Children of the Grave

They give birth astride of a grave,
the light gleams an instant,
then it’s night once more.

(S. Beckett, Aspettando Godot)

An Italian Horror Story

Castel del Giudice, Italy.
On the 5th of August 1875, a pregnant woman, indicated in the documents with the initials F. D’A., died during labor, before being able to give birth to her child.
On the following day, without respecting the required minimum waiting time before interment, her body was lowered into the cemetery’s fossa carnaria. This was a kind of collective burial for the poorest classes, still common at the time in hundreds of Italian communes: it consisted in a sealed underground space, a room or a pit, where the corpses were stacked and left to rot (some inside coffins, others wrapped in simple shrouds).

For the body of F. D’A., things began to get ugly right from the start:

She had to be lowered in the pit, so the corpse was secured with a rope, but the rope broke and D’A.’s poor body fell from a certain height, her head bumping into a casket. Some people climbed down, they took D’A. and arranged her on her back upon a nearby coffin, where she laid down with a deathly pale face, her hands tied together and resting on her abdomen, her legs joined by stitched stockings. Thus, and not otherwise, D’A. was left by the participants who buried her.

But when, a couple of days later, the pit was opened again in order to bury another deceased girl, a terrible vision awaited the bystanders:

F. D’A.’s sister hurried to give a last goodbye to her dead relative, but as soon as she looked down to the place where her sister was laid to rest, she had to observe the miserable spectacle of her sister placed in a very different position from the one she had been left in; between her legs was the fetus she had given birth to, inside the grave, and together with whom she had miserably died. […] Officers immediately arrived, and found D’A.’s body lying on her left side, her face intensely strained; her hands, still tied by a white cotton ribbon, formed an arch with her arms and rested on her forehead, while pieces of white ribbon were found between her teeth […]. At the mother’s feet stood a male newborn child with his umbilical cord, showing well-proportioned and developed limbs.

Imagine the horror of the poor woman, waking up in the dark in the grip of labor pains; with her last remaining energy she had succeeded in giving birth to her child, only to die shortly after, “besieged by corpses, lacking air, assistance or food, and exhausted by the blood loss suffered during delivery“.
One could hardly picture a more dreadful fate.

The case had a huge resonance all across Italy; a trial took place at the Court of Isernia, and the town physician, the mayor and the undertaker were found guilty of two involuntary murders “aggravated by gross negligence“, sentenced to six months in jail and fined (51 liras) – but the punishment was later cut by half by the Court of Appeal of Naples in November 1877.
This unprecedented reduction of penalty was harshly criticized by the Times correspondant in Italy, who observed that “the circumstances of the case, if well analyzed, show the slight value which is attached to human life in this country“; the news also appeared in the New York Times as well as in other British and American newspapers.

This story, however scary – because it is so scary – should be taken with a pinch of salt.
There’s more than one reason to be careful.

Buried Alive?

First of all, the theme of a pregnant woman believed dead and giving birth in a grave was already a recurring motif in the Nineteeth Century, as taphophobia (the fear of being buried alive) reached its peak.

Folklorist Paul Barber in his Vampires, Burial, and Death: Folklore and Reality (1988) argues that the number of people actually buried alive was highly exaggerated in the chronicles; a stance also shared by Jan Bondeson, who in one of the most complete books on the subject, Buried Alive, shows how the large majority of nineteenth-century premature burial accounts are not reliable.

For the most part it would seem to be a romantic, decadent literary topos, albeit inspired by a danger that was certainly real in the past centuries: interpreting the signs of death was a complex and often approximate procedure, so much so that by the 1700s some treatises (the most famous one being Winslow‘s) introduced a series of measures to verify with greater accuracy the passing of a patient.

A superficial knowledge of decomposition processes could also lead to misunderstandings.
When bodies were exhumed, it was not uncommon to find their position had changed; this was due to the cadaver’s natural tendency to move during decomposition, and to be sometimes subjected to small “explosions” caused by putrefaction gasses – explosions that are powerful enough to rotate the body’s upper limbs. Likewise, the marks left by rodents or other scavengers (loose dirt, scratches, bite marks, torn clothes, fallen hair) could be mistaken for the deceased person’s desperate attempts at getting out.

Yet, as we’ve said, there was a part of truth, and some unfortunate people surely ended up alive inside a coffin. Even with all our modern diagnostic tools, every now and then someone wakes up in a morgue. But these events are, today like yesterday, extremely rare, and these stories speak more about a cultural fear rather than a concrete risk.

Coffin Birth

If being buried alive was already an exceptional fact, then the chances of a pregnant woman actually giving birth inside a grave look even slimmer. But this idea – so charged with pathos it could only fascinate the Victorian sensibility – might as well have come from real observations. Opening a woman’s grave and finding a stillborn child must have looked like a definitive proof of her premature burial.
What wasn’t known at the time is that the fetus can, in rare circumstances, be expelled postmortem.

Anaerobic microorganisms, which start the cadaver’s putrefactive phase, release several gasses during their metabolic activity. During this emphysematous stage, internal tissues stretch and tighten; the torso, abdomen and legs swell; the internal pressure caused by the accumulation of gas can lead, within the body of a woman in the late stages of pregnancy, to a separation of amniotic membranes, a prolapse of the uterus and a subsequent total or partial extrusion of the fetus.
This event appears to be more likely if the dead woman has been pregnant before, on the account of a more elastic cervix.
This  strange phenomenon is called Sarggeburt (coffin birth) in early German forensic literature.

The first case of postmortem delivery dates back to 1551, when a woman hanged on the gallows released, four hours after her execution, the bodies of two twins, both dead. (A very similar episode happened in 2007 in India, when a woman killed herself during labor; in that instance, the baby was found alive and healthy.)
In Brussels, in 1633, a woman died of convulsions and three days later a fetus was spontaneously expelled. The same thing happened in Weißenfels, Saxony, in 1861. Other cases are mentioned in the first medical book to address this strange event, Anomalies and Curiosities of Medicine, published in 1896, but for the most part these accidents occurred when the body of the mother had yet to be buried.
It was John Whitridge Williams who, in his fortunate Obstetrics: a text-book for the use of students and practitioners (1904), pointed to the possibility of postmortem delivery taking place after burial.

Fetal extrusion after the mother’s death has also been observed in recent times.

A 2005 case involved a woman who died in her apartment from acute heroine intoxication: upon finding her body, it was noted that the fetus head was protruding from the mother’s underwear; but later on, during the autopsy, the upper part of the baby’s torso was also visible – a sign that gasses had continued to build in the abdominal region, increasing interior pressure.
In 2008 a 38 year-old, 7 months pregnant woman was found murdered in a field in advanced state of decomposition, accelerated by tropical climate. During the autopsy a fetus was found inside the woman’s slips, the umbilical cord still attached to the placenta (here is the forensic case study – WARNING: graphic).

Life In Death

So, going back to that unfortunate lady from Castel del Giudice, what really happened to her?
Sure, the autopsy report filed at the time and quoted in the trial papers mentioned the presence of air in the baby’s lungs, a proof that the child was born alive. And it’s possible that this was the case.

But on one hand this story fits all too perfectly within a specific popular narrative of its time, whose actual statistical incidence has been doubted by scholars; on the other, the possibility of postmortem fetal extrusion is well-documented, so much so that even archeologists sometimes struggle to interpret ancient skeletal findings showing fetuses still partially enclosed within the pelvic bone.

The only certain thing is that these stories – whether they’re authentic or made up – have an almost archetypal quality; birth and death entwined in a single place and time.
Maybe they’re so enthralling because, on a symbolic level, they remind us of a peculiar truth, one expressed in a famous verse from
ManiliusAstronomica:

Nascentes morimur, finisque ab origine pendet.

As we are born we die, our end commences with our beginning.”

The premature babies of Coney Island

Once upon a time on the circus or carnival midway, among the smell of hot dogs and the barkers’ cries, spectators could witness some amazing side attractions, from fire-eaters to bearded ladies, from electric dancers to the most exotic monstrosities (see f.i. some previous posts here and here).
Beyond our fascination for a time of naive wonder, there is another less-known reason for which we should be grateful to old traveling fairs: among the readers who are looking at this page right now, almost one out of ten is alive thanks to the sideshows.

This is the strange story of how amusement parks, and a visionary doctor’s stubbornness, contributed to save millions of human lives.

Until the end of XIX Century, premature babies had little or no chance of survival. Hospitals did not have neonatal units to provide efficient solutions to the problem, so the preemies were given back to their parents to be taken home — practically, to die. In all evidence, God had decided that those babies were not destined to survive.
In 1878 a famous Parisian obstetrician, Dr. Étienne Stéphane Tarnier, visited an exhibition called Jardin d’Acclimatation which featured, among other displays, a new method for hatching poultry in a controlled, hydraulic heated environment, invented by a Paris Zoo keeper; immediately the doctor thought he could test that same system on premature babies and commissioned a similar box, which allowed control of the temperature of the newborn’s environment.
After the first positive experimentations at the Maternity Hospital in Paris, the incubator was soon equipped with a bell that rang whenever the temperature went too high.
The doctor’s assistant, Pierre Budin, further developed the Tarnier incubator, on one hand studying how to isolate and protect the frail newborn babies from infectious disease, and on the other the correct quantities and methods of alimentation.

Despite the encouraging results, the medical community still failed to recognize the usefulness of incubators. This skepticism mainly stemmed from a widespread mentality: as mentioned before, the common attitude towards premature babies was quite fatalist, and the death of weaker infants was considered inevitable since the most ancient times.

Thus Budin decided to send his collaborator, Dr. Martin Couney, to the 1896 World Exhibition in Berlin. Couney, our story’s true hero, was an uncommon character: besides his knowledge as an obstetrician, he had a strong charisma and true showmanship; these virtues would prove fundamental for the success of his mission, as we shall see.
Couney, with the intent of creating a bit of a fuss in order to better spread the news, had the idea of exhibiting live premature babies inside his incubators. He had the nerve to ask Empress Augusta Victoria herself for permission to use some infants from the Charity Hospital in Berlin. He was granted the favor, as the newborn babies were destined to a certain death anyway.
But none of the infants lodged inside the incubators died, and Couney’s exhibition, called Kinderbrutanstalt (“child hatchery”) immediately became the talk of the town.

This success was repeated the following year in London, at Earl’s Court Exhibition (scoring 3600 visitors each day), and in 1898 at the Trans-Mississippi Exhibition in Omaha, Nebraska. In 1900 he came back to Paris for the World Exhibition, and in 1901 he attended the Pan-American Exhibition in Buffalo, NY.

L'edificio costruito per gli incubatori a Buffalo.

The incubators building in Buffalo.

The incubators at the Buffalo Exhibition.

But in the States Couney met an even stronger resistence to accept this innovation, let alone implementing it in hospitals.
It must be stressed that although he was exhibiting a medical device, inside the various fairs his incubator stand was invariably (and much to his disappointment) confined to the entertainment section rather than the scientific section.
Maybe this was the reason why in 1903 Couney took a courageous decision.

If Americans thought incubators were just some sort of sideshow stunt, well then, he would give them the entertainment they wanted. But they would have to pay for it.

Infant-Incubators-building-at-1901-Pan-American-Exposition

Baby_incubator_exhibit,_A-Y-P,_1909

Couney definitively moved to New York, and opened a new attraction at Coney Island amusement park. For the next 40 years, every summer, the doctor exhibited premature babies in his incubators, for a quarter dollar. Spectators flowed in to contemplate those extremely underweight babies, looking so vulnerable and delicate as they slept in their temperate glass boxes. “Oh my, look how tiny!“, you could hear the crowd uttering, as people rolled along the railing separating them from the aisle where the incubators were lined up.

 

In order to accentuate the minuscule size of his preemies, Couney began resorting to some tricks: if the baby wasn’t small enough, he would add more blankets around his little body, to make him look tinier. Madame Louise Recht, a nurse who had been by Couney’s side since the very first exhibitions in Paris, from time to time would slip her ring over the babies’ hands, to demonstrate how thin their wrists were: but in reality the ring was oversized even for the nurse’s fingers.

Madame Louise Recht con uno dei neonati.

Madame Louise Recht with a newborn baby.

Preemie wearing on his wrist the nurse’s sparkler.

Couney’s enterprise, which soon grew into two separate incubation centers (one in Luna Park and the other in Dreamland), could seem quite cynical today. But it actually was not.
All the babies hosted in his attractions had been turned down by city hospitals, and given back to the parents who had no hope of saving them; the “Doctor Incubator” promised families that he would treat the babies without any expense on their part, as long as he could exhibit the preemies in public. The 25 cents people paid to see the newborn babies completely covered the high incubation and feeding expenses, even granting a modest profit to Couney and his collaborators. This way, parents had a chance to see their baby survive without paying a cent, and Couney could keep on raising awareness about the importance and effectiveness of his method.
Couney did not make any race distinction either, exhibiting colored babies along with white babies — an attitude that was quite rare at the beginning of the century in America. Among the “guests” displayed in his incubators, was at one point Couney’s own premature daughter, Hildegarde, who later became a nurse and worked with her father on the attraction.

Nurses with babies at Flushing World Fair, NY. At the center is Couney’s daughter, Hildegarde.

Besides his two establishments in Coney Island (one of which was destroyed during the 1911 terrible Dreamland fire), Couney continued touring the US with his incubators, from Chicago to St. Louis, to San Francisco.
In forty years, he treated around 8000 babies, and saved at least 6500; but his endless persistence in popularizing the incubator had much lager effects. His efforts, on the long run, contributed to the opening of the first neonatal intensive care units, which are now common in hospitals all around the world.

After a peak in popularity during the first decades of the XX Century, at the end of the 30s the success of Couney’s incubators began to decrease. It had become an old and trite attraction.
When the first premature infant station opened at Cornell’s New York Hospital in 1943, Couney told his nephew: “my work is done“. After 40 years of what he had always considered propaganda for a good cause, he definitively shut down his Coney Island enterprise.

Martin Arthur Couney (1870–1950).

The majority of information in this post comes from the most accurate study on the subject, by Dr. William A. Silverman (Incubator-Baby Side Shows, Pediatrics, 1979).

(Thanks, Claudia!)

Placentofagia

Qualche tempo fa, Nicole Kidman dichiarò di aver mangiato la placenta dopo il suo ultimo parto. (Dichiarò anche di bere la propria urina per mantenersi giovane, ma quella è un’altra storia). Follie da VIP, direte. E invece pare che la moda stia prendendo piede.

La placenta, si sa, è quell’organo tipico dei mammiferi che serve a scambiare il nutrimento fra il corpo della madre e il feto, “avvicinando” le due circolazioni sanguigne tanto da far passare le sostanze nutritive e l’ossigeno attraverso una membrana chiamata barriera placentale, che divide la parte di placenta che appartiene alla mamma (placenta decidua) da quella del feto (corion). La placenta si distacca e viene espulsa durante il secondamento, la fase immediatamente successiva al parto; si tratta dell’unico organo umano che viene “perso” una volta terminata la sua funzione.

Quasi tutti i mammiferi mangiano la propria placenta dopo il parto: si tratta infatti di un organo ricco di sostanze nutritive e, sembrerebbe, contiene ossitocina e prostaglandine che aiutano l’utero a ritornare alle dimensioni normali ed alleviano lo stress del parto. Anche gli erbivori, come capre o cavalli, stranamente sembrano apprezzare questo strappo alla loro dieta vegetariana. Pochi mammiferi fanno eccezione e non praticano la placentofagia: il cammello, ad esempio, le balene e le foche. Anche i marsupiali non la mangiano, ma anche se volessero, non potrebbero – la loro placenta non viene espulsa ma riassorbita.

Se per quanto riguarda gli animali è intuitivo comprendere lo sfruttamento di una risorsa tanto nutritiva alla fine di un processo estenuante come il parto, diverso è il discorso per gli umani. Noi siamo normalmente ben nutriti, e non avremmo realmente bisogno di questo “tiramisù” naturale. Perché allora si sta diffondendo la moda della placentofagia?

La motivazione di questa pratica, almeno a sentire i sostenitori, sarebbe il tentativo di evitare o lenire la depressione post-partum. Più precisamente, la placenta avrebbe il potere di far sparire i sintomi del cosiddetto baby blues (quel senso di leggera depressione e irritabilità che il 70% delle neomamme dice di provare per qualche giorno dopo il parto), evitando quindi che degenerino in una depressione più seria. Sfortunatamente, nessuna ricerca scientifica ha mai suffragato queste teorie. Non c’è alcun motivo medico per mangiare la placenta. Ma le mode della medicina alternativa, si sa, di questo non si curano granché.

E così ecco spuntare decine di video su YouTube, e siti che propongono ricette culinarie a base di placenta: c’è chi la salta in padella con le cipolle e il pomodoro, chi preferisce farne un ragù per la lasagna o gli spaghetti, chi la disidrata e ne ricava una sorta di “dado in polvere” per insaporire le vivande quotidiane. Se siete persone più esclusive, potete sempre prepararvi un bel cocktail di placenta da sorseggiare a bordo piscina. Ecco un breve ricettario (in inglese) tratto dal sito per mamme Mothers 35 Plus.

Consci che l’idea di mangiare la propria placenta può non solleticare tutti i nostri lettori, vi suggeriamo un ultimo utilizzo, certamente più artistico, che sta pure prendendo piede. Si tratta delle cosiddette placenta prints, ovvero “stampe di placenta”. Il metodo è semplicissimo: piazzate la placenta fresca, ancora ricoperta di sangue, su un tavolo; premeteci sopra un foglio da disegno, in modo che il sangue imprima la figura sulla carta. Potete anche spargere un po’ di inchiostro sulla placenta prima di passarci sopra il foglio, così da ottenere risultati più duraturi. E voilà, ecco che avrete un bel quadretto a ricordo del vostro travaglio, da incorniciare e appendere nell’angolo più in vista del vostro salotto.

Deformazioni craniche artificiali

Abbiamo già parlato (in questo articolo) dell’antica usanza cinese di deformare i piedi femminili tramite fasciature per motivi estetici. Altri tipi di deformazioni artificiali possono ancora oggi avvenire per motivi di sostentamento economico: pensiamo in particolare ad alcune terribili pratiche di deformazione del bambino nei paesi del Terzo Mondo (e non solo) che rendono i piccoli invalidi a vita – e quindi più adatti a suscitare pietà ed elemosine. Un tempo c’erano poi i famigerati Comprachicos (“compratori di bambini”), immortalati da Victor Hugo nel suo romanzo L’Uomo che ride, che sfiguravano i bambini per assicurare un buon tornaconto nelle fiere e nelle esibizioni di stranezze umane. Altro esempio letterario sul tema è la splendida novella di Maupassant La madre dei mostri, nel quale una diabolica donna porta busti strettissimi durante la gravidanza per ottenere figli deformi da vendere al circo.

Ma nella maggior parte dei casi, proprio come avveniva per il loto d’oro in Cina, la modificazione del corpo in tenera età era estremamente importante soprattutto a livello sociale, perché poteva denotare lo status e la provenienza del bambino. Ed ecco che arriviamo all’argomento centrale di questo articolo: la deformazione del cranio.

Quello che i cinesi facevano ai piedi delle donne, molti altri facevano alle teste dei loro bambini.

Nelle culture primitive, e non soltanto, la modificazione corporale è intimamente connessa con l’appartenenza a una determinata società. Così la fasciatura della testa divenne per un certo periodo una pratica fondamentale per garantire al proprio figlio una posizione sociale influente.

La casistica di queste deformazioni si compone normalmente di teste allungate, teste schiacciate, teste coniche o sferiche. Il comune denominatore è la restrizione della normale crescita delle ossa del cranio durante le primissime fasi della formazione, quando le ossa sono ancora soffici, tramite diversi strumenti: ad esempio, per ottenere un figlio dalla testa allungata occorreva farlo crescere con due pezzi di legno saldamente legati ai lati del capo, in modo che il cranio si sviluppasse verso l’alto. Per avere una testa completamente rotonda occorreva stringerla in forti giri di stoffa.

I primi a utilizzare questo tipo di pratiche di modificazione corporale permanente sembra fossero gli antichi Egizi (infatti Tutankhamen e Nefertiti avevano la testa oblunga), ma alcuni studi indicano che forse anche gli uomini di Neanderthal, vissuti 45.000 anni prima di Cristo, potrebbero averne fatto uso. Nel 400 a.C. Ippocrate scrisse di abitudini simili riferendosi a una tribù che aveva denominato “i Macrocefali”. Congo, Borneo, Tahiti, Samoa, Hawaii, aborigeni australiani, Inca e Maya, nativi Americani, Unni, Ostrogoti,  tribù Melanesiane: ai quattro angoli del globo le tecniche differivano ma l’obiettivo era lo stesso – assicurare al bambino un futuro migliore. Le persone con una testa allungata, infatti, venivano ritenute più intelligenti e più vicine agli spiriti; non soltanto, erano immediatamente riconoscibili come appartenenti ad un determinato gruppo o tribù. Così, più o meno a un mese dalla nascita, i bambini cominciavano a venire fasciati fino circa all’età di sei mesi, ma talvolta oltre l’anno di età.

Non è escluso che queste pratiche avessero altri tipi di valenze – magiche, mediche, ecc. Lascia interdetti scoprire che in Francia la fasciatura della testa durò addirittura fino al 1800: nell’area di Deux-Sevres, si bendavano le teste dei bambini dai due ai quattro mesi; poi si continuava sostituendo il bendaggio con una sorta di cesto di vimini posto sulla testa del bambino, e rinforzato con filo di metallo mano a mano che il ragazzo cresceva.

Il mio bambino è nero!

“Niente che abbiate visto prima d’ora, e niente che abbiate sentito prima d’ora, potrà prepararvi allo shock di…”

“MY BABY IS BLACK!!!”

[youtube=http://www.youtube.com/watch?v=jy-zVlB4mvA]