About Coroner’s Inquests

About the Coroner’s Inquests in this Collection

A Coroner is a judicial officer who is empowered to order or hold an Inquest, or enquiry, into the cause of death of a person falling within his jurisdiction, or in other words, anyone who has died without recent medical knowledge, suddenly, or by accident.

For the purposes of this collection, a coroner was either an established solicitor or practising medical gentleman, and for most of the period of this collection he would hold an inquiry featuring a jury of thirteen local and reputable men – usually local landowners, farmers or shop-owners – who would view the body, hear the evidence from witnesses pertinent to the case – who had been gathered there by the local Constable – and finally, with the Coroner’s advice given in his summing up, would declare a suitable Verdict as to Cause of Death.

Many cases were rather obvious, but where problems of obscurity arose in the evidence provided, the Coroner was there to advise the jurymen in the suitable course of action, often pointing out that they were there not to prosecute – as they thought – some criminal, but to simply find on the cause of death. In cases of murder the Coroner would issue a warrant for the miscreant’s retention by the force of law.

Nowadays, a Coroner’s inquest is held in private, unadvertised and untold, only the intimates of the deceased being involved in any way, but for the whole of the nineteenth and most of the twentieth centuries, they were public inquiries, held in the full glare of the public gaze – for many local people it was a special event, like an annual fair passing through their area, for which they would turn out with great curiosity.

Nowadays of course, much more scientific evidence can be sought and brought to bear for an Inquest than was available two hundred years ago, and for most of the nineteenth century an inquest would be heard within a day or so of the death or discovery of a body, often on the same day, and often very local to the scene of the death, sometimes in a poor labourers cottage or a barn if there were no other building available. Latterly an inquest would have been held in a town hall or a hospital or a hotel, though after 1902 they were not allowed to be held in licenced premises.

Changes in the Collection

You will spot numerous changes between 1800 and 1900, not least in the reporting. Until Pittman’s shorthand system made itself felt in journalism during the 1850s, the reports of inquests are mostly short sentences which one suspects were only included to pad out the page, the Salisbury Journal being a four-page broad-sheet for the first half of that century. After this, however, more care is taken over details, and when an extraordinary case occurred a larger report featured in the paper. Sequences of question, answer and subsequent argument might be reported in later cases.

It could be argued that the Rode Hill House murder of 1860, which captured the interest of the nation for months, propelled a sordid interest in papers covering inquests more thoroughly. But there were also more people able to purchase and read a newspaper as the century progressed, the lower classes slowly catching up in education and status.

The Rode Hill House murder case also showed up the manifold frailties of detective work and policing at the time, and there are a number of other cases which amply hint at a faulty and often tainted constabulary, especially in so much as their non-suspicion of the male master is involved in some cases.

Certainly the working class and labouring folk were viewed as more or less scum by the landed class throughout the century, and in the early part of the C19th the penalty of poverty was not just seen in malnutrition and starvation, but in paucity of safe work and in the penal reaction to the theft of the necessaries of life – a boy was hanged for stealing a gooseberry pie, men were gaoled or cast away to the penal colonies for poaching on lands which were until recent years their own community common lands.

The poor were also more and more brought into the cities by changes in working practises heralded by the Industrial Revolution. Farms saw machinery in the form of thrashing machines, which led to the labour riots of 1830, whilst the coming of the railways brought imminent peril to those who built them, rode on them, operated them and whose land they went through, not to mention those who thought a straight railway road better than their circuitous local lanes.

Poor housing mushroomed in towns. Salisbury was particularly bad in this respect, having at least forty-four courtyards of poor housing behind its street-front houses, lacking clean water and sanitation – a serious price would be paid in 1849 with a cholera epidemic.

Industry ran primarily on the muscles of men and horses, and the two often came to grief when put together, just as new forms of transportation in later decades – velocipede, railway and motor engine – brought their own harvests. One thing easy to forget now is that all the mills on the rivers were used to power some form of industry – the Old Mill at Harnham, for example, now a nice restaurant and hotel, used to be know as the Bone Mill where the skeletal remnants of slaughtered cattle would be ground into fertiliser.

Health and Safety, often joked about, often ignored even nowadays, would have saved many of the lives in this collection, whether it were from the flying pulleys in the mills of Trowbridge, Westbury and Bradford-on-Avon, railings around mill-ponds or across bridges, stair bannisters or the lack of, or barriers to grinding devils.

Simple lack of care often resulted in death where guns were involved, a small but consistent case-load of instances of guns being handed across hedges muzzle-first, or pointed at someone in jest, or just plain shot without care when a bird rose.  One of Salisbury’s finest men, Henry Fawcett, was blinded by gunshot when his father took just a careless shot.  Lack of cleanliness and poor labelling caused their death-load in poisoning cases, especially when things were kept in former drinking bottles.

In an age of poverty when every day meant working to put a bite on the family table, parents could be forgiven their mistakes. Drowning and burning were two of the commonest causes of death – coroners would bemoan the causes of a parent’s ‘temporary absence’ whilst the child leaned towards flickering warmth in the open hearth common to so many homes. Right up to the turn of the twentieth century a lack of fire-guards still allowed numerous child fatalities, usually of a most painful terrible kind. Flannelette clothing for young children would bring a later load of burning fatalities, this fibrous cotton fabric spreading flames more quickly. A lesser but still significant number of child deaths resulted from scalding when youngsters spilled pots or pans on themselves, or sipped from the spout of a tea-pot.

Equally so the lapse of attention that allowed the child to stray too close to some pond or little stream that runs at the back of the garden. But deep river water was also one of the commonest forms of suicide, and many cases feature the local rivers where unhappy situations met their end. Causes of suicidal tendencies are of course numerous, be they emotional or mental troubles, financial ruin, jealousy sped on by drink, or bearing a baseborn baby. This latter is seen again and again in the collection, sometimes clearly and plainly, sometimes only by suspicion – the stigma of bearing an illegitimate child, especially in upper middle class or upper class families, was often the spur to desperate action.

How the mother was made pregnant, by whom and in what circumstances, were of course ignored – for all society at this time the girl alone stood in guilt. If she were a servant – usually the only income available to lower class girls, who lived in the same house in abject subserviance – she would be sacked on the spot even under suspicion of pregnancy, and in all likelihood her parents would not take her back – desperate times lay ahead, and in a number of cases that did not end in suicide, the young mother of a bastard child would made excuses and feign illness as her laying-in approached, hiding the newborn baby or destroying it. Often plain ignorance at the moment of birth brought the baby’s death.

With regard to railways, it is worth noting than an up-platform was for trains up to the terminus – ie: London – whilst a down-platform was for trains coming down from London. The ‘four-foot way’ refers to the standard width of a railway track, whilst the ‘six-foot’ way was the standard gap between adjacent lines.

At the time of the first Salisbury Railway disaster of 1856 the railway companies were in their infancy, and accidents with this new technology were legion, but even in 1906 when the Boat Train accident killed 28 Americans at Salisbury, there were numerous lesser fatalities associated with the railway lines, tracks, yards and engines, except that by this time the companies were enormously powerful and one can sense in any number of inquests of this period the powers from on high pressuring their lowly paid witness to say the right things.

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