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Signs Of Death

(1) Cadaveric appearance; ashy white colour. (2) Cessation of the

circulation and respiration, no sound being heard by the stethoscope.

Cessation of the circulation may be determined by (a) placing a ligature

round the base of a finger (Magnus' test); (b) injecting a solution of

fluorescin (Icard's test); (c) looking through the web of the fingers at

a bright light (diaphanous test); (d) the dulling of a steel needle when

/> thrust into the living body; (e) the clear outline of the dead heart

when viewed in the fluorescent screen. (3) The state of the eye; the

tension is at once lost; iris insensible to light, fundus yellow in

colour; cornea dull and sunken. (4) The state of the skin; pale, livid,

with loss of elasticity. (5) Extinction of muscular irritability. The

above signs afford no means of determining how long life has been

extinct. The following, however, do:

=Cooling of the Body.=--The average internal temperature of the body is

from 98° to 100° F. The time taken in cooling is from fifteen to twenty

hours, but it may be modified by the kind of death, the age of the

person, the presence or absence of clothing on the body, the surrounding

temperature, and the stillness or otherwise of the air about the body.

Still, the body, other things being equal, may be said to be quite

cold in about twelve hours.

=Hypostasis= or =post-mortem staining= is due to the settling down of

the blood in the most dependent parts of the body while the body is

cooling. It is a sure sign of death, and occurs in all forms of death,

even in that due to hæmorrhage, although not so marked in degree.

Post-mortem staining (cadaveric lividity) begins to appear in from

eight to twelve hours after death, and its position on the body will

help to determine the length of time the body has lain in the position

in which it was found. The staining is of a dull red or slaty blue

colour. It must be distinguished from ecchymosis the result of a bruise,

by making an incision into the part; in the case of hypostasis a few

small bloody points of divided arteries will be seen, in the case of

ecchymosis the subcutaneous tissues are infiltrated with blood-clot.

Internally, hypostasis must not be mistaken for congestion of the brain

or lungs, or the results of inflammation of the intestines. If the

intestine is pulled straight, inflammatory redness is continuous,

hypostasis is disconnected. About the neck hypostasis must not be

mistaken for the mark of a cord or other ligature. When the blood is of

a bright red colour after death (as happens in poisoning by CO or HCN,

or in death from cold), the hypostasis is bright red also.

=Cadaveric Rigidity--Rigor Mortis.=--For some time after death the

muscles continue to contract under stimuli. When this irritability

ceases--and it seldom exceeds two hours--rigidity and hardening sets in,

and in all cases precedes putrefaction. It is caused by the

coagulation of the muscle plasma. It commences in the muscles of the

back of the neck and lower jaw, and then passes into the muscles of the

face, front of the neck, chest, upper extremities, and lastly to the

lower extremities.

It has been noticed in the new-born infant, as well as in the foetus. It

lasts from sixteen to twenty hours or more. In lingering diseases, after

violent exertion, and in warm climates, it sets in quickly, and

disappears in two or three hours; in those who are in perfect health and

die from accident or asphyxia, it may not come on until from ten to

twenty-four hours, and may last three or four days. After death from

convulsions or strychnine-poisoning, the body may pass at once into

rigor mortis. 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 muscles then become pulpy,

and assume a dark greenish colour, the whole body at length becoming

changed into a soft, semi-fluid mass. The organ first showing the

putrefactive change is the trachea; that which resists putrefaction

longest is the uterus. These putrefactive changes are modified by the

fat or lean condition of the body, the temperature (putrefaction taking

place more rapidly in summer than in winter), access of air, the period,

place, mode of interment, age, etc. Bodies which remain in water putrefy

more slowly than those in air.

=Saponification.=--In bodies which are very fat and have lain in water

or moist soil for from one to three years this process takes place, the

fat uniting with the ammonia given off by the decomposition to form

adipocere. This consists of a margarate or stearate of ammonium with

lime, oxide of iron, potash, certain fatty acids, and a yellowish

odorous matter. It has a fatty, unctuous feel, is either pure white or

pale yellow, with an odour of decayed cheese. Small portions of the body

may show signs of this change in six weeks.

=Post-Mortem Examination.=--Never make an autopsy in criminal cases

without a written order from the coroner or Procurator Fiscal. If

authorized, however, first have the body identified, then photographed

if it has not been identified. A medical man representing the accused

may be present, but only by consent of the Crown authorities or of the

Sheriff. Clothing should be examined for blood-stains, cuts, etc.

Examine external surface of body and take accurate measurements of

wounds, marks, deformities, tattooings; note degree and distribution of

post-mortem staining, rigidity, etc.

Examine brain by making incision from ear to ear across vertex, reflect

scalp forwards and backwards, and saw off calvarium. Examine brain

carefully externally and on section.

Examine organs of chest and abdomen through an incision made from

symphysis menti to pubis, reflecting tissues from chest wall and cutting

through costal cartilages.

In cases of suspected poisoning have several clean jars into which you

place the stomach with contents, intestines with contents, piece of

liver, kidney, spleen, etc., and seal each up carefully, attaching label

with name of deceased, date, and contained organs, and transmit these

personally to the analyst.

=Exhumation.=--A body which has been buried cannot be exhumed without an

order from a coroner, fiscal, or from the Home Secretary. There is no

legal limit in England as to when a body may be exhumed; in Scotland,

however, if an interval of twenty years has elapsed, an accused person

cannot be prosecuted (prescription of crime).