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.