Chapter XXIV: Section 6: ,216, same as 303, N. Y. P. C (5)

Almost always the motive that prompts these disfigurements of the skin is the result of impulse, of thoughtlessness, or of orgy, and almost all the tattooed come to repent of their folly. The subject of _détatouage_ has of late taken a polemic turn in some of the Continental journals. There are besides many cases on record of severe accidents and complications following the operation, such as severe inflammation, erysipelas, abscess, and gangrene. Dr. Beuchon gives statistics of forty-seven cases, in which four were followed by mutilation and eight by death either directly or in consequence of an amputation. A certain proportion of what is known as _syphilis insontium_ is to be found among the reported statistics of tattooing. Dr. Bispham, of Philadelphia, informs me that while at Blockley Hospital he saw thirty cases of syphilis that had been communicated by the same tattooer.

Tattooing may sometimes be _accidental_. I have seen a departmental clerk with an elongated tattoo on the back of his hand caused by accidental wounding with an inked pen. A bursting shell during a naval engagement has caused a characteristic tattoo on the face of a well-known officer to be seen any day in Washington. Two cases of the bluish-black discoloration of the skin from taking nitrate of silver have also come under my observation. Both occurred in medical men, one of whom lives in Florida, the other in the District of Columbia. Silver discolorations of this kind are indelible, but I learn from one of these gentlemen that large doses of iodide of potassium cause temporary fading of the discoloration, which returns on stopping the medicine.[591]

The _indelibility of tattoo-marks_ is such that their traces may be easily recognized in the cadaver, though in a somewhat advanced stage of putrefaction. They have even been recognized on a gangrenous limb. Sometimes, however, it is impossible to recognize at first sight whether there has or has not been a tattoo. A strong light and a magnifying glass and a microscopic examination of the neighboring ganglia to detect the presence of coloring matter may assist in removing doubt. It has been found on the bodies of tattooed cadavers that the ganglia are filled with grains of coloring matter of the same nature as that employed in making the tattoo. Attempts to remove tattoo-marks generally leave a vicious scar that is equally indelible. An efficacious method is to tattoo the mark with a solution of tannin, which is followed by brushing over with nitrate of silver. A red cicatrix follows, and when the epidermis separates the tattoo disappears. A better method, however, is by means of the electric needle already mentioned in speaking of the electrolysis of nævi.

That _a tattoo-mark may disappear_ by the effects of time and leave no trace is a matter that Cooper reports after examining the mutilated remains of a cadaver, and the statistics of Caspar, Tardieu, and Hutin place it as high as nine in the hundred. An officer of the United States Revenue Marine lately called my attention to several superficial tattooes on the back of his hand which had disappeared. The deeper ones, however, remained. The _spontaneous disappearance of a tattoo_ seems to be possible when the operation has been done in such a superficial way as not to have passed the rete Malpighii, or when the tattooing has been done with some substance not very tenacious, as vermilion, which appears to be easily eliminated. But when the particles of coloring matter penetrate into the fibro-elastic tissue of the derma, the disappearance of the tattoo is rare.

In seventy-eight individuals tattooed with vermilion alone, Hutin found eleven upon whom the tattoo had disappeared. Out of one hundred and four tattooes made with a single color, India-ink, writing ink, blue or back, not a single one had completely disappeared. The results are identical if the tattooes are made with two colors. Thus in 153 tattooes with vermilion and India-ink, one instance showed a fading of the black, in another it had completely disappeared, the red being well marked; twenty times the red was partly effaced, the black being well marked; and in sixteen cases the red had completely disappeared, the black remaining visible.[592]

A tattoo-mark may sometimes be altered, in which case it proves deceptive as an index. A workman changing his trade seeks to transform the insignia of his first calling into those of the second, or a criminal in order to avoid identity will make a change. In the former instance the transformation is not difficult to detect, but in the latter so much care is required to recognize the change that penal science has relegated the sign to a secondary place.

As to the length of time since a tattoo-mark has been executed, authorities are that it is impossible to tell after two or three weeks. Whether a tattoo-mark is real or feigned is easily settled by simply washing the part. This question, as well as that of the judicial consequences of such marks, is hardly pertinent to the matter in hand.

VALUE OF PROFESSIONAL STIGMATA.

The so-called professional signs are of undoubted value in the surface examination for establishing identity, but it does not seem that their importance warrants the extreme prolixity given to them by some Continental writers, and even by one in the city of Mexico, Dr. Jose Ramos.[593] For instance, it is pretended that cataract is more common among jewellers because of the fineness of their work; yet out of 952 cataracts, of which a record has been kept, only two cases occurred in jewellers. Besides, there is not one special sign or physical trace left on the body by which a prostitute may be known, notwithstanding the fact that in life the collective appearance would seldom deceive an experienced man.

Only in the case of sodomy, where anal coitus has been frequent, would characteristic signs be found. On anal examination of 446 prostitutes, Dr. Coutagne[594] found the signs of post-perineal coitus in 180. He cites the case of a young prostitute presenting the astonishing contrast of a gaping anus surrounded by characteristic rhagades, with the genital parts of an extreme freshness, a very narrow vagina, and non-retracted hymen, constituting by their reunion a still firm ring. A fact yet more curious is shown by a specimen in the collection of the museum of the laboratory of legal medicine at Lyons. The genital organs of the cadaver of a woman of twenty-eight or thirty years showed a hymen intact and firm, but on examining the anal region it was surprising to find an infundibuliform deformity with all the signs of sodomitical habits, which of course rectified the opinion that had been made regarding the chastity of this woman.

Many of the signs enumerated as peculiar to different callings have no special anatomical characteristic that is easy to distinguish with precision, consequently they do not present a degree of certainty or constancy sufficient to be invoked as strong medico-legal proof of identity. Moreover, the effects of time or treatment may have caused alteration or disappearance of many of the signs in question, which would at best be of negative rather than of absolute value.

To arrive at an impartial appreciation of the relative value of the professional stigmata as signs of identity, a certain number of the signs should be thrown aside as illusory. Others, on the contrary, are durable, special, and constant, and assist in establishing the identity accordingly as the lesions or alterations are complete or evident; but it should be borne in mind that the physical alterations and chemical modifications resulting from the exercise of certain trades are not in our country so important from a medico-legal point of view as they are in Europe, where class distinctions are more defined.

VALUE OF STAINS AND DIFFERENT IMPRINTS.

In the same manner that a very small portion or fragment of the human body may suffice to establish the _corpus delicti_, so will minute remains or traces, as finger-marks, footprints, and other material surroundings, even smells or traces of perfume, be of great assistance to justice in determining the identity of both culprit and victim, and at the same time throw light on the attendant circumstances of the deed. The traces of a bloody hand or foot, smears of tar or paint, the various spots or stains found on fabrics, instruments, etc., may involve questions of great nicety the relativity of which is apparent, especially in criminal trials. Newspapers have familiarized the public with many cases of the kind, in which medical experts have demonstrated blood and other stains with sufficient accuracy and positiveness to satisfy a jury. The Cronin case is a notable instance.

IMPRINTS MADE BY FINGER-TIPS are known to be singularly persistent. In four specimens of inked digit marks of Sir William Herschel, made in the years 1860, 1874, 1885, and 1888 respectively, though there was a difference of twenty-eight years between the first and last, no difference could be perceived between the impressions. The forms of the spirals remained the same, not only in general character, but in minute and measurable details, as in the distances from the centre of the spiral and in the direction at which each new ridge took its rise. Sir William Herschel has made great use of digit-marks for the purposes of legal attestation among natives of India.[595] The extraordinary persistence of the papillary ridges on the inner surface of the hands throughout life has been a theme of discussion by the Royal Society,[596] and Mr. Galton has devised a method of indexing finger-marks.[597]

The IMPRESS OF A NAKED FOOT covered with blood may serve to direct the investigations of justice. In a criminal affair in France, where eight individuals were implicated, comparative experiments upon the identity of the foot, made with a view to determine to which of the individuals ought to be attributed the bloody footprints found near a wardrobe, it was shown that a degree of recognition could be established on reproducing the footprints with defibrinated blood. From the eight imprints of the left foot of each individual, impregnated with blood, measures and comparisons could be made, thus helping to establish the difference or the resemblance with those found near the wardrobe.

Imprints thus obtained may be looked upon as a kind of documentary evidence, but too much importance should not be attached to them as articles tending to prove criminality. The futility of such evidence is shown in the varying sizes of different impressions of the foot of the same person—first in rapid progression, secondly by standing, and third by slow advance. The results appear less sure in the case of footprints made in mud, sand, dust, or snow. Nevertheless many facts relating thereto may be noted with great certainty. The question has been mooted as to whether or not the impress left upon the soil gives always the exact dimensions of the foot that has made them. One side has contended that the footprints _are a little smaller_, while the other refutes this opinion and thinks that they are _a little larger_. The consistency of the soil, which does not seem to have entered into the discussion, doubtless accounts for the small differences that have given rise to this discrepancy of opinion. The outline of the sole of the foot and the relative position of the toes are more or less neatly designed as the ground is more or less wet or soft. The means employed for taking impressions of foot or other tracks in mud, etc., show considerable ingenuity on the part of those who have elaborated the subject. To discover foot-marks in mud, powdered stearic acid is spread over the imprint and a heat of at least 212° is applied from above. By this means a solid mould may be taken of the imprint. These researches have been extended to the exact reproduction of imprints left upon snow by pouring melted gelatine upon the imprint previously sprinkled with a little common table salt, which rapidly lowers the temperature of the snow about fifteen degrees and permits the mould to be taken without too much hurry. The study has been extended to the configuration of the plantar imprints in tabetics, but it does not appear so far to be of much medico-legal value.

The question may arise as to the length of time since the imprints were made. This would, of course, depend upon many circumstances, as weather, temperature, and the like. It is a fact that in Greenland footsteps in snow have been recognized many months after they were made. A few summers ago, on an arctic expedition, I climbed Cape Lisbourne, Alaska, in company with another person. The ground being thawed in many places, our feet left very decided imprints in the mud. A year afterward I visited the same spot, and on again making the ascent was astonished to recognize the footsteps made the year before.

Circumstances sometimes direct expert attention to vestiges of other animals. The tracks of a dog or of a horse may become the object of a medico-legal inquest. The books record a case in which it was necessary to ascertain whether a bite had been made by a large or a small dog. This question was settled by producing the dogs and comparing their teeth with the scars. Persons familiar with border life know the importance of trails and the minute observation that is brought to bear on them by the experienced frontiersman. In following cattle-thieves and murderers, while with the Fourth United States Cavalry on the Rio Grande frontier, I have known the peculiarity of a horse’s footprint in the prairie to tell a tale of great significance.

Observation in this respect may extend to such apparently trivial objects as the tracks of wheels, as those of a wagon, a wheelbarrow, or a bicycle, or to the singular imprints left by crutches or a walking-stick. The imprint left in the ground by a cane usually occurs in the remarkable order of every two and a half or every four and a half steps. Investigation of such circumstances may result in material facts that may be of great assistance in establishing the relation of one or several persons with some particular act.

DEFORMITIES AND PATHOLOGICAL PECULIARITIES.

The existence of deformities or injuries is so apparent in serving to establish identity that it seems almost superfluous to mention them, except for the purpose of deciding whether the wounds were made during life or after death. In the matter of gunshot wounds on persons who took part in the late Civil War, many of whom unfortunately belong to the vagrant class and are often found dead, their wounds sometimes afford excellent means of identification. In many instances the multiple character of these wounds is almost incredible. When on duty at the Army Medical Museum, in connection with the preparation of the “Medical and Surgical History of the War of the Rebellion,” I saw a man who was literally wounded from the crown of his head to the sole of his foot, the scars being fifty-two in number.

WOUNDS MADE DURING LIFE might show the suggillation peculiar to bruises or traces of inflammation. Besides, the gaping nature of the lips of the wound, the fact of hemorrhage having taken place and the coagulation of the blood, the infiltration of blood into the cellular tissue, etc., are surgical facts that would leave but little doubt as to the infliction of the wounds during life.

The _cause of death_ is often a difficult matter to determine, as it may have been accidental, suicidal, or the result of homicide. The causes relating thereto are, moreover, so many and varied that space and time compel a reference to other headings of this work. In forming an opinion as to _the probable date of death_ the extent of putrefaction is the chief guide. If death is quite recent, we may be guided by the post-mortem rigidity or the extent to which the body has cooled. The march of putrefactive decomposition would, of course, be regulated by circumstances. It takes place very rapidly in persons who have succumbed to excessive fatigue or to any disassimilative excesses or derangement resulting in ante-mortem change of the tissues, such as those occurring in virulent or infectious diseases. The body of an infant decays more rapidly that that of an adult. The course of putrefactive phenomena is also influenced by the seasons, the extent of the exposure to air, and to other mesological causes. There is a manifest difference in the special putrefactive change accordingly as a body is buried in the earth, submerged in a fluid, thrown into a cesspool, or buried in a dung-heap.

In certain cases, especially where the body has been much mutilated, it may be desirable to know whether there was _one or several murderers_. While no definite rule can be laid down on this point, we are justified in supposing that there were two or more assassins when the body of the victim shows both gunshot and knife wounds, or that two persons were concerned in the dismemberment and mutilation of a body which shows the simultaneous presence of parts skilfully cut, while others show evident awkwardness.

Where there is _more than one mortal wound_ on the same dead body, a question of medico-legal significance may arise. This occurred in the Burton murder case at Newport, R. I., in 1885, which gave rise to discussion of the following abstract question: “Whether it is possible for an individual, with suicidal intent, and in quick succession, to inflict a perforating shot of the head and another of the chest implicating the heart. Or, reversing the proposition, is it incredible that a person bent on self-destruction can, with his own hand, shoot himself in the heart and in the head?”

After consideration of the case referred to and reversal of the previous decision of the coroner, the supposed suicide proved to be a homicide. Yet if the abstract question of possibilities is alone regarded, there is no doubt of the fact that a suicide could shoot himself in such manner, both in the head and the heart, or, changing the order, of shots in the heart and in the head. The number of cases recorded establishes beyond a doubt the feasibility of the self-infliction of two such wounds, and make it clear that the theory of suicide may be maintained in such circumstances.[598]

JUDICIAL ANTHROPOMETRY.

Of late years the subject of anthropometric identification has taken such a place before justice that it cannot be ignored by the medical legist. The facts of scientific anthropology have here been applied in such a way as to establish with great certainty both the present and future identity of individuals who attempt dissimulation of their name and antecedents. The method used principally in the identification of criminals and deserters from the army has been adopted in the public service[599] and by most municipalities, with the exception of New York, where the subsequent identification of persons connected with municipal affairs has been and may be a source of no little embarrassment.

The system is based on three recognitory elements: photography, anthropometric measurements, and personal markings, from which a descriptive list is made that gives absolute certainty as to individual identity.

Owing to the illusory nature of photography and the difficulty in finding the portrait of any given individual in the large and constantly increasing collection of a “rogues’ gallery,” the matter has been simplified and facilitated by grouping the photographic collection according to the six anthropological coefficients of sex, stature, age, and color of the eyes. Each of these primordial groups is again subdivided in such a way as to reduce the last group to a small number, when the portrait is easily found and verified on comparing the measurements of the head, of the extended arms, the length of the left foot, and that of the left middle finger.

The photographic proof for each individual consists of two portraits side by side, one of which is taken full face, the other in profile of the _right_ side. On the back of the photographic card is recorded with rigorous precision all personal markings or peculiarities.

The measurements, which can be made by any person of average intelligence in three or four minutes, are extremely simple. The _right_ ear is always measured, for the reason that this organ is always reproduced in the traditional photograph which represents the right face. Other special measurements are taken on the left side. The height sitting, dimensions and character of the nose, color of eyes, etc., are also noted.

It is contended that by these measurements alone the identity of an individual whose face is not even known may be established in another country by telegraph. The application of the system has proved of great service in the apprehension of deserters from the United States army (when the authorities have been able to find the card), while it is claimed to have caused the disappearance of numerous dissimulators of identity in the prisons of Paris. The police authorities of that city report that out of more than five hundred annual recognitions by the foregoing means, not one mistake has yet occurred.[600]

To avoid a _possible source of error_ mensuration of the organs and the ascertainment of their form may be resorted to in the case of a cadaver that is much decayed, or in one that has been purposely mutilated or burned by the assassin in order to prevent recognition. A sufficient number of cases may be cited in which the measurement of a limb or a bone of a deceased person known to have been lame or deformed during life has resulted in the establishment of identity or the reverse.

A mistake may be prevented in the case of supposed mutilation of a drowned body, which may have been caused by the screw of a passing steamer. Other errors may result from carelessness, incorrect observation of signs, and neglect to follow the ordinary precautions that should obtain in all researches on identity of the dead body.

Certain circumstances indicative of the _mental state of the culprit_ may throw light on the identity. A person of unsound mind would certainly be suggested as the perpetrator of such a deed as that of the woman already mentioned, who after killing and cutting up her infant, cooked portions of the remains with cabbage and served them at a meal of which she herself partook. Equally conclusive should be the inference in the case cited by Maudsley of a person who, for no ascertainable motive, kills a little girl, mutilates her remains, and carefully records the fact in his note-book, with the remark that the body was _hot and good_.

The _handwriting_ left by the assassin might also furnish a strong presumption as to the existence of a mental lesion, since the writing of the insane is often characteristic, especially in the initial stage of dementia. I recall the case of a former patient, an _aphasic_, imprisoned for having stabbed a man in the abdomen and for having wounded his wife in such a way that her arm had to be amputated. Having lost the power to express himself phonetically, this man used a book and pencil, but his writing showed a degree of _agraphia_ which alone would establish his identity beyond a doubt.

While it is quite possible that dishonest transactions, and even theft, may take place by _telephone_ and the voices of the perpetrators may be unmistakable between distant cities, it is more likely that the phonographic registration of speech or other sound by means of a _gramophone_ should become a matter of medico-legal investigation and a possible means that may lend great assistance in establishing personal identity. Although no precedent may be cited, it is not going into the domain of theoretical hypothesis to mention a discovery of such real scientific certainty that for years after death, and thousands of miles away, gives an indefinite number of reproductions that cannot possibly be mistaken by any one familiar with the voice before it had become “Edisonized.” Some gramophone disks lately shown me from Germany registered greetings and messages to relatives in Washington, who were delighted to recognize the exact reproduction of familiar tones and accents of the Fatherland.

So limitless is the field of research in this direction that there is scarcely an anthropological, biological, or medical discovery that may not sooner or later be applied with profit in the investigations of personal identity where the combined efforts of an attorney and an expert are required.

After the most rigid and scrutinizing anatomical and material examination is made and the closest inquisition entered on, it may often be impossible to give a reasonable explanation for the cause of the physical facts observed. The medical man should remember that his is the one great exception to the rule that rigidly excludes opinions, and that scientific men called as witnesses may not give their opinion as to the general merits of the case, but only as to the facts already proved. This qualifying rule being altogether reversed in investigations into personal identity, and the physician’s opinion as to identity being indispensable, it becomes a matter of most serious import that this opinion should be grounded upon absolute and well-attested facts.

MEDICO-LEGAL DETERMINATION

OF

THE TIME OF DEATH.

BY

H. P. LOOMIS, A.M., M.D.,

_Professor of Pathology in the University of the City of New York; Visiting Physician and Curator to Bellevue Hospital, New York; Pathologist to the Board of Health, New York City; President New York Pathological Society, etc., etc._

MEDICO-LEGAL DETERMINATION OF THE TIME OF DEATH.

SIGNS OF DEATH.

THE cessation of respiration and the absence of audible heart-beats are signs generally regarded as sufficient in themselves to determine the reality of death. But persons have been resuscitated from a state of asphyxia or have recovered from a state of catalepsy or lethargy in whom, _to all appearances_, the respiratory and circulatory processes have been arrested.

So it is advisable that we should be acquainted with some absolute tests of death which are not connected with the heart-sounds or the respiration.

It is well known that these important functions, although apparently held in abeyance, must be speedily re-established so as to be recognized, or death will rapidly follow. This condition of apparently suspended animation is seen among hibernating animals; the bear, for instance, will remain for four or five months without food or drink in a state of lethargy—the heart-action and respiration hardly appreciable. Yet it will be sufficiently rapid to sustain life during the slow metabolic processes. A number of well-authenticated cases are reported in which persons could slacken their heart-action, so that no movement of the organ could be appreciated. The case of Colonel Townsend, reported by Cheyne, is an example. He possessed the power of apparently dying, by slowing his heart so that there was no pulse or heart-action discernible. The longest period he could remain in this inanimate state was half an hour.

Instances have occurred in the new-born child where without question there have been no heart-beats or respiratory movements for a number of minutes, the limit being set at five.

These are exceptional cases, and it is setting at defiance all physiological experience to suppose that the heart-action and respiration can be suspended entirely when once they are established, for a period as long. So, then, if no motion of the heart occurs during a period of five minutes—a period five times as great as observation warrants—death may be regarded as certain.

The respiratory movements of the chest are sometimes very difficult to observe. They can always be better appreciated if the abdomen and chest are observed together. There are two methods to determine whether respiration is absolutely suspended or not. First, by holding a mirror in front of the open mouth, observing whether any moisture collects on its surface. Second, by placing on the chest a looking-glass or basin of water, and reflecting from it an image by artificial or sun light. The slightest movement would be registered by a change in position of the image. While the writer considers the absence of heart-beats and of respiratory movement an absolute test of death, still some cases may occur in which the establishment of this test is very difficult, and the following additional tests may be employed:

1. Temperature of the body same as surrounding air.

2. Intermittent shocks of electricity at different tensions passed into various muscles, giving no indication whatever of irritability.

3. Careful movements of the joints of the extremities and of the lower jaw, showing that rigor mortis is found in several parts.

4. A bright needle plunged into the body of the biceps muscle (Cloquet’s needle test) and left there, showing on withdrawal no signs of oxidation.

5. The opening of a vein, showing that the blood has undergone coagulation.

6. The subcutaneous injection of ammonia (Monte Verde’s test), causing a dirty-brown stain indicative of dissolution.

7. A fillet applied to the veins of the arm (Richardson’s test), causing no filling of the veins on the distal side of the fillet.

8. “Diaphanous test:” after death there is an absence of the translucence seen in living people when the hand is held before a strong light with the fingers extended and in contact.

9. “Eye test:” after death there is a loss of sensibility of the eye to light, loss of corneal transparency, and the pupil is not responsive to mydriatics.

POST-MORTEM CHANGES.

The human body after death undergoes certain changes which will be discussed under the following heads:

1. Cooling of the body.

2. Flaccidity of the body.

3. Rigor mortis.

4. Changes in color due to

(_a_) Cadaveric ecchymoses.
(_b_) Putrefaction.

COOLING OF THE BODY.

Immediately after death there is a slight rise of temperature, supposed to be due to the fact that the metabolic changes in the tissues still continue, while the blood is no longer cooled by passing through the peripheral capillaries and lungs.

The body gradually cools and reaches the temperature of the surrounding air in from fifteen to twenty hours; this is the ordinary course, but the time may be influenced by a variety of causes, such as the condition of the body at the time of death, manner of death, and circumstances under which the body has been placed.

In certain diseases, as yellow fever, rheumatism, chorea, and tetanus, the temperature of the body has been known to rise as high as 104° F. and remain so for a time. 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.

In determining the temperature of a dead body the hand is not a reliable guide: the thermometer should always be used.

FLACCIDITY.

The first effect of death from any cause is general relaxation of the entire muscular system. The lower jaw drops, the eyelids lose their tension, the limbs are flabby and soft, and the joints become flexible.

In from five to six hours after death, and generally while the body is in the act of cooling, the muscles of the limbs are observed to become hard and contracted, the joints stiff, and the body unyielding. Muscles which are contracted in the death-agony do not necessarily become relaxed at any time.

The muscular tissues in the dead body can be considered as passing through three stages: (1) flaccid but contractile, (2) rigid and incapable of contraction, (3) relaxed and incapable of further contractility.

RIGOR MORTIS.

This is sometimes called cadaveric rigidity and occurs generally within six hours after death and disappears within sixteen to twenty-four hours. Many theories have been advanced to account for it, but the most probable one is that the rigidity is due to the coagulation of the myosin in the muscles by the weak acids which are no longer removed from the system; the muscles always give an acid reaction and are opaque instead of transparent; after putrefaction has set in ammonia is developed, the myosin dissolved, and so flaccidity results.

Rigor mortis occurs first in the muscles of the eyelid, next the muscles of the lower jaw and neck are affected, then the chest and upper extremities; afterward it gradually progresses from above downward, affecting the muscles of the abdomen and lower limbs. The rigidity disappears in the same sequence. The period after death when rigor mortis manifests itself, together with its duration, is chiefly dependent upon the previous degree of muscular exhaustion. Brown-Séquard has demonstrated that the greater the degree of muscular irritability at the time of death, the later the cadaveric rigidity sets in and the longer it lasts. He has also shown that the later putrefaction sets in, the more slowly it progresses.

The more robust the individual and the shorter the disease, the more marked and persistent is this muscular rigidity. It has been noticed that the bodies of soldiers killed in the beginning of an engagement become rigid slowly, and those killed late quickly. This explains the reason why bodies are sometimes found on the battle-field in a kneeling or sitting posture with weapons in hand.

If the rigidity of rigor mortis after it is once complete is overcome, as in bending an arm, it never returns; but if incomplete it may return. This will serve at times to distinguish real death from catalepsy and its allied conditions. While the _average_ duration of rigor mortis has been given as sixteen to twenty-four hours, it must be remembered that in some cases it has been known to last only a few hours, as in death by lightning or by electrocution. In other cases it has persisted for seven and fourteen days.

This long continuance of rigor mortis has been noted in death from strychnine and other spinal poisons, in suffocation, and in poisoning by veratrum viride.

Atmospheric conditions modify to a large extent the duration of rigor mortis. Dry, cold air causes it to last for a long time, while warm, moist air shortens its duration. Also immersion in cold water brings on rigor mortis quickly and lengthens its duration.

CADAVERIC ECCHYMOSIS—CADAVERIC LIVIDITY OR HYPOSTASIS.

Within a few hours after death the skin of the body, which is of a pale, ashy-gray color, becomes covered by extensive patches of a bluish or purple color, which are most pronounced and are first seen on the back part of the trunk, head extremities, ears, face, and neck, and are due to the blood, before coagulating, settling in the most dependent parts of the body, producing a mottling of the surface with irregular livid patches. There is also a stagnation of blood in the capillary vessels, especially in those in the upper layer of the true skin or in the space between the cuticle and cutis. The discoloration continues to increase until the body is cold, when it is entirely arrested. Later on, just before putrefaction begins, the color deepens, and the change appears to proceed from an infiltration of blood pigment into the dependent parts of the body.

At the same time the discolorations are appearing on the surface of the body, _internal hypostasis_ is also taking place, most marked in the dependent portions of the brain, lungs, intestines, kidneys, and spinal cord.

This condition in the brain may be mistaken for so-called congestive apoplexy; in the lungs, for pulmonary apoplexy or the first stage of lobar pneumonia; in the intestines and spinal meninges, for the beginning of inflammatory changes.

The position of these hypostases will afford the best correction for this possible error. The appearances presented by cadaveric ecchymoses have often been mistaken for the effects of violence applied during life. Innocent persons have been accused and tried for murder or manslaughter on charges afterward proved to be groundless. Therefore it is of the utmost importance that the medical jurist should be able to distinguish between ante-mortem and post-mortem ecchymoses.

The following are the points of difference:

1. Situation. Post-mortem ecchymoses are seen on that portion of the body which has been most dependent, generally the posterior aspect, and they involve principally the superficial layers of the true skin; ante-mortem ecchymoses may occur anywhere, and generally the deeper tissues are discolored.

2. In cadaveric lividity there is no elevation of the skin and the discoloration terminates abruptly.

3. After cutting into the tissues where an ecchymosis has been produced by violence, the blood without the vessels is free in the tissue; this is not so in cadaveric ecchymosis.

4. Post-mortem ecchymoses are very extensive, ante-mortem generally limited in area.

A peculiar appearance of cadaveric lividity is observed in bodies which have been wrapped in a sheet and allowed to cool or that have cooled in their clothing. It occurs in the form of bands or stripes over the whole surface, and often gives an appearance as of a person flogged. The explanation of this appearance is that the congestion of the vessels takes place in the interstices of the folds, while the parts compressed remain whole. The unbroken condition of the cuticle, together with the other characteristics just mentioned, are sufficient to distinguish these ecchymoses from those produced by violence. While cadaveric lividity is seen in all bodies after death, it is especially pronounced in those persons who have died suddenly in full health or by violence, as from apoplexy, hanging, drowning, or suffocation. It is very slight in the bodies of those who have died from hemorrhage or anæmia.

The time at which cadaveric lividity appears varies greatly. Casper, who has investigated the subject thoroughly, sets the time at from twelve to fifteen hours after death.

PUTREFACTION.

At a period varying from a few hours to three days after death, certain changes are seen in the human body which show that putrefaction has commenced. A change of color appears first upon the middle of the abdomen and gradually spreads over the rest of the body; it is first pale green, which gradually deepens, and finally becomes purplish or brown. This change in color is due to the action on the hæmoglobin of the gases developed by decomposition. Similar discoloration makes its appearance on the chest, between the ribs, on the face, the neck, the legs, and lastly on the arms, where it is more marked along the large venous trunks, and has sometimes been mistaken for marks of violence. The eyeballs become flaccid, and if exposed to the air the conjunctiva and cornea become dry and brown. Gases are formed, not only in the hollow organs of the abdomen but also in the skin. Those developed in the cavities of the head and face force frothy, reddish fluid or mucus from the mouth and nostrils, and may cause swelling of the features and protrusion of the eyes and tongue. It must be remembered that the gases while producing distention of the abdomen may also cause changes in the position of the blood and slight displacement of the organs; they may also force undigested food into the mouth and into the larynx, and so lead to suspicion of death from suffocation.

As putrefaction advances, after a period of five or six days the entire surface of the body becomes green or brown, the cuticle becomes loose and easily detached; the tissues flaccid and often bathed in a reddish serum in such situations as the neck, the groin, and the back part of the scalp. The thorax and abdomen become enormously distended, the features distorted and scarcely recognizable, and the hair and nails loosened. Beyond this, it is impossible to follow the changes leading to disintegration with any degree of certainty. The changes which I have just described as produced by putrefaction are the _ordinary_ ones seen in a body exposed to the air at a moderate temperature, but it must be remembered that the time and rapidity of the development of these changes may be influenced by a large number of factors, and that they are of very little importance in estimating the time of death. I have seen bodies buried two months that have shown fewer of the changes produced by putrefaction than others dead but a week.

The appearance of a body buried in a coffin will be as follows after a period varying from a few months to one or two years. The soft tissues will have become dry and brown and the face and limbs covered with a soft white fungus. Hard white crystalline deposits of calcium phosphate will be found on the surface of the soft organs, and when found on the surface of the stomach care should be taken not to confound them with the effects of poison. In time the viscera become so mixed together that it is difficult to distinguish them. For the most part the changes that take place in a body buried in a coffin are similar, but much slower, to those that occur if the body is exposed to the air or buried in soil. Even under apparently identical circumstances the most varied results have been observed, so it is not possible for a medical jurist to fix a definite period of death or the time of burial from the appearance of an exhumed body. For example, Taylor records a case where after thirty-four years’ interment an entire and perfect skeleton was discovered, surrounded by traces of shroud and coffin, while in an adjoining grave all that remained of a body that had been dead twenty-five years were the long bones and base of the skull, In one case a body was found well preserved after six years’ burial and in another after even thirty years’ interment.

This brings us next to a consideration of those factors that favor or retard decomposition.

CIRCUMSTANCES FAVORING PUTREFACTION.

1. =Temperature.=—Putrefaction advances most rapidly at a temperature between 70° and 100° F. It may commence at any temperature above 50° F., but it is wholly arrested at 32° F. So one day’s exposure of a body in summer may effect greater changes than one week in winter. After freezing, putrefaction takes place with unusual rapidity upon the thawing out of the body. A temperature of 212° F. stops all putrefactive changes.

2. =Moisture.=—Putrefaction takes place only in the presence of moisture. An excess of moisture, however, seems to retard the process, possibly by cutting off the excess of air. The viscera according to the amount of water they contain decompose at different times after death—for instance, the brain and eye rapidly, the bones and hair slowly.

3. =Air.=—Exposure to air favors decomposition by carrying to the body the micro-organisms which bring about putrefaction; absence of air soon arrests the changes: this is seen in bodies hermetically sealed in lead coffins, which remain unchanged for a long period of time. Moist rather than dry air favors putrefaction by lessening evaporation. Air in motion retards while still air favors the change.

It is to be remembered that a body decomposes more rapidly in air than in water or after burial. Given similar temperatures, the amount of putrefaction observed in a body dead one week and exposed to the air will about correspond to one submerged in water for two weeks or buried in a deep grave for eight weeks.

4. =Age.=—The bodies of children decompose much more rapidly than those of adults; fœtuses still more rapidly. Aged bodies decompose slowly, probably on account of a deficiency of moisture. Fat and flabby bodies decompose quickly for the same reason.

5. =Cause of Death.=—In cases of sudden death, as from accident or violence, the body decomposes more rapidly than when death results from disease. Putrefaction sets in early in death from the infectious fevers, such as typhus, pyæmia, and typhoid fever, also in death from suffocation by smoke or coal gas, by strangulation or after narcotic poisoning. Those parts of a body which are the seat of bruises, wounds, or fractures, decompose rapidly; this is especially seen in parts after a surgical operation.

6. =Manner of Burial.=—When a body is buried in low ground in a damp, swampy, clay soil, decomposition advances rapidly, as also when the grave is shallow so the body can be exposed to constant variations of temperature. A porous soil impregnated with animal and vegetable matter favors putrefaction, as also burying a body without clothes or coffin; this is especially seen where infants have been thrown into the ground and loosely covered with earth.

CIRCUMSTANCES RETARDING PUTREFACTION.

1. =The Temperature.=—Below 32° F. and above 212° F. putrefaction is entirely arrested. The rapidity of the change considerably lessens as the temperature advances above 100° F. A remarkable instance of the preservative power of cold is given by Adolph Erman, who states that the body of Prince Menschikoff, a favorite of Peter the Great, exhumed after ninety-two years’ burial in frozen soil, had undergone hardly any change. Buried in hot sand as is seen in the desert, a body putrefies very slowly and generally becomes mummified.

2. =Moisture.=—Absence of moisture retards decomposition. In the dry air of the desert bodies have been preserved for a long period of time.

3. =Air.=—If access of air to a body be prevented in any way by its inclosure in a coffin, by closely fitting clothes, or by complete immersion in water, putrefaction is retarded.

4. =Age.=—Adults and old people decompose more slowly than children. Males are said to change less rapidly than females, lean people than fleshy ones.

5. =Cause of Death.=—Putrefaction is delayed after death from chronic diseases unless they are associated with dropsy. Poisoning by alcohol, chloroform, strychnine, and arsenic retard putrefaction. In the latter case the putrefactive changes seem to stop after they have once commenced, and often a result very similar to mummification is seen. Death from the mineral acids, especially sulphuric, appears to delay putrefaction.

6. =Manner of Burial.=—Putrefaction is retarded by burial a short time after death; by interment on high ground, in dry, sandy, or gravelly soil; by having the grave deep, over six feet in depth if possible by the body being well wrapped and secured in a tight coffin, a lead one being the best in this respect. Lime or charcoal applied freely about a body will retard decomposition, as will also injection of the body through the arteries with such substances as arsenic, chloride of zinc, or antimony. The ultimate effect of putrefaction is to reduce all bodies to inorganic compounds, chiefly water, ammonia, and carbon dioxide. Three conditions are necessary for its establishment, (1) a given temperature, (2) moisture, (3) free access of air.

The order in which the various organs and tissues undergo decomposition, as given by Casper, who has investigated the subject carefully, is as follows: Trachea and larynx, brain of infants, stomach and intestines, spleen, omentum and mesentery, liver, brain of adults, heart and lungs, kidney, bladder and œsophagus, pancreas, large vessels, and last of all the uterus.

As the result of putrefaction, fluids, generally blood-stained, collect in the serous cavities of the body, and should not be confounded with serous effusions occurring during life. So also the softening of the organs and tissue resulting from decomposition should be carefully distinguished from those resulting from inflammation. These cadaveric softenings are most frequently found in the brain, spleen, and gastro-intestinal mucous membrane. Inflammatory softenings are differentiated by being rarely general but almost always limited, by the substance of the inflamed part being infiltrated with serum or pus and showing traces of vascular injection. In doubtful cases the pathologist should have recourse to the microscope.

As the result of putrefaction, various changes take place in the mucous membrane of the stomach and intestines which simulate the effects of poisons. The color of the stomach varies from red, which becomes brighter on exposure to the air, to a brown, slate, or livid purple. We can only presume that these color-changes are the result of irritant poisons when they are found in non-dependent parts and parts not in contact with organs engorged with blood, when they are seen soon after death, and when the membrane is covered with coagulated blood, mucus, or flakes of membrane.

EFFECTS ON PUTREFACTION OF SUBMERSION IN WATER.

There are certain modifications of the putrefactive changes when bodies have been submerged in water. In the first place, the changes are much less rapid; they often do not show themselves until about the twelfth day, and then as discolorations appearing generally first about the ears and temples, then on the face, from which they spread to the neck, shoulders, chest, abdomen, and finally to the legs. This is almost the inverse order of the putrefactive changes in bodies exposed to the air. As a result of the formation of gases, the body in a short time becomes buoyant; after floating on the surface of the water for a time, the gases escape and the body sinks, rising a second time when fresh gas has formed.

The rapidity of decomposition in water varies, being most rapid when the temperature is from 64° to 68° F. Stagnant as well as shallow water favors putrefaction. If a body becomes coated with mud the change is delayed. Submersion in a cesspool also retards it, and the conditions are such as to favor the formation of adipocere.

After a body has been removed from the water an exposure of a very few hours to the air causes rapid decomposition, so that in twenty-four hours more marked changes may occur than would have resulted from a fortnight’s longer submersion. The face soon becomes bloated and black, so that identification is well-nigh impossible. It is quite important in medico-legal cases to estimate the time which has elapsed since death in bodies found submersed in water. The following are the various changes ordinarily seen at different periods of time, as estimated by Devergie, who has especially investigated the subject:

=First Four or Five Days.=—Little change: rigor mortis may persist, particularly if the water is cold.

=Fourth or Fifth Day.=—Skin of the ball of the thumb and little finger, also the lateral surface of the fingers, begins to whiten. This whitening gradually extends to the palms of the hands and soles of the feet. The skin of the face will appear softened and of a more faded white than the rest of the body.

=Fifteenth Day.=—Face slightly swollen and red; a greenish spot begins to form on the neck and skin of the mid-sternum. The skin of the hands and feet is quite white and wrinkled. The subcutaneous cellular tissue of the thorax is reddish and the upper part of the cortical substance of the brain of a greenish tint.

=At One Month.=—The face is reddish-brown, the eyelids and lips green and swollen, and the neck slightly green. A greenish discoloration is also seen over the upper and middle part of the sternum. The skin is wrinkled. The hair and nails still remain intact. The scrotum and penis are distended by gas. The lungs become very emphysematous and overlap the heart.

SAPONIFICATION.

When the bodies were removed from the Cimetière des Innocents in Paris, in 1786, Fourcray observed that many of them had been converted into a substance which he termed ADIPOCERE. He gave it this name because it resembles both fat (_adeps_) and wax (_cera_). Under certain circumstances which will be considered later, it is known to be a late product of the putrefactive processes. Adipocere is a substance of a cheese-like consistency, yellow or yellowish-brown in color, and composed chiefly of a mixture of the fatty acids. Chevreul has shown by analysis that it is a true ammoniacal soap, but that when formed in water impregnated with lime a calcareous may be substituted for an ammoniacal base. This may take place either in a body exposed to river-water or buried in a grave wet by water containing calcium carbonate or sulphate. Saponification can only take place when animal fat is in contact with nitrogenous matter. Neither fat nor fibrin when kept separate will saponify. Skin deprived of all its fat will not be transformed into adipocere.

Saponification commences in the fat of the female breast, of the cheeks and other parts of the body where large accumulations of fat are found, such as around the kidneys and in the omentum. As fat is distributed extensively throughout the body, nearly all parts may undergo this transformation. Taylor gives the following conditions as favorable to the change:

1. Bodies of young persons, because the fat is abundant and chiefly external.

2. Bodies of corpulent adults.

3. Exposure of bodies to the soil of water-closets.

4. The immersion of bodies in water, the change taking place more rapidly in running than in stagnant water.

5. Humid soil, especially when bodies are placed in it one upon the other. In this case the lowest of them is first changed.

When a body has been completely saponified it may remain in this state for years. In one instance, after seventeen years’ burial many of the organs could still be recognized.