798 DEATH. 



produce a change in the nervous system in- reduced only after a long series of defections in 

 compatible with the continuance of the action the outworks, and a consequent loss of supplies, 

 of the heart ; but mere pain will not account or, to quote the words of an illustrious author, 

 for the fact in question, since in other diseases " Voici done la grande difference qui dis- 

 it attains a more intense degree, and lasts tingue la mort de vieillesse, d'avec celle qui 

 longer, as in neuralgia, without inducing fatal est 1'effet d'un coup subit ; c'est que dans 1'une, 

 consequences. The causation is probably la vie commence a s'eteindre dans toutes les 

 analogous to that of syncope from mechanical parties, et cesse ensuite dans le cceur; la mort 

 injuries of tissues, to which we have already exerce son empire de la circonference au 

 devoted some remarks. But why an inflam- centre. Dans 1'autre, la vie s'dteint dans le 

 matory condition of serous membranes should cceur, et ensuite dans toutes les parties ; c'est 

 exert a more depressing influence upon the du centre a la circonference que la mort en- 

 circulation than that of many other tissues that chaine ses phenomenes."* 

 might be named, is a subject wrapped in deep SIGNS OF APPROACHING DEATH. 

 obscurity ; yet it is scarcely darker than the It would be tedious and altogether beyond 

 question, why such changes should in the first the compass of this work to enumerate all the 

 instance excite and perturb the heart, or why a phenomena presented by the dying system, 

 similar excitement should ensue upon the soft- since they vary with the cause of death. We 

 ening of a cluster of tubercles, and to a degree shall aim rather at describing and accounting 

 inexplicable by the functional derangement for those which are common to most diseases 

 of the part in which the tubercles exist. Dis- and to natural decay ; reserving to ourselves 

 eases in which the powers of the system are the liberty of noticing here and there some of 

 said to be worn out, are in reality such as have the more striking varieties, 

 gradually enfeebled the action of the heart, We might rationally expect that the first 

 partly perhaps through the intervention of indications of dissolution would appear in the 

 changes affecting the blood, the respiration and relative functions ; hebetude of the senses, in- 

 the nervous system, but probably in a great action of the muscles, vacancy of the intellect, 

 measure by as direct a relation between the extinction of the sentiments; and such is, in 

 diseased part and the change in the circulation, fact, the course of events in natural death, 

 as between violent lesions of tissue and syn- We have known the aged man remain feeling- 

 cope. Under the present head are included less, motionless, mindless, for many days be- 

 a host of chronic maladies. 6. Diseases fore the cessation of the organic functions. 

 caused by vitiation of the blood. Such are This kind of death is sometimes imitated by 

 scorbutus, certain forms of marasmus, the apoplexy; but in the former the destruction of 

 cachexiae revealed by dropsies, and certain the animal life does not, as in the latter, arise 

 fevers of a malignant character. We might from a lesion of the brain ; its organs appear to 

 also mention those depravations indicated by undergo a gradual process of enfeeblement. In 

 morbid secretions, such as tubercle, carcinoma, many febrile maladies there is the same priority 

 melanosis, &c. but that the solids are so much of failure on the part of the cerebral functions, 

 involved in these diseases, that it becomes but they are generally preceded by more or less 

 difficult to determine whether the heart's action actual disease of the organ. But in the termi- 

 was weakened by the primary lesion of the nation of some disorders the functions alluded 

 blood, or by the secondary one of the tissues, to continue to the very last, almost surviving 

 7. Diseases which produce vitiation of the the circulation itself. It will be found however 

 blood. Such are that large class in which that the seat of such disorders was remote from 

 there is disorder of the chylopoietic processes, the encephalon, that it did not communicate with 

 and that smaller group in which the convey- the latter by any special sympathy, and that 

 ance of the chyle is impeded. Derangements the extinction of the cerebral functions was at- 

 of the secernent and excernent organs must be tributable to the arrest of circulation in that 

 arranged in this division, and particularly organ, in common with many others. The 

 those of the liver, the skin, and the urinary cases in which the mind is said to continue 

 apparatus. Diabetes is a state of the system clear and vigorous amid the ruin of the body, 

 in which the blood is probably deteriorated will be found to agree in the fact that the 

 both by defective assimilation, and by faulty organ is correspondently unimpaired; they are 

 excretion. Upon the whole of this class of for the most part chronic diseases of the thorax, 

 diseases it must be remarked that we seldom abdomen, pelvis, and extremities. Certain 

 or never have opportunities of witnessing their affections even of the cerebro-spinal system 

 un combined influence in depressing the organs may not interfere with the understanding and 

 of circulation. feelings until almost the last moments; but 

 11. Syncope by old age. We have, in a for- they are such as do not involve those divisions 

 mer article (AGE) endeavoured to trace the with which, thought is believed to be more 

 principal events in senile decay. The death immediately connected: we may instance 

 which follows this gradual decline of the func- tetanus. But although in these maladies we 

 tions, presents the strongest possible contrast do occasionally observe considerable intellec- 

 to that of sudden syncope. In the latter in- tual soundness till within a very short period 

 stance the assault is made upon the very citadel of death, we have far more commonly been 

 of life, the conquest of which secures an im- able to detect some degree of delirium, an 

 mediate surrender of the minor bulwarks and 

 dependencies; but in the former the fortress is * BicLat, Kcch. sur la Vie et la Mort, p. 151. 



