The diagnosis of ecchymosis from hypostasis has been given (see p. 46). A tolerably severe blow after death would be necessary to produce appearances similar to those produced by a slight one during life. In scourging, there are parallel ecchymosed lines, of small spots resembling petechiæ. An internal organ may be ruptured, and yet there may be no appearance of injury externally. The liver is the organ most commonly ruptured. The rupture is almost always longitudinal, and in some cases a portion of the gland is more or less detached. The spleen is also not infrequently ruptured; and this occurs most frequently in countries where ague prevails. Rupture of the lungs and brain is rare. When the pelvis is fractured, the bladder is frequently found ruptured. Death in most cases is due to internal hæmorrhage or shock, when any of the internal organs are ruptured. =Can the appearance of a bruise be produced after death?=--It is possible that the appearance of a bruise inflicted during life may be produced within two hours after death, and in some rare cases even after the lapse of three hours and a quarter (Christison); but these ecchymoses are limited in extent, and when large are due to a rupture in a vein which can be readily ascertained. The experiments of the late Sir Robert Christison, relating to this question, are detailed in the _Edinburgh Medical and Surgical Journal_, vol. xxxi. The amount of violence required after death to produce appearances like those made before death is such as would seldom, if ever, be inflicted on a corpse, and, therefore, where we find a well-marked bruise we ought to infer that it was made before death. The following table, compiled from the experiments of Christison, may assist the diagnosis: --------------------------------+--------------------------------- During Life. | After Death. --------------------------------+--------------------------------- 1. Swelling of the part. | 1. No swelling. | 2. Coagulation of the blood | 2. No such appearance, unless effused into the adjacent | there is a rupture of a large cellular tissue, with or | vessel in the neighbourhood without tumefaction. | of loose cellular tissue. | 3. Incorporation of blood | 3. No such appearance produced with the whole thickness | by a blow after death. of the true skin, rendering | it black instead of white. | --------------------------------+--------------------------------- _N.B._--Extensive effusion may occur without affecting the skin, but when the skin is so affected Christison thought it decisive of _ante-mortem_ injury. The Size and Form of a Bruise should be noted. Why?