conduct, the exalted profession they have chosen, and those who are incompetent will scarcely remain in the State, to be tested and have their certificates revoked. If any do continue to practise to the injury of the community and the disgrace of the profession, there certainly is pride enough in the several schools to purge their ranks of all such.

Then, in reply to the interrogatory, "Is a medical law advisable?" we say, if the law is such as above indicated, free from class legislation and special favoritism, providing for the suppression only of disgraceful and incompetent persons, then we answer unhesitatingly, yes.

Indianapolis, Ind.

MEDICAL JURISPRUDENCE.

BY W. P. STRICKLAND, M. D., LL. D.,

Professor of Medical Literature and Forensic Medicine in the Eclectic Medical College of the City of New York.

(Continued from page 200, May, 1880.)

DEATH IN ITS MEDICO LEGAL ASPECTS.

Questions opening up to the medical jurist may be referred first to those affecting the civil and social rights of individuals, and those arising from injuries against their persons. Inquiries relating to this latter class, include some of the most difficult and important points with which the expert has to deal.

As all injuries against the person, either mediately or remotely, may and often do terminate fatally, in order to our being able to trace the connection between the fatal event and the violence inflicted, it is necessary to have an intimate acquaintance with the various modes of sudden death, and also that which is less speedy, and the appearances they leave on the body. And to be able to discriminate between the forms of death as brought about by natural causes, or the reverse, as furnishing grounds for a decision in cases of violence, three points of inquiry are of great importance: First, the reality, as contra distinguished from the appearance of death. Second, the determination in the body of the period of its decease, where nothing is otherwise known of the date of that event. Third, the ready discrimination at different stages of its decay, between the usual effects of disease or of

violence, and the ordinary progress of its natural decompositionthe fixing, with some precision, of the period which may have elapsed in any particular instance since the death of the person on the view of the body, may be a point of great importance in civil and criminal proceedings. It is important to surviving relatives to secure to them civil rights and the succession to property, that it be ascertained with tolerable certainty at what time death occurred. It is also important in criminal proceedings; in cases of hanging, and still more of strangulation, and in cases of infanticide. The changes which the body undergoes after death must come into consideration, as many of them are known to simulate the effects of violence, of poisons, and even of natural diseases in the living body, and hence may lead to disgraceful mistakes. It is important that the medical jurist be able to distinguish between a wound inflicted before or after death.

The so called immediate causes of death are reducible to a limited number. Much has been done of late years to enable the faculty to determine, with a surprising degree of accuracy, the precise mode in which the various noxious agents, which are arrayed against life, are able ultimately to prevail to its extinction. This topic covers the whole field of pathology. Hitherto but little attention had been paid by pathologists to the state of some of the more important organs of the body immediately preceding the arrest of the vital functions. Physicians in Europe have directed attention to the occurrence of oedema of the lungs generally, as the immediate precursor of death in certain diseases of the heart, and oedema of those portions of the lungs, which alone had remained in a condition to fulfil the ordinary functions, while the rest of these organs had been for some time too diseased to accomplish this.

Systemic, as contra distinguished from molecular life, or the normal action of the vital functions, contrasted with the mere vegetative functions. Systemic life is constituted by those actions which maintain the material dependence of the several parts of the organic whole. Such are the functions which provide new matter for the blood-digestion and absorption; that which effects a chemical change in the blood—respiration ; that which distributes it through the organs and tissues-circula

tion; that which removes from the blood effete matter-secretion and excretion; and that which is intimately connected with all these functions. The cessation of these actions and the consequent solution of connection of the various parts of the body, constitute systemic death. Life cannot continue without the combined inte grity of the nervous, circulatory, respiratory, nutritive and digestive systems, all mutually dependent on each other and alike indispensable to life.

When the injurious agent, whatever it may be, bas exerted its noxious agency, either directly or indirectly, on the central organ of the nervous system, so as to lead to the arrest of its functions, death is said to have happened by coma. When its operation has been on the respiratory organs, producing a suspension of the changes effected by them on the blood, death has taken place by asphyxia. And when its action, direct or indirect, is on the central organ of circulation, followed immediately or after some time by the cessation of its functions, death is caused by syncope. Thus the causes of death are classified: Death beginning at the brain is called coma; death at the lungs, asphyxia; death at the head, syncope. The cause of death by coma is pressure on the brain or medulla oblongata, or from blows, falls, narcotic poisons. The cause of death by syncope is extensive hemorrhage, suppuration, starvation, poisons, acute peritonitis, low fevers, malignant cholera, concussion of the spine. Death by asphyxia is caused by compression of the upper part of the spinal cord, pressure on the chest or abdomen, partial or complete exclusion of atmospheric air by submersion or suffocation.

Having noticed the various modes of the occurrence of death, it is important, in the next place, to notice the series of changes which are found to follow death. We have seen that life is a conjoined operation of certain actions peculiar to organized bodies, and according as the organization is more complicated, so much. the higher are the manifestations of vitality. So perfect is this organization in man, that a cessation of one set of actions soon of necessity involves that of all the rest. This cessation is, however, not simultaneous, and hence the distinction between real and apparent death. Medical men attach the idea of life to the appearance of those functions classed as vital, which include

sensibility, circulation and respiration, and when these are no longer manifested, the person is said to be dead. Apparent or systemic death is a consequence of the arrest of the functions of the brain, heart and lungs, while real or molecular death is not only the arrest of the vital functions, but also those of nutrition and contraction. Only when systemic death is followed by molecular death, can the precise moment of real death be fixed. Persons have apparently died and been revivified, and lived shorter or longer periods afterward. Cases of suspended animation are on record, in which persons apparently dead for two or three days were restored to life. The morbid states which most readily simulate death are syncope, asphyxia, catalepsy and hysteria.

Various practical methods of testing the reality of death have been resorted to, such as the plunging of a needle into the muscles of a limb in the dead body. If after from half an hour to an hour the needle is found to retain its lustre, the person is dead; but if in that time it becomes oxidized, the person is living. The dropping of atropine into the eye, and observing if it acts on the pupil-the injection of a few drops of ammonia under the skin; if it produces no redness, the body is dead—the tying of a ligature round the finger, and noting if redness occurs beyond the ligatured part of the finger.

Simultaneously with the arrest of the vital functions, the eyes lose their lustre, the skin assumes a marked pallor, and the muscles become relaxed. The coagulation of blood in the heart— blood drawn from the body will coagulate the first three or four hours after death. The loss of muscular contractility; the loss of animal heat, and the complete cooling of the body, which takes place in from six to eight hours. As a middle stage before the beginning of decomposition, the changes which take place are the softening of the animal tissues, cadaveric rigidity and cadaveric lividity, and a species of rigidity, which sometimes occurs after death, known as cadaveric spasm, and other forms of tetanic spasm.. These are occasionally found with apoplexy, catalepsy and

syncope.

The last stage of the body's change after death is putrefaction,. which may be hastened or delayed by the media in which the body is placed, or which may be arrested entirely by artificial means..

A phenomenon in the process of putrefaction is the appearance of blisters on the surface of the body, containing more or less greenish fluid. Another product of putrefaction, under certain circumstances, is saponification. It is not necessary to pursue the putrefactive process any further. Suffice it to state generally, that the muscles become softened and greenish, the softened brain takes a grayish or ashy tint, the interior of the softened heart a dark red dye, the placid stomach and intestines various shades of red and blue; on the detachment of the cuticle the skin exudes a brownish liquid, larvæ appear about the nose, eyes and mouth, the surface takes on a brown tint, the abdomen bursts, giving exit to gases and putrid fluids, and the brain escapes by the orbits. It is important that the medico-legal jurist should have a thorough knowledge of all the subjects brought under review in this chapter.-Manual of Medical Jurisprudence.

(To be continued.)

SCALDS AND BURNS.

BY W. H. CHRISTOPHER, M. D.

First immerse the parts burned in tepid water, even if it be the entire person; then continue to add warm water, from time to time, to keep it comfortable. Then keep the part injured immersed in the water from one to four hours. This will relieve the pain, and must be continued until the part can be exposed to the atmosphere without pain. Then dry the part with soft cotton, and apply Tilden & Co.'s bromo chloralum, diluted to one part to ten of water, and immediately cover the part with an ulmus poultice, wet with the same. Gradually strengthen the medicine each day, until you will use one part bromo to eight of water. No other treatment will be necessary, except to oil the poultice with a little linseed or olive oil. New skin will be formed under the old without suppuration, and a cure will be completed in less time than with any other remedy I have ever employed.