A concurrence of peculiar circumstances, beginning in May, 1895, has directed public attention in England to the subject of premature burial, probably to a greater degree, so far as the author’s recollection serves, than at any time during the past half-century. Amongst these may be mentioned the publication of several recent cases of premature burial in the English and American papers; the narrow escape of a child found in Regent’s Park, London, laid out for dead at the Marylebone Mortuary, and afterwards restored to life; the issue in Boston, U.S., of Dr. Franz Hartmann’s instructive essay, entitled, “Buried Alive: an Examination into the Occult Causes of Apparent Death, Trance, and Catalepsy” (a considerable number of copies having been sold in England), and the able leading articles and correspondence on the subject in the Spectator, Daily Chronicle, Morning Post, Leeds Mercury, The Jewish World, Plymouth Mercury, Manchester Courier, To-Day, and many other daily and weekly journals.

It is curious, that while many books and pamphlets relating to this important subject have been issued in France and Germany, no adequate and comprehensive treatise has appeared from the English press for more than sixty years past, nor writings in any form, with the exception of a paper by Sir Benjamin Ward Richardson in No. 21 of the Asclepiad, published in 1889, on the “Absolute Signs of Death,” sundry articles in the medical journals from time to time, and a London edition of Dr. Hartmann’s volume in January, 1896. The section upon “Real and Apparent Death” in the 1868 edition of the late Professor Guy’s Forensic Medicine begins with the words, “This subject has never attracted much attention in England, and no medical author of repute has treated it at any length”—a remark not less true after the lapse of a generation. The following chapters have been prepared with the view, not so much of supplying this omission, as of guiding the public to the dangers of our present mode of treating the apparent dead, in the hope that reforms and preventive measures may be instituted without delay in order to put an end to such unnecessary domestic tragedies.

In introducing the subject the author is aware that the great majority of the medical profession in this country are either sceptical or apathetic as to the alleged danger of living burial. Many do not believe in the existence of death-trance or death-counterfeits, and the majority of those who do believe in them declare that cases are very rare, and that if consciousness is ever restored in the grave it can only last a second or two, and that those who live in fear of such an occurrence should provide for a post-mortem or for the severance of the jugular vein. Many persons, on the other hand, after much careful inquiry, are of opinion that cases of premature burial are of frequent occurrence; and that the great majority of the human race (outside of a few places in Germany, where waiting mortuaries are established, or where the police regulations, such as those described in this volume as existing in WÜrtemburg, are efficiently and systematically carried out) are liable to this catastrophe. Important as the subject is allowed to be, and numerous as are the reported cases, no effective steps, either public or private, appear to have been taken, outside of Germany and Austria, to remedy the evil. At present a majority of the people appear content to trust to the judgment of their relations and to the ordinary certificates of death to safeguard them from so terrible a disaster. That death-certificates and death-verifications are often of a most perfunctory description, both as to the fact of death and the cause of death, has been proved by overwhelming evidence before the recent House of Commons Committee on Death-Certification. Such certificates, when obtained, may be misleading and untrustworthy; while in many cases burials take place without the doctor having either attended the patient or examined the body. Nor, in spite of the appointment of death-verificators by our neighbours across the Channel, is this important precaution effectively carried out by them. M. Devergie reports that in twenty-five thousand communes in France no verification of death takes place, although the law requires it; and he demands that no diploma shall be given without the candidate having proved himself conversant with the signs of death. (Medical Times, London, 1874, vol. i., p. 25.) On personal inquiry from medical authorities in France, during the present year (1896), we learn that this laxity still prevails.

It appears strange that, except when a man dies, all his concerns are protected by custom and formalities, or guarded by laws, so as to insure his interests being fairly carried out to completion. Thus we see that heirship, marriage, business affairs of all kinds, whether of a public or private nature, are amply guarded by such precautionary and authoritative measures as will secure them. But one of the most important of all human interests—that which relates to the termination of life—is managed in such a careless and perfunctory way as to permit of irreparable mistakes. To be sure there are laws in most of the Continental States of Europe that are intended to regulate the care and burial of the dead, but few of them make it certain that the apparently dead shall not be mistaken for the really dead, and treated as such. None of them allow more than seventy-two hours before burial (some allow only thirty-six, others twenty-four, and others again much less, according to the nature of the disease), unless the attending physician petitions the authorities for reasonable delay—a rare occurrence. And even if postponement is granted, it is doubtful if the inevitable administrative formalities would leave opportunities for dubious cases to receive timely and necessary attention, or for cases of trance, catalepsy, coma, or the like, to be rescued from a living burial.

In the introduction to a Treatise entitled “The Uncertainty of the Signs of Death, and the Danger of Precipitate Interments,” published in 1746, the author, Mr. M. Cooper, surgeon, says:—“Though death at some time or other is the necessary and unavoidable portion of human nature, yet it is not always certain that persons taken for dead are really and irretrievably deprived of life, since it is evident from experience that many apparently dead have afterwards proved themselves alive by rising from their shrouds, their coffins, and even from their graves. It is equally certain that some persons, too soon interred after their supposed decease, have in their graves fallen victims to a death which might otherwise have been prevented, but which they then find more cruel than that procured by the rope or the rack.” The author quotes Lancisi, first physician to Pope Clement XI., who, in his Treatise De subitaneis mortibus, observes:—“Histories and relations are not the only proofs which convince me that many persons supposed to be dead have shown themselves alive, even when they were ready to be buried, since I am induced to such a belief from what I myself have seen; for I saw a person of distinction, now alive, recover sensation and motion when the priest was performing the funeral service over him in church.”

After reporting and describing a large number of cases of premature burial, or of narrow escapes from such terrible occurrences, in which the victims of hasty diagnosis were prepared for burial, or revived during the progress of the burial service, Mr. Cooper continues:—“Now, if a multiplicity of instances evince that many have the good fortune to escape being interred alive, it is justly to be suspected that a far greater number have fallen victims to a fatal confinement in their graves. But because human nature is such a slave to prejudice, and so tied down by the fetters of custom, it is highly difficult, if not absolutely impossible, to put people on their guard against such terrible accidents, or to persuade those vested with authority to take proper measures for preventing them.”

Nothing seems to have been done to remedy this serious evil; and forty-two years later Mr. Chas. Kite, a well-known practitioner, called attention to the subject in a volume, entitled “The Recovery of the Apparently Dead,” London, 1788. This author, on p. 92, says:—“Many, various, and even opposite appearances have been supposed to indicate the total extinction of life. Formerly, a stoppage of the pulse and respiration were thought to be unequivocal signs of death; particular attention in examining the state of the heart and larger arteries, the flame of a taper, a lock of wool, or a mirror applied to the mouth or nostrils, were conceived sufficient to ascertain these points; and great has been the number of those who have fallen untimely victims to this erroneous opinion. Some have formed their prognostic from the livid, black, and cadaverous countenance; others from the heavy, dull, fixed, or flaccid state of the eyes; from the dilated pupil; the foaming at the mouth and nostrils, the rigid and inflexible state of the body, jaws, or extremities; the intense and universal cold, etc. Some, conceiving any one of these symptoms as incompetent and inadequate to the purpose, have required the presence of such of them as were, in their opinion, the least liable to error; but whoever will take the trouble of reading the Reports of the (Humane) Society with attention, will meet with very many instances where all the appearances separately, and even where several associated in the same case, occurred, and yet the patient recovered; and it is therefore evident that these signs will not afford certain and unexceptionable criteria by which we may distinguish between life and death.”

Mr. Kite furnishes references to numerous cases of recovery where the apparently dead exhibited black, livid, or cadaverous countenances; eyes fixed or obscure; eyeballs diminished in size, immovable and fixed in their sockets, the cornea without lustre; eyes shrivelled; froth at the mouth; rigidity of the body, jaws, and extremities; partial or universal cold.[1]

The crux of the whole question is the uncertainty of the signs which announce the cessation of physical existence. Prizes have been offered, and prizes have been awarded, but further experience has shown that the signs and tests, sometimes singly and sometimes in combination, have been untrustworthy, and that the only certain and unfailing sign of death is decomposition.

Commenting upon actual cases of premature burial, the Lancet, March 17, 1866, p. 295, says:—“Truly there is something about the very notion of such a fate calculated to make one shudder, and to send a cold stream down one’s spine. By such a catastrophe is not meant the sudden avalanche of earth, bricks, or stones upon the luckless miner or excavator, or the crushing, suffocative death from tumbling ruins. No; it is the cool, determined treatment of a living being as if he were dead—the rolling him in his winding sheet, the screwing him down in his coffin, the weeping at his funeral, and the final lowering of him into the narrow grave, and piling upon his dark and box-like dungeon loads of his mother earth. The last footfall departs from the solitary church-yard, leaving the entranced sleeper behind in his hideous shell soon to awaken to consciousness and to a benumbed half-suffocated existence for a few minutes; or else, more horrible still, there he lies beneath the ground conscious of what has been and still is, until, by some fearful agonised struggle of the inner man at the weird phantasmagoria which has passed across his mental vision, he awakes to a bodily vivification as desperate in its torment for a brief period as has been that of his physical activity. But it is soon past. There is scarcely room to turn over in the wooden chamber; and what can avail a few shrieks and struggles of a half-stifled, cramped-up man!”

To prevent such unspeakable horrors as are here pictured, the Egyptians kept the bodies of the dead under careful supervision by the priests until satisfied that life was extinct, previous to embalming them by means of antiseptics, balsams, and odoriferous gums. The Greeks were aware of the dangers of premature burial, and cut off fingers before cremation to see whether life was extinct. In ancient Rome the recurrence of cases of premature burial had impressed the nation with the necessity for exercising the greatest caution in the treatment of the supposed dead; hasty conclusions were looked upon as criminal, the absence of breath or heat or a cadaverous appearance were regarded as uncertain tests, and the supposed dead were put into warm baths or washed with hot water, and other means of restoration adopted. Neither in the greater part of Europe nor in the United States are any such means resorted to now, except in the case of apparent death by drowning, by asphyxia, or by hanging. Premature burials and narrow escapes are of almost every-day occurrence, as the narratives in the newspapers testify; and the complaint made by a surgeon, Mr. Cooper, a hundred and fifty years ago, that the evil is perpetuated because we are slaves to prejudice, and because those vested with authority refuse to take measures for prevention, remains a serious blot upon our advanced civilisation. The Spectator, September 14, 1895, commenting upon this unsatisfactory state of affairs, observes:—“Burning, drowning, even the most hideous mutilation under a railway train, is as nothing compared with burial alive. Strangely enough this universal horror seems to have produced no desire to guard against burial alive. We all fear it, and yet practically no one takes any trouble to avoid the risk of it happening in his own case, or in that of the rest of mankind. It would be the simplest thing in the world to take away all chance of burying alive; and yet the world remains indifferent, and enjoys its horror undisturbed by the hope of remedy.”

The authors’ own reasonings, opinions, and conclusions are here briefly presented; but as the majority of the public are more or less influenced by authority, it has been thought advisable to furnish a series of authenticated facts under the several headings to which they belong, and to cite the judgments of eminent members of the medical profession who have given special attention to the subject. The source of difficulty has been an embarras de richesse, or how from a mass of material, the extent of which will be seen by reference to the Bibliography, to select typical cases without needless repetition. The premature burials and narrow escapes from such disasters, which are reported by distinguished physicians and reputable writers, may be numbered literally by hundreds, and for every one reported it is obvious from the nature of the case that many are never heard of. Amongst the names of notable persons who have thought the subject sufficiently practical for their attention may be mentioned those of Empedocles, Plato, Aristotle, Cicero, Pliny, Celsus, Plutarch, and St. Augustine in antiquity; of Fabricius, Lancisi, Winslow, Haller, Buffon, Lavater, Moses Mendelssohn, Hufeland, and Alexander von Humboldt in modern times.

The subject has several times engaged the attention of the French Senate and Legislative Chamber, as well as the Legislative Assemblies in the various States of Germany. In 1871, Dr. Alex. Wilder, Prof. of Physiology and Psychological Science, read a paper before the members of both houses of the New York State Legislature at the Capitol, Albany; but we are not aware that the subject has ever been introduced in any of the other State Legislatures, or in the British Parliament, or in any of the Colonial Assemblies.

In an editorial note, as far back as November 27, 1858, the Lancet, referring to a case of death-trance, remarked that such “examples are sufficiently mysterious in their character to call for a more careful investigation than it has hitherto been possible to accord to them.” The facts disclosed in this treatise, the authors hope, may encourage qualified scientific observers to study the subject of death-trance, which, it must be admitted, has been strangely overlooked in England, though it would not be easy to mention one which more deeply concerns every individual born into the world.

In order to prevent unnecessary pain to the reader on a subject so distressing in its nature, the more sensational and horrifying cases of premature burial have been omitted. They can, however, be found in abundance in the writings of Bruhier, KÖppen, Kempner, LÉnormand, Bouchut, Russell Fletcher, and the Boston (U.S.) edition of Hartmann. In England and in America it is the fashion amongst medical men to maintain that the tests known to medical art are fully equal to the prevention of live burial, that the cases quoted by the newspapers are introduced for sensational purposes, and that most of them are apocryphal. The perusal of the cases recorded in this volume, and a careful consideration of the weight of cumulative evidence represented by the very full bibliography, must satisfy the majority of reflective readers that the facts are both authentic and numerous.