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Miracle
Max had his own methods for determining if
someone
was all dead or just mostly dead. They involved
a
bellows and Carol Kane’s voice.
But the point is made,
for
centuries, people were just guessing if others were
really
dead. There were few experts, and they were
probably just comedians in make-up. |
What scares you the most– spiders, public speaking, death? These
three are high on every list of common fears, but it wasn’t so long ago that
another fear was in first place – taphophobia.
Never heard of it? I bet that its mere definition will be enough to send a
chill up your spine.
Technically, taphophobia means “fear of graves” (taphos = tomb, and phobia = fear of), but its common use is “fear of being buried alive.” Premature burial is not an urban legend, incidents have
been documented in nearly every society – and not all of them were just in the
movies or books.
In the 1800’s and earlier, being dead was a lot like being a
duck….. you know, if it looks like a duck, walks like a duck, and quacks like a
duck….. The appearance of death was often enough to make a diagnosis and start
going through their pockets.
As a good example of the wisdom of the age, George Washington
had these last words, "Have me decently buried, but do not let my body be
put into a vault in less than three days after I am dead…….., tis well." He
wanted a sufficient amount of time to pass to ensure that he was in fact dead.
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The
Irish wake probably originated in the leaving of the
tomb
unsealed for several days, just in case the dead
person
might wake. Later, stories came about concerning
the
lead in pewter tankards from which the Irish would
drink.
Lead poisoning could induce a state that resembled
death.
Sometimes, a wake is just another reason to raise
a
glass of ale.
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The hopes of preventing the spread of infection often lead
to burying the dead before they were quite dead. I give you plague victim Eric Idle
in Monty Python’s Search for the Holy Grail – “But I’m not dead yet…. I’m
feeling much better.”
Even without epidemic, most people in the 18th,
19th, and early 20th centuries died at home, having never
seen a doctor. If someone couldn’t hear a heartbeat or feel a pulse, then the
patient was dead. But these were lay people, did they know how to feel for a
pulse? Maybe they relied on another indicator of death - rigor mortis (rigor =
stiffness, and mort = death).
In humans, rigor mortis begins 2-6 hours after death. Rigor
is caused by a loss of ATP production. Follow me here--- no breathing, no
oxygen; no oxygen, no ATP production. With no ATP, the muscle
can’t relax. This may seem strange, since it takes ATP to contract a muscle in
the first place.
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As
described in the text, the thick filament (myosin) pulls
itself
along the thin filament (actin) by grabbing and releasing
actin
monomers. A single sarcomere (contractive subunit,
~100,000
in a muscle cell) has millions of myosin heads. They
grab
actin fibers that run on all sides of the myosin fiber.
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The ADP + P is released from the myosin and it flexes the
head of the protein, which pulls it along the actin. When a new ATP is bound,
the myosin lets go from the actin, and the cycle is repeated. Each muscle fiber in each cell has
millions of myosin heads resulting in a contracted muscle.
In rigor, there is no more ATP, so the myosin doesn’t let go
of the actin, therefore, no relaxation can take place. The muscles remain the
length they were at death. After about 72 hours, the muscle proteins start to
break down, rigor will lessens and the body will become limp again. But as we
will see below, some conditions can mimic the signs of rigor, increasing the
chances of premature burial.
In an effort to see how bad the situation was, the English
reformer, William Tebb, in 1905 made a study of accidental premature burial. Tebb
was quite the joiner; the weirder the society, the more he wanted to join or
lead it. He worked with the Vegetarian Society, the anti-vivisection movement,
the national Canine Defense League, and formed National Anti-Vaccination League
in 1896.
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William
Tebb’s book on premature burial was a best seller.
You’d
think he had a product to sell given the way he
described
some of the incidents. In one, Madame Blunden
was
buried in a crypt under a boys school. The next day, the
students
heard noises from below. They opened the tomb
and
coffin just in time to see her die from lack of oxygen.
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In her 1996 book, The
Corpse: A History, Christine Quigley documents many instances of premature
burial and near-premature burial (I LOVE the title). Skeletons were outside their coffins, sitting up in the corner of their vault
after being opened years later. Others were found turned over in their caskets, with tufts of their own hair in their hands.
How might this happen? What conditions might make it look so
much like you were dead that even your loved ones would let them plant you in
the ground? The list is long and varied, but here are some of the more common
things that can make you look dead:
Asphyxiation – anything
that cuts off your supply of air can make you look dead once you fall
unconscious – continuation of this condition leads to actual death. You look
dead enough and won’t respond to external stimuli, so people assume you are
dead. Close the coffin lid, and soon you really will be dead of asphyxia.
Catalepsy – Many
things can bring on this catatonic state in which the muscles are rigid (like
rigor mortis after death) and no pain is enough make you respond, one example
is epilepsy. Hypnotists call their trances catalepsy (Greek for to grab and
take down), but true catalepsy is much more severe and can last hours to days.
Severe emotional trauma can also bring it on, so you can certainly be scared
enough to look like you are dead.
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Catalepsy
is denoted by muscle rigidity, so it can look like
rigor
mortis. But there is also waxy flexibility in some cases.
The
dead-looking not dead people can be posed, and they
will
hold the pose indefinitely. What little girl wouldn’t love
a
cataleptic doll for Christmas!
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To show how medicine has changed, there is now a battery of
assessments called the Glasgow coma scale (GCS) that are carried out on coma
victims to assess their state and prognosis. In centuries past, you might look
at them, hold a mirror under their nose, maybe lift and drop an arm….. bury
them.
The GCS has traditionally been used in the hospital
environment, but new evidence
shows that a prehospital GCS (assessment at scene or in route) can be just as
accurate and may benefit treatment choice in pediatric traumatic brain injury
patients. The study compared prehospital and emergency department GCS scores
and showed that they were similar. They also compared outcomes with prehospital
scores and showed a positive correlation. If assessment and treatment can be
begun earlier, outcomes should improve.
Apoplexy – this
not a very accurate term any longer, and has meant different things at
different times. It can refer to bleeding within an organ or bleeding during a
stroke. A stroke is very likely to leave survivors that look like they are
dead, and are unresponsive. Nevertheless, there are stroke victims who regain
consciousness.
Due to the above conditions, many people in the 1700’s and
1800’s made a hunk of change by promoting safety coffins and vaults. These
might be as simple as attaching a rope to the hand of the deceased, and running
this rope to the surface where it was attached to a bell.
In other coffins the alterations were more elaborate. There
might be glass plates to view the face of the dead or a periscope to keep an
eye on the corpse. Some thirty designs were patented just in Germany in the
second half of the 19th century, including some that contained
vibration sensors, and later… a telephone line.
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Waiting
mortuaries were built in the 1800’s, mostly in
Germany.
Since the best sign of death was the beginning
of
the rotting process, these mortuaries were basically
holding
cells for bodies while nature took its course. If they
didn’t
start to smell, they had to look for fangs or a way to
arouse
them.
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Modern EEG and EKG have reduced the chance of premature
burial or cremation, but mistakes do get made. In 2007, a Venezuelan man awoke during
his own autopsy, and Quigley also writes of several modern instances of
near-premature burial. Furthermore, the need for quick burial during epidemics
has been replaced by the need for timely organ harvests – maybe they aren’t
done with that kidney yet!
Next week we will take Halloween and death one-step further
– could Halloween, or anything else for that matter, literally scare you to
death?
Christopher Dibble (2010). The Dead Ringer: Medicine, Poe, and the fear of premature burial. Historia Medicinae
Nesiama JA, Pirallo RG, Lerner EB, Hennes H. (2012). Does a prehospital glasgow coma scale score predict pediatric outcomes? Pediatr Emerg Care. DOI: 10.1097/PEC.0b013e31826cac31
For
more information or classroom activities, see:
Rigor
mortis –
muscle contraction –
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