Clarification and medical history of apparent death
The medical theories of antiquity are largely forgotten with the fall of the Roman Empire. Thus, medicine in the Middle Ages initially consisted of improvisation and superstition, [1] if treatment was given at all – because illnesses were God’s work and only he could decide whether recovery would occur or not – then usually with very surprising therapeutic approaches. With the Crusades, Islamic medicine finds its way into the West. It is mainly based on the ancient theories of Hippocrates (ca. 460 – 370 v. Chr.) and von Galen (ca. 130 – 200 n. Chr.), co-founder of the four-fluid theory, according to which a person is only healthy if the four bodily fluids blood, phlegm, yellow bile and black bile are in balance. [2] Due to the dogma of leaving the body intact under all circumstances, two strands develop in the treatment of patients: doctors deal exclusively with internal medicine, surgical treatments fall into the hands of so-called hand surgeons who, without academic training, pull teeth, amputate and drill into skullcaps, all without serious anesthesia, not to mention observing hygiene. Even if there are already some experts who really know how to preserve life, the obscure methods of treatment not infrequently lead to the death of the patient sooner or later. This is how the health care of the Middle Ages and the Renaissance is similar to the doctors of the 17th century. The medicine of the twentieth century has become suspect, and the practical remedies of the time – emetics, pulverized genitals, feces and urine, and other now questionable things – have long since ceased to convince even those who prescribe them. [3] The epidemics of that time always cause chaotic conditions, they bring an almost unbelievable amount of dead, depopulate whole regions and the corpses are hastily buried in mass graves without careful examinations. This is where Bondeson sees a possible beginning of the apparent death discussion, as many doctors in the 17. It seems that the scientists of the nineteenth century had already been aware of the danger that in this chaos fatal errors of judgment could occur. [4] He sees the proof among other things in the discovery of bones during an excavation of a plague mass grave of 1722 in Marseille, to which a good two and a half centimeters long bronze needle stuck in the big toe, presumably intentionally driven under the toenail, in order to examine the entrance of the death. [5] Such methods will be considered in more detail in the next chapter.
While physicians prefer to leave the question of the meaning and nature of death to philosophers and theologians, questions of prediction and exact fixation of the time of death appear to be important for medicine. [6] Since individual cases of apparent death have been known since antiquity, other physical changes are used in addition to the negative breath sample to determine actual death. [7] Traditionally, this is generally pulselessness, pale and cold skin, eye changes and finally death spots and rigor mortis. [8] As a rule, the judgment of relatives is sufficient to convince the doctor that death has occurred. [9] Even if recently there are individual voices of reflection, the general state of research is that until the middle of the 18th century, the blood-letting was not a problem. Twentieth-century apparent death is not a serious problem, either for physicians or for the public consciousness. [10]
The physicians of 17. and 18. The medical science of the twentieth century has to deal with ever new findings and to give up traditional ideas. The emerging questions of medicine concern the whole person, because how can one really heal, if one does not even know what "life" is? is what it means to be "sick" to be and where a disease originates in the first place? [11] A lively discussion developed, with the teachings of the mathematician, physicist and philosopher Rene Descartes (1596 – 1650) in the mid-17th century causing a furor in Germany. The first thing to be mentioned is the nineteenth-century physiology of the body, which describes the still largely incomprehensible physiological processes of the body as quite simple physical ones – namely heat, pressure, expansion, movement – and thus reveals the organism. [12] At first, dissections remained forbidden, but with the ravages of the plague and the fervent desire for a cure, they met with increasing acceptance. [13] With the advent of the natural sciences, the dead body is soon reified, [14] the sanctity of the body finally dissolved. The new interest of medicine does not shy away from anatomical experiments, also resorts to vivisection of animals, and thereby discovers more and more the innermost part of the human being. Thus, in 1628, one of the most groundbreaking discoveries in the history of medicine occurs: William Harvey (1578 – 1657) discovers the circulation of the blood, thus refuting Galen’s theory, which had been valid for centuries. [15] With his intention to support Galen’s theories, which he considered to be "minus firma" ("not quite sure"), it completely overturns the traditional view of the heart and its function and thus calls into question one of the most common methods of treatment: bloodletting. [16] The physician Tankred Koch considers bloodletting, which is automatically prescribed for almost all diseases and which Hippocrates had already ordered in his time, to be one of the most terrible means and the cause of many cases of apparent death. [17] Koch reported cases in which up to two and a half liters of blood were taken, and since plague germs multiplied faster than red blood cells, or blood overloaded with typhoid or cholera germs became thicker and thicker and less and less capable of transporting oxygen, one could quickly imagine that the poor people would soon show the signs of a "vita minima" (literally, "reduced life.", medical term for apparent death) show. [18] If, however, there is a last revolt of the supposed dead, the first remedy is to bring him back to life: Bloodletting. [19] It was not until the time of Christoph Wilhelm Hufeland, when the four-juice theory was replaced by the theory of vitalism – the view of a supernatural, immaterial life force in organisms – that the frequency of bloodletting decreased. [20] Already 100 years earlier, Harvey argues that nature shows the divine order of things, that the blood, for example, has an inherent power of self-motion that drives it through the veins to the center of the body. [21] This view will be dealt with in more detail in the following chapter. First of all, however, the attitude of the Enlightenment thinkers shall be summarized roughly and thus finally the way to the debate on apparent death shall be found.
The longing for the other world, the flight from the ego, the gayness – the main components of the Baroque – are pushed back by a culture of understanding, by rationalism and positivism of the Enlightenment from about 1720 onwards. [22] Reason, i.e. thinking free of superstition and prejudice, is considered the standard for personal and social action. Instead of an omnipotent God, all action now proceeds from the reason-guided, autonomously thinking individual. [23] Man is now seen as an individual being, as one element of a great whole, the individual moves to the center. Before, the meaning of life was seen in preparing for the life in the hereafter, but now a turning to this world takes place. The life of the individual in itself acquires sufficient meaning; bliss now takes center stage. Man becomes happy through the satisfaction of his life’s needs and through virtue. His life task is therefore the promotion of the useful and the good, thus he approaches his life goal: the intellectual and moral perfection. [24] All teachings and traditions of the historical religions that seem to contradict common sense or do not stand up to rationalistic criticism are dismissed as inventions; the claim to authority of the church is consequently rejected. [25] As far as religion is not completely rejected now, one adheres to the idea of deism:
"God stands outside the world; he is the highest intelligence, the wise builder of the world machine, who, having once set it in motion, idly watches its progress. [. ] The relationship to God, the salvation of the soul, death and the hereafter are no longer really burning issues for the Enlightenment thinker. He is mainly interested in man in his self-importance and not in his dependence on fate." [26]
A religious view of the world becomes a scientific one: new sciences will arise; they will now explain what is unclear and will be the salvation of mankind, because the Enlightenment is a flowering of sciences and arts, with it goes an immense scientific progress of knowledge.
Through secularization, religion loses social significance. Man now sees himself freed from the shackles of (super)faith, but at the same time he loses the certainty of the immortality of the soul. The entire expectation of salvation history is shaken, followed by a contingency experience of unknown extent, which makes a new foundation of meaning urgently necessary. [27] According to Gerlind Ruve, this fright lies at the heart of the debate on suspended animation that began in the mid-1800s. Century its beginning takes, underlying. [28]
Discussion: The Fear of Apparent Death – Immanent in Man or Specific to Man around 1800?
Why the apparent death experiences its bloom especially in the times of the Enlightenment will be discussed in detail in the current chapter, because the debate, which was at times very passionate in Germany around 1800, shows itself to be a very complex phenomenon. As already mentioned, the phenomenon was already known in the antiquity, but did not leave the impression of a danger for the whole mankind. [29] The physicians tried to find out the cause already at that time, however, as a rule one saw such occurrences as a divine sign or otherwise a miracle. [30] Also in the Middle Ages no other solution was found, since scholastic medicine, as described above, rigidly adhered to ecclesiastical authorities and the aversion to anatomical studies, especially since medicine was anyway exclusively in the hands of the clergy. [Surgery was disparaged as butchery, sudden death was considered a divine punishment and whoever searched for the causes was condemned as a heretic. [32] Thus, the issue of suspended animation smolders unresolved through the centuries.
Transformation of the conception of the soul
The history of suspended animation begins with the history of the dissolution of the conception of the soul, which is accompanied by an anthropological transformation. [33] Already in the Renaissance there is a dispute about the immortality of the soul: The climax here is the statement of the Italian Pietro Pomponazzi (1462 – 1525), who examined the question only with arguments of reason and this excluded all reasons for the assumption of an immortality of the soul. [34] Thus he does not deny any truths of faith, but claims the right to pursue a doctrine of the soul as a science independent of theology, which is committed to purely rational arguments. [35] The systematic interest of the doctrine of the soul of this time lies in reconsidering basic questions of cognition more intensely, the coming into being of individual perception, its relation to the claim of generality of cognition as well as its safeguarding and scope of validity. [36] However, the Renaissance did not yet know epistemology as a specific science of the essence, principles and limits of cognition. [37] Nevertheless, the discussion of this time already marks an epistemological dilemma, which Michael Stadler summarizes:
"If the generality claim of knowledge is to be maintained, with its connotation of temporal and spatial independence, the assumption of an intellectual soul with the same qualities seems to become necessary. As the subject of cognition, it must be universal, imperishable, immaterial. If, however, cognition is to be reconstructed as a causal process that begins with sensual perception, then the entire human being, the concrete individual, is the subject and the intellectual soul is regarded as the forma corporis [(in the form of bodies)] understood." [38]
Consequently, soul cannot be thought detached from the body and passes away with it. [39] In this one already recognizes the increasing de-substantialization of the soul-thought towards the definition of the soul as a center with equal distance to two reference quantities – however these may be conceptually conceived (for example spirit and body), thus as a function connecting two extremes. [40]
Through new methods such as observation, experience and experiment, anthropology finally changes; they now substantiate statements about the nature and life functions of man, he is no longer the creature of God and knowledge about him is no longer derived from Genesis. [41] Plausibility or truth of knowledge is not revealed by faith, but by visibility: Experiments make knowledge comprehensible for everyone. [42] The new reading is further supported by Descartes’ combination of Harvey’s discovery of the blood circulation, empirical descriptions of human anatomy and Galileo’s physics to a mechanistic view of man: He explains Harvey’s blood circulation as mere hydraulics, a bodily function of the manikin. [43] The body is subject to mechanical-physical laws and can be described mathematically, like a clockwork or an automaton. The human being, up to now surging with all kinds of vital juices, now appears as a closed system; his heart, once the seat of the soul and the fireplace of life, now appears reduced to a simple muscle. [44] This deprives the heart of its traditional symbolic function as the seat of emotion. Descartes also re-locates the soul, integrating it as an organ in physiology, namely in the pineal gland in the brain. [45] Again the question arises: But if now the soul is located in an organ, is it then also of a perishable nature and what does this mean for the promise of immortality?? Descartes does not question immortality and the existence of God, even though for him it is a result and not a prerequisite. [46] In his treatise "Les Passions de l’âme" ("The Passions of the Soul") from 1649 he writes about the human division of body and mind, that all kinds of thoughts belong to the soul (so soul and mind are the same for him) and all kinds of heat and movement belong to the body. [47] This two-substance dualism, which characterizes a new understanding of soul in modern times, is the serious difference to the previous way of thinking of a trinity. [48] Body and mind are strictly separated, but both interact causally with each other. The resulting problem of mediation between the material body and the immaterial soul shall be disregarded here. Important for the further argumentation is the new view on life and death, which comes up with the theory man equals machine. This is how Descartes writes about it:
"In this way we can avoid an error that is well worth noting, since many fall into it. ]. It exists [. ] in that because all dead [. It was believed that the absence of the souls was the cause why the movement and the warmth in their bodies ceased. [. So people have imagined without raison that all our natural warmth and all movement of our bodies comes from the soul." [49]
He comes to a different conclusion, because the strict separation of body and mind can "[. A human being never dies from the fact that something should be missing somewhere in his soul. ]", but because the warmth of the body disappears and the organs that serve the body for movement perish. [50] So the body"[. The life of a living person can be distinguished from that of a dead person only in so far as a watch, or another machine, [. ] when it is broken and its movement ceases". [51] Consequently, death does not occur because the soul escapes, but the soul escapes because death has occurred. The soul is thus no longer a life-giving but a form-giving principle. According to this, dying only happens on the material level, the spirit has nothing to do with it due to its immaterial nature. Along with this change in your mind comes a change in the way you feel about your body. A distancing of man from his body begins to take place. [52] Over the next decades, Descartes’ concept is assimilated by mainstream thought, especially from circa 1750, the body is increasingly perceived as an object in which the soul is trapped. [53] With the Baroque, one begins to turn away from the exterior spaces and towards the interior, thus also the view into the interior of the human body becomes more objective and loses its uncanniness. [54] Man’s understanding of himself as a subjective experiencer is transformed into an objective observer. [55] This will not be further elaborated in the context of this work, but it should be mentioned that anatomy at this time enjoys an unprecedented and never again achieved popularity and publicity, and thus the objective study of the body becomes common property. [56] Thus the relation to the living as well as to the dead body changes definitively; the anatomical specimen, the dead body on the dissecting table, all this destroys the old religious conception of the lapsed body…. [57] The loss of the body-soul unity as well as the loss of the potential resurrection stirs up new fears.
Death as a process
All this does not make the question of a generally valid theory of life (and death) easier. Through Harvey’s discovery and methodology, for example, the precise calculation of the heart’s pumping action, and Descartes’ basically medically correct description of muscle movement and the heart [58], the machine theory seems initially supported. Once again back to Descartes comparison:
"[. ] a[n] clock, or another machine, so von ihr selbst beweget [. It is a kind of "life force", if it is well established, and the cause of its movement, for which it is prepared, is in good condition with all that is driven by it [. ]." [59]
A well-built clock or machine, which once started, drives itself, as long as nothing is broken. What does this mean concretely for man?? How does the life come into the body, if it does not bring the soul with it? And how does it leave the body again? By the opening of the body it is shown that there seem to be forces in the body which function independently of a soul. Descartes sees in this the divine proof: God pushes the life and it runs since then independently, a perpetuum mobile. He explains a movement, such as a reflex of the arm, by spirits of life, a kind of air or subtle wind, flying from the brain through the whole body:
"[. ] the only reason why just one muscle is contracted sooner than another, which is opposed to it, is this, because more life-spirits come to the one than to the other." [60]
Already Harvey suspected a kind of "life force" ] in the blood, a divine fluid that lets the blood flow. [61] So, life is the "life force" which is ordered by nature generated movement of the body machine. [62] Not the moment when the God-given immortal soul leaves the body, but the gradual diminution of the vital forces and thus the disappearance of the organic functions signify death. [63] Death is now a successive process extended in time and no longer a moment, the medieval-Christian conception of death thus finally invalidated. [64] The royal physician and professor of medicine Christoph Wilhelm Hufeland distinguished in 1791 in "On the uncertainty of death and the only infallible means to convince oneself of its reality, and to make burial alive impossible [. ]" three successive stages of death:
"[. ] [State one], where all movement, which our senses can reach, is suspended, and man is the complete image of death, but inside still beats life force, and the organs have not yet lost the ability of their influence, which, if only a suitable stimulus is applied or the binding cause is loosened, must also become visible again externally. So this degree is curable [. ]. Secondly, the state that is completely similar to the previous one on the outside, and where there is also still life force left in the bundled state, but this has lost too much energy, or the finest and noblest organs have lost too much usefulness, to be able to become free and alive again. It is the usual and necessary consequence of the foregoing, for precisely because of the standstill of the machine, after a longer or shorter time, the organs must become useless and the life force itself more powerless. [. ] [Finally] the third degree, [at which] the real dissolution by decay, occurs. Only now is the perfection of death certain [. ]. The death of man is [. ] [thus] a gradual transition from the state of active life into that of the bound or apparent death, and through this only into the perfect death, or the total loss of all life force." [65]
With the Renaissance and finally the Enlightenment, after all the uncertainty and speculations of the Middle Ages, the will for knowledge breaks out with power, but – in spite of all the pioneering achievements of medicine – the solution of the problem seems further away than ever. [66] For the discussed findings hold enormous social shaking potential: On the one hand, the certainty of a soul that ascends to heaven after death and secured the immortality of man, and of resurrection is no longer given. On the other hand, the understanding of death as a transitory situation on the way to eternal salvation or eternal damnation was replaced by the certainty that death could be the absolute end. [67] The knowledge about the existence of a soul and its life in the hereafter are irretrievably shaken. [68] Here the fear of apparent death has its premiere. The needed new meaning of death after the shattering of the expectation of salvation history is now life itself, the transition from the afterlife to this world. [69] The fear of being buried alive can thus initially be seen as a fear of losing earthly life; calls to save life and resuscitation – as will be shown, altogether instructions for action derived from the fear of apparent death – as a valorization of the latter. [70] First, however, a brief look will be taken at the ideas of death in popular belief, for these too find their influence in the apparent death debate.
Folkloric conceptions of death
As stated above, despite all social disciplining, the church could not banish or assimilate all myths from pre-Christian times. And while enlightened medicine seeks to fathom death on the physical level, in popular belief the process of dying is still regarded as the escape of the immortal soul from the body. [71] Thus, most rituals and practices aim, on the one hand, to facilitate the soul’s separation, and on the other hand, to prevent its return, respectively death from catching up with other souls. [72] In this context, the idea that the soul escapes through the natural orifices of the body is a common phenomenon, and in many places funerary practices of covering the eyes of the dead with coins and tying up the jaw with a cloth to prevent the mouth from opening have been preserved. [73] If the rites are not carried out correctly, the danger of revenants, of vampires, threatens. [74] Here the fantasies of suspended animation and vampirism will be intermingled. [75] Popular belief holds that especially the deceased, who have left behind an unpunished crime, were buried dead, but every night or on certain days, for example on anniversaries of the crime, they rise from the grave and in the form of a bat suck the blood from the body of innocent sleepers, so that as a result, without any external cause, they become paler and weaker and finally die. [76] If one has this suspicion, the corpse’s head is cut off, a stake is driven into the chest, or it is burned completely. [77] Even though it is generally assumed today that the vampire myth goes back to very old Slavic sources, interestingly enough, these stories only come to light in the early 18. In Western Europe, the process of dying was mentioned to a greater extent in the mid-nineteenth century, i.e., at about the same time as the spreading fear of apparent death. [78]
Also so-called death miracles occupy humans increasingly. Phenomena such as corpse smacking and the apparent ability of corpses to gnaw off their shrouds or even their fingers and arms, even coffin births, are repeatedly reported. Bondeson, in his book "Buried Alive" on more than fifty pages all possible legends together, which point to apparent victims of the same. people who can only be rescued from the tomb or coffin by the appearance of grave robbers – the reports are all very similar to the legend of the "woman with the ring"; or people for whom any help comes too late, whose bent posture or the above-mentioned observations point to a too early burial and a soon unspeakably cruel death struggle. [79] He notes that people in the 16. and 17. However, in the twentieth century people were still too caught up in their world of superstition, because they interpreted these cases as miraculous resurrections and did not draw the conclusion to investigate more thoroughly people who were thought to be dead. [80] Still in 1798 Hufeland asks in "The art of prolonging human life" states that
"[. ] devilish superstition [. ] among the common heap still more than one thinks prevails[t]. The disgraceful fear of the shameful and dishonest, which the treatment of a [drowned] person entails, belongs to it [. The people of the city, for example, said that one should not fish out a drowned man before sunset in order not to harm the fishery, or that many a river must have its annual victim [. ]." [81]
The German physician Johann Peter Frank adds in his multi-volume writings "System einer vollstandigen medicinischen Polizey" ["System of a complete medicinal police"] [ at 1800 with the quote:
"It does not help whether a drowned person is pulled out of the water a few hours earlier or later; what is to die, dies nevertheless, and what is to live, lives nevertheless!" [82]
Water or rather bodies of water are in this context in principle very meaningful. Thus Stoessel reports of the custom in Ireland of doubling the volume of the dirge when the funeral procession passes rivers or other bodies of water, in order to prevent the water spirits from taking the souls of the deceased. [83] Already in ancient Greece it was considered a principle not to look at one’s reflection in water, because it could be pulled under water by the water spirit and the person, now without soul, would perish. [84] With similar uneasiness one encounters mirrors directly. At the onset of death, doors and windows are opened, mirrors as well as all reflecting objects must be turned over or hung down, so that the soul can disappear unhindered. [85] Moreover, it is said that when a living person sees the corpse in the mirror, he must follow it. [86] In general, the world of the living must be strictly separated from that of the dead: Everything that has come into contact with a dead person is tabooed. [87] Thus it also comes to what Hufeland describes, namely that the fishermen, instead of quickly rushing to the aid of a drowning man and trying to revive him, leave him in the water until after sunset, so as not to curse either themselves or the fishery. Patak also notes the contradiction of progressive thinking on the one hand and persistence in old, security-giving rites on the other hand. [88] Perhaps as a reaction to the triumph of reason and the rationalism that is emerging everywhere, superstition has reached a peak hardly ever seen before. [89] Quackery and the "mysterious powder" have their heyday, even bloodletting is still prescribed in the first place. [90] For Patak, this fact is of fundamental importance for the problem of the fear of apparent death. He asks how such a jumble of superstitious notions, a world full of witches, devils and ghosts, can be made to disappear in one fell swoop by the sober, all-explanatory rationalism that has prevailed in the Enlightenment? [91] His explanation:
"It could only come to a repression of this baroque world of feelings down into the unconscious, a suppression into other realms. From there, however, it abruptly reappeared, concentrated as in a focal point on a single problem, and thereby assumed proportions that shook the whole population: this is the problem of the never-solved question of apparent death, constantly smoldering unnoticed in the imagination. Here the ground of reality must be left before the intellectually incomprehensible concept of the uncanny, here the world of understanding fails, here the whole of enlightenment fails, and through this outlet the whole of the suppressed world of feeling is discharged. The tremendous impact testifies to the huge need of this very time to solve the burning problem." [92]
Stoessel also sees a shift in fear: while medicine is beginning to take an interest in apparent death and is endeavoring to distinguish it from death, the unexplained phenomenon of vampirism is also increasingly coming into the public consciousness. The apparent simultaneity, however, is basically a matter of succession, because on the one hand science also tries to understand vampires under "rational" conditions On the other hand, it is precisely the cases of apparent death that are now appearing in abundance that would feed the belief in vampirism among the common people. [93] The sporadically known vampire legends, just like the legends about feigned deaths in the middle of the 18th century, are therefore not very well known. A twenty-first century update. The old rites are used to try to banish the fear of the world of the dead, but for the more educated classes this superstition is no longer in keeping with the times, since there is only this one world, which should be preserved as long as possible. [94] Consequently, the shift in fear seems to be such that it is no longer the group that needs protection from evil, but one’s own fate that becomes the focus of concern:
"The predominant element is no longer the fear of being haunted, but of being locked up. Parallels can be seen here with the individualization of society that has been progressing since the Renaissance.". [95]
[1] Richard David Precht: The human enigma – From Rene Descartes to Robert Koch: A brief history of medicine. in: The birth of modern medicine: How Europe’s art of healing created a new image of the human being; DIE ZEIT story no. 2/08. S. 18.