800 



DEATH. 



produce a kind of annoyance like that of 

 muscce volit antes, which the hand is instinc- 

 tively attempting to remove. Whether the 

 production of such spectra depends upon 

 changes in the retina, or upon changes in the 

 cerebral extremity of the optic nerve, is not 

 altogether certain ; but we incline to the lat- 

 ter view, principally because other sensations 

 are often revived though the nerves in which 

 they originated have been paralysed or removed. 



Renewals of perceptions of hearing are not 

 uncommon. Such are imaginary voices, and 

 sounds of tolling bells, &c. 



No reason has been assigned for that sym- 

 ptom noted by the earliest observers " pick- 

 ing of the bed-clothes ; " or, in Dame Quickly's 

 phraseology, " fumbling with the sheets." But 

 we think it may be readily accounted for as 

 resulting from revivals of tactual sensations, 

 which produce corresponding movements, so 

 that the fingers grasp the bed-clothes in mis- 

 take for the imaginary substance. Something 

 analogous to this is witnessed in delirium 

 tremens, a disease in which visual conceptions 

 are particularly liable to vivifaction in the 

 form of animals, and in which also we have 

 witnessed the patient picking the ends of his 

 fingers as if to remove something disagreeably 

 adherent. 



Whether consciousness of bodily sensations 

 continues till the very commencement of the 

 death-struggle, or agony ,* as it is termed, is 

 an enquiry often put to the medical attendant 

 either by patients themselves, or by their anx- 

 ious relatives. The ideas entertained by per- 

 sons unaccustomed to physiological study re- 

 specting the pains of dying, have arisen partly 

 from their theoretical views of the nature of 

 the event itself, and partly from their obser- 

 vation of its preceding or accompanying phe- 

 nomena. When they imagined death to be a 

 kind of forcible severing of the spirit from the 

 body, a separation so opposed to the incli- 

 nation of the former that some have fancied it 

 longing to return to the body, 



-- " iterumque ad tarda reverti 

 Corpora, quae lucis miseris tarn dira cupido : " 



or like the shade of Hector, 



x.oii v@yv. 

 Iliad. XXII. 362. 



EJC ptwv <7rra.iJi.svv) 

 "On TTorfjiov yooua-ct, 



or when they regarded the throes of death 

 as efforts of the confined inmate to escape 

 from its tenement ; or when laying aside 

 their imaginings, they witnessed a heaving 

 respiration, cold dew on the face, and 

 convulsive agitations of the whole frame, 

 affections so often known to accompany in- 

 tense bodily suffering, it is not wonderful 

 that the process of dying should have been 

 considered one of distress and anguish. But 

 the practitioner ought to be able to console 



* The reader will scarcely need to be reminded 

 that this word is used in its etymological sense, 

 eiyxv, certamen. 



the friends of the dying by the assurance that 

 whatever may have been the previous torture, 

 it must be all over when once those changes 

 begin in which death essentially consists. He 

 must explain to them how upon the failure of 

 the circulation, the function of the brain must 

 cease by necessity ; that if the cessation of the 

 former be gradual, that of the latter may and 

 often does precede it ; that if the mortal pro- 

 cess begins in the lungs, unconsciousness pre- 

 cedes the arrest of the circulation ; and if in 

 the brain, that an injury of this organ sufficient 

 to affect the lungs and the heart fatally is sure 

 to annihilate its own sensibility. The muscu- 

 lar spasms, the slow, gasping, or gurgling 

 breathing, the collapsed or distorted features, 

 though in some cases accompanied by feeling, 

 are altogether independent of it. Convulsion 

 is not, as superficial observers often interpret 

 it, the sign of pain, or the result of an in- 

 stinctive effort of nature to get rid of the 

 cause of pain, it is an affection of the moti- 

 fic not of the sensific part of the nervous sys- 

 tem.* The pangs of the disease may last till 

 within a short period of death, but it is a 

 great error to attribute them to the process 

 which brings them to an end. Such cases 

 however are rare ; it is far more common for 

 the sensibility to be blunted, or for the cause 

 of pain to subside before the phenomena of 

 dying commence. A person poisoned by an 

 irritant is said to die in great agony ; a very 

 incorrect expression, since death in such cases 

 is ushered in by coma and by convulsions un- 

 attended with pain. Temporary syncope and 

 asphyxia, the neatest approaches to actual 

 death, have nothing formidable in sensation if 

 we may judge from the reports of those who 

 have experienced them ; so far from it indeed, 

 that some have described feelings of extreme 

 pleasure, connected with each of these con- 

 ditions.f 



The relaxation and incapacity of the 

 muscular system, though for the most part ex- 

 treme, has in some cases been much less than 

 might have been expected ; and even chronic 

 maladies, attended during their course with 

 great emaciation and debility, have suddenly 

 terminated when the patients were in the act of 

 walking, or of performing some other exertion 

 disproportionate to the rest of the functions. 

 The condition of certain muscles in the last 

 stage of existence will be alluded to when we 

 come to speak of the general aspect and pos- 

 ture of the dying. 



The voice is generally weak and low as 

 death approaches, but sometimes has a shriller 

 pitch than natural; sometimes it is husky and 

 thick, and not unfrequently it dwindles to a 

 mere whisper. These changes are caused prin- 

 cipally by the debility which the vocal share 



* Dr. W. Philip has some excellent remarks 

 upon this subject in his treatise on Sleep and 

 Death. 



t See Principes de Physiologic Medicale, par 

 Isid. Bourdon, p. 319. [It was either Dr. Black 

 or Dr. Cullen who told his attendant friends that 

 " he wished he could be at the trouble to tell them 

 how pleasant a thing it was to die." ED.] 



