the hypostatic spots, if incised, allow of the escape of merely bloodstained serum, not fluid blood or blood clots; while, if the spot has been caused as an ecchymosis, there will be found traces of fluid blood or clots, which could not have been formed post mortem except in the veins.

402. Internal suggillation.-The same factors at work in the interior of the body produce hypostatic congestion of the various organs in the dependent parts of the body, chiefly in the lungs, brain, kidneys, and intestines.

402a. Lungs. In the lungs it is seen very frequently. It makes its appearance, according to Orfila, within from twenty-four to thirty-six hours after death; but there is no doubt that it often arises far earlier than this, at the time that the blood in general begins to settle. In the case of bodies which have remained lying on the back, both lungs at their posterior part, or about a fourth part of the whole parenchyma, will be found of a much darker color than the rest, and on being laid open, an evident sanguineous engorgement will be seen, even when these organs are anemic. This is so striking that it may easily mislead the inexperienced, and cause them to attribute the death to apoplexy of the lungs, pneumonia, etc. This is especially apt to be the case where the blood is unusually dark, and where edema of the lungs had existed.

402b. Brain. It is important to observe that hypostatic congestion often occurs in the brain even in cases of death by bleeding; so that a quantity of blood in the cerebral veins generally, and especially in the posterior sinuses, is no evidence against this manner of death. Whether, in case this condition does not appear soon after death, it can afterwards be made to appear by changing the position of the body, is doubtful. This common appearance of hypostatic congestion in the brain must not be mistaken for active hyperemia, as may easily be done by the inexperienced, who are thus led to attribute death to an attack of apoplexy where none existed.

402c. Kidneys and intestine. Hypostatic congestion occurs in the kidneys and other organs of the abdomen. It is especially common in the organs which lie in the pelvis. The bluish-red color which appears on the dependent folds of the intestines may easily be mistaken for disease, whereas it is only a cadaveric phenomenon. The diagnosis, however, is easily made by drawing out the whole mass of intestine, when the arborescent appearance will be seen to occur at regular intervals. When the body has remained resting on the back, the posterior half of the kidneys becomes discolored, and in this way may easily be distinguished from a general hyperemia in this organ.

402d. Heart. Suggillation does not occur in the heart; but as this organ exhibits more than any other the so-called polypus, a very important formation as regards medical jurisprudence, it may be conveniently noticed here. These heart polypi are merely coagulated fibrin, and are either clear and white, or colored red by the blood. It is not to be admitted that this coagulation of the blood occurs before death, as an ordinary phenomenon, although in cases of a protracted agony it may begin in this long interval between life and death. As a general rule it takes place after death, and as the body gradually grows cold. Hence, where coagulated blood is found in wounds upon a dead body, it cannot safely be concluded that the wounds were produced before death, upon the ground that "blood cannot coagulate after death." This is one of the many erroneous notions which have persisted, from the habit of treating medical jurisprudence in a merely theoretical way. Engel is probably right when he says: "I do not believe that there is any disease or manner of death after which blood does not coagulate in the dead body. Some special case where it has not occurred may be cited, but many other cases may be adduced where it has occurred after the same disease or manner of death." This coagulation of the blood must follow peculiar laws which are as yet unknown; for it not only takes place after those kinds of death of which a fluid state of the blood is characteristic, as, after different kinds of suffocation,-but, what seems quite inexplicable, the coagulation occurs in many organs and vessels sooner than in others; not only in the heart (the right ventricle), but also in the inferior vena cava, the liver, etc. The proposition that "coagulated blood around or in a wound shows reaction during life, because no coagulation of the blood can take place after death," is, with all its consequences, erroneous.

403. Extinction of animal heat.-The extinction of animal heat after death is a gradual process, varying with the condition of the body, the media in which the body happens to lie, and the manner of death. In general fat or muscular bodies retain their warmth, ceteris paribus, longer than those which are lean. So, too, bodies that are in the air cool slower than those in water, and those in foul water slower than those in clear water. Naturally, those that are clothed lose their heat less rapidly than those that are uncovered. As to the manner of death, bodies of persons struck by lightning, or dying of suffocation, cool less slowly than usual; and the bodies of those who have died of microbic diseases, such as cholera, yellow fever, smallpox, etc., and, in general, those dying of acute rheuma

tism, injuries to the central nervous system, or of abdominal disease, are liable to show a rise of temperature of several degrees after death. As a general rule, bodies have a distinctly cold surface temperature in from eight to twelve hours.

Dr. Niderkorn has made some observations of great interest on this subject. (De la Rigidité Cadavérique chez l'Homme, Paris, 1872.)12 The following table records the average results of 135 observations of temperature in the axillæ of persons who had died from various diseases:

Goodhardt estimates13 the rate of cooling for the surface temperature of the body to be, during the first three hours, at the rate of three and a half degrees Fahrenheit an hour if the bodies are fat; four and a half degrees an hour if the bodies are emaciated; for the second three hours at the rate of three degrees an hour; and after that at the rate of about one degree an hour until near the temperature of the surrounding medium.

404. Condition of muscles; primary relaxation.-Immediately after death there is a relaxation of the muscles, and with this primary relaxation there comes a diminished excitability of the muscle. If not diseased before death it may still respond to the electric stimulation, but to other stimulation its response is very much decreased. With this relaxation of the skeletal muscles there is also a relaxation of the sphincters, notably the sphincter ani,-allowing the escape of feces. 405. Cadaveric rigidity. This state of muscular relaxation is followed by one of cadaveric rigidity,-the well known rigor mortis. This condition may be simulated by catalepsy, but there will be some evidence of life: the body temperature is normal, and, after flexion of the rigid extremities, they return to their previous position. It may also be simulated by the freezing of the body after death; but then the entire body, joints and all, will be rigid, and bending of the joints will be accompanied by the crackling sounds of breaking of ice. Moreover, raising the temperature of the body at once overcomes the frozen condition. Rigor mortis is, as a rule, present to some extent in all con

48.

"Tidy's Legal Medicine, Vol. I., p.

13 Goodhardt, Guy's Hospital Reports, 1870.

ditions after death. Hofmann14 excepts, however, the conditions of parenchymatous degeneration of the muscle, phosphorus and mushroom poisoning. It does not appear, either, in the immature fetus after a miscarriage, and in the newborn is slight, early to appear, and of short duration. The order in which this rigidity extends over the body, or, at least, over the skeletal muscles (for, while the involuntary muscles and heart also undergo a similar rigidity, the time of their involvement is not accurately known), is not fixed, but it seems, with certain exceptions, to appear first in the neck and jaws, and then to spread to the rest of the body.

The time when this rigidity appears is generally from two to six hours after death; but Brown-Séquard has reported an instance of emaciation from typhoid fever, where the jaw became rigid fifteen minutes before the heart stopped beating, spread all over the body immediately after death, and disappeared in half an hour after death. Similar conditions have been observed in animals after the injection into them of septic material.15 In other cases the appearance of rigidity has not come on until long after death, as in the cases where the body has been frozen immediately after death, and all of the postmortem processes delayed indefinitely. The duration of this rigidity is usually from twenty-four to forty-eight hours, but this, too, may be cut short or much prolonged. The existence of this muscular rigidity seems to depend largely upon the strength of the muscles of the body. If the muscles are exhausted, either by physiological or abnormal work just before death, the rigidity appears early, and is of shorter duration than in the cases where the muscles are well developed and at rest. The condition of the nerve system must, however, also be taken into account, for it has been shown16 that this rigidity may be delayed by cutting the nerves. We find practically, too, that rigor mortis comes on early in death from fever, exhaustion, old age, in deaths from lightning and sunstroke, and in poisoning by strychnin, atropin, pilocarpin and veratrin.

406. Cadaveric spasm. To be distinguished from this cadaveric rigidity are the cases of cadaveric spasm, where, immediately following death, there occurs a spasmodic contraction of some or all of the muscles of the body, so that the position of the body immediately before death is retained after death. This seems to occur in cases where there has been a high mental tension just preceding death, and death

"Hofmann, Ger. Med.,

15

p. 864.

Brouardel, La Mort et la Mort Su- 1888.

Beerfreund, Arch f. d. ges. Physiol.,

has been immediate, as in the cases of death from lightning, gunshot wounds of the head and chest, some cases of drowning and hanging. In these we find the explanation of the cases where the dead person still holds in his hand the weapon with which he killed himself, or a bit of seaweed from the bottom of the pond where he was drowned. There is one historical case of this condition which occurred in the charge of Balaklava, in the Crimean war.17 Captain Nolan, while riding in front of the cavalry, was struck by a Russian shell, which tore open his chest. The arm which was waving in the air at the time remained high uplifted, and he retained his seat on his horse, which wheeled round and returned. The rider gave a death shriek, and passed through the ranks in the same position and attitude before dropping from the saddle.

407. Secondary relaxation. After the period of cadaveric rigidity there comes a period of secondary muscular relaxation. In this state, however, molecular death of the muscles has begun, and they fail to respond to any stimulation,-a certain sign of death.

408. Destruction of the body, in general. The post-mortem chemical changes may lead to the destruction or the more or less complete preservation of the body. On the sequence of these changes depends the determination of the period of time that has elapsed between the death of the person and the examination, the possibility of identifying the body, and other significant questions. These changes may take the form of putrefaction, saponification, or mummification.

409. Rate of putrefaction. The essential factors modifying the rate of putrefaction are the presence of putrefactive germs, and the conditions favorable for their growth: the presence of water, oxygen, a suitable temperature, and the absence of germicidal agents. During life, under all circumstances, there are present in the body a vast number of germs, many of them putrefactive, but apparently not injurious to life. In health these germs are found on the skin, in the intestinal tract, and in the respiratory passages, and it is from these points that the processes of putrefaction start after death. When the resistance of the tissues to the entrance of germs is reduced after death, they not merely destroy the tissues with which they are immediately in contact, but, entering into the blood vessels, are driven through them to the different parts of the body by the variation in pressure upon those vessels, due to the development of the gases which these germs have produced. This post-mortem circulation of fluids in the blood vessels is called a posthumous circulation, and naturally it

27 Ogston, Lect. on Med. Juris., 375.