DEATH FROM COLD
This form of death is rare in England, but is more common in countries where the winters are severe. Anything that depresses the vital powers renders the individual more or less susceptible to cold; such, for instance, as drunkenness, previous illness, or deficiency in the amount of food. The following post-mortem appearances are given by Ogston, who holds that they point, in the absence of any other obvious cause of death, “if not with absolute certainty, yet with high probability,” to death caused by cold:
1. An arterial hue of the blood generally, except when viewed in mass within the heart; the presence of this coloration not having been noted in two instances.
2. An unusual accumulation of blood, as in Quelmalz and Cappel‘s cases, on both sides of the heart, and in the larger blood-vessels of the chest, arterial and venous.
3. Pallor of the general surface of the body, and anæmia of the viscera most largely supplied with blood. The only exceptions to this were moderate congestion of the brain in three cases, and of the liver in seven of them.
4. Irregular and diffused dusky-red patches—“frost erythems”—on limited portions of the exterior of the bodies, encountered in non-dependent parts, these patches contrasting forcibly with the pallor of the skin and general surface.
These signs are not so well marked in children as in adults. The late Sir Benjamin Brodie considered that the effect of cold is to destroy the principle of vitality equally in every part, and that it does not exclusively disturb the functions of any particular organ. The fact of a body being found frozen is no proof that death has been brought about by cold.
Symptoms.—Exposure to severe cold produces loss of energy, lethargy, followed by drowsiness, with an intense desire to sleep, which, if gratified, passes on to stupor and coma. There may be delusions before the coma. The primary cause of death is attributed to the lessened dissociation of oxygen from the hæmoglobin to the tissues, and a lessened power of the latter to utilise it.
Diagnosis.—The general appearance of the deceased, and the absence of any other cause of death, together with the appearances just mentioned, will assist in forming an opinion on this difficult subject. The body lies as if in a deep and calm, sleep, without any external appearance to guide us as to the cause of death, except perhaps a swelling of the extremities, which has come on prior to death. If a body be found buried in snow, and putrefaction present, death did not in all probability take place from cold, provided that the cold has been severe and continuous. Death from cold is generally accidental, except in newly-born children, when it may be either accidental or homicidal, according to circumstances.
When freezing of the body has taken place prior to the onset of rigor mortis, the latter comes on after the body thaws. This, combined with the other post-mortem signs given above, affords evidence of the strong probability that death had resulted from exposure to cold. In view of the red colour of the skin being similar to that caused by poisoning with CO, a spectroscopic examination of the blood should be made.