Aids to Forensic Medicine and Toxicology | Page 7

of the pulmonary artery; and from spasmodic contraction of the thoracic and abdominal muscles in strychnine-poisoning.
The symptoms of this condition are fighting for breath, giddiness, relaxation of the sphincters, and convulsions.
Post mortem, cadaveric lividity is well marked, especially in nose, lips, ears, etc.; the right cavities of the heart and the ven? cav? are found gorged with dark fluid blood. The pulmonary veins, the left cavities of the heart, and the aorta, are either empty or contain but little blood. The lungs are dark and engorged with blood, and the lining of the air-tubes is bright red in colour. Much bloody froth escapes on cutting into the lungs. Numerous small h?morrhages (Tardieu's spots) are found on the surface and in the substance of the internal organs, as well as in the skin of the neck and face.
3. =Coma=, or death beginning at the brain, may arise from concussion; compression; cerebral pressure from h?morrhage and other forms of apoplexy; blocking of a cerebral artery from embolism; dietetic and ur?mic conditions; and from opium and other narcotic poisons.
The symptoms of this condition are stupor, loss of consciousness, and stertorous breathing.
The post-mortem signs are congestion of the substance of the brain and its membranes, with accumulation of the blood in the cavities of the heart, more on the right side than on the left.
It must be remembered that, owing to the interdependence of all the vital functions, there is no line of demarcation between the various modes of death. In all cases of sudden death think of angina pectoris and the rupture of an aneurism.
The following is a list of some of the commoner causes of sudden death:
(a) =Instantaneously Sudden Death=--
1. Syncope (by far the commonest cause).
2. Aortic incompetence.
3. Rupture of heart.
4. Rupture of a valve.
5. Rupture of aortic aneurism.
6. Embolism of coronary artery.
7. Angina pectoris.
(b) =Less Sudden but Unexpected Death=--
1. Cerebral h?morrhage or embolism.
2. Mitral and tricuspid valvular lesions if the patient exerts himself.
3. Rupture of a gastric or duodenal ulcer; rupture of liver, spleen, or extra-uterine gestation, or abdominal aneurism.
4. Suffocation during an epileptic fit; vomited matter or other material drawn into the trachea or air-passages; croup.
5. Arterio-sclerosis may lead to thrombosis, embolism, or aneurism.
6. Poisoning, as by hydrocyanic acid, cyanide of potassium, inhalation of carbonic acid or coal gas, oedema of glottis following inhalation of ammonia.
7. Rapid onset of some acute specific disease, such as pneumonia or diphtheria; collapse from cholera.
8. Heat-stroke, lightning, shocks of electricity of high tension.
9. Mental or physical shock.
10. Exertion while the stomach is overloaded.
11. Diabetic coma; ur?mia.
12. Status lymphaticus. This is a general hyperplastic condition of the lymphatic structures in the body, and is seen in enlargement of tonsils, thymus, spleen, as well as of Peyer's patches and mesenteric glands. It is a frequent cause of death during chloroform an?sthesia for slight operations in young people.
In addition, it may be as well to remember that death sometimes occurs suddenly in exophthalmic goitre, hypertrophy of the thymus, and in Addison's disease.
In some cases of sudden death nothing has been found post mortem, even when the autopsy has been made by skilled observers, and the brain and cord have been submitted to microscopical examination.

VI.--SIGNS OF DEATH
(1) Cadaveric appearance; ashy white colour. (2) Cessation of the circulation and respiration, no sound being heard by the stethoscope. Cessation of the circulation may be determined by (a) placing a ligature round the base of a finger (Magnus' test); (b) injecting a solution of fluorescin (Icard's test); (c) looking through the web of the fingers at a bright light (diaphanous test); (d) the dulling of a steel needle when thrust into the living body; (e) the clear outline of the dead heart when viewed in the fluorescent screen. (3) The state of the eye; the tension is at once lost; iris insensible to light, fundus yellow in colour; cornea dull and sunken. (4) The state of the skin; pale, livid, with loss of elasticity. (5) Extinction of muscular irritability. The above signs afford no means of determining how long life has been extinct. The following, however, do:
=Cooling of the Body.=--The average internal temperature of the body is from 98° to 100° F. The time taken in cooling is from fifteen to twenty hours, but it may be modified by the kind of death, the age of the person, the presence or absence of clothing on the body, the surrounding temperature, and the stillness or otherwise of the air about the body. Still, the body, other things being equal, may be said to be quite cold in about twelve hours.
=Hypostasis= or =post-mortem staining= is due to the settling down of the blood in the most dependent parts of the body while the body is cooling. It is a sure sign of death, and occurs in all forms of death, even in that