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MEDICAL
JURISPRUDENCE.
BY
J. A. PARIS, M.D. F.R.S. F.L.S.
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS;
AND
J. S. M. FONBLANQUE, Esq.
BARRISTER AT LAW.
“Hæc est illa amica Imperantiam atque Medentium conspiratio, qua effectum est, ut aliquo veluti connubio Medicina ac Jurisprudentia inter se jungerentur.”
Hebenstreit Anthropolog: Forens:
IN THREE VOLUMES.
VOL. II.
LONDON:
PRINTED & PUBLISHED BY W. PHILLIPS, GEORGE YARD, LOMBARD STREET;
SOLD ALSO BY T. & G. UNDERWOOD, AND S. HIGHLEY, FLEET STREET;
AND W. & C. TAIT, EDINBURGH.
1823.
Medical Jurisprudence.
PART III continued.
[3. Of Homicide generally.]—[ 4. Of Real and Apparent Death.]—[ 5. Of the Physiological Causes, and Phenomena of Sudden Death.]—[ 6. Of Syncope.]—[ 7. Of Suffocation, by Drowning, Hanging, and other causes.]—[ 8. Death by exposure to Cold—Heat—Lightning—Starvation.]—[ 9. Application of the Physiological Facts established in the preceding chapters, to the general treatment of Asphyxia.]—[ 10. Of the Coroner’s Inquest.]—[ 11. Suicide.]—[ 12. Of Murder generally—by Wounding or Blows—by Poisoning.]—[ 13. Of Poisons, Chemically, Physiologically, and Pathologically considered.]—[ 14. Of Homicide, by Misadventure or Accident.]—15. A Synopsis of the Objects of Inquiry in Cases of sudden and mysterious Sickness and Death,—Commentary thereon, including practical rules for Dissection.—16. Abortion and Infanticide—with Physiological Illustrations.—17. Of Criminal Responsibility, and Pleas in bar of Execution.—18. Of Punishments.—19. Postscript.
3. OF HOMICIDE GENERALLY.
To aid the administration of justice in cases of homicide is not only the most useful, but the most frequent, application of medical jurisprudence; this subject, as well for its complexity as for its importance, must be subdivided into many heads. It is first necessary that the medical practitioner should determine by examination, inspection, or dissection, whether the matter ought to be referred to the criminal tribunals, or whether the decease of the party is to be attributed to any of those natural causes, which are generally classed as “Death by the Visitation of God.” In some instances this examination will take place in aid of the coroner’s inquest, in others it will be preparatory to it; in both cases it is equally important that it should be minutely, faithfully, and ably conducted; for it is on the medical report that the first impressions will be founded, and the prejudices created by it in the public mind may not easily be effaced by any subsequent investigation. If, however, it be determined that the cause of death has been violent, it is then necessary to enquire to which of the classes of homicide the act is to be attributed.
“Homicide, properly so called, is either against a man’s own life, or that of another.” 1 Hawk. P. C. 102.
The first offence constitutes the crime of suicide or felo de se.
The second has many varieties; it may be justifiable, excusable, or wilful; and this last again, may be with, or without, malice prepense, which constitutes the difference between manslaughter and murder; both are felony, the one with,[[1]] the other without, the benefit of clergy; to these and their numerous subdivisions we shall separately direct the attention of our reader; having first, by a general view of the physiology of death, and some practical observations on the best modes of investigation, prepared the way for a minuter examination of many of those various modes of destruction to which human life is liable.
OF REAL AND APPARENT DEATH.
If life be defined, that power by which organized beings are enabled to resist the physical and chemical operation of surrounding agents, it follows that death must be marked by the occurrence of those phenomena to which the elective attractions, no longer suspended or controlled, will necessarily give rise; hence putrefaction has been considered by many authors as the only certain sign of dissolution; unfortunately, however, this process of decomposition does not immediately display its agency by visible effects; the countenance has remained unchanged for a considerable time after death, and cases have occurred in which its colour and complexion have not only been preserved, but even heightened. This difference in the celerity with which the body putrefies did not escape the observation of the ancients, and like every other mysterious occurrence, was attributed by them to divine interposition; we accordingly find that their poets mentioned those who preserved the appearance of freshness after death, as favoured persons, who had fallen by the gentle darts of Apollo and Diana; thus Hecuba[[2]] declares that Hector, although dead for twelve days, still remains fresh, like one who had died by the hands of Apollo. On the other hand, in certain morbid states of the living frame, so feebly do the powers of life resist the operation of physical agents, that if the body cannot be said actually to enter into a state of putrefaction, it may at least assume appearances so analogous as to be mistaken for it. The test of death, therefore, must rather be sought for amongst those signs which indicate the quiescence, or cessation of the functions of life, than from those which manifest the decomposition of the organs by which they are performed; and here again it may be imagined that no difficulty or fallacy can occur; the total cessation of respiration, pulsation, sensation, and all motion, it might be supposed, would indicate to the least experienced the departure of life, while the general aspect of the body, its pale and livid hue, the coldness of its surface, and the stiffness of its limbs, we might conclude were signs so palpable and satisfactory as to defy the possibility of doubt. To the skilful medical practitioner we apprehend such signs must ever be unequivocal; but we are not prepared to say that a common observer may not be sometimes deceived by them; in cases of extreme debility, as in the latter stage of fever, and where the patient is confined in vitiated air, the exhaustion may be so considerable as to lend all the appearance of death; indeed that such cases have occurred we have no less a testimony than that of the philanthropic Howard, who, in his work on Prisons, says, “I have known instances where persons supposed to be dead of the gaol fever, and brought out for burial, on being washed with cold water, have shewn signs of life, and soon afterwards recovered.” Hippocrates, in his Epidemics, also mentions the case of a woman who, being in appearance dead, from fever, was recovered by throwing thirty amphoræ of cold water over her body. Diemerbroeck[[3]] relates the case of a rustic who having appeared to die of the plague, discovered after three days no signs of respiration, but, on being carried to the grave, recovered and lived many years afterwards; and Paul Zacchias relates an analagous case which occurred at the hospital of Santo Spirito at Rome. At a period when the small-pox raged with such epidemic fury, and physicians so greatly aggravated its violence by their stimulating plan of cure, there can be no doubt but that many persons were condemned as dead who afterwards recovered; amongst the numerous cases that might be cited in support of this opinion, the following may be considered as well authenticated: the daughter of Henry Laurens, the first President of the American congress, when an infant, was laid out as dead, in the small-pox; upon which the window of the apartment, that had been carefully closed during the progress of the disease, was thrown open to ventilate the chamber, when the fresh air revived the supposed corpse, and restored her to her family; this circumstance occasioned in the father so powerful a dread of living interment, that he directed by will that his body should be burnt, and enjoined on his children the performance of this wish as a sacred duty.
We can also imagine, that women, after the exhaustion consequent on severe and protracted labours, may lie for some time in a state so like that of death, as to deceive the by-standers; a very extraordinary case of this kind is related in the Journal des Sçavans, Janvier 1749.
Dr. Gordon Smith, in his work on Forensic Medicine, has observed that in cases of precipitancy or confusion, as in times of public sickness, the living have not unfrequently been mingled with the dead, and that in warm climates, where speedy interment is more necessary than in temperate and cold countries, persons have even been entombed alive; we feel no hesitation in believing that such an event may be possible; but the very case with which the author illustrates his position is sufficient to convince us that its occurrence would be highly culpable, and could only arise from the most unpardonable inattention; “I was” says Dr. Smith, “an eye witness of an instance in a celebrated city on the continent, where a poor woman, yet alive, was solemnly ushered to the margin of the grave in broad day, and whose interment would have deliberately taken place, but for the interposition of the by-standers;” if the casual observer was thus able to detect the signs of animation, the case is hardly one that should have been adduced to shew the difficulty of deciding between real and apparent death. Many other illustrations might be adduced, but it is not our intention to amuse the reader with a relation of those numerous nugæ canoræ that enliven several popular productions on the subject of trances, premature interments, and extraordinary resuscitations; the public have always betrayed a morbid curiosity upon the subject, and the stories of persons buried alive have ever found a ready access to our credulity, as well as to our compassion.
Amongst the different anecdotes which have been brought forward in support of the popular belief in the frequency of living interment, and in proof of the fallacy of those signs which are commonly received as the unerring indications of death, we read of numerous instances where the knife of the anatomist has proved the means of resuscitating the supposed corpse; Philippe Peu, the celebrated French accoucheur, relates, himself, the case of a woman, upon whose supposed corpse he proceeded to perform the cæsarean section, when the first incision betrayed the awful fallacy under which he operated; the history of the unfortunate Vesalius, physician to Philip II. of Spain, furnishes another instance, upon which considerable stress has been laid; upon dissecting a Spanish gentleman, it is said that on opening the thorax the heart was found palpitating; for which he was brought before the inquisition, and would probably have suffered its most severe judgment, had not the king interceded in his behalf, and obtained for him the privilege of expiating his offence by a pilgrimage to the Holy Land.[[4]]
M. Bruhier[[5]] also relates a case on the authority of M. l’Abbé Menon, of a young woman who was restored by the first incision of the anatomist’s scalpel, and lived many years afterwards. With respect to the instance of Vesalius we would make this general observation, which will probably apply to most of the cases on record; that the movements which have been observed on such occasions are not to be received as demonstrations of life, they merely arise from a degree of muscular irritability which often lingers for many hours after dissolution, and which, on its apparent cessation, may be even re-excited by the application of galvanic stimuli.
But there is a propensity in the human mind to believe in these horrors, because between credulity and fear there is an inherent affinity and alliance; and it may be very safely asserted, that there is nothing of which we have a greater instinctive horror,[[6]] than of any force by which our voluntary exertions are totally repressed; hence it is, as Cuvier has remarked, that the poetic fictions best calculated to insure our sympathy, are those which represent sentient beings inclosed within immoveable bodies; the sighs of Clorinda issuing, with her blood, from the trunk of the cypress, as related in the fable of Tasso, would arrest the fury of the most savage mortal; and the sufferings which attended the confinement of Ariel, by the witch Sycorax, within the rift of a cloven pine, are described by Prospero as being of so pitiable a description as to move the sympathy of the very beasts of the forest.
--------“She did confine thee,
By help of her more potent ministers,
And in her most unmitigable rage,
Into a cloven pine; within which rift
Imprison’d, thou didst painfully remain
A dozen years.”
--------------“Thou best knows’t
What torment I did find thee in: thy groans
Did make wolves howl, and penetrate the breasts
Of ever-angry bears; it was a torment
To lay upon the damn’d.”
Tempest, Act i, s. 2.
The author of the present chapter had once an opportunity of witnessing a most striking manifestation of the popular feeling to which he has just alluded; a sailor, who had died suddenly on board a vessel in Mount’s Bay, was sent on shore for interment on the same evening: this indecent haste in consigning the yet warm corpse of a human being to the grave, excited a very strong and natural feeling in those to whom the fact was communicated; in a few hours the knowledge of the circumstance became general in the town of Penzance, and imagination which, in cases that interest the feelings, is always ready to colour each feature with the hue most congenial to the fancy, soon represented the case as one of living interment, and by midnight the impression had produced so strong an effect upon the credulity of the town, that many hundred persons assembled at the house of the mayor and insisted upon the disinterment of the body; the author, in his professional capacity, was called upon to accompany the magistrates in the investigation, which was accomplished by torch light, amidst an immense concourse of people; the body was disinterred, when, it is almost needless to add, that not the slightest mark was observed that could in the least sanction the popular belief so readily adopted, and enthusiastically maintained.
Within the last few years a singular and unphilosophical work[[7]] has appeared from the pen of a learned divine, which is well calculated to cherish the public credulity upon the subject under discussion, and to excite many groundless alarms, as well as unjust expectations, respecting the possibility of latent life; the reverend author, it must be confessed, has furnished a practical proof of his talents in his favourite art of resuscitation, by recalling into life the numerous idle tales, and superstitious histories, that we had hoped had long since been for ever consigned to the “tombs of all the Capulets.” The histories of persons having been buried alive, or recovered after apparent death, are not, however, confined to the annals of modern times; we are informed by Diogenes Laertius that Empedocles acquired great fame for restoring a woman, supposed to be dead, from a paroxysm of hysteria; and Pliny, in his Natural History, devotes a chapter to the subject, under the title of “De his qui elati revixerunt[[8]];” in which an interesting case is related of Avicola, whose body was brought out and placed on the funeral pile, the flames of which are said to have resuscitated the unhappy victim, but too late to allow it to be rescued from its powers; but such cases merely go to shew that the common observer may be deceived. We feel no hesitation in asserting that it is physiologically impossible for a human being to remain more than a few minutes in such a state of asphyxia, as not to betray some sign by which a medical observer can at once recognise the existence of vitality, for if the respiration be only suspended for a short interval, we may conclude that life has fled for ever; of all the acts of animal life this is by far the most essential and indispensable; breath and life are very properly considered in the scriptures as convertible terms, and the same synonym, as far as we know, prevails in every language.[[9]] However slow and feeble respiration may become by disease, yet it must always be perceptible, provided the naked breast and belly be exposed; for when the intercostal muscles act, the ribs are elevated, and the sternum is pushed forward; when the diaphragm acts, the abdomen swells; now this can never escape the attentive eye, and by looking at the chest and belly we shall form a safer conclusion than by the popular methods which have been usually adopted, such as the placing a vessel of water on the thorax, in order to judge by the stillness or agitation of the fluid; or holding the surface of a mirror before the mouth, which, by condensing the aqueous vapour of the breath, is supposed to denote the existence of respiration, although too feeble to be recognised in any other way.
----“Lend me a looking-glass;
If that her breath will mist or stain the stone,
Why, then she lives.”
Lear, Act v, s. iii.
For the same purpose, light down, or any flocculent substance, from the extreme facility with which it is moved, has been supposed capable of furnishing a similar indication; but the result must not be received as an unequivocal proof, and accordingly Shakspeare, with that knowledge and judgment which so pre-eminently distinguish him, has represented Prince Henry as having been thus deluded, when he carried off the crown from the pillow of Henry the Fourth—
--------------“By his gates of breath
There lies a downy feather, which stirs not.
Did he suspire, that light and weightless down
Perchance must move.”
With respect to the above tests it may be remarked, that an imperceptible current of air may agitate the light down, and thus simulate the effects of respiration, while an exhalation, totally unconnected with that function, may sully the surface of a mirror held before the mouth; on the other hand, we have learnt from experience that mirrors have been applied to persons in a state of mere syncope without being in the least tarnished.
Having thus considered the value of the tests of respiration, we shall proceed to appreciate those which have been considered as furnishing no less certain indications of death. The absence of the circulation, the impossibility of feeling the pulsations of the heart and arteries have been regarded as infallible means of deciding whether the individual be dead; but it is proved beyond all doubt that a person may live for several hours without its being possible to perceive the slightest movement in the parts just mentioned. It has been thought also, says Orfila, that an individual was dead when he was cold, and that he still lived if the warmth of the body was preserved; there is perhaps no sign of so little value; the drowned who may be recalled to life, are usually very cold; whilst in cases of apoplexy, and some other fatal diseases, a certain degree of warmth is preserved even for a long period after death. Stiffness of the body is another sign of death upon which great reliance has been placed; but as it sometimes happens that it exists during life, it becomes necessary to point out the difference between the stiffness of death, and that which occurs during life, in certain diseases. For the following observations upon this subject we acknowledge ourselves indebted to the judicious treatise of Orfila.
1. Stiffness may be very considerable in a person who has been frozen, who is not yet dead, and who may even be recalled to life. This stiffness cannot be confounded with that which is the inevitable result of death, because it is known that the body has been exposed to the action of severe cold, and above all because it is very general; in fact, the skin, breasts, the belly, and all the organs may possess the same rigidity as the muscles, a circumstance not observable in cadaverous stiffness, in which the muscles alone present any degree of resistance; besides, when the skin of a frozen person is depressed, by pressing forcibly upon it with the finger, a hollow is produced which is a long time in disappearing. When the position of a frozen limb is changed, a little noise is heard, caused by the rupture of particles of ice contained in the displaced part.
2. The stiffness to which the late M. Nysten has given the name of convulsive, and which sometimes manifests itself in violent nervous diseases, may be easily distinguished from cadaverous stiffness; when a limb is stiff in consequence of convulsions, &c. the greatest difficulty is experienced in changing its direction, and when left, it immediately resumes its former position; it is not the same in stiffness from death; the limb, the direction of which has been changed, does not return to its former position.
3. The stiffness which occurs in certain forms of Syncope, can never be confounded with cadaverous stiffness; for, in the former case, the stiffness takes place immediately after the commencement of the disease, and the trunk preserves a degree of warmth; whereas the cadaverous stiffness is not observed until some time after death, and when the heat of the body is no longer evident to the senses.
If, from a cause which it is not always possible to foresee, the individual who has been thought dead for a long time be cold and flexible, instead of offering a certain degree of stiffness, and at the same time if no evidence of putrefaction has as yet displayed itself, the body ought not to be buried hastily—“Satius est adhiberi millies nimiam diligentiam, quam semel omitti necessariam.”
The cadaverous state of the face, of which Hippocrates has given the following description, has been regarded as a sign of real death; the forehead wrinkled and dry, the eye sunken, the nose pointed, and bordered with a violet or black circle, the temples sunken, hollow, and retired, the ears sticking up, the lips hanging down, the cheeks sunken, the chin wrinkled and hard, the colour of the skin leaden or violet, the hairs of the nose and eye-lashes sprinkled with a kind of yellowish white dust. It must be admitted that such signs, if taken separately, are of no value, since they are sometimes observed in patients twenty-four or forty-eight hours before death; while, on the other hand, they are often absent in cases of sudden dissolution. The softness, dimness, and above all, the flaccidity of the globe of the eye have been considered as very unequivocal in their indication. Professor Louis[[10]] has offered some remarks upon this subject worthy our notice; he says that, in the dead, the transparent cornea is commonly covered with a thin slimy membrane, which breaks in pieces when touched, and is easily removed by wiping the cornea; but he remarks that some appearance of it takes place in the eyes of the dying, and also allows that it may be the result of disease; so much for the value of this sign: the one which follows appears to us less exceptionable; in a few hours after death, adds this author, the eyes become soft and flabby, an effect not to be produced under any circumstances in the living body; we join in this opinion; but how often does it happen that the globe of the eye undergoes no alteration in form, until the putrefactive process has been fully established?
OF THE PHYSIOLOGICAL CAUSES, AND PHŒNOMENA OF SUDDEN DEATH.
It has been asserted by Bichat[[11]] that the immediate cause of death, when it takes place suddenly, must be the cessation of the functions of the heart, brain, or lungs; although it is sometimes difficult to determine which of these organs is the first to fail in its action; this may be well exemplified by the poisonous operation of Arsenic upon the animal economy, which when introduced into the circulating system will, according to the valuable experiments of Mr. Brodie, occasion stupor and paralysis, a feeble and intermitting contraction of the heart, and slow and laborious respiration; but it is found that in some cases, one order of symptoms will predominate, and be the first to display themselves, whilst in others, the very contrary will obtain, without perhaps our being able to assign the immediate cause of such deviations. There are, moreover, cases of sudden death, in which the principle of animation would seem to be at once annihilated in every part of the animal machine, and when every organ appears to be simultaneously affected, as in that occasioned by the agency of intense cold, and sometimes, for it is not in every instance, by that of lightning, or electricity; still, as a general proposition, the aphorism of Bichat must be admitted; and we shall proceed to investigate the subject of sudden death, as connected with medico-judicial inquiry, upon principles deduced from the enlightened views of this distinguished philosopher. To the able and satisfactory researches of our English physiologist, Mr. Brodie, we are also greatly indebted for a correct notion of the nature and order of succession, of those events by which life is quickly extinguished; his attention was many years ago directed to one important branch of this subject,—to the investigation of that series of changes produced on living bodies by the operation of poisons, the results of which were published in the Philosophical Transactions,[[12]] to which we shall have frequent occasion to refer in the following pages. Since that period he has diligently pursued the subject in its more extensive ramifications, and in his lectures, delivered from the anatomical chair of the College of Surgeons during the last year, he presented a condensed and philosophical history of the phenomena of death, in general, in which he elucidated many leading points that were before obscure, established several propositions that have long been considered doubtful, and rejected a mass of popular error, which, under the sanction of authority, has continued to retard our inquiries, and to embarrass and misguide our practice. The author of the present section of this work has to acknowledge the kindness and liberality by which he is enabled to avail himself of these luminous researches, having been furnished by his friend Mr. Brodie with the manuscript notes from which the lectures were delivered.
The organs more immediately necessary to life are, the Heart, which conveys to every part of the body that fluid, without a constant supply and change of which, vitality must be speedily exhausted; and the Lungs, by whose functions this essential fluid undergoes those unknown changes, from the action of the atmosphere, which adapt it for the performance of the important duties to which we have alluded.
In conformity with these views, the functions of the heart, and their connection with those of the lungs and brain, very naturally present themselves as the first objects of physiological inquiry; and there is certainly no discovery in modern times more interesting in its relations, and at the same time so useful in practical application, as that which has determined the nature of the connections between the functions of respiration and the motions of the heart; and shewn why the cessation of the former should occasion the destruction of the latter. The existence of this mysterious connection constituted a subject of interest and inquiry in the more remote ages, and it will not be unprofitable to take a review of the different theories which have been proposed for its explanation. Until the celebrated experiment[[13]] of Hook, it was supposed that the heart’s motion was maintained by the alternate contraction and dilatation of the lungs in the act of breathing; but the extraordinary philosopher above mentioned decided this point by exposing the thorax of a dog, and separating the pleura extensively from the external surface of the lungs, and then, by means of a pair of double bellows, keeping up a constant stream of air through the air cells; by this contrivance respiration was duly performed, while the lungs remained motionless, and yet it was found that the vigour of the heart’s action was not in the least impaired; whereas, if the theory which Hook undertook to refute, had been founded in truth, the heart, under such circumstances, must necessarily have become quiescent. Mr. Hunter[[14]] supposed the existence of a sympathy, or association, between the motions of the heart and lungs; and the same opinion appears to have been entertained by Dr. Currie[[15]]; Dr. Darwin[[16]] deduced the existence of this immediate connection from that general law of the animal œconomy, by which motions that are frequently repeated in succession acquire the power of recurring in the same order, independently of the original exciting cause; “it is thus,” says he, “that by the stimulus of the blood in the right chamber of the heart the lungs are induced to expand themselves.” Dr. Bostock[[17]], however, has very satisfactorily opposed this hypothesis, by observing that in the fœtus the heart commences its contractions immediately upon its formation, while the lungs remain perfectly at rest; and that when the animal leaves the uterus, the motion of the lungs commences, but the periods of the contraction of the diaphragm bear no determinate ratio to those of the systole of the heart.
It was long supposed that the cessation of respiration occasioned that of the heart’s motion, in consequence of the black blood not having sufficient power to stimulate its fibres; but does not the right side of the heart, which, under all circumstances, contains de-oxygenated blood, contract with a vigour equal to that of the left? It was reserved for Bichat to offer a true explanation of this phenomenon; he has very justly stated that, in consequence of the suspension of the respiratory function, the coronary vessels, by which the muscular structure of the heart is supplied, are compelled to carry black, instead of scarlet blood; a fact which in itself is quite adequate to explain the cause of the heart ceasing to contract; for the irritability of this, like that of every other muscle, can be alone maintained by duly oxygenized blood. But it remains to be shewn how the functions of the brain and nervous system stand related to those of the heart and lungs. Although the agency of nervous influence is necessarily involved in impenetrable obscurity, yet we shall not have much difficulty in proving, that the brain[[18]] is immediately necessary to life only because the muscles of respiration owe their action to its influence. M. Lallemand has published the history of a fœtus, in which the brain and spinal marrow were equally deficient, notwithstanding which, it even exceeded the usual size, the heart was perfect, and it was evident that the circulation had been properly performed; no sooner, however, was the monster born than it perished, because the diaphragm and other muscles of respiration were unable to perform their functions without the aid of nervous excitement; no air was therefore inhaled into the lungs, and in a few minutes the heart ceased to contract from the deficient supply of oxygenized blood. If the phrenic nerves of a quadruped be divided,[[19]] the motion of the diaphragm ceases, and the animal breathes by the motion of the ribs alone, panting and respiring with difficulty and distress. If the spinal marrow be divided below the origin of the phrenic nerves in the lower part of the neck, no interruption is given to the transmission of the nervous influence to the diaphragm, but the ribs now become motionless, and respiration is performed by the diaphragm only; if the spinal marrow be divided in the upper part of the neck, above the origin of the phrenic nerves, the nervous influence is neither transmitted to the diaphragm, nor to the muscles which produce the motion of the ribs, and respiration is entirely suspended; under these circumstances the heart continues to contract for some minutes, after which it ceases, as there is no supply of blood which has received the influence of the air, and, consequently, the muscular fibres of the heart lose their excitability, and the blood is no longer circulated; if, however, the lungs be artificially inflated, before the action of the heart has ceased, its motions are continued. The experiment may also be very satisfactorily varied in the following manner; apply a ligature to the carotid arteries in the neck, so as to prevent the occurrence of hemorrhage, and then decapitate the animal; if respiration be now artificially maintained, the heart will suffer no disturbance in its motions, but the circulation will be preserved for several hours in the body of the decapitated animal. In further illustration of this view of the subject, Mr. Brodie observes, that many reptiles which are capable of respiring by means of the skin, will survive the loss of the brain for so long a period, that the wound made by decapitation, becomes cicatrized, and death only takes place at last in consequence of inanition.—(Manuscript Notes.)
In farther illustration of these views, let us observe the mode in which death takes place in apoplexy, or in cases of pressure on the brain, whether occasioned by a depressed portion of bone, or by blood extravasated within the cranium. At first the patient is insensible to all external impressions, but the breathing is not affected; after an interval, however, the respiration becomes difficult and laborious, and the purple hue of the lips and cheeks, from the sub-cutaneous vessels, demonstrates that the blood is imperfectly oxygenized. The arterial action becomes more slow, in proportion only as the respiration is more difficult; and the pulse may even be distinguished at the wrist, after the breathing has altogether ceased; under such circumstances it is obvious that life might be protracted for several hours by artificial inflation of the lungs, but as no ultimate benefit could be derived from such an operation, its expediency may be fairly questioned.
Enough has been said to shew that the brain is not immediately necessary to the action of the heart; but Mr. Brodie has very justly observed that the general proposition thus established, must not lead us to the conclusion that the heart is therefore incapable of being affected by violent impressions on the nervous system; the fact is quite otherwise, for although the brain may be removed, and the circulation be nevertheless maintained by artificial respiration, yet an injury inflicted on the brain, of another kind, may be followed by those immediately fatal consequences which decapitation itself would not produce. Dr. Wilson Philip states that if the brain be violently crushed, the action of the heart is immediately stopped; and the fact is too notorious to be questioned, that a blow on the head is frequently succeeded by Syncope; there are but few circumstances, says Mr. Brodie, in the history of the animal œconomy which appears more remarkable than this fact, that an injury of a part which is not immediately essential to the heart’s action, should nevertheless, under certain circumstances, have the effect of occasioning its immediate cessation. The late researches of Le Gallois may perhaps receive farther elucidation from the above proposition; this physiologist has stated that if a wire be introduced into the Theca vertebralis, and be moved upward and downward, so as to destroy the texture of the spinal marrow, the action of the heart presently ceases; and he from thence advances to the conclusion, not only that the spinal marrow is necessary to the heart’s action, but that every part of the animal body derives its vital properties from it; from what I have observed, says Mr. Brodie (Manuscript Notes) in the repetition of the foregoing experiment, I should infer that the fact is correctly stated, as far as it relates to warm-blooded animals, but the conclusions are undoubtedly premature; and the history of the fœtus, as related by Lallemand, in which, notwithstanding the absence of the brain and spinal marrow, the child was even larger than usual, the heart perfect, and it was manifest that the circution had been duly performed, is in direct opposition to such a theory. We must here agree with Mr. Brodie, that such phenomena are quite incompatible with the doctrine in which the spinal marrow is supposed to be directly necessary to the existence of vitality in the system generally, and to the action of the heart in particular; and that we must therefore look for some other explanation of the effects which are produced by the destruction of the spinal marrow in warm-blooded quadrupeds.—May they not be explained by supposing them to be the effect of the shock which must necessarily attend the removal of the spinal marrow, which can never be effected with the facility that attends decapitation?
We have deemed it necessary to offer these few remarks upon the relations which subsist between the functions of the heart, lungs, and brain, in as much as the propositions which have been thus established respecting them, can alone lead to a correct pathology of those diseases, by which life is suddenly extinguished, or suggest a rational and effectual plan of treatment, in cases of suspended animation.
SYNCOPE:
In which the pulsations of the heart cease, before the action of the respiratory organs.
The heart may cease to beat either from organic lesions in its own structure, or in that of its vessels; or from being sympathetically affected by injuries in other parts[[20]]; or from the operation of certain poisons; or from a shock of the general nervous system, as experienced in paroxysms of certain passions.
In ordinary fainting it is evident that some slight and feeble motions of the heart still continue, although insufficient to produce a sensible pulsation in the more distant arteries; and where this has continued for an unusual period, and the respiration has been so obscure as to escape common observation, the phenomenon has been eagerly seized by the admirers of the marvellous, and credulity has attached to its history, under the name of Trance,[[21]] circumstances of extravagance and mystery, to which it can hardly be necessary to allude on the present occasion. But the motions of the heart may have ceased altogether, and in such cases it becomes a question, no less interesting to the practical physician than to the physiologist, whether they can ever be restored, and if so, we have to inquire under what limitation, as to time; under what circumstances; and by what means? The views which have been already offered respecting the pathology of Syncope will afford us considerable assistance in the solution of a problem, so intimately connected with inquiries of forensic importance. It would appear that where the heart has ceased to pulsate, in consequence of the cessation of respiration, it can never again be set in motion; but that where it has stopped from other causes, as from the operation of certain poisons, its muscular irritability not having been exhausted, its action may be occasionally revived. Where Syncope arises from hemorrhage, we shall find, on dissection, that the heart and its great vessels are either empty, or contain only a small quantity of blood in their cavities; but where Syncope arises from other causes, the heart is seen distended to an unusual magnitude, and the blood in the left auricle and ventricle is generally of a more or less florid colour, and has not the hue of venous blood; a circumstance which depends upon the pulsation of the heart ceasing before the function of respiration, and which is the very reverse of what happens in death from suffocation, as we shall hereafter explain.
Violent passions of the mind very commonly produce syncope, which has in some instances terminated in death; we are however inclined to believe that in fatal cases of this nature the persons must have laboured under some organic affection of the heart, or its vessels; Philip V. died suddenly on being told that the Spaniards had been defeated, and on opening the body, his heart was found ruptured.
Dr. Tissot relates also the case of the father of a numerous family, who having lost his wife whom he tenderly loved, was suddenly seized with laborious respiration, and died at the end of two days; when the lungs were found gorged with blood, and the heart ruptured. Now in both these cases, it is probable that the muscular structure of the heart had been softened by previous disease.[[22]] So in the case of Mr. John Hunter, whose life was suddenly extinguished by mental emotion, the valves of the heart had been long in a state of disease, and so well aware was he of the danger to which he was constantly exposed, that he had for some time previous to his death, been in the habit of retiring from all those situations, in which his passions were likely to be excited. It is said that the instances of death from sudden joy are more numerous than those from grief, probably because the effect of this latter passion is rather to retard than to accelerate the circulation; Sophocles, being desirous of proving that at an advanced age he was in full possession of his intellectual powers, composed a tragedy, was crowned, and died through joy; the same fate befel Philippides the comic writer; thus too the Lacedemonian Chilon expired in the embrace of his son who had borne away the prize at the Olympic games; and we read of Roman women who died in the same manner, upon seeing their sons return from the battles of Thrasymene and Cannæ. On the other hand, we might adduce much classical authority to shew that death has frequently been the sudden effect of grief.
Montaigne relates the case of a German, who after having performed great feats of valour, was killed at the siege of Osen; one of the general officers having desired to see the corpse of so gallant a man, was conducted to the body, when he instantly recognised the features of his own son, and died on the spot. The record of our own times will furnish us with an instance in which an actor of celebrity suddenly expired upon repeating a passage that contained a fancied allusion to the domestic affliction under which he was suffering.
Dr. Ozanam,[[23]] in illustration of the influence of pain and terror in producing sudden extinction of life, relates the case of a middle aged criminal, who having throughout evinced extreme weakness and depression, expired in his way to the scaffold, and was stiff before he arrived at the place of execution, which was about seven miles distant.
In such cases of sudden death, from the operation of violent mental emotions, we apprehend that dissection will frequently demonstrate the existence of previous disease in some of the organs immediately essential to life; and we shall hereafter have occasion to refer to the influence of the passions in hastening the fatal termination of a chronic disease; on the present occasion we introduce the following extremely interesting case, in confirmation of the position we are endeavouring to maintain; the case was originally published in the Transactions of the Physico-Medical Society of New York, by Dr. Valentine Mott; it afterwards appeared in the Journal Universel des Sciences Medicales, Avril, 1819; and lately it has found its way into the Medical Repository of this country. A robust and plethoric female, aged 22, long addicted to dissolute and intemperate habits, had complained for some time of slight and apparently rheumatic pains; but within a day or two of the fatal event, she had been deserted by a man to whom she was engaged in marriage; in consequence of which her mind became very deeply affected; after having supped on the preceding night, she retired to rest as usual, and in the morning was found dead in bed; she lay in a bent position on the left side; and was hence supposed at first to be in a profound sleep; neither the countenance nor the limbs were in the least distorted. On dissection the pericardium was found to contain ten ounces of coagulated blood, and two of serum; the heart on all sides being covered by it, was of ordinary volume, but much loaded with fat; at the summit of the aortic ventricle was discovered the breach from which the effused blood had issued; the parietes of the ventricle around the rupture were much thicker than in the natural state, and on close examination a very sensible fluctuation was distinguished, to the extent of an inch on one side of it, from which flocculi of a cheese-like substance were discharged on pressure; the pericardium also presented traces of inflammation.
We have here then a case in which a morbid change in the structure of the heart had existed for a considerable period, and which was suddenly brought to a fatal termination by an affection of the mind.
Before we quit the consideration of Syncope, we have to notice a fatal variety of that disease, which well deserves the attentive consideration of the forensic Physician, whose highest duty, let it be remembered, is the investigation of sudden death. It is described by Mr. Chevalier[[24]] under the term Asphyxia Idiopathica, in which the patient suddenly faints and dies; the essential circumstances of the disease evidently denote, says Mr. Chevalier, a sudden loss of power in the extreme vessels to propel the blood; in consequence of which the heart after having contracted, so as to empty itself, and then dilated again, continues relaxed for want of the return of its accustomed stimulus, and dies in that dilated state. On dissection all the cavities of the heart are found completely empty, and the viscus itself in a state of extreme flaccidity.
SUFFOCATION.
Suffocation may be defined, the destruction of life by the suspension of the function of respiration, occasioned by external violence. Unless we add “by external violence” we shall perceive that the definition would be far too comprehensive; and the term Suffocation would be made to embrace a much wider range of subjects than its popular acceptation would allow. If the physiological views be correct which we have adopted and explained in the foregoing section, “On the causes and phenomena of sudden death,” we should be compelled, without such a protecting adjunct, to include under the history of Suffocation, not only the phenomena of Drowning, Strangling, Hanging, Smothering, and noxious inhalation, but even those of Apoplexy, fatal Intoxication, and various diseases of the brain and spinal marrow, together with the effects of a great proportion of Poisons; for by such agents death is undoubtedly occasioned through the failure of the respiratory functions.
In Death from Suffocation the heart continues to pulsate for several minutes after the breathing has entirely ceased, in consequence of which the blood which passes through the pulmonary vessels no longer receives the influence of oxygen, and therefore black blood circulates; the brain, it would appear, soon feels the want of the florid arterial stream, by which alone its energies can be maintained. Bichat has shewn that when dark coloured blood is injected into the vessels of the brain, by means of a syringe connected with the carotid artery, the functions of the brain become immediately disturbed, and, in a short time, entirely cease; the effect is precisely similar, whether the dark coloured blood be transmitted to the brain by the syringe of the experimentalist, or by the heart itself. It is not until after the full effects of the suspended respiration are thus produced on the brain, that the motions of the heart become enfeebled, and that the ventricles contract less powerfully, and at longer intervals; at length, the action of the heart is altogether arrested, and if the thorax be examined at the instant that the circulation has ceased, nothing is observed, except a slight tremulous motion of the auricles; the cavities of the left side are much contracted, and contain only a small quantity of blood, while the right auricle and ventricle, and the large vessels communicating with them, are distended to an unusual size. This state of the heart, it will be observed, is very different from that which we have described as constantly occurring after Syncope. In the contemplation of these phœnomena, a question very naturally suggests itself in regard to the probable interval which elapses between the cessation of respiration, and the consequent failure of the heart’s action; in other words, it may be asked, how long can the heart support its contractions without the aid of respiration? It would appear that this interval not only varies in duration in different animals, but even in the same animal under different circumstances, such as that of age,[[25]] capacity of the thorax, quantity of air in the lungs, state of the stomach, and general vigour of the animal; but in man, under the most favourable circumstances, it is extremely doubtful whether the heart ever continues to pulsate for so long a period as five minutes[[26]] after the lungs have ceased to perform their office; and it is very questionable whether, in most instances, the interval is not considerably shorter than this.
BY DROWNING.
It was formerly believed that Asphyxia[[27]] from drowning, always depended upon the lungs and intestinal canal being filled with water;[[28]] whereas it is hardly necessary to observe that it alone depends upon the blood, in consequence of the suspension of breathing, ceasing to possess the qualities which are essential to the preservation of life. M. Gauteron immersed a dog for more than a quarter of an hour, without inflicting the least injury, having previously inserted a long tube in the trachea, which was kept elevated during the experiment above the surface of the water.
If a small animal be immersed in water, contained in a transparent glass vessel, the phenomena of drowning are readily discernible; there is first a deep expiration, by which bubbles of air are expelled from the lungs; there is then an effort to inspire, but the effort is ineffectual; there being no air which can be received into the lungs, and a spasm of the muscles of the glottis seems to forbid the admission of any considerable quantity of water into the trachea. The attempts to breathe are repeated several times, and at each attempt at expiration a small proportion of air is expelled from the mouth and nostrils, until the air-cells of the lungs are almost emptied;[[29]] then the animal becomes insensible; and convulsive action of the voluntary muscles mark the instant when the brain begins to suffer from the influx of the dark coloured venous blood. After the cessation of these convulsive actions, the animal becomes motionless, and gives no sign of life; but if the hand be applied to the thorax, the actions of the heart, gradually becoming fainter and fainter, indicate that some remains of vitality still linger in the system. Before the circulation of the blood altogether ceases, the muscles of respiration once more resume their actions, and ineffectual efforts are made to breathe. It is a remarkable circumstance that the diaphragm continues to exert itself nearly as long as the heart itself, and that the interval between the cessation of the motions of the diaphragm and that of the motions of the heart, which is so short in animals that die by strangulation, is still shorter in those who perish by drowning.[[30]] These phenomena follow each other in rapid succession, and the whole scene is closed, and the living animal is converted into a lifeless corpse, incapable of recovery, in the brief space of a few moments, (Brodie’s Manuscript Notes). If however the animal be taken out of the water before the total extinction of life, and the diaphragm contract afterwards, so as to draw air into the lungs before the action of the heart has ceased, the circulation is maintained, and the animal continues to respire; he will thus have escaped immediate death from suffocation; but his life still remains in jeopardy, for there is a second period of danger, and one at which death may take place, when we are the least prepared to expect it; for the dark coloured blood which has been transmitted through the circulatory system, during the suspension of respiration, would seem to act like a narcotic poison upon the brain; no sooner therefore does it enter that organ, but deleterious effects are produced, the animal at first falls into a state of stupor, the pupils of the eyes become dilated, the respiration laborious, the muscles of the body convulsed, and the animal dies, poisoned by its own blood.
The body of a person who has died from drowning exhibits a physiognomy which it is important to notice. The whole surface is distinguished by a remarkable coldness and pallor; the eyes are half open, and their pupils considerably dilated; the tongue is pushed forward to the internal edges of the lips, and sometimes wounded; and the mouth and nostrils are covered with foam. At other times, instead of a pallid visage, we have one that is swelled, and bloated with livid blood.
Upon dissection we shall perceive the vessels of the brain more or less gorged with blood;[[31]] in the trachea a watery and bloody froth will be found; the lungs will appear expanded, full of frothy mucus, and, generally, livid; the right cavities of the heart gorged with blood, the left nearly empty; and it has been sometimes noticed that the blood remains fluid[[32]], and follows after every incision by the scalpel. The stomach will generally be found to contain some water. Hebenstreit also states, that since in the act of drowning the person dies on an inspiration, the diaphragm is necessarily found convex, or bent towards the abdomen; this statement however is erroneous.
Upon these appearances we have a few observations to offer, especially as they have given origin to some important questions; and first, with respect to the presence of water in the stomach and lungs, than which few indications, connected with the subject of drowning, have given occasion to greater controversy.[[33]] For since it hath been observed that water is rarely found in the stomach or lungs of a person who has been submerged after death, it was inferred that the presence of that fluid in these organs necessarily proved that the individual must have been plunged into the water during life. As a general proposition this may be admitted as correct, although it is liable to certain exceptions with which the medical jurist ought to be acquainted; we may, for instance, suppose a case, in which the submerged person may be so plunged at once under water, as to have been suffocated without his previously coming to the surface, and when asphyxia has taken place, the powers of deglutition, on which the presence of water in the stomach wholly depends, are at an end; or we may suppose that the party in question faints from terror; a remarkable instance of this kind is quoted by Foderè,[[34]] from Plater, of a young woman, who having been condemned to be drowned for infanticide, fainted at the moment she was plunged in the water, and having remained for a quarter of an hour under its surface, recovered after being drawn out.[[35]]
With respect to the presence of water in the bronchiæ and lungs, we may observe that, in the violent struggles of a drowning man, a certain portion of water generally passes the epiglottis; and being immediately mixed with the air and mucus of the trachea, constitutes that frothy mucus, which we have described as being so highly characteristic of this species of violent death; although we are not to conclude with Larrey, that it is the immediate cause of dissolution in such cases. The quantity of water, however, thus forced into the pulmonary structure, is extremely small, for its entrance is powerfully opposed by a spasm of the muscles of the glottis;[[36]] were it to occur in any considerable quantity, and to appear in its fluid state, instead of that of froth, the influence would clearly be, that it had passed in after death.
Although the presence of this frothy matter must be considered as a strong presumptive proof that the person found in the water had perished by drowning, the converse of this proposition is by no means established by the absence of such an indication.
The buoyancy of the human body is another point in the history of Drowning, which has occasioned much discussion; and in solving the problem, so highly important in its forensic relations, whether a body found in the water, had been drowned, or thrown in after death, it has been considered by some physiologists as capable of affording a certain degree of presumptive evidence, although we are inclined to attach but little or no importance to such an indication. The specific gravity of the human body, under ordinary circumstances, is very little greater than that of fresh water, so small indeed is the difference that, when the lungs are inflated, a man will float[[37]] with little or no effort, if he have sufficient self possession, and does not attempt to raise too great a portion of his body out of the sustaining fluid;[[38]] but, when the air of the lungs is expelled, and probably, at the same time, a certain quantity of water is taken into the stomach,[[39]] the body becomes specifically heavier, and the victim sinks. It may be assumed as a general rule, that no newly drowned body floats, although many facts have been adduced in support of a contrary opinion; the naval custom of loading the dead bodies with weights, before they are consigned to a watery grave, is not for the purpose of sinking the corpse, but for preventing its rising after the process of putrefaction has commenced. The period during which a body will remain at the bottom cannot be very accurately determined, as the change does not take place until a sufficient quantity of air be generated to buoy it again to the surface; in the melancholy instance of the loss of the Royal George, the dead bodies were observed ascending to the surface of the sea, on or about the fifth day. The general position of a body which has thus risen, provided there be no external or adventitious circumstances to change it, is such, that it floats nearly immersed, the face, arms, and legs hanging downwards, and the loins being uppermost; this is the form which the body must mechanically and hydrostatically assume, if the sustaining power of generated air be, as it generally will, in the cavity of the abdomen, where putrefaction is more likely to commence; for the head and limbs are generally[[40]] specifically heavier than water, while the trunk, especially if inflated with air, is somewhat lighter.
It has been said that a position, different from that which we have just described, will take place where the person has been strangled, and the body then thrown into the water; for in this latter case, it is contended, that the lungs will be distended with air, and that consequently, the sustaining power must be in the thorax; in support of this opinion the story of the appearance of Caraccioli[[41]], Admiral of the Neapolitan navy, has been ingeniously adduced; this unfortunate man was hanged in pursuance of the sentence of a court martial, and his body was committed to the deep in the usual manner; thirteen days after which, while the King of Sicily was walking on the deck of Lord Nelson’s ship, he suddenly exclaimed with a yell of horror—“Vien! Viene!”—The Admiral’s corpse, breast high, was seen floating towards the ship; the shot that had been attached to the feet for the purpose of sinking it, not being sufficiently heavy. This may perhaps be explained by supposing that the corpse was stiff before it was immersed, in which case, the centre of gravity being exceedingly low on account of the shot tied to the feet, he must have floated upright, wherever the buoyant power from generated air might be situated. At all events, we feel no hesitation in at once rejecting the proposition, for the support of which it has been brought forward; the fact is that, in relation to gaseous contents, the lungs are the same in strangled, as in drowned persons; for in both cases a quantity of air is forcibly expelled from them before dissolution.
2. BY HANGING:
The suspension of a person by means of a cord, or some other ligature, round the neck, by which death is produced by closing the trachea, and preventing respiration.
Although we are in this case bound to admit that the immediate cause of death is suffocation, yet we cannot deny that other injuries are often produced by hanging, such as
1. Pressure on the vessels.
2. Pressure on the nerves.
3. Fracture of the spine, and dislocation of the odontoid process.
1. Pressure on the Vessels.—The red and livid hue of the face of persons killed by hanging, very naturally induced a belief that Apoplexy[[42]] was the immediate cause of death; while it is evident that the pressure on the jugular veins must necessarily so prevent the return of blood to the heart, as to produce an accumulation in the vessels of the brain: Dr. Hooper has a preparation of the brain of an executed criminal, in which blood is seen extravasated among the membranes; and various other cases have occurred, where dissection has clearly demonstrated the existence of those vascular congestions and sanguineous effusions, upon which apoplexy is supposed to depend; but this merely goes to prove that apoplexy occasionally takes place from hanging; it does not establish the fact of its being the common cause of death on such occasions.[[43]] Gregory made the following experiment to shew that it is to the interception of air that death is to be attributed; after having opened the trachea of a dog he passed a slip knot round the neck, above the wound; the animal, though hanged, continued to live and respire, the air was alternately admitted and easily expelled through the small opening; but as soon as the constriction was made below the orifice, the animal perished. Mr. Brodie hanged a dog, and as soon as it became insensible, the trachea was opened below the ligature, upon which he breathed, and his sensibility returned.
2. Pressure on the Nerves of the Neck. Although the pressure of a ligature on the nerves of the neck cannot be considered as the immediate cause of death in hanging, yet Mr. Brodie has very justly observed, that if the animal recovers of the direct consequence of the strangulation, he may probably suffer from the effects of the ligature upon the nerves afterwards. Mr. Brodie passed a ligature under the trachea of a Guinea pig, and tied it tight on the back of the neck with a knot; the animal was uneasy, but nevertheless breathed and moved about; at the end of fifteen minutes the ligature was removed; on the following morning, however, the animal was found dead. On dissection no preternatural appearances were discovered in the brain, but the lungs were dark and turgid with blood, and presented an appearance similar to that which is observed after the division of the nerves of the eighth pair; I do not, observes Mr. Brodie (Manuscript Notes) positively conclude from this experiment that the animal died from an injury inflicted upon the nerves of the eighth pair, but I think that such a conclusion is highly probable; and it becomes an object of inquiry whether a patient having recovered from hanging, may not, in some instances, die afterwards from the injury of the par vagum.
3. Fracture of the Spine, and Dislocation of the Neck. The death of a hanged person may occasionally take place by the luxation of the cervical vertebræ, and the consequent injury of the spinal marrow; this effect will be more likely to happen in heavy persons, and where the culprit suffers on a drop that precipitates him from a considerable height. It is said that Louis discovered that of the two executioners in Paris and Lyons, one dispatched the criminal condemned to be hanged by luxating the head on the neck, whilst those who perished by the hands of the other were completely strangled.
An animal, when first suspended, is observed to make repeated but ineffectual attempts to inspire; violent convulsions of the whole body then ensue, but which are not to be considered as the indications of suffering, for they arise in consequence of the dark coloured blood having reached the brain and spinal marrow; and the animal at this period is necessarily insensible; hanging does not occasion a painful death.[[44]]
The lips, nose, and all those parts in which the hue of the blood can be observed, exhibit a dark colour; the countenance is distorted, the eyes protruded, and frequently suffused with blood, the tongue is also forced out of the mouth, and sometimes wounded, although it has been observed that this phenomenon will entirely depend upon the position of the rope, for that when it presses above the thyroid gland the tongue will be pushed back, in consequence of a compression upon the os hyoides, whereas if the pressure be applied under the cricoid cartilage it will have the effect of thrusting out the tongue. Blood is sometimes discharged from the ears. It is not unusual for the sufferer to void his urine, fæces, and even semen, in articulo mortis. The fingers are usually bent, the nails blue, and the hands nearly closed; and the whole physiognomy exhibits a highly characteristic appearance.
“But see, his face is black and full of blood,
His eye-balls further out than when he lived,
Staring full ghastly, like a strangled man,
His hair uprear’d, his nostrils stretch’d with struggling,
His hands abroad display’d, as one that grasp’d
And tugg’d for life, and was by strength subdu’d.”
Henry VI, Part ii, Act iii, s. 2.
The dissection of a hanged person exhibits the same phenomena as those described under the history of drowning, with the exception of the absence of water in the bronchiæ. With respect to the quantity of air found in the lungs, much discrepancy of opinion has existed. Dr. Goodwyn, in his experiments on respiration, found that the lungs of a person who had died from hanging, contained double the quantity of gaseous contents of those who had died a natural death. This result, however, is certainly not correct; for there is always, as we have already stated, a very forcible expulsion of air from the lungs in the act of strangulation, and they are accordingly found almost empty after death. Mr. Coleman hanged an animal, and then secured the trachea by a ligature, and removed the lungs; when, upon receiving their gaseous contents in the hydro-pneumatic apparatus, he found their quantity was very far less than that which would have been collected under other circumstances.
3. BY MANUAL STRANGULATION.
Whether strangulation be induced by the suspension of the body by the neck, or by a ligature drawn tight, or by any other pressure upon the trachea, the physiological phenomena of death are the same; where, however, the person has died from manual strangulation, the marks about the neck will probably be more evident, and the discolouration will correspond with the marks of the fingers and nails; and we may also expect to find traces of violence upon the chest, for since the weight of the body is not obtained in such a case, additional force becomes necessary to consummate the fatal act. On opening the bodies of those who have been taken off by manual strangulation, Dr. Smith thinks that the usual appearances of this kind of death may not seem so conclusive as in other cases: an opinion in which we feel inclined to coincide; for in consequence of the greater resistance of the sufferer, the functions of respiration and circulation may continue in some measure for a longer period than in drowning or hanging, which must be considered as more summary processes of suffocation. In the case of a woman who had been thus strangled by two men, Littre found the tympanum of the left ear lacerated, whence flowed about an ounce of blood; the vessels of the brain were unusually turgid, red blood was extravasated in the ventricles, as well as at the base of the cranium; the lungs were distended and their membrane vascular; not more, however, than an ounce of blood was found in the right ventricle of the heart, and it was fluid and frothy, like that in the lungs; this circumstance deserves particular notice, and can only be explained by supposing that the respiration and circulation were not at once arrested, but that the unhappy sufferer was enabled to inhale air, at intervals, during the protracted struggle[[45]]; and yet in certain cases, death may be very easily occasioned by manual strangulation, of which the murder of Dr. Clench, in the year 1692, may be adduced as an example; this gentleman was strangled in a hackney coach by two men, while driving about the streets of the city, without the coachman having the slightest knowledge of the transaction, until he afterwards found him quite dead, kneeling down with his head on the seat, and a handkerchief bound about his neck, in which was a piece of coal, placed just over the windpipe.[[46]]
4. BY SMOTHERING.
In this act the transit of the air into the lungs is prevented by forcibly closing the nostrils and mouth. It is very obvious that such a mode of destruction can very rarely occur in an adult; for a comparatively feeble resistance will be sufficient to overcome the assailant in such an attempt. It may, however, occur accidentally; it is not difficult to imagine that a person, in a fit of intoxication, may be unable to extricate himself from a position in which he might fall, and in which respiration could not be performed. In children this mode of suffocation is less rare, and it may be either the result of design or accident, to which we shall have occasion to refer, when treating the subject of Infanticide.
5. BY THE INHALATION OF AIR DEPRIVED OF OXYGEN.
There are many gases, the inspiration of which occasions death; some of these act simply by excluding oxygen, while others exert an absolutely deleterious action in consequence of the specific powers which they possess. It is exclusively to the first species that our attention is at present to be directed; the latter will constitute matter for future consideration, under the title of Aërial Poisons.
It is a fact too well established to require any discussion, that oxygen is the only principle which is capable of producing the necessary changes in the blood, during its transmission through the lungs; and that, accordingly, whenever atmospheric air is deprived of this principle, it is no longer capable of supporting life, and the animal immersed in it instantly dies. It is thus that death takes place from exposure to the fumes of charcoal[[47]], to those of lime-kilns, to the atmosphere of cellars, caverns, wells, and dungeons.[[48]]
The asphyxia from privies, drains, and common sewers, depends upon a different cause, and will be considered under the head of Sulphuretted Hydrogen, in the history of poisons.
The fatal effects of confined air in a small and crowded room, were fully exemplified in the year 1742, when twenty persons were crammed in a part of St. Martin’s round-house called the hole, during the night, several of whom died; the surgeons on that occasion gave it as their opinion, that when the doors and windows were shut, the place could not support twenty persons for three hours without danger of their lives. A trial took place at the Old Bailey in consequence; but we have not been more successful than Dr. Gordon Smith in our search for its report. The medical jurist would be called upon, on such an occasion, for his opinion as to the nature of the deteriorated air, the causes of its accumulation, and whether it was adequate to the production of the alleged effects; and possibly, whether the fatal consequences might not have been averted by judicious caution, or active exertion. The most awful exemplification of the fatal effects of confined air is, however, recorded in the interesting narrative of what happened to the English in the black hole at Calcutta; and which we shall briefly relate in this place; as it involves some physiological phenomena to which we shall hereafter have occasion to refer.
It was in the month of June, 1756, that the Viceroy of Bengal laid siege to Fort William, the English factory at Calcutta. Mr. Holwell, assisted by the factors and the garrison, defended this post with extreme bravery; but was at length obliged to surrender. There were at this time remaining in the fort, an hundred and forty-five men and one woman. The whole of this unfortunate company, many of whom were wounded, and several very dangerously, were shut up the same night in a small prison only eighteen feet square. This prison, which is now better known in England by the name of the black hole, was enclosed by strong walls, and had only two small windows at one end, secured by iron grates. In this confined situation, which allowed only a space of about eighteen square inches to each individual, the heat and want of fresh air soon excited the most horrible effects; the prisoners, in a state of despair, began by attempting to force open the door, but in this they were unsuccessful. Mr. Holwell, who was placed near one of the windows, was more at his ease than the rest, and was consequently more cool and tranquil; and he recommended his companions to be quiet and orderly, and not to exhaust their strength by useless efforts. This advice produced some little calm, interrupted, however, by the groans of the wounded and the dying. The heat increased every moment. Mr. Holwell recommended them to strip off their cloaths, as a means of acquiring more space; this was accordingly done, but with no great relief; they attempted to improve this by fanning the air with their hats, but even this was too painful a task for men who were worn out by the fatigue of the siege, and the heat of this dungeon. Another of the company was for their kneeling down, that they might have more air. They all readily agreed to do this; and to rise together in order to avoid confusion. This was done several times, but every time the signal was given to rise, the number of those who had strength enough to obey it diminished. There were constantly some remaining on the floor, who were unable to get up, and these were trodden to death by the survivors. All this happened during the first hour of their imprisonment. At nine o’clock in the evening they began to complain of excessive thirst, and to renew their efforts to open the prison door, and to tempt the centinels to fire upon them. Some of those who were farthest from the window became at once furiously delirious. The cry for water was unanimous. The guards brought water, and Holwell and two of his wounded friends received it at the window in their hats, and were going to pass it on to the rest; but so eager and tumultuous were the efforts of the crowd to get at this water, that Holwell’s two friends were suffocated, the water was spilt, and Holwell saw himself surrounded with dead bodies, who had either been crushed to death, or died for want of fresh air.
Hitherto the commander and benefactor of these unfortunate people, had been treated with some degree of respect, but now all distinction began to be forgotten; the whole company eagerly threw themselves towards the windows, and seizing the iron bars, some of them got even upon his shoulders. He was so borne down by this enormous weight, as to be deprived of all power of motion; he implored the pity of those who were upon his head and his shoulders, and requested them to let him go and die at the bottom of the prison; this request was readily complied with, every one was desirous of succeeding to his place, and without much difficulty he reached the farther end of the dungeon. The third part of these unhappy people were already dead, and they who were still alive pressed so eagerly towards the windows, that Holwell found himself somewhat freer in his new station; but the air was so corrupted, that his breathing soon became extremely difficult and painful. Unable therefore to support this, he attempted once more to make his way to the windows; and leaning on a heap of dead bodies, he now resolved to wait patiently for death. In this situation he remained about ten minutes, and then he experienced such a pain of the breast, and so violent a palpitation of the heart, that he was obliged to make one more attempt towards getting a less fatal air. There were five rows of his companions between himself and the window; his despair carried him through four of these. The palpitation of his heart now began to abate, but he felt inexpressible thirst, and cried out for water; but the water seemed to increase instead of alleviating his thirst; he therefore resolved to drink no more, and rather chose to suck the moisture from his shirt, which seemed to afford him some relief. A young man quite naked, who stood before him, eagerly seized the sleeve of his shirt, and for some moments deprived him of this salutary refreshment. It was not yet midnight. The small number of those who were left, were transported to the greatest excess of rage and despair. They all called aloud for air, because the water that had been brought to them afforded no relief. Soon after this the noise suddenly ceased. The greater part who were living laid themselves down, deprived of all their strength, and peaceably breathed their last. Others aimed at getting into Holwell’s situation; a Dutchman mounted on one of his shoulders, and a black soldier on the other. In this situation he remained till two in the morning, when he gave up his place to a marine officer, who was soon forced out of it by the Dutchman. The officer retired with Holwell to the other corner of the prison, and in a few moments afterwards died. Holwell himself was soon deprived of sense, and from that time till sun rise we have no account of what passed. One of those who remained alive, at five in the morning, drew forth Holwell from the heap of dead, and found in him some signs of life; about that time the Viceroy inquired whether he was still alive; he was told, that if the door was immediately opened, it would, perhaps, be possible to recover him, and orders were accordingly given for this purpose. But the door of the prison opened inwards, and they who were within it, and living, were deprived of all their strength, so that more than twenty minutes elapsed before the dead bodies were removed, which prevented the door from being opened.
At a quarter after six o’clock, there came out of this melancholy dungeon three and twenty persons, the remains of the hundred and forty-six who had entered it on the preceding evening.
Upon the events thus related we have to remark, that no advice could be more judicious than that given by Holwell to his companions in the early part of their imprisonment—“to be quiet and orderly, and not to exhaust their strength by useless efforts.” Nor can we imagine any measure more calculated to increase the sufferings of their situation than that which was subsequently proposed, and adopted, by another of the company, “to fan the air with their hats, and to kneel down and rise together, by a simultaneous motion.” It has been satisfactorily established by physiological researches, that the demand for oxygen, in an animal body, will be in proportion to its expenditure by muscular exertions.[[49]] Whenever, therefore, circumstances may render a supply of air deficient, we shall best economise that which we possess by perfect quiet. Lavoisier says, that a man, under ordinary circumstances, consumes 1300 or 1400 cubic inches of oxygen in an hour, but he found that if he is engaged in raising weights the consumption is at the rate of 3200 in the hour.
Infants appear to be less able to sustain the deprivation of oxygen than adults; and in some cases on record, life has been destroyed by circumstances that we should have a priori considered as hardly adequate to such an effect. A case is related of a child, who was suffocated by some drunken men having repeatedly blown out a candle, and held the smoaking wick under its nose. The faculty of Leipsic investigated the circumstances, and declared the death to have taken place in consequence of suffocation. (Valentini Pand: Med: Legal: Sect: 2.)
6. BY OTHER MODES, NOT INCLUDED IN THE FOREGOING SECTIONS.
We have already stated that if the muscles of respiration be paralysed, the animal can no longer breathe; and it dies in a state of suffocation. There are several mechanical modes by which such a condition may be produced; a person buried in a heap of ruins, although his head should be free, will perish from the pressure of the surrounding rubbish preventing the due action of the respiratory muscles. It was in this way that criminals who obstinately refused to plead, often died under the pressure of the weights that were heaped upon their bodies.[[50]].
There is a mode of suffocation, described by Galen, as being practised by the slaves when brought into the presence of the judges or executioners; it consisted in swallowing their tongue, by which it is said they voluntarily terminated their own existence. Several more modern authors have noticed this incredible mode of suicide, as one that is resorted to by negroes: now to confute such an idea, we have only to shew the attachment of the muscles of this part, and the motions which they permit; equally absurd is it to suppose with other physiologists, that persons can occasion suffocation by a voluntary suspension of their breathing; for if such an attempt were even made, the effort would be ended when self-possession was once lost, for then the impulse of nature must instantly triumph over any struggle to oppose it. We are not, however, prepared to say that such an attempt might not, in certain cases, occasion such a cerebral congestion as to produce apoplexy.
The last cause of suffocation which we have to mention is mechanical obstruction, from the entrance of foreign bodies into the aperture of the glottis; instances of this kind are too numerous and familiar to require many observations: it is thus that Anacreon is said to have perished from a grape-seed; Gilbert, the poet, terminated his existence in a similar manner; he was a man of great appetite, and in the midst of a festival went into a neighbouring room, but did not return to the great surprise of his convivial companions. He was found stretched on a couch without any signs of life. The assistance administered by his kind but uninformed friends was useless; on opening the body a small piece of mutton was found, that had stopped at the entrance of the larynx, and completely prevented the passage of air into this organ. In Oct. 1821, two inquisitions were taken at Mildenhall, before the Coroner of Bury St. Edmonds in Suffolk; in the one case it appeared that John Harris had eaten some honey, from the honey-comb, and that a bee, having been concealed in it, entered the glottis, and occasioned almost immediate death by suffocation; the other case was that of an infant, Mary Bacon, who fell with her face upon a quantity of slacked lime, when a particle of it getting into the wind-pipe, produced inflammation of the lungs, and sloughing of the trachea, of which she died. We have no doubt but that persons, during the state of intoxication, or that of a spasmodic paroxysm, have often perished from suffocation, when the death has been attributed to other causes; if the stomach should reject its contents during a state of insensibility[[51]], such an occurrence is by no means unlikely. We have lately received the history of a case of this description, which occurred in the St. James’s workhouse, and fell under the particular notice of Mr. Alcock. The patient was seized after a hearty meal of pork with an epileptic fit, during which he died; when upon opening the trachea, it was found to contain a quantity of animal matter resembling the pork upon which he had recently dined.
8. DEATH BY EXPOSURE TO COLD.
That an animal must perish as soon as the temperature of the medium in which it lives ceases to preserve the blood in a state of fluidity, is one of those self-evident propositions which scarcely requires notice, much less explanation; but that a degree of cold not sufficiently intense to occasion any physical changes upon the constituent parts of the body should extinguish its vitality is a fact, whose history involves some of the most interesting questions of physiology.
The degree of cold, necessary for the production of its fatal effects, varies in a very remarkable degree with the strength and circumstances of the individual to whom it is applied, as well as with the rapidity of the cooling process. In some instances we find that man has endured an extreme degree of cold with but little inconvenience, whilst in other cases, we see him perishing from it in a temperature at which water even retains its fluidity. The interesting history of Sir Joseph Bankes (at that time Mr. Bankes), Dr. Solander, and eleven others, on a botanical excursion to the mountains of Terra del Fuego; and more recently, the narrative of our enterprizing countrymen, in their voyage to the Polar seas, will furnish a good illustration of the former fact, whilst the melancholy fate of the Cambridge student, as hereafter explained, affords a curious and instructive example of the latter. Animal heat, as Mr. Brodie observes, is in some way or other dependant upon the integrity of the functions of the Nervous System; and consequently the absolute degree of cold which an animal can bear with impunity will, cæteris paribus, be determined by his powers of producing heat; we must therefore cease to regard the fact as extraordinary, that an animal, which is under the influence of a deleterious narcotic poison, or in whom, from any other morbid cause, the powers of the nervous system are exhausted, may be destroyed by a diminished temperature, that would scarcely affect even the sensations of one, differently placed in relation to his nervous energy; thus it is with a person in the last stage of intoxication, in whom the powers of life are ebbing, in consequence of the previous state of morbid excitement; in the course of the last winter, two instances occurred of drunken persons being taken to the watch-house; where, there not being any charge against them, they were dismissed by the constable of the night, and perished in the streets. A military friend has lately communicated to us an instance, where out of a great number of troops who were exposed to intense cold, the only one who perished was under the influence of intoxication; and we learn from Le Baume’s interesting account of the campaign in Russia, that similar results were observed during the disastrous retreat of the French army on that memorable occasion.
In our own country scarcely a winter passes without the occurrence of some event equally illustrative of this physiological fact; and it is highly important that the medical jurist should be able to appreciate its influence; those who perish in this manner are generally individuals of the most wretched condition, and will be found to have undergone much suffering and privation; by which their nervous energy had been too much exhausted to generate sufficient heat to counteract the diminished temperature of the atmosphere; an event of this nature occurred in London during the winter of 1819, when a man and his wife, aged persons, and poor, but not supposed, nor indeed proved to have been quite destitute, were found dead in their apartment, although food was discovered in the room, and money was in the pocket of the man: the night (28th of December) had been inclement, and there was neither bed nor fire in the miserable couple’s apartment. It appeared in evidence that they had been previously ailing. The verdict recorded that they had perished from the inclemency of the weather, in consequence of the destitute circumstances under which they were found.
It would seem that persons who are long exposed to intense cold do not suffer a painful death; they gradually lose their sensibility, become drowsy, and die as if through the effects of an opiate. Mr. Brodie[[52]] classes the effects of cold in the following order.
1. It lessens the irritability, and impairs the functions of the whole nervous system.
2. It impairs the contractile powers of the muscles.
3. It causes contraction of the capillaries, and thus lessens the superficial circulation, and stops the cutaneous secretion.
4. It probably destroys the principle of vitality, equally in every part, and does not exclusively disturb the functions of any particular organ.
These positions have been confirmed by experiment. Dr. Chassat states that in an animal immersed in a cold bath, death may take place at 79° Fahr. (26 Centig.), although it may be sometimes cooled down as low as 69° (17 Cent.) before it dies; but, cæteris paribus, the animal dies sooner as the cooling is more rapid.
M. Portal thinks that cold produces death by inducing apoplexy, and remarks that the examination of the bodies of persons who have died from cold, proves the presence of sanguineous congestions in the vessels and cavities of the body, and especially in those of the brain. Dr. Cooke, however, has remarked that “M. Portal’s notions on this subject seem to want confirmation. Excessive cold undoubtedly produces, first drowsiness and afterwards a profound sleep, in which the unfortunate individual generally perishes; but we have not on record a sufficient number of cases with particular descriptions of symptoms and appearances on dissection, to enable us to say positively that cold kills by apoplexy.”
After death the blood is generally florid in the aorta, so that the animal does not die of suffocation; the heart sometimes contracts feebly after the muscular irritability of the limbs and intestines are nearly destroyed; the cerebral veins contain but little blood; the ventricles contain a small portion of fluid. Mr. Brodie’s experiments coincide in most respects with those of Dr. Chassat, who uniformly found after death, the heart much distended with blood, as in Syncope, scarlet blood occupying the left side; and he also found that the heart ceased to contract before the diaphragm, so that he has seen the animal insensible, and gasp for breath, even after the chest was opened and the heart excised! The muscles were unusually florid, and the peristaltic motions of the intestines were generally observed to continue longer than the action of the heart. The voluntary muscles, he says, lose their irritability in different degrees, those of the legs before those of the thighs, and those of the thighs before the abdominal muscles.
DEATH BY THE AGENCY OF HEAT.
We have not yet a sufficient number of well reported experiments on the effects of heat on animals, to enable us to draw any satisfactory conclusions respecting the mode in which life is destroyed by this agent; although it seems probable that it acts by destroying the muscular energy of the heart and diaphragm.[[53]]
Mr. Brodie placed a rabit in a basket in an oven, the temperature of which was not more that 150°, and it died in a few minutes without any apparent suffering; the heart was afterwards found distended with blood, on both sides, as in Syncope.
DEATH BY LIGHTNING.
It has been incontrovertibly established by the experiments of modern philosophers, that the phœnomena of electricity are identical with those of thunder and lightning. The human body is alike affected by both; and death, whether it be occasioned by the discharge of an electrical battery, or by that of a thunder cloud, exhibits effects precisely analogous.
Mr. Hunter supposed that when death is thus occasioned, there is an instantaneous and entire annihilation of the vital principle, in every part of the animal machine; and that the muscles are therefore relaxed, and incapable of contraction, that the limbs do not stiffen[[54]], as in other cases of death, nor the blood coagulate, and that the body very speedily runs into a state of putrefaction. The experiments however of Mr. Brodie[[55]] will induce us to pause, and institute farther enquiries before we receive this theory as unexceptionable. It will appear that in the following experiments of this physiologist, an instantaneous extinction of vitality did not take place, but, on the contrary, the functions of the brain were those on which the electric shock exercised its primary influence. An electric battery of six jars having been charged with electricity, the shock was made to pass through a Guinea pig, in the longitudinal direction from the head to the tail: the animal immediately fell on one side, insensible, as if stunned; a convulsive action of the muscles of the extremities was observed, but did not long continue; and the function of respiration was not interrupted. In a few minutes sensibility was restored, and the animal recovered. A shock from a battery of nine jars was then passed in the same manner through another Guinea pig; the animal immediately fell on its side, exhibited a convulsive action of the voluntary muscles of the limbs, but uttered no cries, and although attentively watched, no signs of respiration could be discovered after the shock had passed through it. Three minutes afterwards, Mr. Brodie opened the chest, and found the heart acting with regularity and vigour, about 80 times in a minute, and circulating dark coloured venous blood; the peristaltic motion of the intestines was likewise visible; and the muscles, when made the part of a galvanic circuit, readily contracted. In this experiment, observes Mr. Brodie, it is evident that the electric shock did not destroy the irritability of the muscular fibre, nor did it affect the action of the heart. Death took place precisely in the same manner as from a severe injury of the head; and the animal died, manifestly from the destruction of the functions of the brain; and, in this case, Mr. Brodie has no doubt, but that if the lungs had been artificially inflated, the action of the heart might have been maintained, and the animal probably have been restored to life.
The nature and extent of the injury inflicted by lightning, depend upon the intensity and direction of the electrical discharge, and vary greatly in degree; by far the greater number of flashes are harmless discharges from one cloud to another, and the instances in which it strikes the earth are comparatively rare: when however this does occur, and it directs its course through a human being, it may expend its influence upon the surface, and produce partial or general vesications.[[56]] Sometimes the clothes of the person have been violently rent, and the metallic substances about them melted; or it may pass through the body, without including the clothes, and it may occasion death without injuring the organic structure of any part of the body: or it may pass through only a particular portion of the body, and produce local injury.
But it has happened that persons have been struck when the tempest has appeared to be at a considerable distance; this has been explained by Signor Beccaria, by supposing that it is a discharge of electric fluid from the earth, occasioned by the passing of a cloud that has just before, in the elemental strife, been rendered negatively electric. Lord Stanhope distinguishes such a discharge by the name of the Returning Stroke.[[57]]
As a provision for personal security during a thunder storm, a few precautions are necessary, and we are induced to notice them in this place, as their history is necessarily involved in our enquiries concerning death by lightning. In the open air, shelter ought not to be sought immediately under trees, for should they be struck, such a situation would be attended with the most imminent peril: on the contrary, the distance of twenty or thirty feet from such objects, may be considered as affording a place of safety, for should a discharge take place, they will most likely receive it, and the less elevated bodies will escape. Any surface of water, and even the streamlets that may have resulted from a recent shower should be avoided, for being excellent conductors, the height of a man, when connected with them, is very likely to determine the course of an electrical discharge. The partial conductors, through which the lightning directs its course when it enters a building, are usually the appendages of the walls and partitions; the most secure situation is therefore the middle of the room, and this situation may be rendered still more secure by lying on a hair mattress, or even on a thick woollen hearth rug. The part of every building least likely to receive injury is the middle story, as the lightning does not always pass from the clouds to the earth, but is occasionally discharged from the earth to the clouds, as in the case of the “returning stroke;” hence it is absurd to take refuge in a cellar, as recommended by Dr. Priestley; indeed many instances are on record, in which the basement story has been the only part of a building that has sustained severe injury, the electric charge being divided and weakened as it ascended. Any approach to a fire-place should be particularly avoided, for the chimneys are very likely to determine the course of the lightning; the same caution is necessary with respect to gilt furniture, bell-wires, and moderately extensive surfaces of metal of every description.
DEATH BY STARVATION.
That a living animal body cannot long survive without the ingestion of alimentary matter, is too self-evident to require demonstration. Living bodies, says Cuvier, may be considered as a kind of furnaces into which inert substances are successively thrown, which combine among themselves in various manners, maintain a certain place, and perform an action determined by the nature of the combinations they have formed, and at last fly off in order to become again subject to the laws of inanimate nature.
It must, however, be observed, that there is a difference, depending on age and health, in the proportion of the parts which enter into the current, and those which abandon it; and that the velocity of the motion usually varies according to the different conditions of each living body; hence it follows, that the period during which an individual may exist without food, will be liable to variation. We have already stated (page [394]) that, cæteris paribus, he will perish from inanition with a rapidity proportioned to his youth, and state of robust vigour; and we remarked in what strict conformity with physiological principles the poet Dante had described the fate of Ugolino and his family.[[58]] The same fact appears also to have been well understood by the ancient physicians;[[59]] equally evident is it that women are able to support abstinence longer than men. It has been also observed that a moist atmosphere contributes to the protraction of life, under circumstances of privation; this may depend, not only upon the fluid matter thus furnished to the body, but upon the non-conducting power of the medium, in relation to aqueous vapour; the ingestion of a very small proportion of water revives in an extraordinary degree, the animal perishing from famine, and prolongs his existence. Redi[[60]] instituted a series of experiments with the sole view of ascertaining how long animals can live without food. Of a number of capons which he kept without either solid or liquid food, not one survived the ninth day; but one to which he allowed water, drank it with avidity, and did not perish until the twentieth day. Elizabeth Woodcock, who was buried under the snow, near Cambridge, for the space of eight days, undoubtedly owed her preservation to the snow which she occasionally sucked.[[61]]
Those cases of extraordinary fasting, which are recorded in the different Transactions and Journals of almost every country, are to be generally regarded as gross impositions; we[[62]] have already exposed the fallacy of several of the more popular histories of this kind. Such impostors, however, in their attempt to delude the world, have unintentionally offered themselves as the voluntary victims of physiological experiment; for we have at least learnt from them how small a portion of aliment is sufficient to preserve the life of a human being; a fact which had never before been satisfactorily proved, however probable it had been rendered, by the recorded habits of many of the early Christians, especially those of the East, who retired from persecution into the deserts of Arabia and Egypt.
The sufferings of a person perishing from inanition[[63]] must be considered as the most acute that can befall humanity; and yet we have instances on record of their having been voluntarily encountered as the means of suicide; a very interesting and well-authenticated instance of this kind has been related as having occurred in Corsica;[[64]] and, as it is calculated to afford, at once, a history of the symptoms of Starvation, and an exemplification of their severity, we shall introduce a brief account of the case in this place. Luc Antoine Viterbi was condemned to death as an accomplice in the assassination of Frediani, a crime which he denied to the last moment, and appealed against a sentence passed upon him by a Court composed of his personal enemies. Towards the end of November, Viterbi (knowing his condemnation, and being confined in the prison of Bastia), resolved to die. To effect his purpose, he abstained from food for three days, and then ate voraciously, and to a forced excess, in the hope that, after fasting so long, he should thereby put an end to his existence; in this however he was deceived, and, on the second of December, he determined to starve himself to death; from that day nothing could shake his awful resolution, although he did not expire until the night of the 21st of that month. During the three first days, Viterbi felt himself progressively tormented by hunger; under these circumstances a report was made to the public minister, who ordered bread, water, wine, and soup to be taken daily to his cell, and placed conspicuously in view. No debility was manifested during these three days, no irregular muscular movement was remarked, his ideas continued sound, and he wrote with his usual facility, but took no nourishment.
From the 5th to the 6th, to hunger insensibly succeeded the much more grievous suffering of thirst, which became so acute, that on the 6th, without ever deviating from his resolution, he began to moisten his lips and mouth occasionally, and to gargle with a few drops of water, to relieve the burning pain in his throat; but he let nothing pass the organs of deglutition, being desirous not to assuage the most insupportable cravings, but to mitigate a pain which might have shaken his resolution. On the 6th, his physical powers were a little weakened; his voice was nevertheless still sonorous, pulsation regular, and a natural heat equally extended over his whole frame. From the 3d to the 6th, he had continued to write; at night several hours of tranquil sleep seemed to suspend the progress of his sufferings, no change was observable in his mental faculties, and he complained of no local pain. Until the 10th, the thirst became more and more insupportable; Viterbi merely continued to gargle, without once swallowing a single drop of water; but in the course of the 10th, overcome by excess of pain, he seized the jug of water, which was near him, and drank immoderately. During the last three days, debility had made sensible progress, his voice became feeble, pulsation had declined, and the extremities were cold. Viterbi, however, continued to write; and sleep, each night, still afforded him several hours ease.
From the 10th to the 12th the symptoms made a slight progress. The constancy of Viterbi never yielded an instant; he dictated his journal, and afterwards approved and signed what had been thus written agreeably to his dictation. During the night of the 12th, the symptoms assumed a more decided character, debility was extreme, pulsation scarcely sensible, his voice extraordinarily feeble, the cold had extended itself all over the body, and the pangs of thirst were more acute than ever. On the 13th the unhappy man thinking himself at the point of death, again seized the jug of water, and drank twice, after which the cold became more severe; and congratulating himself that death was nigh, he stretched his body on the bed, and said to the gendarmes who were guarding him, “Look how well I have laid myself out.” At the expiration of a quarter of an hour, he asked for some brandy; the keeper not having any, he called for some wine, of which he took four spoonsful; when he had swallowed these the cold suddenly ceased, heat returned, and Viterbi enjoyed a sleep of four hours. On awaking (on the morning of the 13th) and finding his powers restored, he fell into a rage with the keeper, protesting that they had deceived him, and then began beating his head violently against the wall of his prison, and would inevitably have killed himself, had he not been prevented by the gendarmes. During the two following days he resisted his inclination to drink, but continued to gargle occasionally with water; during the two nights he suffered a little from exhaustion, but in the morning found himself rather relieved. It was then that he penned some stanzas. On the 16th, at five o’clock in the morning, his powers were almost annihilated, pulsation could hardly be felt, and his voice was almost inaudible; his body was benumbed with cold, and it was thought that he was on the point of expiring. At ten o’clock he began to feel better, pulsation was more sensible, his voice strengthened, and, finally, heat again extended over his frame, and in this state he continued during the whole of the 17th. From the latter day until the 20th, Viterbi only became more inexorable in his resolution to die. During the 19th, the pangs of hunger and thirst appeared more grievous than ever; so insufferable, indeed, were they, that for the first time, Viterbi let a few tears escape him; but his invincible mind instantly spurned this human tribute. For a moment he seemed to have resumed his wonted energy, and said, in the presence of his guards, and the gaoler, “I will persist, whatever may be the consequence; my mind shall be stronger than my body; my strength of mind does not vary, that of my body daily becomes weaker.” A little after this energetic expression, an icy coldness again assailed his body, the shiverings were frequent and dreadful, and his loins, in particular, were seized with a stone-like coldness, which extended itself down his thighs. During the 19th a slight pain at intervals affected his heart, and for the first time, he felt a ringing sensation in his ears; at noon, on this day, his head became heavy; his sight, however, was perfect, and he conversed almost as usual, making some signs with his hands.
On the 20th, Viterbi declared to the gaoler and physician, that he would not again moisten his mouth; and feeling the approach of death he stretched himself, asking, as on a former occasion, whether he was well out, and added, “I am prepared to leave this world.” Death did not this time betray his hopes. On the 21st Viterbi was no more.
In this interesting history, we receive a faithful account of the physical effects of starvation upon a human being, and perceive how greatly a very inconsiderable portion of liquid is capable of producing an invigorating effect upon the body, when in a state of extreme inanition; but the mind of the subject before us was stern and invincible, inflexibly bent upon self destruction; and we therefore do not perceive the developement of those moral effects, which in other cases are the general consequences of starvation. The histories of besieged towns[[65]] would afford us ample evidence upon this subject; and would shew that famine destroys all the most powerful instincts of our nature. We know not, however, a more awful illustration of this fact than that furnished by the account of the wreck of the Méduse,[[66]] and its appalling consequences; it appears that this frigate struck on the bank of Arguin, and as all attempts to save her were fruitless, nothing remained but to concert immediate measures for the escape of the passengers and crew; five boats were accordingly got in readiness, and a raft, destined to carry the greatest number of people, was hastily constructed; biscuit, wine, and fresh water were also apportioned to each; but in the tumult of abandoning the wreck, it so happened that the raft had the least share of the provisions, and in which there was not a single barrel of biscuit. This raft, containing no less than one hundred and fifty souls, was to have been towed by the boats, with which it was connected by ropes; but the adventurers had not proceeded far, when the boats cast off, and cruelly abandoned the raft to the mercy of the ocean; to the scene which ensued it is impossible for any language, however florid, to do adequate justice. Despair, aided by the pangs of hunger, soon excited a mutiny; a dreadful slaughter ensued, and the flesh of their murdered comrades afforded to the survivors a short respite from the immediate sufferings of famine.
THE APPLICATION OF THE PHYSIOLOGICAL FACTS ESTABLISHED IN THE PRECEDING CHAPTERS, TO THE GENERAL TREATMENT OF ASPHYXIA.
Although our researches into the causes and phenomena of asphyxia, or suspended animation, will afford, on many occasions, but very scanty encouragement with regard to the extent and value of the resources of art, yet we apprehend that to the intelligent practitioner they will not on that account be less acceptable; for to him it must be well known, that the detection of error is the first step in the discovery of truth, and although the tendency of the present investigation will be to reject, as useless, many of those plans of treatment which have long enjoyed the confidence of the public and the profession; yet it will suggest the application of some that have not hitherto been duly appreciated, and regulate that of others whose efficiency entirely depends upon the time and manner of their administration. But the fact is not to be concealed, that the medical profession, as well as the public, have long been too sanguine in their estimate of the probabilities of recovery by art, in cases where life is suddenly arrested by the operation of external causes; and upon this occasion, the establishment of the “Royal Humane Society for the recovery of persons apparently dead,” requires some notice, in relation to the possible extent of its successful exertions. Without some explanation it will be impossible to reconcile the reports of that philanthropic institution, with the physiological views which we have attempted to establish in the present work; it therefore becomes a part of our duty to explain the nature of the fallacies into which the witnesses and reporters of cases of suspended animation appear to us to have been unconsciously betrayed, and which have so frequently bestowed upon fable the colour of truth, and given to vague report, the apparent stability of credible testimony. In the first place we would observe, that in those cases in which a long interval is stated to have occurred between the suspension of breathing, from drowning, and the restoration of that function by art, it is probable that the anxiety of by-standers who witnessed the struggles, and the impossibility of justly appreciating the lapse of time in such moments of anxiety[[67]] and distress, have led to the erroneous statements with which the subject is embarrassed. There is, moreover, another fallacy into which the anxious observer is very likely to fall,—the sufferer may have breathed unobserved during the alleged interval of asphyxia; and if this fact be admitted, we at once reduce some of the most incredible of these reports to the rational standard of physiological probability. Nor shall we hesitate in the present chapter to offer our remarks upon the plan of recovery proposed by this society with as much freedom, and as little reserve, as we have ventured to question the literal accuracy of their reports. But while, thus fortified by physiological arguments, we profess to discredit many of the results stated by this society, let it not be supposed that we would prefer a charge of insincerity against their authors, or attempt to withhold any portion of that public patronage and consideration, to which their zeal and philanthropy so justly entitle them.
The agents which are employed in cases of suspended animation, are far too indiscriminately recommended; some of them, without doubt, offer valuable resources to the physician, and only require a judicious application to ensure their success; while others are entirely useless and frivolous, and ought to be dismissed from our service, since the retaining them only embarrasses the practitioner, and that too at a period which of all others requires the utmost decision in the selection of a plan of treatment, and the greatest promptness in its execution.
The following may be considered as the principal resources upon which the Humane Society rely for restoration of persons apparently dead from sudden accidents, viz.
1. Inflation of the lungs.
2. Application of heat.
3. Internal Exhibition of stimulants.
4. Friction.
5. Electricity.
6. Exposure of the surface of the body to cool air.
7. Blood-letting.
We shall offer a few observations upon the methods of applying these agents.
On the manner of producing artificial respiration.
We are indebted to Mr. Brodie for the valuable directions that are to guide the execution of this important operation. (Manuscript Notes.) A common pair of bellows will be found as manageable and efficient an apparatus for the inflation of the lungs, as any instrument that could be contrived; those manufactured for the service of the Humane Society are not of a size sufficient to inflate the lungs of even a large dog, much less those of man; nor is it necessary to employ double bellows on this occasion, for the air will escape from the lungs without being withdrawn by suction; besides which, it is stated that the forcible exhaustion of the lungs is liable to occasion pulmonic hemorrhage. It has been proposed to insert the tube of the bellows into the trachea, by means of a wound in that structure, but there are great objections to such a proceeding; the hemorrhage which is likely to occur,[[68]] may inundate the windpipe; besides which, the operation occasions delay, which, however trifling, will be important in cases where the action of the heart has become much enfeebled; and moreover the wound itself is an evil which ought to be avoided, if artificial respiration can be established without it; and were these objections even overruled, there still remains another; experience has shewn that the air thus introduced issues by the opening of the larynx, without having dilated the lungs.
A tube may be constructed for the purpose of being inserted through the mouth into the rima glottidis; if the patient be sensible, the introduction of such a tube might be difficult; but as the patient is in a state of insensibility, the introduction may usually be effected without much difficulty, but not altogether without trouble; for the mere circumstance of having to open the mouth, to pull forward the epiglottis, to direct the tube into the proper aperture, may occasion delay which will be of importance in cases where success depends upon the skill with which the time has been economised.
It is for such reasons more expedient to inflate the lungs by means of a tube inserted into one nostril, keeping the other and the mouth carefully closed: the bellows having been thus disposed, the air should be driven into the lungs with a certain degree of force; the lungs will thus become fully inflated, and in the intervals between the different inflations, the air from the lungs will escape by the mouth and by the other nostril, and when the lungs are thus emptied, the process may be repeated. There is but one objection to this method of exciting artificial respiration, viz. that at each inflation, a portion of air will sometimes find its way into the stomach, through the œsophagus: it is very desirable to prevent such an occurrence, for when the stomach is much distended with air, the descent of the diaphragm is prevented, and, consequently, a perfect inspiration cannot be accomplished. The passage of air into the stomach may be prevented by pressing on the thyroid cartilage, so as to close the communication between the pharynx and œsophagus. All that is necessary for the operator is, to produce the inspiration; we are recommended indeed to press the margin of the ribs gently upwards, so as to expel the air, and produce expiration; but this is altogether unnecessary, for the elasticity of the ribs, and the pressure of the abdominal muscles and viscera, and the elasticity of the lungs themselves, are quite sufficient to occasion the expiration without any assistance from external pressure. We must not omit to state that the inhalation of oxygen gas, instead of common air, has been strongly recommended, not only as being in itself a more powerful stimulus, but as being more efficient in the removal of the accumulation of that carbonized matter which, under ordinary circumstances of respiration, is regularly thrown off; the practical eligibility however, of such a plan is very questionable, and to say nothing of the difficulty of obtaining oxygen upon an occasion where the least delay is fatal, it is very doubtful whether the effects of this gas are really such as our theory would at once lead us to believe. We have deemed it necessary to enter into these details, in order to afford some practical instruction upon a subject of manipulation but little understood, but which is undoubtedly the most valuable of all the resources which art can furnish for the preservation of human beings that are in danger of perishing from accidental causes. The principal circumstances to be remembered are comprised in the following precepts.
1. The lungs are to be sufficiently, but not too much inflated.
2. The inspiration must be made of sufficient frequency.
3. The air is to be allowed a free exit from the lungs, so that the same air shall not be transmitted more than once.
4. The method of inflating the lungs must be simple, and easy of adoption; for as the interval of time, during which the artificial respiration can possibly be of any service, is very limited, it is important to avoid whatever may occasion the least delay.
Application of Heat.
There is perhaps no medium through which we can more successfully apply heat to the human body than that of the bath, because we can manage its application with precision; we know the exact degree of heat, and can avoid applying it in extremes; we, at the same time, can communicate it more rapidly, and more equally, than by any other means, and we are enabled to increase or diminish the temperature, by the addition of fresh portions of water, as circumstances may render it expedient.
Internal Exhibition of Stimulants.
The introduction of fluids into the stomach is not an easy process in many cases of suspended animation, as trismus is by no means an uncommon occurrence; where, however, the spasm of the jaw has subsided, the practitioner with a little address may by means of a flexible tube easily accomplish his object. Glysters will likewise furnish an easy mode of applying stimulants.
Electricity.
No sooner was the discovery made that galvanism is capable of exciting muscular contraction in animals apparently dead, than the physiological enthusiast seized it with avidity, and at once hailed it as the long desired influence that was to restore vigour to the enfeebled, and resuscitation to those that were in a state of suspended animation. It had been long known that muscles could be made to contract, by irritating the nerves belonging to them with the point of the scalpel, but not in a degree that remotely approached the vigorous contractions occasioned by the galvanic influence, whose stimulus seemed almost equivalent to that of volition. The sanguine expectations, however, which were thus very naturally excited, have ended in the most complete disappointment; and we are bound to confess that although galvanism is capable of exciting extraordinary contractions in the VOLUNTARY muscles, and of astonishing the multitude, yet its influence does not extend to those that are INVOLUNTARY. Bichat states distinctly that the involuntary muscles are beyond the reach of galvanism.[[69]] Mr. Brodie has frequently attempted to restore the heart’s action by the galvanic stimulus, in an animal dead from syncope, but never with success. The author of the present work may add, that he has attempted the same object by modifying the experiment in several different ways, but with no better success. But it may be said that, as galvanism will excite the contractions of the diaphragm, and other muscles of respiration, it may be made subservient to the purpose of producing artificial respiration: granted,—but it never can be made to act with the certainty, regularity, promptness, or convenience, which attend the operation of a common pair of bellows, nor even if it could, would any advantage be obtained which might not be equally insured by the use of this latter simple instrument. It is, moreover, questionable whether so powerful a stimulus may not produce a subsequent exhaustion of the muscular energy; such effect indeed would appear to have happened in the case related by Dr. Babington, where the asphyxia had been occasioned by the fumes of burning charcoal; “having passed,” says he, “a galvanic shock through the chest, the patient instantly, to our surprise, drew his breath deep; the muscles of the abdomen were seen to react, though feebly, while those of the face were slightly convulsed, and the eyelids were raised; at each successive application of this powerful agent, the respirations were more forcibly performed, and the stroke of the artery at the wrist rose in the same proportion. Having procured a bladder filled with oxygen gas, we caused it to be inspired, and we thought that it was followed by an increased activity of the powers of respiration and circulation; as the heat of the body was not deficient, we now sprinkled the face and chest with cold water, which also had the effect of rousing the dormant powers of sensation, as the respiratory muscles were uniformly thrown by it into action, though in a more feeble and interrupted manner than when we employed the galvanic influence. Having received a large supply of oxygen gas, we repeated the inhalation and the galvanic succussions alternately, through the chest and head, every half-hour, for three hours, when the galvanic influence was discontinued, as the heart, though uniformly excited by it, seemed in the intervals to act more feebly, and we were apprehensive that by exalting the action of one power continually, we might destroy that equilibrium of forces which is necessary to the maintenance of life.”[[70]]
TREATMENT OF PARTICULAR CASES OF ASPHYXIA.
CASE I.
Wherein the action of the heart fails before that of the respiratory organs.
In no case of this description can artificial inflation of the lungs afford the least assistance, for the left side of the heart always contains florid blood at the moment of its cessation; and since this fact proves that it failed in its action, while under the full influence of duly oxygenized blood, how can we expect that the stimulus, which was unable to preserve the heart’s action while yet in motion, shall be able to re-excite it after it has ceased? Such a practice can only have been suggested by that erroneous physiology which maintained that the motion of the lungs excited that of the blood.
The preservation of the body from the influence of external cold is always important, for it is only within a certain range of temperature that the vital functions can be performed; and during a state of asphyxia, the body is necessarily incapable of generating any portion of animal heat; where the heat is lost it should be gradually restored, and for such a purpose the introduction of wine, the volatile alkali, and other stimulants, into the stomach, by means of a flexible tube, would probably, in certain states of syncope, prove serviceable; although in cases of suffocation it can never occasion the least benefit. We have been also directed to employ frictions on the surface of the body, for the purpose of assisting the circulation of the blood; as if, says Mr. Brodie, (Manuscript Notes) this could answer any useful purpose where the action of the heart has ceased, or as if it could be necessary where it still continues.
Under the head ‘death from cold,’ we have stated that the left cavities of the heart contain florid blood; it therefore follows that the directions of the Humane Society, to inflate the lungs in such cases, are founded in error.
CASE II.
Wherein the function of respiration ceases, while the heart continues to circulate black blood.
It has been stated that in cases of suffocation the heart continues to contract for a short period, after the cessation of breathing; that this interval is extremely short, but liable to vary from several causes; and that it is uniformly shorter in cases of death by drowning, than in those by strangulation. To the physician this is an interval of anxiety and importance; let him beware how he trifles with the fleeting moments, in which alone the resources of his art can be of any avail. If artificial respiration be established at this period, the blood will become once more oxygenised, the action of the heart will be continued, the scarlet blood will be transmitted to the brain, and sensibility will therefore return; the nervous energy will be once more transmitted to the respiratory organs, and the animal will at length make a voluntary effort to inspire air. Here then is the interval of time, during which artificial breathing may be employed so as to effect a restoration to life, where death must otherwise have been inevitable. Mr. Brodie has made a great variety of interesting experiments upon this subject, from which may be deduced the following important corollaries.
1. If the lungs be inflated, the action of the heart will continue.
2. If the action of the heart has become feeble, but the circulation is nevertheless not entirely suspended, the inflation of the lungs will cause the feeble actions to become again frequent and vigorous.
3. If the action of the heart has entirely ceased, it is impossible to restore it by the inflation of the lungs.
4. If the action of the heart has not entirely ceased, but is so feeble as no longer to maintain the circulation, the artificial respiration will prove as useless, as if the heart were perfectly motionless.
There is still, however, another period at which artificial respiration may be employed with the greatest advantage; we have stated that after the natural respiration has been re-established, and the animal would appear to be advancing towards recovery, it not unfrequently relapses into a state of insensibility, becomes convulsed, and dies. As this depends upon the black blood which is circulating through the brain, so paralysing that organ as to prevent a necessary transmission of its influence to the muscles of respiration, life may be preserved if artificial respiration be established until the brain is again supplied with duly oxygenized blood; after which the animal will be enabled to perform its own functions without any assistance from art.
The same treatment will, of course, apply in every case where the natural respiration ceases in consequence of being deprived of a due supply of nervous energy, from the insensibility of the brain; as from a blow on the head—the action of a narcotic poison—from lightning?
It has been proposed, in cases of suffocation, to take away blood from some of the larger veins; as far as relates to the asphyxia, no advantage can accrue from such a practice, but incidental benefit may arise where congestion has taken place in the brain, as happens in hanging: in such cases the jugular veins are those from which the blood can be taken with the greatest chance of success.
Advantage is also said to accrue from the application of volatile alkali, or other pungent bodies to the inside of the nostrils; whatever promotes sneezing or coughing is supposed to give a succussion to the diaphragm and its antagonist muscles, and thereby to promote the re-establishment of respiration.
Cordials, moderate warmth, and quiet, are the resources upon which we are to rely for the ultimate recovery of the vital powers, after the complete establishment of the function of respiration.
For a long period, injections of tobacco enjoyed a high, but unmerited reputation amongst the medicinal agents that were supposed capable of rousing the latent energies of life, in cases of suspended animation; and strange as it may appear, this most powerful narcotic poison, until within a few years, was annually recommended for such purposes by those who professed to instruct the profession and the public upon these important topics; this may be considered as one of the most stupendous errors that ever occurred in the exercise of the medical art.
Where the asphyxia has arisen from the inhalation of noxious vapours, as those emitted by burning charcoal, the exposure of the body to cold has been strongly recommended. In Russia, where from the mode of heating the dwellings, accidents of this kind very frequently occur, the general practice is to rub the body with snow, and it is said with the happiest effect; this plan, says Dr. Babington, is probably of use, from the strong impression which is made upon the skin as a sentient organ. It is also a well known fact, that the recovery of the dogs which are made the subjects of experiment in the Grotto del Cane, is much favoured by their being plunged into a neighbouring lake.
Is it necessary to repeat, that the idea respecting the presence of any considerable portion of water in the lungs of a drowned person, has no foundation in truth? we should have scarcely deemed the notice of such a fallacy, and that of the practice founded upon it, of hanging by the heels, called for in this place, had not an opinion been lately delivered, by a medical witness, that a person drowned in the Thames might possibly have been recovered, but for the impurity of the water, arising from the gas-works. We have only to observe upon this occasion, that had the individual in question recovered in the hands of a practitioner who could have delivered so absurd an opinion, he would have been more indebted to good fortune than to skilful attention.
A drowned animal will, in general, be recovered more slowly and with greater difficulty than one which has fallen into a state of asphyxia from strangulation. It is probable that, in the former case, the sudden reduction of temperature will contribute to the more rapid extinction of vitality.
Having thus examined the pretensions to which the several modes of restoring animation are entitled, we may conveniently introduce in this place some observations upon the different methods which have been adopted to secure condemned criminals against the fatal effects of their execution. There can be no doubt but that by making an opening in the trachea, below the ligature, death might in some cases be prevented, provided the neck were not dislocated, nor the weight of the body very considerable. Richerand says, that a surgeon of the imperial armies, whose veracity cannot be questioned, assured him that he had saved the life of a soldier by performing the operation of laryngotomy some hours before he was executed.
Dr. Male[[71]] states that it was tried on one Gordon, a butcher, who was executed at the Old Bailey in the early part of the last century; the body having hung the usual time, was removed to a neighbouring house, where a surgeon waited to receive it, and enforce every means calculated to restore animation: he opened his eyes, and sighed, but soon expired: the want of success was attributed to his great weight, but we apprehend that, if the statement be correct as to his opening his eyes and sighing, the failure must have depended upon want of skill in the operators. We have yet to notice those cases of spontaneous recovery which have taken place after execution, and which are too well authenticated to admit of doubt; upon this point we would observe, that such results by no means militate against the accuracy of the physiological views which have been already presented to our readers. Whenever such a recovery occurs, the strangulation has never been complete, and feeble motions of the heart have been preserved by imperfect and occasional respirations, during the interval of suspension; this may depend, in a great measure, upon the situation of the noose; if placed at the side of the neck, it would be pulled tight by the weight of the body; but if at the back of the neck, it would be far otherwise. John Smith, who was executed at Tyburn on the 24th of December 1705, was cut down in consequence of the arrival of a reprieve, nearly fifteen minutes after he had been turned off, but is said to have been recovered by venesection and other means[[72]]; Governor Wall was a long time in the act of dying, and it was subsequently discovered that this was owing to an ossified portion of the trachea resisting the pressure of the rope; but the most extraordinary instance of this kind, and one well authenticated, is that of Margaret Dickson, of Musselburgh, who was tried and convicted in Edinburgh in the year 1728, for the murder of her child; her conviction was accomplished by the evidence of a medical person, who deposed that the lungs of the child swam in water; there were, however, strong reasons to suspect the justness of the verdict, and the sequel of the story was well calculated to cherish a superstitious belief on the occasion. After execution, her body was cut down, and delivered to her friends for the rites of interment; it was accordingly placed in a coffin, and sent in a cart to be buried at her native place, but the weather being sultry, the persons who had the body in charge stopped to drink, at a village called Peppermill, about two miles from Edinburgh; while they were refreshing themselves, one of them perceived the lid of the coffin move, and uncovering it, the woman immediately sat up, and most of the spectators ran away with every sign of trepidation; a person, however, who was in the public house immediately bled her, and in about an hour she was put to bed, and by the following morning, was so far recovered as to be able to walk to her own house[[73]], after which she lived twenty-five years and had several children.[[74]]
OF THE CORONER’s INQUEST.
The office of Coroner (Coronator, from his duty in Pleas of the Crown, 2d Inst. 31. 4. Inst. 271) which is of great antiquity, was also of considerable dignity;[[75]] for the Coroner, together with the Sheriff, was to keep the peace of the county. He is to be elected by the full county, and for life (except in cases of misconduct, when he may be removed). The writ De Coronatore eligendo, F.N.B. 163, commands the Sheriff “quod talem eligi faciat, qui melius et sciat et velit et possit officio illi intendere”, and the 3 Edw. 1 c. 10. enacts, that none but lawful and discreet knights should be chosen. But now it is held sufficient if he have enough to be made a knight (1 Bl. Com. 347), which is but lands to the amount of £20 per annum, (I Edw. 1. Stat. de milit). But as the office is attended with many unpleasant duties, gentlemen, in these nicer times, have shrunk from its performance, and it has consequently fallen into disrepute; and too frequently into low and indigent hands. For though in great counties, and some populous places, it is held by very worthy and experienced men, yet in remoter parts it is to be feared that it is ill exercised; and at least, that the persons holding it have not the learning and practice necessary for its due execution. And this in all probability is an increasing evil; for an office once fallen into disrepute, and only propped by the addition of emoluments to be derived from fees (per job), generally becomes venal; and there is now too much reason to fear, that decency may be outraged by the ill-timed activity of some[[76]], as much as justice is defeated by the corruption and supineness of others, who have of late been chosen to this ancient and once honorable office. It is therefore to be wished that some legislative measure may correct or prevent this evil, by restricting the elections to persons duly qualified; and by appointing medical assessors or inspectors, who might usefully assist the Coroner in the discharge of his duties in cases of inquisition of death.
The statute De Officio Coronatoris, 4 Edw. 1 c. 2. directs the mode in which Inquisitions of Death shall be held. “The Coroner, when commanded by the King’s bailiffs, or by honest men of the county, shall go to the places where any be slain, or suddenly dead or wounded, and shall forthwith command four of the next towns[[77]], or five or six to appear before him, in such a place; and when they are come thither, the coroner upon the oath of them shall enquire if they know where the person was slain; whether it were in any house, field, bed, town, tavern, or company, and who were there. Likewise it is to be enquired who were culpable either of the act or of the force; and who were present, either men or women, of what age, if they can speak or have any discretion. And such as are found culpable by inquisition shall be taken and delivered to the sheriff, and committed to gaol; and such as be found, and be not culpable (i.e. the witnesses, and these the coroner shall bind over by recognizance to the next assizes,) shall be attached until the coming of the justices[[78]] and their names written in the coroner’s roll. If any be slain and the body found in the fields or woods; first, it is to be enquired whether he was slain in the same place or not;[[79]] and if it were brought and laid there, endeavour shall be made to follow their steps who brought the body thither; whether brought upon a horse or in a cart. Also it shall be inquired, whether the dead person were known or a stranger, and where he lay the night before. And if any be found culpable of the murder, the coroner shall immediately go into his house, and inquire what goods he has, &c. how much land, and the yearly value, and what corn on the ground, which shall be valued and delivered to the township, which shall be answerable before the justices for all; and the land shall remain in the king’s hands until the lords of the fee have made fine for it, &c.
“Also it is to be enquired of those who were drowned or suddenly dead; and after it is to be seen of such bodies whether they were so drowned or slain, or strangled by the sign of a cord tied straight about their necks, or about any of their members, or upon any other hurt found upon their bodies: whereupon they shall proceed in the form above said. And if they were slain, then ought the coroners to attach the finders and all others in company.
“Upon appeal of wounds and such like, especially if the wounds be mortal, the parties appealed shall be taken immediately, and kept until it be known perfectly whether he that is hurt shall recover or not; and if he die, the offenders shall be kept: and if the party recover, the offenders shall be attached by four or six pledges after, as the wound is great or small: if it be for a maim, he shall find more than four pledges: and two pledges if it be for a small wound without mayhem. Also all wounds ought to be viewed; the length, breadth, and depth, and with what weapons, and in what part of the body the wound or hurt is, and how many wounds there be, and who gave them: all which must be enrolled by the coroner.
“Moreover if any be appealed, the party appealing of the fact shall be taken, and the party appealed of the force shall be attached also, and kept in ward, until the parties appealed of the fact be attainted or delivered.
“Also horses, boats, carts, &c. whereby any are slain, shall be valued, and delivered unto the towns as beforesaid.
“If any be suspected of the death of any man, being in danger of life, he shall be taken and imprisoned as before is said.”
This statute is but in confirmation of the common law, and therefore does not restrain the powers of the coroner which he before possessed, even though they be not mentioned in it. 1 East. P. C. 381, where see observations on each part of this duty.
He is to inroll the verdict of his jury, written on parchment, and return the Inquisition, either to the Justices of the next gaol delivery of the county, or certify it into the King’s Bench, 2 Roll. Abr. 32.
He must take notes of the evidence,[[80]] and bind the witnesses to appear, for neglect of which he may be fined, 1 & 2 Ph. & Mary, c. 13. 1 Lil. Abr. 327. And if he hath not enough to answer, his fine (for this or any other offence in execution of his office), shall be levied on the county, as a punishment for electing an insufficient officer. Mirror, c. 1. s. 3. 2 Inst. 175.
When it happens that any person comes to an unnatural death, the township shall give notice thereof to the coroner. Otherwise if the body be interred before he come, the township shall be amerced. Hale P.C. 170. And Holt, C. J. says, It is a matter indictable to bury a man that dies a violent death, before the Coroner’ Inquest have sat upon him. 2 Hawk. P.C. n. 8. 1 Burn’s Just. 562.
Though it is not necessary that the inquisition be taken in the place where the body was viewed, 2 Hawk. P.C. c. 9. s. 25. yet he has no authority to take an Inquisition of Death, without a view of the body, and if an inquest be taken by him without such view, it is void. 2 Lev. 140[[81]]. But after the view, which must be by the jury and coroner together, the inquest may adjourn to a more convenient place.[[82]]
He may in convenient time take up a dead body that hath been buried, in order to view it: but if it be buried so long that he can discover nothing, or if there be danger of infection, the inquest ought not to be taken by the coroner, but by Justices of Peace, by the testimony of witnesses; for none can take it on view, but the coroner. Bro. Coron. 167. 173. If the body is improperly buried, or suffered to lie till it stinks, the town shall be amerced. 2 Danv. Ab. 209. Hale, P.C. 270. 2 Hawk. 48.
A Coroner’s Inquisition being final, the coroner ought to hear counsel[[83]] and evidence on both sides.[[84]] 2 Sid. 90. 101. He must admit evidence as well against the king’s interest as for it; and for omitting to do so, his inquisition may be quashed. 2 Hale, P. C. 60.[[85]] 1 East’s P.C. 383.
The coroner among other things must enquire of the deodand, which on the violent death of any one, even though purely accidental, has accrued to the king or his grantee.
This mulct was, in ancient times, applied to the purpose of purchasing masses, for the repose of the soul of the deceased; it is now converted into an ill apportioned, arbitrary, or, in a few cases, inadequate fine[[86]] on the individual, whose property has been, whether innocently or culpably, the cause of death. It is as absurd that a ship under sail, from which a man has fallen and been drowned, should be forfeited to the king; as it is lamentable that the ignorant, and too frequently the criminally negligent vender of oxalic acid for Epsom salts, should escape all punishment.
Where a thing is not in motion, that part of it which actually caused the death is alone forfeited, “as if a man be climbing on the wheel of a cart, and is killed by falling from it, the wheel alone is a deodand. 1 Bl. Com. 300. But whenever the thing is in motion, not only that part which immediately gives the wound, (as the wheel which runs over his body) but all the things which move with it, and help to make the wound more dangerous (as the cart and loading, which increase the pressure of the wheel) are forfeited.” ibid. The utmost penalty of this law might often be inflicted on the proprietors of stage coaches, where the wilful negligence, drunkenness, or brutality of the driver had occasioned the loss of life. “It matters not whether the owner were concerned in the killing or not; for, if a man kill another with my sword, the sword is forfeited.” ibid. The learned Commentator thus concludes, “But juries have of late very frequently taken upon themselves to mitigate these forfeitures, by finding only some trifling thing, or part of an entire thing, to have been the occasion of the death. And in such cases, although the finding of the jury be hardly warrantable by law, the Court of King’s Bench hath generally refused to interfere on behalf of the lord of the franchise, to assist so unequitable a claim.” 1 Com. 301. Thus is the justice of the country injured, in order to restrain the rapacity of individuals, improperly invested with the prerogatives of the crown. See also 1 East. P. C. 386.
A coroner may be punished for misconduct by fine, imprisonment, or removal; as if he be remiss in coming to do his office when he is sent for, he shall be removed by virtue of the statute De Coronatoribus 4 Ed. l. c. 2: Salk. 37. Hale P. C. 170. or if he do not properly execute his office. 1 Lill. Abr. 327.
If his Inquisition be quashed, and a melius Inquirendum is granted, that Inquisition must be taken by the Sheriffs or Commissioners, upon affidavits.[[87]] 1 Danv. Abr. 210. Salk. 190.
The filing of a coroner’s inquest may also be stopped for mismanagement. 1 Mod. 82. If he conceal felonies he shall be fined, and suffer one year’s imprisonment. 3 Ed. 1 c. 9. In Lord Buckhurst’s case a coroner not returning his inquisition of murder to the next gaol delivery, but suppressing it, was discharged from his office, and fined £100. 1 Kebl. 280.
If a coroner be convicted of extortion, wilful neglect of duty, or misdemeanor in his office, the Court before whom he shall be convicted, may adjudge that he shall be removed from his office. 25 Geo. 2. c. 29.
And lastly, by the writ De Coronatore exonerando, F.N.B. 163. 164: he may be discharged for negligence, or insufficiency, in the discharge of his duty, and when coroners are so far engaged in any other public business that they cannot attend the office; or if they be disabled by old age or disease, or have not sufficient lands, or live in an inconvenient part of the county. 2 Inst. 32. 2 Hawk. P.C. c. 9. s. 12. But if any such writ be obtained on an untrue suggestion, the coroner may procure a commission out of Chancery to enquire thereof; and the king may grant a supercedeas of the writ. Reg. Orig. 177. 178. F.N.B. 164. As the coroner’s is an office of freehold, the Court of Chancery will not suffer the writ to issue, unless on affidavit that the defendant has been served with notice of the petition for it. 3 Atk. 184. On the election of a new coroner the office of the old one is ipso facto extinguished.
We have entered more fully into this description of the office and duties of coroner in general, as we deem the due execution of them to be of the utmost importance to the public welfare; not indeed intending it as a guide to coroners themselves, for to that purpose it would be insufficient; but to give some insight into the nature and character of the office, to those who may, from time to time, be called upon to aid its administration. It is however necessary for us to add that there are some exceptions to the above mentioned rules, arising out of local customs and peculiar jurisdictions; thus the Lord Mayor of London is by virtue of his office, coroner within the City, and the Court is holden before him or his deputy. 4 Inst. 250. And other places, as some of the Royal residences, &c. have their separate coroners; but all, whatever the mode of election or appointment, are in cases of misconduct subject to the jurisdiction of the Court of King’s Bench.
SUICIDE.
Self-murder is ranked among the higher crimes, being a peculiar species of felony, as implied in the technical term felo de se. To constitute this offence, the party must be in his senses, else it is no crime; but this excuse ought not to be strained to that length to which our coroner’s juries are too apt to carry it,[[88]] viz. that the very act of suicide is an evidence of insanity; as if every man who acts contrary to reason, had no reason at all; for the same argument would prove every other criminal non compos, as well as the self-murderer. The law very rationally judges, that every melancholy or hypochondriac fit does not deprive a man of the capacity of discerning right from wrong; and, therefore, if a real lunatic kills himself in a lucid interval, he is felo de se as much as another man. 1 Hales, P. C. 412. 1 Hawk. P. C. c. 27, s. 3.
As to the punishment which human laws inflict on this crime, they can only act upon what the criminal has left behind him,—his reputation and fortune; on the former, by an ignominious burial in the highway, with a stake driven through his body; on the latter, by the forfeiture of all his goods and chattels to the king.
In this as well as all other felonies, the offender must be of the age of discretion, and compos mentis; and therefore an infant killing himself, under the age of discretion, (of which some extraordinary instances have lately been related in the public journals) or a lunatic during his lunacy, cannot be a felo de se. 1 Hawk. P. C. c. 27, s. 1. Crom. 30, a 6, 31; Hales P. C. 28; Dalt. c. 92; 3 Inst. 54.
He who kills another, though at his own desire or command, is a murderer;[[89]] and the person killed is not looked upon as a felo de se, in as much as his assent was merely void, being against the law of God and man; 1 Hawk. P. C. c. 27, s. 6; Keilw. 136; Moor 754. But query, as he is the guilty cause of his own death, is he not a felon? for if the question had been of the death of another, his consent to it would have been equally against the laws of God and man; yet if poison were given by his direction or command, even though he were not present, and might have repented, it would be murder, much more then, when he actually assists at the perpetration.
Further, as to what a felo de se shall forfeit, it seems clear that he shall forfeit all chattels, real or personal, which he hath in his own right; and also all chattels real, whereof he is possessed jointly with his wife, or in her right; and also all bonds and other personal things in action, belonging solely to himself; and also all personal things in action, and as some say, entire chattels in possession, to which he was entitled jointly with another, on any account, except that of merchandize. But it is said, that he shall forfeit a moiety only of such joint chattels as may be severed, and nothing at all of what he was possessed of as executor or administrator; 1 Hawk. P. C. c. 27, s. 7, and authorities there. However the blood of a felo de se is not corrupted, nor his lands of inheritance forfeited, nor his wife barred of her dower. 1 Hawk. P. C. c. 27, s. 1; Plowd. Com. 261 b, 262 a; 1 Hales, P. C. 413. The will of a felo de se becomes void as to his personal property, but not as to his real estate. Plowd. 261.
Not any part of the personal estate is vested in the king, before the self-murder is found by some inquisition; and consequently the forfeiture thereof is saved by a pardon of the offence before such finding; 5 Co. R. 110 b; 3 Inst. 54; 1 Saund. 362; 1 Sid. 150, 162. But if there be no such pardon, the whole is forfeited immediately after such inquisition, from the time of the act done, by which the death was caused; and all intermediate alienations and titles are avoided. Plowd. Comm. 260; Hales P. C. 29; 5 Co. R. 110; Finch. 216. All such inquisitions ought to be by the coroner super visum corporis, if the body can be found; and an inquisition so taken cannot, as some say, be traversed. Hale, P. C. 29; 3 Inst. 55; 1 Hawk. P. C. c. 27, s. 9, 10, 11. But see also 3 Mod. 238, 1 Burr. 17.
But if the body cannot be found, so that the coroner, who has authority only super visum corporis, (vide ante. p. [93]), cannot proceed, the inquiry may be by Justices of the Peace, (who by their commissions have a general power to inquire of all felonies,) or in the King’s Bench, if the felony were committed in the county where the court sits; and such inquisitions are traversable by the executor, &c. 1 Hawk. P. C. c. 27, s. 12; 3 Inst. 55; Hales P. C. 29; 2 Lev. 141.
Also all inquisitions of this offence being in the nature of indictments, ought particularly and certainly to set forth the circumstances of the fact; and in conclusion add, that the party in such manner murdered himself. 1 Hawk. P. C. c. 27, s. 13; 3 Lev. 140; 3 Mod. 100; 2 Lev. 152. Yet if it be full in substance, the coroner may be served with a rule to amend a defect in form. 1 Sid. 225, 259; 3 Mod. 101; 1 Keb. 907; 1 Hawk. P. C. c. 27, s. 15.
If a person is unduly found felo de se; or on the other hand found to be a lunatic, when in fact he was not so, and therefore ought to have been found felo de se; although a writ of melius inquirendum will not be granted, yet the inquisition is traversable in the King’s Bench. 3 Mod. 238.
By the rubrick in the Common Prayer, before the burial office, (confirmed by Statute 13 and 14, Car. 2, c. 4) persons who have laid violent hands on themselves shall not have that office used at their interment. Yet the priest has no power of enquiry, or even as it would appear of delay, in order to enquiry, when a body (though it be of a notorious suicide) is brought to his church for interment. “The proper judges, whether persons who died by their own hands were out of their senses” (and a fortiori whether they did or not die by their own hands) “are doubtless the coroner’s jury. The minister of the parish hath no authority to be present at viewing the body, or to summon or examine witnesses, and therefore he is neither entitled nor able to judge in the affair; but may well acquiesce in the public determination, without making any private enquiry. Indeed, were he to make one, the opinion which he might form from thence could usually be grounded only on common discourse, and bare assertion. And it cannot be justifiable to act upon these in contradiction to the decision of a jury, after hearing witnesses upon oath. And though there may be reason to suppose that the coroner’s jury are frequently favourable in their judgment in consideration of the circumstances of the deceased’s family with respect to the forfeiture, and their verdict is[[90]] in its own nature traversable, yet the burial may not be delayed,[[91]] until that matter on trial shall finally be determined. But on acquittal of the crime of self-murder by the coroner’s jury, the body in that case not being demanded by the law, it seemeth that a clergyman may and ought” (we can safely add is compellable) “to admit that body to christian burial.” 1 Burn’s Ecc. Law, tit. Burial.
OF MURDER GENERALLY.
There are so many various modes by which this infamous and horrid crime may be perpetrated, that it would be an almost endless task to enumerate them. In a legal point of view it is scarcely necessary; for wherever death ensues from illegal violence[[92]], with malice prepense, it is felony; yet for the better aid of medical investigation it is expedient to class them under several heads.
Sir Matthew Hale, in his pleas of the Crown, vol. 2, p. 431, enumerates several ways of killing.
1. By exposing a sick or weak person or infant unto the cold, to the intent to destroy him, 2 Ed. 3, 189, whereof he dieth.
2. By laying an impotent person abroad, so that he may be exposed to and receive mortal harm, as laying an infant in an orchard, and covering it with leaves, whereby a kite strikes it and kills it. 6 Eliz. Compt. de Pace; 24 Dalton, cap. 93, (new edit. 145.)[[93]]
3. By imprisoning a man so strictly that he dies, and therefore where any dies in gaol, the coroner ought to be sent for to enquire of the manner of his death.
4. By starving or famine.
5. By wounding or blows.
6. By poisoning.
7. By laying noisome and poisonous filth at a man’s door, to the intent by a poisonous air to poison him. Mr. Dalton, cap. 93, out of Mr. Cook’s reading.[[94]]
8. By strangulation or suffocation.
“Moriendi mille figuræ.”
The two first of these modes frequently occur in cases of infanticide, and to that head, which requires separate consideration on account of its intricacy, we shall therefore refer it. Adults can seldom, if ever, be exposed to destruction in this manner; though, as in —— Brownrigg’s case, and others of the same class, it may constitute a part of the crime of murdering children, even of an advanced age, by duress and starvation; where it is by a combination of cruel injuries, and not by one specific blow or wound, that death is produced. These cases we shall include under a general head, having first disposed of those which require more specific notice.
“By imprisoning a man so strictly that he dies, and therefore where any dies in gaol[[95]] the coroner ought to be sent for to enquire of the manner of his death.”[[96]]
Death by duress of imprisonment was in all probability a very frequent occurrence in the earlier periods of our history, we know that it has often been inflicted by the individual tyranny of the nobles on their vassals; and we have every reason to suppose, that even the keepers of our public prisons were not free from the imputation of cruelty to their unfortunate inmates; many have died by violence, more by neglect; it was therefore a wise and humane precaution that the circumstances of every death of a prisoner should be made the subject of minute enquiry; it is also desirable that such enquiry should be carried on by persons of competent skill, and with every possible and proper publicity. Our own times we will hope are entirely free from the crime of premeditated murder on the body of a prisoner; but we must not allow our confidence in the modern improvements of prison discipline to lull us into a false security as to the conduct of gaolers and their underlings many of these may be men of mild and humane disposition, but as their daily occupation must tend to blunt the finer feelings of humanity, it is well that every charge of misconduct should be met by immediate and rigorous enquiry. On this subject see Rex v. Huggins, warden of the Fleet, 2 Lord Raym. 1578; 2 Str. 882; 9 Harg. St. Tri. 107; Bambridge’s case, 9 Harg. St. Tri. 146, 151; Acton’s case, 9 Harg. St. Tri. 182, 210, 218; see also the several Parliamentary Reports on Coldbath-fields, Ilchester, &c.
“A gaoler, knowing a prisoner to be infected with an epidemic[[97]] distemper, confines another prisoner against his will, in the same room with him, by which he catches the infection, of which the gaoler had notice, and the prisoner dies; this is a felonious killing. Stra. 856; 9 St. Tri. 146. So, to confine a prisoner in a low damp unwholesome room, not allowing him the common conveniences which the decencies of nature require, by which the habits of his constitution are so affected as to produce a distemper of which he dies; this also is felonious homicide. Stra. 884; Lord Raym. 1578. For although the law invests gaolers with all necessary powers for the interest of the commonwealth, they are not to behave with the least degree of wanton cruelty to their prisoners. O. B. 1784, p. 1177; and these were deliberate acts of cruelty, and enormous violations of the trust the law reposeth in its ministers of justice. Forster, 322.” See I Hawk. P. C. by Leach, p. 119.
Previous to the researches of the celebrated John Howard, (see his treatise on Prisons and Lazarettos) our prisons appear to have been in a most disgraceful state; they are now greatly improved, but something may yet be done for their amelioration, more particularly as affecting the health of the prisoners; and this principally, by allowing the most unrestrained medical inspection by disinterested practitioners, who should be as much as possible unconnected with local prejudices, or partialities; some of the parliamentary regulations of madhouses might in this respect be usefully extended to all places of confinement; those who are not sui juris are ever entitled to additional protection.[[98]]
The best practical proof of improvement, in the construction of our prisons, and in our prison discipline, is to be found in the disappearance of that fatal pest, which was commonly called the gaol fever, a disorder which, with something of retributive justice, frequently extended its ravages to those, whose proper vigilance might have prevented its generation. At the assizes held at Oxford in 1577,[[99]] called the black assize, we learn from Baker’s Chronicle (p. 353) that all who were present died within forty hours: the Lord Chief Baron, the Sheriff, and about three hundred more. Lord Bacon ascribed the fatality to a disease brought into court by the prisoners, and Dr. Mead entertained the same opinion; nor was similar infection, though to a less extent, an uncommon occurrence[[100]], see vol. 1, p. 125. The ancient practice of strewing the court with aromatic herbs and flowers, and presenting bouquets to the Judges, is said to have derived its origin from the idea of preventing infection: fresh air, still wanting in our courts, would have proved a more powerful, and not less agreeable prophylaitic.
BY WOUNDING, OR BLOWS.
In investigating the subject of Wounds, it will be convenient to adopt, on the present occasion, the usual classification of local injuries, viz. 1. Incised wounds, or cuts; 2. Punctures, or such as are inflicted by pointed instruments; 3. Bruises, injuries occasioned by blunt instruments; 4. Lacerations, where the integuments are torn, and 5. Gun-shot wounds; upon each of which we shall offer a few observations, and, in the first place, it may be remarked generally, that no graduated scale of wounds, expressive of the degree in which they are curable or dangerous, can ever be constructed; in appreciating the probable degree of danger that attends a wound other data will be required for the solution of the problem than those deduced from situation and extent, such as the constitution and temperament, age, habits of life, especially as they regard temperance and sobriety, previous state of health, unnatural structure and disposition of parts, and existing diseases of the wounded individual; together with the temperature of the season, and other extrinsic circumstances. As a general rule for our guidance a division of wounds into four classes has been suggested, viz. 1. Absolutely mortal. 2. Dangerous. 3. Accidentally mortal. 4. Not mortal. Every practitioner, however, must be aware that death will occasionally supervene on the slightest injury, and at other times that the patient recovers in spite of the most serious and extensive mischief; in proof of the former assertion, the author may state that he has seen a case in which the extraction of a tooth was followed by death in less than forty-eight hours; and every experienced surgeon must in the course of his practice have observed the slightest wound[[101]] productive of alarming and even fatal consequences; in illustration of the occasional occurrence of a contrary result we may recal to the recollection of the reader the extraordinary case[[102]] of Mr. Thomas Tipple, who recovered after an accident, by which the shaft of a chaise had been forced through the thorax! There have also been instances of the recovery of persons whose brain has been wounded to a considerable depth, of others shot through the head; Dr. Male states that a pauper in Paris, some years ago, used to receive charity in a piece of his skull. In the second volume of the Medico-chirurgical Transactions, we have a well attested case of a bayonet wound in the heart not causing immediate death. Littre has given us a report of a man who inflicted upon himself no less than eighteen stabs in the abdomen with a knife; and although some of them did not penetrate beyond the parieties, yet others wounded the contents; the symptoms which followed are stated to have been very severe, but by judicious treatment the patient recovered; seventeen months afterwards, however, he threw himself into the street from a three pair of stairs window, and was instantly killed. On examining the body all the wounds were found healed, and, with the exception of one, all the cicatrices were firm and level; they were traced into the intestines, where corresponding adhesions were observed.[[103]]
The surgical practitioner will, after such cases, be cautious in his prognosis, and profit by the experience of Hoffman, who says, “In judicio de vulnerum lethalitate ferendo multorum Medicorum fama et fortuna periclitantur.”[[104]] Fortunately for the administration of justice, that act of the Legislature, called “the Ellenborough act,” relieves us from many of those embarrassments under which the professional witness[[105]] must otherwise have laboured, and the surgeon will appreciate the high importance and utility of the law, by which wounding with an intent to kill is deemed equally criminal, whether death be the result or not. Still, however, the testimony of the medical practitioner will always be important; indeed the evil intent is often to be inferred, or disproved, by the nature of the injury inflicted; as is so well illustrated in the case of a man, who fractured the skull of a boy with a stick, upon finding him in the act of plundering his orchard; when it was clearly made out in evidence, that a mere chastisement was only intended, for the size of the stick was not such as to have occasioned any fatal effect, had not the skull of the unfortunate boy been unusually thin.
If the surgeon is called upon to inspect a wound, with a view to ascertain whether it produced death, he should in the first instance, endeavour to examine its nature and direction, so as to disturb as little as possible the position in which the body was found; the knife of the anatomist must afterwards explore its more particular condition and relations, by a dissection, for the performance of which we shall give ample directions in a future chapter.
The importance of examining the wound, so as not to alter the position of the parts must be obvious when we consider how necessary it may afterwards become to compare as strictly as possible the internal appearances with the external lesions. The direction of a wound is frequently a circumstance of much greater importance than may at first appear, we ought not therefore to probe it without extreme caution, lest we should give to it a direction which it did not originally possess. This precaution becomes the more necessary as the putrefactive process advances.
Of incised wounds, or cuts. The prognosis of wounds made with a cutting instrument varies, cæteris paribus, according to the extent and depth of the division, the nature of the injured parts, and the circumstances which attend the operation; where the instrument has been so sharp as not to occasion any contusion or laceration, the fibres and texture of the wounded part will have suffered no other injury but their mere division; and there is consequently less tendency to inflammation, suppuration, gangrene, and other bad consequences; if the wound be large and deep it will be more dangerous, as well as more difficult to heal, than one which only affects the skin. Wounds, accompanied with injury of considerable vessels or nerves, are more or less hazardous, according to the magnitude or number of those vessels or nerves; generally speaking, the most dangerous examples of incised wounds are those which are made about the throat; here there are so many large blood-vessels, nerves and other parts of great importance, that deep incised wounds often prove fatal, either immediately, or in a few days; in some cases of suicide the carotid artery is opened, and the person perishes from hemorrhage on the spot, before any assistance can be afforded; in other instances he divides some of the principal branches of the external carotid, and after losing a great deal of blood, he faints, and the hemorrhage being thus checked, the life of the patient is preserved, until surgical assistance can be procured. Cut wounds of the extremities, when such arteries as the femoral and brachial are injured, may also suddenly destroy the patient, by hemorrhage.
Punctures, or such as are made by the thrust of pointed weapons, as by swords, daggers, lances, and bayonets, or by the accidental and forcible introduction of considerable thorns, large nails, skewers, &c. into the flesh,[[106]] comprise a class of wounds of great importance and danger, as they generally penetrate to a great depth, so as to injure large blood-vessels, nerves, viscera, and other organs of importance; and being inflicted with considerable violence the parts always suffer more injury than what would be produced by their simple division. It must also be considered, that a great number of the weapons by which such wounds are occasioned, increase materially in diameter from the point towards their other extremity; and hence, when they penetrate far, they must force the fibres asunder like a wedge, and cause a serious degree of stretching and contusion. It is this circumstance which gives so dangerous a character to bayonet wounds in the soft parts. The opening which the point of such a weapon produces is quite insufficient for the passage of the thicker part of it, which can therefore only enter by forcibly dilating, stretching, and otherwise injuring the fibres of the wounded flesh. But mortal injury may be inflicted by an extremely slender instrument, so as to occasion an apparently trivial puncture; and in some cases, the external injury is healed before the death, which it occasions, takes place. Such cases can only receive satisfactory elucidation from the lights of an anatomical dissection, under which head we have furnished several instructive examples.
Bruises, or Contusions, strictly comprehend those injuries which are occasioned by the violent application of blunt or obtuse instruments to the soft parts. They are not unfrequently complicated with severe internal injury resulting from the violence which the parts have sustained, such as inflammation, suppuration, or even the rupture of some of the viscera, of which we shall hereafter present several illustrative cases.
A blow on the region of the stomach sometimes occasions instant death; an effect which would appear to arise from an injury inflicted upon the eighth pair, and great sympathetic nerves, by which the heart is instantly paralysed. In these cases the heart has been found empty, and the stomach has appeared red and inflamed; this latter appearance is the obvious effect of the sudden cessation of the heart, producing the settling of the blood in the extreme arterial branches.
Wounds of this description are, of course, more or less important, according to their locality; unless complicated with laceration, they are never attended with any considerable hemorrhage, although the minute vessels are necessarily ruptured, and the effusion of their contents produces the discoloration so characteristic of this kind of injury.
As in the case of wounds, so also in respect of blows, injuries apparently inadequate have produced death; it then becomes difficult to fix the degree of guilt which should be attached to the aggressor; for though according to the strict letter of the law, every man is responsible for the ultimate effect of an illegal act committed by him; yet in moral justice there is much difference between the atrocity of him who strikes a grievous wound with a deadly weapon, from which by chance his victim may recover; and the fault of him who transported by sudden passion gives an ordinary blow, which by accident, by reason of some inward and unknown disease of his adversary, or by injudicious treatment, becomes fatal. Numerous cases might be cited in support of this position: that of Brain for the murder of Watts, Cro. Eliz. 778: H. P. C. 455. is one of the most remarkable, not only from the circumstances attending the trial, where the jury were fined and imprisoned for a corrupt verdict, but also for the physiological circumstance, that the deceased died instantly from a blow on the calf of his leg. The parties had previously quarrelled and fought; and Brain, the prisoner, was hurt; the next day Watts passing his shop made mouths at him, on which new provocation Brain hit him the blow which instantly proved fatal. The Court held that the new provocation was insufficient, and that the death must be referred to precedent malice—might they not also have considered that a blow on the calf of the leg was more insufficient to produce death under ordinary circumstances, than a wry face to induce or inflame a quarrel? The prisoner was found guilty, but not without considerable and as it appears to us proper resistance on the part of the jury; the case being on Appeal, the Crown could not pardon, though the appellant might compromise his suit:—we are not informed whether the prisoner was executed.
A case, nearly parallel to the above, is that of Lydia Alder, who was tried in 1744 for the murder of her husband, whom she kicked on the groin; in consequence of which, having at the time an inguinal rupture, mortification came on, and he died. Verdict, Manslaughter. The circumstances attending the case of Bartholomew Quain were, in some respects, different; he was tried and convicted for the murder of his wife, at the Assizes for the Isle of Ely, in 1790. It appeared in evidence, that a rupture of the spleen was produced by the violent kicks, of which the indictment stated that she had died. The jury, under the direction of the Chief Judge of Ely, found a special verdict, in order to take the opinion of the Court of King’s Bench upon the following question, whether the facts found by the jury amounted to murder, or only to manslaughter, when the Court was clearly of opinion that it was murder, because there did not appear to have been any provocation on the part of the deceased; and no man had a right, even to inflict chastisement, without a just provocation.
Lacerations, where the integuments are torn.—These differ from incised wounds not only in the circumstance of their being less disposed to heal by the first intention, but in the singular fact of their not bleeding to any extent; there are perhaps no facts, in the history of surgery, more extraordinary than those which have been recorded on the subject of whole limbs being torn away, without hemorrhage. The most remarkable of these is related by Cheselden, in his work on Anatomy, being the case of a miller, “whose arm, with the scapula, was torn off from his body, by a rope winding round it, the other end being fastened to the coggs of a mill; there was no hemorrhage, nor did any severe symptoms supervene, so that the wound was cured by superficial dressings only, the natural skin being left almost sufficient to cover it.” Analogous cases are recorded by La Motte, in his Traité des Accouchemens; by Mr. Carmichael, in the fifth volume of the Edinburgh Medical Commentaries; and by others, in the second volume of the Mem. de l’Acad. de Chirurgie. In appreciating the degree of danger attendant upon wounds of this description, the practitioner must not overlook the possible occurence of Tetanus.
Gun-shot wounds. Long after the invention of gunpowder, Surgeons continued to entertain very vague opinions respecting the nature of wounds produced by it; some considered that the injured parts were either dreadfully burnt by the heat of the projected body, or were irritated by the presence of poison, communicated to them by the powder. Thomas Gale, who served as a Surgeon in the army of Henry 8th, at Montreuil in 1554, was the first to refute the absurd opinions of “the poisoning, burning, and conquassation of gun-shot wounds.” A gun-shot wound is now defined “a violent contusion, with, or without a solution of continuity, suddenly and rapidly effected by a solid body projected from fire-arms.” If a musket or pistol ball has struck a fleshy part, without injuring any material blood-vessel, we see a hole about the size of, or smaller than the bullet itself; with a more or less discoloured lip forced inwards, and if it has passed through the parts, we find an everted edge, and a more ragged, and larger orifice at the point of its exit; the pain in this case is so inconsiderable that the wounded person is frequently not aware of his having received any injury. The course of balls is frequently most extraordinary, and it behoves the judicial surgeon to keep in mind a fact which may often throw considerable light upon the subject of his investigation. A ball will often strike the thorax or abdomen, and, to an inexperienced eye, appear to have passed directly across, or to be lodged in one of the cavities. If great difficulty of breathing or hemorrhage from the mouth, with sudden paleness and laborious pulse, in the one case, or deadly faintness, coldness of the extremities, and the discharge of stercoraceous matter from the wound, in the second, are not present, we shall perhaps find that the ball has coursed along under the integuments, and is marked in its progress either by a redness, which Mr. Hunter compared to a blush, or by a wheal, or dusky line, terminated by a tumour, on the opening which it will be easily extracted. In some of these long and circuitous routes of balls, where we have not this mark, a certain emphysematous crackling discovers their course, and leads to their detection. The ball is in many instances found very close to its point of entrance, having nearly completed the circuit of the body. In a case related by Dr. Hennen, as one that occurred to a friend of his in the Mediterranean, the ball, which struck about the Pomum Adami, was found lying in the very orifice at which it had entered, having gone completely round the neck, and being prevented from passing out by the elasticity and toughness of the skin which had confined it to this circular course. This circuitous route is a very frequent occurrence, particularly when balls strike the ribs, or abdominal muscles, for they are turned from the direct line by a very slight resistance indeed, although they will at times run along a continued surface, as the length of a bone, along a muscle, or a fascia, to a very extraordinary distance. If there is nothing to check its course, and if its momentum be very great, it is surprising what a variety of parts may be injured by a musket ball. Dr. Hennen states that in one instance, which occurred in a soldier, who having his arm extended in the act of endeavouring to climb up a scaling ladder, had the centre of his humerus pierced by a ball, which immediately passed along the limb, and over the posterior part of the thorax, coursed among the abdominal muscles, dipped deep through the glutæi, and presented on the fore part of the opposite thigh, about midway down. In another case, a ball which struck the breast of a man standing erect in the ranks lodged in the scrotum. The propensity of balls to take a curved direction is often seen in their course on a concave surface; in short, they take very unusual and deep-seated routes, not at all to be accounted for by any preconceived theories drawn from the doctrine of projectiles, nor to be explained by diagrams founded upon mathematical rules. These considerations ought to render the Surgeon very cautious how he delivers his opinion, as to the direction in which the shot was fired, and yet instances frequently occur where no difficulty can arise upon this point, such was the case of Richard Annesley, tried for the murder of Thomas Eglestone (9 Harg. Sta. Tri. 327). The deceased was a poacher. Annesley who was in company with the game-keeper, stated in his defence, that his gun had accidentally gone off in his attempt to secure the deceased. The instructions given by the Court on this occasion was that if the jury were of opinion that the gun had so gone off accidentally, they should bring in a verdict of Chance-medley, which was returned accordingly, in consequence of the evidence of the Surgeon who had examined the wound, and stated that its direction being upwards, very satisfactorily proved that the fowling-piece had not been levelled from the shoulder, which would have implied design; but must have been discharged at the trail, which must have been accidental.[[107]] An idea long existed that a ball might produce injury without striking any part of the body; this was supposed by some to arise from the violent commotion produced in the air by the rapid motion of the ball; and by others, to depend upon an electrical shock on the parts, in consequence of the ball being rendered electrical by friction in the calibre of the gun, and giving off the electrical matter as it passes by. This, however, is contrary to all our received notions respecting electricity; metals can never acquire such a property by friction.
In avowing our total disbelief in the existence of such wind-contusions, as they have been called, we are well aware that we shall oppose many very respectable authorities. “Amicus Plato, sed magis amica Veritas.”
An important question, connected with the present subject, still remains for elucidation; where a body has been found dead with wounds and contusions, by what signs we are to determine whether they were inflicted during life, or after death. As the solution of this interesting problem requires various data, its consideration will be reserved for that part of our work, where all the Objects of Inquiry, in cases of sudden and mysterious death, are considered in their various relations to each other, with a view to appreciate their individual and joint importance.
BY POISONING.
No species of murder is so base and cowardly, or so cool and deliberate in its perpetration as murder by poison, which because of its secresy prevents all precaution, whereas most open murder gives the party killed some opportunity of defence;[[108]] it is generally committed in violation of domestic duty and confidence, and too frequently evinces that unrelenting and barbarous depravity, which can witness the sufferings of its victim for days nay months unmoved; therefore our ancient laws adjudged those convicted of poisoning to a severer punishment than other offenders. 3 Nels. Abr. 363. Jac. Law Dict. tit. Poison. By the 22 Hen. 8. it was ex post facto enacted that Richard Roose, (or Cooke), for putting poison into a pot of pottage in the Bishop of Rochester’s kitchen, by which two persons were killed, should be boiled to death; and that the offence in future should be adjudged High Treason; but this among other new treasons (with which the reign of Henry the 8th had abounded) was abolished by the statute of Edward 6, and now to poison any one wilfully is murder if the party die in a year. 1 Edw. 6. c. 12.
By the 43 Geo. 3. c. 58. (commonly called Lord Ellenborough’s Act) any person administering poison with intent to murder another, (though no death ensue) or to procure the miscarriage of a woman quick with child, is declared guilty of felony without benefit of clergy: and persons administering medicines to procure miscarriage, though the woman is not quick with child, are declared guilty of felony, punishable by imprisonment or transportation (vide post). If a man persuade another to drink a poisonous liquor, under the notion of a medicine, who afterwards drinks it in his absence, or if A, intending to poison B, put poison into a thing, and deliver it to D who knows nothing of the matter, to be by him delivered to B, and D innocently delivers it accordingly in the absence of A;[[109]] in this case the procurer of the felony is as much a principal as if he had been present when it was done (2 Hawk. P. C. 443: Vin. Ab. tit. Accessory) or if one mix poison with any eatable with intent to kill another, and a stranger casually eat it and die,[[110]] it is murder; Dalton, 93. Agnes Gore’s case for poisoning by ratsbane (9 Co. Rep. 81: Palm. R. 547.), not so if it be to kill vermin; but query if it be manslaughter where there is not proper precaution, as where the poison is laid in ordinary places for keeping meat, and mixed with ordinary food, so that a child may take it. 1 East. P. C. He that counsels another to give poison, if that other doth it, the counsellor, if absent, is accessory before. Coke, P. C. 49. Case of the murder of Sir Thomas Overbury, Harg. St. Trials. But he that absolutely gives or lays the poison, to the intent to poison, though he be absent when it is taken by the party, yet he is principal, and this was Weston’s case. Harg. St. Trials: Co. P. C. p. 49. Vaux’s case, ubi supra, and Donellan’s case for the murder of Sir Theodosius Boughton, Warwick Assizes, 1784. See Appendix, 243.
It is not our intention to detail every mode by which murder by poison may be committed; too many are already known to the world in general; on those which are known, we may safely comment; nor would there be as much mischief as is commonly supposed in hinting at some others; for if any should study this subject with evil intention, he may be assured that the progress of modern science, though it may have discovered some new modes of destruction, has been yet more fertile in antidotes for the injured, and in means of detecting the guilty.
OF POISONS,
CHEMICALLY, PHYSIOLOGICALLY, AND PATHOLOGICALLY CONSIDERED.
Toxicology, or the history of Poisons, forms one of the most important and elaborate branches of Forensic Medicine, and in tracing the subject through all its numerous and interesting relations to Jurisprudence, we shall experience no small degree of gratification by observing, how greatly and progressively this obscure department of science has, within the last few years, been enlightened by the discoveries of Chemistry and Physiology.
The labours of the modern Chemist, indeed, have enabled us to recognise and identify each particular substance by its properties and habitudes, with an infallible delicacy, which the Physicians of a former age could scarcely have anticipated, and much less practised.
The Physiologist, by an invaluable series of observations and experiments, has demonstrated the particular organ, or texture, upon which each individual poison exerts its energies; and the Pathologist has been thus enabled to establish the mode in which it depraves the health, or extinguishes the life of an animal. Nor has the Anatomist withheld his contributions upon this interesting occasion, for he has demonstrated the situation, extent, and intensity of the organic lesions which result from the operation of these terrible agents upon the living body; and has pointed out several appearances which occur from natural causes, but which might be mistaken by the unskilful or superficial observer, for the ravages of poison. It remains for the Forensic Physician to converge into one focus the scattered rays which have thus emanated from so many points, and thereby to elucidate and determine the line of conduct which the medical attendant is called upon to pursue, for the relief of the patient suffering under the torments of poison, and for the establishment of the guilt or innocence of the party charged with the perpetration of a crime, which may be said to rob courage of its just security, while it transfers to cowardice the triumphs of valour. That engines so powerful and secret in their work of destruction, should have universally excited the terror of mankind is a fact which cannot surprise us, and, when we consider how intimate are the relations between fear and credulity, we need not seek farther for the solution of the many problems to which the exaggerated statements of ancient Toxicologists[[111]] have given origin; the most extraordinary of those relate to the alleged subtlety of certain poisons, which was believed to be so extreme as to defeat the most skilful caution, and at the same time so manageable, as to be capable of the most accurate graduation; so that, in short, the accomplished assassin was not only thus enabled to ensure the death of his victim through the most secret, and least suspicious agents, but to measure his allotted moments with the nicest precision, and to occasion his death at any period that might best answer the objects of the assassination. The writings of Plutarch, Tacitus, Theophrastus, Quintillian, and Livy, abound with such instances of occult and slow poisoning; most of which, however, notwithstanding the weight they may acquire from their testimony, bear internal evidence of their fallacious character. Plutarch informs us that a slow poison which occasioned heat, cough, spitting of blood, a lingering consumption of the body, and a weakness of intellect, was administered to Aratus of Sicyon. This same poison is also alluded to by Quintillian in his declamations. Tacitus[[112]] informs us that Sejanus caused a secret poison to be administered by an eunuch to Drusus, who in consequence gradually declined, as if by a consumptive disorder, and at length died. Theophrastus[[113]] speaks of a poison, prepared from Aconite, that could be so modified as to occasion death within a certain period, such as two, three, or six months, a year, and even sometimes two years.
To such an extent does the crime of poisoning appear to have been carried, about two hundred years before the Christian æra, that according to Livy,[[114]] above one hundred and fifty ladies, of the first families in Rome, were convicted and punished for preparing and distributing poison. The most notorious and expert character of this kind is handed down to us by the historians and poets under the name of Locusta, who was condemned to die on account of her infamous actions, but was saved in order that she might become a state engine, and be numbered, as Tacitus expresses it, “Inter instrumenta regni.” She was accordingly employed to poison Claudius by Agrippina, who was desirous of destroying the Emperor, and yet feared to despatch him suddenly, whence a slow poison was prepared by Locusta, and served to him in a dish of mushrooms, of which he was particularly fond, “Boletorum appetentissimus;” but it failed in its effects, as we learn from Tacitus, until it was assisted by one of a more powerful nature. “Post quem nihil amplius edit.” This same Locusta prepared also the poison with which Nero despatched Britannicus, the son of Agrippina, whom his father Claudius wished to succeed him on the throne. This poison appears to have proved too slow in its operation, and to have occasioned only a dysentery. The Emperor accordingly compelled her by blows and threats, to prepare in his presence one of a more powerful nature, and as the tale is related by Suetonius, it appears that it was then tried on a kid, but as the animal did not die until the lapse of five hours, she boiled it for a longer period, when it became so strong as instantaneously to kill a pig to which it was given. In this state of concentration it is said to have despatched Britannicus as soon as he tasted it.[[115]] Vide Tac. An. 13. s. 15. 16. Now it would clearly appear from these statements that Locusta, avowedly the most accomplished poisoner of ancient Rome, was wholly incapable of graduating the strength of her poisons to the different purposes for which they were applied.
The records of modern times will furnish examples no less atrocious than those we have just related. Tophana, a woman who resided first at Palermo, and afterwards at Naples, may be considered as the Locusta of modern history; she invented and sold those drops so well known by the names of Aqua Toffania; Aqua della Toffana; Acquetta di Napoli, or simply Acquetta. This stygian liquor she distributed by way of charity to such wives as wished for other husbands; from four to six drops were sufficient to destroy a man, and it was asserted that the dose could be so proportioned as to operate within any given period.[[116]] It appears that in order to secure her poison from examination, she vended it in small glass phials, inscribed, “Manna of Saint Nicolas Bari,” and ornamented the vessel with the image of the Saint. Having been put to the rack she confessed that she had destroyed upwards of six hundred persons, for which she suffered death by strangulation in the year 1709[[117]]. In 1670 the art of secret poisoning excited very considerable alarm in France; the Marchioness de Brinvillier, a young woman of rank and great personal beauty, having intrigued with, and subsequently married an adventurer named Saint Croix, acquired from him the secret of this diabolical act, and practised it to an extent that had never before been equalled. She poisoned her two brothers through the medium of a dish at table. She also prepared poisoned biscuits, and to try their strength she distributed them herself to the poor at the Hotel Dieu. Her own maid was likewise the subject of her experiments. To her father she gave poisoned broth, which brought on symptoms characteristic of those induced by corrosive sublimate. Her brothers lingered during several months under much suffering. The detection of this wretch is said to have been brought about in the following manner. Saint Croix, whenever engaged in the preparation of his poisons, was accustomed to protect himself from their dangerous fumes by wearing a glass mask, which happening to fall off by accident, he was found dead in his laboratory.[[118]] A casket directed to the Marchioness, with a desire that in case of her death it might be destroyed unopened, was found in his chamber, a circumstance which in itself was sufficient to excite the curiosity and suspicion of those into whose hands it fell. The casket was accordingly examined, and the disclosure of its contents at once developed the whole plot, and finally led to the conviction of this French Medea, who after a number of adventures and escapes, was at length arrested and sent to Paris, where she was beheaded, and then burnt, on the 11th of July, 1676. The practice of poisoning, however, did not cease with her execution, and it became necessary in 1679 to establish a particular Court, for the detection and trial of such offenders; which continued for some time to exert its jurisdiction under the title of Chambre de Poison, or Chambre Ardente.
With respect to the secret modes in which poisons have been supposed capable of acting, mankind have ever betrayed the most extravagant credulity, of which the numerous tales upon record afford ample proof; such as that reported of Parasapis by Plutarch, from Ctesias, in his life of Artaxerxes, who, it is said, by anointing a knife on one side by poison, and therewith dividing a bird, poisoned Statira with one half, and with the other regaled herself in perfect security. We are also told of Livia who poisoned the figs on a tree which her husband was in the habit of gathering with his own hands. Tissot informs us that John, king of Castille, was poisoned by a pair of boots prepared by a Turk; Henry VI, by gloves[[119]]; Pope Clement VII, by the fumes of a taper[[120]]; and our king John, in a wassail bowl, contaminated by matter extracted from a living toad. To these few instances of credulity may be added the offer of the priest to destroy queen Elizabeth by poisoning her saddle[[121]], and the Earl of Essex, by anointing his chair.
Incredible and absurd as these opinions now appear, they continued until a late period to alarm mankind, and to perplex and baffle judicial investigations; even Lord Bacon in his charge against the Earl of Somerset for the murder of Sir Thomas Overbury, in the Tower, seemed to give credit to the story of Livia, and he seriously stated, that “Weston chased the poor prisoner with poison after poison; poisoning salts, poisoning meats, poisoning sweetmeats, poisoning medicines and vomits, until at last his body was almost come, by the use of poisons, to the state that Mithridates’s body was by the use of treacle and preservatives, that the force of poisons was blunted upon him;” Weston confessing, when he was reproached for not despatching him, that he had given enough to poison twenty men.[[122]] The power of so graduating the force of a poison as to enable it to operate at any given period seems to have been considered possible by the earlier members of the Royal Society, for we learn from Spratt’s history of that learned body, that very shortly after its institution, a series of questions were drawn up by the direction of the Fellows, for the purpose of being submitted to the Chinese and Indians, viz. “Whether the Indians can so prepare that stupifying herb, Datura, that they make it lie several days, months, years, according as they will have it, in a man’s body, without doing him any hurt, and at the end kill him without missing half an hour’s time?”
That mankind were, in a very early stage of their existence, not only acquainted with the deadly effects of certain natural substances when applied in minute quantities, but that they availed themselves of such knowledge for the accomplishment of the worst purposes, is very satisfactorily shewn by the records of sacred as well as profane authors. But such is the ambiguity of ancient writers upon this subject, and so intimately blended are all their receipts with the practices of superstition, that every research, however learned, into the exact nature of the poisons which they employed, is necessarily vague and unsatisfactory. Of this one fact, however, we may be perfectly satisfied, that they were solely derived from the animal and vegetable kingdoms, for the discovery of mineral poisons was an event of later date; owing however to the defect of botanical nomenclature, it is even doubtful whether the plants which are designated by the terms Cicuta, Aconitum, &c. in ancient authors, were identical with those we designate by the same names. (See Pharmacologia, edit. v. vol. 1, p. 66.) With respect to the poisons of Locusta, all cotemporary writers speak of the venom of the toad as the fatal ingredient of her potions, and in the Alexipharmaca of Dioscorides we find the symptoms described, which are said to be produced by it;[[123]] but what is very extraordinary, the belief of the ancients on this matter was all but universal. Pliny is express on the subject; Ætius describes two kinds of this reptile,[[124]] the latter of which, as Dr. Badham has suggested, was probably the frog, as well from the epithet, as that he ascribes deleterious powers only to the former. It is scarcely necessary to observe that this ancient belief has descended into later times; we find Sir Thomas Browne treating such an opinion as one of the vulgar errors; and we have before alluded to the legend of king John having been poisoned by a wassail bowl in which matter extracted from a living toad was said to have been infused. In still later times, we have heard of a barrel of beer poisoned by the same reptile having found its way into it. Borelli and Valisnieri maintain that it is perfectly harmless, and state that they had seen it eaten with impunity. Spielman[[125]] expresses the same opinion, “Minus recte itaque effectus venenati a bufonibus metuuntur.” Franck,[[126]] on the contrary, accuses Gmelin of too much precipitancy in rejecting the belief respecting toad-poison,[[127]] Modern naturalists recognise no poisonous species of toad; even the most formidable of the species, to appearance, that of Surinam, is said to be perfectly harmless.
If we may venture to offer a conjecture upon this subject, we are inclined to consider the origin of this opinion to have been derived from the frequency with which the toad entered into the composition of spells or charms, into philtres or love potions, and which, like the bat and the owl, most probably derived its magical character from the gloom and solitude of its habitation. Shakspeare has accordingly introduced this reptile into the witches’ enchanted cauldron, in Macbeth.
“Round about the cauldron go;
In the poison’d entrails throw.
Toad that under coldest stone
Days and nights hast thirty-one
Swelter’d venom sleeping got,
Boil thou first i’ the charmed pot!”