SOMATIC AND MOLECULAR DEATH SYNCOPE. 1033 



of vital changes in various organs and tissues of the body, after the death 

 of the body at large ; as is manifested in the performance of ciliary and of 

 muscular movements, in acts of secretion and perhaps even of nutrition, 1 in 

 the maintenance of the local circulation ( 261), and in the generation of 

 animal heat ( 424) ; and the fact is even yet more remarkably manifested 

 in the reunion (even after the lapse of some hours) of parts that have been 

 entirely severed, such as fingers or toes, noses or ears, by adhesion between 

 the cut surfaces when brought into apposition, which could not take place if 

 the severed part were already dead. 



882. The permanent and complete cessation of the Circulating current, 

 which essentially constitutes Somatic Death, may be directly or indirectly 

 consequent upon several distinct causes. In the first place, it may be due to 

 failure in the propulsive power of the Heart, which constitutes Syncope. 

 This failure may occur either (a) in consequence of a loss of the proper 

 irritability of the Muscular tissue, or (6) through the supervention of a 

 " tonic spasm," the organ remaining rigidly contracted without its usual 

 alternation of relaxation. The phenomena attending death in the two cases 

 are not dissimilar, when the loss of irritability is sudden and immediate (as 

 when it arises from violent impressions on the nervous system) ; for the in- 

 dividual suddenly turns pale, falls back or drops down, and expires with 

 one gasp. But under the former condition, the heart is found flabby, some- 

 times empty, sometimes distended with blood, both cavities being equally 

 filled ; whilst in the latter the heart is contracted and hard, containing little 

 or no blood, as when in the state of rigor mortis. The cause of the loss of 

 irritability, when sudden, usually lies in the influence of a " shock " trans- 

 mitted through the Nervous system, and originating either in some severe 

 lesion of its central organs or of its peripheral expansion ( 244), or in a 

 deficiency of its supply of blood or diminution of its usual pressure (such 

 as is produced by rapid detraction of blood, especially in the erect posture, 

 by the rapid removal of the fluid in ascites without the substitution of arti- 

 ficial pressure, or by suddenly rising into the erect posture, after prolonged 

 recumbency,- still more, after long stooping), or in some powerful mental 

 emotion, either exciting or depressing. A more gradual effect of the same 

 kind is produced by severe lesions of the internal organs (such as rupture of 

 the uterus), which often prove fatal by the general " collapse " thus induced, 

 rather than by the disturbance which takes place in their own proper func- 

 tions ; and this seems to be the usual modus operandi of corrosive poisons, 

 whose effect upon the heart's action resembles that produced by severe burns 

 of the surface in children. The influence of the proper sedative poisons, 

 however, such as digitalis, tobacco, aconite, and upas, seems to be directly 

 exerted, through the blood, upon the tissue of the heart itself; and the same 

 is probably the case with some of those " morbid poisons," whose introduc- 

 tion into the system gives rise to diseases of the most intensely adynamic 

 type, such as Maligant Cholera, in which the " collapse " is out of all pro- 



1 Thus Mr. T. Bell mentions (History of British Keptiles, p. 61), that having been 

 engaged in the careful dissection of the poison apparatus of a large Rattlesnake, 

 although the animal had been dead for some hours, and the head had been taken off 

 immediately after death, yet the poison continued to be secreted as the dissection 

 proceeded, so as to require to be occasionally dried off with a bit of sponge. A 

 growth of Hair is said to have been noticed in several instances after death ; and if 

 the temperature of the surrounding medium be not too low for the vital activity of 

 the hair-bulbs, there seems no adequate reason why this should not take place. 



2 Hence it is that great caution should be exercised in allowing patients who are 

 convalescent from acute diseases to rise into the erect position, many cases of fatal 

 syncope having been thus induced. The state of general debility, and the continued 

 recumbency both favor this result, especially in persons advanced in life. 



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