Determining whether the dead were really dead was a perplexing and occasionally inaccurate science in the days before modern medicine. A 2001 Wired News article recounts some of the techniques once used to establish the finality of those presumed deacesed:

Administering enemas of tobacco smoke to the suspected dead had a strong following among many members of the medical profession in the 17th and 18th centuries.

ther doctors preferred to insert hot pokers into various orifices, pinch nipples with pliers, and vigorously yank on the tongue of a presumed corpse in order to ascertain that their patients were quite dead.

Tongue-pulling became so popular that a device was created to automate the procedure. The suggested modus operandi was to clamp the maybe-dead person’s tongue to the machine and then turn a crank that rapidly moved the tongue in and out of the patient’s mouth.

This procedure had to be continued for at least three hours, doctors believed, so a village’s most-easily amused person was usually assigned to the task.

Although some were reputed to have been restored to life during these medically sanctioned tortures (sadly, no reports on their response to being pinched, penetrated and pulled has survived), many doctors felt that the only true sign of death was putrefaction.

They advised that anyone who was presumed to be dead should be placed in a very warm place and observed for signs of decomposition before burial.

Since few people fancied the idea of watching their loved ones rot, in the late 18th century France and Germany embarked upon the wide-scale construction of “vitae dubiae asylums” –- hospitals for the “doubtful dead,” also known as waiting mortuaries.

Here, corpses were placed in an environment that would encourage them to decompose rapidly but were also optimistically supplied with a string that, when gently yanked, would signal their resurrection.

Unfortunately, real corpses have a disconcerting but natural tendency to twitch and writhe, so the mortuaries were often filled with the strident sound of alarm bells.

The ultimate technological development in this quest to prevent premature interment was the Security Coffin, an invention that allowed the mistakenly buried to communicate with the world above ground. Variations on the invention proliferated in the 19th century, especially in Germany, where the fear of being buried alive was apparently especially severe. In the United States, at least 22 patents for security coffins were filed between 1868 and 1925. Most models included an air tube and a device that allowed the undead (and presumably terrified) individual enclosed in the coffin to alert the living by either ringing a bell, blowing a horn, or raising a flag. One model included a mechanical brass hammer that smashed open a glass plane in the coffin lid. Another allowed the prematurely buried individual to launch a firecracker through the coffin’s air tube. Some, impractically, also came equipped with a shovel.

These facts and images are drawn principally from Buried Alive: The Terrifying History of Our Most Primal Fear, a wonderful book by Jan Bondeson.