Readers of London's Fortnightly Review must have been startled to learn in 1899 that death had “lost its terrors” for the British. “Perhaps the most distinctive note of the modern spirit,” Joseph Jacobs announced, was “the practical disappearance of the thought of death” from everyday life. Improved urban sanitation had lengthened average life expectancy, so that “we are more willing to go, less eager to stay.” With clergymen often acting as “social regenerator[s]” rather than as prophets of heaven and hell, charity in the present was crowding out a sacrament-based focus on the hereafter. Besides, the “hurry-scurry” of industrial capitalism left “no one time to meditate among the tombs.”Footnote 1 Jacobs connected the “dying of death” with some noteworthy social trends. The growing popularity of cremation, for example, was presumably linked to a waning regard for the old graveyard obsequies. Similarly, he construed the rising incidence of suicide as proof of “the disappearance of the death dread.” The words on Thomas Huxley's tombstone—“It is well even if the sleep be endless”—seemed to reflect a “general feeling.”Footnote 2

But when did endless sleep begin? The Fortnightly's author could not have spent much time reading other periodicals or the daily newspapers. For the 1890s in fact witnessed an explosion of popular concern about how dead bodies should be treated and, more fundamentally, about ensuring that the dead truly were dead. The London Association for the Prevention of Premature Burial (LAPPB), founded in 1896, gave organizational form to diffuse fears. Blending middle-class unease over Britain's lax death certification standards with residual working-class worry about defilement at the hands of anatomists, the association labored to publicize the hazards of hasty interment. Stuffing postboxes with pamphlets that recounted “narrow escapes” from the grave, pestering Parliament to save citizens from the “ultimate woe,” recruiting its own corps of physicians to verify the end of life, the association's work seemed curious even by the standards of a society that entrusted so much to voluntary effort.Footnote 3 Still, LAPPB activists managed to sustain a now largely forgotten “moral panic.”Footnote 4 Their warnings about the nightmarish potential of misdiagnosed death sounded all the more dire to a population that was deeply ambivalent about the ambitions of medical science.

The essay that follows will treat late-Victorian fears of premature burial as expressions of this ambivalence. At the same time, it will insist on the plausibility of these fears. To dismiss vivisepulture as “that cliché of nineteenth-century gothic” may be tempting.Footnote 5 After all, like the gothicized belief in savage cannibalism, the notion of the corpse that is not yet a corpse conjures up an image of the world as grotesque. Accounts of premature burials, like reports of cannibal feasts, moreover, share the tendency to dissolve under close scrutiny.Footnote 6 Equally tempting is the impulse to ridicule those who led the agitation. According to one otherwise evenhanded account of the Anglo-American humane movement, only a slide into “battiness” could explain why Walter Hadwen, a prominent antivivisectionist, began to fret about citizens being buried alive.Footnote 7 Such concern seems peculiar to us now. If, however, the best point of entry into a foreign culture is where it appears most opaque, then Victorian anguish over the signs of death, no less than cat killings in ancien régime Paris, should be fit for reflection.Footnote 8

The disquieting liminality of near-death states will receive close attention here. Anthropologists, and more recently historians and literary critics, have turned to investigating borderlands, frontiers, and boundaries as fruitful sites for understanding the creation of cultural hybridity.Footnote 9 But a threshold (limen in Latin) can be conceived in physiological as well as cultural terms. The Victorians employed an opulent if unstable vocabulary to designate bodily conditions that hovered between the fully animate and the irrecoverably dead. Trance, coma, syncope, catalepsy, insensibility, suspended animation, human hibernation, and anesthesia were only the most common labels for what appeared to be corporal frontiers. Like mesmerism, these liminal categories were far from fixed; their ambiguity, indeed, both reflected and reinforced the enormous expansion of mental power that many Victorians associated with altered forms of consciousness.Footnote 10 Inseparable from the somatic ambiguity of premature burial was its literary life as a metaphor for cruel confinement. Readers of the popular press were familiar with anti-Catholic tales of innocent girls immured in nunneries; with the financially feckless entombed in debt; with pottery workers slowly suffocating in clay dust; and of course with coal miners and grave diggers who, on occasion, were literally buried alive.Footnote 11 Where the trope ended and true vivisepulture began could be nearly as hard to distinguish as the body's vital signs.

One further ambiguity shapes this account of Victorian alarms over premature burial. Both the nineteenth-century medical establishment and some modern commentators would agree that the British people were less susceptible than the Germans or the French to this “most ghastly” of all terrors.Footnote 12 Victorian allopaths, or at any rate those consulting specialists who by the last third of the nineteenth century had fashioned themselves into a professional elite, held that physicians trained in Britain were too thorough to confuse “death-counterfeits” with the real thing: “modern stories of premature burial in England…belong to the domain of the novelist rather than of the scientist.”Footnote 13 Even conceding the remote possibility that a doctor might mistake life for death, the British poor, supposedly in contrast to their continental peers, were wont to keep bodies at home long enough for putrefaction to remove all uncertainty.Footnote 14 Where most Victorian doctors gave short shrift to the dangers of premature burial, modern historians of the subject have tended to deduce popular mood from legal prescription. The Leichenhaus movement built “asylums for doubtful life” in several German towns during the first three decades of the nineteenth century, and functionally equivalent “waiting mortuaries” later opened in Vienna and Paris.Footnote 15 British towns constructed nothing of the sort.Footnote 16 Only in late-Victorian Britain, however, did public concern over premature burial trigger a coherent “burial reform” movement. Explaining why this should have been the case requires, first, an assessment of the physiological confusion that the Victorians inherited and, second, an appreciation of the contested nature of medical authority.

The near-death trance of pre-Victorian times belongs partly to Britain's rich tradition of prophetic preaching. The long eighteenth century produced several visionaries—ecstatic Quakers, Wesleyan schismatics, and messengers of the millennium—whose journeys back from the grave were “wonders” to be celebrated in tract and chapbook.Footnote 17 Pious men, women, and children might lapse into multiple-day comas so deathlike that their funerals were ordered. But these people did not go into the ground because they always revived at the last moment, keen to tell their mourners about the paradise beyond.Footnote 18 The most enduring of these revelations involved one Henry Watts, variously identified as the devout incumbent of a parish in Yorkshire, Surrey, or Oxford, who, in either the late seventeenth, late eighteenth, or early nineteenth century, had already been nailed up in a coffin when his wretched groaning averted tragedy.Footnote 19 All these accounts featured a visitor to the other side who could regain consciousness through an act of will. What came to preoccupy British medicine in the late eighteenth and early nineteenth centuries, by contrast, were precisely those victims of accidents who had no gift for self-resuscitation.

The confidence that death could be known as never before derived from the Enlightenment's “recovery of nerve,” a renewed faith in material and intellectual progress.Footnote 20 The lure of medical progress allegedly expressed itself among educated French people as “a growing reluctance to accept illness fatalistically, and an intensified shrinking in [the] face of pain.” According to this view, France's mid-eighteenth-century fixation with premature burial was a form of “hypochondriacal zeal.”Footnote 21 While such a claim cannot hold for Georgian Britain, it is clear that two continental treatises on the physiology of death, by the sober Danish anatomist Jacques-Bénigne Winslow and the flamboyant French physician and translator Jean-Jacques Bruhier, encouraged British medicine to reconsider the signs of death. Bruhier's Dissertation sur l'incertitude des signes de la mort (1742), a sensationalized version of Winslow's thesis Mortis incertae signa (1740), detailed 181 cases of the “apparently dead” who had risen from “their Shrowds, their Coffins, and even from their Graves.” Both treatises drove home the point that putrefaction was the only infallible proof of death. Where putrefaction had not commenced, Bruhier's readers were urged “so to treat the Body as not to hinder it from returning to Life.”Footnote 22

Bruhier's warning found an alert British audience. Although the old custom of “watching” a corpse between death and burial lingered in some localities through the 1830s, its persistence had more to do with popular dread of grave robbery and dissection than with heightened concern over careless interment.Footnote 23 Britain's openness to the physiological advice of Bruhier and Winslow followed instead from a long-standing interest in the resuscitation of those apparently dead. Well before René Antoine Réaumur published his landmark study of artificial respiration in Paris in 1740, the tales of Anne Green (whom Sir William Petty revived in 1650 after her hanging at Oxford for killing her illegitimate baby) and Colonel Townsend (who “astonish'd to the last degree” Doctors Cheyne and Baynard around 1730 by entering and then leaving a state of suspended animation) had grown legendary.Footnote 24 Thus, the news that in 1767 some wealthy Dutch merchants had established a “Society for the Recovery of Drowned Persons” in Amsterdam was received as a challenge. For “if the number of accidents is proportional to the number of persons employed on the water,” reasoned one doctor, then “this kingdom [Britain] is more interested than any other nation, in the art of restoring drowned persons.”Footnote 25

Those genteel imitators who founded the Royal Humane Society (1773) may have been investing in social harmony: like the hospital movement, their campaign to restore the “senseless” victims of drowning, strangulation, and stroke showed an appreciation on the part of the propertied classes that to be secure, wealth must wear a human face. Some of the society's subscribers may have been staunch evangelicals.Footnote 26 But the sustaining impulse of those who for a generation would throw themselves into experiments on human and animal vitality was neither tactical nor theological. Rather, they aimed to minimize needless suffering. In this respect the Humane Society, along with the novel, the autopsy, and the social case history, contributed to what Thomas Laqueur terms an emerging “humanitarian narrative,” a bridging of compassion and action through which the “flesh speaks.”Footnote 27 These activists were an optimistic lot. By 1794, reckoned Anthony Fothergill, his colleagues had gone to the rescue of 3,000 people who had ceased breathing, resuscitating two-thirds of them. Like Linnaeus before them, the Humane Society's doctors and gentlemen physiologists faced “determined assailants.” Incredulity would soon fade, though, as it became more widely known that medical science, not divine intervention, held the key to survival.Footnote 28

Doubting the semblance of death struck members of the Royal Humane Society as the most literal form of healthy skepticism. Such doubt launched a search for restorative techniques—better ways to stimulate the body's “irritability” that ranged from vigorous rubbing with woolen cloths to blowing tobacco smoke up the rectum with a bellows.Footnote 29 Yet precisely how death came to the drowned, the hanged, and the electrocuted remained a subject “perplexed with discordant theories.” Handsome cash prizes encouraged physiologists to kill alarming numbers of puppies and kittens in an effort to establish the exact relationship between the heart and the lungs.Footnote 30 Although these Georgian vivisectors provoked far less outrage than their late-Victorian heirs, closely related experiments on human corpses intensified public unease about the boundary between life and death. As historians have noted, “resurrection” riots over the hanging of felons at Tyburn derived in part from fears that where the noose had not done its job, unconscious people might be sent to the surgeons' hall for a second and far worse execution.Footnote 31 Less well known to the public but more fascinating to British medical science was Giovanni Aldini's galvanic manipulation of the criminal Forster's hanged corpse in 1803. Attaching separate piles of zinc and copper plates to the man's mouth and ear, Aldini induced an invisible galvanic “arc,” whereupon Forster's “jaw began to quiver, the adjoining muscles were horribly contorted, and the left eye actually opened.”Footnote 32 Some British investigators were already convinced that with “dextrous management” electricity might alternatively suspend and restore animation in certain animals. But with rumors that a galvanic fluid was capable of growing new heads on decapitated snails, with Aldini continuing to proclaim galvanism's power to tap the “springs of life” in human victims of asphyxia, and eventually, by the mid-1830s, with the hotly disputed news of Andrew Crosse's success in creating mites through the electrification of a chemical solution, it was becoming reasonable to wonder whether death itself was a fixed condition.Footnote 33

Thus, to characterize the Victorian worry about premature burial as a product of “morbid romanticism,” or of the “sheer mythopoeic force” of vivisepulture, is to ignore the deep confusion over human physiology that persisted into the twentieth century.Footnote 34 True, gothic fiction, that protean genre first associated with a late eighteenth-century literature of excess, provided the sort of dark sensibility that helped naturalize stories of premature burial. Consider The Monk (1796), Matthew Lewis's crude and once wildly popular gothic novel. His Father Ambrosio effectively buries alive the virtuous Antonia, sending her drugged body to the cemetery vault where he rapes her amid “putrid” flesh and “rotting bones.”Footnote 35 True, too, Joseph Taylor's The Danger of Premature Interment (1816) and John Snart's Thesaurus of Horror (1817) wallow in claustrophobia: the frantic beating of elbows, knees, and forehead against coffin walls leave the undead bleeding from every pore.Footnote 36 And granted that Edgar Allan Poe's “The Premature Burial” (1844) was a sepulchral tour de force. Partly inspired by a similar first-person fantasy in Blackwood's, Poe graphically imagined the “appalling and intolerable horror” of the “rigid embrace of the narrow house.”Footnote 37

Nonetheless, Poe's chilling tale would not have resonated so powerfully with its transatlantic readership had medicine been of one mind about the nature of human vitality. There were, in fact, two very different approaches to the problem of living states that mimicked death. Cases in which inert bodies had been revived could suggest that respiration and pulse were not actually essential to life. If this were true, then these functions could no longer be used as the criteria of death; new criteria, perhaps even a new definition of death, would be required. Alternatively, perhaps the vital functions never fully stopped in such cases. It was possible that blood continued to circulate and be oxygenated at a level below the sensitivity threshold of the available instrumentation. If this were true, then medical science should devote itself to finding better diagnostic tests.Footnote 38

Nineteenth-century physiologists hedged their bets by distinguishing between “sensorial” and “absolute” death, or, still more abstractly, between “molecular” and “systemic” death. Xavier Bichat's famous animal experiments in France made conceivable a decentralized vitality wherein the individual might possess both living and dead tissue. In the most liminal of all medical models, the German physician Cristoph Wilhelm von Hufeland had suggested that a state of profound unconsciousness, the Scheintod, always precedes true death.Footnote 39 “Who shall decide, when doctors disagree”? Alexander Pope's question had rarely seemed so apt.Footnote 40

But doctors do not merely disagree. Their errors can be disastrous, a fact of which the Victorian public was acutely aware. The so-called medicalization of modern society, a totalizing term used to denote the displacement of community involvement with basic health decisions by a remote expert knowledge, has drawn deserved criticism. At the level of epistemology, to speak of “medicalization” is to imply a disciplinary impulse so diffuse as to resist identification.Footnote 41 As applied to death, “medicalization” often assumes a false dichotomy between modern “clinical” treatments of the body and older “socialized” funeral rites.Footnote 42 With respect to Victorian Britain, recent scholarship has charted some of the spatial and conceptual limits to medical expertise.Footnote 43 We should appreciate, furthermore, how provisional the authority of medicine must have seemed when pronouncing on many physical states.

For example, the nineteenth-century doctor could mistake human life at the start. It was fine for C. Pajot to declare, “There are no false pregnancies,…only false diagnoses.” But in fact “pseudocyesis,” a term coined in 1823, caused real if rare obstetrical embarrassment. All the telltale signs of pregnancy—cessation of the menses, nausea, and swelling of the breasts and abdomen—might be present, but prior to the fifth month, even an experienced hand could not trust his stethoscope to settle the matter.Footnote 44 In 1839, a physician's “vile” judgment that Lady Flora Hastings was with child triggered the first court scandal of Victoria's reign.Footnote 45 At the other end of the life cycle, the awful speed with which cholera could render a body cold and stiff from muscular spasm lent credence to accounts of ignorant doctors who condemned the living to a fate worse than death.Footnote 46 From time to time Victorian medicine stood accused of lethal apathy, such as failing to halt the “revival” of leprosy.Footnote 47 Medical men purportedly condoned “blood assassination” against the poor in the form of compulsory smallpox vaccination.Footnote 48 Doctors were accused of training psychiatric “bodysnatchers” whose quest to enlarge the domain of madness involved committing perfectly sane people to lunatic asylums. Finally, during the last third of the nineteenth century, the profession drew heavy fire for perpetrating experimental outrages against innocent animals, and for undertaking the “instrumental rape” of suspected prostitutes.Footnote 49

Often confused, sometimes careless, and, it was charged, occasionally cruel, Victorian doctors were poorly positioned to reassure the public about their ability to know death when they saw it. This assertion would verge on the preposterous if one were to consider only medical technology. By the close of the nineteenth century, a British doctor's tools would likely have included both a reliable stethoscope and an accurate body thermometer, and possibly also an ophthalmoscope (to search the retina for early evidence of decomposition), a hypodermic syringe (used for the subcutaneous injection of ammonia to test for an inflammatory response), and a magnesium lamp (to examine the skin between the fingers for signs of circulation).Footnote 50 Yet no one test for death, other than the slow and unpleasant wait for putrefaction, was regarded as definitive by itself. Moreover, few doctors, especially overworked general practitioners, would have had the time to follow Benjamin Ward Richardson's widely publicized four-step protocol.Footnote 51 Just as significantly, many of the same medical experts who promoted these instrumental tests continued to employ an old and thoroughly unsystematic vocabulary to describe near-death states. In so doing they unwittingly sustained popular apprehensions. What has been called the late-Victorian era's “new professional certainty” about the signs of death was in fact sabotaged by a nomenclature of mysterious gradation.Footnote 52

The term “suspended animation,” to take an obvious example, popularly implied a self-induced trance that might masquerade as death. Exceptional humans supposedly shared with certain animals the ability to “hibernate,” a physiological state wherein vital functions slowed to levels approaching the imperceptible. Tellingly, the most spectacular of animal hibernators, Ceylonese frogs who “entombed” themselves in clay to await the return of the monsoon, and their human counterparts, ascetics who reportedly could survive for a month sewed up in linen shrouds and placed in holes covered with great slabs of stone, were both exotics from the Indian East.Footnote 53 As Alison Winter has remarked, among the strongest associations Victorians made with India involved trances, induced either by opium or religious fervor; it was therefore easy to think of the subcontinent as a kind of laboratory for the cultivation of altered states of mind.Footnote 54 Although Indian “fakirs” would continue to represent the closest human approximation of “the torpor of the lower animals,” suspended animation was a migratory phrase whose meaning wandered from the realm of comparative zoology into discussions of the nearly drowned. For the lay public, it suggested the “dormant” yet undead body.Footnote 55

On the cutting edge of medical science, however, suspended animation acquired quite another meaning with the advent of inhalation anesthesia. The introduction of ether (1846) and chloroform (1847) marked a major advance in the war on pain, rendering patients “dead to the world” during surgery. But the conquest of pain so celebrated in medical journals came at a high cost. Chloroform, capable of producing a deeper anesthetic state than ether, was also more dangerous. Although the incidence of chloroform-related deaths could not be established with precision, professional anxiety rose along with the sharp peak in fatalities at century's end. Embarrassingly, 1897, the fiftieth anniversary of Sir J. Y. Simpson's administration of chloroform, saw more anesthetic deaths (96) than any previous year.Footnote 56 Keen to establish the material basis of the anesthetic state, Richardson speculated in 1879 that a combination of drugs and cold might keep humans in suspended animation for “weeks or months.” The anesthetists claimed as well to be Britain's great resuscitators, but how comforting was Richardson's vision of patients kept in a prolonged medical limbo?Footnote 57 How, for that matter, did anesthetic oblivion differ from the rival trances induced in the mid-nineteenth century by mesmerism and, toward century's end, by hypnotism? In 1854, it was reported that the “most respectable” Mrs. Flowerday's right breast had been painlessly amputated at London's Mesmeric Infirmary. A generation later, Alfred Wootton, a lead worker, was hypnotized in front of a crowd at the Royal Aquarium, spent six days sealed in a casket (fitted with an air shaft) under eight feet of earth, and emerged healthy if rather stiff and cold. Had both patients experienced the same “nervous congestive state of the brain”? Had both been rendered temporarily insane, entering the same “ideoplastic state” that characterized sleepwalking?Footnote 58 To classify these “hysterical” symptoms as forms of suspended animation strained reason.

Distressingly elastic, the phrase “suspended animation” was at least comprehensible to the layperson. Not so such designations for unconsciousness as “syncope” and “catalepsy.” These terms had been part of a specialized Anglo-American medical vocabulary since at least the mid-eighteenth century. Syncope referred to fainting, that is, to “a deep and sudden swooning, wherein the patient continues without any sensible heat, motion, sense, or respiration, and…all the [body] parts turn pale and cold as if dead.” Catalepsy originally designated a seizure where the limbs remain “in any position in which they are placed, however painful or fatiguing.”Footnote 59 Late-Victorian Britain's leading forensic physician, C. M. Tidy, reserved syncope to describe those traumas—hemorrhage, starvation, and exhaustion, among others—that caused death “beginning at the heart.” Looser usage, however, implied a profound shock to the central nervous system.Footnote 60

The biomechanism of catalepsy was more obscure still. In Poe's grim short story, both the causes and the diagnoses of this disorder were vague. The victim, still faintly warm, might suffer less than a day from an “exaggerated lethargy”; then again, an extreme attack might last for weeks or months, during which time no medical test could detect the vital spark. In 1850, The Times reported a real-life cataleptic, Ann Cromer, said to be approaching the end of her thirteenth year in a trance where breathing, body heat, and periodic groaning were discernible.Footnote 61 But it was the “petrified” parts of some bodies that fascinated doctors. Enough like rigor mortis to fool the unwary physician, catalepsy seemed to be either a spectacular form of hysteria or else an early symptom of epilepsy, though its underlying pathology, in the words of an eminent neurologist, could “only be guessed at.”Footnote 62 Blows to the head or spine might cause a cataleptic seizure, but so also might influenza, chloroform poisoning, prolonged intellectual strain, or “unsatisfied sexual desire.” The scalpel-happy Isaac Baker Brown wrote proudly of three women whose cataleptic “fits” either diminished or disappeared after he sliced away their clitorises.Footnote 63 Those afflicted with this disease were judged capable of almost any strange act. Pondering the physical basis for supernatural phenomena, the novelist Edward Bulwer Lytton ventured that “all Media and clairvoyants are more or less cataleptic.”Footnote 64

Lord Lytton's remark mirrored the common equation of trance, variously defined, with spiritualism. During the 1840s British society was awash in séances where, to prove her complete sensory suspension, the mesmerized subject might be pricked with pins, given electrical shocks, or even anointed with acid. Half a century later, the Society for Psychical Research sought repeatedly to verify claims that thought transference between the living and the dead occurred during certain trance states.Footnote 65 According to the 1911 Encyclopaedia Britannica, in an “ecstatic” trance the soul was alleged to transcend the bounds of space or time and to glimpse some distant reality. In the “mediumistic” trance, by contrast, the soul temporarily vacated its body, making room for another spirit. Conventional medicine tended to view both states as manifestations of severe mental defect.Footnote 66 Yet doctors and laypersons could agree (for different reasons) on one fact: the entranced risked real physical harm. The death in 1889 of W. I. Bishop sent a shudder throughout the transatlantic spiritualist world. Bishop, an American well known in Lancashire for his psychic prowess, succumbed to “hysterical catalepsy” while reading a mind in a New York City gentleman's club. The story did not end here, however, because within four hours of his apparent death, Bishop's brain was dissected in defiance of his wish that there be no autopsy. Had the renowned psychic fallen prey to a horrible “human vivisection”? Frances Power Cobbe, the doyenne of Britain's antivivisection movement, would always wonder.Footnote 67

Given such doubt about Victorian medicine's capacity to distinguish life from death at these physiological frontiers, the precautions of some middle-class citizens begin to look more rational than eccentric. The will instructing executors to guard against premature burial has become a staple of antiquarian lore. Some of the cases on offer are fictions compounded in the retelling. Hence, the legend that Harriet Martineau ordered a doctor to remove her head before burial sprang from sloppy research in William Tebb and Edward Perry Vollum's Premature Burial and How It May Be Prevented (1896). If one actually consults Martineau's will, one learns that this mid-Victorian journalist and humanitarian donated both her skull and her brain to a London physician “for purposes of scientific observation.”Footnote 68 Nonetheless, what the Burial Reformer called the “fears of famous people” did yield some remarkable instructions. Before his body was cremated, Herbert Spencer specified that it “be placed in a coffin with a loose lid easily opened from below.” Lady Isabel Burton, widow of the famed explorer and linguist, wanted a needle passed through her heart. For graphic clarity, however, it would have been hard to surpass Miss Cobbe. She left a neighboring physician twenty guineas “to perform on my body the operation of completely and thoroughly severing the arteries of the neck & windpipe (nearly severing the head altogether) so as to render my revival in the grave absolutely impossible.”Footnote 69

“Safety coffins” served a similar purpose. Actually, few of the British coffin patents awarded between 1855 and 1896 had vivisepulture in mind. They aimed instead to make the casket airtight, to deodorize the corpse, or, with the growing popularity of cremation after 1880, to ensure that both box and body would be fully combustible. Nevertheless, coffins featuring breathing tubes, alarm bells, and spring-activated flags were available to the cautious consumer.Footnote 70

Caution appears rational also because coroners at the local level and Home Office personnel at the national were loath to permit exhumations in cases of alleged premature burial. Ruth Richardson has shown that working-class fears about grave robbing and dissection did not vanish with passage of the 1832 Anatomy Act—legislation that regulated the supply of cadavers for medical teaching. Scattered evidence suggests, indeed, that the fusion of these fears with proletarian anger against the New Poor Law turned graveyards into potential battlefields. Ten years after the Anatomy Act became law, an unruly crowd of nearly two thousand watched as furious Loughborough women used bare hands and broken plates to dig up a pauper man believed to have been buried alive. Although his body turned out to be fully dead and in perfect repose, the event had encouraged bystanders to conflate workhouse discipline and vivisepulture. An all-out riot over the desecration of pauper coffins shook Sheffield as late as 1862.Footnote 71 English coroners could order the exhumations of, and inquests for, all persons whose deaths aroused suspicion. In 1888, the coroner of Leeds did just that when a grave digger reported “a strange knocking and creaking” while he was covering a coffin. But most coroners were not inquisitors in the mold of Thomas Wakley, forensic scourge of West Middlesex. Preferring instead to minimize “vexatious” action, these officials typically reserved their exhumation power for cases where a suspected crime, usually poisoning, might be confirmed through toxicological analysis.Footnote 72 Similarly, Home Office personnel held firm against disinterments to ease the grief of kin. If the government could deny a widow her wish to gaze one last time on her husband's face, it was easy to dismiss exhumation requests based on fears of cataleptic burials.Footnote 73 Allowed no second chance to right a “frightful” wrong, then, some citizens welcomed the idea of holding medical men to a higher standard where death was in question.Footnote 74

By century's end, the wider British public had been exposed to a “sensational” habit of mind through both fiction and popular science. Where Wilkie Collins's best-selling The Woman in White (1859–60) derived its nervous force from “the most horrible of all false imprisonments,” namely, confinement in a lunatic asylum, his less celebrated Jezebel's Daughter (1880) went one step further with its melodramatic revival of a corpse in the “dead house” at Frankfurt.Footnote 75 Missionary accounts and travel-adventure tales agreed that among the dark tribes of southern Africa and the western Pacific, live burial was commonplace.Footnote 76 Yet this quintessentially “savage” custom might also be threatening higher civilization at the hub of the British Empire. For the ordinary British doctor was not only ill-prepared to distinguish between life and death but also, it emerged in the mid-1890s, often too busy to notice.Footnote 77

Late-Victorian fears about premature burial constituted a “moral panic” in the sociological sense of that term. Originally applied during the early 1970s to the demonization of British youth cultures, the notion of moral panic built on U.S. theories of social deviance and collective behavior.Footnote 78 Since its initial use, explaining how the mass media “amplified” teenage misbehavior in the interest of reinforcing community norms, moral panic has been associated with crusades centered on everything from the sexual abuse of children in the United States to popular representations of HIV/AIDS in the Philippines, from flag burning to family values, and from crime on city streets to pornography on television.Footnote 79 The term is often bandied about to denote a social “shock,” “scare,” or “menace,” with little or no recognition of the conceptual stakes involved.Footnote 80 Still, three elements of the moral panic model make it suggestive for the present discussion.

First, moral panic involves popular overreaction to a perceived threat. At the close of the nineteenth century, the British medical establishment held that not one authenticated case of premature burial had been unearthed in a generation; virtually all the evidence for a fear that “tormented” a “large number of persons” was hearsay.Footnote 81 This incongruity between remote danger and acute public concern typifies a second element of the moral panic: its tendency to occur when ethical boundaries seem blurred.Footnote 82 Just as the physiological frontier separating life from death was vague, so also were the lines of medical responsibility. While medicine's moral mandate urged doctors to do no harm, some physicians, it appeared, broke the Hippocratic Oath on a regular basis. Allegedly cavalier about the certification of death, the late-Victorian doctor impressed critics of conventional medicine as a professional reprobate or, to use Stanley Cohen's phrase, a “folk devil.” This third defining feature of the moral panic has often emphasized the process by which disciplinary agents—police, prosecutors, and judges—help vilify the socially marginal.Footnote 83 In the moral panic over premature burial, however, it was a coterie of middle-class activists who led the charge against what they took to be a dangerous legal defect.

A French physician observed in 1875 that the prospect of waking up at the bottom of a grave could, given enough publicity, unleash “universal panic.”Footnote 84 But the late-Victorian version of this fear was in fact highly particular, much as earlier British panics over poisoning (1855–56), wrongful confinement in lunatic asylums (1858–59 and 1876–77), and garotting (1862) had materialized around specific “sensations.”Footnote 85 The sensational truth about dying, according to the parliamentary investigation of 1893–94, was that British physicians often issued death certificates without having seen the deceased in life.

Where children were concerned, this was old news. Class-based accusations against “depraved” parents first surfaced during the 1840s when public health activists trained their guns on the practice of insuring young lives. Although “industrial assurance” helped shield the poor from ruinous burial expense, opponents of this custom insisted that the tendency of doctors to grant death certificates willy-nilly encouraged crime.Footnote 86 The respected coroner for South-Western London, A. Braxton Hicks, pointed out that at best medical men had a “very imperfect knowledge” of their duties under the 1874 Registration of Births and Deaths Act. There was worse to contemplate. The House of Lords learned that general practitioners frequently felt economic pressure to issue death certificates for children, as punctilious doctors risked alienating parents.Footnote 87

The 1893–94 Select Committee on Death Certification only heightened anxieties about medical recklessness. Chaired by Sir Walter Foster, M.D., M.P. (and a vice president of the British Medical Association), this parliamentary investigation was more intent on improving the accuracy of vital statistics than on preventing “very terrible accidents.” But once Foster's committee began investigating irregularities in medical attendance during a patient's “last illness,” alarms were bound to sound.Footnote 88 Those medical officers of health who testified had heard nothing about premature burials in their districts. Ominously, though, the committee's report conceded that “a further reason for requiring inspection of the body, by a medical man prior to his giving a certificate [of death], consists in the fact that in some instances a skilled observer only would be able to pronounce whether life was extinct.”Footnote 89 This comment aimed to buttress the case against allowing unlicensed healers any role in the management of death. Yet its unintended consequence, and indeed the general thrust of the report, was to “confirm the prevailing…uneasiness of the public mind.”Footnote 90

During the late summer and early autumn of 1895, London's popular press accentuated such unease by publishing a raft of material on the hazards of hasty interments. The media presentation—in the language of moral panics, the “inventory”—was largely anecdotal. Bearing titles such as “The Dead Alive,” “Mistaken for Dead,” and “Sounds from Another Coffin,” these letters and editorials would at first seem to confirm mainline medicine's view that August and September marked the “silly season,” the news doldrums when a “trancemogrification” craze might safely be indulged.Footnote 91 The ironies were strained. “As a German,” huffed one correspondent, “I should be afraid to die in England.” “Our entire system of death certification would not do credit to a tribe of wandering Arabs,” complained another.Footnote 92 Even so, the eagerness with which highly literate citizens greeted the 108 horror stories in Franz Hartmann's Buried Alive (1895) demands explanation. An Austrian who had emigrated to the United States in the 1860s, Hartmann may have been a licensed physician; he was certainly an enthusiastic Theosophist and Rosicrucian.Footnote 93 That his grotesque tales (of the “dissected alive” in particular) sounded credible to some British readers owed as much to their antimedical tone as to their occult packaging. “In these evolutionary times,” mused the English Mechanic and World of Science, “people seem in a hurry to rid themselves of defunct relatives.” Were doctors ready to oblige? Why should physicians, already inured to the cruelties of compulsory vaccination and vivisection, be trusted to distinguish between a “dead faint” and genuine death? The “superior manner” of medical men supposedly masked the “wild mistakes” of their “guesswork.”Footnote 94 If the flesh spoke, were doctors listening?

Britain's central government made no move to implement the key recommendation of Foster's select committee: that the medical practitioner should be legally bound to verify the fact of death, either personally or by means of a certificate to that effect signed by two neighbors of the deceased. The Lancet urged reform, as did less reputable sources.Footnote 95 Whereas the Cremation Society required two separate medical inspections of all bodies before burning, the British state merely watched as 11,464 “corpses” went into the ground unexamined during 1896.Footnote 96 Then, toward the beginning of that same year, a new book bristling with case studies proclaimed that “narrow escapes” from living death numbered in the “thousands.”Footnote 97

The joint effort of an English antivaccination crusader and a former U.S. Army surgeon, Premature Burial and How It May Be Prevented soon became the core text of the burial reform movement. Tebb and Vollum's tome struck the medical press as a “farrago of nonsense.” It struck the lay public as “very interesting,” in a “gruesome” sort of way.Footnote 98 Encouraged by the book's wide notice, and convinced that the medical profession would never deign to train doctors in the subtleties of death verification, Tebb and Vollum turned to philanthropy. Their London Association for the Prevention of Premature Burial was founded in December of 1896.Footnote 99 For seventeen years the LAPPB would function as one of Britain's more obscure pressure groups. But its very existence meant that the moral panic of 1895–96 did not fully recede until World War I produced another kind of body count.

Mired in confusion, the signs of death invited a semiotics of dread. Meanwhile, at the end of the nineteenth century, critics of orthodox medicine were seeking not only to shape diffuse fears into a demand for stringent death certification but also to promote the scientific investigation of trance.Footnote 100 The moving force here was Tebb. Whereas “obsolete” laborers have long since been rescued from the “enormous condescension of posterity,” the historical rehabilitation of bourgeois “heretics” like Tebb is far from complete.Footnote 101 The reformist loyalties of the well-traveled Tebb remind us that the boundaries—social as well as theoretical—between medicine's professional center and its fringe were fluid. His allegiances to antivaccination, antivivisection, and vegetarianism describe what has been called “polymathic unorthodoxy,” the tendency for varieties of religious and medical dissent to attract one another.Footnote 102 Yet there was more to Tebb, and to his close allies, than a predictable confluence of causes.

Although Tebb's public life in Britain would center on London, his roots were northern and sectarian Protestant. Born (1830) and privately educated in Manchester, then the nation's wellspring of political reform, Tebb probably did absorb the Anti-Corn Law League's critique of special privilege, for freedom of conscience remained his paramount concern.Footnote 103 But the peculiar tenets of a nearby Salford chapel may have exercised as much long-term influence as the free trade gospel of Richard Cobden and John Bright. A neo-Swedenborgian outpost, the tiny Bible-Christian Church had since its formation in 1809 preached abstinence from meat and alcohol; such self-denial of the body aimed to starve cruel habits and so elevate the soul at the dawn of the millennium. We know that in 1817 several Bible-Christians immigrated to Philadelphia, where they established a U.S. branch of their sect. We know also that organized vegetarianism in Britain and the United States evolved out of the dietary evangelism of these congregations. Finally, we know that in the summer of 1852, Tebb, age twenty-one, sailed to Philadelphia as an emissary of the Vegetarian Society of Great Britain. A few months later he spoke at length to the second annual meeting of the American Vegetarian Society.Footnote 104

What began as a tour of the U.S. vegetarian circuit became a nine-year education in the politics of abolition. Tebb arrived in the northeast United States already disposed through his Bible-Christian associations to support temperance and women's suffrage (votes for women being another hallmark of “universal humanity”).Footnote 105 He returned to Britain at the start of the Civil War having wed Mary Scott, a direct descendant of Roger Williams, in 1856, and having found common cause with some of that era's leading antislavery zealots. How closely Tebb worked with William Lloyd Garrison, Wendell Phillips, and Alexander Ross is unclear. A colleague who knew him well recalled at Tebb's death that “more than once” antiabolitionists had destroyed his property. In fact, the physical frailty from which Tebb suffered throughout much of his adult life was allegedly a product of his “experiences by night in wood or swamp, helping to pilot escaping slaves to freedom” on the Underground Railway.Footnote 106 But no doubt surrounds his later equation of a U.S. “slavocracy” with English magistrates bent on fining or jailing those who refused to vaccinate their young. Both fugitive slaves and resisting parents were “hunted.”Footnote 107

In time, Tebb, too, would feel hunted. When he began refusing to expose his third daughter to the “virulent pollution” of smallpox vaccine around 1875, Tebb was living near Regent's Park in central London and possessed means enough to pay thirteen police court fines and the legal costs for one failed appeal to Queen's Bench.Footnote 108 Disgusted with what he perceived as a legal outrage and a medical atrocity, Tebb threw himself into a new cause, transforming the Vaccination Inquirer into the voice of the antivaccination cause and launching the London Society for the Abolition of Compulsory Vaccination (LSACV) in 1880. Under Tebb's leadership, the LSACV imposed discipline on a previously fractured movement. His footsoldiers interviewed ordinary people at railway stations, aboard buses, and on doorsteps about the dangers of a vile “operation,” while Tebb himself aimed to convert the socially and scientifically prominent.Footnote 109 In addition, LSACV propaganda cast doubt on government health statistics and taunted doctors about defectors within the ranks. Ultimately, in 1898, Tebb and company won legal relief for parents with conscientious objections to vaccinating their children. This was a victory for libertarianism rivaling the repeal of the Contagious Diseases Acts in 1886. The so-called conscience clause of the 1898 Vaccination Act reflected Tebb's vision of the civic good: absolute equality before the law coupled with defense of the defenseless.Footnote 110 Late-Victorian Britain's moral reform temper, which championed the cause of vulnerable groups yet remained suspicious of both professional and state authority, typified Tebb's philanthropic leanings. Thus, he was a generous contributor to the Royal Society for the Prevention of Cruelty to Animals and at the same time a keen supporter of the Vigilance Association for the Defence of Personal Rights.Footnote 111

Strange but true to say, the moral panic over premature burial also hinged on the defenselessness of the victim. For slipshod death certification might consign a deeply entranced body “to perpetual silence, beyond appeal or escape.”Footnote 112 The coauthors of Premature Burial each claimed to have witnessed a close call: Tebb in his immediate family and Vollum in himself—when laid out for dead after passing through “a state of profound suspended animation from drowning.”Footnote 113 Although Vollum was plainly the junior partner in this literary collaboration, his acquaintance with death was very real. During a thirty-eight-year career in the U.S. Army, which saw him rise from assistant surgeon to medical inspector, Colonel Vollum had attacked grasping contractors, clumsy physicians, and neglectful nurses. Inefficiency appalled him. Charged with evacuating the Union wounded at Gettysburg, for example, Vollum blasted the railroad companies when they put profit ahead of compassion.Footnote 114 His stern humanitarianism matched Tebb's. Together, they formed a team whose personal integrity was difficult to impugn.

Their London Association for the Prevention of Premature Burial embraced “practical” reforms. Few contemporaries disagreed that greater care in the administration of anesthesia was wanted.Footnote 115 Nor did the LAPPB's stand against funeral extravagance raise eyebrows. (More peculiar was its hope that handsome “civic mortuaries,” where loved ones could decompose in dignity, might gratify the poor.)Footnote 116 At base, though, the LAPPB attracted those whose shared concern was the mistreatment of the body. Homeopathic advertisements peppered the association's journal. Since their therapeutic expertise rested on the close observation of a patient's whole symptom complex, homeopaths must have welcomed the LAPPB's demand that each “corpse” be meticulously checked for signs of life. Similarly, blood contamination, a danger expressed elsewhere in vampiric terms, haunted LAPPB members, many of whom had long denounced smallpox vaccine as a state-imposed poison. They understood that it was “matter out of place that matters.”Footnote 117 And no dislocation, no boundary transgression, seemed more horrible than a living body left underground.

Although Tebb would remain President of the LAPPB until his death in 1917, his move to rural Surrey around 1897 marked a slow retreat from pressure-group politics.Footnote 118 Those who now stepped forward in the LAPPB were easier to attack. From 1905 to 1914, Arthur Hallam, a proponent of healing through “human radiation,” served as editor of its quarterly journal, the Burial Reformer (renamed Perils of Premature Burial in 1909).Footnote 119 More combative was the young Swedish suffragette and radical antivivisectionist Emelie Louise Lind-af-Hageby, who moved to London in 1905. During her LAPPB-sponsored lecture tour of 1906–7, Lizzy was denounced for airing “repulsive” details about putrefaction. “Some living people smelt worse than the dead,” she shot back.Footnote 120 But Walter Hadwen, professional pariah, made the best target. Following his prize-winning medical school days, he had become a determined antivaccinationist and, later on, a relentless opponent of vivisection. Cobbe's hand-picked successor at her British Union, this Gloucester physician was both a teetotaler and a confirmed vegetarian, as well as the LAPPB's chief public presence.Footnote 121 Hadwen personified the Edwardian medical fringe.

Hadwen once assured vegetarians that, “Reforms, like fire, begin at the bottom of the grate, and work up through the social strata of society.” This was certainly not the burial reformers' experience. Wielding a related image, Tebb tried to rally his small band by reminding them in 1906 that just as it had taken William Lloyd Garrison's “fire” to melt “mountains of ice,” so public ignorance of grave mistakes must be set alight.Footnote 122 However inflammatory, the LAPPB's propaganda and parliamentary lobbying failed to usher in a new era of burial safety. One guinea per year (two, outside the metropolitan area) might buy the LAPPB's middle-class members peace of mind. That sum guaranteed them “careful death verification” by one of the LAPPB's designated doctors, most of whom would have carried a special handbag stocked with everything from dissecting tools to adrenalin chloride solution—the latter being of “supreme use in restoring animation in cases of collapse.”Footnote 123 But burial reformers made no headway in their main battle to secure reliable death certification. From 1908 to 1914 the LAPPB's “Death Registration and Burials Bill” was introduced annually in the House of Commons, thanks to George Greenwood, the Liberal M.P. for Peterborough. Despite support from the popular press, legal experts, and Parliament's own Departmental Committee on Coroners, this measure received scant notice from a government then preoccupied with more visible enemies.Footnote 124

Such political failure is hardly surprising. The burial reformers waged a strange campaign that appeared to fall somewhere between protecting and terrifying the British public. On one hand, as the Hospital remarked, it defied “the most rudimentary requirements of common sense” that bodies could be returned to the earth without first having been competently certified as dead. On the other hand, it seemed “probable that the efforts of the well-meaning Association…cause a great deal of unnecessary anguish…to many sensitive persons.”Footnote 125 The LAPPB would survive World War I, though only as a philanthropic shell, its power to sustain the moral panic of 1895–96 ebbing along with the energy of its founders.Footnote 126

Tebb in particular represents what sociologists have termed a “moral entrepreneur,” one who actively promotes rules of morality or systems of law. Yet the sociological distinction between “rule creators” and “rule enforcers” masks more than it reveals in Tebb's case.Footnote 127 For this blinkered enthusiast sought liberation from doubt, not the invention of a more potent discipline. To be sure, moral absolutism often drove him toward tactical dead ends. His campaign against vivisepulture teetered on a foundation of rumors, some of which Bruhier had broadcast back in the 1740s. Bruhier, however, had sensationalized in support of experimental physiology. Tebb and those around him viewed Victorian medical science as based on experimental pain and professional arrogance. Thus, sensationalism in the assault on a “merciless” pride was no vice.Footnote 128 Britain's late nineteenth-century campaign against premature burial should not be trivialized as the morbid obsession of cranks. The burial reformers chose a characteristically Victorian path, voluntary action, to confront what Sigmund Freud later called “the most uncanny thing of all.”Footnote 129 Tebb's circle knew nothing about our debate over the meaning of brain death, but they would have found instant allies among modern bioethicists who warn that even “final” signs may mislead.