Chapter II: Act V: Sc. III

For the same reason the stirring of any light substance, such as down, which may rest about the mouth, has been regarded as a fine indication of the act of respiration; but this, like the mist on the looking-glass, is but a deceptive or inaccurate method; and Shakspeare accordingly represented Prince Henry as having been deceived, when he carried off the crown from his father’s pillow--

“By his gates of breath
There lies a downy feather which stirs not;
Did he suspire, that light and weightless down
Perchance must move.”[4]

If the observance of the respiration be taken as the indication of life, and its absence as a proof of death, the exposure of the naked chest and abdomen would enable the spectator to form a much more accurate appreciation of it, especially if it be made carefully and for a sufficient length of time.

One indication of death is found in the Rigidity of the corpse. It is true that persons in some nervous diseases have been represented as closely assimilating the dead, even with respect to the stiffness of the body. The professional man could scarcely, however, be deceived by such cases. The stiffness of death is often not fairly established until the body is already cold[5], and, when overcome by pressure, does not return, as the contractions which arise from nervous causes. Some cases of catalepsy have been related which are indeed very astonishing, but, as I have said, they could only deceive unprofessional people, and those not familiar with the appearances of a corpse.

The rigidity of death appears to come on with various degrees of rapidity, and its duration is also various. It usually commences in about seven hours[6], but it may be deferred considerably longer, even to twenty or thirty hours. When the body is greatly weakened by disease, the rigidity comes on much sooner, but is more evanescent. It has been known to arise in fifteen or twenty minutes. Again, in its duration there is much variety; ordinarily it exists from twenty-four to thirty-six hours, but may continue many days. Much may be supposed to depend on the humidity and warmth of the atmosphere.

There is something singular in this stiffening of the body. It seems like the final act of life, and has been supposed to be the last effort of muscular power. Every one must be struck with the analogy it presents to the coagulation of the blood; and, indeed, it has been imagined by some physiologists that it was dependent on that cause. This does not appear in reality to be the case; but there are still many interesting points of similarity between these phenomena, and they are both probably dependent on the last efforts of life.

The rigidity of the corpse is, perhaps, never entirely wanting, though it may be brief in particular cases.

It does not seem to be confined to the external muscles of the body, but is also evident, and indeed particularly manifested, in the heart and great blood-vessels. The walls of the heart contract forcibly after the external signs of death, and the arteries also contract, and propel their contents into the veins. Before this circumstance was properly understood, it was common to suppose that this contracted state of the heart was the result of disease; and even in modern times this error has been made. In the same way the ancients were misled by this contraction; for, as they found the arteries void of blood, they regarded them as tubes for the conveyance of air; and in this way arose the term artery (ἀὴρ, air; τηρέω, to keep), improperly used to indicate a blood-vessel.

The rapidity with which the body cools after death, must be very dependent on the circumstances in which it is placed, and the manner in which it is clothed. According to Dr. Taylor, the average time is about fifteen or sixteen hours when not much clad, and when the temperature is about 60°. He has known a body keep warm thirty or forty hours; and as he remarks, the heat would obviously remain the longest, when the death was violent and the person robust. There is always, however, some uncertainty in judging of the period of death by the warmth of the body.[7]

It is a curious fact in relation to the temperature of the body, that in cases of Asiatic cholera, the body, previously quite cold, has become warm immediately before, or even after death.[8]

The effects of Stimulants in producing muscular contractions soon after the cessation of all outward signs of vitality, are curious and interesting. When punctures are made in the limbs or heart, contractions follow, and in some cases alternate contractions and relaxations continue for some time. The most astonishing experiments of this kind are, however, those made by the agency of galvanism on the human body. The appearances produced by it are of the most frightful nature, and awaken horrible fancies on the mind of the spectator;--the eyes roll wildly, and the countenance is distorted with ghastly grins, whilst the limbs move in forcible and convulsive actions. The most successful effort to resuscitate by galvanism, was that made on the body of John White, who was executed for a murder at Louisville.

The particulars are given in the Annals of Electricity. The body, after hanging twenty-five minutes, was cut down, and, whilst yet warm, and even trembling, was subjected to the stimulus of galvanism. The man suddenly rose from his bench to a sitting posture, afterwards stood on his feet, opened his eyes, and gave a terrific screech. His chest worked as if in respiration. One of the surgeons present exclaimed that he was alive. On another shock being given, he jumped up with a sudden bound, disengaged himself from the wires, and ran into a corner of the room. He frequently opened his eyes, and the breathing became so regular, that many addressed him, but he made no sign of understanding. Nevertheless, by the assistance of a medical student, he took a few steps on the floor, and seated himself in an arm-chair. He seemed like a man intoxicated, and overcome with the exertion he had made. Every effort was put in practice to equalise the circulation; but congestion of the brain eventually came on, and terminated his existence. A man of the name of Clydesdale, who was executed for murder at Glasgow, was also made the subject of a similar experiment.

In respect to the application of stimulants, it is not likely that the more powerful, such as electricity or galvanism, will be made use of by any other than medical men; and this mode of testing the continuance of life is therefore more interesting in a physiological point of view, than useful in its practical application. Cold water to the face and sinapisms to the feet are often employed in the last moments of life,--if not to test the existence of vitality, at least to act as curative agents.

When Putrefaction commences, there can, of course, be no longer any doubt of the departure of life,--premising, that the putrefaction is general, and not of a local kind. There is nothing more appalling and humiliating than the decomposition of the dead;

“Before Decay’s effacing fingers
Have swept the lines where Beauty lingers,”

we may, indeed, persuade ourselves, that the dead are only silent and unmovable; but when changes gradually manifest themselves, and we can no longer recognise the familiar features we have so often looked upon, we see the greatness of that alteration, and feel what it is to die.

Shall we “look upon those lips that we have kissed we know not how oft,” pale, cold, and repulsive, and not experience the immensity of this change!

The peculiar cadaverous odour of the body is well known to most people, and the appearances of incipient putrefaction need no explanation. The finer changes are, perhaps, best indicated by the flaccidity of the cornea, and the loss of transparency in the eye. These can seldom be mistaken by medical men, though death may undoubtedly take place before they are strikingly apparent. Amongst other indications of decomposition, the gravitation and transudation of the blood to the surface on which the body lies, are important subjects for consideration, because they have been mistaken by persons ignorant of such matters for indications of injuries and bruises. They often present very singular lines and marks, and have certainly a very close resemblance to the extravasations produced by blows. These marks have been termed sugillations,--the term sugillation is rather an awkward word, but it is derived from the Latin _sugillatio_, which signifies a black mark. Several instances are recorded of their being mistaken for the ecchymoses produced by blows.

Belloc relates an instance where a woman, who was pregnant, was ill-treated by her husband, who kicked her on the thigh and abdomen. She subsequently fell ill of the smallpox, and died. The second day of the fever she had an abundant hæmorrhage from the nose, the blood being _dissolved and black_ (_dissous et très noir_). She died covered with sugillations, and some traces of the smallpox. It then became a question, whether she had died from violence. The body was exhumed for the purpose of inspection, but the medical men who made the examination concluded that her death was the result of the epidemic smallpox.[9]

Beck, in a note, quotes a case from Phillips’s Law of Evidence, of a John Stringer, who was tried for the murder of his wife, in the year 1765. It appeared that they had often quarrelled; and a young surgeon gave it as his opinion that the marks found on the body had the appearances of mortification produced by bruises. The man was found guilty; but a Mr. Carsan, an eminent surgeon, who had from mere curiosity also examined the body, was convinced that the marks were those of incipient putrefaction; and on the case being fairly represented to the Archbishop of Canterbury, a complete pardon was eventually obtained.[10]

Sugillations may be distinguished from ecchymoses, by their being found only on the more dependent parts of the body, or those which _have_ already been dependent, and from their not being accompanied by corresponding _subcutaneous extravasations_. In the case of sugillations, therefore, if the skin be fairly divided, the livid appearance will not be found traceable to any more deeply-seated cause. The blood, too, in the case of sugillations is thin and fluid from its decomposition; whereas, in the lividity from blows, clots are commonly found beneath the spot indicated. But the effects of gravitation are not only to be taken into consideration in estimating the external appearances of the body, but also in considering the internal parts; and this is of great consequence in the appreciation of the appearances supposed to be the result of disease.

Sometimes discolourations of the body after death assume the appearance of stripes, as if the subject had been previously beaten. The term _Vibices_ (_vibex_, a stripe) has been adopted to express this appearance. Certainly, any one not previously aware that such marks are common, would be strongly tempted to suppose that they were produced by flagellation. It seems that these marks are caused by the dress and wrappings of the corpse causing the transudation of the blood to be determined to particular parts.

In the year 1837, Μ. P. Manni, professor in the University of Rome, offered to the Academy of Sciences, to place at its disposal the sum of 1500 francs, to be given to the author of the best memoir on the question of apparent death. In the same year the Academy proposed the following questions on the subject for a prize: 1. What are the distinctive characters of apparent death? 2. What are the means to prevent premature interment?

It was not until the year 1846 that any memoir appeared which was considered worthy of the prize; and it was then adjudicated to Μ. Bouchut, whose treatise is now before the public.[11]

It appears from Μ. Bouchut’s able researches, that the _sounds_ of the heart, as indicated by the stethoscope, are never entirely wanting, except in real death; and that the longest interval between the last beats of the heart is about six or seven seconds. These, therefore, are very important points in ascertaining the departure of life at the earliest possible period. The remarks of Μ. Bouchut are indeed such as must naturally recommend themselves to our reason; but he is the first who has fairly made the state of the heart in apparent death the subject of direct observation and experiment.

Μ. Bouchut further insisted on the complete dilatation of the pupil as a corroborative sign of death, remarking that, though contracted in the death struggle, it afterwards and speedily becomes dilated; so truly may we say that, “la pupille est la fenêtre de l’ame.”

It would seem, then, that the indications of death are sufficiently marked to render it improbable that premature interment can often take place; and whenever this occurs, it must be the result of great carelessness, ignorance, and haste.

Even the alterations which take place after the body is committed to the grave, have engaged the attention of medical inquirers, and Μ. Orfila, in his treatise on Judicial Exhumations, has brought forward much curious matter respecting them. It is not very probable that the features of the dead can be recognized after fourteen or fifteen days’ interment; and in three or four months all vestiges of the face are destroyed.

In cases, however, where pains are taken to exclude the air, the preservation may be wonderfully protracted; and on this point I may add some very interesting particulars relative to the posthumous examination of the body of Charles I.

Until a recent period, doubt had been entertained as to the precise spot where the remains of Charles I. were buried.

In the progress of some alterations which were made in connexion with the tomb-house of St. George’s Chapel, an aperture was accidentally made in Henry VIII.’s vault, through which the workmen saw two coffins, supposed to contain the bodies of Henry VIII. and Jane Seymour, and a third covered with a black velvet pall which, from Mr. Herbert’s narrative (Athenæ Oxonienses), was conjectured to contain the body of Charles I.

By the desire of the Prince Regent, and in his presence, an examination of this latter was made on the 1st of April, 1813. On removing the pall a plain leaden coffin was discovered, on which were inscribed, in large letters, King Charles, 1648. A square opening was made into the upper part of the lid, and through this a wooden coffin was seen, very much decayed, inclosing the body, carefully wrapped up in cere-cloth. It appeared that a quantity of greasy and resinous matter had been melted into the coffin so as to fill it completely, and exclude the air. It was not an easy matter to detach the cere-cloth from the body, except at such parts as were covered with unctuous matter, and these presented a correct impression of the features to which they had been applied.

When the face was at length uncovered, it presented a dark discoloured appearance, but the forehead and temples had lost nothing of their muscular substance, and the face was long and oval. The cartilage of the nose was gone; the left eye was open and full when first exposed, but it rapidly vanished. The pointed beard, so characteristic of this period, was perfect. Many of the teeth remained, and the left ear was found entire. It was impossible not to perceive the likeness which still remained to the coins and busts, and especially the pictures of the king by Vandyke. When the cere-cloth was sufficiently disengaged, the head was found loose and detached from the body; the hair was thick at the back part of the neck, and had been apparently cut short for the convenience of the executioner. At first it seemed black, but when cleaned and dried, presented a beautiful brown colour. The fourth cervical vertebra was cut transversely and smoothly, as if from a heavy blow of a sharp instrument. The examination having proceeded thus far, was thought to be sufficient to identify the body, and the head was immediately restored, and the coffin soldered up again. The other coffins were not disturbed; but the larger one, which is believed to have contained Henry VIII., and was six feet ten inches in length, was beaten in, as if by violence, and its outer wooden covering was decayed, and in small fragments. Through the opening the skeleton of the king might be perceived, but there was nothing found of a discriminative character, and no inscription on the coffin. It is supposed, that the coffin of King Henry had been injured by the precipitous introduction of that of King Charles, at a period when little respect was paid to the remains of monarchs. It may be interesting to add, that a very small mahogany coffin, covered with crimson velvet, lay on the pall which covered King Charles, and contained the still-born child of the Princess George of Denmark, afterwards Queen Anne.[12]

If the fear of premature interment be not unnatural, the fear of death itself is obviously less so.

In some cases, however, illness gradually removes this dread, and the change is welcomed, and even earnestly desired; the sufferer has ceased to take an interest in the things around him: they have lost all the charms they borrowed from hope and anticipation, and he has no future earthly prospect but the grave.

But even where the act of dying is dreaded, there are many who would not altogether be ignorant of the change. I have known people express a strange fear of dying whilst they are asleep. I was once earnestly asked by a patient who was on her death bed to awaken her if I thought she was dying. I should imagine that this fear was not uncommon; for I have heard it named more than once in my own experience. In a very interesting memoir of Mr. Edgeworth, a part of which is autobiographical, the writer states that his wife expressed this dread; but, alas! the sleep of death is one from which we cannot awaken our dearest friends!

“Three days before she died,” says Mr. Edgeworth, “I was suddenly called up to her room. I found her in violent convulsions. Youth, beauty, grace, charms of person and accomplishments of mind, reduced to the extreme of human misery, must have wrung the most obdurate heart. What must her husband feel at such a moment? I felt her pulse, and whispered, ‘You are not dying;’ she looked at me with an effort of resolution and kindness to thank me.

* * * * *

“She soon fell asleep, and awakened smiling. ‘I am smiling,’ said she, ‘at my asking you to sit beside me as a sort of protection, and at my being afraid to _die in my sleep_, when I never felt afraid of dying when awake.’”

Sometimes consciousness remains to the last moment of existence, and even when the tongue refuses to speak, the wistful eye and wave of the hand serve to impress the dying injunction. How beautifully and truly is this pictured in the story of Lefevre, where the poor soldier looks first at his son, and then at my Uncle Toby; “and the ligature, fine as it is, was never broken!”

When death is inevitable, it becomes the duty of a medical man to consider the propriety of informing his patient of his condition. The subject is very ably treated in a paper by Sir H. Halford; and written in his usual classical style. Sir Henry thinks it desirable that the physician should make known his opinion rather to the friends than to the patient, and allow the friends themselves to be the means of communicating the intelligence to the sick. “They do so,” he says, “without destroying his hopes, for the patient will still believe that he has an appeal to his physician beyond their fears; whereas, if the physician lay open his danger to him, however delicately he may do this, he runs a risk of appearing to pronounce a sentence of condemnation to death, against which there is no appeal.”[13] Sir H. Halford goes on to say, “that in the case of his late majesty (alluding to George IV., who died on the 25th of June, 1830), the Government and the royal family were informed, on the 27th of April, that his majesty’s disease was seated in his heart, and that an effusion of water into the chest was soon to be expected. It was not, however, until the latter end of May, when his majesty was so discouraged by repeated attacks of embarrassment in his breathing, as to desire me to explain to him the nature of his complaint, and to give him my candid opinion of its probable termination, that the opportunity occurred of acknowledging to his majesty the extent of my fears for his safety. This communication was not necessary to suggest to the king the propriety of religious offices, for his majesty had used them daily; but it determined him, perhaps, to appoint an early day to receive the sacrament. He did receive it with every appearance of the most fervent piety and devotion, and acknowledged to me repeatedly afterwards, that it had given him great consolation, true comfort. After this, when ‘he had set his house in order,’ I thought myself at liberty to interpret every new symptom, as it arose, in as favourable a light as I could, for his majesty’s satisfaction; and we were enabled thereby to rally his spirits in the intervals of his frightful attacks, to maintain his confidence in his medical resources, and to spare him the pain of contemplating approaching death, until a few minutes before his majesty expired.”

The changes which immediately precede death are, of course, more or less painful, according to their nature and severity; yet there can be no doubt but that dissolution itself is the cessation of suffering. In some instances the approach of death is betokened by strange and awful sensations; and it is probable that where consciousness remains to the last, the feelings are always peculiar and unmistakeable.

These premonitions of death often give rise to a degree of restlessness, and a wish for change, which is odd and capricious in its manifestations. Persons who have long remained tranquil will suddenly express a desire to be dressed and go down stairs, or have their beds moved to another position. Strange yearnings for particular places and old scenes sometimes arise, which seem like the shadowing forth of dim instincts, which have been concealed in the recesses of the mind. How painfully must such longings have been felt when death has hovered over the couch in the wild and inhospitable districts of the tropics, or the frozen regions of the extreme north!

With the exception of those who are worn down by long illness, or reduced to despair by mental anguish and misfortune, there are few who can believe that they have accomplished all the purposes of life; and we naturally look forward to the infirmities of old age to wean us from the interests of the world. But even then we are reluctant to leave; and it is only when deserted by friends, that we can say in the words of the poet,--

“I have liv’d long enough; my way of life
Is fall’n into the sear--the yellow leaf.”

In speaking of others it is common to regard life as properly terminating when usefulness, activity, and fortune are declining. When, reverses succeed a happy and prosperous career, we say that existence has been too protracted: it is on this account that the poets have spoken of the happiest moment of life as the most proper time for death; a notion certainly more poetical than rational. Thus, in Don Juan, Byron says, speaking of his lovers,--

“Why did they
Then not die?--they had liv’d too long
Should an hour come to bid them breathe apart.”