than one half of his body was burnt, and yet he recovered, though with scars such that he had to walk all bent up. Children seem especially susceptible to the effect of burns. Vibert describes the case of an infant thirteen days old that received a burn which covered an area 4 by 6 centimeters on the abdomen, and involved only the superficial portion of the skin, in which the infant died on the sixth day. Adults, also, at times show a marked idiosyncrasy to burns. Vibert also quotes1 the case of a man twenty-nine years old who, by an explosion of gas, was burned superficially on the face and hands; the epidermis was detached only in a few limited areas. The man died on the twentieth day, and showed well-marked internal lesions due to the burns.

300a. Complications.- Burns which are not immediately fatal may, in the course of their healing, develop symptoms due to the infection of the open surface, or to embolism from the coagulated blood in the vicinity of the burn, or to some of the rarer complications, such as ulcers of the duodenum. If the burn involves the mouth, as in burns by gases, ulceration and edema of the pharynx and larynx may be very important complications.

300b. Burn scars.-In the cases where death does not follow burns the resulting scars may be very disfiguring or even disabling from their vast extent and marked contraction, as in the case just noted from Maschka. Burns of the first and second degrees produce merely pigmentation scars. Burns of the third degree leave scars that are on the level of the skin, white and shiny. Burns of the fourth degree leave characteristic sunken scars, irregular in shape, radiating, and puckered. Burns of the fifth and sixth degrees show the loss of tissue.

301. Causes of death.-The cause of death after burns is dependent upon several factors. In many cases where the person is caught in a burning room, death is due to asphyxia from the gases inhaled rather than to the burn itself.1a Shock is often a very important element, especially in cases where death is immediate. In many cases there is an absorption of the products of the burn from the burnt surface. There are alterations in the blood, due to the heat, which are very detrimental; and the function of the skin is decreased, due to its destruction. In addition to these factors there is

Vibert, Précis de Méd. Lég.

la Casper (Ger. Leichenöff. 2te Hund. Cases 97 and 99) describes the postmortem examinations of two children who perished in a room that had been

set on fire. In them the trachea was filled with frothy mucus in which particles of soot could be recognized easily. It is probable, therefore, that the im mediate cause of death was suffocation.

a congestion of the internal organs, and often a distinct nephritis, with even blood-stained urine.

302. Post-mortem examination; local lesions.-The post-mortem examination of the local lesion in the first degree burns may be entirely negative, because the reddening of the skin disappears after death; there may, however, be a bran-like desquamation of the skin. Those of the second degree will show the characteristic blebs, which should be distinguished from the blebs due to disease, and show the eschar on the area burnt. In burns of the sixth degree, where there has been carbonization of the tissues, the charred area may have been so cracked in the burning as to simulate an incised wound of the part. Bodies that have been exposed entirely to the flames, and have been more or less carbonized, show contractures of the muscles so that the body may assume the attitude of a "boxer." The retraction of the skin around the mouth exposes the lips and the teeth. Later the skin bursts, and possibly the deeper tissues, opening the abdomen, thorax, or even the skull by one or both layers of bone. The exposed viscera are shriveled or charred. The last viscera to be affected are the pregnant uterus, and the bladder filled with urine. The bones even become calcined, and are liable to fall to pieces rather than to fracture.

302a. Internal lesions. The internal lesions in the very acute cases are usually negative. If the person has lived several days there may be congestion of the internal viscera, cloudy swelling of the kidneys, hyperemia of the meninges, often edema of the brain, ecchymoses in the serous and mucous membranes, with ulceration of the duodenum. If the person has lived longer, there is advanced fatty and granular degeneration of the internal organs, and often hypostatic or embolic pneumonia, or a broncho-pneumonia, due to the irritation of the bronchi from the hot air. There may be sepsis from the wound infection or venous thrombosis from the thickened blood. 302b. Other causes of death.— The examination of the body of a person who has been burned to death should always include a search for other causes of death. A case is reported in Henke's Zeitschrift in which two old people were found burned in their house; the fact of their having been previously stunned, if not killed, by blows upon the head, was ascertained by the existence of fractures of the skull, under which coagulated blood was found effused upon the dura mater. The criminal was not discovered for a long time, but the circumstances of the murder were betrayed by an associate. A singular circumstance was observed in this case, viz., that, although the bodies

were both almost destroyed by fire, that portion of the head by which the murder was revealed had been spared.2 Dr. Wyman, in his evidence in the Webster case, stated that "some of the fragments of the bones of the skull (of Dr. Parkman) had the appearance of having been broken previous to calcination, or being burned with fire. Calcination," he remarked, "removes the animal matter which gives to bone its tenacity; before this is removed, it breaks with sharp angles, and is more likely to splinter. Common surgical experience shows this. After calcination, the bone is more likely to crumble." 3

In an interesting case of assassination, related by Casper, the presence of contused wounds and extravasated blood upon the forehead and face of an aged woman, and vesications from burning upon some portions of the body, gave indubitable evidence of violence during life. Here the criminal confessed that he had struck his victim in the face with his fist and a paving stone, by which she was rendered senseless; but, with a strange refinement, would not acknowledge that he had designedly set fire to the apartment in which the half-consumed body was found.4

4a

303. Duration of life after fatal burns.-Mr. Erichsen found that of fifty fatal cases from burns there died:

304. Post-mortem burns; first degree; reddening.-Burns made upon the dead body, if of the slighter degrees, are distinct from those made on the living body. Burns of the first degree can not be produced on the dead body, because there can be no inflammatory reddening. Even the redness of the first degree burns produced during life disappears after death.

304a. Second degree; vesication. Likewise burns of the second degree cannot, under ordinary circumstances, be produced on the dead. body. In some cases there may result blebs filled with gas. Blebs containing serum were never obtained by Casper or Hofmann. In

'Henke's Zeitschrift, 1844, p. 284. Bemis's Report of the Webster case, Boston, 1850.

'Gericht. Leichenöff, sup. 1stes Hundert, Fall. 96. On this subject

see a paper by M. Tardieu, Ann. d'Hy. giène, Jan. 1860, p. 124.

4a J. E. Erichsen's Science and Art of Surgery, 1878, Vol. I., p. 220.

anasarcous bodies, however, where the tissues are full of transudate fluid, burns after death may produce blebs full of a clear, watery liquid, but not the serum of ante-mortem burns.

Orfila says that vesication manifestly denotes that the burn was made during life. According to Dévergie, if boiling water or a redhot iron be applied to the skin of a person, ten minutes after death, neither redness nor vesication will be produced; and it is not possible to mistake a burn made after death for one which was made before it. Dr. Christison made six experiments, with a view of satisfying himself as to the distinction. He says that it is evident from these that the application of heat, even a few minutes after death, causes no effects which can be mistaken for those induced by the vital reaction. In one case, in which a young man lay in a hopeless state of coma from poisoning with laudanum, a hot iron was held on the outside of the hip-joint, and half an hour after death, a red-hot poker was applied to three places on the inside of the arm. It is stated that vesications were formed in both instances, those made during life contained serum, and those formed after death air. Dr. Taylor says that he has performed many experiments on the bodies of infants, eighteen and twenty hours after death, both with boiling water and heated solids; but that in no case did he observe any kind of vesication to follow at that period. The skin became shriveled, and was partly destroyed by the heat, but no blisters were produced. Dr. Casper made four experiments with the same result. It is stated, however, by MM. Leuret and Champouillon, and also by Dr. Wright, of Birmingham, that serous blisters may be produced after death, in anasarcous subjects. In M. Leuret's experiment, the blister con- . tained an abundance of reddish-colored serum. In those of the other two observers, the serum was not tinged with blood. In one of Casper's experiments, however, a flame was held close to the dropsical scrotum of a dead body; the skin nearest the flame shriveled up and acquired a shining silver-gray surface, but no blister was raised. We think, however, it may be fairly objected to this and the preceding experiments of Casper, alluded to, that the degree of heat employed was much beyond that necessary to produce vesication. In two of the other three experiments, cotton wadding soaked in turpentine was placed in contact with the skin and lighted. In one case it was allowed to burn four minutes, in the other three and a half. In the third experiment, the flame of an oil lamp was held three minutes in contact with the back of the foot. In each case the skin was superficially roasted. The result might, perhaps, have been different had

a less intense heat been employed. Casper also alludes to a fact of some importance in this connection. He says that it is a common practice to drop burning sealing-wax upon the pit of the stomach immediately after death, with the hope of reviving the defunct, but that in the large number of bodies he has seen, in which this unintentional experiment had been performed, not one presented a trace of vesication in consequence. It may therefore, we think, be fairly inferred that, with perhaps the exception of anasarcous bodies, the presence of vesications upon the skin may be looked upon as a sure indication of the burn having been made during life, or immediately after, while the body is still possessed of a certain degree of organic vitality. Their absence, however, will be no evidence that the burns were not made upon the living person, since it is very possible that only the more serious results of burning may be found. There is, however, another sign of burning during life which cannot be simulated upon the dead body, viz., the congested and inflamed state of the skin around the blister or the burn, which is indicated by a red line which gradually merges into the color of the surrounding skin. This red border remains after death, and experiments made by Drs. Christison and Taylor prove that it cannot be produced by the application of heat to the dead body. The same may be said also of the red and granulated appearance of the true skin under the blisters.

The only experiments which appear to throw doubt upon the correctness of these conclusions are those of Drs. Maschka5 and Gräff. The first of these gentlemen found, in his experiments upon the dead body, that when the flame was brought in contact with the skin, blisters were formed of various sizes, from that of a pea to that of an apple, within the space of one minute. These burst with a noise and discharged serum. No redness, however, was observed under or around these vesications until the denuded surface had been some time in contact with the air. The application of boiling water produced the same result. When the heat was maintained, the further changes could not be distinguished from such as would have been caused upon a living person. Dr. Gräff, whose object in his experiments was to ascertain the length of time required to consume a head to a degree similar to that in which this portion of the body of the murdered Countess of Görlitz was found, laid the emaciated body of a person aged about fifty years upon a table in such a manner that the head hung over one end of it. A vessel containing alco