of marine animals. From the effects of these putrid gases upon the face, there may be such a change in the features as to render an identification of the body by the physiognomy a difficult if not an impossible matter. The decomposition of the upper regions of the bodies of the drowned, after removal from the water and exposure to the air, proceeds with the greatest rapidity. Features which were quite distinct at the time of the recovery of the body may become quite unrecognizable after the lapse of twenty-four hours in the summer.

There is also a change in the color first observed as a sign of decomposition. The red of the superficial veins will change to a brownish black, and the green color of the abdomen and other parts of the body changes to a brown and even to a black.

Simultaneously with the changes produced externally by putrefaction are changes in the appearances of the viscera. The mucosa of the larynx and the bowels present discolorations which might be mistaken for the signs of poison or disease. The mucous membrane of the stomach presents various tints: a reddish brown, a livid purple, or, more commonly, if observed a considerable time after death, a slate color. This slate color is particularly noticeable in the brain where the bodies are examined within a week or ten days after death, provided no means have been used to retard decomposition.

It is by no means easy for the medical jurist always to distinguish between the effects of poison and the effects of decomposition by mere inspection. In both cases there will be redness, and this more or less circumscribed; and an additional element of doubt is presented when the possibility of the action of the digestive fluids themselves is considered. Taylor lays down the rule that the change has taken place during life if it is met in an examination soon after death; yet I have seen many cases where the stomach presented a redness suspiciously like that caused by irritant poison, when death had occurred from natural causes soon after the ingestion of food. When the redness is accompanied by effusion of coagulated blood, mucus, or the effects of ulceration, corrosion, or destruction of the coats of the stomach, we may assume that it was the result of a vital process. In such cases, if there be doubt, the wellknown effects of irritant poisons upon other organs, notably the liver and kidneys, should help the solution of the problem, and at all events a properly made chemical analysis of the viscera should absolutely determine the question. A delay in expressing an opinion till the facts are definitely ascertained can do no possible harm, while the opposite course might involve the physician in an awkward dilemma at a later period.

Another point, which will be of service in the differential diagnosis of irritant poisoning during life, and the reddening of the mucous membrane of the stomach after death, is that this redness will be observed in all the other viscera as well. It is especially noticeable in the membranes which naturally have no color. The deep staining of the aorta and of the respiratory canals is an instance in point. It is true, however, that Trouseau and Roget succeeded in producing the appearances of true inflammation upon the bodies of the dead, so far as these appearances consisted in the injection of the vessels rather than the general dyeing of the parts.

As a consequence of the progress of putrefaction the blood becomes fluid, and the action of the gases may change its position to the extent

that it may be forced from the cavities of the heart, where it was in large quantity at the time of death. It is propelled toward the capillaries, and gives to the external portions of the bodies, seen some weeks after death, a diffuse redness differing from the early post-mortem discoloration; and this redness is accompanied by a looseness of the cuticle, which presents a sort of blistered appearance. Moreover, this discoloration affects the true skin, and the subcutaneous areolar tissue is bathed in reddish serum, and the back part of the scalp presents an appearance appropriately compared by Ogston to red-currant jelly.

In the cases which I have observed I have found that the suggestions made by Ogston are of much value: namely, that, first, in post-mortem redness the color is limited to the course of the vessels, while in inflammatory redness the parts around the vessels partake more or less of the coloration; and second, that in inflammatory redness the color is usually limited to the inflamed membrane, while in the redness from putrefaction the color pervades the whole of the tissues of the part.

It is true that aside from obvious changes, such as the presence of clots, tumors, or abscesses, the brain gives on examination very little that is of absolute diagnostic value, especially in the matter of differentiating between inflammatory and putrefactive alteration. There is something in favor of the assumption of inflammatory change if the appearances are found at the superior portion of the brain instead of at the base. where, if the body has remained in the usual position, there would be likely to be, from obvious conditions, the greatest amount of coloration in a location provided with the material favoring a more rapid decomposition and color change.

If an individual tract of the mucous membrane of the larynx be alone considered, there might be difficulty, as Casper has pointed out, in distinguishing between the effects of a laryngitis and a post-mortem staining, or the effects produced in death by drowning. After all, attention to the collateral appearances and the history of the case should ordinarily be sufficient to determine the question.

The fact that the contents of the gall-bladder may transude through the coats of the duodenum and even of the stomach, and thus present appearances simulating those produced by the swallowing of nitric acid during life, is not of great moment, inasmuch as the great changes necessarily produced in the mouth and oesophagus by swallowing acid would prevent any error in diagnosis.

Effusion of fluid into the cavities of the body is a further effect of putrefaction. The blood ferments, becomes full of bubbles, and is driven onward toward the capillaries, and ultimately to the place where it meets the least resistance. In the serous cavities will be found blood-tinged serum in greater or less quantity. The amount is usually less in the peritoneal cavity than in the pleural. The odor is distinct, and the color brownish red. This effusion is seldom met with in the earlier period after death, probably never during the first week-except in cases of death from heart disease with pulmonary edema and cases of death from drowning and usually not till after the lapse of several weeks.

Parts that have been affected with gangrene in the living and parts that have been the seat of severe injury putrefy more rapidly than those which have not, and post-mortem putrefaction may easily simulate the appearance of gangrene in the living. In such cases caution should be

observed in giving an opinion. Testimony of those who have seen the condition of affairs in the person while alive would be conclusive, and if no other part of the limb was in a state of putrefaction, the probabilities would favor the theory of gangrene during life; but even then allowance should be made for the more rapid putrefaction of wounded parts.

Any confusion which might arise as to the origin of the fluids found in the cavities of putrefied bodies will be avoided if attention be paid to the character of the fluid, its homogeneity, its freedom from pus, lymph, or false membranes, and its color, which is not so dark as that of putrefying blood. It does not seem necessary here to speak of the changes produced in the body after death by purely adventitious means, such as the wounds made by the striking of the body against hard substances while floating, or the ravages of marine animals, or the gnawing of squirrels or rats, which often leave well-defined marks of their attacks upon the bodies of those exposed in fields or even in the dead-houses of cities.

The rapidity with which decomposition occurs varies considerably, according to several factors which may obtain. It is favored by high temperature, by moisture, as exemplified in the cases of the dropsical and the decay of the upper portions of the bodies of the drowned, by free access of air, absence of clothing, previous injuries, sudden death, acute diseases, especially those of a septic character, corpulence, and possibly by the cause of death having been poisonous gases or animal poisons. Whether prussic acid favors rapid decomposition, as claimed by some authors, or not, I cannot say further than that in the few cases which have come under my personal observation there was no perceptible increase in the rapidity of decomposition within the first three days, as compared with that of cases of death from other causes.

On the other hand, decomposition will be retarded by low temperature, or very high temperature where the body has been thoroughly cooked and charred. Also profuse hemorrhages, which diminish the amount of fluid in the body, tend to retard decomposition. Continued immersion in water and burial in a deep grave, by keeping the body at a low temperature, also retard putrefaction, though the process of decomposition goes on with the greatest rapidity after the body has been removed from such surroundings. Burial soon after death, and burial in dry sand or earth and in dry, elevated ground, is said to retard decomposition. This does not correspond with my observations in a few cases of exhumation, neither does the claim that nitrogen gas and the residuum of air in airtight coffins retard decomposition. Certain poisons, especially arsenic and alcohol, are claimed to render the body less liable to rapid putrefaction. I have found that the cases of death from acute and chronic alcoholic poisoning differ in rapidity of decomposition very little from those of death from other causes; if there has been a difference, it is that the bodies seem to decay with rather greater rapidity than the bodies of those where death has resulted from various natural causes, which seems only reasonable when the changes produced in the body by alcoholic narcosis are considered.

I may say, in this connection, that the most rapid and repulsive condition of putrefaction which I have seen, a case where the body was largely liquefied, was that of a man who had died of arsenic poisoning, where the drug had been administered in pretty large doses for a period of several days, and where the body had been buried in dry, elevated soil in

a nominally air-tight casket, and afterward exhumed and transported two days before examination. Of course, leanness—and old age, which favors leanness (aside from dropsical conditions or corpulence), favors slow putrefaction by the absence of an excess of those fluids which naturally hasten this process. Since writing the above I have had occasion to examine the body of a man exhumed after a burial of eight weeks. The cause of death was organic disease of the heart. This body was, in general, in a very good state of preservation. Chiefest to be noted were the large spots of mold upon the cheeks and chin and forehead, while the orbits were filled with a white fluffy mold presenting quite a contrast to the greenish tinge of the mold elsewhere. There were some vesicles as large as an English walnut upon the flanks, purplish in color and full of serum, but slightly tinged. The brain was quite soft, but preserved its form and permitted of sections with a thin, very sharp knife, and the different structures, as, for instance, the corpora striata, were in condition to be fully examined. The heart, as would be expected of an organ which resists decay among the longest, admitted of clear discrimination. between the effects of post-mortem change and the fatty infiltration which had occurred during life. The scalp was mummified, rendering its removal rather more difficult than usual; but all the organs were in a better state of preservation than I have seen, twenty-four hours after death, in many cases of septicemia, where the body had been kept in a moderately cool room.

Various forms of so-called embalming are supposed to prevent putrefactive changes. I have never had occasion to witness the condition of a body at any long period after the injection of the cavities or the arteries with the various so-called preservatives, but in many cases I have noticed that putrefaction proceeded with unusual rapidity after this process, while in none have I seen any difference in the putrefactive change between the embalmed and non-embalmed during the usual period elapsing between death and burial. Of course, much may depend upon the kind of fluid and the skill of the operator; but as far as my own experience goes, this process of embalming tends rather to the obscuring of signs of death from poisoning, and the pecuniary advantage of the undertaker, than to anything else.

Any consideration of the subject of putrefaction would be incomplete without allusion to a change which occasionally occurs at a long period after death, namely, the saponification of the body, or the formation of adipocere. This change is wholly chemical, and consists in the union of the fatty acids with ammonia. It has been oftenest observed in bodies that have lain a long time in water or in very damp soil, where moisture has continuously acted upon a putrefying corpse. There are some other conditions under which adipocere is formed, but the two mentioned are the only ones definitely known. Its formation to any considerable extent usually requires a long time, though it may begin to form at a rather early period. Casper cites the case of one child where adipocere was observed after the interval of only three weeks, and of another child where it was noted after a period of only thirteen weeks; but usually a period of three to four months in the water, or of six months in moist earth, is required before this saponification occurs. It is not necessary that so long a period as many years should elapse before it is formed, as was at one time supposed.

Adipocere is a fatty substance, generally of a yellow color, occasionally of a pure white. It is unctuous or soapy, brittle, and soft to cut. It melts at different degrees of temperature, some requiring no more than 200° F. As it is due to the checking of the colliquative putrefaction, it occurs more readily in the bodies of fat people than in the lean, and children present the change more readily than do adults. In addition to the value of this condition as an indication of the length of time that has elapsed since death, it is of importance to bear in mind a fact to which Günts has called attention, namely, that adipocere is always greater in volume than the total amount of fat preëxisting in the body, and therefore in weighing the body of a new-born child for the purpose of ascertaining the age allowance must be made for the difference.

This saponification of the body has also been termed mummification, but as true mummification is essentially different from the chemical process by which adipocere is formed, the terms should not be used as if interchangeable.

True mummification consists in the rapid evaporation of the watery constituents of the body. This change is favored by very high temperatures with great dryness of the atmosphere, and by atmospheric draught. In this dried state the soft parts are retained, and the features, though distorted, are preserved, and present a rusty brown color. The internal organs have partly disappeared, or are blended together so as not to be distinguished from one another, and they present an odor more like cheese than that of a putrefying body.

Whether occupation has any effect on the process is not known, in spite of the assertion of the First Clown in "Hamlet," that "a tanner will last you nine year." It must be admitted that his assertion that "your water is a sore decayer of your whoreson dead body" is confirmed by medico-legal observation.

At all events, the value of the process of mummification to the medical jurist is, as Casper says, practically confined to the question of the mummification of the umbilical cord in the new-born and the mummification occurring in bodies after arsenic poisoning.

Chronological Order. Though it doubtless is true that the medical jurist should never refuse to perform an autopsy, irrespective of the time that has elapsed after death, it is well to consider what the relative order of change is, in order that the probability of obtaining any satisfactory data, either as to the cause of death or any other ante-mortem conditions, may be properly estimated. It is well known that certain organs resist decay much longer than others; and in a body where there would be no possibility of determining whether the cause of death may have been natural, like typhoid-fever, or a poison, like hydrocyanic acid, it might still be possible to determine the sex by the discovery of a uterus or a prostate gland, or to determine the question of pregnancy in the female. Even in the bodies of those dead for a number of years, though pathological changes are no longer to be perceived, yet the remains may afford proof of the presence of some of the mineral poisons in the débris.

Therefore the chronological order of the phenomena of putrefaction in the internal organs deserves especial attention. There is practically little difference among authors as to this order. First to present the changes of putrefaction are the trachea and larynx. Whether due to the access of atmospheric air or to imbibition, it is certain that in from