Hektoen International

A Journal of Medical Humanities

Premature burial in literature

The Premature Burial. Antoine Wiertz, 1854. Wiertz Museum. Via Wikimedia.

Nothing is more terrifying than the thought of being buried alive, of being wrapped in a shroud, bound hand and feet, with no way to escape. This thought has long haunted human imagination. It was a real possibility before and during the 17th to 19th centuries, when numerous documented cases of premature burial, both verified and rumored, fueled public hysteria. Accounts abounded of coffins opened for a later reason and found with scratch marks on the interior lid or of bodies exhumed with signs suggesting desperate attempts to escape.

It was until relatively recently difficult to distinguish between death and certain states that mimic it, such as catalepsy, coma, or deep syncope. In times of epidemics, the speed with which bodies were disposed of increased the risk that unconscious but living individuals might be buried alive. These fears manifested in elaborate safety measures, such as using “safety coffins” equipped with devices designed to signal life to those above ground—such as bells, flags, ventilation tubes, or mechanisms whereby the “deceased” could pull a cord from inside the coffin to alert cemetery attendants should they awaken underground.

In literature, the most iconic treatment of premature burial comes from Edgar Allan Poe’s 1844 short story The Premature Burial. Poe’s narrator suffers from catalepsy, a condition causing deathlike trances, and becomes obsessed with the possibility of being mistakenly interred. The story catalogues historical instances of premature burial, thus blending gothic terror with psychological realism and anxieties.

Another of Poe’s stories, The Fall of the House of Usher (1839), presents the dramatic example of Madeline Usher being entombed while still alive, only to re-emerge bloodied and silent, having clawed her way free. Her return destroys her twin brother Roderick and brings the decaying Usher lineage to a literal collapse.

A condition resembling premature burial also appears in Leo Tolstoy’s The Death of Ivan Ilyich (1886), in which the author explores the psychological horror of a man confronting death and feels socially buried before death—alienated, ignored, entombed in bureaucracy and false consolation.

Further examples include:

  • Giovanni Boccaccio, The Decameron (14th century): A young man named Guiscardo is killed and his heart is fed to his beloved. In another tale, a woman believed dead awakens in her tomb and returns home. Boccaccio’s use of premature burial reflects medieval anxieties surrounding death and misdiagnosed illness.
  • Jan Neruda, Grave Mistake (Czech 19th century short story): A young woman presumed dead is accidentally buried and awakens in her coffin. She is rescued just in time. The story reflects similar themes to Poe, including the fear of waking in darkness.
  • Victor Hugo, The Hunchback of Notre-Dame (1831): The character Esmeralda is nearly buried alive after a mock execution, and her near-death experience resembles the typical blend of horror and injustice.
  • Nikolai Gogol, Viy (1835): In this Ukrainian horror tale, a seminarian is forced to pray over the body of a witch-like girl who may not be entirely dead. It reaffirms that the boundary between life and death is tenuous, and this is combined with folkloric fear of the undead.
  • Charlotte Brontë, Jane Eyre (1847): The madwoman in the attic, Bertha Mason, is metaphorically “buried alive” in Thornfield Hall’s upper rooms.
  • Hans Christian Andersen, The Story of a Mother (1847): A mother follows Death to retrieve her child. More allegorical than literal, the story evokes the horror of entrapment and the liminal state between life and death.
  • Sheridan Le Fanu, Carmilla (1872): Carmilla, a vampire, is caught between death and life. The story hints that some of her victims may have been buried prematurely due to misunderstood catalepsy or trance states. Le Fanu merges premature burial with the vampire mythos, feeding off Victorian anxieties around female sexuality and medical uncertainty.
  • Wilkie Collins, Jezebel’s Daughter (1880): A woman is mistakenly pronounced dead and is about to be buried when a friend suspects she is still alive. Her revival is dramatic and eerie, and the story is used to underscore the fallibility of 19th-century medical practices and build suspense.
  • Jules Verne, The Carpathian Castle (1892): A superstitious village fears a castle that seems to house the living dead. A buried character may not be fully dead. Verne plays with gothic and technological themes, blending the fear of premature burial with illusions and proto-scientific explanations.
  • Ambrose Bierce, The Premature Burial (1893): A satirical piece mocking Poe’s obsession with premature burial. Bierce imagines ridiculous and improbable scenarios of mistaken internment.
  • Franz Kafka, The Trial (published posthumously in 1925): While no literal burial occurs, the protagonist’s helpless entanglement in a faceless judicial system evokes the suffocating feeling of being trapped in a premature burial, demonstrating the theme’s enduring appeal and malleability.
  • William Faulkner, As I Lay Dying (1930): The decaying body of Addie Bundren, carried across rural Mississippi in a coffin, haunts the living, and blurs the lines between death and memory. Addie’s posthumous presence—embodied in the claustrophobic, decomposing coffin—serves as a stand-in for the terror of awareness trapped in a lifeless shell.

These examples illustrate that many of these stories represent not only the fear of being buried alive, but also of being forgotten, isolated, exiled, or imprisoned under horrific circumstances.


Spring 2025

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