Researches on the Natural History of Death. By Bennet Dowler,
M. D., of New Orleans. 8vo. pp. 22.
Various circumstances have interfered with our intention to
acknowledge the receipt of Dr. Dowler’s characteristic essay at
an earlier date. We have further to regret that similar interrup-
tions will compel us to confine the present notice of his views
within narrower limits than the importance of the topic may
demand.
No one who reflects that in the midst of life we are in death,
can fail to take a deep interest in every intelligent and independ-
ent discussion of the momentous question to which the doctor’s
paper is devoted in the present instance. We gladly undertook
the examination of these “ Researches” therefore, and would still
more gladly introduce them to our readers sufficiently in extenso
to enable them to speak as effectually for themselves to others as
they have to us, if such a course were practicable in a brief re-
view of an article which itself is entirely too brief and occasional
in character to admit of lengthened critical analysis.
Without attempting “ a formal monograph on death,” or “ even
an outline of the several branches of the natural history of death,”
he’.has given to his readers, in the course of twenty-two pages,
(written, according to his own account, “ in fragments, one por-
tion having been in the printer’s hands while another remained to
be written,”) an amount of information and highly suggestive
speculation that is not only curious in itself, but entitled to atten-
tion as the offering of a physiological observer of established ex-
perience and sagacity. Indeed, with all due deference to our
author’s other inclinations, or perchance more important occupa-
tions, we think his readers would have been much more thankful,
and much better able to do justice to his work, had he chosen to
spend a little more time and pains upon its elaboration. Grateful
as we are for the favor of his lucubrations on the subject, their
very richness in fact and illustration has filled us with regret that
the formal monograph disclaimed, or, at any rate, that “an outline”
were not the actual result. The “ preludes” of death, he tells us at
the outset, “ its characteristics, general and special, its progress,
its prognostics, and its pathological anatomy, will be omitted, not
for want of facts, but because the facts I have collected on these
subjects are too numerous and unwieldy for the narrow limits to
which this paper must be restricted. The pathological anatomy
of death, the changes due to the agony itself, its immediate ante-
cedents and effects, physical and physiological, including the order
in which functions cease, and tissues die, together with the result-
ing anatomical alteration, being subjects of great importance, and
deserving of the fullest investigation, cannot be disposed of in a
summary manner. The period intervening between the agony
and the usual time of post-mortem examination is rich in facts
which have been too much neglected.” All this is doubtless as
true as words can make it, while it tells our trouble at the present
writing just as clearly. It is the old story over again—so much
to do, and so little time to do it in. Hence our tears. We hear
of the great treasure which “ still so near us, yet beyond us lies;”
we are graciously allowed a glimpse of it, and see and taste just
enough of its mysterious wealth to make us hunger and cry for
more with all our might.
The leading object of the author seems to be to notice, “ more
as an experimenter than as a critic,” “ the criteria of the certainty
of death, particularly the tests of death as set forth by the recent
proceedings of the Academy of Sciences of Paris, in the award
of the Manni prize.” He endeavors to show that the means of
distinguishing real from apparent death, proposed by the success-
ful aspirant, M. Bouchut, and sustained by the Academy, are
not by any means as conclusive as the French savans would have
us to believe. But in thus destroying the fair fabric of our Gallic
compeers, erected on the discovery of the test by auscultation of
the heart’s action, Dr. Dowler hastens to calm the fears of the
most timid of his readers with a triple source of consolation.
Not content with assuring us in the strongest manner, what we
fully believe, that bona fide premature interments are rare almost
to an infinite degree, and that the ordinary signs are all-sufficient,
he proposes a test of death himself, which he considers more
available, as well as more reliable, than that of M. Bouchut.
This substitute for auscultation, is not, we are told, the result of
mere closet speculation, but “ is founded on numerous prolonged
experiments, probably one thousand, made directly on several
hundred bodies.” For the reasons already given in regard to
the unavoidable omission of many interesting topics, nothing is
said, in this discussion, “ of the peculiar physiognomy of the dead,
the lividity and cadaveric injection of dependent parts, the flatten-
ing of the tissues that sustain the weight of the body, and the other
signs of death of minor importance,” among which we may
enumerate loss of elasticity, opacity of the fingers, the peculiar
inward flexure of the thumbs, the expulsion of alimentary sub-
stances from the mouth, cessation of capillary circulation, and loss
of susceptibility to the action on the skin of external irritants.
Following our author in his own way and order, we have
first to call attention to a few remarks respecting contractility and
two or three other so-called phenomena of life alone. He re-
peats, what he has often said elsewhere, that “ contractility, ani-
mal heat, capillary circulation, and the like, do not prove the body
to be alive in the popular, legal, and utilitarian sense.” “ As to
what is commonly called life, the body may be wholly deprived
of it without necessarily losing muscular contractility or muscular
life.” “ Life is an aggregation of vital phenomena, or of means
and ends; death is a destruction or alteration of these means and
ends: all those vital phenomena which remain after the extinction
of all the useful means and ends of life do not really constitute
life in its ordinary acceptation or essential condition, implying
thinking, feeling, willing, and acting.” “ Contractility, in its iso-
lated character, does not prove that life is present in its ordinary
or utilitarian sense; nor is rigidity, as is generally assumed, abso-
lutely incompatible with the contractile power. These forces are
neither incompatible nor identical, much less are they connected
as cause and effect.”
In regard to rigidity as a criterion of death, we may as well
place in this connection the addendum on that subject with which
the tract concludes:
“ Rigidity, as a criterion of death, is inconvenient in practice,
as it may be tardy in its appearance, and occasionally absent, or
of very short duration. Hence its verification requires the con-
stant presence of the physician; otherwise, it might appear and
disappear during a short absence from the corpse, throwing doubt
on the certainty of the death, and causing delay in the burial.
Still, however, it is a sign of great value, and the manner or order
in which it disappears is highly characteristic. The suppleness
or relaxation of the muscles very generally take place first in
those parts that were che first invaded by the rigor mortis, as,
for example, in the neck. Rigidity is liable to other objections:
it may be simulated; it may originate mesmerically, and convul-
sively.”
Cadaveric rigidity, however, is more easily overcome than the
simulated, and when overcome it does not return. It somewhat
resembles also the stiffness of congelation, but need not be con-
founded wi’h it. Rigidity in the corpse is best recognised, as our
author intimates, by its successive phenomena in progress, and
above all by the peculiar relaxation which succeeds it. Relaxa-
tion following rigidity, in the opinion of good authority, is one of
the most confirmatory signs.
In continuation of the pamphlet, we next have a very enter-
taining and instructive historical sketch of the inquiry, especially
in its relations to the institution of the prize under the auspices of
the Parisian Academy. This, together with a digression by the
way respecting early post-mortems in warm climates, and sundry
other matters, we would be glad to lay before our readers in the
doctor’s own words, if the space had been allowed us.
After some five pages of these curiosities of resurrectionary ex-
perience, he returns to the Manni prize. This was placed, by a
royal decree, at the disposal of the French Academy in 1837, and
had been founded “ with the hope,” for obvious reasons, “ of dis-
covering some other satisfactory sign anterior to that of decompo-
sition. According to M. Bouchut, the successful candidate, the
“ certain signs of death are immediate or remote. The first con-
sists in 1, the prolonged absence of the sounds of the heart; 2, the
simultaneous relaxation of the sphincters; and 3, the sinking of
the globe of the eye, with loss of transparency of the cornefe. The
first of these, alone, is regarded by the committee as conclusive.
The remote signs are: 1, cadaveric rigidity; 2, the absence of
muscular contractility under the influence of galvanism; and 3,
...gutref?rqtion.”
Dr. Do'wlei^sr first objection to the principal or cardiac test, that
its application must be limited, “because there are but few good
stethoscopists among good practitioners, and in the best hands,
certainty is often not attainable,” is certainly not a strong one
against its scientific value. For granting that the “ actual state
- of auscultation” is so lamentably low, the distinction in this case
to be ascertained, is not between certain sounds of the heart under
different states of action, but between the presence and absence of
any kind of sound whatever—a distinction which can be made by
any one possessed of hearing, whether that hearing be previously
sharpened by exercise or not. It would be hard to imagine
any sound in the thorax, especially in the cardiac region, of a
corpse, that could be mistaken for that of the pulsation of the
heart ; at all events we are not aware of any yet on record. The
next objection is much more to the purpose, although even there
the learned experimentalist, in our humble opinion, is running a lit-
tle too far in his comparative physiology, in spite of the excuse he
gives when he cites the hearts of alligators in his illustration of
the same organ in man. But let us hear him in his own words :
“The Academy, and M. Bouchut, take for granted, that which
may not be true, and which is the very thing to be proved! Who
has proved that the heart, like the pulse, like every other organ,
may not fall into temporary quiescence or inaction ? May not the
heart itself suffer apparent not real death, as all analogies drawn
from other muscular organs teach 2 The sphincters, uterus, intes-
tines, and stomach, the respiratory, lingual, ocular and locomotive
muscles may be palsied, inactive, apparently dead for a time. It
is a downright begging of the question, to assume that the heart
cannot itself fall into this very state of apparent death. The natu-
ral history of the movements of the heart, indicates the probability
of a temporary suspension of action; at one time it gives 200, at
another 8 or 10 strokes in a minute; it intermits, or is irregular.
In cholera it is probably cramped in some cases; temporarily quies-
cent in others. Moreover, it has, in common with other muscles,
a kind of life of its own; it is not the known sole criterion of gene-
ral life. Comparative physiology shows that an animal may live
hours without the heart, and the heart for days* without the body.
An alligator’s heart will act with regularity for many hours, perhaps
for days, after having been cut out of the body, and emptied of its
blood. Let an alligator thus deprived of its heart, be roasted ; re-
turn its heart, and apply the stethoscope, and then the dead will af-
ford this certain sign of life! The commission of the Academy
cannot object to this argument, because they themselves experimen-
ted on the inferior animals in testing M. Bouchut’s claims: as for
myself, I have shown, in my published papers, that I attach less
importance to comparative physiology, as the interpreter of human
physiology, than systematic writers do themselves. If I take their
own point of departure, they can require nothing more.
*This I cannot vouch for as an observation made by myself, but Dr. Lind,
say, of this city, has seen the separated heart of the alligator still in action,
on the second day after its removal from the body, which I fully believe,
though I have never watched the heart more than 6 to 9 hours continuously
after separation.
“M. Dumas, author of the Article Cceur, in the Dictionnaire
d’Histoire Naturelie, quotes Bacon, Haller, and Diemerbroeck, who
state, that in man the heart may be removed without suddenly
extinguishing life, and that men have looked about, spoken and
prayed after having lost their hearts by the executioner; though M.
Dumas does not vouch for the truth of these statements, (iv. 289.)
“Moreover, has any one asserted, much less has any one proved,
that the action of the heart is always appreciable ; that it never can
be so feeble as to escape observation, remote as it is from sight, and
even from the hearing ? To sav with the Academy, that a prolong-
ed absence of cardiac sounds, is an absolute proof of death, is
vague and unsatisfactory; prolonged absence of animal heat, or of
respiration, would equally prove the reality of death, not to mention
other tests, as rigidity, &c.
The very object contemplated by the Manni prize, is to dispense
with this prolongation ; for if a prolongation be necessary, there is
an infinitely better test; one absolutely certain, the characteristics
of which all know as well as the Academy, namely, putrefaction,
and which ought not to have entered into the enumeration of M.
Bouchut at all. Had M. Bouchut adopted as the criterion of death,
the prolonged absence of respiration, the rest had been equally, nay
more certain, and, withal, of easier application, than the uncertain-
ties of auscultation. “ If the respiration,” says Dr. Paris, “ be sus-
pended only five minutes, we may conclude that life is fled forever.
Of all the acts of animal life, this is by far the most essential.
Breath and life are properly considered in the Scriptures as convert-
ible terms ; and the synonyme, as far as we know, prevails in every
language.”
“ As M. Rayer, the reporter, and his coadjutors of the committee,
regard this auscultatory test as the principal feature of M. Bouchut’s
essay, it is proper to look a little further into this matter. M. Rayer and
the commissioners made some experiments on the human subject,
and on animals; from which they conclude, with M. Bouchut, that
“ the absence of pulsation of the heart for five minutes leaves no
doubt of the cessation of life ;” but how many experiments they
made does not appear: let us suppose fifty. Now from the very
nature of the case, this is but a negation ; a non sequitur; for it
might have happened, that all, or a portion of the next fifty cases
would have revived after a temporary cessation of the heart’s action.
Suppose the commission had tried the non-respiratory test for the
same period, namely five minutes, would they have found any revi-
vals? Would they not have been able to draw a conclusion equal-
ly certain ?”
In conclusion of this branch of the argument, we may as well
annex another ££ addendum” of the author, which he has inserted
as an afterthought at the end of his pamphlet. It is no doubt
well known to many of our readers.
“ Mr. John Hunter, the celebrated surgeon, long before death,
had according to his own statement, (confirmed by his medical at-
tendants, Sir George Baker, and Doctors William Hunter, Huck,
Saunders and Fordyce,) an alarming spasmodic attack, in whichthe
heart’s action entirely ceased for three quarters of an hour. ‘ This
curious fact in physiology, says his biographer, has never been satis-
factorily explained.’ Mr. Hunter’s intellectual powers remained
unimpaired. He sustained his respiration by forced, or rather
voluntary efforts.”
Next we are treated to the ££ Shaksperian criteria of death.”
These ££ will probably not fail once in a thousand years, if ever.”
We omit the verse, giving only the paraphase in prose :	££ The
circulation ceases ; the body cools ; the breathing ends; an ashy
paleness replaces the natural hues; the cornea grows dim and re-
laxes ; rigidity prevails. These signs may safely challenge, for
certainty, all those of the stethoscopes of the whole academy.”
The ordinary tests of respiration, such as the motion of the
chest, ascertained by sight, and the action of the breath itself in
misting the looking glass and agitating the suspended feather, al-
though good tests, may be fortified, according to our author, ££ by
other respiratory phenomena which have been little noticed in
this connection, by poets or physiologists, namely—the peculiar
progressive, or rather retrogressive manner by which respiration
recedes from the lungs to the trachea, from the latter to the larynx,
from the larynx to the mouth, and from the mouth to the very lips;
this is characteristic, nay, conclusive, if I may judge, of true
death, though I do not know that it has ever been regarded at all.
It is indeed very different from the cessation of breath in cases
of suspended animation, or apparent death, in hysteria, catalepsy,
croup, convulsion, stagnation, fainting and the like. The manner
of the cessation of respiration, though indescribable to the inexpe-
rienced, is very peculiar, and is the earliest absolute sign of real
death. The prse-mortem signs are very conclusive.” This is all,
doubtless, very true, but we need hardly stop to say why their ap-
plicability as tests must be limited to a comparatively small num-
ber of cases. M. Bouchut’s second great sign of death, sustained
by the academy, the relaxation of the sphincters, is totally dis-
credited by Dr. Dowler. In denying its authority, the latter speaks
from “ an experience in this particular line that probably has never
been equalled—an experience incidental to several years’ experi-
ments on animal temperature—a single experiment often costing
several hours, during whieh thermometers have been repeatedly
passed within the sphincters.” “ The latter,” continues the Doc-
tor, “with very few exceptions, contract strongly after death.
Relaxation of the sphincters is not a post mortem, but an ante or
prae-mortem phenomenon. It happens sometimes as a disease, and
is not a fatal symptom.”
The third and last sign relied on by M. Bouchut and the Academy
is not more satisfactory to our investigator. He insists with great
reason that it fails in uniformity, whether we study its condition
before or after death. We know that it is sometimes a well marked
ante-mortem symptom, and that at other times it is absent for some
time after vitality has ceased. So much for the Academy and its
chosen apostle. We have seen the different fragments of their
really noble monument to the philanthropy of the Italian abbe,
and their own scientific enterprise, one by one assailed, if not actu-
ally demolished. We turn now with renewed interest to the single
pillar which our worthy friend has undertaken to plant in opposi-
tion to the more imposing structure of his brother savans. Let
him speak to us once more in his own language :
“I propose the thermometer as a means of testing death, possessing,
as it does, superior certainty over the stethoscope. The latter
method takes for granted, that in apparent death, the heart’s action
continues; that it cannot be for a time suspended, and that its ac-
tion can always be heard! The very analogies of apparent or
temporary death seem to oppose or contradict these assumptions.
The analogies and the positive facts known of animal temperature,
teach that, during life, the body is not heated and cooled like inert
matter. Place two or three thermometers in the arm-pits—in the
bend of the arm, (the fore-arm being flexed,)—in the mouth and
within the sphincters, to ascertain the heat of the surface, and of
the centres, (the rectum is the best and most accessible centre.) The
application of the thermometer requires no skill, and is open to the
inspection of all, and is a test for all the warm blooded animals, at
least for man. While the auscultatory test takes for granted that
there can be no temporary inaction of the heart, and that all its
motions can be heard ; the thermometrical test takes nothing for
granted without the most indubitable proof. Its great axiom is
that man, in his living state, maintains an uniform temperature, inde-
pendent of the surrounding media, while a dead man, like other
inert matter, has no independence of this kind, but steadily re-
sponds to, and is governed bv, calorific conditions altogether physi-
cal—heating and being heated, receiving and radiating caloric.
This is not the result of speculation, but of prolonged and varied
experimental research.
“The refrigeration of the body before death, in cholera, conges-
tion, and the like, is not physical refrigeration, responding to the
calorific condition of the surrounding media ; it is a morbid, or
physiological caloricity, which, for a time, augments or continues
stationary after death, until it shall be replaced by physical refrige-
ration, as its phenomenal history clearly shows.
“The facts which I have published concerning post mortem calo-
ricity, do not invalidate this thermometrical - test; for soon, or late
the physical refrigeration must take place. I may here add, that
the speculative opinion which prevails among those who do not take
the trouble to make experiments, namely, that these calorific move-
ments are the effects of putrefaction, is wholly unfounded (so far as
it regards the human subject;) how much soever it may be counte-
nanced by certain analogies derived from other inert matter. The
calorific, and the putrefactive periods, so far from coinciding, antago-
nize each other, so long as the heat is not in accordance with the
ordinary physical laws of caloric. The point of coincidence and
equilibrium, is really the point of putrefaction, unless the circum-
stances be of an extraordinary character, such as involve the freez-
ingpoint, or that of torrefaction. But the predomination of the in-
variable law of physical refrigeration, is a criterion always attainable,
and may be proved, as to its times, distances, and velocities, by
arithmetical calculation; ascertain the temperatures of the media,
and of the heated body ; the velocity of the refrigeration will be
proportioned to the times and distances, and will proceed from the
surface to the centre, until the equilibrium be attained. The only
objection that lies against this rule relates to calorific conditions,
where the differences between the heated body and the media
are very slight; but this is of no importance in practice, because
there is always a marked difference between the average tempera-
ture of the air in the shade, and that of a living, or recently dead
person.”
In thus bringing forward his substitute for the Bouchut test, Dr.
Dowler seems to have covered the ground in behalf of its superior
certainty and availability, and to have met the practical objec-
tions to it well enough to satisfy an attentive reader previously fa-
miliar with the subject. It is a matter of regret, however, that
in the introduction of so important an adaptation of a striking
physiological truth, he has not taken the time and trouble, albeit at
the expense of other matter, to explain his views, and especially
his practical deductions, with more fulness and precision. It would
not have been hard for him, with his idea of its extreme simplicity,
to bring the application of the test he advocates, at least as much
within the reach of general readers, as M. Rayer and Bouchut have
brought the test which he rejects. The philosophy of vital heat,
and of its prse-mortem and post-mortem changes in different parts
of the body, under various internal and external influences, includ-
ing the best mode of appreciating their condition and their results,
is not quite so easily comprended, even by the trained observer.
It is certainly not less puzzling than the simple axiom of the incom-
patibility of the slightest sound of cardiac pulsation with actual
death, and vice versa. There is no doubt about the change of
temperature after death ; and he who runs may read how low the
thermometer has gone in any given case and in the course of a
given time. But it is not every one who can so calculate “ the
times and distances” as to tell how low the thermometer ought
to go, or how rapidly it ought to fall.
Dr. Dowler is not singular in his denial of certainty to the in-
action, or inappreciable action, of the heart as an evidence of death.
The merely negative assertions of the Academy, founded on a limit-
ed experience, which determined five minutes to be the longest
possible suspension of the cardiac action during life, had been
nullified by the positive data of Braschet and others (supposing
them to be worthy of respect) before the scruples of their American
antagonist had been presented to the public. M. Braschet in-
forms us in his protest,* that he had repeatedly restored the vitality
of infants, in whom no pulsation whatever could be discovered,
from fifteen to thirty minutes, although his mode of sub-diaphrag-
matic exploration (i. e. the application of one or two fingers under
the ribs, and between the diaphragm and liver directly under the
pericardium,) practised by himself extensively for thirty years, is,
in his opinion, as effectual as the nicest auscultation. This writer
furnishes his readers with two recent examples, in point. The
first was that of a child, who had revived after twenty minutes'
insufflation, although during that time no trace of pulsation could
be heard or felt. The other was that of a man set. 33, whose
heart presented no contraction that could be detected during at
least eight minutes, although the ear was applied again and again.
Twenty minutes after the suspension of its action a slight contrac-
tion was perceived in the heart; its pulsations then became regu-
lar, and the patient opened his eyes. “ Boiling water was thrown
upon the limbs” of the poor man, and every possible external
stimulant was applied, doubtless including artificial heat; so that,
in the latitude of New Orleans, he might have been stripped for the
tender mercies of the ice-box or dissecting table, or perchance en-
closed in his coffin for immediate interment, almost before refrige-
ration could have had a chance to display its progress on the most
susceptible thermometer. A medical friend of ours, in the course
of a steamboat voyage up the Mississippi last summer, was pre-
sent at the digging of a grave on shore, intended for a fellow-
passenger, who was dying of cholera. The poor creature
had gone on with his apparent refrigeration, while his provi-
dent undertakers were at work upon his contemplated lodging.
He disappointed them at last, however; for when they were
ready he was not, inasmuch as, although the heat had left his
body, the breath was still in it. We do not know that such contre-
temps as this ever happen in New Orleans to embarrass the pre-
paration for the premature examinations which are common in
that city. Sure we are, however, that we should have little faith
in any sliding scale of refrigeration, however central in its appli-
Gazette des Hopitaux, No. 135.
cation, while such a complexity of horrors were menacing our
closing hours. With the scalpel alre'ady bared on the one hand,
a yawning grave on the other, and no other admissible alterna-
tives but the ice-box or putrefaction, we would rather a thousand
times encounter the worst exhalations of a dead-house than trust
the disposal of a friend’s remains to the decision of the best ther-
mometer that ever was made.
After all, the difficulty is vastly more apparent than real.
At the present day, especially, is it infinitely more serious in theory
than in practice. Premature interments and marvellous revivals
appear frequently enough among the items of the newspapers; but in
the grave-yards themselves, at all events in the British,‘German,
and American burying-grounds, such accidents are utterly un-
known. It is otherwise among the French, if we are to listen
to the startling representations of their numerous writers on the
subject. There is every reason, however, to accord with Dr.
Dowler and the London Quarterly Review* in estimating the
statistics and various romantic stories of Bruhier, Louis, Thierry,
Nysten, Fontenelle, and others, as so many draughts on the
credulity of a wonder-loving public.
*No. clxx, Oct., 1839.
The signs of death, properly so called, should be studied under
different aspects. First, when the opportunity allows, they should
be watched intheir progress before, as well as directly after, the final
change; secondly, in their succession after death; and, lastly, in
their assemblage as a whole. Many of them are important indi-
vidually, but it is in the last named general view that they become,
in spite of adverse theory, sufficiently conclusive for all practical
purposes.
Having disposed to his satisfaction of the prominent points in
the discussion of the criteria of certain death, our author contin-
ues his “ Researches” in some seven pages of highly interesting
miscellaneous matter, embodying a variety of curiosities of medical
and philosophical experience, chiefly relating to the “agony” of
death. This portion of the pamphlet we are compelled to pass
without further comment than to recommend it to the attention
of all who have time to avail themselves of the inexhaustible in-
genuity and reading of its author.
To return for a moment to the question of the difference be-
tween real and apparent death, we cannot do better than to con-
clude with the closing survey of a recent French reviewer in the
Gazette Medicale. We present it as much for the summary it gives
as for the precept it enjoins. “ Experience,” says he,<£ has shown
the insufficiency of each of these signs, with one exception—'putre-
faction. The absence of respiration and circulation, the absence of
contractility and sensibility, general loss of heat, the hippocratic
face, the cold sweat spreading over the body, cadaveric discolora-
tion, relaxation of the sphincters, loss of elasticity, the flatten-
ing of the soft parts on which the body rests, the softness
and flaccidity of the eyes, [the loss of catoptric reflection too, and
opacity and dryness of the cornea,] the opacity of the fingers, [and,
we may add, the peculiar inward bending of the thumbs,] cadave-
ric rigidity, the expulsion of alimentary substances from the mouth;
all these signs combined or isolated, may present themselves in
an individual suffering only from apparent death. Doubtless their
complete co-existence, except in case of actual death, is extremely
rare. Doubtless, too, some of these signs have so discouraging a
signification, even separately, that their presence is equivalent to
a sentence of death. Still, in so grave a matter the very rarest ex-
ception possesses an infinite value. We will go farther and say,
that it ought even to weigh as much as the rule itself in governing
the conduct of the physician and attendants. Here, if ever, is the
axiom, Melius anceps quam nullum, to be applied. Were the
chances of success only one in a thousand, one in ten thousand, or a
hundred thousand, every precaution, every measure likely in a
remote degree to realize such success, becomes a bounden duty.”