In the same year that the Ripper crimes began, in 1888, four other East End women died from cut throats – all supposed to be suicides. When I first went through the musty old pages of the Royal London Hospital record books and noticed the numerous women admitted with cut throats, I anticipated that these deaths might have been Ripper murders assumed to be suicides. But more time and research revealed that cut throats were not unusual in a day when most impoverished people did not have access to guns.
CHAPTER TWELVE
THE YOUNG AND BEAUTIFUL
People of the East End were put out of their misery by infections and diseases such as tuberculosis, pleurisy, emphysema, and pneumoconiosis. Men, women, and children were burned and scalded to death by accidents at home and at work.
Starvation killed, as did cholera, whooping cough, and cancer. Parents and their children, weakened by malnutrition and surrounded by filth and vermin, did not have immune systems that could fight off non-lethal illnesses. Colds and flu became bronchitis and pneumonia and death. Many infants weren’t long for the world of the East End, and the people who lived and suffered there hated the London Hospital and avoided it if they could. To go there was to get worse. To let a doctor touch them was to die. Often this was true. An abscessed toe requiring amputation could lead to osteomyelitis – a bone infection – and death. A cut requiring sutures could lead to a staph infection – and death.
A sampling of hospital admissions for alleged suicides shows that in 1884, five men tried to kill themselves by cutting their throats, while four women cut their throats and two slit their wrists. In 1885, five women are listed as suicides or attempted suicides by poisoning and one by drowning. Eight men slashed their throats, one used a gun, and another a noose. In 1886, five women attempted suicide by cutting their throats. Twelve women and seven men tried to poison themselves, and another twelve men cut their throats or stabbed or shot themselves.
It simply isn’t possible to sort out who really committed suicide and who might have been murdered. If the individual was a person of the dustbin in the East End, and the death or attempted death was witnessed, then police tended to accept what witnesses said. When a woman’s abusive, drunk husband hurled two lit oil lamps at her, setting her on fire, she told police in her dying breath that it was entirely her fault. Her husband wasn’t charged. Her death was listed as an accident.
Unless a case was obvious, there was no certainty that the manner or even cause of death would be accurate. If a woman’s throat was cut indoors and the weapon was nearby, the police assumed she had killed herself. Such assumptions, including those made by the well-meaning Dr. Llewellyn, not only sent police down a false trail – if they bothered following up at all – but bad diagnoses and determinations of injury and death could destroy a case in court. Forensic medicine was not sophisticated in Dr. Llewellyn’s day, and this rather than carelessness is the most likely explanation for his hasty, baseless conclusions.
Had he examined the pavement after Mary Ann’s body was picked up and loaded into the ambulance, he would have noticed the blood and the blood clot that Constable Phail observed. Dr. Llewellyn might have noticed blood or a bloody fluid trickling into the gutter. Visibility was bad, so maybe he should have thought to wipe up some of this fluid to determine first whether it was blood, and second whether the serum was separating from the blood as it does during coagulation, which would have offered another clue about time of death.
Although taking the ambient temperature at the crime scene and the temperature of the body wasn’t standard in death investigation, Dr. Llewellyn should have noted the stage of rigor mortis or stiffness, which occurs when the body no longer produces the adenosine triphosphate (ATP) needed for muscles to contract. Dr. Llewellyn should have checked for livor mortis, which occurs when the blood no longer circulates and accumulates in certain parts of the body due to gravity. In a hanging, for example, the lower body will turn purplish-red if the victim has been suspended by his or her neck for as little as half an hour. Livor mortis becomes fixed after about eight hours. Not only could livor mortis have suggested the time of Mary Ann Nichols’s death, it could have told Dr. Llewellyn if her body had been moved at some point after her murder.