Mortification (medicine)

“ Rigor mortis must be distinguished from cadaveric spasm or the death clutch; in the former, articles in the hands are readily removable, in the latter this is not the case. In tetanic spasm the limbs when bent return to their former position; not so in rigor mortis.
Putrefaction appears in from one to three days after death, as a greenish-blue discoloration of the abdomen; in the drowned, over the head and face. This increases, becomes darker and more general, a strong putrefactive odour is developed, the thorax and abdomen become distended with gas, and the epidermis peels off. ”

“ The heart, moreover, continues to contract after the lungs have ceased to perform their duty. Death is thus due to apnœa—that is, death beginning at the lungs—and not to syncope. Death in some cases is from neuro-paralysis or nervous apoplexy. In death by shock, which in most cases is instantaneous, both sides of the heart are equally filled. Death, the result of disease, may present all the signs of death from suffocation, and no suspicion may be aroused as to the cause of death from the post-mortem appearances, especially if putrefaction have set in. ”

“ Both suicides and murderers are usually more violent than is necessary to destroy life; murderers more than suicides.
Putrefaction may cause external marks to disappear.
All marks on a body should be carefully noted; the cavities of the skull, thorax, and abdomen carefully examined; the possibility of death having occurred from other causes, even in strangulation, must be considered. ”

“ A caution may be given here against allowing the post-mortem signs of disease or external injury to exclude the idea of poisoning; for death may to all appearance be the result of disease or injury, and yet be caused by poison. An attention to the post-mortem appearances is important in all cases; for in many instances, where the symptoms were unknown to the experts at the time the inspection was made, they were subsequently found to correspond with the morbid changes which the autopsy revealed. ”

“ Again, it has been observed that when death has taken place suddenly, as from accident, apoplexy, or acute disease, the body retains its heat for a long time. The bodies of persons dying from hanging, electrocution, suffocation, or poisoning by carbon dioxide, do not generally cool for from twenty-four to forty-eight hours, and cases are recorded where three days have elapsed before the body was completely cold. On the other hand, bodies dead from chronic wasting diseases or severe hemorrhage cool very rapidly, even in four or five hours. ”

“ When a mortification arises from some external injury done to the part, it is not preceded by a gangrene, but is produced by an absolute stagnation of the blood and juices, and all the injured parts become insensible and putrid at the same time, without any previous inflammation. A mortification arising from some internal cause, or a deficiency of natural heat, comes on in the same manner, but is more tardy in its progress, although it exhibits similar appearances; but the nature of the disease may be readily discovered. ”

“ It has been said, and most naturally, what guarantee is there against poisoning if the remains are burned, and it is no longer possible, as after burial, to reproduce the body for the purpose of examination? It is to my mind a sufficient reply that, regarding only ‘the greatest good to the greatest number,’ the amount of evil in the shape of disease and death which results from the present system of burial in earth is infinitely larger than the evil caused by secret poisoning is or could be, even if the practice of the crime were very considerably to increase. ”

“ Mortification is a word with an interesting etymology. It means literally the dying or more properly the putting to death of one part of an animal body while the rest is alive. From this it has come to mean, to quote the Century Dictionary, "The act of subduing the passions and appetites by penance, abstinence or painful severities inflicted on the body." It has had this signification from the very earliest times of Christianity, for the early Fathers spoke of dying to self to have a higher and a nobler life. ”

“ In the latter case death may be due as much, if not more, to other causes than the wound, and sometimes not at all to the wound itself. Thus death may be due to natural causes, latent disease, an unhealthy state of the body, imprudence or neglect of treatment, or improper treatment, etc. These various degrees of responsibility of a wound as the cause of death we will now consider more at length. ”

“ If there is no disease found which could be rapidly fatal the case is still stronger. The body should be pallid after fatal hemorrhage, but the same may be the case from death from other causes. In case the body and surrounding objects have not been disturbed, then the amount of clotted blood in the wound, on the body and clothes, and about the body, taken in connection with the foregoing points, can leave no doubt. ”

“ Incineration destroys all disease germs and at once removes all possibility of the contamination of air and water by the dead.
Then why not introduce cremation and do away with all the evils described in this chapter? It is of no consequence to the dead, whether they rot in the earth and originate miasma, or are transformed by fire into pure white ashes. They feel as little of the process of decay as they do of the flame; their eye is surrounded by the same darkness, whether they are down in the deep grave or in the glowing light of the crematory furnace. ”

“ The eyes in some cases are sunken deeply in their sockets, and where the disease has been protracted there is often very great emaciation. Rigor mortis is commonly well marked after a few hours. When death occurs from puerperal pyæmia there are generally found some indications of the recent parturition, although the principal lacerations or injuries may be confined to the womb. All fluids disappear from external wounds before the death of the patient, and they remain dry afterward. ”

“ These conditions increase with the length of time after death, so that after a time a wound made on a cadaver would show very little if any clotting owing to very slight hemorrhage, and little or no clotting of the blood extravasated. When the body has lost its animal heat and rigor mortis has begun to set in, then there is no more coagulation of the blood and no more hemorrhage, under normal conditions, for the blood has mostly become clotted in the vessels of the body. ”

“ Death during alcoholic intoxication favours the duration of rigor mortis. After violent muscular exercise death is quickly followed by rigidity. Animals that have been hunted for some time before death stiffen very rapidly. When convulsions precede death, rigor mortis sets in early as a rule, but in certain cases, where death has been preceded by strong convulsions, rigidity may appear quickly, but last for some days, as in some cases of poisoning by strychnine. ”

“ In all epidemics of a severe type cases now and then occur in which the poison is so intense, or it acts with such frightful energy, that death occurs even within the first day. The patient is overpowered at the outset of the disease by the virulence of the specific principle, perishing in coma, preceded perhaps by convulsions. The autopsy in such cases reveals hyperæmia of the brain and cranial sinuses, blood of a dark-red color, capillary hemorrhages in various parts, a flabby heart, and perhaps some engorgement of the spleen and kidneys. ”

“ Partial or local death may be molecular as in ulceration, or it may affect an organ or part of an organ, as in necrosis, sphacelus, or sloughing. Somatic death is a loss of vitality of the entire body and is manifested by a complete cessation of the bodily functions, including that of nutrition. Usually the arrest begins with one of the great vital processes, in advance of the others, and thus in different cases, we have death beginning at the heart, at the lungs, and at the brain. ”

“ In the first two to four hours after death, therefore, as far as the condition of the blood is concerned, it may be difficult or impossible to say whether a wound was made before or soon after death. In other words, this difficulty exists as long as the tissues of the body live after the body as a whole is dead. ”

“ The amount of retraction grows less and less after death for about two hours, after which it is very slight if it occurs at all, owing to the loss of elasticity of the tissues. This sign is especially useful in the case of a mutilated body where, by examining the degree of retraction of the muscles, we may infer whether the mutilation was done before or after death. The sides of a cut made on the cadaver are comparatively smooth and even, owing to the absence of the unequal retraction of the various elements, which makes the surfaces of a gaping ante-mortem wound uneven and irregular. ”

“ Everything is going to be nice and quiet and respectable. The effect of the poison is similar to heart failure. No one can tell the difference on the corpse. There's going to be no blood anywhere. I will be found dead in my house in the morning with heart failure, or else he will be picked up dead in the street, far enough away so as to make no talk. ”

“ If the corpse be that of a nobleman, whose family can well afford a funeral pyre, it may be cremated. In some remote districts earth burial is customary; and it is commonly employed everywhere when death has been caused by a very contagious and dangerous disease, like small-pox for example. ”

“ There is one which causes death if it be buried in the earth, in the shade of the head of the intended victim, who is at once struck with bewilderment and loses all consciousness, and perishes if a proper antidote be not administered. ”

“ It must be admitted that cases of criminal poisoning, such as would be detected by an exhumation and examination of a buried body, are very rare, for in our day Lucrezia Borgias and Brinvilliers are few and easily detected. In a community like ours cases of this kind are extremely rare. In a vast majority of cases the cause of death is perfectly evident to any intelligent physician. No doubt obscures the case. The list of causes of death, perfectly evident even to the friends and non-medical persons, embraces probably at least nine-tenths of the whole mortality. ”

“ When proofs of respiration—it may be to such an extent as to leave no doubt as to live-birth—have been found, the cause of death is then to be investigated. Wounds, and other forms of injury, must be sought for. There may be signs of strangulation, suffocation, puncture of the fontanelles and consequent injury to the brain, the administration of a poison, or other means of procuring death. ”

“ As an original supporter of an enterprise that never sought to make money, I need not shrink from giving it bold advertisement. The one valid objection to cremation, that death by poisoning might be undetected, is obviated by the precautions all along insisted upon by the Cremation Society, which, along with its own aims, has advocated such more stringent examination into the cause of death as itself requires in every case. ”

“ It is not an unusually early onset of rigor mortis in the muscles affected, because they do not share in the initial relaxation that precedes it, or the weapon would fall from the hand, and the bodies would not retain the peculiar attitudes which have been described in different instances. Nothing can simulate cadaveric spasm and it cannot be produced in any way after death. Instantaneous rigor only occurs in cases in which there has been great mental tension and nerve excitation before death. ”

“ These phenomena occur whilst the body is cooling. The muscle becoming rigid is dying, the rigid muscle is dead. The cause of the rigor mortis is held to be due to the coagulation of the myosin. The reaction is acid from the presence of sarcolactic acid, but becomes alkaline during putrefaction.
If fresh difibrinated blood be passed through the rigid muscle, it will become flaccid, and respond by contraction to electric stimulation.
Cadaveric rigidity generally supervenes from eight to twenty hours after death, and may continue from a few hours to four or nine days. ”

“ When such softening is the result of postmortem autolysis or digestion, as is so often the case in the stomach (postmortem perforations) , thymus, pancreas, adrenals, brain, etc., the term postmortem softening is more frequently used in this country. Soft tumors are described as medullary, encephaloid, etc. In all judgments as to consistence the normal differences between the organs must be considered, as well as the length of time between death and the autopsy, the cause and manner of death, undertaker’s manipulations, temperature, moisture, rigor mortis, putrefaction, etc. ”

“ To quote his own words, "We ought to require very strong testimony indeed to convince us in any case that concretions found in the heart at the time of death have caused death, still more to convince us that those clots which resemble in every point the clots which are the mere result of dying have had this effect." ”

“ Post-Mortem Appearances in Cases of Death by Cobra-bite.
Rigor mortis generally comeson about the usual time and is as well marked as it is in death from ordinary causes. The blood in man is fluid, as a rule, and in the lower animals coagulated. If examined directly after death no changes can be recognised by the microscope. After a time the corpuscles may change in shape, become crenated, and blood-crystals may form, but at the moment of death no change can be recognised. The parotid glands may be swollen. The brain presents no marked deviation from normal. ”