CHAPTER V. MODES OF DEATH. 17. Syncope.-Syncope, or death beginning at the heart, is due to anemia, where the heart-power is strong, but the blood supply is deficient; or to asthenia, where the heart-power is deficient, but there is no lack of blood. In death from syncope proper, a combination of asthenia and anemia is present. Sudden death from shock probably results from syncope. The general post-mortem appearances which follow death from syncope show that both sides of the heart contain equal amounts of blood; and the brain, lungs, and capillary system generally appear normal. 18. Coma.-Coma, or death beginning at the brain, is marked by more or less profound stupor; by gradually increasing loss of consciousness and sensibility; the breathing heavy, irregular, and slow. The post-mortem shows the right side of the heart and lungs fairly filled, but the left side empty. Frequently, too, effusions (unusual quantities of blood) will be found in the head. 19. Asphyxia.-Asphyxia, or death beginning at the lungs, is indicated by intense struggles to breathe, followed by dizziness, loss of consciousness, spasms, and death. The right side of the heart, the veins, etc., will be found engorged with blood, very dark in color; while the left side of the heart and the arteries will practically be empty. Not infrequently these three forms of death may be combined, and it is then difficult, if not impossible, to say which predominates. The usual forms of death from asphyxiation are best known as suffocation, strangulation, hanging, and drowning. 20. Suffocation.-Suffocation takes place when the proper supply of pure air is kept from the lungs, but does not include the other three forms just mentioned. It may be due to the deterioration of the air supply, as when it is heavily laden with noxious gases; or to the closing of the air passages in the throat, either by disease or by the entrance of foreign bodies; or to the closing of the mouth and nose externally. This latter is known frequently as smothering. Foreign bodies may be placed in the throat intentionally. Suicide and homicide from such cause, however, are infrequent except in the case of destruction of new-born infants. But accidental death from this cause is common, often occurring during eating. Closure of the mouth and nose is rarely, if ever, a means of suicide. Homicide not infrequently occurs in this manner, often in cases of infanticide; and in many instances where murder is not intended, but the mouth and nose of the victim are forcibly closed to prevent outcries. Death also results from the accidental closing of the mouth and nose, as where a bank or mine caves in, or where one who is unable to help himself, as an infant, or one drunk or paralyzed, becomes entangled in bedclothing. In any form of suffocation the usual post-mortem appearances of asphyxiation are present. 21. Strangulation.-Strangulation is due, usually, to shutting off the air supply by strictures about the neck. These may be by a band or cord, by pressure of the hand or fingers, or by any other mechanical means. It is a frequent means of homicide, but is rarely used with suicidal intent. Seldom is it possible for strangulation to take place without leaving upon the neck marks of the fingers, cord, cloth or other instrument used to produce death. When accompanied by great violence, the face may be almost black; the tongue protruding; genitals swollen; and involuntary escape of fecal matter and urine may result. If strangulation is the cause of death, the superficial air-vessels of the lungs will be ruptured; this is the safest test to apply in determining whether the strangulation was ante-mortem or post-mortem. 22. Hanging.-Hanging may cause death either by asphyxia or by dislocating the spinal cord and column. When it produces asphyxia, it means that form of strangulation in which the pressure upon the neck is caused by the weight of the body suspended from the constricting cord, or band. Where the hanging is a judicial execution, the body is suddenly dropped several feet, and death is ordinarily due to the breaking of the spinal cord. In cases of suicide by hanging, the suspension of the body will usually be gradual, and death results from asphyxia. In hanging, the external marks of the cord upon the neck are oblique, instead of horizontal, as in strangulation. These marks may be made by a post-mortem hanging; but if signs of saliva appear straight down the neck and breast, death was due to hanging, as the discharge of saliva is a living process. The usual post-mortem appearances of violent death are present, but the superficial swelling of the lungs with air or gas, known as emphysema, is usually absent. 23. Drowning.-Drowning is that form of asphyxiation due to interference with the air supply by some liquid. Drowning may take place in a comparatively small quantity of the fluid, sufficient merely to stop the air passages. Thus, where one who is drunk or attacked by sudden dizziness falls face down in a few inches of water, as in a shallow brook, ditch or gutter, death from drowning may readily ensue if the person is not rescued. Where the victim has been suddenly immersed in water, involuntary inspiration takes place and water is taken into the lungs and usually some is swallowed. This will produce asphyxia to some extent, which will become complete if one or two more attempts at respiration follow. If the body has been placed in water after death, little or no water will be found in the lungs, or in the stomach. This will be an important factor in determining whether death was due to drowning or not. Homicidal drowning, except in the case of young infants, is rare; and if the body be that of a youth or adult, who was the victim of foul play, some evidences of a struggle before immersion in the water will usually be found. But care must be taken to distinguish evidences of a struggle from those marks of violence frequently resulting from a considerable fall before striking the water, which may produce bruises, dislocations, and even fractures. The post-mortem appearances of a body submerged for a short time only will show the skin cold, contracted, covered with "goose-pimples." This latter condition of the skin, if there be also a fine froth from the nose and mouth, is almost conclusive of death by drowning; for they indicate that the body entered the water during life, and that vital processes took place during submersion. Rigor mortis sets in and disappears early when the body is submerged. 24. Death from cold. This is usually due to accident, rather than design, although instances are not infrequent of new-born infants being killed by exposure, to which they yield very readily. The very aged are also very susceptible to cold; and wounded persons will have their dangers increased by exposure to cold. 25. Death from heat.-During the warm weather deaths frequently result from sunstroke. Dr. Ewell names three classes of cases falling under the term "sunstroke," viz.: (1) Acute meningitis or phrenitis, said to be very rare; (2) heat exhaustion with collapse, feeble but rapid pulse, skin cold and moist, and the general tendencies of syncope; (3) thermic fever (that caused by excessive heat), although this may be due to external artificial heat as well. There are no especially characteristic post-mortem appearances in death from heat. Rigor mortis comes on quickly, and decomposition rapidly follows. 26. Death from electricity.-Such an event may be due to shock, to the severe burns or wounds received, or to the destruction of some of the vital tissues. While there may be evidences of the lightning |