On December 14, 1799, as George Washington lay in his final moments on his death bed, he told his secretary Tobias Lear what were likely his last words. Tobias recalled later:

In his 19th century painting, John Meister imagines “George Washington on His Deathbed”. Credit: Mount Holyoke College Art Museum / Wikipedia
Why did George feel the need to state this on his death bed? These were his last known words, and must have been a thought of importance to Washington. Taphophobia, or the fear of being buried alive, may, in part, explain his final words.
The medical field advances constantly and surprises us every day with new knowledge of the human body. DNA testing, cancer screening, vaccines, bionic limbs… I could go on forever about how the world of medicine has evolved. Today, it’s hard to imagine life before these advances when something as simple as detecting death was not even clear cut.
Technological and medical advancements in the mid-20th century brought us machines that could detect even a very faint heartbeat – the surest sign of life – and, by that time, people were no longer as concerned with accidentally being pronounced dead. Certainly, after embalming became standard, people were even less worried about waking in the grave because one could not survive the embalming process.
In earlier centuries, however, being incorrectly pronounced dead and accidentally buried was a real possibility and a common fear. George Washington wasn’t alone in taking precaution to ensure he was not buried prematurely. Several historical figures, the best known being Edgar Allen Poe, were taphophobic, as were some other members of the Washington family.
A Brief History of Being Buried Alive (Vivesepulture)
Have you heard the tale of Margorie McCall, whose tombstone in Lurgan, County Armagh in Northern Ireland reads “Margorie McCall, Lived Once, Buried Twice”? As her story goes, in 1705, poor Margorie fell ill with fever (fever being a catch-all term for illnesses not yet identified). Her husband, a doctor, was sick with worry as many people during the time rapidly succumbed to now treatable ailments. When Margorie died, her husband, aware of how rampantly sickness could spread, had her buried quickly.

The gravestone of Margorie McCall in Lurgan, Northern Ireland. Credit: Charlie Hintz / cultofwierd.com
As soon as the dirt settled, grave robbers aware of Margorie’s wealth decided to loot her grave. She was buried with her wedding ring, which was of considerable value. The grave robbers could not pull off the ring due to swelling, so they used a knife and began to remove the finger. The moment she was cut, a confused Margorie awoke, presumably giving the grave robbers the fright of their lives. They fled, and she wandered back home to make a full recovery, have children, and outlive her husband.
While the grave of Margorie McCall is real, the legend may be just that – a legend. “Lady with the ring” tales existed in several European countries from the 14th through the 18th centuries and continued into American folklore. The place, names, and dates were different, but the fate of the lady remained the same. But why would people believe it? Why was it passed on for centuries?
Well, in part, this and similar stories were spread by anti-premature burial activists (Yes, this was a thing.) in European countries in the 18th and 19th centuries. Some authors even sold pamphlets on the subject of premature burial, and used “lady with the ring”-style stories to agitate fear on the subject. Dr. Franz Hartmann, published a pamphlet entitled Buried Alive: An examination into the occult causes of apparent death, trance and catalepsy in 1894, that was filled with gruesome (and mostly untrue) tales of premature burial. These kinds of stories resonated and instilled taphophobia in everyday people.
How to be Sure that Someone is Dead
Taphophobia was a fear with some validity. Indeed, for most of history, the only sure way to determine that life was extinguished from a person was noticeable decomposition.
Just before Hannah Bushrod Washington, George Washington’s sister-in-law, died two years after George’s death, she made a specific request regarding the treatment of her body after death. She wrote in her will that since:
For several reasons – spread of disease, the smell, etc. – not everyone was comfortable with or had the means to allow a corpse to decompose above ground.
So, how did people in earlier centuries make certain that they didn’t bury a living person? One way was to remove the heart of the deceased. Some instances exist of people putting in their will to have their heart removed or to even be decapitated before burial. For those that didn’t want to accidentally have their still-beating heart removed, as this may have been an even worse fate than the premature burial itself, there were other options to be sure that a corpse was really a corpse. Pouring liquid ammonia into the nose, burning the bottoms of the feet with an iron, and pricking needles underneath the fingernails, for example, were ways to rouse a person in a death-like state. As cringe-inducing as all of these options are, it’s not surprising that they would indeed wake someone who was only unconscious. Additionally, tobacco pipe enemas were considered another useful way to rouse the dead. Putting a light source behind the fingers to look for signs of circulation, or a “diaphanous test”, was a less painful way to look for life.

The Old Tomb where George Washington was originally buried in 1799 before ultimately being moved to the New Tomb, which Washington had ordered built in his will, in 1831. Credit: Sarah Stierch / Wikipedia
Why They Mistook the Living for Dead
Ideally, one just waited the customary three days before burial, but that was not always feasible. During epidemics before the spread of disease was fully understood, hasty burial of the sick was common.
Today, with medical advances and a much better understanding of the human body, the likelihood of misidentifying death is minimal, but it is not unheard of even in the modern era when people suffer rare conditions that cause them to appear dead. There are many death-like conditions that can fool us. Catalepsy, a condition that can leave you unresponsive and immobile for minutes, days, or even weeks was rare and unknown to past physicians. Catalepsy can accompany a variety of mental disorders, which themselves were not well understood, even into the 20th century. “Sleeping sickness”, or African Trypanosomiasis, was a very real condition caused by the bite of a tsetse fly that caused a coma-like state that led to people being presumed dead in the 19th century. Several other conditions that result in unconsciousness even today like seizures, diabetes, dehydration, and low blood pressure could have been the culprits in people being presumed dead before the modern era.
Being shot in the head would also constitute as a condition that could lead doctors, even today, to believe you were dead. But, in May of 1799, about 7 months before George Washington’s death, an article was published in a Philadelphia newspaper telling of a soldier who had been shot in one temple, the bullet exiting the other temple. Even today most would assume death of the victim was imminent. A grave was even being dug and the soldier prepared for burial. However, a fellow soldier “thought that he noticed symptoms of animation” in the man. Unbelievably, the man was miraculously alive and gaining consciousness. The lucky soldier was attended by a surgeon and made nearly a full recovery, suffering later only some weakness in his eyes. Had George perhaps heard of this, and possibly have been startled by the fact that this man was nearly buried alive?
How to Not Bury Someone Alive
When burial couldn’t wait, or when the deceased or the family of the deceased were really taphopohbic, there were avenues to ensure an escape from the grave, if the dead returned to life. The use of bells was perhaps the most affordable way to watch for premature burial. Bells were tied to the body and hung on the ground surface above the grave. The bell would ring if there was movement below ground. This is where the term “dead-ringer” originates.
Other inventions required a bit more expense, so not everyone had access to them. “Safety coffins” were gave piece of mind to the loved ones of the deceased. Some featured an air pipe AND an alarm system that indicated movement if a buried person became conscious. Air pipes would be removed once the smell of decomposition set in or a sufficient amount of time had passed.

Patent drawing for a safety coffin. Credit: U.S. Patent Office
The first “waiting mortuary” or Leichenhaus, was designed in Germany in 1792. A worker, called a Leichenhäuser, would be expected to sit vigil at the window of the corpse room and await movement. Workers were not allowed to leave the “patients” for any period of time, and were required to have equipment to resuscitate a person if they stirred.
Similarly, a special vault was once built in Wildwood Cemetery in Williamsport, Pennsylvania that featured air flow and hand wheels on doors for those who awoke in the vault to help them escape. It was used as a safe holding area to give the deceased time to revive before being removed to their grave in another part of the cemetery.

Wildwood Cemetery’s special vault in Williamsport, Pennsylvannia as featured in the July 1921 edition of Popular Mechanics.
There were many normal reasons for relocating a family member’s body, just as George Washington’s body was moved into the new vault at Mount Vernon 32 years after his death. What wouldn’t be considered normal, would be to find that the deceased had rolled over, pulled out their hair, or scraped off their fingernails on the interior of the coffin lid. Opening a burial vault for the first time in years to relocate a body, or to inter another family member, only to come to the realization that the person was clearly not dead when they entered the grave, was a common fear. Stories existed of family finding the skeleton of a deceased relative inside a vault but outside of their coffin, having apparently starved to death in the mausoleum. No doubt some of these stories were fictional, but some were probably true as well.
Finally, glass windows allowed people to see into the grave vault. They weren’t always installed just for fear of premature burial. Families have been known to install grave windows for other reasons that have to do with the mourning process. They were a useful tool, however, in being able to make sure the dead had not woken up. Some famous examples of grave windows still exist today.

A window into the grave of Dr. Timothy Clark Smith in the Evergreen Cemetery in New Haven, Vermont. Credit: Vermonter.com
Upon his death in November of 1829, Bushrod Washington, Hannah Bushrod Washington’s son and George Washington’s nephew, requested a special coffin to be placed in for a while before burial on top of a waiting period to be sure he was actually dead:

Bushrod Washington was George Washington’s nephew, the son of John Augustine Washington, and an Associate Justice of the Supreme Court of the United States. Depicted in an engraving made in 1830 by James Barton Longacre from a portrait by Chester Harding. Credit: New York Public Library.
A “phobia” is a word used in terms of an irrational fear. But was taphophobia really irrational in the 18th and 19th centuries or was it simply justified caution? Ultimately, we will never know how many people tragically succumbed to vivesepulture. What we do know is that George Washington made certain that he would not.
Elyse Adams, Archaeologist
Archaeology Lab Technician