The writer must surely have overlooked the able treatises by Winslow, Kempner, Russell Fletcher, Hartmann, Gannal, and others, supported by evidence in the aggregate of thousands of cases of premature burial or narrow escapes, or have forgotten the dreadful cases which have appeared from time to time in the columns of the _British Medical Journal_ itself. Commenting upon the case of a child nearly buried alive, this medical authority in its issue of October 31, 1885, under the head of “Death or Coma,” sensibly refers to some of the difficulties in distinguishing apparent from real death as follows:-- “The close similarity which is occasionally seen to connect the appearance of death with that of exhaustion following disease, was lately illustrated in a somewhat striking manner. An infant, seized with convulsions, was supposed to have died about three weeks ago at Stamford Hill. After five days’ interval, preparations were being made for its interment, when, at the grave’s mouth, a cry was heard to come from the coffin. The lid was taken off, and the child was found to be alive, was taken home, and is recovering. Such is the published account of the latest recorded case of suspended animation. We need not now attempt a dissertation on the physical meaning of coma. It is well known that this condition may last for considerable periods, and may at times, _even to the practised eye_, wear very much the same aspect as death. In the present instance, its association with some degree of convulsion may easily have been mistaken by relatives, dreading the worst, for the rigid stillness of _rigor mortis_. This is the more likely, since the latter state is apt to be a transient one in infants, though it is said to be unusually well marked in death from convulsions. One cannot, however, help thinking that the presence of the various signs of death was not, in this case, very carefully inquired into. It is hardly possible that, had the other proofs as well as that of stiffening been sought for, they would have been missed. _It is true that hardly any one sign short of putrefaction can be relied upon as infallible._ In actual death, however, one may confidently reckon on the co-existence of more than one of these. After a period of five days, not one should have been wanting. Besides _rigor mortis_, the total absence of which, even in forms of death which are said not to show it, we take leave to doubt, the _post-mortem_ lividity of dependent parts afford sure proof, as its absence suggests a doubt, of death. Then there is the eye, sunken, with glairy surface, flaccid cornea, and dilated insensitive pupil. Most practitioners, probably, are accustomed to rely upon stethoscopic evidence of heart-action or respiration. These alone, indeed, are almost always sufficient to decide the question of vitality, if they be watched for during one or two minutes. There is no information as to whether the child so nearly buried alive was seen by a medical man.