Physiological Researches on Life and Death

by Xavier Bichat

In the first class, the immediate cause of death, appears to be the simple presence of the black blood, in the various parts of the body, the general effect of which is always the same, in whatever manner produced; accordingly, the attendant symptoms and secondary results of all these sorts of death, are nearly alike, their duration the same, and if it varies, it varies only in consequence of the more or less complete interruption of the passage of air into the lungs.

This variety in the duration and intensity of the asphyxiating cause, may nevertheless occasion some variety in the symptoms also; such as a greater or less lividity and swelling of the face, a more or less considerable embarrassment of the lungs; but all these differences indicate only so many modifications of the cause, 1st, A man who is hanged, does not die as a man who is suffocated by an inflammatory tumour, or a pea or bean which perchance may have fallen into the trachea.[102] 2dly, An animal will perish much more slowly under a vessel of air, than when the trachea is tied. 3dly, The symptoms of asphyxia, when occasioned by a great rarefaction of air, or by a suffocating heat, are much less slowly produced, than where the cavity of the lungs is opened.

In all these cases the cause of death, namely the absence of red blood in the arterial system, is simple and unique, but according to the greater or less oxygenation of the venous blood, will be the appearances after death, for the longer the process of asphyxia endures, the less irritability will there be found in the system.

But if the cause of asphyxia, have been the introduction of some deleterious fluid into the lungs, then the variety of the symptoms will depend upon the difference in the nature of the fluid. In these cases the cause is of two kinds: 1st, There is no red blood in the system. 2dly, A pernicious fluid is present in the system. All the gases however do not act as deleterious substances: in pure hydrogen for instance, the animal perishes only as it would from the want of respirable air.

But when a man in descending into a common sewer, into a cellar, or into any place where putrid matters are accumulated, falls into asphyxia at the moment when he inspires their exhalations, and when such state is attended with convulsive movements and extreme agitation, then indeed, there must be something more in the cause of his death, than a simple suspension of the chemical functions of the lungs.

In fact, together with the mephitic vapour, there continues to enter into the lungs a sufficient quantity of air to keep up life and its different functions. 2dly, Supposing even that the quantity of mephitic air were such as to leave no place for the entrance of respirable air, still the death ensuing should only be gradual, without agitation and convulsion, were it occasioned only by the absence of such air: now the very different way in which it supervenes, very evidently indicates the action of a deleterious substance, upon the animal œconomy.[103]

These two causes then act together, in those asphyxiæ which are produced by certain gases, sometimes the one predominates, sometimes the other. If the deleterious substance be violent, it kills before the action of the black blood can have produced much effect, if weak, it is the black blood, which is principally the cause of death.

The asphyxiæ then, which are produced by the gases, differ only, in consequence of the nature of the deleterious substance, which varies ad infinitum. In some of the aeriform fluids indeed it is supposed to be known, but in the greater number of them it is not so:[104] I shall notice therefore in a general way the effects, which result from the action of the deleterious substance, remarking at the same time, that the symptoms by which they are displayed, are strongly or weakly marked, according to the age and temperament of the individual.

Deleterious substances introduced into the lungs, together with the mephitic vapours of which they form a part, can act only in two ways. 1st, By affecting the nerves of the lungs, which re-act on the brain. 2dly, By passing into the blood, and exercising their influence, by means of the circulation on the various organs of the system.