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December 8, 2016

Modes of Death recognized by Law in Medical Jurisprudence

Various Modes of Death and Autopsy Finding in Medical Jurisprudence

There are three modes of death irrespective of what the remote cause of death may be. These modes are;

  1. Coma
  2. Syncope
  3. Asphyxia

Coma

This is death from failure of the function of the brain and irreversible damage to its vital centers. It is due to;

  • Raised intracranial pressure from diseases fo the brain or its membranes, and injuries to the brain.
  • Poisons such as opiods and alcohol.
  • Metabolic disorders like uremia.
  • This autopsy will reveal the specific cause excpt in cases of poisoning or metabolic disorders when oedema or congestion of the brain and its covering membranes is commonly found.

Syncope

This is death from failure of function of the heat resulting in hypo perfusion and hypoxia of the brain. It is due to;

  • Heart disease
  • Hemorrhage
  • Pathological states of blood
  • Exhausting diseases
  • Poisoning due to digitalis, potassium, aconite or oleander

At autopsy, the heart appears contracted. It contains very little blood if death is due to hemorrhage. The viscera appear pale and the capillaries congested.
A syncopal type of death may also result from reflex cardiac arrest due to;

  • Vagal stimulation commonly known as vaso-vagal shock, vagal inhibition or neurogenic shock
  • Rarely ventricular fibrillation due to cardiac problems or spontaneous sympathetic nervous discharge

Vagal inhibition is important in certain cases of accidental hanging; throttling (manual strangulation); blow to the epigatrium; abortion; emotional tension; sudden immersion of the body in cold water; insertion of an instrument into the uterus, blacker rectum, or any other body cavity and light anesthesia. In these conditions, as the trauma may be very trivial, the injury is not visible. Therefore, there are no characteristic postmortem appearances and the cause of death is inferred from the history and negative findings, viz, no natural disease, injury or poisoning to account for the cause of death.

Asphyxia

This is death from failure of respiratory function. It occurs in pathological conditions of the respiratory system, such as in pneumonia, paralysis of respiratory centre as in opioid poisoning, occlusion of air passage, breathing of irrespirable gases, and in traumatic asphyxia. In all these conditions, respiratory function ceases before that of the heart.
The autpsy appearances are indeed characteristic and comprise: cyanosis, pronounced lividity, petechial hemorrhages, visceral congestion, and sometimes cardiac dilatation, in addition to special changes dependent upon the type of death, e.g. Local injuries to neck in hanging, strangulation, and throttling and color of blood in acute carbon monoxide poisoning.

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