Sudden and unexpected natural death: IV. Sudden and unexpected natural death in infants and young children

Abstract

Sudden und unexpected natural death in infants and young children encounteredin medicolegal practice is chiefly found in male subjects and seldom beyond the age of 3 years. Of a group of sixty-nine patients under 5 years of age studied in detail, only six were older than 2 years of age. The contribution of Negroes goes far beyond their proportion of the population, and is not regarded as a purely biologically racial phenomenon. Respiratory disease is the great leveler, accounting for almost 80 per centof the unexpected deaths in infants. Caution may be necessary, however, less undue weight be placed on the role of anatomically minor inflammatory changes in the breathing apparatus. There is a group of sudden and unexpected natural deaths in which thepresent usual means of investigation fail to uncover the cause of death. Such cases are encountered in apparently normal infants, usually between the ages of 4 and 8 months. The role of the thymus has yet to be clarified in the production of unexpected death. The variability of its weight, especially in the newborn infant, makes an evaluation of the lethal role of size alone exceptionally difficult. A single instance of a thymus sufficiently enlarged to have pressed upon the upper airway is recorded, but there was no evidence to indicate why the child died when it did, and not sooner or later. A plea is made for complete necropsy, including bacteriologic and chemical examination, for judicious evaluation of necropsy evidence and correlation with the clinical history, and for a willingness to admit inability to fix the cause of death. Sudden und unexpected natural death in infants and young children encounteredin medicolegal practice is chiefly found in male subjects and seldom beyond the age of 3 years. Of a group of sixty-nine patients under 5 years of age studied in detail, only six were older than 2 years of age. The contribution of Negroes goes far beyond their proportion of the population, and is not regarded as a purely biologically racial phenomenon. Respiratory disease is the great leveler, accounting for almost 80 per centof the unexpected deaths in infants. Caution may be necessary, however, less undue weight be placed on the role of anatomically minor inflammatory changes in the breathing apparatus. There is a group of sudden and unexpected natural deaths in which thepresent usual means of investigation fail to uncover the cause of death. Such cases are encountered in apparently normal infants, usually between the ages of 4 and 8 months. The role of the thymus has yet to be clarified in the production of unexpected death. The variability of its weight, especially in the newborn infant, makes an evaluation of the lethal role of size alone exceptionally difficult. A single instance of a thymus sufficiently enlarged to have pressed upon the upper airway is recorded, but there was no evidence to indicate why the child died when it did, and not sooner or later. A plea is made for complete necropsy, including bacteriologic and chemical examination, for judicious evaluation of necropsy evidence and correlation with the clinical history, and for a willingness to admit inability to fix the cause of death.