CHAPTER IV.

DEATH AND ITS SIGNS.

15. Death.-Death, or the cessation of life, is either somatic, or the death of the body as a whole; or molecular, or the death of a part, that is, some organ or tissue, of the body. Molecular death, when complete, as when it has progressed until the entire organism has lost its vital force, is the true scientific death; but somatic death is the popular idea of death, or dissolution, and means the complete cessation of the vital functions. It is recognized, usually, by the stoppage of circulation and respiration. But even after somatic death has taken place, some molecular life may continue. This is evidenced by the rise in temperature of the body which frequently follows somatic death; by growth of nails and hair after burial; and instances are even recorded of the post-mortem action of the heart, and of secretion and nutrition.

16. Signs of death.—There are a number of signs, varying in importance, by which to determine death.

(1) Cessation of circulation and respiration. These systems do not necessarily cease functioning at the same time. The heart may beat, noticeably, for several minutes after breathing has ceased, as seen in death by asphyxiation. Mere absence of pulsation at the wrist is not a sure sign of death. The use of the stethoscope to hear the heart beats; putting a lig

ature about one of the fingers, when, if it has not ceased circulating, the blood will be stopped in its return; opening a vein or small artery to determine coagulation, or clotting, and arterial bleeding, respectively, are means frequently used to learn

whether heart action has ceased or not.

To determine respiration, a highly polished, cold surface, as a mirror, is held over the nose and mouth: moisture condensed on the mirror would show respiration. So, too, a feather suspended near the mouth, and moving, indicates respiration. If a glass of water or mercury be placed on the naked chest, the liquid surface will be disturbed by the slightest motion. But all these tests are positive merely; that is, although moisture on the looking-glass, and motion of the feather or liquid, will show that respiration still exists and life is not yet extinct, the absence of such moisture or motions does not conclusively prove that respiration and life have ceased. For a short time respiration may be imperceptible, and life remain. But an entire and continuous cessation of respiration, as shown by the tests named, would indicate death.

(2) Insensibility in the cornea is also produced by death, but as the same condition may be brought on by certain brain injuries, or by some of the poisons, this is not a very strong proof of death.

(3) The normal temperature of the body will be changed by death. An increase of temperature may occur immediately following dissolution, and this is frequently the case when death has occurred from yellow fever, smallpox, tetanus (lockjaw), cholera,

etc., and such an increase of temperature is sometimes caused by molecular life after somatic death. The rapidity of the cooling of the body in any given case depends so much upon the circumstances, and upon so many, that it is impossible to give an accurate rule. The temperature of the body will never be reduced below that of the surrounding medium. Thin bodies and those more or less wasted by long illness will cool more rapidly than fat ones; those of children and elderly people lose heat quicker than those of middle age. Cooling is prolonged by clothing upon the body, keeping it in a small, close room, or keeping it upon non-conducting material. A general approximation indicates that for the first three or four hours after death the body loses heat at the rate of about four degrees Fahrenheit per hour.

(4) Death pallor, or an ashy color, usually overspreads the entire body after dissolution. But this cannot be taken as a positive sign of death, as it occasionally does not occur; and it may also be found, or at least closely simulated, under other circumstances. such as fainting and collapse.

(5) Rigor mortis is a positive sign of death. It consists of a stiffening of the muscles, due to coagulation of a part of the muscular tissue somewhat resembling the albumen or white of an egg, and generally is complete in six or eight hours after death; although this cannot be taken as a rule for every case, as the time of setting in of rigor mortis varies, depending upon the cause of death, and upon the individual's condition. It continues for varying periods, usually from

sixteen to twenty-four hours, and disappears when putrefaction sets in. It must not be confused with cadaveric spasm, or that involuntary contraction of the muscles which, closely resembling rigor mortis, occurs frequently in those who have died a violent death as by suicide. Rigor mortis has a very definite progression, the muscles of the eye being first attacked, then those of the jaw and neck, and passing down to the chest, arms, abdomen and lower extremities, in order. It passes away in the same order.

(6) Cadaveric lividity, or suggillation, or cadaveric ecchymosis, as it is variously called, is the appearance of certain livid or violet-colored patches on the body, and within it as well, usually noticed in from twelve to fifteen hours after death. It is due to the settling of the blood after life has ceased.

(7) Putrefaction ordinarily follows death, and is a positive sign of dissolution. It follows rigor mortis, setting in at periods varying from a few hours to three days after death. A greenish discoloration first appears on the abdomen, whence it gradually spreads to the rest of the body. Internally, the larynx and trachea show the first signs of decomposition; then, in the case of young children, the brain; the stomach, intestines, spleen and liver, in order; next the brain, in the case of adults; the heart, lungs, kidneys, bladder, gullet, the diaphragm and arteries; last, the uterus, the toughest organ of the body, and which has been known to resist putrefaction for seven months or more. As the uterus is an organ which often receives medico-legal investigation, its ability to resist decomposition is a fact of especial importance.

In some cases the body does not putrefy, but becomes mummified, and dried up. This can only take place when it is exposed to dry air, and protected from moisture.

(8) Adipocere is a soapy substance, into which the soft parts of the body are sometimes converted under certain conditions, and is a modification of the putrefying process. Its formation is favored by complete immersion of the dead body in running water, or burial in cess-pool soil. When saponification (turning into a soapy substance) is complete the body may remain for many years without further decay, and the various organs be readily identified.

(9) The time which has elapsed since death is frequently of great importance to ascertain. If the dead body alone be the basis of calculation, then only an approximation of the time of death can be made. If the body is only slightly cold, with eyes glazed and jaws somewhat rigid, death probably took place from fifteen minutes to four hours previously. But if entire rigidity and cooling throughout be present, death occurred from twelve to fifteen hours to three or four days before. Cadaveric lividity would indicate that death occurred from one to four days previously. If rigor mortis has passed off, and putrefaction set in, from one to three days in summer, and from three to six or eight days in winter, have probably elapsed since death. The state of digestion of food found in the stomach may be of great aid in determining the question.