Page:The American Cyclopædia (1879) Volume XI.djvu/353

 MEDICAL JURISPRUDENCE 341 rather horizontal than oblique. Bruises of pe- culiar form around the neck may show that strangulation was effected by the hands. It is impossible that these should have been made by the suicide, because the hands lose their power as insensibility advances. But in cases of hysteria, apoplexy, or epilepsy, the sufferer may in his agony have pressed the hands to the throat, and in this way have made the marks which give rise to a suspicion of murder. Ob- vious and distinctive marks are, says Dr. Chris- tison, rarely present in a case of death by suf- focation. They are the less evident as death is the more rapidly induced ; for if there be no time for the accumulation of blood in the ve- nous system, there will be no enlargement of the pulmonary vessels, no turgescence of the veins, and no discoloration of the skin. In the cases which occurred in the Champ de Mars in Paris in 1837, of suffocation by pressure in the crowd, when death was probably caused by respiration being incomplete, and was long de- ferred, the bodies of the dead exhibited pecu- liar appearances. Their faces and necks were of a uniform violet tint, spotted with blackish ecchymosis, and in some instances blood and froth oozed from the mouth and nostrils. As in hanging, so in drowning, life is destroyed by different modes, sometimes by suffocation, or rather by the asphyxia which that causes. This is the most usual form of death by drowning. Another form is that of syncopal asphyxia. In these cases, the coldness of the water, or per- haps intoxication, throws the system into a con- dition of nervous inaction, and the body pre- sents only the appearance of simple asphyxia, paleness of the body, no froth in the trachea or bronchi, and but slight disturbance of the in- ternal organs. Still another cause of death is apoplexy from cerebral congestion. A drowned body usually presents general paleness of the skin, yet the face will be discolored if death was preceded by long-continued struggling. It is to be remarked that upon exposure of the body to the air, discoloration very speedily en- sues. The eyes may be found half open, at- tended by dilatation of the pupils. These signs, as also frothing at the mouth, may proceed from other violent means, but still are strong proof of drowning. Of the internal appearances of the body may be mentioned a fulness in greater or less degree of the blood vessels of the head and of the right side of the heart. The con- gested condition of the brain varies with the proximate cause of death. If that was apo- plexy, it would certainly be present, but rarely or not at all in the case of syncopal asphyxia. The blood of the drowned is generally found fluid. The existence of froth in the bronchi is perhaps not a conclusive proof of the mode of death ; but it is certainly the result of vital action, and so may be a valuable sign in con- junction with others to prove that life existed when the body was immersed. The presence of water in the stomach is merely accidental, and is not very nearly connected with the cause of death. As upon high authority it is asserted that water cannot pass into the stomach after death, its presence in it may be in certain in- stances significant. When death arises from obstruction of the breath by water, and not by apoplexy, some of the fluid enters the lungs with the last efforts of inspiration. Yet neither the fact that it is found there, nor its quantity, can be regarded as proving conclusively that death took place in consequence of immersion ; for under favorable circumstances water may penetrate into the lungs even of a dead body. Fod6r6 defines poisons as those substances which are known by physicians to be capable of altering or destroying, in a majority of cases, some or all of the functions necessary to human life. The intent with which such a substance is administered enters of course into the legal conception of a poison. Poisons may be ranked under the two great divisions of ir- ritant and narcotic. To irritant poisons belong the corrosive acids and some of their com- pounds, the alkalies and their salts, the metallic compounds, and the vegetable, animal, and me- chanical irritants. The characteristic of these poisons is the inflammation which their appli- cation excites. Their most notable effects upon the human body are heat, irritation, or singu- lar dryness in the ossophagus, accompanied by a sensation of strangling ; pain in the stomach and intestines or in the region of the kidneys, followed by strangury; evacuations both by vomiting and at stool, convulsions, faintings, cold sweats, and an irregular thready pulse. There is usually a retention of the intellectual faculties until the disease approaches a fatal termination. Narcotic poisons, on the other hand, which include many vegetable substances, prussic acid and its compounds, and the nar- cotic gases, nitrogen, carbonic acid and oxides, oxygen, hydrogen, and others, are distinguished by the disorders which they produce in the nervous system. They are defined by Orfila to be those which cause stupor, drowsiness, paralysis, or apoplexy and convulsions. Among their usual effects, in the various stages of their influence upon the body, may be men- tioned numbness, coma, and sometimes delir- ium, cold and fetid perspiration, swelling of the neck, face, and sometimes of the whole body, dilatation of the veins, protrusion of the eyes, general prostration, chilliness and pa- ralysis of the extremities, and, just preceding death in some instances, pain and Convulsions. The narcotic-acrid poisons produce combina- tions of several of these symptoms. The effects of poisons differ widely in different persons, and are more or less distinctly marked accord- ing to the form, whether solid or liquid, in which the poisonous substance is administered. The symptoms are naturally varied too by the condition of the system, particularly of the stomach, when the poison is taken. It may be added here that the effects of poisons may be closely imitated by certain diseases, as for ex- ample cholera. Rupture of various intestines,