Popular Science Monthly/Volume 3/July 1873/The Physiology of Death
| THE PHYSIOLOGY OF DEATH. |
By FERNAND PAPILLON.
TRANSLATED FROM THE FRENCH, BY A. R. MACDONOUGH.
OF old, the spoils of death fell to the anatomist's share, while the physiologist took for his part the phenomena of life. Now we submit the corpse to the same experiments as the living organism, and pry into the relics of death for the secrets of life. Instead of seeing in the lifeless body mere forms ready to dissolve and vanish, we detect in it forces and persisting activities full of deep instructiveness in their mode of working. As theologians and moralists exhort us to study the spectre of death face to face at times, and strengthen our souls by courageous meditation on our last hour, so medicine regards it as essential to direct our attention toward all the details of that mournful drama, and thus to lead us, through gloom and shadows, to a clearer knowledge of life. But it is only with respect to medicine in the most modern days that this is true.
Leibnitz, who held profound and admirable theories of life, had one of death also, which he has unfolded in a famous letter to Arnauld. He believes that generation is only the development and evolution of an animal already existing in form, and that corruption or death is only the reënvelopment or involution of the same animal, which does not cease to subsist and continue living. The sum of vital energies, consubstantial with monads, does not vary in the world; generation and death are but changes in the order and adjustment of the principles of vitality, simple transformations from small to great, and vice versa. In other words, Leibnitz sees everywhere eternal and incorruptible germs of life, which neither perish at all nor begin. What does begin and perish is the organic machine of which these germs compose the original activity: the elementary gearing of the machine is broken apart, but not destroyed. This is the earlier view held by Leibnitz. He has another, conceiving of generation as a progress of life through degrees; he can conceive of death also as a gradual regress of the same principle, that is to say, that in death life withdraws little by little, just as it came forward little by little in generation. Death is no sudden phenomenon, nor instantaneous evanishing-it is a slow operation, a "retrogradation," as the Hanoverian philosopher phrases it. When death shows to us, it has been a long time wearing away the organism, though we have not perceived it, because "dissolution at first attacks parts invisibly small." Yes, death, before it betrays itself to the eye by livid pallor, to the touch by marble coldness, before chaining the movements and stiffening the blood of the dying person, creeps with insidious secrecy into the smallest and most hidden points of his organs and his humors. Here it begins to corrupt the fluids, to disorganize the tissues, to destroy the equipoise and endanger the harmony. This process is more or less lingering and deceitful, and, when we note the manifest signs of death, we may be sure that the work lacked no deliberate preparation.
These ideas of Leibnitz, like most of the conceptions of genius, waited long after the time of their appearance for confirmation by demonstrative experiment. Before his day, bodies were dissected only for the sake of studying in them the conformation and normal arrangement of the organs. When this study was once completed, science took up the methodical inquiry into the changes produced in the different parts of the body by diseases. Not until the end of the eighteenth century did death in action become the subject of investigation by Bichat.
Bichat is the greatest of the physiological historians of death. The famous work he has left on this subject, his "Physiological Researches upon Life and Death," is as noteworthy for the grandeur of its general ideas, and its beauty of style, as for its precision of facts and nicety of experiment. To this day it remains the richest mine of recorded truths as to the physiology of death. Having determined the fact that life is seriously endangered only by alterations in one of the three essential organs, the brain, the heart, and the lungs, a group forming the vital tripod, Bichat examines how the death of one of these three organs assures that of the others, and in succession the gradual stoppage of all the functions. In our day, the advance of experimental physiology in the path so successfully traversed by Bichat, has brought to light in their minutest details the various mechanical processes of death, and, what is of far greater consequence, has disclosed an entire order of activities heretofore only suspected to be at work in the corpse. The theory of death has been built up by slow degrees along with that of life, and several practical questions that had remained in a state of uncertainty, such as that of the signs of real death, have received the most decisive answer in the course of these researches.
I.
Bichat pointed out that the complete life of animals is made up of two orders of phenomena, those of circulation and nutrition, and those that fix the relations of the living being with its environment. He distinguishes organic life from animal life, properly so called. Vegetables have only the former; animals possess both, intimately blended. Now, on the occurrence of death, these two sorts of life do not disappear at one and the same moment. It is the animal life that suffers the first stroke; the most manifest activities of the nervous system are those which come to a halt before all the rest. How is this stoppage brought about? We must consider separately the order of occurrences in death from old age, in that occasioned by disease, and in sudden death.
The man who expires at the close of a long decline in years, dies in detail. All his senses in succession are sealed. Sight becomes dim and unsteady, and at last loses the picture of objects. Hearing grows gradually insensible to sounds. Touch is blunted into dulness, odors produce but a weak impression, only taste lingers a little. At the same time that the organs of sensation waste and lose their excitability, the functions of the brain fade out little by little. Imagination becomes unfixed, memory nearly fails, judgment wavers. Further, motions are slow and difficult on account of stiffness in the muscles; the voice breaks; in short, all the functions of outward life lose their spring. Each of the bonds attaching the old man to existence parts by slow degrees. Yet the internal life persists. Nutrition still takes place, but very soon the forces desert the most essential organs. Digestion languishes, the secretions dry up, capillary circulation is clogged: that of the large vessels in their turn is checked, and, at last, the heart's contractions cease. This is the instant of death. The heart is the last thing to die. Such is the series of slow and partial deaths which, with the old man spared by disease, result in the last end of all. The individual who falls into the sleep of eternity in these conditions, dies like the vegetable which, having no consciousness of life, can have no consciousness of death. He passes insensibly from one to the other, and to die thus is to know no pain. The thought of the last hour alarms us only because it puts a sudden end to our relations with all our surroundings; but, if the feeling of these relations has long ago faded away, there can be no place for fear at the brink of the grave. The animal does not tremble in the instant before it ceases to be.
Unfortunately, death of this kind is very rare for humanity. Death from old age has become an extraordinary phenomenon. Most commonly we succumb to a disturbance in the functions of our vital system, which is sometimes sudden, sometimes gradual. In this case, as in the former one, we observe animal life disappearing first, but the modes of its conclusion are infinitely varied. One of the most usual is death through the lungs; as a result of pneumonia and different forms of phthisis, the oxidation of the blood becoming impossible on account of the disorganization of the pulmonary globules, venous blood goes back to the heart without gaining revivification. In the case of serious and prolonged fevers, and of infectious diseases, whether epidemic or otherwise, which are, characteristically, blood-poisonings, death occurs through a general change in nutrition. This is still more the fact as to death consequent upon certain chronic disorders of the digestive organs. When these are affected, the secretion of those juices fitted to dissolve food dries up, and these fluids go through the intestinal canal unemployed. In this case the invalid dies of real starvation. Hæmorrhage is one of the commonest causes of death. Whenever a great artery is opened from any cause, permitting the copious outflow of blood, the skin grows pale, warmth declines, the breathing is intermittent, vertigo and dimness of sight follow, the expression of the features changes, cold and clammy sweat covers part of the face and the limbs, the pulse gets gradually weaker, and, at last, the heart stops. Virgil describes hæmorrhage with striking fidelity in the story of Dido's death.
Sudden death, unconnected with outward and accidental causes, may occur in various ways. Very violent impressions on the feelings sometimes abruptly check the movements of the heart, and produce a mortal swoon. Instances are well known of many persons dying of joy—Leo X. is one—and of persons who succumbed to fear. In foudroyant apoplexy, if real death is not instantaneous, there is at least the sudden occurrence of the phenomena of death. The sufferer is plunged in profound sleep, called by physicians coma, from which wakening is impossible; his breathing is difficult, his eyes set, his mouth twisted and distorted. The pulsations of the heart cease little by little, and soon life utterly vanishes. The breaking of an aneurism very often occasions sudden death. Not less often the cause of death is found in what is called an embolism, that is, a check to the circulation by a clot of blood suddenly plugging up some important vessel. And there are also cases of sudden death still unaccounted for, in the sense that subsequent dissection discovers nothing that could explain the stoppage in the operations of life.
Death is usually preceded by a group of phenomena that has received the name of the death-agony. In most cases of disease the beginning of this concluding period is marked by a sudden improvement of the functions. It is the last gleam springing from the dying flame; but soon the eyes become fixed and insensible to the action of light, the nose grows pointed and cold, the mouth, wide open, seems to call for the air that fails it, the cavity within it is parched, and the lips, as if withered, cling to the curves of the teeth. The last movements of respiration are spasmodic, and a wheezing, and sometimes a marked gurgling sound, may be heard at some distance, caused by obstruction of the bronchial tubes with a quantity of mucus. The breath is cold, the temperature of the skin lowered. If the heart is examined, we note the weakening of its sounds and pulsations. The hand, placed in its neighborhood, feels no throb. Such is the physiognomy of a person in the last moments of death in the greater number of cases, that is, when death follows upon a period of illness of some duration. The death-struggle is seldom painful, and almost always the patient feels nothing of it. He is plunged into a comatose stupor, so that he is no longer conscious of his situation or his sufferings, and he passes insensibly from life to death, in a manner that renders it sometimes difficult to fix the exact instant at which a dying person expires. This is true, at least, in chronic maladies, and especially in those that consume the human body slowly and silently. Yet, when the hour of death comes for ardent organizations—for great artists, for instance, and they usually die young—there is a quick and sublime new burst of life in the creative genius. There is no better example of this than the angelic end of Beethoven, who, before he breathed out his soul, that tuneful monad, regained his lost speech and hearing, and spent them in repeating for the last time some of those sweet harmonies which he called his "Prayers to God." Some diseases, moreover, are most peculiarly marked by the gentleness of the dying agony. Of all the ills that cheat us while killing by pin-pricks, consumption is that which longest wears for us the illusive look of health, and best conceals the misery of living and the horror of dying. Nothing can be compared with that hallucination of the senses and that liveliness of hope which mark the last days of the consumptive. He takes the burning of his destroying fever for a healthful symptom, he forms his plans, and smiles calmly and cheerfully on his friends, and suddenly, some morrow of a quiet night, he falls into the sleep that never wakes.
If life is everywhere, and if, consequently, death occurs everywhere, in all the elements of the system, what must be thought of that point in the spinal marrow which a famous physiologist styled the vital knot, and in which he professed to lodge the principle of life itself? The point which Flourens regarded as this vital knot is situated nearly at the middle of the prolonged spinal cord—that is, the middle of that portion of the nerve-substance which connects the brain with the spinal marrow. This region, in fact, has a fine and dangerous excitability. A prick, or the penetration of a needle into it, is enough to cause the instant death of any animal whatever. It is the very means used in physiological laboratories to destroy life swiftly and surely in dogs. That susceptibility is explained in the most natural way. This spot is the starting-point of the nerves that go to the lungs; the moment that the slighest injury is produced in it, there follows a check on the movements of respiration, and ensuing death. This vital knot of Flourens enjoys no sort of special prerogative. Life is not more concentrated nor more essential in it than elsewhere; it simply coincides with the initial point of the nerves animating one of the organs indispensable to vitality, the organ of sanguification; and in living organisms any alteration of the nerves controlling a function brings a serious risk as to its complete performance. There is, therefore, no such thing as a vital knot, a central fire of life in animals. They are collections of an infinity of infinitely small living creatures, and each one of these microscopic living points is its own life-centre for itself. Each on its own account grows, produces heat, and displays those characteristic activities which depend upon its structure. Each one, by virtue of a preëstablished harmony, meets all the rest in the ways that they require; but, just as each lives on its own account, so on its account each dies. And the proof that this is so is found in the fact that certain parts taken from a dead body can be transferred to a living one without suffering any interruption in their physiological activity, and in the fact that many organs which seem dead can be excited anew, awakened out of their torpor, and animated to extremely remarkable vital manifestations. This subject we now proceed to consider.
II.
Death seems to be absolute from the instant that the pulsations of the heart are stopped without renewal, because, the circulation of the blood no longer proceeding, the nutrition of the organs becomes impossible, and nutrition is demanded for the maintenance of physiological harmony; but, as we have said above, there are a thousand little springs in the organism which keep up a certain degree of activity after the great main-spring has ceased to act. There is an infinite number of partial energies that outlive the destruction of the principal energy, and withdraw only by slow degrees. In cases of sudden death especially the tissues keep their peculiar vitality a very long time. In the first place, the heat declines only quite slowly, and the more so in proportion as death has been quick. For several hours after death the hair of the head and body, and the nails, continue to grow, nor does absorption either stop at once. Even digestion, too, keeps on. The experiment performed by Spallanzani to test this is very curious. He conceived the idea of making a crow eat a certain quantity of food, and killing it immediately after the meal. Then he put it in a place kept at the same temperature as that of a live bird, and opened it six hours later. The food was thoroughly digested.
Besides these general manifestations, the dead body is capable, during some continued time, of different kinds of activity. It is not easy to study these on the bodies of persons dying of sickness, because they are not permitted to be made the subject of anatomical examinations until twenty-four hours after death; but the bodies of beheaded criminals, which are given up to savants a few moments after their execution, can be of use in the investigation of what takes place immediately after the stopping of the living machine. If the heart is uncovered a few minutes after execution, pulsations are remarked which continue during an hour or longer, at the rate of forty to forty-five a minute, even after the removal of the liver, the stomach, and the intestines. For several hours the muscles retain their excitability, and undergo reflex contractions from the effect of pinching. M. Robin noted the following phenomenon in the case of a criminal an hour after his execution: "The right arm," to quote his description, "being placed obliquely extended at the side of the trunk, with the hand about ten inches away from the hip, I scratched the skin of the chest, at about the height of the nipple, with the point of a scalpel, over a space of nearly four inches, without making any pressure on the muscles lying beneath. We immediately saw the great pectoral muscle, then the biceps, then the anterior brachial, successively and quickly contract. The result was a movement of approach of the whole arm toward the trunk, with rotation inward of the limb, and half flexion of the forearm upon the arm, a true defensive movement, which threw the hand forward toward the chest as far as the pit of the stomach."
These spontaneous exhibitions of life in a corpse are trifles compared with those excited by means of certain stimulants, particularly of electricity. Aldini, in 1802, subjected two criminals, beheaded at Bologna, to the action of a powerful battery. Influenced by the current, the facial muscles contracted, producing the effect of horrid grimaces. All the limbs were seized with convulsive movements; the bodies seemed to feel the stir of resurrection, and to make efforts to rise. The springs of the system retained the power of answering the electric stimulus for several hours after beheading. A few years later, at Glasgow, Ure made some equally noted experiments on the body of a criminal that had remained more than an hour hanging on the gallows. One of the poles of a battery of 700 pairs having been connected with the spinal marrow below the nape of the neck, and the other brought in contact with the heel, the leg, before bent back on itself, was thrust violently forward, almost throwing down one of the assistants, who had hard work to keep it in place. When one of the poles was placed on the seventh rib, and the other on one of the nerves of the neck, the chest rose and fell, and the abdomen repeated the bike movement, as takes place in respiration. On touching a nerve of the eyebrow at the same time with the head, the facial muscles contracted. "Wrath, terror, despair, anguish, and frightful grins, blended in horrible expression on the assassin's countenance."
The most remarkable instance of a momentary reappearance of vital properties, not in the whole organism, but in the head alone, is the famous experiment suggested by Legallois, and carried out for the first time in 1858 by M. Brown-Séquard. This skilful physiologist beheads a dog, taking pains to make the section below the point at which the vertebral arteries enter their bony sheath. Ten minutes afterward he sends the galvanic current into the different parts of the head thus severed from its body, without producing any result of movement. He then fits to the four arteries, the extremities of which appear in the cutting of the neck, little pipes connected by tubes with a reservoir full of fresh oxygenated blood, and guides the injection of this blood into the vessels of the brain. Immediately irregular motions of the eyes and the facial muscles occur, succeeded by the appearance of regular harmonious contractions, seeming to be prompted by the will. The head has regained life. The motions continue to be performed during a quarter of an hour, while the injection of blood into the cerebral arteries lasts. On stopping the injection, the motions cease, and give place to the spasms of agony, and then to death.
Physiologists asked whether such a momentary resurrection of the functions of life might not he brought about in the human subject—that is, whether movement might not be excited and expression reanimated by injecting fresh blood into a head just severed from a man's body, as in M. Brown-Séquard's experiment. It was suggested to try it on the heads of decapitated criminals, but anatomical observations, particularly those of M. Charles Robin, showed that the arteries of the neck are cut by the guillotine in such a way that air penetrates and fills them. It follows that it is impracticable to inject them with blood that can produce the effects noted by M. Brown-Séquard. Indeed, we know that blood circulating in the vessels becomes frothy on contact with air, and loses fitness for its functions. M. Robin supposes that the experiment in question could be successful only if made upon the head of a man killed by a ball that should strike below the neck; in that case it would be possible to effect such a section of the arteries that no entrance of air would occur, and, if the head were separated at the place pointed out by M. Brown-Séquard, those manifestations of function remarked in the dog's head would probably be obtained by the injection of oxygenated blood. M. Brown-Séquard is convinced that they might be obtained, if certain precautions were observed, even with the head of a decapitated criminal; and, so strong is his conviction, that, when it was proposed to him to try the experiment—that is, to perform the injection of blood into the head of a person executed—he refused to do so, not choosing, as he said, to witness the tortures of this fragment of a being recalled for an instant to sensibility and life. We understand M. Brown-Séquard's scruples, but it is allowable to doubt whether he would have inflicted great suffering on the head of the subject; at most, he would only have aroused in it a degree of very dim and uncertain sensibility. This is easily explained. In life, the slightest perturbation in the cerebral circulation is enough to prevent thought and sensation utterly. Now, if a few drops of blood too much or too little in the brain of an animal in full health suffice to alter the regularity of its psychical manifestations, much more certainly will the completeness of the brain's action be deranged if it is awakened by an injection of foreign blood, a forcible entry too, which, of necessity, cannot cause the blood to circulate with suitable pressure and equipoise.
Corpse-like rigidity is one of the most characteristic phenomena of death. This is a general hardening of the muscles, so great that they lose the property of extension till even the joints cannot be bent; this phenomenon begins some hours after death. The muscles of the lower jaw are the first to stiffen; then rigidity invades in succession the abdominal muscles, those of the neck, and at last the thoracic ones. This hardening takes place through the coagulation of the half-fluid albuminoid matter which composes the muscular fibres, as the solidification of the blood results from coagulation of its fibrine. After a few hours the coagulated musculine grows fluid again, rigidity passes away, and the muscles relax. Something not dissimilar takes place also in the blood. The globules change, lose shape, and suffer the beginning of dissociation. The agents of putrefaction, vibrios and bacteria, thus enter upon their great work by insidiously breaking up the least seen parts.
At last, when partial revivals are no longer possible, when the last flicker of life has gone out and corpse-like rigidity has ceased, a new work begins. The living germs that had collected on the surface of the body and in the digestive canal develop, multiply, pierce into all the points of the organism, and produce in it a complete separation of the tissues and humors; this is putrefaction. The moment of its appearance varies with the causes of death and the degree of outward temperature. When death is the result of a putrid malady, putrefaction begins almost immediately when the body has grown cold. It is the same when the atmosphere is warm. In general, in our climates, the work of decomposition becomes evident after from thirty-eight to forty hours. Its first effects are noticeable on the skin of the stomach; this takes on a greenish discoloration, which soon spreads and covers successively the whole surface of the body. At the same time the moist parts, the eye, the inside of the mouth, soften and decay; then the cadaverous odor is gradually developed, at first faint and slightly fetid, a mouldy smell, then a pungent and ammoniacal stench. Little by little the flesh sinks in and grows watery; the organs cease to be distinguishable. Every thing is seized upon by what is termed putridity. If the tissues are examined under the microscope at this moment, we no longer recognize any of the anatomical elements of which the organic fabric is made up in its normal state. "Our flesh," Bossuet exclaims in his funeral-sermon on Henrietta of England, "soon changes its nature, our body takes another name; even that of a corpse, used because it still exhibits something of the human figure, does not long remain with it. It becomes a thing without a shape, which in every language is without a name." When structure has wholly disappeared, nothing more remains but a mixture of saline, fat, and proteic matters, which are either dissolved and carried away by water, or slowly burned up by the air's oxygen, and transmuted into new products, and the whole substance of the body, except the skeleton, returns piecemeal to the earth whence it came forth. Thus the ingredients of our organs, the chemical elements of our bodies, turn to mud and dust again. From this mud and this dust issue unceasingly new life and energetic activity; but a clay fit for the commonest uses may also be got from it, and, in the words of Shakespeare's Hamlet, the dust of Alexander or Caesar may plug the vent of a beer-cask, or "stop a hole to keep the wind away." These "base uses," of which the Prince of Denmark speaks to Horatio, mark the extreme limits of the transformation of matter. In any case the beings of lowest order that toil and engender in the bosom of putrefaction are really absorbing and storing away life, since without their aid the corpse could not serve as nutriment to plants, which in their turn are the necessary reservoir whence animality draws its sap and strength. It is in this sense that Buffon's doctrine of organic molecules is a true one.
Death is the necessary end of all organic existence. We may hope more or less to set at a distance its inevitable hour, but it would be madness to dream of its indefinite postponement in any species whatsoever. No doubt there is no contradiction in conceiving of a perfect equilibrium between assimilation and disassimilation, such that the system would be maintained in immortal health. In any case, no one has yet even gained a glimpse of the modes of realizing such an equilibrium, and death continues, till further orders, a fixed law of Fate. Still, though immortality for a complete organism seems chimerical, perhaps it is not the same with the immortality of a separate organ in the sense we now explain. We have already alluded to the experiments of M. Paul Bert on animal-grafting. He has proved that, on the head of a rat, certain organs of the same animal—as the tail, for instance—may be grafted. And this physiologist asks himself the question, whether it would not be possible, when a rat provided with such an appendage draws near the close of his existence, to remove the appendage from him, and transplant it to a young animal, which in his turn would be deprived of the ornament in the same way in his old age in favor of some specimen of a new generation, and so on in succession. This tail, transplanted in regular course to young animals, and imbibing at each transference blood full of vitality, perpetually renewed, yet ever remaining the same, would thus escape death. The experiment, delicate and difficult, as we well see, was yet undertaken by M. Bert, but circumstances did not allow it to be prolonged for any considerable time, and the fact of the perpetuity of an organ, periodically rejuvenated, remains to be demonstrated.
III.
Real death, then, is characterized by the positive ceasing of vital properties and functions both in the organic or vegetative life, and in the animal life, properly so termed. When animal life disappears without any interruption occurring in organic life, the system is in a state of seeming death. In this state the body is possessed by profound sleep quite similar to that of hibernating animals; all the usual expressions and all signs of internal activity have disappeared, and give place to invincible torpor. The most powerful chemical stimulants exert no control over the organs, the walls of the chest are motionless; in short, seeing the body presenting this appearance, it is impossible not to think of it as dead. There are quite numerous states of the organism which may thus imitate death more or less closely; the commonest one is that of fainting. In this case neither sensation nor movements of circulation or respiration are any longer perceptible; the warmth is lowered, the skin pallid and colorless. Instances of hysteria are cited in which the attack has been prolonged for several days, attended with fainting. In this strange condition all physiological manifestations remain suspended; yet they are not, as it was long supposed, suspended absolutely. M. Bouchest has proved that, in the gravest cases of fainting, the pulsations of the heart continue, weaker and rarer, and harder to be heard than in normal life, but clearly distinguishable when the ear is laid on the precordial region. On the other hand, the muscles retain their suppleness and the limbs their pliability.
Asphyxia, which properly is suspension of breathing, and consequently of the blood's revivification, sometimes passes into a serious fainting condition followed by seeming death, from which the sufferer recovers after a period of varying length. This state may be induced either by drowning or by inhaling a gas unfit for respiration, such as carbonic acid in deep wells, emanations from latrines, or the chokedamp of mines, or by suffocation. In 1650 a woman named Ann Green was hanged at Oxford. She had been hanging for half an hour, and several people, to shorten her suffering, had pulled her by the feet with all their strength. After she was placed in her coffin it was observed that she still breathed. The executioner's assistants attempted to end her existence, but, thanks to the help of physicians, she came back to life, and continued to live some time afterward. Drowning occasions an equally deep insensibility, during which, very singularly, the psychical faculties retain some degree of activity. Sailors, after timely resuscitation from drowning, declare that, while under water, they had returned in thought to their families, and sadly fancied the grief about to be caused by their death. After a few minutes of physical rest, they suffered violent colic of the heart, which seemed to twist itself about in their chests; afterward this anguish was followed by utter annihilation of consciousness. It is very difficult, moreover, to determine how long apparent death may be protracted in an organism under water. It varies greatly with temperaments.
In the islands of the Greek archipelago, where the business of gathering sponges from the bottom of the sea is pursued, children are not allowed to drink wine until, by practice, they have grown accustomed to remain a certain time under water. Old divers of the archipelago say that the time to return and take breath at the surface is indicated to them by painful convulsions of the limbs, and very severe contractions in the region of the heart. This power of enduring asphyxia for some time, and resisting by force of will the movements of respiration, has been remarked under other circumstances. The case of a Hindoo is mentioned, who used to creep into the palisaded enclosures used for bathing, in the Ganges, by the ladies of Calcutta, seize one of them by the legs, drown her, and rob her of her rings. It was supposed that a crocodile carried her off. One of his intended victims succeeding in escaping, the assassin was seized and executed in 1817. He confessed that he had practised the horrible business for seven years. Another instance is that of a spy, who, seeing preparations making for his execution, endeavored to escape it by feigning death. He held his breath, and suspended all voluntary motions for twelve hours, and endured all the tests applied to him to put the reality of his death beyond doubt. Anæsthetics, too, like chloroform and ether, sometimes produce stronger effects than the surgeons using them desire, and occasion a state of seeming death instead of temporary insensibility.
It is easy to recall persons to life who are in a state of seeming death; it is only needful to stimulate powerfully the two mechanical systems that are more or less completely suspended in action, namely those of respiration and circulation. Such movements are communicated to the frame of the chest, that the lungs are alternately compressed and dilated. A sort of shampooing is applied over the whole body, which restores the capillary circulation; chemical stimulants, such as ammonia or acetic acid, are brought under the patient's nostrils. This is the mode of treatment for drowned persons, whose condition is brought on by ceasing to breathe the air, not by taking in too much water. A very effective method in cases of apparent death, caused by inhaling a poisonous gas, such as carbonic acid or sulphuretted hydrogen, consists in making the patient draw in large quantities of pure oxygen. And, again, it has very lately been proposed, as Hallé suggested without success early in this century, to adopt the use of strong electric currents for stimulating movement in persons who are in a state of syncope.
In all the cases of seeming death we have just mentioned, one mark of vitality persistently remains, that is, pulsation of the heart. Its throbs are less strong and frequent, but they continue perceptible on auscultation. They are regularly discernible in the deepest fainting-fits, in the various kinds of asphyxia, in poisonings by the most violent narcotics, in hysteria, in the torpor of epilepsy, in short, in the most diverse and protracted states of lethargy and seeming death.
Yet, this result, now a practical certainty, was unknown to physicians of old, and it cannot be denied that, in former times, seeming death was quite often mistaken for true death. The annals of science have recorded a certain number of errors of this kind, many of which have resulted in the interment of unfortunate wretches who were not dead. And for one of these mistakes that chance has brought to light either too late, or in time for the rescue, even then, of the victim, how many are there, particularly in times of ignorance and carelessness, that no one has ever known! How many live men have only given up their last breath after a vain struggle to break out of their coffin! The facts collected by Bruhier and Lallemand in two works that have become classic compose a most mournful and dramatic history. These are some of its episodes, marked by the strange part that chance plays in them. A rural guard, having no family, dies in a little village of Lower Charente. Hardly grown cold, his body is taken out of bed, and laid on a straw ticking covered with a coarse cloth. An old hired woman is charged with the watch over the bed of death. At the foot of the corpse were a branch of box, put into a vessel filled with holy water, and a lighted taper. Toward midnight the old watcher, yielding to the invincible need of sleep, fell into a deep slumber. Two hours later she awoke surrounded by flames from a fire that had caught her clothes. She rushed out, crying with all her might for help, and the neighbors, running together at her screams, saw in a moment a naked spectre issue from the hut, limping and hobbling on limbs covered with burns. "While the old woman slept, a spark had probably dropped on the straw bed, and the fire it kindled had aroused both the watcher from her sleep and the guard from his seeming death. With timely assistance he recovered from his burns, and grew sound and well again.
On the 15th of October, 1842, a farmer in the neighborhood of Neufchâtel, in the Lower Seine, climbed into a loft over his barn to sleep, as he usually did, among the hay. Early the next day, his customary hour of rising being past, his wife, wishing to know the cause of his delay, went to look for him, and found him dead. At the time of interment, more than twenty-four hours after, the bearers placed the body in a coffin, which was closed, and carried it slowly down the ladder by which they had gained the loft. Suddenly one of the rounds of the ladder snapped, and the bearers fell together with the coffin, which burst open with the shock. The accident, which might have been fatal to a live man, was very serviceable to the dead one, who was roused from his lethargy by the concussion, returned to life, and hastened to get out of his shroud with the assistance of those of the bystanders who had not been frightened away by his sudden resurrection. An hour later he could recognize his friends, and felt no uneasiness except a slight confusion in his head, and the next day was able to go to work again. At about the same time a resident of Nantes gave up life after a long illness. His heirs made arrangements for a grand funeral, and, while the performance of a requiem was going on, the dead man returned to life and stirred in the coffin, that stood in the middle of the church. When carried home, he soon regained his health. Some time afterward, the curé, not caring to be at the trouble of the burial ceremonies for nothing, sent a bill to the ex-corpse, who declined to pay it, and referred the curé to the heirs who had given orders for the funeral. A lawsuit followed, with which the papers of the day kept the public greatly amused. A few years ago Cardinal Donnet, in the Senate, told his own story of the circumstances under which he narrowly escaped being buried alive.
Besides these instances of premature burial in which the victim escaped the fearful consequences of the mistake made, others may be cited in which the blunder was discovered only too late. Quite a number of such cases are known, some of which are told with details too romantic to entitle them to implicit belief, while, however, many of them show unquestionable signs of authenticity. There long prevailed a tradition, not easily traceable to any source, which attributed the death of the Abbé Prévost to a mistake of this kind. All his biographers relate that the famous author of "Manon Lescaut," falling senseless from the effect of a rush of blood, in the heart of the forest of Chantilly, was supposed to be dead; that then the surgeon of the village having made an incision into his stomach, by direction of the magistrate, to ascertain the cause of death, Prévost uttered a cry, and did then die in earnest. But it has since been proved that the story is imaginary, and that it was made up after Prévost's death; nor do any of the necrological accounts published at the time refer it to the consequences of a premature autopsy. Though the account of Prévost dissected alive seems doubtful, that is not the case with the story told with regard to an operation by the famous accoucheur, Philip Small. A woman, about to be confined, fell into a state of seeming death. Small relates that when he was summoned to perform the Cesarean operation, the by-standers, convinced that the woman was dead, urged him to proceed with it. "I supposed so, too," he says, "for I felt no pulse in the region of the heart, and a glass held over her face showed no sign of respiration." Then he plunged his knife into the body, and was cutting among the bleeding tissues, when the subject awoke from her lethargy.
We cite some still more startling instances. Thirty years ago, a resident of the village of Eymes, in Dordogne, had been suffering for a long time from a chronic disorder of little consequence in itself, but marked by the distressing symptom of constant wakefulness, which forbade the patient any kind of rest. Worn out with this condition, he consulted a doctor, who prescribed opium, advising great caution in its use. The invalid, possessed with that common-enough notion that the efficacy of a drug is proportioned to its quantity, took at one time a dose sufficient for several days. He soon fell into a deep sleep, which continued unbroken for more than twenty-four hours. The village doctor, being summoned, finds the body without warmth, the pulse extinct, and, on opening the veins of both arms in succession, obtains but a few drops of thick blood. The day after, they prepared for his burial. But, a few days later, closer inquiry revealed the imprudence the poor wretch had committed in taking an excessive quantity of the prescribed narcotic. The report spreading among the villagers, they insist on his disinterment, which is allowed. Gathering in a crowd, at the cemetery, they take up the coffin, open it, and are met by a horrible sight. The miserable man had turned over in his coffin, the blood gushing from the two opened veins had soaked the shroud; his features were frightfully contorted, and his convulsed limbs bore witness to the cruel anguish that had preceded death. Most of the facts of this kind are of rather remote date. The latest instances have happened in the country, among an ignorant population, usually in neighborhoods where no physician was called on to ascertain the decease, that is, to distinguish the cases of seeming death from those of true death.
How, then, can we certainly know apparent from real death? There is a certain number of positive signs of death; that is to say, signs which, when absolutely discerned, leave no room for mistake. Yet some physicians, and many people who know nothing of science, are still so doubtful about the certainty of these signs as to wish that physiology could detect others of a more positive character. A zealous philanthropist, quite lately, gave a sum for a prize of twenty thousand francs to the discoverer of an infallible sign of death. Doubtless, the intention is excellent, but we are safe henceforward in regarding the sexton's work without alarm; the signs already known are clear enough to prevent any mistake, and to make the fatal risk of premature burial impossible.
We must point out, in the first place, the immediate signs of death. The first, and the most decisive, is the absolute stoppage of the heart's pulsations, noted for a duration of at least five minutes, not by the touch, but by the ear. "Death is certain," says the reporter of the commission named in 1848, by the Academy of Sciences, to award the prize of competition as to the signs of true death, "when positive cessation of pulsations of the heart in the subject has been ascertained, which is immediately followed, if it has not been preceded, by cessation of respiration, and of the functions of sensation and motion." The remote signs equally deserve attention. Of these, three are recognized: corpse-like rigidity, resistance to the action of galvanic currents, and putrefaction. As we have already seen, rigidity does not begin till several hours after death, while general and complete disappearance of muscular contractility, under the stimulus of currents, and, last of all, putrefaction, are only manifest at a still later period. These remote signs, particularly the last, have this advantage, that they may be ascertained by those unacquainted with medicine, and it is very well to pay some attention to them in countries where physicians are not charged with the verification of the disease, but they are of no importance wherever there are doctors to examine the heart with instruments, and to decide promptly and surely upon the death, from the complete stoppage of pulsation in that organ. At the beginning of the century, Hufeland, and several other physicians, convinced that all the signs of death then known were uncertain, except putrefaction, proposed and obtained, in Germany, the establishment of a certain number of mortuary houses, intended to receive, and keep for some time, the bodies of deceased persons. During the whole existence of these establishments, not one of the bodies transported into those asylums has been known to return to life, as the authentic declarations of the attendant doctors agree. The usefulness of such mortuary houses is still more questionable in our time, when we have a positive and certain means of recognizing real death. Those police regulations that forbid autopsies and interments until the full term of delay for twenty-four hours, measured from the declaration of death, still remain prudent precautions, but they do not lessen at all the certainty of that evidence furnished by the stopping of the heart. When the heart has definitely ceased to beat, then resurrection is no longer possible, and the life which deserts it is preparing to enter upon a new cycle.
Hamlet, in his famous soliloquy, speaks of "that undiscovered country from whose bourn no traveller returns," and mournfully asks, what must be the dreams of the man to whom death has opened the portals of those gloomy regions. We can give no clearer answer, in the name of physiology, than Shakespeare's prince gives. Physiology is dumb as to the destiny of the soul after death; of that it teaches, and it can teach us, nothing. It is plain, and it would be childish to deny it, that any psychical or sentient manifestation, and any concrete representation of the personality, are impossible after death. The dissolution of the organism annihilates surely, and of necessity, the functions of sensation, motion, and will, which are inseparable from a certain combination of material conditions. We can feel, move, and will, only so far as we have organs for reception, transmission, and execution. These assurances of science are above discussion, and should be accepted without reserve. Do they tell us any thing of the destiny of the psychical principles themselves? Again we say, No, and for the very simple reason that science does not attain to those principles; but metaphysics, which does attain to them, authorizes us, nay, further, compels us to believe that they are immortal. They are immortal, as the principles of motion, the principles of perception, all the active unities of the world, are immortal. What is the general characteristic of those unities? It is that of being simple, which means being indestructible, which means being in harmonious mutual connection, after such a manner that each one of them perceives the infinite order of the other. If this connection did not exist, there would be no world. What is the characteristic of the psychical unities more especially? It is that of having, besides the consciousness of such perception, the feeling also of the relations that bind the whole together, and those faculties, more or less developed, which that consciousness and that perception imply. But why should these unities be any more perishable than the others? Why, if all these forces, all these activities, are eternal, should those alone not possess eternity which have this high privilege, that of knowing the infinite relations which the others sustain without knowing that they do so?
To form a conception of the immortality of the soul, then, we must place ourselves at that point of view to which men rarely and hardly rise, of the simplicity and the indefectibility of all those principles of force that fill the universe. We must train ourselves to understand that what we see is nothing in comparison with what we do not see. The whole force, the whole spring, of the most complex movements, the most magnificent phenomena of Nature, and the most subtle operations of life, thought included, proceed from the infinite commingling of an infinity of series of invisible and unextended principles, whose activities ascend in the scale of perfection from simple power of movement up to supreme reason. Human personality, such as we see and know it, is only a coarse and complex result from those of these primitive activities which are the best and deepest thing in us. It is not that personality which is immortal––that is no more immortal than the motive force of a steam-engine is, or the electricity of a voltaic battery, although movement and electricity are of themselves indestructible. It is not that personality which can aspire to a home in the bosom of God. Our true personality, our real I, that which may without illusion count on a future life, is unity released from every material bond, and all concrete alloy; it is that force, necessarily pure, which has a more or less clear consciousness of its own relations with the infinity of like unities, and which more or less draws near to them by thought and by love. It is beyond our power to conceive what will become of that unity when, quitting its prison of flesh, and soaring into the ideal ether, it will no longer have organs with which to act; but what we can affirm is that, precisely by reason of this freedom, it will rise to a clearer knowledge of all that it had only known obscurely, and to a purer love of what it had adored only through the veil of sense. And this certainty, which is the ennobling and elevating force of life, is also the consolation for death.—Revue des Deux Mondes.
