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When the 1837 Act for Registering Births, Deaths and Marriages established national registers, the first priority of the Registrar General and of his Superintendent Registrar, Dr William Farr, was to ensure the comprehensiveness of the 940 000 events registered each year. Conscious of the prevalence of idiosyncratic diagnoses of the causes of death, and of the potential value of comparing patterns in different populations, Farr led a campaign for the international standardization of causes of death according to modern medical concepts, to which we owe the International Classification of Diseases.
Despite the best educational efforts of the Registrars General, their annual reports for England, 1863-1911, included, ‘sting by a blue bottle’, ‘bite of a leech’, ‘bite of a child’ and ‘Indian corn blown in ear’, as registered causes of death. The brief period 1894 to 1900 saw a remarkable cluster of 28 deaths reported as having been caused by boots. ‘Tight boots’ was given as cause of death for 4 females, ages 35-64, and for 18 males, ages 1-84, while ‘chaffing boot’ killed one female in the age group 5-9 years. ‘Injury by boot’ accounted for the deaths of 4 females in the age range 4-64, ‘rubbing by boot’ the death of 1 female in the age group 15-19. Neither in the preceeding years 1863 to 1894, nor in subsequent years 1900 to 1911, was the boot mentioned as causal agent.
The Registrars General have noted the emergence and disappearance of certain diagnoses in their Death Register over the generations, and have accounted for these phenomena. However, it is not evident how, by applying the underlying principles, one might account for the time cluster of boot-associated deaths. The contemporary authors Gissing, Wells and Collins, though their booted heroes and heroines trudged repeatedly across London and far out into its suburbs, provide no clues to the reasons for this mystery.