DEATH-CERTIFICATION.
A SELECT COMMITTEE of the House of Commons, under the chairmanship
of Sir Walter Foster, M.D., was appointed on March 27, 1893, to
inquire into the subject of death-certification in the United Kingdom.
Fourteen sittings were held, and thirty-two witnesses examined. All
the witnesses practically agreed as to the serious defects in the law,
and a number of recommendations were made. It was shown that in about
four per cent. of the cases the cause of death was ill-defined and
unspecified, many practitioners having forms specially printed for
their own use, in which all mention of medical attendance is omitted,
the object being to enable the doctor to give certificates in cases
which he has never attended. Numerous deaths attended by unqualified
practitioners were certified by qualified practitioners who had
probably never seen the cases; and deaths were certified by medical
practitioners who had not seen the patient for weeks or months prior
to death, and who knew only by hearsay of the deaths having occurred.
Deaths were also certified in which the true cause was suppressed in
deference to the feelings of survivors; these last in particular are
reported to be very numerous.
[INADEQUATE RECOMMENDATIONS.]
In Q. 2552-83, remarkable evidence was produced as to the reckless mode
of death-certification. One medical witness testified that he saw a
certificate of death, signed by a registered medical practitioner,
giving both the fact and the cause of death of a man who was actually
alive at the time, and who lived four days afterwards, with facts of
even a more startling character described as “murder made easy.” It was
pointed out that fraud and irregularity in giving false declarations of
death are by no means infrequent. Various other matters are treated,
and the following are some of their recommendations:--
1. That in no case should a death be registered without the production
of a certificate of the cause of death by a registered medical
practitioner, or by a coroner after inquest, or, in Scotland, by a
procurator-fiscal.
2. That in each sanitary district a registered medical practitioner
should be appointed as public medical certifier of the cause of
death in cases in which a certificate from a medical practitioner in
attendance was not forthcoming.
3. That a medical practitioner in attendance should be required,
before giving a certificate of death, to personally inspect the body,
but if, on the ground of distance, or for other sufficient reason, he
is unable to make this inspection himself, he should obtain and attach
to the certificate of the cause of death a certificate signed by two
persons, neighbours, verifying the fact of death.
4. That medical practitioners be required to send certificates of
death direct to the registrar instead of handing them to the relatives
of the deceased.
5. That a form of certificate of death should be prescribed, and that
medical practitioners should be required to use such form.
From the _Times_, May 23, 1896:--
DEATH-CERTIFICATION.
At the special meeting of the Metropolitan Counties Branch of the
British Medical Association, held last night at the Museum of
Practical Geology, Jermyn Street, the subject of an improvement in
the present procedure in death-certification and registration came up
for discussion. Sir W. Priestley, M.P., president, took the chair.
Sir Henry Thompson moved the following resolution:--“Considering
that a Select Committee of the House of Commons has in 1893 made
an extended inquiry into the subject of death-certification and
registration on the plan now followed in this country, and has
reported that it manifestly fails to accomplish the purpose for
which it was designed, this meeting is of opinion that Her Majesty’s
Government should be respectfully memorialised to bring in a bill as
soon as possible to give effect to an improved procedure in general
accordance with the suggestions offered in the Committee’s report.”
He said that, during the last twenty years or more, circumstances had
not unfrequently occurred to attract public attention to the existence
of grave defects in the system of death-certification adopted in this
country, whether regarded as a safeguard against criminal attempts
on life, or as a means of forming trustworthy records of disease for
scientific purposes. From the Registrar-General’s report for England
and Wales for the year 1892, it was shown that in fifteen thousand
cases of death no inquiry had been made as to its cause, and that no
certificate had been obtained from any source--a number amounting to
nearly three per cent. on the total returned for the year. On the
same authority it appeared that in twenty-five thousand more, or four
and a half per cent., the cases “were so inadequately certified as
not to be classifiable,” making together a class of seven and a half
per cent. in which no evidence of any value as to the cause of death
existed. After what had already been done in the matter, all that
appeared to be necessary at present seemed to him to be that they
should forward a memorial to the Home Secretary, with a request that
he would consider the important work which had been already done by
the Select Committee, and, if he saw fit, take steps to embody their
recommendations in an Act of Parliament, for the purpose of giving the
country a greatly improved procedure in exchange for that at present
employed. Dr. Isambard Owen, in the absence of Dr. Farquharson, M.P.,
seconded the resolution, and asserted that the State now winked at
an exceedingly loose system of death-certification, since under
the present procedure it was possible for a medical man to give a
death-certificate on a patient whom he might not have seen for an
interval of several weeks, and perhaps months. The resolution was
supported by Dr. Nelson Hardy, Dr. Alderson, Dr. Hugh Woods, Dr.
Sykes, and others, and was unanimously adopted.
A well-known physician in large practice, writing to the author from
a Midland town, October 10, 1895, says:--“Medical men, attending
patients seriously ill, accept the statement of the friends that the
patient died in the night, and give a certificate at once, without any
inspection of the body. This is the regular practice.”
[INTERMENTS WITHOUT CERTIFICATES.]
In Ireland matters are no better, and clergymen and others, with whom
the author has been in correspondence, say they are much worse, and
the danger of premature burial is, if possible, greater than it is in
England. The Rev. W. Walters, writing from Ventry Parsonage, Dingle,
Ireland, September 16, 1895, says:--“In Ireland interment usually takes
place the day after decease, and no certificate as to the cause of
death is ever required. There is no safeguard whatever, and amongst the
ignorant poor I fear premature burial is terribly frequent.”
A prominent medical officer of health, having charge of a populous
metropolitan parish, wrote to the author, October 8, 1895, in reply to
inquiries:--“When a doctor attends a patient in an illness, and the
patient dies, he usually accepts the word of the friends as to the
facts of death, and if they are poor, or in moderate circumstances,
he grants the certificate in the ordinary way. If he is satisfied as
to the cause of death he dare not refuse the certificate. You will
see by the form I send you that _he need not actually satisfy himself
that the patient is dead_; if he is not satisfied he writes, ‘As I
am informed,’ in the space left for the words.... On one occasion
I was directed by a lady to drive a very long hat-pin through her
heart after death, to ensure that she should not be buried alive.
I have given so little attention to the matter that I cannot say
if the Continental practice in this respect is better than ours.
_Signs of decomposition are, I believe, the only ones of any real
value._ The form of certificate of death referred to is marked,
‘Printed by authority of the Registrar-General,’ and a request marked
‘N.B.’ is to read the suggestions on page ii. In this other form,
which is entitled ‘Suggestions to medical practitioners respecting
certificates of the cause of death,’ elaborate instructions are set
forth under ten separate clauses, with examples showing in what way the
death-certificates are to be filled up, but not one word of instruction
or caution as to the fact of death--whether it be real or apparent--the
absolute signs of death, or the steps to be taken in doubtful cases,
or in the various forms of suspended animation, such as coma, trance,
catalepsy, etc.”
The _Times_, January 19, 1878, p. 9, foot of column 6, reports a
singular case in point:--
“PREMATURE.--A poor woman lay very ill in her scantily-furnished home
in Sheffield. The doctor was sent for, and came. He at once saw that
hers was a very grave case, and that she had, as he thought, little
chance of recovery, even if she could get the nourishment her illness
required. As he was about to leave, the question was put, ‘When should
we send for you again, doctor?’ ‘Well,’ was the reply, as he looked at
the poor woman and then at her wretched surroundings, ‘I don’t think
you need send for me again. She cannot possibly get better; and to
save you further trouble I’ll just write you out a certificate for her
burial.’ And he did. After the doctor departed the woman--women always
were wilful--got better rapidly. She has now completely recovered,
and goes about carrying her burial certificate with her.--_Sheffield
Telegraph._”
[WORTHLESS DEATH-CERTIFICATES.]
Dr. Charles Cameron, M.P., in moving the introduction of the Disposal
of the Dead (Regulation) Bill, in the House of Commons, on April 30,
1884, said:--“A very large number of our population die without any
medical attendance at all, or at least without having ever received
sufficient medical attention to enable a certificate of the cause of
death to be given worth the paper on which it is written. In many
of these cases some sort of worthless certificate is procured and
presented to the registrar, but many thousands of persons are each year
buried in the United Kingdom without even this formality.”
The contrast between the laxity at home and the regulations laid down
by authority in Würtemburg, Bavaria, and other Continental States, is
remarkable, and should receive the attention of the Registrar-General
without delay.
From the _Lancet_, 1890, vol. i., p. 1440:--
“UNCERTIFIED CAUSES OF DEATH IN ENGLAND.
“Considering the general progress that has been made in public health
during the last twenty years, it is seriously to be regretted that this
matter of unknown and uncertified causes of death has been practically
left untouched, and its settlement is, therefore more urgently needed
now than when so often pressed upon the public notice by the late
Dr. William Farr during his connection with the Registrar-General’s
department.”
The Parliamentary Committee above referred to omitted an unexampled
opportunity of inquiring into the facts of premature burial. They
could have summoned pathologists, who had made trance and catalepsy a
subject of close and searching investigation, as well as physicians,
who, in their practice, have been called in to decide upon cases of
apparent death, and of witnesses up and down the country who know
of such cases, and others who have met with narrow escapes from
these horrible mishaps. Instead of taking this reasonable course of
procedure, the Committee contented themselves by examining two or
three medical men, who had been summoned to give evidence upon the
irregularities of death-certification only, and whose negative and
apathetic replies showed either that the subject had never engaged
their attention, or that they were unwilling to charge any member of
the profession with a fault so ruinous to his professional reputation
as to be unable to discriminate between the living and the dead. No
questions were submitted to the witnesses as to the signs of death,
the characteristics of catalepsy, trance, asphyxia, syncope, etc., or
how to distinguish these from death, or as to the submission of tests
in doubtful cases in order to ascertain the fact of death. Indeed, it
may be observed that the investigation regarding a most vital point
connected with death-certification appears to have entirely escaped
the notice of this tribunal. As a specimen of the proceedings under
this head are the following (“Report,” p. 116)--Mr. John Tatham, M.A.,
M.D., being under examination by the chairman, Si Walter Foster, M.D.
[RELUCTANT ANSWERS.]
Q. 2112--Have you ever had any instances within your knowledge, or
brought to your notice, of cases where persons have been buried
alive?--Never.
Q. 2113--Do you think such cases occur frequently?--I have no means of
knowing.
Q. 2114--Supposing the public think they do sometimes, your methods
(of medical death-certification) would be a great barrier to anything
like that?--Yes.
Q. 2115--The doctor’s examination and identification of the body would
enable them to detect in many instances if such an occurrence was
likely to take place?--I think so.
Further questions were asked of the same witness by Dr. Farquharson.
Q. 2178--You do not believe in people being buried alive?--I do not
think that occurs in Manchester.
Q. 2179--Do you think it occurs anywhere?--I do not know.
Q. 2180--We read occasionally very horrifying descriptions of bodies
having been found to have turned in their coffins. How do you explain
that?--I am not able to explain it.
A correspondent of the _Undertakers’ and Funeral Directors’ Journal_,
July 22, 1893, p. 92, writes:--
“PREMATURE BURIAL.
“Sir,--The newspapers continue to give us fresh accounts of premature
burials. Seeing how frequently cases are heard of (in spite of the
exhumations being not one-thousandth per cent. of the interments), the
occurrence is probably far more common than is generally supposed.
It is, therefore, surprising that medical men have not discovered an
infallible evidence of death--whatever the cause of death may be; or
a simple means of proving, beyond the possibility of doubt, that life
is extinct. Further, the application of such a test should, by law,
be made to form part of the certificate of death.--I am, Sir, your
obedient servant,
“LUX.
“July 3.”
VERIFICATION OF DEATHS.
“In Paris and the large French towns medical inspectors, called
_médecins verificateurs_, are appointed, whose business it is to visit
each house where a death occurs, and ascertain that the person is
really dead, and that there are no suspicious circumstances connected
with his or her decease. More than eighty qualified medical men are
employed for this purpose in Paris.
“In the rural districts of France this system is not in force; two
witnesses making a declaration to a civil officer that a death
has taken place, is considered sufficient. The burial is not
allowed to take place until at least twenty-four hours after the
declaration.”--_Blyth: Dictionary of Hygiene and Public Health._
[VERIFICATIONS ILLUSORY.]
Dr. Léonce Lénormand, in his admirable work “Des Inhumations
Précipitées,” p. 140, accuses the _médecins des morts_ in France
with culpable carelessness in the exercise of their function, which
consists in verifying the reality of the death. Instead of making a
minute examination of the body to ascertain the fact of death, this
writer says they are content (except in cases of death from violence)
to merely glance at the body, and immediately to hand the family the
necessary authorisation for interment. The inspector knows that if
he examined every part of the body, as in duty bound, he would be
accused of barbarism and profanation. Those, therefore, who think that
premature burial could be prevented in England by means only of a more
stringent law of compulsory death-certification, would, if it were
carried, find themselves in hardly any better position than at present,
where the fact of death is left to a great extent to the judgment of
friends, if the deceased has any, or to the perfunctory inspection of
the undertaker. It is in France where probably, in spite of _médecins
verificateurs_, more premature burials occur than in any country in
Europe except Turkey, immediate burial after real or apparent death
being the inexorable rule. Dr. Lénormand attributes the frequency
of premature burials in France, first of all, to the negligence and
prejudices of the families of the deceased; then to the carelessness of
the doctors charged by the State with the inspection of the dead; and
lastly, to the imperfection of the police regulations.
From the _British Medical Journal_, January 28, 1893, p. 204. (Special
Correspondence, Paris.)
“PREMATURE BURIAL.
“The question whether premature burial occurs, and how to prevent it,
is, notwithstanding the all-absorbing interest of the Panama question,
attracting some attention here. The ‘Union Medicale’ devotes one of
its feuilletons to it, in which two or three _nouvelles à sensation_
are reproduced, and easily proved to be untrue. Premature burial
cannot occur, the writer says, when a death is duly verified. The
77th Article of the Code obliges the _officier de l’état civil_ to
visit the death-bed and verify every death; but this Article is a
dead letter. The officer in question has neither time nor knowledge
sufficient to put it in practice. In small country places, rarely any
precautions are taken to prevent premature burials. In more important
villages and towns, the mayors delegate the doctors of the locality
to verify deaths before burial. Throughout the whole of France, it
appears that there are not fifty towns where the death-verifying
service is well organised; and, on an average, there are from twenty
thousand to thirty thousand burials without previous verification of
death. The declaration of two witnesses is sufficient, who obtain
their information from those around the deceased. In Paris, the two
mortuaries already in existence--one at the Montmartre Cemetery,
the other at Père La Chaise--are rarely used. The bodies of those
who die in the streets, from accident or sudden death, are taken
there when there is no domicile; also, those of foreigners who die
in lodging-houses. In the course of eighteen months the mortuary of
Montmartre received five dead bodies, and Père La Chaise one. In
Germany the mortuaries are much used, and every arrangement made is in
order that any who come back to life may be able to easily summon help.
At Munich, a ring in connection with a bell-cord is put on one of the
fingers of the hands of the dead. At Frankfort, similar precautions are
taken.”
[CONTINENTAL REGULATIONS.]
Extracts from “Regulations for the Domiciliary Examination of the Dead
in the City of Brussels Civil Government (Medical Service).”
“ARTICLE 1.--The Medical Service of the Civil Government is
distributed among the medical heads of divisions, the deputies and
chiefs of the Department of Hygiene.”
“ARTICLE 5.--No interment can take place except after the decease has
been verified by the doctors of the Civil Government by means of a
careful and complete examination of the corpse.”
This verification, as well as the identity of the person deceased,
shall be certified by a _procès-verbal_ [statement, or description,
for which a blank is furnished “A”], which they shall leave at the
house of the deceased.
“ARTICLE 8.--They shall notify the officers of the Civil Government,
and their superintendents of police, of any infractions of the
regulation provisions which forbid proceeding with autopsy, moulding
[making a cast?], embalmment, or putting in a coffin the corpse,
before the death has been duly ascertained.”
“ARTICLE 9.--The verification of the decease of still-born or of
newly-born infants shall exact a most attentive examination on the
part of the examining doctors. They shall indicate in their report if
the infant has died before, during, or after birth; and, in the last
case, how long it lived after birth.”
“ARTICLE 10.--If they doubt the reality of the death, they shall
employ, without delay, every means of recovery that science suggests
under the circumstances. They shall immediately notify the visiting
doctor, and, in every case, shall prepare the _procès-verbal_ of the
verification of death only after certainty has been established, and,
if need be, by repeated visits.”
“ARTICLE 11.--When a woman has died in a state of advanced pregnancy,
they shall direct the artificial extraction of the infant, supposed to
be yet living; and, in the lack of an attending doctor, shall perform
it themselves when necessary.”
EXAMINATION AND CERTIFICATION OF THE DEAD IN WÜRTEMBURG.
A Royal Decree, entitled “Dienst-Vorschriften für Leichenhaüser,”
for the inspection and burial of the dead, promulgated by the King
of Würtemburg, January 24, 1884, provides for the appointment of
medical inspectors of the highest integrity and qualifications in
every commune, the position being justly regarded as one of great
responsibility.
Immediately after a death, the body must under no circumstances be
interfered with, and must not be removed from the death-bed until after
the authorised inspection. _Post-mortems_ can be made only if the fact
of death has been previously clearly established. Precise instructions
are laid down, so that the inspector, who is to examine the entire
body, may see that the various forms of suspended animation are not
certified as actual death. Amongst these are the following:--
“Section ii.--To see that sensibility, pulsation of the heart, neck,
temples, and forearm, and the breath, have ceased. That the muscles of
the body have lost their elasticity; therefore the limbs are limp, the
face sunken, the nose pinched, the eyes sunken, and, when the eyelids
are forcibly opened, they remain so, the lower jaw drops more or less,
and drops again when pressed upwards.
“In actual death the body gradually gets colder, beginning with the
exposed limbs, and in from ten to sixteen hours the body will be
quite cold. The colour of the face becomes ashy pale, and the lips
discoloured. The eye loses its brilliancy, and is usually dulled by a
covering of dried mucus.
“If all the foregoing symptoms are exhibited, and particularly if the
deceased was of an advanced age, or if the death was caused by severe
or long illness, which led to the expectation of a fatal result, the
fact of death may be safely assumed.
“But, on the other hand, if part of these symptoms are missing, or in
cases of pregnancy, or exhaustion in consequence of flooding after
confinement, or if death occurs under fits, or in violent outbursts
of passion, the possibility of counterfeit-death is to be taken for
granted.
“Notwithstanding the existence of all the symptoms (signs of death)
before mentioned, the possibility of _apparent_ death is not excluded
in cases where the death has occurred after syncope, tetanus,
suffocation, or in cases of drowning, stroke of lightning, or from a
severe fall, or from frost, or in still-born children.”
After detailing instructions as to a variety of experiments to
ascertain whether the death is actual or apparent, this Royal Decree
proceeds:--
“Section viii.--These experiments may, however, not give absolute
certainty as to the complete extinction of all life. If, therefore,
the slightest doubt remains as to the reality of death, the inspector
is to take the necessary precautions for the protection of the
deceased, by frequent inspections, and the most careful examinations,
and to obtain the assistance of the nearest physician or surgeon, who
is to co-operate with him to promote resuscitation. If these attempts
prove abortive, he must see that nothing is done which would be
detrimental to reanimation, or resumption of life.”
Then follow minute instructions how to proceed under the varied
circumstances which may have produced the symptoms known as apparent
death. _In no case must the burial certificate be handed over by the
inspector until he has thoroughly satisfied himself of the presence of
unmistakable signs of actual death._
One cannot help contrasting these carefully considered rules with
the lax and haphazard methods of dealing with the dead and apparent
dead both in England and in the United States. As a consequence,
cases of premature burial in Würtemburg are of very rare occurrence,
and sensible people in that country, knowing that the danger of
premature burial has been reduced to a minimum, are not consumed by an
ever-abiding anxiety as with us, nor is it the custom for testators in
Würtemburg to give instructions to their executors for piercing the
heart or severing the jugular vein, or some other form of mutilation,
as in France, Spain, and other countries, where the risks are so
terribly great.
[IN WÜRTEMBURG.]
The only case of the danger of premature burial that has come to the
author’s notice in Würtemburg is related by Bouchut, in his “Signes de
la Mort,” p. 48:--
“In the village of Achen, in Würtemburg, Mrs. Eva Meyers, twenty-three
years of age, was taken ill during an epidemic. Her condition became
rapidly worse, and she apparently died. They put her into a coffin,
and carried her from the warm into a cold room, there to await burial,
which was to take place at two p.m. on the following day. Shortly
after noon on that day, and before the carriers arrived, she awoke and
made an effort to rise. Her aunt, who was present, and who believed
that a ghost had taken possession of her, took a stick and would
have killed her, if she had not been prevented by another woman.
Nevertheless, she succeeded in pushing the body back violently into
the coffin, after which she indignantly went to her room. The patient
remained helplessly in that condition, and would have been buried if
the usual hour for the burial had not for some reason been changed.
Thus she remained for another twelve hours, when she was able to
gather sufficient strength to arise. She still lives, and has paid
the charges for her funeral, which were claimed by the clergy, the
bell-ringer, and the undertaker.”
In the United States the subject of Death-Verification has only
recently begun to engage public attention. The following appears to
be the only instance in which reasonable, although not altogether
adequate, precautions are adopted.
“DOVER, NEW HAMPSHIRE.--CITY ORDINANCES, 1895.
“CHAP. XVII.--VITAL STATISTICS.
[AN AMERICAN CITY ORDINANCE.]
“SECTION 3.--Whenever any person shall die within the limits of the
city, it shall be the duty of the physician, attending such person,
during his or her last sickness, to examine the body of such deceased
person before the burial thereof, and to make out a certificate,
setting forth, as far as the same may be ascertained, the name, age,
colour, sex, nativity, occupation, whether married or single, duration
of residence in the city, cause, date, and place of death of such
deceased person; and it shall be the duty of the undertaker, or other
person in charge of the burial of such deceased person, to add to such
certificate the date and place of burial, and, having duly signed the
same, to deposit it with the city clerk, and obtain a permit for
burial; and, in the case of death from any contagious or infectious
disease, said certificate shall be made and forwarded immediately;
and, in each case of a physician so examining and reporting, he shall
receive of the city a fee of one dollar.”
“SECTION 4.--Whenever a permit for burial is applied for, in case of
death without the attendance of a physician, or it is impossible to
obtain a physician’s certificate, it shall be the duty of the city
physician to make the necessary examination, and to investigate the
case, and make and sign a certificate of the probable cause of death;
and, if not satisfied as to the cause and circumstances attending such
death, he shall so report to the mayor.”
“SECTION 5.--No interment or disinterment of the dead body of any
human being, or disposition thereof in any tomb, vault, or cemetery,
shall be made within the city without a permit therefor, granted as
aforesaid, nor otherwise than in accordance with such permit.
“No undertaker, superintendent of cemetery, or other person shall
assist in, assent to, or allow any such interment, or disinterment, to
be made, until such permit has been given as aforesaid....
“Any person violating any of the provisions of this chapter shall be
fined not less than ten nor more than twenty dollars.”
Mr. A. Braxton Hicks, Barrister-at-Law, and Coroner for London and
Surrey, states that--
“The giving of certificates of death, and the registration of deaths,
is regulated by 37 and 38 Vict. c. 88, called the Registration of
Births and Deaths Act, its object being to provide a proper and
accurate registration of births and deaths, with the causes of the
latter.
“In case of the death of any person who has been attended during his
last illness by a registered medical practitioner, that practitioner
shall sign and give to some person, required by this Act to give
information concerning the death, a certificate stating, to the best
of his knowledge and belief, the cause of death.
“No certificate given by an unregistered medical man can be
registered, and any person who covers an unregistered medical
man by giving a certificate, or lending his name to the giving
of a certificate by an unregistered medical man, is guilty of
_unprofessional conduct_, as defined by the Medical Council.”--_Hints
to Medical Men concerning the granting of Certificates of Death._
A DOCTOR FOR THE DEAD.
Dr. J. Brindley James, in a communication to the _Medical Times_,
May 23, 1896, pp. 355-356, calls attention to the insufficient
safeguards against premature burial under the present system of
death-certification, and observes--“The dread possibility of premature
interment ever hangs like a gloomy sword of Damocles over all our
heads, and fearful indeed is the authentic record of persons buried
alive, who have recovered consciousness; too late, alas! to be rescued
from their frightful dungeon. How often does our overworked--we do not
say careless--practitioner sign the death-certificate of a patient
whose death-bed he did not attend--whose corpse he has not visited? And
even assuming him to have done so, and conscientiously too, in how many
of the fearful cases above alluded to have not these formalities proved
insufficient, clearly suggesting the advisability of a specialist,
experienced in _post-mortem_ inspection, solely sanctioning interment
in all cases.” And Dr. Frederick Graves, writing in the same journal of
July 18, 1896, says:--
“I have recently heard of a case which illustrates the utility of
a medical examination before burial. A soldier in the German army,
during the forced march on Paris, became unconscious, with five
others, from sunstroke, and the six were put aside for burial by
their comrades, when the timely examination of the army surgeon
prevented premature burial of the person referred to, who is alive and
well at the present time.”
[STRINGENT LEGISLATION SUGGESTED.]
The _Daily Chronicle_, London, September 16, 1895, in a leading article
on the danger of premature burial, says:--“The truth is, the whole
system of certifying for burial needs to be reconsidered and reformed,
and that for other reasons than the danger of entombment before life is
extinct. We do not want a coroner’s inquest, with its jury, for every
death; but the doctors should be compelled, under severe penalties, to
discover the certain sign of death before they authorise the burial,
and to know the cause of death in every case. We trust now too much to
individuals in a generally trustworthy profession, who may not reach
the high general standard of their class, or may grow listless through
the indifference wrought by use and wont, or who think they can detect
the _rigor mortis_ at a glance, never having seen the severest form
of catalepsy. There would be no difficulty in getting Parliament to
pass a more stringent regulation for death-certificates without much
discussion, and there is no reason why Sir Matthew White Ridley should
not turn his attention to the matter, and, with such medical advice as
the Health Department of the Local Government Board will be pleased to
lend him, propose a necessary little bill to the House of Commons next
February.”
The following letter by a German resident in England appeared in the
_Times_ of September 20, 1895:--
“BURIED ALIVE.
“Sir,--As this important subject appears to be arresting the
attention of the public in England, may I venture to state the law
as to the examination of corpses in my own country? In a copy of
the official regulations in Würtemburg for the inspection of dead
bodies (‘Dienst-Vorschriften für Leichenhaüser in Würtemburg, 1882.’
Stuttgart, W. Kohlhammer), I find the following:--
“‘No corpse must be interfered with before the arrival of the
inspector, who is expected to pay several visits before granting the
death-certificate, which he alone is authorised to do. In cases of
death from infectious disease the body must be removed to a mortuary,
where it is carefully watched.’
“These inspectors are highly qualified, State-appointed physicians,
but, as if to show the uncertainty of all this care and experience,
as we see by the researches of Dormodoff, Hufeland, Hartmann, and
others, as well as by the reports of startling cases in the press,
those medically and officially declared to be dead do occasionally
come to life before burial. This is a state of things unworthy of the
civilisation and humanity of which we are proud.
“Medical examination, not being infallible when carried out at its
best, must be very unreliable when performed in a careless manner.
“A safer plan would be to send every supposed corpse to a mortuary,
there to remain until decomposition manifests itself. As a German I
should be afraid to die in England (excuse the paradox) for fear of
being buried alive.
“P. P.
“Forest Hill, September 17.”