The infrequent and rambling thoughts of Paul Howse...

Buried Alive

I have recently been trying to have an article published, entitled “Misdiagnosing Death.” It’s about the fear of misdiagnosing death in ancient Rome, the evidence gathered from a number of anecdotes found in various ancient authors – mainly Valerius Maximus and Pliny’s Natural History – and corroborated by some rather striking peculiarities in the Roman rituals surrounding death. Unfortunately, my first attempt at having it published was unsuccessful. Part of the “referee’s report” included mention of the lengthy introduction which took a while to even mention Rome as the subject matter.

A point well taken.

However, I really like that first bit – I thought it really exposed the potential for a society to fear the possibility of prematurely burying the dead. So I thought I would provide it here. The text follows the break.

Haec est conditio mortalium: ad has et eiusmodi occasiones fortunae gignimur, ut de homine ne morti quidem debeat credi.

This is the condition of mortals: to this and other occasions of fortune we are subject, so that concerning man no confidence should be placed even in death.

(Pliny Natural History 7.52.173)

A problem commonly experienced to do with death is the anxiety associated with the accuracy of its diagnosis.  The line between life and death is not as distinct as popular culture and the medical profession often presents it.  One of the most recent reminders of this fact, and certainly one of the most widely publicised, was the case of Theresa (Terry) Schiavo in the USA.  The history of the legal dispute is complicated, but the controversy in the public spotlight centred on the question of the point at which a society considers someone to be deceased.  Eventually the justice system decided that Ms. Schiavo was mentally and socially dead, and that therefore the actual physical expiration had already taken place, much to the consternation of the people who thought otherwise.  The heart of the matter was whether Terry Schiavo met the criteria currently in place to consider a person dead, a definition which has gone through major changes in the last thirty years.  The definition of death itself can sometimes be seen as a fluid concept which reflects the consensus of the majority, or the presiding interests, of the culture.  This raises the possibility that a person might be officially considered dead when, according to some dissenting individuals, they are not.  There are limitations to the accuracy of diagnosing the event of death, which once again leads to the possibility of the individual in question being disposed of before, in reality, being deceased.  To combat these fears, the medical profession has in place procedures for pronouncing a person dead;[i] the judgement must be done by a qualified person, usually a doctor. Without the pronouncement by a doctor a death certificate cannot be issued, and legally the person must be considered alive unless various obvious signs of mortality, such as decapitation, are present.  The doctor must follow a strict set of diagnostic guidelines to pronounce a person deceased.  However, sometimes these diagnostic measures are themselves open to challenge and debate.[ii]

The anxieties to do with the diagnosis of death are revealed most starkly in times of high mortality; plague conditions necessitate swift burial, and sometimes this results in mistakes.  Problematically, some common “plague” viruses can depress signs of vigour.[iii] The mix of the two issues gives rise to the likelihood of premature disposal.  As an example of the measures certain societies have created to mitigate these problems, during the medieval and early modern plagues in Europe it became common practice to furnish a new grave with a bell; should a person wake up having wrongly been interred, the theory was that they should ring the bell, and be delivered from their plight.[iv] Popular etymological thought has it that the phrases “saved by the bell” and “dead ringer” came from this practice, and that the phrase “graveyard shift” originally indicated those individuals tasked with listening for the ringing of the mistakenly buried.

Several works were written in the eighteenth and nineteenth century collecting tales of premature burial or dissection.  One of the most notable was Franz Hartmann’s contribution in 1895, which indicated over 700 cases of premature burial, including copious evidence of each case, such as “hissing noises from coffins or vaults, bodies that had moved after interment, torn shrouds, wood splinters discovered under the fingernails…” among many other particulars.  Although the British Medical Journal of 1896 dismissed these claims, it remains evidence of the continued fear of this occurrence, and was by no means the only book on the subject to be published about the same time.  In fact, in 1896, Count Karnice-Karnicki, a Russian doctor and member of the Faculty of Law at the University of Louvain, invented a device to be placed in a coffin that would respond to any motion of the corpse by ringing a bell, raising a flag and opening an air vent.[v]

Recent scholarship has provided further information on the subject of this fear. Jan Bondeson published a study in 2001 entitled Buried Alive.  This text centres on the medical debate regarding the accuracy of the diagnosis of death in the eighteenth and nineteenth centuries.  During this time there were quite substantial fears about this topic, leading to the establishment of many anti-premature burial societies, including the London Society for the Prevention of Premature Burial, which was founded in 1896.  The society contended, based on the number of corpses found in contorted positions within opened graves, that as many as ten percent of the population were buried alive.[vi] Bondeson’s work furnishes a wealth of anecdotal and factual evidence of the strength of this fear within communities who have reason to distrust their methods of identifying death.


[i] These criteria, however, appear to be taught in an informal manner; Park 2004 indicates that few medical textbooks provide a decent coverage of the topic, with the notable exceptions of the Oxford Textbook of Medicine and the Oxford Handbook of Clinical Medicine.

[ii] Our own community has been forced to revisit the definition of death as more advanced medical technology has allowed us to keep individuals respirating and their hearts beating even after all evidence of higher brain function has disappeared. The ethics of continuing to support the basic functions of a body whose living status is in doubt is highly controversial. This problem has been further complicated by the related issue of organ transplant.  To resolve this issue, the definition of death has been modified in Western countries to more accurately explain the point at which a person is considered deceased, changing the definition from solely being based on heart rate and respiration to determination of brain function. The work which has formed the basis of the adoption of brain death as a criterion for determination of death by most Western countries was produced by the ad hoc committee of the Harvard Medical School, published in 1968 entitled “A definition of Irreversible Coma” in the Journal of the American Medical Association 205/6, August 5 1968 pp.85-88.  See the National Health and Medical Research Council’s Certifying Death: the Brain Function Criterion; Ethical Issues in Organ Donation Discussion Paper no.4, 1997, Canberra p.5. For the contrary position see Potts et al. 1994. It is traditional for those who disagree with the brain function criterion of death to lament the lack of opposition to the acceptance of the redefinition of mortality, although recent events as seen in the Terry Schiavo case have undermined this assertion. That today’s legal definition of death is a nuanced and difficult matter is shown by the fact that even those medical professionals who routinely deal with cases similar to these tend to use incorrect language in regards to the patient, tending to speak of them as “living” while the activities maintained by the brain stem (such as respiration and circulation) continue, while legally that fact is irrelevant to the determination. See Stuart Youngner et al. 1989 p.2209, Singer 1994 pp.32-34. See also Bondeson 2001 pp.270-272, who considers the sudden and temporary rise in cases of taphophobia in the 1970s and 1980s as due to this redefinition of the criteria for diagnosing death.

[iii] For details of epidemics in Rome see Kohn 2001 pp.7, 73-74, 188-189, 279-280.  See also MacNeill 1976 pp.112-114 and New Pauly columns 545-546, “Disease: Pathocenosis and Epidemiology.”  The major explosion in epidemics at Rome appears to have begun in the third century AD.  For further information on diseases present in ancient Rome see Scheidel 1994.

[iv] Chidester 2002 p.5.  See also Bondeson 2001 pp.118-136, who discusses the transient popularity of “security coffins” in the late nineteenth century.

[v] Innes 1999 p.75.

[vi] Bondeson 2001 p.278.  See also Davies 2005 p.144.

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