3. _The Lungs._--The lungs are completely distended, almost entirely overlapping the heart, and pressing close to the ribs. They are spongy to the feel, and when cut into, a considerable quantity of bloody froth escapes. The _froth_ found in the lungs is the result of the powerful attempts to breathe, and cannot be produced by artificial means. It adheres not to the sides of the bronchial tubes, as does the exudation of bronchitis or pneumonia. The distension of the lungs is due partly to an actual hyperæmia, and partly to inhaled fluid. Water is present in the pleural cavities. 4. _The Heart and Great Vessels._--As is common to other forms of asphyxia, the left side of the heart is entirely, or almost entirely, empty; the right, on the contrary, is engorged. This condition of the heart is, therefore, not a diagnostic sign of drowning, and is absent in the drowned when death takes place by neuro-paralysis; in fact, in some cases of undoubted drowning, both sides have been found empty, probably, however, the result of putrefaction (Ogston). The same may be said of the accompanying congestion of the pulmonary artery. 5. _The Blood._--As is common in all forms of death where respiration has been arrested, the blood is found to be remarkably _fluid_, and of a cherry-juice colour. M. Faure in his monograph on asphyxia states that he has found large and firm clots in the right side of the heart in the drowned who have not remained long under water. The blood is diluted with water, most marked in the left side of the heart. The amount of dilution is greater in slow drowning. 6. _The Stomach._--Casper considers that the presence of fluid in the stomach, corresponding to that in which the body is found, is “an irrefragable proof of the actual occurrence of death from drowning,” and that the swallowing of it must have been a vital act of the individual dying in the water. The absence of water from the stomach does not negative death from drowning. Water is not always present. It is possible for it to reach the stomach of a submerged body after death. Water in the intestines is a more reliable sign of death from drowning, and indicates submersion during life. It is only after very long submersion and under great pressure that water finds its way into the intestines after death. _N.B._--Putrefaction in the drowned in most cases commences in the upper part of the body, and extends downwards. The face, head, and neck are first attacked. This is the reverse of putrefaction in air. CHAPTER X DEATH FROM STARVATION, COLD, HEAT, BY LIGHTNING AND ELECTRICITY DEATH FROM STARVATION Death from starvation may be due to the total withdrawal of food, to prolonged insufficiency, defective quality, inability to swallow it, and inability to retain it.