RULES FOR OFFICIAL INSPECTORS.
In the Royal Decree issued by the Government for examining the dead in Würtemberg, dated January 24, 1882 (Dienst-Vorschriften für Leichenschäuer, Stuttgart, 1885), various signs and experiments for enabling the official inspector of deaths to ascertain if actual death has taken place are laid down. Among these are:—
(1) “The cessation of sensibility may be assumed if, on raising the eyelid, the pupil remains unaltered when a lighted candle is held close to it; or if pungent odours, such as those derived from onions, vinegar, sal-ammoniac, or severe friction of the chest, arms, or soles of the feet, the application of mustard, or burning tinder, or if sealing-wax dropped upon the chest produces no reaction, and particularly if in the latter case the skin does not blister.
(2) “The stoppage of the circulation of the blood, apart from the absence of heart beating, if, after tying a tight bandage around the arm, the veins do not swell up, upon the hands being firmly gripped; also if, upon pricking the lips, no blood escapes; furthermore, if, on holding the hand in front of a bright light (the diaphanous test), the finger-tips are no longer translucent as in the living.”
Nor should the inspector ever neglect to examine the heart to ascertain the complete absence of all sound, and to test the absence of breath by other experiments.
The rescript further adds that these experiments “may not furnish absolute proof of death,” and describes what further proceedings to institute. These are referred to in this volume in the chapter devoted to Death Certification.
An editorial note in the Lancet, January 29, 1887, p. 233, shows the difficulty of distinguishing real from
APPARENT DEATH.
“It was only last year that we commented in our columns upon the ‘signs of death,’ drawing attention to the more important criteria by which a skilful observer may avoid mistaking cases of so-called suspended animation from actual disease.CASES FROM THE “LANCET.” Quite recently two instances have been recorded, in which, if report be true, it would seem there is still room for maturing the judgment upon the question herein raised. At Saumur a young man afflicted with a contagious disease apparently died suddenly. His body was enshrouded and coffined, but as the undertaker’s men were carrying the ‘remains’ to their last resting-place they heard what they believed to be a knocking against the coffin-lid, and the sound was repeated in the grave. Instead of testing at once the evidence of their senses, they, in accordance with judicial custom, sent for the Mayor, in whose presence the lid was removed from the coffin. Whereupon, to the horror of the spectators, it was observed that the dead man had only just succumbed to asphyxia. The above narrative seems on the face of it too ghastly to be true, especially as the occupant of the coffin must have been shut up in a space containing oxygen in quantity totally inadequate to sustain an approximation to ordinary breathing. But in cataleptic and similar states the organic functions are reduced to the lowest ebb, and history records several instances in which, for a time at least, the determination of the living state was a matter of uncertainty. In our issue of the 15th inst., p. 129, the reader will find an account of ‘Post-mortem Irritability of Muscle,’ in which the phenomenon was manifested in a marked degree two hours after death from a chronic wasting disorder—a condition which favours early extinction of vital action in muscle. It may be argued, then, with some show of reasonableness, that it is quite possible for the heart to stand still, as it were, and yet retain the power of action, although experience tells us but little on the question as regards the human subject. Experiments on the lower animals, however, show that over-distension of the right cavities of the heart causes cessation of cardiac contraction, and that relief from the distension may be followed by resumption of the function of contractibility. It must not be forgotten that an analogous condition is witnessed at times in patients suffering from capillary bronchitis or other physical states underlying acute distension of the right heart; for, in these cases, venesection is not uncommonly instrumental in arresting the rapidly failing cardiac contractions. The second case of apparent death alluded to above happened in ‘the land of big things.’ An inhabitant of Mount Joy, Paramatta, was believed to be dead, and his supposed remains were about to be committed to the earth, when a mourning relative startled the bystanders by exclaiming, ‘I must see my father once more; something tells me he is not dead.’ The coffin was taken from the grave to the sexton’s tool-house, and there opened, and was found to contain a living inmate, who justified the presentiment of his son by ‘slowly recovering.’ As no mention is made in either case of the period that elapsed between the occurrence of apparent death and the body being placed in the coffin, or of the time during which the encasement lasted, special and minute criticism is uncalled for. Enough has been said on the subject to emphasize the exhortation, ‘Get knowledge, and with all thy getting get understanding.’”
The British Medical Journal, of September 28, 1895, in a leading article on the “Signs of Death,” says:—