SUDDEN DEATH may be induced by natural or by violent causes, and the detection of the true cause is obviously of very great importance, since the acquittal or conviction of a suspected person may depend upon it. Sudden death may occur naturally from syncope (fainting or swooning), from asphyxia (literally pulselessness), or, more correctly, apnea (privation of breath), or from coma (insensibility). Syncope, or sudden cessation of the heart's action, may occur, as Dr. C. J. B. Williams points out in his Principles of Medicine, in two ways; (1.) By the heart losing its irritability (or becoming paralyzed), so that it ceases to contract; and (2.) by its being affected with tonic spasm, in which it remains rigidly contracted, losing its usual alternation of relaxation. Sudden death from asphyxia, or, more correctly, from apnea, occurs when, from any cause, the entrance of air into the lungs is prevented. It is not so often witnessed as a result of disease as of accident. It is sometimes caused by a spasmodic closure of the chink of the glottis (see LARYNX). Sudden death from coma is liable to occur in apoplexy and injuries of the head.
In all cases of sudden death there is a strong tendency on the part of the public to suspect the poisoning. It is very hard to make them understand that persons may die a
natural death suddenly as well as slowly; or conversely, that death may really take place slowly, and yet be the result of poison. "One of the means," says Dr. Taylor, "recom mended for distinguishing narcotic poisoning from apoplexy or disease of the heart is the difference in the rapidity with which death takes place. Thus apoplexy, or disease of the heart may prove fatal either instantly or within an hour. The only poisons likely to operate with such fatal rapidity are prussic acid or nicotina. Poisoning by opium is com monly protracted for five or six hours. This poison has never been known to destroy life instantaneously or within a few minutes. Thus, then, it may happen that death will occur with such rapidity as to render it impossible, under the circumstances, to attribute it to narcotic poison."—Op. cit., p. 145.
In its relations to medicine and medical jusisprudence the subject of this article has been fully discussed by Herrick and Popp, Der platzhcite Tod acts inneren Ursacken, 1848.