aoa 



DEATH. 



that it occasioned " refoulement vers la tcte 

 de la portion fluide du sang qui est contenu 

 dans 1'oreillette droite, et par suite, repletion, 

 tumefaction des veines du cou, de la face, 

 de 1'encephale, suintement, exsudation sereuse 

 ou sanguinolente par les porosites, les extre- 

 rnitcs des reseaux capillaires; quelquefois 

 aussi, par suite de ce reflux dans les reseaux 

 capillaires, resserrement de la pupille, reple- 

 tion, distension, saillie des yeux, qui elaient 

 d' abord ternes et relaches, cc. See."* 



M.Villermef has described an appearance 

 of the hand which he considers characteristic 

 of death. He says that when dissolution has 

 taken place the ringers are brought together 

 and slightly bent, but that the thumb is co- 

 vered by them, being always found in the 

 hollow of the hand directed towards the root 

 of the little finger. The phalanges of the 

 thumb are extended upon one another, but 

 the first is flexed upon the metacarpal bone. 

 Villerme states that he had often noticed this 

 appearance in dead bodies on fields of battle 

 and in hospitals, but that he had never at- 

 tached any importance to it as a sign of death, 

 till his attention was directed to its value by 

 M. Breschet. We have often confirmed the 

 truth of Villerme's description by our own 

 observations, particularly in hospital cases, 

 before the bodies have been subjected to the 

 straightening processes of the attendants upon 

 the dead. When the appearance has been 

 wanting, we have had reason to suspect that it 

 had been removed by force. 



The last sign to be spoken of is the altered 

 colour of the surface, presenting lividities of 

 various extent. They may occur in spots or in 

 circumscribed patches, but more frequently 

 they take the form of an irregular suffusion of 

 a pale violet, or a dull reddish hue. They 

 always occupy the depending parts, and are 

 most intense where the skin hangs loose, as in 

 the scrotum, the penis, and the labia. They 

 have also a direct ratio with the suddenness 

 of the death, the quantity of blood in the 

 system, and its tendency to continue fluid. 

 Their presence indicates that gravitation has 

 either subdued the capillary forces, or has come 

 into play after the cessation of the latter. But 

 they may occur during life. We have often 

 noticed that the livor of the skin in bronchitic 

 affections is more intense in the back and 

 the sides, and is even confined to these parts. 

 There can be no doubt that congestions in the 

 parenchyma of the lungs are often dependent 

 upon position. The questions that arise out 

 of these appearances have more to do with the 

 cause of death than with the reality of this 

 occurrence. When circumscribed, they may be 

 confounded with ecchymoses resulting from 

 violence. To enter upon the discrimination of 

 these conditions would engage us in a dis- 

 cussion far too lengthened for this article, 

 which has already exceeded its limits; we 



* Considerations sur 1'Ouverture des Cadavres, 

 p. 88. 



t Ann. d'Hyg. t. iv. p. 420. 



must content ourselves with referring to me- 

 dico legal treatises and to an extremely valu- 

 able paper by Dr. Christison in the Edinburgh 

 Medical and Surgical Journal.* 



We shall conclude with a brief abstract of 

 M. Devergie's observations upon the know- 

 ledge which we may collect from the state of 

 the body respecting the time which has elapsed 

 since death. 



We may suspect that the body has been 

 dead from two to twenty hours if there be 

 flexibility, elasticity, heat, and contractility ; 

 from ten hours to three days, if there be rigi- 

 dity of the joints, pitting of the soft parts, 

 the natural colour of the skin, loss of animal 

 heat, and no contraction under electric stimu- 

 lus; from three to eight days, if there be 

 flexibility (after rigidity) and no contractility ; 

 from five to twelve days, if the soft parts are 

 puffed, elastic, and shining. After the twelfth 

 day there is usually a separation of the epi- 

 dermis, as well as a green tint of the ab- 

 dominal integuments.-!- But no certainty must 

 be attached to these statements; they are 

 merely approximative. The modifying in- 

 fluence of external media upon putrefaction is 

 all but unbounded. In summer as much 

 alteration may take place in five or six hours, 

 as in eight or even fifteen days of winter. 



BIBLIOGRAPHY. Hippocrates, Praenotionum Li- 

 ber, sect. i. Lord Bacon, Historia vitae et mortis. 

 Lancisi, De subetaneis mortibus, 4to. Rom. 1707. 

 Winsluw, Dissertatio an mortis incerta sint indicia. 

 4to. Paris, 1740. Bruhier, Dissertation surl'incer- 

 titude des signes de la mort. 12mo. Paris, 1742. 

 Louis, Lettres sur la certitude des signes de la mort. 

 12mo. Paris, 1752. Sacht, Oratio qua senile fatum 

 inevitabile necessitate ex humani corp. mechanis- 

 mo scqui demonstratur. 4to. Ultraj. 1729. Van 

 Geuns, De morte corporea et causis moriendi. 

 4to. Lugd. Batav. 1761. (Recus in Sandif. Thes. 

 vol. iii.) Lange, Facies Hippocratica levi penicillo 

 adumbrata. 8vo. Jenes, 1784. Ploucquet, Resp. 

 Schmid. De vmica vera causa mortis proxima. 

 4to. Tubing, 1786. C. Himly, Commentatio mor- 

 tis, historiam, causas, et signa sistens. 4to. Crot- 

 ting. 1794. Attschel, Thanatologia, sive in mortis 

 naturam, causas, genera ac species, et diagnosin 

 disq. 8vo. Gotting. 1795. Ontyd, De morte et 

 varia morendi ratione. 8vo. Lugd. Bat. 1797. 

 Bichat, R>cberchessur!avieet la mort. 8vo. Paris, 

 an. viii. Ferriar, Medical histories and reflections. 

 Currie, on apparent death, 2ded. 8vo. Lond. 1815. 

 Chaussier, Table des phenomenes cadaveriques. 

 Adelon, Diet, de Med. art. Mort. Beatty, Cyclo- 

 paedia of Pract. Med. art. Persons found dead. 

 Devergie, Diet, de Med. et Chir. Prat. art. Mort. 

 R. B. Todd, Cyclop, of Pract. Med. art. Pseudo- 

 niorbid appearances. W. Philip on the nature of 

 sleep and death. M. Julia de Fontenelle, Recher- 

 ches medico-legales sur 1'incertitude des signes de 

 la mort, &c. 1834. The systematic works of 

 Mahon, Fodere, Paris, Smith, Orfila, Devergie, 

 and Taylor, upon forensic medicine ; and a chap- 

 ter on the causes of sudden death in Dr. Alison's 

 Outlines of Physiology and Pathology. 



(J. A. Symonds.) 



* Vol. xxxi. p. 248. See also an able article 

 upon Pseudo-morbid Appearances by Dr. R. B.Todd 

 in the Cyclopaedia of Practical Medicine. 



t Op. cit. 



