Causes of Death.
The causes of death are due to several conditions. This fact is explained in part by the relation which exists between the cerebro-spinal and sympathetic nervous systems, and of the nervous supply of the surface to that of the internal organs, which in cases of extensive injury proportionately modify the conditions of the visceral organs. As death in burning results from various causes, it is convenient to consider them under two classes:
1st. Those immediately fatal.
2d. Those fatal after an interval.
The FIRST DIVISION would include cases in which the deprivation of fresh air and the presence of asphyxiating products of combustion (carbon monoxide and carbon dioxide) were the immediate causes of death by suffocation or asphyxia (Cases 9, 18).
Accidents in endeavoring to escape or injuries by falling walls or timbers may cause death immediately, and burning the body occur subsequently.
Immediate death may result from syncope or collapse from the violence of the shock to the nervous system by the pain resulting from the burns.
The SECOND DIVISION includes those conditions where death may result early, from a series of causes less immediate than those just mentioned.
Cerebral congestion and effusion, resulting in death from coma, is not unusual (Case 15). In this connection Taylor[705] cites a case of alleged poisoning by opium, in the treatment of a burn, in a child dying comatose, and emphasizes the undesirability of administering opium or its preparations to children in cases of burns of any severity. The danger claimed to exist is hardly to be considered. In the case referred to, Abernethy, who was a witness in the case, ascribed death to coma induced by the effect of the burn. The powerfully depressing influence of the pain in sensitive organizations and liability to death from shock therefrom must be remembered.