Abstract
In 1891 the Italian psychiatrist Enrico Morselli (1852–1929) described taphophobia, defining it as an extreme condition of claustrophobia due to the fear of being buried alive. This rare psychopathological phenomenon reflects an ancient fear, and its origin is not known. Taphophobia is closely linked to the problem of apparent death and premature burial. In the nineteenth century, scientists and authors paid particular attention to the issue of apparent death, and special devices (safety coffins) were invented to ensure that premature burial was avoided. Nowadays taphophobia is quite a rare psychiatric disorder; different forms of social anxiety disorders are much more widespread. Its modern equivalent could be the fear of organs harvested from a patient who is still alive.
Enrico Morselli was born in Modena in 1852, and graduated at its university in 1874 with a thesis entitled La trasfusione del sangue, in which he tried to deny the effectiveness of this practice in psychiatry (Morselli, 1876). In 1877 he was appointed Director of the Mental Hospital of Santa Croce in Macerata and, for the first time in Italy, began to apply non-custodial doctrines, allowing groups of patients to leave the mental hospital and attend public places. Afterwards he was the Director of the royal mental hospital of Turin (1887) and Director of the psychiatric clinic of the University of Genova (1890). He participated in the founding of many periodicals such as Quaderni di psichiatria, Rivista sperimentale di freniatria, Rivista di filosofia scientifica, Rivista di patologia nervosa e mentale, and was the author of many works on psychiatry, including the Manuale di semiotica delle malattie mentali (Morselli, 1885). In the last years of his life he devoted himself to the study and dissemination of Freudian psychoanalysis. Morselli died in 1929 (Bartolucci and Lombardo, 2012: 247).
In 1891 Morselli (Figure 1) described taphophobia in his book Sulla dismorfofobia e sulla tafefobia, defining it as an extreme condition of claustrophobia due to the fear of being buried alive as the result of an erroneous decision that death had occurred (Morselli, 1891: 110).

Enrico Morselli (1852–1929), c. 1920, photographer unknown (available at: http://bms.beniculturali.it/ritratti/ritratti.php?chiave=ritr0174).
The fear of being buried alive is included among the neuroses. This rare psychopathological phenomenon reflects an ancient fear, and its origin is unknown. Agutter et al. (2013: 133) report a well-documented case from medieval Persia, in which the incident was due to conversion syndrome for hysterical paralysis. However, in the nineteenth century the Romantic Movement, with morbid attention to everything mysterious and terrifying, took particular interest in apparent death and premature burial. Several cases of taphophobia were reported by Dietrich (1977: 195), and it seems that the great Romantic author Edgar Allan Poe (1809–49) was suffering from the disorder. He was certainly attracted by the subject and in 1884 published his novel The Premature Burial in the Philadelphia Dollar Newspaper (Kennedy, 1987). Other authors who have written on the subject include the winner of the 1997 Nobel Prize for Literature, Dario Fo: in his comedy Settimo: ruba un po’ meno, (1964), the character Nascimbene, suffering from a fear of the coffin, asks to rent a coffin to lie in, thinking it is the only cure. In an interesting paper, Olry (1996: 111) reports several references to premature burial from 1728 to 1849. He identifies two key dates: the first, 1728, was the year of publication of Michael Ranft’s vampire book De Masticatione mortuorum in tumulis liber (Ranft, 1728) and the latter, 1849, was the year in which the Manni Prize was awarded to Eugène Bouchut (1818–91); he was a French physician and author of Traité des signes de la mort et des moyens de prévenir les enterrements prématurés, a treatise on the prevention of premature burials (Bouchut, 1849).
Taphophobia is closely linked to the problem of apparent death and premature burial. The literature – history, medical and popular – provides many examples of people being buried alive. The corpse of the German monk Thomas à Kempis (1380–1471) had splinters under his fingernails and there were scratches on the lid of the coffin. It was believed that he had been accidentally buried alive, and for this reason the canonization process did not progress, since a saint, when prematurely buried, would not have fought death (Wilkins, 1990). Many such stories are unreliable, though case histories have also been published in respected scientific journals. In 1877 a woman in Naples was believed dead and was buried with all the formal rites. After a few days, following the opening of the tomb to bury another body, it was found that the woman’s clothes were torn to pieces on her body, and there were obvious injuries inflicted in an attempt to break free (Norman, 1877).
Particularly in the eighteenth and nineteenth centuries, there were many scientists who proposed solutions for the problem of diagnosing the condition of death. Jacques Winslow (1669–1760) described procedures to be carried out on the supposed corpse in order to ascertain death. Some of these were very curious: ‘pour vinegar and salt or warm urine in the mouth’, ‘put insects in the ear’ and ‘cut the soles of the feet with razor blades’. According to Winslow, death was both certain because it is inevitable and also uncertain because its diagnosis is sometimes fallible (Winslow, 1740). The English physician James Curry (1763–1819) distinguished absolute death – identifiable by the absence of breathing and heartbeat, the immobility of the body and the loss of sensitivity to pain from puncture and heat – from apparent death where the vital principles were only dormant and could still be awakened if promptly and properly resuscitated. However, he stated that evidence of absolute death is only unequivocal when there are signs of putrefaction (Curry, 1815). The Italian obstetrician Pietro Manni (1778–1839) (Cascella, 2014), affected by his brother’s death, devoted himself to the study of apparent death and published a book entitled: Manuale pratico per la cura degli apparentemente morti (Manni, 1833).
In the Age of Positivism taphophobia almost became a social problem because of the numerous urban legends of people being accidentally buried alive, and the interest of the Romantic literature in the topic (Bodenson, 2002). In her book The Corpse: A History, the American writer of morbid books Christine Quigley (1966) provides much important historical information. She reports that, in 1896, an American funeral house manager, TM Montgomery, estimated that nearly 2% of exhumed people were no doubt victims of a state of apparent death, and that, in 1905, the English reformer William Tebb collected accounts of premature burial, including 219 cases of near live burial, 149 actual live burials, 10 cases of live dissection and 2 cases of awakening while being embalmed.
Many inventors tried to take advantage of the possible business related to premature burial and produced special devices to ensure it was avoided. All sorts of arrangements were made for the construction of safety coffins: glass lids for observation, escape hatches, ropes to bells for signalling, and breathing pipes for survival until rescued. I will show three examples. On 15 November 1843, Christian Henry Eisenbrandt of Baltimore filed a patent for a unique model of a ‘Life preserving coffin’ (Figure 2), a real contradiction in terms! This coffin (to be used in case of doubtful death) had a porthole for breathing and to allow the voice to be heard and was also equipped with a complex lever and spring mechanism, which was ‘easy to operate even for a weakened man’; an advertisement claimed that the person could immediately lift the spring-loaded, heavy lid and return to life (US patent No. 3335).

Eisenbrandt’s life-preserving coffin, 1843 (available at: http://www.google.com/patents/US3335).
On 25 August 1868, Franz Vester of New York filed US Patent No. 81,437 (Figure 3), with this description: The nature of this invention consists in placing on the lid of the coffin, and directly over the face of the body laid therein, a square tube, which extends from the coffin up through and over the surface of the grave, said tube containing a ladder and a cord, one end of said cord being placed in the hand of the person laid in the coffin, and the other end of said cord being attached to a bell on the top of the square tube, so that, should a person be interred ere life is extinct, he can, on recovery to consciousness, ascend from the grave and the coffin by the ladder; or, if not able to ascend by said ladder, ring the bell, thereby giving an alarm, and thus save himself from premature burial and death; and if, on inspection, life is extinct, the tube is withdrawn, the sliding door closed, and the tube used for a similar purpose …

Vester’s improved burial-case, 1868 (available at: http://www.google.com/patents/US81437).
Another inventor of a safety coffin was a woman, Marie Costant Hippolyte Nicolle, whose device was patented on 5 December 1899 (Figure 4). The movement of the head of the apparently dead person drove a lever system connected to an alarm. In the document she wrote: ‘I have devised an improved coffin which permits the body to be kept during a certain time until decomposition sets in and, moreover, enables the person inclosed in the coffin to give warning if there has been a mistake’ (US patent No. 638265).

M.C.H. Nicolle’s coffin, 1899 (available at: http://www.google.com/patents/US638265).
Nowadays taphophobia is quite a rare psychiatric disorder, and the different forms of claustrophobia and the social anxiety disorders are much more widespread (Brunello et al., 2000). According to Pita and Carmona (2004: 70), a modern equivalent of the taphophobia could be the fear of organs harvested from a still-living patient. However, much progress has been made since the Age of Positivism. Modern medicine is no longer empirical, and diagnosis of brain death (and organ donation legislation) are among the greatest achievements of medicine.
Footnotes
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
