In 1746, Jacques-Bénigne Winslow wrote: ‘Tho’ Death, at some Time or other, is the necessary and unavoidable Portion of Human Nature in its present Condition, yet it is not always certain, that Persons taken for dead are really and irretrievably deprived of Life’. Indeed, the Danish anatomist went on to claim that it was ‘evident from Experience’ that those thought to be dead have proven otherwise ‘by rising from their Shrowds [sic], their Coffins, and even from their Graves’. 
Fears over premature burial were ubiquitous in the 18th and 19th centuries. In 1792, the first ‘safety coffin’ was constructed for Duke Ferdinand of Brunswick which included a window to allow light in and a tube to provide a fresh supply of air. The lid of the coffin was then locked and two keys were fitted into a special pocket sewn into his burial shroud: one for the coffin itself and one for the tomb. Similar constructions followed, including coffins designed with signalling mechanisms to allow the person buried below to notify those above that he or she was not dead.
Perhaps even worse than premature burial was the thought of being dissected while still alive. The 19th-century physician and surgeon, Sir Robert Christison, complained that dissection in St Bartholomew’s Hospital was ‘apt to be performed with indecent, sometimes with dangerous haste’. He wrote:
It was no uncommon occurrence that, when the operator proceeded with his work, the body was sensibly warm, the limbs not yet rigid, the blood in the great vessels fluid and coagulable [sic]. I remember an occasion when [William] Cullen commenced the dissection of a man who died on hour before, and when fluid blood gushed in abundance from the first incision through the skin…Instantly I seized his wrist in great alarm, and arrested his progress; nor was I easily persuaded to let him go on, when I saw the blood coagulate on the table exactly like living blood. 
The 17th and 18th centuries were rife with stories about executed criminals who had ‘returned from the dead’ just moments before being dissected. In 1651, Anne Greene was hanged in Oxford for infanticide. For thirty minutes, she dangled at the end of the noose while her friends’ thump[ed] her breast’ and put ‘their weight upon her leggs [sic]…lifting her up and then pulling her downe againe with a suddain jerke’ in order to quicken her death. Afterwards, her body was cut down from the gallows and brought to Drs Thomas Willis and William Petty to be dissected. Just seconds before Willis plunged the knife into her sternum, Anne miraculously awoke. [For more about Anne Greene, click here]. 
Anatomists, themselves, worried about the precise moment of death when cutting open the bodies of the recently dead. To avoid disaster, Winslow suggested that a person’s gums be rubbed with caustic substances, and that the body be ‘stimulate[d]…with Whips and Nettles’ before being dissected. Furthermore, the anatomist should ‘irritate his Intestines by Means of Clysters and Injections of Air or Smoke, as well as ‘agitate…the Limbs by violent Extensions and Inflexions’. If possible, an attempt should also be made to ‘shock [the person’s] Ears by hideous Shrieks and excessive Noises’. 
To our modern sensibilities, these measures may seem extreme, even comical, but to Winslow, this was no laughing matter. In fact, he went even further, recommending that the palms of the hands and the soles of the feet be pricked with needles, and that the ‘Scapulae, Shoulders and Arms’ be scarified using fire or sharp instruments so as to ‘lacerate and strip [them] of the epidermis’ . Indeed, when reading Winslow’s work, one gets the innate feeling that he took pleasure in imaging new ways to torture the dead.
That said, it wasn’t just medical practitioners who came up with ways of testing whether a person was dead or not. Family and friends of the deceased also devised methods for ensuring that their loved ones were not prematurely buried, including shouting the name of the person and poking his or her eyes. Most commonly, the body of the recently deceased was watched for a period of 3 days before burial, during which time putrefaction and decay would have become evident.
Of course, there were situations that warranted immediate burial of the body, as in the case of plague victims. In these instances, there was no time to wait for the body to begin decomposing. In his book, Winslow recalls the story of a man in Rome whom, upon being ‘accounted dead’, was to be ‘interred with the utmost Expedition’. As his body was being carried over the Tiber River to the plague pit, the boatman ‘discovered some Signs of Life’ and brought the young man back to the hospital ‘where he perfectly recovered Life’. Two days later, however, the man fell back into a similar state and was ‘judged irreparably dead’. His body was ‘without any farther [sic] Hesitation laid among those destin’d for the Grave’. Once again, to the horror of those around him, the man ‘returned to Life’ and escaped premature burial for a second time. 
Recently, archaeologists found evidence that bronze pins were implanted in the ‘palmar surface of the hands, scapular area, under the plantar surface of the feet, and…under the toe nails’ of plague victims in Marseilles. The position of the skeletons in the mass graves also suggest that the dead were given ‘fast burials’ as rigor mortis, which typically appears six hours after death, had not set in before the plague pit was covered over. In the midst of a plague outbreak, one can easily imagine how some people may have been mistaken for dead before being dumped into a pit of rotting corpses. 
Today, our societal fears over premature burial have dwindled considerably. However, new debates have arisen over the very definition of death itself with the emergence of ‘beating heart cadavers’. Though considered dead in both a medical and legal capacity, these ‘cadavers’ are kept on ventilators for organ and tissue transplantation. Their hearts beat; they expel waste; they have the ability to heal themselves of infection; they can even carry a foetus to term. Crucially, though, their brains are no longer functioning. It is in this way that the medical community has redefined death in the 21st century. 
Yet, some wonder whether these ‘beating heart cadavers’ are really dead, or whether they are just straddling the great divide between life and death before the lights finally go out. ■
This article was initially posted on Lindsey Fitzharris’ fantastic website, The Chirurgeon’s Apprentice, which dedicates itself to the study of early modern surgeons, and all the blood and gore that comes with it.
Lindsey Fitzharris is a medical historian. She recently completed her doctorate at Oxford University, where she specialised in the history of seventeenth-century alchemical medicine. She is currently a Wellcome Trust Postdoctoral Research Fellow at Queen Mary, University of London. Her work focuses on the rise of the surgeon in Restoration London (1660-1700); however, her interests in the history of surgery reach much further.
Follow Lindsey on Twitter @ChirurgeonsAppr.
1. Jacques-Bénigne Winslow, The Uncertainty of the Signs of Death, and the Danger of Precipitate Interments and Dissections(1746), pp. 1-2.
2. R. Christison, The Life of Sir Robert Christison (1885-6), pp. 192-3. Originally quoted in Ruth Richardson, Death, Dissection and the Destitute (2000), p. 98.
3. Richard Watkins, News from the Dead (1651), p. 2.
4. Winslow, The Uncertainty of the Signs of Death, p. 21.
5. Ibid., p. 23.
6. Ibid., pp. 4-5.
7. Georges Leonetti, et al., ‘Evidence of Pin Implantation as a Means of Verifying Death During the Great Plague of Marseilles (1722)’, in Journal of Forensic Science 42:4 (1997), pp. 744 – 748.
8. For more on ‘beating heart cadavers’ and new definitions of death, see Dick Teresi, The Undead: Organ Harvesting, the Ice-Water Test, Beating-Heart Cadavers—How Medicine is Blurring the Line Between Life and Death (2012).