OF DEATH. 1055 



a certain minute portion of the nervous centres, or such a lesion of the heart's 

 structure as would be trivial in almost any other organ, may be the occasion of 

 immediate death j because these changes arrest the respiratory movements, 'or 

 interfere directly with the action of the heart, so as to bring the flow of blood 

 to a stand. It sometimes happens, however, that life may be prolonged, after 

 the death or removal of some important organ, in consequence of the pWer 

 which some other possesses of discharging its function ] thus we find that, in 

 Man, the kidneys seem occasionally to take upon themselves the elimination 

 of the constituents of bile from the blood ( 622) ; and in the Frog, the skin 

 can perform part of the office of the Lungs, so as to effect the aeration of the 

 blood in a sufficient degree to prolong life for some time, unless the temperature 

 be elevated. 1 But although the vital activity of every part of the body is 

 dependent upon a due supply of circulating fluid, yet this dependence is usually 

 not so close as to involve the immediate suspension of vital activity in every 

 part, whenever the general Circulation shall have been brought to a stand. For 

 we have distinct evidence of the persistence 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 ( 231, 328), in 

 acts of secretion ( 945) and perhaps even of nutrition, in the maintenance of 

 the local circulation ( 522), and in the generation of animal heat ( 652) ; 

 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 dead. 



1066. 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 Mus- 

 cular 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 impres- 

 sions on the nervous system) ; for the individual suddenly turns pale, falls back 

 or drops down, and expires with one gasp. But under the former condition, 

 the heart is found flabby, sometimes 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 

 ( 335). The cause of the loss of irritability, when sudden, usually lies in the 

 influence of a " shock" -transmitted through the Nervous system, and originat- 

 ing either in some severe lesion of its central organs or of its peripheral expan- 

 sion ( 321), 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 substitu- 

 tion of artificial pressure, or by suddenly rising into the erect posture after pro- 

 longed recumbency, 51 still more, after long stooping), or in some powerful mental 



former may be in a state of absolute putrescence, before the respiration and circulation have 

 been brought to a. stand ; and he learns from his friend Prof, Jackson, of Philadelphia, 

 that he has more than once witnessed the same occurrence. 



That such cannot take place in Man, is due not merely to the far less complete adapta- 

 tion of his skin for the aeration of the blood, but also to the difference in the type of his 

 circulation, which causes the arrest of blood in the pulmonary vessels to produce a stagna- 

 tion of the entire current. 



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

 valescent from acute diseases to rise into the erect position ; many cases of fatal syncope 



