“The question of the possibility of the interment of living beings has recently been exercising the minds of a portion of the public, whose fears have found expression in a series of letters to some of the daily papers. It is a matter of regret that so much irresponsible nonsense and such hysterical outpourings should find a place in the columns of our great daily press. No attempt at the production of evidence in support of their beliefs or fears has been made by the majority of writers, whilst the cases mentioned by the few are either the inventions of the credulous or ignorant, or are destitute of foundation. It cannot be said that the few medical men who have joined in this public correspondence have either contributed any useful information or have seriously attempted to allay the fears of the public. One medical gentleman managed to earn for himself a cheap notoriety by employing, with very scanty acknowledgment of the source, copious extracts from Dr. Gowers’ article on ‘Trance’ in Quain’s ‘Dictionary of Medicine.’
“The possibility of apparent death being mistaken for real death can only be admitted when the decision of the reality of death is left to ignorant persons. We are quite unprepared to admit the possibility of such a mistake occurring in this country to a medical practitioner armed with the methods for the recognition of death that modern science has placed at his disposal. Moreover, even by the ignorant the reality of death can only be questioned during the period preceding putrefaction. During this period various signs of death appear which, taken collectively, allow of an absolute opinion as to the reality of death being given. To each of these, as a sign of death, exception may perhaps be individually taken, but a medical opinion is formed from a conjunction of these signs, and not from the presence of an individual one.”
The writer must surely have overlooked the able treatises by Winslow, Kempner, Russell Fletcher, Hartmann, Gannal, and others, supported by evidence in the aggregate of thousands of cases of premature burial or narrow escapes, or have forgotten the dreadful cases which have appeared from time to time in the THE “BRITISH MEDICAL JOURNAL.” columns of the British Medical Journal itself. Commenting upon the case of a child nearly buried alive, this medical authority in its issue of October 31, 1885, under the head of “Death or Coma,” sensibly refers to some of the difficulties in distinguishing apparent from real death as follows:—
“The close similarity which is occasionally seen to connect the appearance of death with that of exhaustion following disease, was lately illustrated in a somewhat striking manner. An infant, seized with convulsions, was supposed to have died about three weeks ago at Stamford Hill. After five days’ interval, preparations were being made for its interment, when, at the grave’s mouth, a cry was heard to come from the coffin. The lid was taken off, and the child was found to be alive, was taken home, and is recovering. Such is the published account of the latest recorded case of suspended animation. We need not now attempt a dissertation on the physical meaning of coma. It is well known that this condition may last for considerable periods, and may at times, even to the practised eye, wear very much the same aspect as death. In the present instance, its association with some degree of convulsion may easily have been mistaken by relatives, dreading the worst, for the rigid stillness of rigor mortis. This is the more likely, since the latter state is apt to be a transient one in infants, though it is said to be unusually well marked in death from convulsions. One cannot, however, help thinking that the presence of the various signs of death was not, in this case, very carefully inquired into. It is hardly possible that, had the other proofs as well as that of stiffening been sought for, they would have been missed. It is true that hardly any one sign short of putrefaction can be relied upon as infallible. In actual death, however, one may confidently reckon on the co-existence of more than one of these. After a period of five days, not one should have been wanting. Besides rigor mortis, the total absence of which, even in forms of death which are said not to show it, we take leave to doubt, the post-mortem lividity of dependent parts afford sure proof, as its absence suggests a doubt, of death. Then there is the eye, sunken, with glairy surface, flaccid cornea, and dilated insensitive pupil. Most practitioners, probably, are accustomed to rely upon stethoscopic evidence of heart-action or respiration. These alone, indeed, are almost always sufficient to decide the question of vitality, if they be watched for during one or two minutes. There is no information as to whether the child so nearly buried alive was seen by a medical man. It is difficult to believe that, if it had been, some sign of life would not have been observed. Still, the case is a teaching one, even for medical men, and warns us to look for a combination of known tests where any doubt exists as to the fact of death.” The italics are ours.
Prof. Alex. Wilder, M.D., in “Perils of Premature Burial,” p. 20, says:—
DR. ALEXANDER WILDER’S OPINION.
“The signs of total extinction of life are not so unequivocal as many suppose. Cessation of respiration and circulation do not afford the entire evidence, for the external senses are not sufficiently acute to enable us to detect either respiration or circulation in the smallest degree compatible with mere existence. Loss of heat is by no means conclusive; for life may continue, and recovery take place, when no perceptible vital warmth exists.”
M. B. Gaubert, in “Les Chambres Mortuaires d’Attente,” p. 187, Paris, 1895, says:—
“One of the most celebrated physicians of the Paris hospitals, according to Dr. Lignières, declares that out of twenty certified deaths, one only presented indubitable characteristics of absolute death.”