Medical Jurisprudence, Forensic medicine and Toxicology. Vol. 1

by R. A. Witthaus; Tracy C. Becker

Fortunately in the patients suffering from electric shock the severer forms of these affections are not so common. In most of the cases reported recovery has been more or less rapid. Cases in which previous hysteria or neurasthenia have existed are more liable to these manifestations than persons of a previously equable nervous constitution, but these latter are by no means wholly exempt. To consider these conditions, as is sometimes done, as the fault of the patient seems to us both unwarrantable and unjust.

LIGHTNING.

We now come to the consideration of the action of electricity in another form, that of natural electricity or lightning. The effects of this are practically the same as those of the forms previously described, except such differences as seem to be fairly accounted for by the vastly greater force of the currents with which we have to deal. Injuries and deaths from lightning stroke have been recognized and described for many centuries, and we have now a large collection of careful observations on them. They occur in most temperate regions with comparative frequency. In France the number of deaths from 1835 to 1852 inclusive (eighteen years) was 1,308. In England, including Wales, there were in twenty years, 1865 to 1884 inclusive, 416 deaths. In 1846 Mr. Eben Merriam, of Brookline, wrote to Mr. Arago that in the three last years about 150 persons had been killed by lightning in the United States. In thirty years, from 1855 to 1884 inclusive, we find 101 deaths in Massachusetts from this cause.

Exposure.—Injuries and deaths from lightning may occur in various places and under various conditions. The severe lightning strokes are popularly supposed to occur only during thunder-storms, and in this latitude this is undoubtedly, as a rule, true, but lightning strokes are reported to have occurred, particularly in the South, from a clear sky, and there seems no reason to doubt that this may happen. It is said also that dangerous discharges from the earth to the atmosphere may take place at a considerable distance from an atmospheric storm. As a rule, the lightning is more likely to strike some tall object, as a tree or a tower or steeple, and for this reason, and to avoid injury from falling branches, the shelter of trees should not be sought during thunder-storms if lightning stroke be dreaded. Ships at sea are frequently struck by lightning, partly perhaps on account of the height of the masts and partly on account of the metal in or on them.

Lightning obeys the same general laws as the other forms of electricity and naturally follows the paths of least resistance. Persons, therefore, who are in the neighborhood of or in contact with good conductors are in more danger of injury by lightning than when surrounded by or in contact with poor conductors. The proximity or contact of a large metallic object exposed in a thunder-storm is consequently more or less dangerous. On the other hand, the absence of tall objects or of specially good conductors of any kind does not insure safety. In many cases persons in fields are struck, and cases are related of persons struck on the prairies in the West. In Fredet’s case a shepherd was found dead in the midst of the barren moors (landes) in Southern France.

More accidents appear to occur directly to persons out-of-doors than to those in houses or other buildings. When inside buildings, persons struck are usually near an open door or window through which the lightning enters, and they are more exposed to danger from this source if there be some metal object or good conductor in the vicinity. Persons carrying or wearing metallic objects render themselves thereby more liable to be injured in this way.

Not only does the liability to injury from lightning vary somewhat according to the exposure or position of the person, both in relation to the free access of the atmospheric air and to the contact with or neighborhood of metallic objects or other good conductors, but also the severity of the injuries may be largely dependent upon what they are wearing or carrying and the condition of their clothing at the time. If the clothing be wet it will act as a good conductor, as will also any metallic object about the person. We have already referred to the action of metallic objects upon the passage of the electricity to and from the body and to the condition of the skin in relation thereto. The laws of conduction and resistance are precisely the same for the electricity of lightning as for the other forms. Hence the greater the resistance to the electricity at the points where it enters or leaves the body, the deeper will be the burn. Thus we find not infrequently that the lightning, in its course from the head to the feet, meets with a chain or a truss, and almost invariably at least a portion of the current follows this, causing a deep burn where it again passes into the skin. All the external burns of the lightning, except the initial one, are determined by the position and conditions of the body, the clothing, and the conductors near. All electricity obeys the same law and, roughly speaking, follows the path or paths of least resistance.

The clothing worn by a person when struck by lightning may be acted upon in the most various ways. Sometimes it is wholly stripped off the unfortunate sufferer, who, as in a case reported by Cook and Boulting, may have to be protected with sacks or other hastily improvised coverings. In a case reported by Nason, a girl of thirteen was struck while in the street and most of her clothes stripped off and torn to shreds, and the top of her hat, which contained steel wires, was torn from the brim. In the case of Wilks the body was stripped entirely naked and absolutely nothing left on except a portion of the left arm of the man’s flannel shirt. The clothing is sometimes torn to the finest shreds, like those of a mouse’s nest, as described by Van Horn, and in another case (Claes), where the patient was struck while on board ship, his woollen jacket was torn into fine bits, which stuck to the ropes, and the deck was covered with fibres of wool as fine as those of cotton-wool. In this case the woof of the trousers was said to have been wholly destroyed, while the web was untouched.

The clothing is also often burnt. Not only are holes burnt in it as is usually the case at the point where the lightning strikes and at the point where it leaves the body, but it may be set on fire. It may be found smoking or in flames.

Of all portions of the clothing injured, perhaps the coverings of the feet are the most frequently so, as the electricity is very apt to leave the body through the feet, and the resistance opposed is great. Hence the boot or shoe is frequently injured. Sometimes it is pierced as by a bullet, or a large hole is torn in it, or it may be torn to pieces or reduced almost to lint, while the foot remains uninjured. It may be torn, shrivelled, and burnt. In one case the soles of the shoes had disappeared; in another the leg of the boot was clearly divided from the sole and both straps were torn out; while again in another the shoe was carried wholly off.