Certain authors make a distinction between lethargy and apparent death. But, leaving out of view the cases of so-called lucid lethargy, a variety of the trance state, the difference is rather one of degree than of kind. The movements of respiration and of circulation, though greatly diminished, are readily observed in ordinary forms of lethargy, while in apparent death the pulse can no longer be discovered, and only the faintest sound can be distinguished in the region of the heart. It therefore becomes imperative to have within reach a crucial test of the persistence of general vitality. Such a test, according to Rosenthal, exists in the faradic current. Within two or three hours after genuine death the muscles cease to be excitable by the induced current, but in a case of apparent death this form of electro-muscular contractility never disappears. Every other test that has been proposed has failed under certain circumstances. This alone gives uniformly positive indications.
Lucid Lethargy.
In certain cases of apparent death the patient presents the external phenomena of suspended animation, but the power of conscious perception does not cease. The senses of sight and hearing remain, and are perhaps intensified by inhibition of the power of projecting cerebral volitions into space. The sufferer hears and sees; perception, memory, reasoning, judgment, emotion, volition, all persist. The possibility of centrifugal projection from the sphere of consciousness into the realm of space seems to be the only thing that is wanting.
The victims of this form of apparent death are usually women, or men who are characterized by a feminine nervous organization. Great mental excitement, fatigue, semi-starvation, and exhausting diseases are the principal proximate causes of the event. The following case, which was observed by my friend P. S. Hayes of Chicago, illustrates all these facts: A female physician, about thirty years of age and consumptively inclined, after a long and wearisome hospital service was attacked with typhoid fever. After a period of great prostration the hour of death seemed to have arrived. In the presence of her physician and surrounded by her relatives she ceased to breathe and the pulse stopped. Bottles of hot water were applied to the limbs, and other methods of restoration were employed, but a number of hours elapsed before these efforts yielded any result. At last she began to breathe once more; life was resumed and a gradual recovery followed. During all this time of apparent death consciousness had been preserved. She seemed to be looking down from above her bed, by the side of which she could see the physician holding her wrist, and she felt grief at witnessing the sorrow of her friends. Ordinary sensation was suspended, for she did not feel the scalding heat of the bottles that were applied to her limbs. Borne upon the wings of a liberated imagination, she thought she beheld the celestial city, but might not enter within its gates. In this exaltation the reasoning faculties also shared, so that certain philosophical problems which had long baffled her intellect were now perfectly comprehensible, and the memory of their interpretation persisted after recovery.
Many similar narratives have been duly authenticated, but the limits of the present article will not permit a discussion which properly belongs to an investigation of the phenomena of trance. The important fact for present consideration is the persistence of conscious life despite the appearance of death. In this preservation of consciousness, notwithstanding temporary suspension of certain forms of sensibility, together with loss of the power of voluntary motion, may be discovered a relationship between the events of lucid lethargy and various somnambulic modifications of sleep which have been previously passed in review.
ACUTE AFFECTIONS PRODUCED BY EXPOSURE TO HEAT.
BY H. C. WOOD, M.D., LL.D.