3. Water and mud in the stomach. 4. Froth in the air-passages.

5. Distended lungs.

6. General signs of death by asphyxia.

It should be remembered that the fact of the hands being tied together or to the feet does not militate against suicide by drowning.

If wounds and other injuries be found on the body, the question arises as to whether the injuries were sufficient in themselves to cause death, and then as to whether they were caused during life. A person jumping from a height into the water may sustain severe injuries,-dislocation of both arms, fracture of the skull and of the vertebræ, or even lacerated wounds of more or less severity. The absence of the signs proper to death by drowning, coupled with the presence of external injuries, would point to death by violence prior to immersion.

The following considerations may assist in forming an opinion:

1. Previous history of person found in the water. a. Any history of suicidal tendency.

b. Any motive that would render suicide probable.

2. Height from which the person fell.

3. Absence or presence of signs of death by drowning. The time required to cause death by drowning is so short, that persons seldom recover after submersion for one or two minutes; but the cessation of respiration is no guide to the extinction of life, and an attempt at resuscitation should always be made; for if the respiration be fairly restored, the heart will

soon act.

Recapitulation of the Post-mortem Appearances in the Drowned.

1. EXTERNAL.

a. In the Skin.-The

presence of goose skin-cutis an

serina-is hardly ever absent, even in summer. The cutis anserina is not, however, characteristic of drowning, as it may be present in other forms of violent death, and also in some persons during life. It is a vital act, the result of nervous shock, and does not depend upon the temperature of the water for its production.

b. The Tongue.The tongue is just as often found behind the jaws as between them' (Casper).

c. The Hands and Feet.-The hands and feet acquire a greyish-blue colour when the body has lain in the water from twelve to twenty-four hours. The skin also becomes corrugated in longitudinal folds. The nails may contain particles of sand and weeds. 'No corrugation or discoloration of the skin of the hands or feet is ever observed on the body of any one drowned, who has been taken out of the water within half an hour, within two, six, or even eight hours' (Casper).

d. The Genitals.-Contraction of the penis is an almost constant symptom, and Casper has 'not observed anything similar so constantly after any other kind of death.' It is due, probably, to the same cause as the cutis anserina, which Brettner attributes to 'bundles of unstriped muscular fibres lying in the upper stratum of the true skin, surround the sebaceous glands, and force them forwards by their contraction, thus making the cutis anserina. Precisely similar unstriped muscles are found in the subcutaneous cellular tissue of the penis; they run principally parallel to the long axis of the member, but very often large bundles run across it.' The action of cold and fright is to induce contraction of these cutaneous muscles, with a resulting contraction of the penis.

2. INTERNAL.

a. The Brain.-Cerebral hyperæmia is most rare in the drowned, but cerebral hypostasis is not infrequently mistaken for it.

b. The Trachea. The mucous membrane of the trachea and larynx is always more or less injected, and is of a cinnabar-red colour, which must not be mistaken for the dirty brownish-red, the result of putrefaction. A white froth, but seldom bloody, is also found in varying quantity in the trachea, and is a most important sign of vital reaction, but its diagnostic value is destroyed by putrefaction.

c. The Lungs.-The lungs are completely distended, almost entirely overlapping the heart, and pressing close to the ribs. They are spongy to the feel, and when cut into, a considerable quantity of bloody froth escapes. The froth found in the lungs is the result of the powerful attempts to breathe, and cannot be produced by artificial means. The distension of the lungs is due partly to an actual hyperæria, partly to inhaled fluid, and partly to hyperæmia.

d. The Heart and Great Vessels.-As is common to other forms of asphyxia, the left side of the heart is entirely, or almost entirely, empty. It is therefore not a diagnostic sign of drowning, and is absent in the drowned when death takes place by neuro-paralysis. The same may be said of the accompanying congestion of the pulmonary artery.

e. The Blood.-As is common in all forms of death where respiration has been arrested, the blood is found to be remarkably fluid, and of a cherry-juice colour.

f. The Stomach.-Casper considers that the presence of fluid in the stomach, corresponding to that in which the body is found, is an irrefragable proof of the actual occurrence of death from drowning,' and that 'the swallowing of it must have been a vital act of the individual dying in the water.'

N.B.-Putrefaction in the drowned in most cases commences in the upper part of the body, and extends downwards. The face, head, and neck are first attacked. This is the reverse of putrefaction in air.

Restoration of the Drowned.-As soon as the body is

removed from the water, it should be placed in a warm bath of the temperature of 100° F. If a warm bath is not procurable, the body should be wiped dry, and placed in hot blankets with the face downwards, to allow any water from the mouth and air-passages to drain away. All foreign bodies should be removed from the mouth and nostrils, and the tongue drawn forwards. The body may now be placed on the back, with the head slightly elevated, and rubbed with hot cloths; the arms at the same time being raised from the sides and carried above the head, retained for one or two seconds in that position, and then lowered again to the sides, the same movement being continued till respiration is restored. Pressure may at the same time be made on the breast bone to aid exspiration. Ammonia and snuff may be applied to the nostrils.

STARVATION.

Death from starvation comes in as an item in the ill-treatment of children, and it has also been known as a form of suicide, chiefly in lunatics. Little is known for certain as to the length of time required to cause death by starvation, but it is certain that life may be prolonged for some time without food, if water be allowed.

The morbid appearances are anæmia and emaciation, together with remarkable attenuation of the coats of the intestines.

Diagnosis.-The

absence of any other cause for death, and the previous history of the case, will alone assist in forming an opinion.

Recapitulation of the Post-mortem Appearances of Death by Starvation.

1. In the Body generally.—Marked general emaciation of the body. The skin is dry and shrivelled; the

muscles soft, reduced in size, and free from fat. A peculiar fœtid odour is given off from the body.

2. In the solid viscera of the Thorax and Abdomen.The liver is small, and the heart and kidneys deprived of any surrounding fat. All the internal organs are shrivelled and bloodless.

3. In the Stomach and Intestines.-The stomach in some cases is quite healthy; in others it is found collapsed, contracted, empty, and the mucous membrane more or less ulcerated. The intestines are thin, contracted, empty, and so shrunken that the canal is almost obliterated.

DEATH FROM COLD.

This form of death is rare in England, but is more common in countries where the winters are severe. Anything that depresses the vital powers renders the individual more or less amenable to cold; such, for instance, as drunkenness, previous illness, or deficiency in the amount of food. There are no postmortem appearances which are characteristic of death due to cold, and the fact of a body found frozen is no proof that death has been thus brought about.

Diagnosis.-The general appearance of the deceased, and the absence of any other cause of death, will alone assist in forming an opinion on this difficult subject. If a body is found buried in snow, and putrefaction present, death did not in all probability take place from cold, provided that the cold has been severe and continuous. Death from cold is generally accidental, except in newly-born children, when it may be either accidental or homicidal, according to circumstances.