CONCLUSION.

It is universally admitted that nothing is less certain than life; and if the reader will weigh the facts, which it has been the authors’ intention to understate rather than overstate, he will rightly conclude that nothing is more uncertain than the signs which are ordinarily accepted as indicating death. It would have been easy to fill a much larger volume than this with reports of authentic cases of premature burial, and narrow escapes from such terrible mischances, and with more detailed results of the authors’ researches on the subject in various parts of Europe and America, as well as in the East. The cases adduced to illustrate the text are, however, presented as types of hundreds of others obtainable from equally reputable sources, and to be found in the works of various trustworthy authorities, the titles of which can be seen in the Bibliography at the end of this volume.

The London Review for July, 1791, p. 40, referring to “An Essay on Vital Suspension: Being an Attempt to Investigate and Ascertain those Diseases in which the Principles of Life are Apparently Extinguished,” by a Medical Practitioner—observes, that this is one of many publications “written by physicians and surgeons, versed in medical science, and well skilled in anatomy, to demonstrate, beyond a possibility of contradiction, that there are many cases in which the human body has the appearance of death, and preserves it for a considerable time, without the reality; the vital principle being still unsubdued, and a restoration of all its powers and functions practicable by the administration, in due time, of proper means.” The author of the pamphlet under review says, “It is a proof of the temerity and imbecility of human judgment, that we have too many instances on record, wherein even the most skilful physicians have erred in the decisions they have pronounced respecting the extinction of life.”

Unfortunately, we appear to be no nearer the prevention of these terrible mistakes now than we were when the reviewer called attention to them a century ago. The imbecility of human judgment complained of exists now in an unmitigated degree. The appearance of death is generally taken for its reality: and the great mass of the inhabitants of this planet are hurried to their graves without (except in a comparatively few cases of drowning or poisoning) the application of any serious efforts at restoration, and without waiting for unequivocal signs of dissolution.

Whether the risks of being buried alive are as great as those declared by some of the authorities quoted in this volume, must be left to the reader to determine for himself; but that they are considerable there appears little room for doubt by those who have taken the trouble to inquire into the facts. How often is the reader shocked by reading narratives in his daily or weekly newspaper of persons either buried alive, or of those in a state of suspended animation, but diagnosed and duly certificated by the attending doctor as dead, who have returned to consciousness during the funeral rites or at the grave itself.

The Lancet has borne frequent testimony to these disasters, some of which are quoted in this volume; and, just as we are writing the closing chapter, the leading medical journal, in its issue of September 12, 1896, p. 785, records the following from its Cork correspondent as having occurred at Little Island, Ireland, which, the writer says, is thoroughly vouched for:—

“A child of four years of age contracted (typhoid) fever, and to all ordinary appearances died. The time of the funeral was appointed, and friends were actually on their way to attend it. When the supposed corpse was about to be removed from the bed to the coffin, signs of animation were exhibited. The services of the medical man were again requisitioned, and the child, opportunely rescued from such a terrible death, is now progressing satisfactorily.”

Amongst the headings of paragraphs taken from recent papers lying before me are the following:—“Buried Alive,” “A Gruesome Narrative,” “Restored to Life in a Mortuary,” “Premature Burial,” “The Dead Alive,” “Buried Alive,” “Sounds from Another Coffin,” “Mistaken for Dead,” “A Lady Nearly Buried Alive,” “Revivification After Burial,” “A Woman’s Awful Experience,” “Bolt Upright in His Coffin,” “Almost Buried while Alive,” “A Woman Buried Alive,” “The Corpse Sat Up,” “Alive in Her Coffin,” “Seemed to Rise from Death,” “Escaped Burial Alive,” “Revival at a Wake,” “Snatched from Death at the Graveside,” “Laid Out, but not Dead,” “Alive in His Grave,” “Interment before Death,” “Came to Life in the Coffin,” “Corpse Seems to Live,” “The Corpse Moved,” etc.

According to the “London Manual and Municipal Year Book,” 1896-97, there are over four hundred public authorities at work in governing London, who spend over twelve million pounds a year, and from other sources it is said that seven millions a year are collected in the Metropolis for charitable purposes, and yet there are no officials, associations, or insurance companies to safeguard the people either in this wealthy Metropolis or in any part of the United Kingdom against one of the most terrible physical calamities that can overtake any member of the human family.

The Registrar-General’s Decennial Supplement for 1881-90, published this year (1896), includes a “Life Table” furnishing the expectations of life in England and Wales. It appears that the death-rate has fallen from 21.3 in the decade ending 1880 to 19.0 per thousand living in that ending 1890. The expectation of life at birth, according to the actuary’s standard in the decade 1871-80, was 41.3 years for males, and 44.6 years for females. This has been increased, as shown in the “Life Table” 1881-90, to 43.6 for males, and 47.2 for females, mainly through sanitary amelioration. A perceptible increase, the author believes, could be shown if steps were taken to restore still-born children, who constitute about five per cent. of births, and if the same trouble were adopted to restore the apparently dead from other diseases (which are sometimes only crises of repose after wasting disease) as is generally taken with respect to those accidentally poisoned or drowned. Besides reducing the mortality and increasing the expectation of life, such a reform would greatly diminish the appalling suffering of those who, through our apathy and ignorance, are, under our present system of laissez faire, consigned to precipitate interment, and would bring tranquillity of mind to those who are haunted all their lives through fear of such a catastrophe. Why we should limit our efforts at restoration of those apparently dead to a few cases has never been shown, and is surely a serious oversight, which should be remedied without delay.

Dr. Hartmann, in “Premature Burial,” observes—“As by cleaning a dusty watch the watchmaker causes the hindrances to be removed which prevented the energy stored up in the watch from setting the clockwork in motion, so, in cases of apparent death from catalepsy, asphyxia, syncope, and other diseases causing obstacles to the manifestation of the life-energy in the body, these obstacles may be removed by appropriate means, such as are known to many intelligent physicians, and the energy of life being latent in the physical form may be enabled to manifest itself again when the harmony of the organism has been sufficiently restored, even after the heart has entirely ceased to beat.”

Dr. A. Fothergill says:—“Since no one, from prince to peasant, can at all times be secure from these dreadful disasters, which suddenly suspend vital action; and since medical practitioners themselves are not exempt, it surely becomes them to use every exertion to improve the art of restoring animation. May each progressive step in this interesting path of science tend to that great object! and may every laudable attempt undertaken with that benevolent view enable us with more certainty to preserve life and to diminish the sum of human infelicity!”

It is regrettable that medical practitioners, neither in this nor in any of the Continental states, except, possibly, a few in Germany, have been trained to distinguish apparent from real death; and when a case of death-trance occurs, they certify to actual death, and the unfortunate person is interred in a strong coffin, which effectually conceals the tragedy following resuscitation. Moreover, the ordinary practitioner, both in England and the United States, considers himself exonerated from blame when he thus follows the traditions and practice of the heads of his profession. Personally, he has neither the time, opportunity, or inclination to study the abnormal phenomena of trance, catalepsy, or hypnotisation, and thus the evil of live sepulture is perpetuated from generation to generation.

SUMMARY OF CONCLUSIONS.

(1) An examination of both the historical and modern cases of trance, catalepsy, and other death-counterfeits shows that nothing is more uncertain than the so-called signs of death, and that in all countries and in all ages many persons supposed by their attendant physicians and relations to be dead have revived, while the cases are as numerous and the danger as great at the present day as at any previous period.

(2) That the risk of premature burial is especially serious in France, in Spain and Portugal, in the west of Ireland, in both European and Asiatic Turkey, and in India; also amongst the Jews, where both the Jewish law and ancient customs enjoin burial within a few hours of death, and for similar reasons in all Oriental countries; and in the Southern States of North America.

(3) That the various signs which are supposed to indicate death, such as the cessation of respiration and of cardiac action, a pale, waxy and death-like appearance, the stiffening of the limbs, or rigor mortis, insensibility to cutaneous excitation, the departure of heat from the body, are singly and collectively illusory; the only safe and infallible test of dissolution being the manifestation of putrefaction in the abdomen.

(4) That medical death-certificates have been shown by various witnesses before the Select Parliamentary Committee of Inquiry of 1893-94 to be often misleading as to the cause of death, and inconclusive as to the fact of death. Any compulsory extension of the death-certification system in the present imperfect state of medical knowledge would only partially meet the necessities of the case, and might have the effect of crystallising a defective system into perfunctory routine. A certain safeguard would, however, be provided if the law made it binding on medical practitioners to set forth on the death-certificate a precise statement of indications showing that dissolution has actually occurred.

(5) That the only safe and effective method of reform is the establishment of appropriately designed waiting mortuaries, such as are provided at Munich, Weimar, Stuttgart, and other German cities, with qualified attendants and appliances for resuscitation, and where doubtful cases of death (and all are doubtful in which decomposition has not clearly manifested itself) can be deposited until the fact of death is unequivocally established.

(6) That premature burial in civilised countries is mainly possible owing to the fact that instruction in the phenomena of trance, catalepsy, syncope, and other forms of suspended animation is not systematic in the medical schools in any country, and the means of prevention are therefore practically unknown. This omission should be immediately remedied by the inclusion of the subject at the appropriate place in the medical curriculum, and in the examination for degrees.

(7) That, inasmuch as a radical change in the methods of treating the dead or supposed dead is extremely urgent, and legislation with an overworked Parliament in England and apathetic State Legislatures in America will probably be delayed, the authors recommend, as a preliminary measure of protection, the formation of associations for the prevention of premature burial amongst their members, as in some cities in France, Austria, and the United States, or the alternative plan of engrafting such an obligation of prevention upon existing associations, clubs, and insurance companies established for other purposes.

If the foregoing conclusions are established, the need for immediate action is urgent and imperative, and the prompt intervention of Parliament should be at once invoked. May we hope for the cordial co-operation of all classes and of all sections on a question in which the whole community have a deep and vital interest, and on which procrastination will certainly be fatal to some of its members. It is not an academic question, but one of the gravest practical character, the earnest consideration and treatment of which cannot be neglected with impunity.

APPENDICES.