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Disposal Dead

death, body, deafness, corpse, especially, rigidity, skin, occurs and difficult

DEAD, DISPOSAL OF.—Owing to the more or less rapid disintegration of the body after death, the corpse becomes a menace to health. Hence the earliest possible removal of the corpse from the dwelling is necessary, especially when the extent of the residence is limited, or when the deceased has died of an infectious disease. A mortuary serves as a place to keep the dead body until its final disposal.

The opinion prevailing among the public that a cemetery can give rise to the propagation of infectious diseases is erroneous, upon the whole, since the disease-germs entering the earth with the dead body soon perish there. At most, objections might be raised to the use of water from graveyard wells for drinking purposes. Cremation of the dead has lately become customary to some extent. Forceful reasons of a hygienic nature that recom mend cremation in preference to interment do not generally exist. Cre mation is preferable in times of epidemics of infectious diseases. Extraneous reasons favour the destruction of the dead by fire, especially in large cities, as, for want of suitable space, the burial places must be moved further and further away from the cities, causing the transportation of the dead to become tedious and expensive.

DEAF-DUMBNESS.—See SPEECH DISTURBANCES.

DEAFNESS.—Inability to perceive sounds ; a condition which may affect one or both ears. Defective hearing of severe grade is often con founded with deafness. The usual causes of deafness are serious and incura ble changes in the labyrinth. Cases of hysteria may be accompanied with deafness of one or both ears, but, as a rule, these cases are quickly cured. Unilateral deafness is difficult to demonstrate by examination. Congenital deafness, or deafness acquired in early childhood, leads to muteness. See SPEECH DISTURBANCES. Vertigo frequently accompanies deafness.

Deafness appearing suddenly, and accompanied by dizziness and vomiting, is the result of a disease of the labyrinth (Meniere's Disease) which is rarely cured. See EAR, DISEASES OF.

DEATH.—The cessation of life is not always ushered in by gradual diminution of consciousness, but often occurs with unimpaired conscious ness. At times death comes as a gentle slumber ; at other times it is accom panied by severe struggles. When death occurs, it is the duty of faithful nurses to act with presence of mind and with consideration. The last moments ought not to be made more difficult by painful expressions of grief on the part of the relatives. Quiet and consolation should surround the dying person. He should be kept clean and comfortable until he has drawn his last breath, and even after that. The lips should be moistened with water or with fruit-juice, the perspiration wiped away, and every wish of the dying person carefully listened to and fulfilled if possible.

After death the corpse should be laid on its back and cleansed. It should be dressed without delay before rigidity sets in ; otherwise dressing is difficult. The hair should be arranged, the eyelids closed softly, and the

open mouth closed with a cloth drawn around the head and under the chin. The corpse should be covered with a shroud. In the summer-time chloride. of lime may be sprinkled over the body, or the shroud which covers the body may be packed with salt and ice. The windows of the room in which the body lies may be opened, especially when the weather is cool. For evidences of death, see DEATH, APPARENT.

DEATH, APPARENT.—The manifestations of life, especially those of the respiration and heart-beat, are sometimes reduced to such a degree that it appears as if life were extinct. The skin is cool to the touch and entirely devoid of colour ; no muscle is moved ; respiration is suspended so far as the eyes are able to observe ; and the pulse cannot be felt. And yet the differen tiation between death and apparent death is of the utmost importance, because attempts at resuscitation must be made so long as death is not demonstrated beyond any question of a doubt, especially in persons who have met with accidents.

The danger of being buried alive is scarcely ever present, as burial under ordinary circumstances takes place at a time when the signs of death are obvious. The latter are : bluish-red, dirty-red, or rose-red death spots upon the dependent parts of the body, particularly upon the back ; the eyelids remaining open when drawn apart ; cloudiness and folds in the horny layer of the eyes ; greenish discoloration of the skin in the soft parts of the body ; cadaveric rigidity, which generally occurs twelve hours after death, lasting from 24 to 4S hours ; and lowering of the temperature of the body to below So° F., taken in the rectum.

If these sure signs are absent, it is necessary to make more certain, even if the respiration and pulse are no longer noticeable. Death has occurred if, upon constriction of a finger or a toe with a thread, the skin of the con stricted part does not discolour to a distinct red, and later, blue ; if, further, upon dripping hot water or sealing-wax upon the chest, the skin is not reddened, but if at once a blister is formed which bursts rapidly, showing a colourless background. In cases which even then remain doubtful, further guarantee is furnished by the electric current. This test, however, requires expert knowledge. In cases where suspicion exists that death is only apparent, a thorough examination should be made to discover the possible cause. It is occasionally noted that the position of limbs changes after death. This is due to the rapid onset of post-mortem rigidity, and it is by no means a sign that the patient has been alive. Changes of position of the corpse in the coffin are to be explained by the movements due to post-mortem rigidity.