248. Appearances.-Dr. Taylor endeavored to solve the question of the differences between wounds inflicted before and after death, in an experimental way. In one experiment, an incised wound, about three inches long, was made in the calf of the leg, two minutes after its amputation. The skin retracted considerably, the adipose tissue underneath protruded between its edges, but the quantity of blood which escaped was small. Examined after the lapse of twenty-four hours, the edges of the wound were found red, bloody, and everted; the skin not in the least tumefied, but merely flaccid. A small quantity of loosely coagulated blood was found at the bottom of the wound, but no clots were found adherent to the muscles. In the second experiment, which was made ten minutes after the limb was amputated, the skin appeared to have already lost its elasticity, the edges of the wound became very slightly everted, and scarcely any blood escaped from it. On examination, twenty-four hours afterwards, the wound presented none of the characters of a wound inflicted during life, except that, at the bottom of the wound, a few coagula were found. Other experiments were made at a still later period after the removal of the limbs, but it was found that the wounds then made possessed still fewer points of similarity with wounds inflicted during life. From these experiments, one fact, at least, may be fairly inferred, that the coagulation of the blood is not a safe criterion of the time at which the wound was made, but that, as long as the body retains its warmth after death, this apparently vital process may still take place. If, therefore, a wound be made upon a person just dead, it is not impossible that the blood will coagulate in the wound. Facts, more pertinent than the above experiments, are, however, required to establish the fact beyond a doubt, as the accidental determination of the question upon the entire body would be naturally more conclusive than experiments upon separate limbs. On dissecting the body of a person who died of the low typhus fever which prevailed during the autumn of 1847, in a district inhabited by the lowest class of negroes, the blood was quite fluid, although death had taken place but six or eight hours before; but when allowed to stand in a cup, or in the chest whence the lungs had been removed, it speedily formed a dark and moderately firm coagulum.68 Several cases in which the blood retained its coagulability after death are reported by Casper. In one of these, relative to a man who was suffocated by coal gas, it is stated that four days after death, and during very cold weather in January, the blood

Gericht Med. I., 29.

flowed freely when the body was opened, but coagulated quite rapidly, and so firmly that the clots could be raised quite easily with the handle of a scalpel.69 Although the swollen and everted condition of the lips of the wound is a good indication of its having been inflicted upon the living person, this appearance may be removed by causes acting after death. Thus, if the body have lain in the water, this, together with the blood effused in the wound may have disappeared before the inspection is made, by the maceration to which the body has been thus subjected, and it is also often materially changed by the advance of putrefaction, since, by this process, the skin very soon becomes puffy, and many of the relations of the wound are changed. This is strikingly true of fat bodies, in which wounds, and especially incised ones, often assume, when the body begins to swell, an appearance which it is very difficult to distinguish from the effects of the inflammatory process.

249. Hemorrhage. The amount of hemorrhage is generally a reliable test of the period at which the person was wounded, but is, of course, only applicable in wounds involving a solution of continuity. In those made after death, even while the body is yet warm, the amount of blood poured out will, of necessity, be far less than while the active circulation of the blood is going on. This is especially true of wounds of certain parts which prove unavoidably fatal by copious and sudden hemorrhages, such as those of the heart, aorta, or any of the great blood vessels. In fact, wounds involving the left side of the heart, or the arteries, would probably, if made after death, be attended with no hemorrhage whatever; whereas, in the division of any of the venous trunks, soon after death, the amount of blood lost would be far smaller than would have been poured out during life, and would depend, in a great measure, upon the position of the part injured. In a celebrated case of assassination, tried in Berlin, the head of the murdered person had been severed from the body, but, at the same time, other injuries of a fatal nature had been inflicted. Dr. Casper gave his opinion that the neck had been severed before life was extinct, for the reason that a very large amount of blood was found to have been effused from the cervical vessels. The chief distinction, therefore, between hemorrhage before and after death, is that, in the latter case, the amount lost is comparatively trifling, and exclusive of a venous character.

249a. Coagulation.- While the signs we have referred to are the principal means of discrimination in wounds involving a loss of

"A. Stillé, Gen. Pathology, p. 426.

blood, there is another large class of wounds to which they do not have so extensive an application. Thus, although in contused wounds the coagulation of the blood under the surface injured sometimes affords, especially in injuries of the head, an indication of the blow having been given during life, yet, on the other hand, the want of coagulation is no proof that it was not inflicted till after death. The blood may, from various causes, remain fluid after death. Its coagulability may be impaired by disease, or by the mode of death. If, for instance, the person murdered has been affected with scurvy, or his death caused partly by any mode of asphyxia, the fluidity of the blood under contused wounds, or indeed in any kind of wound, in such an individual, would not be inconsistent with the opinion that the wound was given while the person was alive.

250. Ecchymoses.- Ecchymoses that are found in subcutaneous wounds inflicted after death may closely resemble those following wounds of a similar character inflicted during life. From experiments made by Dr. Christison, it appears that blows inflicted two hours after death will produce a discoloration of the skin, similar to what might be expected during life, except in regard to extent, which does not correspond with the severity of the blow. The experiments of Dr. Christison establish a strong presumption that, when contused wounds have been inflicted immediately after death, the external similarity will be still greater, and the correspondence between the amount of violence and the discoloration more exact. While this author was performing his experiments to ascertain whether blows given after death would produce similar appearances to those inflicted during life, he selected, as a subject for a series of these experiments, the body of a female who had died in the infirmary. The body, being afterwards carried to the dead house, and there seen by some persons who were not aware of the experiments having been performed, was not allowed to be buried until an inquiry had been made into the circumstances, so persuaded were these persons that the woman must have died in consequence of barbarous treatment received during life.

In this connection, the following remarks of Casper are not without importance: "Where death has been caused by violence, it is extremely common, especially where the bones lie immediately under the skin, to find suspicious spots upon the body. They are from one to three-quarters of an inch in diameter, usually rounded, red or reddish-brown, or dirty or yellowish-brown, more or less hard

"Op. cit., Vol. I., p. 127.

to the touch, and tough under the knife, but exhibiting no real suggillation. These spots may perplex the examining physician, and, indeed, when the mode of death is unknown or attended with suspicious circumstances, demand the closest examination and description, because they may possibly indicate and throw light upon a struggle in which life was lost. In the majority of cases, however, these pseudo-suggillations are produced at the moment of death by the body grazing or falling against some hard substance, and consequently have no relation to the cause of death. They may even be produced after death by the rough handling or carrying of the body, and may be imitated, after the lapse even of several days, by friction with a coarse brush or cloth, and so as not to be distinguishable from similar injuries produced during life." "When," says Engel, "these excoriations are found upon parts of the body in which the blood cannot settle after death, the portion of dried integument acquires a yellowish-brown color, and is translucent at the edges; on the other hand, if they form in situations where the blood tends to accumulate, their color is a very dark brown, and they cannot be distinguished from excoriations produced during life." Casper insists upon the practical importance of these distinctions, declaring that the cases are numberless in which ignorance of them or inattention to them has led to the most erroneous conclusions and mischievous consequences.

The inference from the considerations here presented is not that there is no distinction possible between ecchymoses produced before and after death, but that great caution is necessary in giving an opinion upon this point. The external bruise must be carefully compared with the effusion into and under the skin and adjacent tissues. If the latter be at all extensive, and especially if the blood be coagulated, we think there need be little hesitation in declaring that the injury must have been inflicted during life. Moreover, there are few cases of vital ecchymosis, without attendant swelling of the skin and other signs of vital reaction. If, while the body is fresh, the ecchymosed spot be found at all swelled, there can be no suspicion of post-mortem violence. Also, if the ecchymosis, though trifling in extent, be accompanied with excoriations or abrasions of the skin, as is often found in cases of strangulation with the hand, the fact of the violence having been done upon a living person will be manifest. The difficulty of discriminating between contusions made before and after death will be much enhanced by the putrefactive process, the effect of which is to so alter the consistence and

color of the skin and subjacent parts as to destroy all characteristic signs.

Dévergie1 has remarked that ecchymoses are often concealed on the bodies of the drowned, when first they are removed from water, owing to the sodden state of the skin; they may become apparent only after the body has been exposed for some days, and the water has evaporated.

251. Cadaveric spots. The spots and blotches (suggillations) produced by cadaveric changes are more likely to give rise to mistakes. In persons unaccustomed to inspect the bodies of the dead, the stasis or congestion of the blood in the capillary vessels of the skin, which sooner or later invariably occurs, may lead to the suspicion of violence having been inflicted before death. This lividity is most apparent and extensive in those who have died suddenly in full health, by some asphyxiating cause. It occurs in almost any part of the body, but is usually deeper and more distinct in those which are the most dependent. The time at which it is developed varies from the moment of dissolution up to the occurrence of rigidity; and is, of course, hastened or retarded by various causes, such as the mode of death, the season of the year, and the age of the subject. The blood is merely superficially diffused in the outer surface of the skin, and this mark alone ought to suffice to distinguish these discolorations from those produced by violence, since in the latter the blood is effused in the whole substance of the cutis and generally, also, in the subcutaneous cellular tissue, muscles, etc.

The forms assumed by the marks of cadaveric lividity are various; sometimes the skin is mottled, at others large blotches spread over the surface, and at others, again, the lividity is more uniformly diffused, without necessarily appearing on a dependent part. The marks of the clothing which the deceased wore, if they have remained upon him until rigidity has taken place, give a very singular appearance to the skin. Those portions which have compressed the body tightly will be recognized by the paleness of the surface, while the intervening spaces may be deeply tinged. The folds of a sheet often thus communicate to the body an appearance of flagellation, the back being covered with stripes. These are called vibices, and are familiar to every one accustomed to the inspection of persons recently dead. This stage of cadaveric lividity, which is due to the congestion of the capillary vessels, runs gradually into another at the approach of

"Taylor's Medical Jurisprudence, sixth American edition.