7. Rupture of internal organs: distended bladder, spleen, pregnant uterus, or other abdominal viscus.
8. Hæmorrhage into the pancreas.
9. Conditions associated with the nervous system: mental emotions, epilepsy, uræmia, laryngismus stridulus in children.
10. Sudden death has occurred in Addison‘s disease, in diabetes, in cases of lymphatism or status lymphaticus in young people, during the early stage of chloroform anæsthesia, during simple vaginal examination in women, during the injection of fluids into the vagina or uterus. Bouvalat (Annales d‘Hygiène, 1892) relates a case in which, as the cannula of a syringe was being introduced into the os uteri of a woman with the object of criminal abortion, she fell back before any fluid was injected, and died in a few minutes.
A similar case came under my notice, in which death took place while the husband of the woman was attempting to introduce a solution of 20 minims of tincture of iodine, mixed with water to measure two drachms, into her uterus through a No. 3 catheter.
SIGNS OF DEATH
Real or Apparent Death
It will be unnecessary here to discuss any of the theories put forward with regard to cases of apparent death or prolonged trance, but simply to note in the order of their occurrence the phenomena which attend real death.
Real Death
Under this heading it is important to draw a distinction between “Somatic death” and “Molecular death.” “Somatic death” is defined as “the cessation of the vital functions and of the general renewal of tissue consequent on that cessation”; “Molecular death” is the death of the tissues themselves.