1056 OF DEATH. 



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

 is produced by Jesions 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 functions; 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 

 11 morbid poisons" whose introduction into the system gives rise to diseases of 

 the most intensely adynamic type, such as Malignant Cholera, in which the 

 " collapse" is out of all proportion to any local lesion. But again, the loss of 

 the Heart's irritability may be a gradual process, resulting from the deteriora- 

 tion of its tissue by fatty degeneration or by simple atrophy ; and this last con- 

 dition may be due to deficiency of blood, as happens in chronic starvation and 

 diseases of exhaustion, in which the failure of the circulation seems due to the 

 weakening of the heart's power and to the lowering of the quantity and quality 

 of the blood, as concurrent causes, the condition thus induced being appropri- 

 ately designated Asthenia. In all cases it is to be observed, that when the Vital 

 powers have been previously depressed, a much slighter impression on the Nerv- 

 ous system is adequate to produce Syncope, than would be required when it 

 is in a state of full vigor. The causes of the tonic spasm of the heart have not 

 been clearly made out, but it seems producible, like the more common form of 

 Syncope, by agencies operating through the Nervous system; thus it has super- 

 vened upon the ingestion of a large quantity of cold water into the stomach. 



1067. Somatic Death may be occasioned, secondly, by an obstruction to the 

 flow of blood through the capillaries of the lungs, constituting Asphyxia ( 574) ; 

 and this may be consequent upon a disordered state of the lungs themselves, or 

 upon suspension of the respiratory movements through affections of the Nervous 

 centres. It is in this mode that most fatal disorders of the Nervous System pro- 

 duce death, except when a sudden and violent impression occasions a cessation of 

 the heart's power ; thus in Apoplexy, Narcotic Poisoning, &c., death results from 

 the paralyzed condition of the Medulla Oblongata ; whilst in Convulsive diseases, 

 the fatal result ensues upon a spasmodic fixation of the respiratory muscles. 

 Thirdly, Somatic death may be occasioned by a disordered condition of the Blood 

 itself ( 178), which at the same time weakens the power of the Heart, impairs 

 the activity of the Nervous system, and prevents the performance of those changes 

 in the systemic capillaries which afford a powerful auxiliary to the circulation. 

 This is Death by Necrdemia.* Fourthly, Somatic death may result directly from 

 the agency of Cold, which stagnates all the vital operations of the system. 

 Where the cooling is due to the agency of an extremely low external temperature, 

 which acts first upon the superficial parts, there is reason to think that the con- 

 gestion of the internal vessels thereby induced occasions a torpid condition of 

 the nervous centres, and that the cessation of the Circulation is immediately due 

 to Asphyxia. But when the cooling is gradual, and the loss of heat is almost 

 equally rapid throughout, it is obvious that the stagnation must be universal, 

 and that no cessation of activity in any one part is the occasion of the torpor in 

 the functions of the remainder. It is in this manner that death results from 

 Starvation ; and not by the weakening of the heart's action, as commonly sup- 

 posed. The proofs of this have been already stated ( 658). And as a general 

 rule we find, that the more active the changes which normally take place in any 



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

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



1 See Dr. C. J. B. Williams's " Principles of Medicine," 3d Am. Ed. p. 484. 



