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?