from burns are not very constant. Among those frequently noticed, however, are capillary injection of the mucous membrane of the alimentary canal and bronchi, perforating ulcers of stomach and duodenum, and serous effusion of the ventricles of the brain. It has frequently occurred that the body of a person murdered has been burned after death, in the hope that the death might be attributed to accident, and so enable the murderer to escape the consequences of his crime. It may become, therefore, very important in medico-legal cases for the examiner to be able to state whether a body was burned during life or after death. Among the facts that may be mentioned as proving that burns had been inflicted during life an important one is the presence of blisters and particularly of blisters containing serum. It is true that blisters may be produced a few minutes after death by heat; but when so produced they contain air, not serum.1 It should be mentioned, however, that in the case of dropsical persons blisters containing serum might be produced by the application of heat after death. On the other hand, the absence of blisters does not prove that a body was not burned during life, since blisters do not necessarily result from burns. Further, blisters, even when present, are sometimes so modified by the effects of the heat when intense as to be unrecognizable. Another proof that a body has been burned during life is the presence of a red line around the burn, the color of which gradually fades away into that of the surrounding skin. This red line remains after death, and cannot be produced by the application of heat to the dead body. It must be admitted, however, that it is often extremely difficult to state positively whether a body has been burned during life or after

1 Christison: Edinburgh Medical Journal, 1831, p. 320.

death. Indeed, if a dead body be found completely charred, it would be impossible to decide whether the individual had been burned alive or not.

Death from Suffocation.-Death from suffocation, whether by strangulation, hanging, or drowning, or however produced, is due in each instance to the same cause-the deprivation of the system of air, or asphyxia. Apart from the three principal modes of death from suffocation, which have just been referred to, and which will be considered separately, there are other modes of death from suffocation less common than those mentioned, but occurring so frequently as to demand some attention. Thus, for example, infants are frequently suffocated accidentally from being too closely wrapped up, or from being rolled upon by their mothers, often so intoxicated as to be unaware of what they are doing. Children, feeble persons, and drunkards have been suffocated by falling into ash-heaps, dirt-piles, etc. The passage into the larynx of marbles and whistles accidentally swallowed by children, of half-chewed meat bolted through over-haste in eating-a habit unfortunately too common even in adults-is a not uncommon cause of suffocation. Occasionally, suffocation is intentionally produced, as in cases where individuals, having determined to commit suicide, force foreign bodies, like balls of hay, for example, down their own throats. Death from suffocation may be, however, homicidal as well as accidental or suicidal. Indeed, one of the commonest ways of killing new-born children is by suffocation, the crime being easily committed and leaving but few traces to tell the tale. Frequently, persons have been suffocated by having foreign bodies like corks and pieces of meat forced down their

Tidy op. cit., part ii. pp. 448, 449; Taylor: op. cit., p. 426; Wharton and Stillé: vol. iii. p. 348.

throats, the murderers hoping that death would be attributed to accidental suffocation, and thus have suspicion diverted from themselves. Therefore, the medical examiner, in cases of death from suffocation, even after most careful examination, should be extremely cautious in expressing an opinion as to whether death was accidental, suicidal, or homicidal. The post-mortem appearances usually observed in cases of death from suffocation and from causes such as those mentioned are lividity of the face and lips, congestion of the eyes, bloody mucous froth about the mouth and nose, congestion of the lungs and of the right side of the heart and kidneys.

Death from Suffocation by Strangulation.-Strangulation may be produced either by simple pressure of the hand on the windpipe, as in throttling, or by means of a rope, strap, handkerchief, piece of a sheet, bowstring, etc. It differs from hanging principally in the position of the cord, which is horizontal in the former case and oblique in the latter. From a medico-legal point of view this is an important distinction, since death from strangulation would be usually regarded as homicidal, that from hanging as suicidal. Among the signs of death from strangulation may be mentioned the staring eyes with dilated pupils, the livid and swollen face, the protruding and often-bitten tongue, blood about the nose, mouth, and ears, turgidity of the genitalia, with escape of urine and feces. The larynx is flattened, congested internally, and coated over with a bloody frothy mucus. The right side of the heart and the venous system are gorged with blood. The marks made by the fingers and thumb upon the front of the neck, as in throttling, or the horizontal mark or marks made by the cord according to the number of times it was wound around the neck, with the infiltrated blood beneath, are striking

evidences of death from strangulation. It is true that such marks can be made by winding a cord around the neck of a dead body, and that therefore too much importance must not be attached to their presence; but it must be borne in mind that the livid, swollen countenance, the protruded tongue, the staring eyeballs, which are always present in death from strangulation, and which cannot be produced after death, must be always taken into consideration, as well as the marks observed on the front of the neck. According to Tidy,' an ecchymosed mark can be produced experimentally within three hours, a non-ecchymosed one within six hours, after death. Casper, however, states, as the results of his experiments, "that any ligature with which any body may be suspended or strangled, not only within a few hours, but even days after death, especially if the body be forcibly pulled downward, may produce a mark precisely similar to that which is observed in most of those hanged while alive." It is remarkable that the marks of strangulation sometimes persist weeks and even years after burial.

Strangulation is sometimes produced accidentally. Cases have occurred, for example, where death was due to compression of the windpipe by straps or strings habitually worn around the necks of persons engaged in carrying heavy baskets of fish or vegetables for sale. Suicidal strangulation is rare. Among the insane, however, it is not of unfrequent occurrence, being so easily accomplished. Indeed, in certain cases it requires the greatest vigilance on the part of the attendants to prevent it.

Death from Suffocation by Hanging.—In this mode of death the body is suspended by the neck, the weight of the 1 Tidy: op. cit., part ii. p. 431. 2 Casper op. cit., vol. ii. p. 173.

body acting as the compressing force. If the neck is compressed beneath the thyroid cartilage, death is usually due to asphyxia, and is rapid; but if just beneath the chin, as is usually the case in executions, to congestion of the brain (apoplexy), and is slow. In most cases, however, death is due rather to the effects of both causes combined. Оссаsionally, death is caused immediately by pressure upon the spinal cord through fracture or displacement of the odontoid process of the second cervical vertebra. The hyoid bone and thyroid cartilage have also in some instances been fractured. Death from fracture of the vertebræ in hanging, however, is not so frequent as is usually supposed. The post-mortem appearances observed in cases of death from hanging do not differ essentially from those already described in death from strangulation. Indeed, the mere inspection of the body will not enable the examiner to state positively that death was due to hanging. The flow of saliva out of the mouth, down the chin, and straight down the chest, is possibly one of the most positive signs of this kind of death; but the absence of such a flow would hardly justify the examiner in stating that death was not due to hanging. It is also extremely difficult to determine, when a body is found dead from hanging, whether the death should be regarded as accidental, suicidal, or homicidal. It is true that in cases of suicide by far the greatest number are committed by hanging; but that would only lead to a presumption as to the cause of death. From the fact that very young children rarely commit suicide, it might be supposed that the age of the deceased might assist the examiner to some extent in determining the cause of death. It must be remembered, however, that suicide has been committed by hanging by a boy of nine and by a man of ninety-seven years of age, and that death from