DEFINITION AND PHENOMENA OF DROWNING.
Late studies as to the cause and mechanism of asphyxia by submersion or drowning warrant our speaking of submersion as immersion complete enough to menace or to extinguish life.
When an animated body or a part only of the body is immersed a sufficient time in water or any liquid medium whatever in such a way as to exclude fresh air from the respiratory orifices, suffocation follows, and death by submersion or drowning takes place.
The phenomena occurring in such instances are mostly those common to imperfect aeration or non-aeration of the blood, and for this reason the majority of medical writers describe asphyxia or apnœa, that is, death beginning at the lungs, as the determining cause of death by drowning. It must not be thought that asphyxia is always the mode of death in those submerged, although it is commonly present in a certain number of cases. Other causes may often modify the circumstances of the death or directly produce it, as congestion of the brain and syncope, or the cause of death may be a mixed one. Occasionally one reads accounts of persons resuscitated from drowning who, on recovering from the primary effects of the asphyxia, die suddenly without apparent cause after a lapse of a few minutes or several days. Such cases are explained as the secondary results of the arrested interstitial nutrition that took place during the period while breathing was temporarily arrested. Another secondary cause is physical injury to the lungs from water penetration, which may result in a fatal pneumonia. A case related in England last summer is that of a drowning boy who, on being resuscitated after submersion in contaminated water, suddenly died of cholera.