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Full text of "Medical Jurisprudence And Toxicology"

CHAPTER   VI

DEATH IN ITS MEDICO-LEGAL ASPECTS

Definition.—Death is classified as somatic or systemic and molecular.
JScmatic death is that state of the body in which there is complete cessation
of the functions of the brain, heart and lungs which maintain life and health.
and are, therefore, called u the tripod of life'". Molecular death means the
death of the tissues and cells individually, which takes place some lime after
the stoppage of the vital functions, and is accompanied by cooling of the
body, the temperature of which is reduced to an equilibrium with the
external world.

MODES OF DEATH

x     Ju all kinds of death, whether natural or accidental, there are three
primary modes of death, viz.,

1.    Coma.

2.    Syncope.

3.    Asphyxia.

COMA

Coma means insensibility resulting in death from some cause preventing
the action of the brain.

Causes.—1. .Compression of the brain resulting from injuries or diseases
of the brain or its membranes, such as concussion, effusion of blood on, or
in, the brain substance due to subarachnoid haemorrhage, fracture of the
skull, inflammation, abscess or new growth of the brain, or embolism and
thrombosis.

2.    Poisons, such as opium, alcohol, carbolic acid, etc. having a specific
action on the brain and nervous system.

3.    Poisons acting on the brain after they are generated in the body in
certain   diseases   of   the   liver   and   kidneys,   e.g.   cholsemia,   acetonsemia,
uraemia, etc.

Symptoms.—First of all, there is a condition of stupor from which the
patient may be roused temporarily for a few seconds or more. In_this
condition the reflexes are usually present, or are exaggerated, and the patient
may be able to swallow fluids. This is followed by complete unconscious-
ness from which the patient cannot be roused. In some cases sudden insen-
sibility supervenes without an initial stage of stupor. During the comatose
condition the reflexes are lost, the sphincters are relaxed, and the pupils
are dilated or contracted, and insensible to light. Tl^e skin is generally
covered with cold perspiration, and the temperature is sub-normal or normal,
except in the lesions of Pons Varolii, where it is high. TJue pulse is usually
full and bounding, but slow. The breathing is slow, irregular and stertorous.
Mucus collecting in the air passages causes the sound which is known as
~frtrie death rattle ".

Post-mortem Appearances.—Injuries of the skull bones or of the brain
and consequent effusion of the blood into the cranial cavity may be present.
" The brain and its membranes are found congested. Haemorrhages within
the cranium due to disease are found within the membranes or in the brain
substance, but when due to injury, are commonly found in clots between
the skull bones and the membranes, or on the surface of the brain. The
right side of the heart is usually full and the left empty. The lungs and the
venous systems are gorged with blood, but not so much as in death from
asphyxia.