Vaults

Mr- Hutchinson, surgeon, Farringdon-street, was called on Monday morning, the 15th March, 1841, to attend a girl, aged 14, who was labouring under typhus fever of a highly malignant character. This girl was the daughter of a pew-opener in one of the large city churches, situated in the centre of a small burial ground, which had been used for the interment of the dead for centuries, the ground of which was raised much above its natural level, and was saturated with the remains of the bodies. There were vaults beneath the church, in which it was still the custom, as it had long been, to bury the dead. The girl in question had recently returned from the country, where she had been at school. On the preceding Friday, that is, on the fourth day before Mr. Hutchinson saw her, she had assisted her mother during three hours and on the Saturday during one hour, in shaking and cleansing the matting of the aisles and pews of the church. The mother stated, that this work was generally done once in six weeks ; that the dust and effluvia which arose, always had a peculiarly foetid and offensive odour, very unlike the dust which collects in private houses ; that it invariably made her (the mother) ill for at least a day afterwards ; and that it used to make the grandmother of the present patient so unwell, that she was compelled to hire a person to perform this part of her duty. On the afternoon of the same day on which the young person now ill had been engaged in her employment, she was seized with shivering, severe pain in the head, back, and limbs, and other symptoms of  commencing fever. On the following day all these symptoms were aggravated, and in two days afterwards, when Mr. Hutchinson first saw her, malignant fever was fully developed, the skin being burning hot, the tongue dry and covered with a dark brown fur, the thirst urgent, the pain of the head, back, and extremities severe, attended with hurried and oppressed breathing, great restlessness and prostration, anxiety of countenance, low muttering delirium, and a pulse of 130 in the minute. "

From  : PRACTICE OF INTERMENT IN TOWNS EDWIN CHADWICK, (1843)