this in place of a signature:At this stage of proceedings the cause of the child’s death remained a mystery. Tripping over a brick and landing on one’s face should not be a fatal accident. Evidently something else had happened, undetected by the parents. The inquest also heard from George Beauchamp Knowles, a surgeon who conducted a post mortem:

I have this morning opened the deceased, and on examining the throat I found a portion of tobacco pipe two inches long, which had penetrated between the atlas and the basis of the skull, entering the skull through the foramen magnum, and passing nearly an inch into the brain.

The atlas is the top vertebra of the spinal column, immediately below the skull. The foramen magnum is the crucial opening into the skull, through which the spinal column passes. The crucial structures of the brainstem (governing such basic functions as breathing and heart rate) are mere centimetres away, so an injury to this part of the brain can easily be fatal.

It passed over the top of the wind-pipe, and wounded a large vessel. It was completely hid until the parts were dissected aback. When the child was brought to me I found a part of a pipe about two inches long in the child’s mouth; but I saw no other injury. The mouth bled a little, and being told the child had been playing, I thought the pipe I found occasioned the bleeding.

The journal’s editor appends a brief note on the technical details of the post-mortem examination, adding that it ‘appears to have been conducted with considerable deliberation and care.’ It seems that the child had ‘borrowed’ its father’s pipe and was running around with it in his or her mouth. By any standards a freak accident, and horribly unlucky; little consolation for the parents, but it must have been an almost instantaneous death.