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Golden rules of medical evidence

Chapter 26: IV. VITAL ACTIVITIES WHICH MAY HAVE IMMEDIATELY PRECEDED SUDDEN DEATH,
By Stanley B. Atkinson
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About This Book

A practical manual advising medically qualified practitioners on duties and conduct when called to give legal testimony, covering classes of evidence and witnesses, preparation and presentation of medico-legal reports and court testimony, distinctions between coroner's inquiries and adversarial trials, procedures for examining the living, dying, and the dead, the limits of post-mortem and expert opinion, rules on fees and subpoenas, precautions when suspicious circumstances or poisoning are suspected, and guidance on documentation, exhibits, consultation with legal authorities, and professional conduct to preserve accuracy and avoid improvised opinion.

IV. VITAL ACTIVITIES WHICH MAY HAVE IMMEDIATELY PRECEDED SUDDEN DEATH,

1. Respiration: Soot or froth may be in the mouth, trachea, or nostrils.

2. Deglutition and Peristalsis: Local water or blood may have been swallowed; food may be in the stomach (e.g., of the newly-born); vomit or fæces may have been voided; salivation may have been profuse.

3. Blood-Circulation: Much blood may have been lost, possibly having “spurted” (e.g., in the newly-born); the heart and vessels may be empty; there may be true extravasation into or hyperæmia of the tissues (a microscope will reveal reaction to an irritant); the veins may be swollen on the distal side of a ligature; the blood may give spectroscopic tests for poisonings.

4. Neuromuscular: Articles may be clutched e.g., weapons, grass (“a drowning man catches at a straw”), hair, mud; cutis anserina may be present; emissio seminis or abortion may have occurred; the eyelids are usually open at death; children are usually born with the eyelids sealed.