THE PHYSIOLOGY OF DEATH. 2 73 



starvation. Haemorrhage is one of the commonest causes of death. 

 Whenever a great artery is opened from any cause, permitting the 

 copious outflow of blood, the skin grows pale, warmth declines, the 

 breathing is intermittent, vertigo and dimness of sight follow, the ex- 

 pression of the features changes, cold and clammy sweat covers part 

 of the face and the limbs, the pulse gets gradually weaker, and, at last, 

 the heart stops. Virgil describes haemorrhage with striking fidelity in 

 the story of Dido's death. 



Sudden death, unconnected with outward and accidental causes, 

 may occur in various ways. "Very violent impressions on the feelings 

 sometimes abruptly check the movements of the heart, and produce 

 a mortal swoon. Instances are well known of many persons dying 

 of joy Leo X. is one and of persons who succumbed to fear. In 

 foudroyant apoplexy, if real death is not instantaneous, there is at 

 least the sudden occurrence of the phenomena of death. The sufferer 

 is plunged in profound sleep, called by physicians coma, from which 

 wakening is impossible; his breathing is difficult, his eyes set, his 

 mouth twisted and distorted. The pulsations of the heart cease little 

 by little, and soon life utterly vanishes. The breaking of an aneurism 

 very often occasions sudden death. Not less often the cause of death 

 is found in what is called an embolism, that is, a check to the circula- 

 tion by a clot of blood suddenly plugging up some important vessel. 

 And there are also cases of sudden death still unaccounted for, in the 

 sense that subsequent dissection discovers nothing that could explain 

 the stoppage in the operations of life. 



Death is usually preceded by a group of phenomena that has re- 

 ceived the name of the death-agony. In most cases of disease the be- 

 ginning of this concluding period is marked by a sudden improvement 

 of the functions. It is the last gleam springing from the dying flame ; 

 but soon the eyes become fixed and insensible to the action of light, 

 the nose grows pointed and cold, the mouth, wide open, seems to call 

 for the air that fails it, the cavity within it is parched, and the lips, as 

 if withered, cling to the curves of the teeth. The last movements of 

 respiration are spasmodic, and a wheezing, and sometimes a marked 

 gurgling sound, may be heard at some distance, caused by obstruction 

 of the bronchial tubes with a quantity of mucus. The breath is cold, 

 the temperature of the skin lowered. If the heart is examined, we 

 note the weakening of its sounds and pulsations. The hand, placed in 

 its neighborhood, feels no throb. Such is the physiognomy of a per- 

 son in the last moments of death in the greater number of cases, that 

 is, when death follows upon a period of illness of some duration. The 

 death-struggle is seldom painful, and almost always the patient feels 

 nothing of it. He is plunged into a comatose stupor, so that he is no 

 longer conscious of his situation or his sufferings, and he passes insen- 

 sibly from life to death, in a manner that renders it sometimes difficult 

 to fix the exact instant at which a dying person expires. This is true, 



VOL. III. 18 



