Chapter IV: Part III: continued (2)

_Whether any articles have been broken or injured in the pockets?_—The case of the Cornish murder related at page 27 affords an example of the value of this inquiry; but in appreciating the indications which it may furnish, we must view the circumstance in relation to the other features of the case, when it may acquire an importance which the fact did not individually assume; or it may lose by such a comparison the little value which it appeared to possess.

_Whether there is reason to believe that the deceased had been robbed?_—We are to derive from this question a probable argument in support of the fact of suicide, for in such a case it is not reasonable to expect any evidence of robbery. In the unfortunate case of suicide lately committed in Hyde Park, a base sixpence was found in the pocket of the deceased; had he been plundered, the robber would not have left the base coin, which in the dark and hurry he could not have distinguished. In the instance of a travelling empiric, of the name of _Evans_, or _Evando_, as he called himself, for the sake of euphony, who was found dead in a ditch in Cornwall, the exact sum was discovered in his pocket, which he had taken in change at the last public house. Any memorandum found on the person of the deceased, in his own hand-writing intended to convey directions, or his last wishes, to his friends, is a strong presumptive proof that he fell by his own hand. The remains of any poison found about him is one of those facts that is equally favourable to the suspicion of murder as of suicide. We must be allowed to observe that upon the occasion of an unknown person being found dead, some responsible individual should examine the contents of his pockets, and having, if possible, acquired every information as to his name and residence, he should carefully enclose every article so found in a paper, and place his seal upon the packet, and his signature, and the date of the event, upon the cover.

_If the deceased be a female, whether there be any marks or bruises that would indicate the commission of a rape?_—The importance of this inquiry need not be argued, nor is it necessary in this place to point out the indications which may confirm our suspicions upon this subject. We must refer the reader to our chapter on rape, _vol._ I, _p._ 416. The interesting trial of Abraham Thornton, for the murder of _Mary Ashford_, abounds with curious evidence upon this point.

2. _Circumstances to be learnt by an examination of surrounding and
collateral objects._

The information which may be occasionally derived from the state of the objects surrounding the body, will be best illustrated by the numerous cases in which they have furnished the principal means of discovery.

_Whether the spot in question be of a description to explain the cause of the deceased having been found there; or how far its retired situation excites the suspicion that the body has been conveyed thither for concealment, or some other purpose?_—Having examined all the circumstances which attach to the _person_ of the individual, we should direct our attention to the spot in which the body is found. The Cornish case which is related at _page_ 27, offers an admirable illustration of the utility of such observations. The nature of the place may perhaps suggest the probability of the person having fallen down from some height, in which case any appearance of wounds must be examined with reference to such a suspicion. We may also in the progress of such an inquiry be led to conclude that the spot may have been infested with some unwholesome vapour, destructive of life; the various circumstances which may contribute to the generation of noxious air have been fully examined under the head of _Suffocation_, _vol._ ii, _p._ 48, and were we to discover a dead body in the vicinity of a lime-kiln, or in an unventilated apartment, where charcoal[19] had been burning, or in a cellar where carbonic acid might probably have accumulated, we should derive an important clue for the investigation.

_Whether any indications of a struggle having happened on the spot are visible on the ground, or herbage near the deceased; and whether any footsteps can be traced near the body?_—The Cornish case presents itself to us again in illustration of this question. There are also several cases where impressions upon the snow have led to the detection of the guilty party. In the case of _Wm. Spiggot_, _Wm. Morris_, _David Morgan_, _Walter Evans_, _Charles Morgan_, and _David Llewellin_, for the murder of _Wm. Powell, Esq._ at Glenareth, in Caermarthenshire, March 30, 1770, footsteps were traced from _Powell’s_ house (a deep snow having just fallen) to that of _Charles Morgan_, who was in consequence apprehended, and did not long deny the fact. Some very interesting evidence was delivered upon the subject of footsteps, on the celebrated trial of _Abraham Thornton_, for the murder of _Mary Ashford_, at the Warwick assizes of 1817. _William Lovell_, a workman at Penn’s Mills, and several other witnesses, spoke as to the presence and direction of the footsteps of a man and a woman, which approached each other at one spot; their appearance shewed that the persons had been running, and dodging each other, “as well from the stride, as the sinking in of the ground, and the little scrape at the toe of the woman’s shoe.” The footsteps were afterwards compared with the shoes of _Thornton_, and found to coincide; the shoes, moreover, had a particular nail, called a _sparrow bill_, the impression of which was also perceptible. The same comparison was made with the shoes of the unfortunate _Mary Ashford_, and with a result which appeared to be equally satisfactory and conclusive. Instances have also occurred in which the presumption of guilt against certain persons has arisen from the absence of such marks; this happened in the murder of _Mr. Jeffries_, by _Elizabeth Jeffries_, his niece, and _John Swan_, his servant, at Walthamstow, in July 1751; in which case the perpetrators of the deed were suspected to have been domestics, from the single circumstance of the dew on the grass surrounding the house not having been disturbed on the morning of the murder, which must have happened, had any persons left the premises.

_Has there been any thunder storm?_—For an account of the appearances in the body of a person, who has been thus suddenly deprived of life, we must refer the reader to our chapter on “Death by Lightning,” vol. ii, p. 63. It will, at the same time, be right to consider, whether the death of the person in question can have arisen from an exposure to the rays of the sun, which has occasionally happened in the harvest field—“And Manasses was her husband, of her tribe and kindred, who died in the barley harvest. For as he stood overseeing them that bound sheaves in the field, the heat came upon his head, and he fell on his bed, and died in the city of Bethulia.” _Judith_, _chap._ viii, _v._ 2, 3. _Sauvage_ relates the case of several young persons, who suffered an asphyxia from sleeping in an open field, exposed to the rays of the sun; and it may deserve notice in this place, that in such cases, hemorrhage from the nose is not an uncommon occurrence; the appearance of blood will thus receive an explanation which might otherwise excite unjust suspicions of violence.

_Whether any, and what weapons are lying near the body; and what is their position in relation to it?_—Much light may be thrown upon the inquiry by an attentive examination of the weapons found near the deceased; and some interesting cases are recorded, wherein this circumstance alone led to their developement. In the year 1764, a citizen of Liege was found shot, and his own pistol was discovered lying near him; from which circumstance, together with that of no person having been seen to enter or leave the house of the deceased, it was concluded that he had destroyed himself; but on examining the ball, by which he had been killed, it was found to be too large ever to have entered that pistol; in consequence of which, suspicion fell upon the real murderers. The wadding of the pistol has also in several instances offered the means of affixing the accusation on the guilty. The Lord Chancellor, in a debate in the House of Lords, in November 1820, quoted a very curious case in which the wadding of the pistol was found to correspond with a torn letter in the possession of the murderer.

_If the body is found in the water, are there any and what reasons for supposing that it was killed by other means, and subsequently thrown into the water?_—This question has upon several occasions been discussed with great eagerness; see _the Reports of the Edinburgh Colleges in the case of Sir James Standfield_, in our _Appendix_, _p._ 225; and also _Extracts from the medical evidence in the case of Spencer Cowper, Esq. for the murder of Sarah Stout_, _ibid._ _p._ 230. We have already, under the consideration of the phenomena of drowning, _p._ 35, endeavoured to appreciate the true value of the several indications which have been received as physiological evidence upon this subject, such as the presence of water[20] in the stomach and lungs, the buoyancy of the body, &c. We have therefore only to observe in this place, that upon such occasions there will generally exist collateral circumstances to fortify our judgment; where, for instance, mud, or sand, are found under the nails, or any grass or weeds are discovered in the grasp of the deceased, the inference will be strong that the person died under water; on the contrary, if we discover mortal wounds, or any marks of violence inflicted upon the body, by weapons, we may very justly suspect that the deceased was murdered, and subsequently thrown into the water. But in conducting this enquiry we must be aware of the fallacies to which it is exposed; a person may in the act of drowning accidentally receive bruises and lacerations, or he may have been driven against rocks and stakes by the force of the current. The following case, related by _Dr. Gordon Smith_, offers a very good illustration of this point. “A few years ago, a man who had leaped from each of the three bridges into the Thames with impunity, undertook to repeat the exploit for a wager. Having jumped from London bridge he sunk and was drowned. When the body was found, it appeared that both his arms were dislocated, in consequence of having descended with them in the horizontal, instead of the perpendicular position.” If we arrive at the conclusion that the body was drowned, we have next to inquire whether the event was accidental or malicious? and whether the act was perpetrated by the deceased or others? The solution of these problems is to be generally effected by the examination of what may be called the external circumstances of the case; the locality of the water may be such as to account for the deceased having accidentally fallen into it, or its situation may at once preclude the possibility of such an event. The suspicion of the person having been violently thrown into the water by the hands of the assassin, will be fortified by the discovery of footsteps on the brink, and by the indications of resistance on the part of the deceased, as manifested by the appearance of bruises on the arms and other members of the body. In the case of _Mr. Taylor_ who was murdered at Hornsey, in December, 1818, marks of footsteps, deep in the ground, were discovered near the new river; and on taking out the body, the hands were found clenched, and contained grass, which he had torn from the bank. If the person be found in the water tied hand and foot, there is a strong presumption that he was forcibly placed in such a situation; and yet there are two instances on record which afford very extraordinary exceptions to the truth of such a conclusion. The one occurred in the end of June, 1816, in the case of a gauging-instrument maker, who had been missing from home for several days. His body was discovered floating down the Thames; and on being taken out, his wrists were found tied together, and made fast to his knees, which were in like manner secured to each other. He had been in a state of mental derangement for two years. The cord with which he had tied himself was recognised as one that had hung from the ceiling over his bed, by which he used to raise himself up, having been confined to his bed for several weeks; he was a good swimmer, and it was presumed he had taken the precaution to prevent himself from swimming. The verdict was “_found drowned_.” The other instance occurred two years afterwards. A man, aged 28, with a wife and children, was reduced to great distress. On a certain day he took an affectionate leave of his family, declaring he would not return until he had obtained some employment, by which he should be able to procure them bread. The following day his body was taken out of the new river, with his hands and legs tied. A card with his address was found in his pocket; and also three-pence; when he left home he had five-pence, and it was supposed that he had purchased the cord with the deficient sum. The verdict in this case was “_insanity_.”

_If the deceased be found hanging by the neck, whether he was suspended during life, or hung up after death? Whether it was an act of suicide or murder?_—In cases where the deceased has been hanged alive, we shall find the trace of the rope in the neck very distinctly marked by a deep discolouration; whereas, the effect occasioned by such a ligature upon the dead body, will be far less striking. We have also to inquire whether the deceased has any wounds, or whether, upon dissection, the usual appearances are found which generally occur in hanged persons. But, should any marks of external violence present themselves upon such an occasion, we must judge of them with caution. They may perhaps be purely accidental. _Dr. Male_ supposes a case in which the person, with the view of speedily destroying life, may have thrown himself off with violence, broken the rope, and wounded himself by falling upon articles of furniture, and yet had sufficient fortitude again to suspend himself. “An apprentice boy, in my neighbourhood,” says this author, “working alone in an attic, tied one end of a rope loosely round his neck whilst his master was from home, probably without any intention of destroying himself, and twisted the other round the projecting part of the top of a door, the planks of which were irregular and somewhat divided; a small stool, on which he stood, slipped from under him, when he fell forwards, striking his temple against the corner of a box which cut him to the bone; he lay along the floor, his head and shoulders only elevated a few inches above it; the cord not being tied, had run nearly its whole length, and then caught between the planks of the door; in this state he perished. The wound was magnified by popular rumour into many, and vengeance was denounced against the innocent master, who was accused of having first killed, and afterwards suspended the boy. On examining the boy the mark of the cord was found to extend from ear to ear; the vessels of the brain were turgid, the thyroid cartilage broken; the nails blue, and the hands firmly closed. From this and other important circumstantial evidence, the coroner’s jury were convinced that the charge was unfounded.” _Dr. Smith_ remarks that, except in the instance of children, or extremely feeble persons, it is very difficult to hang an individual by force, unless the situation be remote, and no interruption likely to take place; or the assailants be numerous and powerful enough, (as in the celebrated case of _Porteus_) to set all interference at defiance.

Persons have been accidentally hanged, as in the case above cited from the work of _Dr. Male_, and instances are recorded where the operation has been resorted to as a mode of exciting passion. In all such cases of doubt and difficulty, each particular circumstance, however minute, must be noticed—the nature of the ligature—the manner in which it is fixed—the state of surrounding objects, are often capable of throwing light upon the transaction. In the case of _George Hebner_, a tailor, who was found hanging to the top of a bedstead, in a garret of a house of ill-fame in Dean Street, East Smithfield, kept by a widow of the name of _Hughes_, the manner in which the hands of the deceased were tied behind his back, and his handkerchief was drawn over his face, proved most decidedly that he had not strangled himself. Upon examining the rope round his neck, it was found to have been fastened by what is termed a sailor’s knot; in consequence of which circumstance a sailor named _Richard Ludman_, together with the aforesaid _Eleanor Hughes_, were indicted for the murder, found guilty, and executed.

_If the deceased be found in an apartment, whether it be in a house of ill-fame?_—Although the act of sudden death in a brothel very naturally excites the suspicion that some act of violence may have been committed, yet this feeling should not be carried too far; we must remember that the individual has been thus exposed, in an increased degree, to the occurrence of several of those natural accidents by which life is so suddenly extinguished; apoplexy, hæmopthysis, and syncope have assailed those who might have been predisposed to such diseases, at the moment of sexual indulgence. In persons advanced in life the trunks of the internal, carotid, and basilary arteries are frequently diseased, and are therefore very liable to rupture whenever the blood is accumulated in any unusual quantity, or the circulation is preternaturally accelerated.

3. _Circumstances to be learnt by the Interrogation of competent
witnesses._

It is merely necessary to enumerate the facts which it is our duty to elicit by such an inquiry, in order to shew their importance and relations; we shall therefore conclude this part of our subject without any farther comments, and proceed to furnish such directions as may enable the medical witness to complete his investigation by the anatomical examination of the body, without which, our preceding researches can never be received as satisfactory and conclusive. “_Inspectio ejusmodi cadaveris adeo necessaria est, ut omissa ea, nihil certi de reo statui possit._”[21]

4. _Circumstances to be learnt by Anatomical Dissection._

After the observations which we have already offered upon the subject of wounds, it can be scarcely necessary to urge the necessity of a speedy examination of the more superficial lesions, which are likely to be effaced, or changed in character by the progress of decomposition; “_putredo mutat formam cadaveris et lesionem_.” The deeper wounds may at the same time be inspected, but the greatest care should be taken that they are not extended during the dissection, for unless they be preserved, as far as it is possible, in their natural condition, we shall not be able to establish a satisfactory connection between the external injury, and the internal lesions with which it may be complicated. Having complied with these injunctions, we are to proceed to lay open the cavities. The order in which these operations are to be performed is not of much moment; but let it be generally understood that the discovery of what may appear sufficient to account for death in one cavity, ought never to prevent our proceeding to the investigation of the rest.

_Dissection of the brain and its membranes._—The body having been placed on its breast, and the chin raised and supported by a block of wood, the anatomist must proceed by making an incision over the top of the head, from the root of one ear to that of the other; and then by dissecting off the integuments, so as to invert one flap over the face, and the other over the occiput, he will be able to discover whether the scalp has sustained any injury, as indicated by the presence of abscesses, sinuses, contusions, and extravasations; he will, at the same time, ascertain whether any fissure or fracture exist, or any morbid change has occurred in the bone, such as sponginess, exostosis, caries, or exfoliation. In performing this part of his duty, we trust he will not mistake, as _Hippocrates_[22] confesses he once did, a fracture for a suture, and vice versa. It is not always easy, however, to determine whether a fracture discovered in the cranium, was produced during life. If it should have occurred immediately before the death of the person, there will be found coagulated blood upon the bone and in the fissures; if the individual has survived for some time, there will be marks of inflammation, and perhaps the formation of pus in contact with the skull; but if a fracture has been occasioned in making the dissection, an accident which may occur in the most careful hands, the blood in the fracture will not be coagulated, nor will there be any effusion around the portions. The skull-cap may be now removed; for which purpose the cranium is to be sawed in a circular direction, about a finger’s breadth above the superciliary ridges, and lateral sinuses; the operation must be conducted with great care, or we shall be in danger of wounding the _dura mater_; the bone must be then divided by a few slight strokes with the chissel and mallet. We shall always find a strong adhesion between the inside of the cranium, and the _dura mater_; partly, in consequence of the small blood-vessels with which these surfaces are connected, and partly, from the close application of the fibrous structure of the membrane to the bone, and which will vary with the age of the subject, and the form of the skull; the handle of the scalpel carefully introduced will afford the best instrument for overcoming this resistance, and will not be liable to lacerate the _dura mater_, or to injure the brain. In effecting the separation, the _meningeal vessels_ frequently deluge the whole surface with blood, a circumstance that deserves attention, in as much as their plenitude marks the congestive state of the brain; it shews also that the blood is in a liquid condition, a fact to which some importance has been attached, as it is supposed to occur more particularly in cases of suffocation. The inner surface of the skull may be inspected with the view of ascertaining whether it be carious. The _dura mater_, thus brought into view, may exhibit marks of inflammation; or coagulated blood or pus may be discovered on its surface, especially in cases where external violence has been inflicted; and it is particularly worthy of notice that such an extravasation, or injury, is not necessarily under the fracture, or part of the cranium upon which the violence that produced it, had been received; on the contrary it often happens that disorganization occurs in the hemisphere opposite to that upon which the blow was struck; a phenomenon to which the term “_contre coup_” has been aptly applied.[23] The _dura mater_ may now be removed and thrown back, by dividing it all round the margin of the skull, and separating its attachment to the _crista galli_ with a pair of scissars; before we part, however, with this membrane, we should observe whether any osseous deposits,[24] or other morbid alterations are visible in its texture; for such changes are not uncommon in the _dura mater_, especially in the falx: the _tunica arachnoidea_ thus brought into view may present various morbid appearances; it may be opaque, or water may be found effused under it.[25]. The _pia mater_ often exhibits its veins turgid with blood, which indicates that some impediment had existed to the return of the circulation from the head to the heart. It is very important to distinguish between this appearance and that which is the result of the inflammation of the membrane; in this latter case, it should be remembered, that the small _arterial_ branches are the vessels gorged with blood;[26] and which are so multiplied as to form, by their numerous anastomoses, a beautiful network. In true inflammation also the membrane will be found thickened. There is still another source of fallacy with which the anatomist may have to contend in his examination of this organ, a state of vascular congestion, arising after death, from the effect of gravitation. In attending however to the position of the head, and to the circumstances above mentioned, it will not be difficult to establish a just diagnosis upon these occasions. Before cutting into the brain, we should observe whether the convolutions are furrowed as usual, for when much fluid is contained in the ventricles, as in hydrocephalus, the _sulci_ are more or less obliterated. Such a change, therefore, will offer a precaution to the anatomist, to proceed slowly in his dissection, so that the accumulated fluid may not escape. Where a person has been suddenly killed, while in a state of health, the ventricles will, on examination, appear merely lubricated with a fluid; but in cases where the patient has died after protracted disease, more or less serum will be found in these cavities. In our examination of the substance of the brain, we ought to notice its consistence and tenacity, for in many recorded cases, a _part_ of the medullary mass has been found so morbidly soft as to have assumed nearly the consistence of custard; and it has been said to have occurred in cases of fatuity; it seems, however, more correct to consider it as the effects of inflammation: the phenomenon must be carefully distinguished from that natural deliquescence which the _whole_ of the brain undergoes after death, when in an incipient stage of putrefaction. In some instances, the texture of the brain has been found tougher than is natural, and even to have been dry and friable. (_See our observations upon the brain in cases of mania_, _vol._ i, _p._ 327.) Scrophulous and encysted tumours, hydatids, abscesses, and extravasated blood, may also occur, and its cavities may be distended with fluid. The state of the larger blood-vessels should be attentively inspected, for in persons advanced in life there appears to be a strong disposition to disease in the internal carotid and basilary arteries. The great importance of minutely inspecting every part of the brain cannot be too frequently, or too forcibly urged, in cases of forensic inquiry. The instances already recorded (_page_ 16) are sufficient to sanction this assertion; and to these, we may add the following illustration which is to be found in the article _Cas Rares_ of the _Dictionnaire des Sciences Medicales_, by _M. Fournier_, who was called upon for his opinion in a case of alleged murder at Brussels.[27] The deceased had quarrelled with another man, some blows had been interchanged, and he had died a fortnight afterwards, emaciated and completely exhausted. Two of the lowest order of practitioners in France, officiers de Santé, as they are called, inspected the body, and pronounced that death had taken place in consequence of the blows. _M. Fournier_ discovered an extensive suppuration in the brain, with a very carious state of the inner surface of the cranium, and learnt that the deceased had been afflicted with head-aches for twenty years. He therefore declared it to be his opinion, that the man had died of a disease of long standing. In this opinion we concur, but it is not equally clear that the crisis was not accelerated by the violence which he had sustained.[28]

We ought not to quit the examination of the head, until we have examined the base of the cranium, in order to determine whether any fracture exists in that part; a curious case is related by _Mr. Charles Bell_,[29] of a person who died suddenly some weeks after having received an injury of the head, when it appeared, on dissection, that the base of the skull had been fractured, and that the _foramen magnum_ having been thus roughened, a sudden turn of the head had forced a spiculum of bone into the spinal marrow. The brain has also received fatal injuries from the introduction of pointed instruments through the orbits; _Macklin_, the comedian, was tried for killing a brother actor by the thrust of his cane. _Thomas Dangerfield_, one of the celebrated and perjured witnesses on the Popish plot, in the reign of Charles II, was killed by _Mr. Robert Francis_, by the blow of a cane, the end of which penetrated the orbit.[30] The author also well remembers the case of an old woman, who, in a fit of intoxication, fell to the ground upon the stem of the tobacco-pipe with which she was smoking, when it penetrated the orbit, and occasioned immediate death; the cause of her dissolution was never suspected until after dissection, as no external wound was visible. In some cases it may be considered expedient to extend our anatomical researches into the spinal column, which may be effected by sawing off the transverse processes. The cervical vertebræ should always be examined where dislocation of the neck can be suspected; for in such cases death may be produced without leaving any external vestige of the injury. This has frequently occurred to coachmen and others, who have been crushed while driving under low archways, by which the nerves, necessary for the support of the vital organs have been compressed or lacerated, and death has in consequence ensued. If the cervical vertebræ should be dislocated, a general paralysis will follow, and life can no longer be maintained. _M. Petit_ relates the case of a boy suspended by the head, who striving to disengage himself dropped down dead; and _Dr. Monro_ saw a case where four of the cervical vertebræ were dislocated by a fall, which ended fatally in a few hours.

_Dissection of the contents of the thorax._—An incision must be made through the integuments, in a straight line from the _os hyoides_ to the navel; we are then to open into the cavity of the abdomen, for the sake of affording the anatomist free space for his dissections in the chest; and this is to be effected by incisions from the navel to each spine of the ilium, so that we shall have thus described by our dissection a figure resembling the letter Y inverted, thus [Inverted Y]. In performing this part of our labour, it is essentially necessary to avoid puncturing or injuring any of the viscera; where such a blunder has been committed the dissection has lost much of its value. The integuments of the breast are then to be carefully dissected so as to expose the cartilaginous articulations of the ribs, which must be cut through on both sides; the clavicles should also at the same time be separated from the sternum, by dividing the loose cartilage which unites them. The latter bone, together with the cartilaginous portions of the ribs, must be next turned upwards over the face, so that the cavity of the thorax shall be brought into view. In some cases it will be found expedient to make a still more extensive exposure of this cavity; for which purpose a broader flap must be turned up in front, by extending our dissection of the parietes of the thorax farther towards the back; and, instead of cutting through the cartilaginous extremities of the ribs, dividing the bones themselves with a saw. In bending back the sternum, or flap in front, we must take care and divide the _mediastinum_ with the scalpel as near the bone as possible, in order to avoid making any opening into the _pericardium_, which would otherwise be very apt to happen. As soon as an opening is effected into the thoracic cavity, the lungs collapse, unless the adhesions formed between them and the pleura should prevent it. Our first object will be to observe whether any quantity of fluid is present in the chest, and whether it be limpid, as in dropsy; turbid and containing flakes of coagulated lymph, as in cases preceded by much inflammatory action; or purulent, as in empyema. Having removed the liquid, should any be present, by the application of a large sponge, we must proceed to examine the lungs, as to their colour and general appearance; and, by the introduction of a blow-pipe into the trachea, we should by means of the mouth or bellows inflate these organs, so as to ascertain the degree of distention of which they are susceptible. We may at the same time inspect their structure more minutely by raising each lobe with the hand, introduced into the cavity of the thorax for that purpose. We are next to cut into their substance in order to observe whether they are gorged with blood, and inflamed; whether they are crepitous and light, or dense like liver; and whether they contain any tubercles; should these latter bodies be discovered, we have to ascertain their magnitude, extent, and maturity, and whether any of them have been developed into _vomicæ_. The anatomist should be cautioned not to mistake the deep colour, and compact texture which occur in the depending portions of the lungs, from the mere accumulation of blood in consequence of gravitation, for an inflamed state of the organs; in which latter case a crowd of fine vessels injected with blood of a florid colour furnish a diagnosis that cannot be mistaken.

In cases where a violent effort has preceded death, violet-coloured spots containing venous blood may be perceived on the surface of the lungs, and which are true ecchymoses, occasioned by the rupture of some small vessels. Such phenomena must be carefully distinguished from the livid, black spots, which have been observed in cases of narcotic poisoning, and which are characterised by a more dense, and less crepitating texture. In this stage of the dissection, we may conveniently extend our examination into the trachea, and bronchiæ, and observe whether these tubes contain frothy mucus as in drowning; coagulated blood, as in pulmonary hemorrhage; pus, as in the event of the rupture of a vomica or impostume; or ropy and tenacious mucus or lymph, as in croup, tracheal inflammation, and bronchitis; or chyme, as may occur in cases of intoxication, and diseases of the brain, where vomiting has taken place during a state of insensibility.[31] We shall at the same time be enabled to ascertain whether any mechanical obstruction, from the presence of foreign bodies, exists in the pulmonary passages, and which might have occasioned death to the patient, as related under our history of suffocation, vol. ii, p. 57.

The _pericardium_ may now be laid open by a longitudinal incision, and we should note the quantity of fluid found in this cavity; in that of a healthy subject there is generally as much as a tea-spoonful of serum. It is important also that we should observe the quality, as well as quantity, of this liquor. Blood has occasionally been found in this situation, when neither a rupture of the heart, or any of its vessels could be discovered; in such cases _Dr. Baillie_ is of opinion that the blood has either passed through the coats of the vessels upon the surface of the heart, by transudation, or been poured out by the relaxed extremities of the small vessels opening upon the surface of that portion of _pericardium_ which forms the immediate covering of the heart.[32] The general appearance of the heart, as to colour, flaccidity, size, and external character, should be observed before its cavities are opened; for the energy of the heart may, in some degree, be inferred from the tension of its fibres, and the red colour of its substance; on the contrary, the opposite appearances would indicate a very different condition of this vital organ, as is well illustrated in the _asphyxia idiopathica_ of _Mr. Chevalier_.[33] It is not very unusual to find adhesions connecting the heart more or less closely to the pericardium; and it is perhaps worthy of remark that the length of these adhesions will furnish, in some measure, an indication of the interval that has elapsed, since the occurrence of the inflammation by which they were produced; for they become gradually elongated by the heart’s motion. _Dr. Baillie_ has noticed in his “Morbid Anatomy” an appearance which the author has frequently met with in his dissections,—a white opaque spot, as if from a thickening of the pericardium; in some cases, it is not broader than a sixpence, at other times, it equals in size that of a crown piece; it is most commonly situated on the surface of the right ventricle, and consists of an adventitious membrane formed on a portion of the pericardium, which covers the heart, and may be easily dissected off, so as to leave that membrane entire. The attention of the enquirer is directed to the subject with a view to remind him, that the appearance is one that ought not to be considered as morbid in its origin, or dangerous in its effects. In acute rheumatism a fatal translation of the disease to the heart sometimes occurs, in which case, its surface will be found encrusted with coaguable lymph.—The condition of the blood-vessels forms the next object of research; and they should be examined previous to the removal of the heart, as to their calibre, and thickness, and whether any inflammatory indications are observable, or any aneurism; this latter disease has often existed without exciting any suspicion during life. In opening the body of George II, the aorta was found callous at the lower border of its curvature, and so dilated at its upper border, that it was as thin as the finest paper, in which part the rupture took place, and which was succeeded by a fatal hemorrhage; and yet the king, before his death, had not the slightest symptom that appeared to deserve much attention. In every case of sudden death the heart should be removed from the body for the purpose of examination, and no anatomical evidence should be received as conclusive, unless such an operation has been duly performed. For this purpose, the blood-vessels should be first secured by ligatures, for it is very essential to prevent the effusion of blood; and, having then separated it from its attachments, we should proceed to examine the organ in the following manner. Slit open, longitudinally, by means of scissars, the right auricle, at its foreside, then make an incision from the mouth of the pulmonary artery to the point of the heart, guarding against the accident of injuring the two sets of valves; now cut open the whole length of the pulmonary artery, except at its beginning, and at its valves, which ought to be left entire; lastly, open the pulmonary veins, and then the left auricle and ventricle, in a similar manner with what was done to the corresponding parts of the right side.

We beg to direct the attentive consideration of the anatomist to this important part of the inquiry; he ought to notice the quantity of blood contained in the cavities of this organ, as well as its colour, and state of coagulation, especially in relation to the arterial and venous sides of the heart; the indications which such an examination may afford will be fully appreciated by referring to our chapter upon “the causes and phenomena of sudden death,” and that upon “suffocation.” In examining the cavities of the heart, especially the ventricles, it not unfrequently happens, that a mass of coagulated lymph, of a yellowish colour, and of considerable firmness, is found to occupy them; this phenomenon, from the manner in which its processes extend into the fasciculi of muscular fibres of the heart, has acquired the name of “_polypus of the heart_,” and was regarded by the older anatomists as a very common and fatal disease. It is necessary to observe that the phenomenon is now better understood, and it is universally admitted to be the result of slow coagulation after death. The state of the valves of the heart should be attentively inspected, for a disease in these parts may have been the cause of the sudden death which we are endeavouring to discover. The three _semi-lunar_ valves at the origin of the aorta, and the _mitral valves_, are sometimes in a state of ossification; those placed at the commencement of the pulmonary artery, and the _tricuspid_ are less disposed to take on morbid action than the preceding ones that occupy the arterial side; indeed, there are very few well authenticated instances of such a change. Such a state of the valves of the heart necessarily places the life of the individual in extreme jeopardy, a rupture may be induced, and thus prove instantly fatal, or the action of the heart may be suddenly arrested, and a fatal syncope be the result; and from the suddenness with which death takes place in such cases, there is no doubt that many persons so dying, have been erroneously included in the list of apoplectic deaths. In certain diseased states of the valves, the extremities of the body become gangrenous, as if the heart were unable to propel its blood to the extreme parts: the author well remembers two females who were admitted into the Westminster hospital, with a disease of this kind, in which the gangrene gradually extended upwards, and that, after death, the valves of the heart were found ossified. The coronary arteries are occasionally ossified, a circumstance which often accompanies a diseased state of the valves of the heart, and that of the aorta; a change which has been regarded as giving rise to the disease, termed _angina pectoris_, but which would seem to be symptomatic of any morbid state of the heart. In some cases the heart itself has been found ruptured; we have already offered some observations upon this event, under the history of syncope, p. 27. _Dr. Baillie_ has seen only one case, and in that, the blood escaped into the pericardium, and the person instantly expired.

_Examination of the abdomen._—In proceeding to the examination of this cavity, and its contents, the first appearance to be noticed, is that of the _peritoneum_, in which we have to observe whether any marks of inflammation exist, as displayed by a crowd of very small vessels, injected with florid blood, and a change in the texture of the membrane, by which it appears to be thickened, more pulpy, and less transparent. The existence and character of any fluid in the abdominal cavity should be noted, for its nature will be found to be immediately connected with the nature and extent of the disease by which it has been produced; if the liver be schirrous, the fluid will be tinged with bile, and of a yellowish colour; if extreme debility accompany the disease, it will often be of a chocolate colour, from the admixture of blood; should no disease exist in any of the viscera, it will resemble that of the serum of the blood. Previous to the removal of the viscera for more minute examination, it will be proper to observe their general situation and appearance, and to notice particularly whether the calibre of the visceral tube be natural, distended, or contracted; in some instances its diameter is sensibly diminished, as in cases of poisoning by lead. It sometimes occurs that the intestines are glued together with extravasated lymph; and, at others, that the abdominal viscera are more or less joined together by adhesions, which are the effects of former inflammation; these adhesions become gradually so elongated as to produce little or no inconvenience. If upon opening the cavity of the abdomen we should have reason to suspect the existence of any perforations in the stomach or bowels, the anatomist must proceed with great caution, so as not to enlarge their diameters, or alter their appearance. In the case of _Miss Burns_, the medical report lost much of its value, from the want of due precaution in this particular; _see our account of the dissection_, _vol._ ii, _page_ 178. Should the contents of the stomach or intestines have escaped into the general cavity, we should be careful in collecting such matter, with a view to its future analysis. The size and appearance of the stomach must be noted, and we should observe whether any marks of inflammation, or gangrene, are visible on its external surface; in tracing the intestinal tube through its course, any appearance of inflammation, or phlogosis, should be attentively examined; for which purpose a ligature may be passed at some distance above and below the patch, and the portions of the intestine be then removed. In many cases it will be essential to remove the stomach, as where poisoning is suspected; for which purpose double ligatures, about an inch asunder, must be placed above the _cardia_, and similar ones in the _duodenum_; the division may then be made by the scalpel in the space between them. The stomach should be examined without delay, for no one who has not been engaged in such researches, can form an idea of the rapidity with which this viscus loses its characteristic appearances by exposure to air. The stomach is to be slit open with a pair of scissars, care being taken that none of its contents are lost. If the deceased had been found in the water, the quantity of that fluid, found in this viscus, should be noted; and under such circumstances, the presence of any weed, mud, or other extraneous matter, requires particular notice. The quantity of alimentary matter will also afford an object of remark, and it will be right to observe whether, by odour or inflammability, the presence of any spirit can be detected. Having then disposed of the contents of the stomach, and referred them to the chemist for examination, we proceed to examine the viscus itself; in the first place, we should be careful in ascertaining whether any white, or shining particles adhere to its coats; if so, the substance must be preserved for future analysis; the _cardia_ and whole interior of the stomach is to be carefully inspected, and every indication of inflammation, ulceration, gangrene, and schirrosity, is to be noted in reference to its exact situation and appearance; with a view to deduce an opinion as to the probability of its being the effect of poisonous ingesta, or of recent, or remote disease. The mucous membrane of the stomach should be squeezed between the fingers, and the nature of the matter, if any should ooze out, must be noted, which on some occasions will furnish a valuable diagnosis; where, for instance, the person had died of _melæna_, a black matter, similar to that vomited will exude, a phenomenon which is never visible in cases of acrid or corrosive poisoning. We have already entered so fully into the history of gastric perforations, that it will be only necessary to allude to them on this occasion; _see vol._ i, _page_ 164. The state of the villous coat should always be minutely inspected, we should however be cautious in pronouncing every red appearance as indicative of inflammation; it may in some cases depend upon the presence of colouring matter derived from the ingesta; (_see the case related in vol._ ii, _p._ 231.) Nor ought the state of the œsophagus to be overlooked, which in cases of poisoning will afford an important indication; it should, therefore, be removed from the body; had this dissection been performed in the case of _Miss Burns_, the medical witnesses on that memorable occasion, would have been spared, at least, one great cause of censure. It is not impossible but that the œsophagus may be ruptured in a violent paroxysm of vomiting, and thus be the cause of death. _Boerhaave_ relates an interesting case of this kind, which occurred to _Baron Van Wassener_, Admiral of Holland.

Rupture of the stomach is an occurrence which sometimes takes place from the action of vomiting, during the progress of ulceration, when the membranes of this viscus are nearly perforated. It also occasionally happens from external violence. In the _Medical Repository_,[34] a case of ruptured stomach is related by _Mr. Brown_, in which the accident must have been occasioned by the action of the diaphragm and abdominal muscles, at the time of exertion, the stomach of the individual having, from disease, been less capable of sustaining any degree of violence. The following are the particulars of the case; “A coal-heaver, aged 50, whilst stooping in the act of lifting some coals, placed his hand suddenly on the pit of the stomach, and complained of severe pain in that situation; this was immediately succeeded by two deep sighs, when he dropped down and expired. On dissection, the parts immediately round the opening were in a higher state of vascularity than the rest, and put on a decidedly torn appearance, which was also observable in the peritoneal coat.”

In pursuing the track of the alimentary canal we have to observe whether any marks of peritoneal inflammation present themselves; and whether any signs of inflammation in the muscular or mucous coats are visible through the transparent parietes of the intestine; and although no appearance of this kind can be discovered on the external coat of the bowels, we are not, on that account, to conclude that they have been free from inflammation; we must persevere in our dissection, and slit open the intestines in different parts, especially at the entrance of the _ilium_ into the _colon_; the valve of the latter gut should also be inspected; nor should the _rectum_ escape our attention, for its extremity is sometimes inflamed together with the stomach, while the intermediate portions of the canal are not in the least affected; this peculiarity occurs in many cases of poisoning, as those, for instance, in which colocynth or elaterium have been exhibited. An empoisoned clyster may have been administered; or, as in the case of _King Edward_ II, a hot poker, or some other instrument thrust up the rectum. We should also in this part of the dissection, ascertain whether any _intus-susceptio_ has taken place, a derangement not very rare, and frequently fatal; it consists in a portion of gut passing for some length within another portion, and dragging along with it a part of the mesentery; it may take place in any part of the canal, but it more usually occurs in the small intestines, especially where the ilium terminates in the _colon_; in the examination of infants an _intus-susceptio_ is not unfrequently found, which had been unattended with mischief, and in which the natural peristaltic motion of the intestines would have easily disentangled them; but, in other cases, an unrelenting obstruction is established, inflammation follows, and life is soon terminated, as was exemplified in the case of the infant Princess Elizabeth of Clarence.

The liver may present several morbid phenomena, which, in a dissection instituted for the purpose of discovering the cause of death, ought not to be overlooked. It may also be found ruptured, an occurrence which may take place where little or no external injury can be perceived, as from a sudden fall, or from the application of strong pressure applied to the upper part of the abdomen, such as might be occasioned by the passage of a heavy carriage over the body. _Morgagni_ relates several instances of ruptured liver, by mechanical causes, without any considerable injury of the integuments. In the _Medical Transactions of the College of Physicians_,[35] a very interesting case is communicated by _Dr. George Pearson_, of a young man who fell with his _right hypogastrium_ and _epigastrium_, upon the edge of a pail, which he held in his hand, as the sixth step of a ladder, upon which he was standing, suddenly broke; his death happened ten hours after the accident, and upon dissection, the right lobe of the liver was discovered divided, in an oblique direction, through its whole substance, from its extremity on the right side, to the border of the left lobe; the two portions being only connected by the _vena cava_, and the trunks of the _venæ cavæ hepaticæ_.

The author has been informed by _Dr. Harrison_ that, while at _Mantua_, he saw a man who had received a kick on the right _hypochondrium_ from a horse that he was shoeing; he did not complain of much pain at the time, but exhibited an anxious countenance, and was attacked with _coffee-ground_ vomiting. He died on the following day, and upon opening the abdomen the liver was found ruptured, and the peritoneum inflamed.[36]

The spleen may be brought into view for our examination by drawing the stomach towards the right side, when the one viscus will follow the other. This organ, like the liver, may be ruptured by violence; of which we have already cited an instance[37].