'7 MEDICAL JURISPRUDENCE) 1 ' ❖.^^v^v. ,•,' \mv \ \ \ u ? i % &\\ <&m*n MEDICAL JURISPRUDENCE. BY JAMES WEBSTER, JR. OF PHILADELPHIA. PHILADELPHIA: PRINTED BY WILLIAM BROWN, 1824. 4 AN TOAWWlAi* BSSATd FOB THE DEGREE OF DOCTOR OF MEDICINE. SUBMITTED TO THE EXAMINATION OF THE REV. FREDERICK BEAZELY, D.D. PROVOST, THE TRUSTEES, AND MEDICAL PROFESSORS OF THE UNIVERSITY OF PENNSYLVANIA On the 8th day of April, 1824. TO JOHN VAUGHAN, ESQ. With sentiments of esteem and gratitude, this essay is inscribed by the AUTHOR. MEDICAL JURISPRUDENCE. In glancing over the various subjects which present them- selves, none appear better calculated for an inaugural disserta- tion than the subject of Medical Jurisprudence. Until within the last few years, this important branch of medical science seemed to be almost entirely neglected in this country. But of late it has assumed a more imposing aspect, and is now held as an indispensable part of medical education in several of our colleges. We shall confine ourselves to the consideration of some of the more important subjects which come under the observation of medical men in a legal point of view, and more particularly of those relating to the destruction of human life. CHAPTER I. § 1. PHENOMENA OF PREGNANCY. It is asserted by some authors that women experience a par- ticular sensation immediately after conception ; the first, and certainly one of the most important signs, is a cessation of the catamenia, but it by no means follows when this is the case, that a woman is certainly pregnant; there may be suppression, which in many instances, will induce the usual symptoms atten- dant on pregnancy, as depraved appetite, a dyspeptic state of the stomach, morning and evening sickness, cardialgia, languor, &c.; on the contrary, it is said by some, that a woman may con- tinue to menstruate and still be pregnant ;* this, however, is denied by others, and the discharge is asserted to be only a se- cretion from the vagina and neighbouring parts. Together with the symptoms enumerated, the breasts about the third month become enlarged and painful, a brown areola encircles the nip- * Vide note in Francis' edition of Denman's Midwifery, p. 231. 2 0 pies, and on pressure a serous fluid issues from them. In some instances, a salivation occurs, there are pains about the face and teeth, accompanied with a febrile disposition. In others, no such changes occur, and the woman is not aware of her situation, until after quickening takes place ; hence, it appears that in the early months, our means of judging are far from being sufficient to entitle us to draw a decided conclusion in cases of importance, or in a court of justice. About the end of the fourth month, the uterus ascends from the cavity of the pelvis into the abdomen, and the movements of the child being then first perceived, it is said to quicken; but in some instances the ascent is so gradual, that the sensation of quickening is not to be perceived. If, however, after this period, the woman suddenly recovers her usual health, the symptoms alluded to no longer exist, and the suppression of the catamenia continues, we can scarcely have a better proof of the existence of pregnancy. The abdomen now becomes enlarged, the skin is tense, and by relaxing the abdominal muscles, the womb which is now in the cavity of the abdomen may be plainly felt between the symphisis pubis and the umbilicus. Various causes may conspire to produce abdominal enlarge- ments, and consequently many mistakes have been made. As- cites has been mistaken for pregnancy, and pregnant women have been killed by the introduction of the trocar; they may exist together, and women in this state have borne children; they are lo be distinguished by fluctuation, except the water be encysted. Diseases of the ovaria, but more particularly dropsy, may also be confounded with it. Tumours sometimes form in the uterus, giving rise to a greater than ordinary enlargement of the abdomen, as hydatids, scirrhus, moles, retention of the menses, &c.: in these cases it has been supposed that the motion of the child could be perceived; this is very probably caused by wind in the intestines, or the pulsation of the large blood-vessels. Within the last few years it has been proposed that ausculta- tion might be applied to, ascertain the state of pregnancy. Thinking with propriety that the tube or stethoscope of M. Laennec would be applicable to this purpose, M. Kergaradec embraced the earliest opportunity of testing it, and having made a number of .observations on the subject, published them in a small memoir.* He was led to the conclusions that by this means, it will be possible " to acquire some information as to the * Memoire sur Pauscultation appliquee a Pctude de la Grossesse, ou Re- cherehes sur deux nouveaiix signes propres a faire reconnaitre plusieurs circonstances de 1'ctat de gestation. Par. M. J. A. Lejumeau de Kergara- dec, D. M. P. &c. Paris, 1822. 7 existence or absence of the state of pregnancy, and particularly as to the vitality of the child." Fodere mentions* that M. Maoir, of Geneva, had discovered that it was " possible to recognise the vitality of a child when nearly at the full period of gestation, by the application of the ear to the mother's abdomen." For judiciary purposes, however, we must resort to an ex- amination—and here that delicacy is not required, which is so strictly to be observed when merely private opinion is concern- ed. At about the end of the sixth month, we may generally be able to determine with the greatest degree of certainty. Having previously evacuated the contents of the bladder and rectum, let the subject be so placed that the abdominal muscles may be relaxed; when a tumour will be distinctly felt between the pubes and umbilicus, inclining to one side or the other, or hanging over the pubes, turning proportionally the os uteri to the opposite side, or back towards the sacrum, carrying it at the same time higher up and further from the reach of the finger.t The motion of the child will now be very perceptible, on dip- ping the hand in cold water, and applying it to the region of of the uterus4 At the end of the seventh month, the tumour extends as high as the naval; and by the end of the eighth month it rises to about mid-way between the umbilicus and scrobiculus cordis, the os tincae is smooth and high up in the pelvis ; before the termination of the ninth month, the fundus uteri is as high up as the scrobiculus cordis, and the os tinea? begins to relax. § 2. TERMINATION OF PREGNANCY. The proper period for the expulsion of the foetus having ar- rived, the uterus takes on a new action, and ceasing to enlarge, it begins powerfully to contract, until its contents are finally ex- pelled. Taking it for granted then, that the foetus is expelled, it may become our province to decide whether or not the delivery has actually taken place ; for this purpose, if an examination be made immediately, we can generally decide with a tolerable de- gree of certainty. As might be expected, the abdomen is pro- minent, and its parietes are lax and hang in loose folds; white lines called lineae albicantes, caused by lacerations in the epider- * Dictionaire des Sciences Medicales, torn. 57. f Bard's Midwifery, p. 98. * Smith's Forensic Medicine, p. 485. r* mis, mark its surface. These lines, however, may be produced by other enlargements, as ascites, obesity, &c. therefore they cannot be considered of the least importance. The uterus may be felt like a ball through the integuments ; the external organs are considerably enlarged; the vagina is distended and flabby; the lochial discharge which proceeds from it, may be distin- guished by its pale colour and peculiarly fetid odour, which cannot be mistaken. The os uteri is dilated, soft, and nearly circular, and the parts are extremely tender. The mammae are enlarged and secrete milk, the areola around the nipples is of a deep brown colour. The eyes are sunken and are surrounded by a dark-coloured ring, the skin is of a peculiar whiteness, re- sembling that of a person convalescing from disease ;* and not unfrequently in cases of solitary delivery, may we expect to find lacerations of the perineum, as the proper precautions against this accident cannot be taken under such circumstances. It will also be remembered that women, immediately after deli- very, generally suffer considerably from debility and langour; exceptions, however, to this are not at all unfrequent, and in these cases we depend entirely upon the local appearances. It was formerly supposed that we could ascertain at any period by an examination after death, if pregnancy had ever taken place, and how often. The vesicles of the ovaria having received the stimulus of the male, discharge the ovum, which is caught by the fimbriae of the fallopian tube, thence it is carried into the uterus and finally develops a perfect foetus. The coats of the vesicles become thickened, the cavity from which the ovum was expelled is en- tirely obliterated, and a peculiarly rugous appearance is present- ed to us, having a yellow tinge, which is called corpus luteum. An opinion has prevailed that corpora lutea were only to be found in the impregnated female, but at the present day it is generally admitted, that it may be produced by strong desires alone, and instances are not wanting, to prove that such is the fact.t It is said that the corpora lutea of virgins may be distinguish- ed by their small size, and in a preparation, in the possession of Dr. Blundell, taken from a girl aged seventeen years, who died of chorea, where the hymen is unbroken and the entrance of the vagina nearly closed, there are no less than four corpora lu- tea, which in every respect are so natural that " I occasion- * Beck's Medical Jurisprudence, p. 137. f Vide Sir E. Homes paper in the 1st No. Philosophical Transactions for 1819; also Dr. Blundell's on Generation, Medico-Chirurgical Transactions of London, vol. x. p. 245. 9 ally, (says Dr. Blundell) circulate them in the class-room, as accurate specimens of the luteum upon the small scale." From these facts it is very evident that none but an experienced eye can distinguish them, and still, great uncertainty must exist in the mind of the practitioner. § 3. MISCELLANEOUS OBSERVATIONS. We have now gone over in a cursory manner, the subject of pregnancy. There still, however, remain some important con- siderations connected with it, of which I propose to treat in this section ; and first, of the length of time that a woman may carry a child. Nine calendar months or forty weeks, calculating from two weeks after the last appearance of the menses, are usually re- quired for the completion of the process of gestation ; but a child may be born perfectly formed, one or two weeks earlier, or, may be prematurely delivered. On the contrary, delivery may be retarded longer than this period, and physicians now generally agree that it may be protracted even for a longer time than the tenth month.* The laws of most countries consider children legitimate, though born more than nine months from the death of the hus- band. In this country, as in England, no definite time is pre- scribed by law ;t it considers all children as legitimate, who are born within forty weeks after the death of the husband. The laws of Scotland allow that a child is legitimate, if born six months after marriage, or ten months from the death of the husband ; and before the revolution, those of France consider- ed it so if born in ten months after connexion, but we find that " the legitimacy of a child born three hundred days after the dissolution of the marriage contract, may be contested."! The Roman law allowed ten months, and the Emperor Adrian de- creed for eleven, " where the mother was of good and chaste manners." Women not unfrequently feign themselves to be pregnant when in fact they are not so. In such cases, an absence of the signs mentioned in the first section would alone be sufficient to * Professor James informed me that a case had fallen under his observa - tion, where delivery had been retarded until near the end of the tenth month. \ For a more detailed account of the laws of England, on the subject of inheritance, see Judge Cooper's notes in Male's Forensic Medicine, p. 215. * Code Napoleon, Titre VII. Chap. I. Art 315, Paris, 1813. 10 confute them, but others suggest themselves. Before the period of puberty, nor at a later period, when the menstrual discharge has ceased, a woman rarely becomes pregnant. The former varies considerably in different individuals and climates; in warm climates, it takes place at between eight and nine years of age, and in northern, or cold climates, the period does not arrive until the woman has attained to the age of eighteen or twenty years. In our own country at the age of thirteen or fourteen years, is the period when it generally takes place. The change of life, or period when the menstrual discharge ceases, occurs from the forty-fourth to the fifty-fifth year; in this climate at about the forty-fifth. Cases however are mentioned by Smith and Capuron, where pregnancy has taken place before the appear- ance and after the cessation of the menses. There may be present some one of the diseases of the uterus, any of which will prevent impregnation, as scirrhus, proci- dentia, tumours, &c. a closure of the os uteri; imperfect hymen ; inveterate fluor albus; an inordinate flow of the menses, or a union of the sides of the vagina, so as to preclude the possibility of connection. CHAPTER. II. § 1. PHENOMENA OF DEATH. Previously to entering upon the more immediate object of this essay, as the subject is an important one, and so intimately connected with our succeeding remarks, we shall enumerate in a succinct manner the signs of death.* In forming an opinion, we must first take into consideration the circumstances of the case, and in some instances these will be sufficient to determine the question; on the other hand, they may be the very means which will throw obscurity and incertitude upon the subject, and cause us to hesitate before we decide. On first beholding a dead body, we are generally struck with the peculiar expression of countenance or cadaverous appear- ance which is presented to our view, denominated the fades Hippocratica; this peculiar appearance has also been observed * For an interesting paper on this subject, by Dr. Ducachet of New York. see Am. Med. Recorder, vol. 5. p. 39. 11 during life, when dissolution is approaching, therefore of itself, it cannot be of much importance, but in connection with other signs it is most undoubtedly deserving of attention. The most certain signs, when found to exist together, are an absence ol respiration, evinced by holding a looking-glass before the mouth, setting a cup of water on the sternum and observing whether the water moves or not; stoppage of the circulation ; rigidity of the limbs; flaccidity of the cornea;* a film formed over the eyes ; loss of motion in the eye-lids ; flatness of the buttocks ;t relaxation of the sphincters; coldness and insensibility of the body. Various means have been proposed to be employed in cases of a doubtful nature, to ascertain if death had actually taken place. Among others, cupping has been recommended ; and if blood flows from the capillaries, it is extremely probable that life is not extinct; powerful stimuli are to be blown into the nos- trils, in order, if possible, to excite sneezing; the introduction of a sharp pointed instrument under the finger nails, will often rouse persons from the most alarming syncope, and has there- fore, been recommended in cases of apparent death ;% incisions with the knife ; scalding with boiling water or oil; loud noises; cauterizations, &c. may all be of service. Nothing need be said of galvanism nor electricity, as their effects on dead animals are well known, and as they exhaust the irritability of the heart and blood-vessels they are dangerous in debilitated subjects. The last and certainly the most conclusive evidence of death, is putrefaction. "But it is a nicer point to determine the presence of putrefaction than is commonly supposed," and the opinion of a physician may be called for, when from the smell it is sup- posed to have commenced, which may be owing to a decom- position of the alimentary matters, or, from the appearance of purple spots on the surface, which are not unfrequently the con- sequence of disease; hence it appears that unless putrefaction has already affected the solid parts, " it is safer to judge from the concurrence of signs enumerated above, than to trust to the appearance of putrefaction alone." Besides other symptoms of putrefaction occurring in certain diseases during life, blood drawn from the arm has produced fainting in the operator from its horrible smell; the urine too, may be the source of a putrefactive odour, and in typhus fever, from which persons have been recovered after asphyxia has taken place, the odour of putrefaction has been present. • Hunter on the Animal Economy. f Elliotson's translation of Blumenbach, as quoted by Dr. Ducachet * Ducachet on the signs of death, Am. Med. Recorder. 12 § 2. FETICIDE. By this term we understand the destruction of the embryo, by producing abortion during the early months of pregnancy. Women are very subject to miscarriage, and in many instances the greatest care and attention are required, in order to prevent an occurrence, which not unfrequently jeopardizes the life of the mother, and renders her exceedingly liable to it in succeeding pregnancies. It is, however, to the subject of criminal abortion that our remarks will chiefly refer. The circumstances which have urged females to the commission of such a crime, are various, but in by far the greatest majority of cases, it has been for the purpose of avoiding the disgraceful consequences of illicit intercourse, and consequently, it is generally in these cases, that the physi- cian is called upon to give his testimony. His first object must be to ascertain if the woman has had an abortion, and, except it be in the early months, (when it will be difficult and perhaps impossible to ascertain) nearly the same appearances will be pre- sented as at the termination of pregnancy : of course, they will not be so distinct as those caused by the delivery of a mature child. Should several days have elapsed, the probability is that the parts will be so restored to their natural appearance, that our examination will lead us to no satisfactory conclusion. It may be, as is not unfrequently the case where violent mea- sures have been resorted to, that the death of the woman is the consequence, and as there may be persons charged with having aided in procuring it by improper means, an examination after death must decide. If the pregnancy be several months ad- vanced, and our examination be made immediately after the death of the woman, in connexion with the other circumstances of the case, the appearances presented on dissection might be important. The uterus is enlarged and thickened, its capacity greatly increased, its blood-veSsels are enlarged; the part from whence the placenta was detached is rough; the cervix uteri is relaxed; the vagina is dilated ; the ligamenta rotunda are relax- ed ; the ligamenta lata are nearly effaced,* and if the examina- tion is made immediately after death " it is probable that the venous sinuses may still remain considerably enlarged."! Some of these appearances may be produced by various other causes; * Dr. J. B. Beck's Dissertation on Infanticide, p. 37 ; and Male's Forensic Medicine, p. 162. ■\ Hutchinson on Feticide, London Medical and Physical Journal, No. 251 p. 13. 13 moles, as they sometimes induce some of the usual symptoms of pregnancy, when thrown off, may also give the appearance of a miscarriage;* the relaxation may be the consequence of flooding.! Of the corpora lutea, nothing need be said; that they may exist where impregnation has never taken place, we think there can be no doubt. The destruction of the foetus may be accomplished, 1st, by direct means, as the introduction of instruments into the uterus, blows and pressure on the stomach; 2d, by indirect, or such means as act through the medium of the mother, as medicines taken internally, evacuations, &c. The former of these modes is now very seldom employed, but the latter most generally. This includes the drastic purgatives, electricity, salivation, vio- lent emetics, and frequent bleedings, especially, in the foot; cases are recorded where after having been bled by a practitioner, the woman on his departure has removed the dressings in order to encourage haemorrhage for this purpose.J Emmenagogues, amongst which, those most commonly employed for this pur- pose are the juniperus sabinae, the cucumis colocynthis and the helleborus niger. The ergot, which has lately been introduced into obstetric practice, seems to exert a specific action on the uterus, and is said by some, to be frequently fatal to the child,§ this, however, is denied by others. It will, however, be very rare, that any of these means will produce the required effect, perhaps never, unless used to an extent dangerous to the mother, except, indeed, there exists a constitutional predisposition to abortion. || The causes of abortion may be perfectly natural, and the dis- criminating practitioner will always bear them in mind in cases of importance. Besides an existing predisposition to it in the female, it is produced by great mental emotion; violent exer- cise ; blows on the abdomen ; accidental falls ; frequent vomit- ing; drastic purgatives; diseases of the uterus; excessive venery; previous abortion; death of the foetus; too great indulgence in the use of spiritous liquors; fluor albus ; attachment of the placenta over the os uteri; haemorrhage, " from whatever source or at any period ;"1F and, what is but too common in fashion- able life, external pressure on the abdomen. These, with many * Smith's Forensic Medicine, p. 298. f Male, p. 162. t Smith's Forensic Medicine, p. 306. § Dr. Hosack's paper in the New York Medical and Physical Journal, vol. 1. p. 206; and Dr. Atlee on Ergot, American Medical Recorder, vol. iv. p. 144. || Beck's Dissertation, p. 42. If Burns on Abortion; and Beck on Infanticide, p. 42. o O 14 more!, may induce abortion without the least degree of crimi- nality being attached to the female. In order to avoid any uncertainty that might exist respecting the mass discharged, a short account of the progressive develop- ment of the foetus in utero, may not be unnecessary, but perhaps useful. We shall say nothing of it at a very early period, as microscopic observations are not considered valid in forensic in- quiries,* but commence at the period when we conceive an abortion can be first proved. At about the forty-fifth day, the form and parts from whence the extremities are to arise, may be discerned, its length is then about ten lines;! at sixty days, it is more perfect, and two inches in length; at three months, it is still more so, and in fourteen or fifteen weeks, according to the observations of Chaussier, all the external parts, except the hair and nails, are completely formed. It thus progressively becomes perfected, and after the end of the fourth month, when quickening takes place, there can be no difficulty in distinguish- ing it. From the fifth to the seventh month, the foetus may be born living, but generally cannot maintain existence, hence, it is immature; after the seventh month it is completely formed in every respect except in size and weight; is capable of being reared, and cannot therefore be considered under the head of abortion, but as premature. Instances are related in which children born between the fourth and fifth months, have been raised. In some of the earliest nations of antiquity, abortion was not only tolerated as a private act, but indirectly favoured by the laws.J According to those of Lycurgus, it was permitted with a view to preserve the number of citizens, equal to the number of lots of ground. During the reign of the Caesars, and until the time of Constantine, this practice prevailed to a considerable extent in ancient Rome. In modern times, we find in some parts of the world, that this crime is not yet abolished; but it is to be hoped, that in proportion as Christianity, which has al- ready planted the standard of peace in some of the most savage nations of the world, spreads its enlightening and benign influ- ence over mankind, will crimes so atrocious in their nature, so baneful in their effects, and so revolting to humanity, cease to be recorded on the page of history. According to the laws of most civilized nations, the degree of punishment varies according to the time at which abortion is procured; it being considered a crime of greater enormity, if committed after, than before quickening; respecting the pro- * Hutchinson, Essay on Infanticide, p. 4. ! Ibid. t London Medical and Physical Journal, p. 91. 15 priety of such a distinction, we need not remark that it is found- ed in error, and likely to have a very mischievous tendency. That the embryo, from the very earliest period, is endued with life, requires no arguments to prove; such is the opinion enter- tained by the most enlightened medical philosophers of the pre- sent day. Before the reign of Henry the second, the punishment inflict- ed in France, on persons convicted of having procured abortion, was death. In 1791, the new penal code, punished it with twenty years imprisonment in irons; the code for 1S10, punishes it with imprisonment. The laws of Germany and Bavaria punish it with from two to six years, if procured during the first thirty weeks, and from eight to ten, if during the last, month.* By the laws of England, if any person or persons wilfully use means intending the destruction of the foetus and consequently abor- tion, the woman not being, or not proved to be quick with child, the same shall be declared guilty of felony, and liable to transportation for a term not exceeding fourteen years;—but should such means be employed after the period of quickening, the person so offending, the aiders and abettors shall be declar- ed guilty of felony and punished with death accordingly.! In the laws of this state I find no distinction made with respect to punishment, as to the period at which abortion may be pro- cured. " If any person or persons shall counsel, advise or direct a woman to kill the child she goes with, and after she is deli- vered of such child, she kills it, every such person so advising or directing, shall be deemed accessary to such murder, and shall have the same punishment as the principal shall have."i § 3. INFANTICIDE. As it was stated in the last section, that a child of seven months may be raised, so the destruction of it after that period, is considered to be a crime of the same enormity as if it was born at the full time. As it is now perfect, except in size and weight, these may enable us to form a tolerably correct opinion respecting its age. The weight of a child at seven months should be at least five pounds, avoirdupois, and not less than fifteen inches in length.§ || There are also some other peculiari- * Hutchinson on Feticide, p. 96. f Chitty's Criminal Law. * Laws of Pennsylvania, Vol. 1. Chap. 236, p. 113. § Smith's Forensic Medicine, p. 312. || The following account of the gradual progress in the length of the foetus from the fifth, until the ninth month, taken from the Dictionaire des Scien- ces Medicales, will aid us in forming an opinion on the subject. It will be lb ties;—as the head is unproportionably large, the bones are soft and yielding; the fontanelles are very wide and open ; the eyes are closed ; the superficial vessels are turgid with blood, giving an appearance of great vascularity to its whole surface, but more particularly, and for a greater length of time, to the palms of the hands and soles of the feet; the membrana pupil- laris does not entirely disappear, and the iris is not yet perfectly formed. In the female the clitoris is very large, and the exter- nal parts are protuberant; in the male, at the end of the seventh month, the testes are not found in the scrotum. On dissection we find the liver disproportionably large and filling a considerable part of the abdominal cavity; the fluid in the gall-bladder, if any be there, is watery and transparent, the heart is also very large, and the lungs are in a state of collapse, very small and hard.* According to the scale of admeasurement given by Professor Chaussier, the middle of the body of a mature child, corresponds exactly with the umbilicus ; it is two or three centimeters higher at the eighth month ; still higher at the seventh month, and at the sixth month, it is exactly at the abdominal extremity of the sternum. The object of a professional man, when called upon to give his evidence in a case of alleged infanticide, will be, after hav- ing fixed an actual delivery on the mother, to establish the fact relative to the child, of its having been born alive, and if it was, what were the causes of its death. The death of a child may take place several weeks before birth, and still the child may be carried to the usual period; under these circumstances, it is exposed to the action of the liquor amnii, which will cause the cuticle to separate, and render the body flaccid ; there are also bloody effusions in the large cavities;! we can in these cases observed that there is some disparity between this statement and that of Dr. Smith. " Les recherches suivies du Professor Chaussier, preuvent qu'une enfant bien conform^, et naissant au terme de neuf mois de grossesse, pese le plus ordinairement, trois mille grames, e'est-a-dire, cent onces ou six livres un quart; etque le terme moyen le plus ordinaire de la grandeur du foetus, de- puis la fin du cinqui^me mois jusqu' a la fin du neuvieme, est A 5 mois 255 millimetres ou 9 pouces ""' 6 325 12 7 380 14 y de longeur. 8 440 16 9 488 18 Dictionaire des Sciences Medicales, Art. Avortment, torn. 2. p. 487. • Smith's Forensic Medicine, p. 312. ! Ibid, p. 315. 17 generally determine with accuracy; but when the child is re- cently dead, it is sometimes a nice and very difficult matter to decide. In a child born dead, or when respiration has not taken place, the lungs will be found to be of a dark brown colour; solid and contracted, occupying but a very small space within the cavity of the thorax. Upon taking them out of the body and nutting them in water, they sink, and when cut into with a knife, the same sensation is conveyed to the finger, as if cutting through a solid piece of flesh; no air is emitted ; no blood flows, nor is there any crepitation ; the ductus arteriosus and ductus venosns are open and contain blood; the diaphragm is convex upwards and greatly arched. On the contrary, when the child is born alive the appearances presented are exactly the reverse of those enumerated. The moment respiration commences, the colour of the lungs is changed to a bright florid red ; they become light and spongy, and in proportion to the length of time that respiration has continued so are they expanded, and when com- pletely inflated, they entirely fill the the cavity and cover the pericardium. When put into water* they are so light as to swim on its surface; on being cut into, a peculiar sensation is perceived, the air rushing from the cells causes a very peculiar crepitating sound, and a small quantity of a bloody fluid will follow the incisions; the ductus asteriosus and venosus will be found to contain no blood, and the diaphragm, on account of the pressure of the inflated flungs, will not be so convex and arched. It has been contended by some very eminent physiologists, that the evidence drawn from the state of the lungs was un- certain, and not to be depended on. It will be impossible, in the short space allotted to the subject in this essay, to enter into a full discussion on this important and interesting subject; my observations must therefore be very general. The objections which have been urged against the hydrostatic test, in cases of infanticide, may be summed up in a few lines. As much credit may be attached to these objections as the reader may con- ceive they merit. 1. It has been asserted that a child may breathe whilst yet in the uterus, and still, not be born alive; if such has been the case the lungs will be dilated and buoyant. 2. One lung has been observed to sink in water, whilst the other floated. • It must be borne in mind that the temperature of the water should be the same as the surrounding atmosphere. It should also be perfectly free from salt, for when this is contained in it, its, specific gravity becomes in- creased. 15 •3. The lungs of children born alive, and who had respired, it has been said, have sometimes sunk in water. 4. After the putrefactive process has continued, sufficient air will be evolved to cause the lungs to float. 5. The lungs of still-born children may be partially inflated by artificial means, as blowing air into the mouth and nos- trils. 6. The child may be born alive, and respiration not com- mence for some time ; in this state the child may exist. With regard to the first objection, granting that a child may breathe whilst in the uterus " when its mouth presents at the dilated orifice of that organ, and the vagina admits a free passage for air to it," it is perhaps the only case in which a child can possibly breathe whilst contained in that viscus. A presentation of the face, as it is very rare,* is also very difficult to manage, and hence professional aid is generally required, so that under these circumstances a charge cannot be brought, as it must be evident the crime could not be committed secretly.! The child may breathe, after the head has passed the os uteri and whilst it is in the vagina or resting on the perineum ; Dr. Smith mentions an instance, which came under his own obser- vation, where he had every reason to believe that such was the case. That a child should die before birth under either of these circumstances, seems strange, for the fact of its having breathed so prematurely, would seem to indicate, that it was possessed of unusual strength and vigour; and if pressure on the cord be al- leged as the cause of death, it would be inconsistent, for "it is wholly immaterial whether the circulation in it be stopped or not after respiration has commenced, as the foetal circulation has then become unnecessary."! To the second objection we reply, that from the researches of M. Portal, we know that air enters the right lung first, the right bronchial tube being the shortest, hence if it should be the right lobe which floats, any difficulty is readily cleared up, by a knowledge of this important fact; we know also that " res- piration is not completely performed on the first effort, but that it is.a process gradually advancing to perfection; and that it will be more or less protracted according to the degree of vigour of which the infant is possessed."§ The third objection seems to have been urged more from * See the report of L'Hospice de la Maternite at Paris from 1797 to 1806, in James' Burns. f Smith's Forensic Medicine, p. 324. i Beck on Infanticide, p. 53. S Ibid. p. 333; and Hutchinson on Infanticide; 19 analogy than from actual observation and facts; it is well knowrr that several of the diseases of the pulmonary organs of adults, will cause them to sink in water, but in the case of infants, such an occurrence must necessarily be very rare. A single case of aborted foetus which had scirrhous lungs is mentioned by Bren- delius and referred to by Dr. Beck. There can be no difficulty in deciding whether the lungs are sound or diseased ; and if diseased, and respiration has ever taken place, as some air must have entered them, it can be very readily decided. On cutting them into several pieces and putting them in water, some will certainly float, and then there can be no doubt respecting the conclusion to which we are entitled. On the contrary, when none float we may infer that the child never respired ; " where difficulties are thrown in the way, however, which we cannot get over satisfactorily, our duty will be to decline any positive deduction, and leave justice to satisfy herself in some other man- ner." As respects the fourth objection, accurate observations have proved that the lungs, which are the last parts of the body to become putrid, although they have not respired, will often float on the surface of water, after putrefaction has commenced, and so long as their organization is not completely destroyed by it, but when this is the case they will sink. It is evident that some difficulty will exist in these cases; nevertheless rules have been laid down by the generality of witers on legal medicine for dis- tinguishing between the air of respiration and that which is emphysematous. As the air consequent on putrefaction is situa- ted under the external membrane of the lungs in bubbles, by squeezing them hard, these bubbles will burst and the Jungs of consequence will sink in water.* The air bubbles of respiration are so small as hardly to be perceived by the naked eye, whilst those of emphysema are large and run in lines between the com- ponent lobuli of the lungs.! Lungs which have respired although putrid, always have a crepitus on being cut into, whilst those which have not respired, although they float, do not possess this peculiarity 4 Respecting the fifth objection there can be no doubt that the lungs may be artificially inflated; it may be the last act of ma- ternal kindness endeavouring to preserve a life, which if spared must inevitably bring shame and disgrace upon her, and which in the fulness of her heart, she had rather suffer than see her in- * Smith's Principles of Forensic Medicine, p. 329. ! William Hunter on the Uncertainty of the signs of Murder, &c. Med, Observations and Inquiries, vol. 6. p. 284. i Marc's Manual, and Beck's Dissertation, p. 59. 20 fant perish without an attempt to save it. She may have been the deluded victim of some vile seducer; under these circumstances, when she discovers that the child is really dead, what good end could it answer to make it known ? What moral principle re- quires her to divulge her secret? She resolves to conceal her shame, and perhaps for the future to lead a virtuous life ; it may be discovered, and the means she used only to hide her shame, will be considered as proof of her guilt. Aware then that the lungs may be thus artificially inflated, various tests have been proposed by writers on this subject, amongst which those of Buttner, and Ploucquet are deserving of most attention. The former knowing that the blood does not pass through the lungs until after respiration had commenc- ed, concluded that in a child born dead " the arteries and veins of the lungs are found destitute of blood, and in a collapsed state, notwithstanding any artificial inflation that may have been practised upon them. On the contrary, the vascular dis- tention of the pulmonary organs proves that the child has breath- ed, for nothing but natural respiration can produce this effect."* The absolute weight of the lungs is not increased by the intro- » duction of air after death, whereas, when respiration has taken place such is not the case, and hence the test of Ploucquet is highly important. It is said the air introduced artificially may be squeezed out of the lungs, upon which they sink in water. Observe if there is any crepitation, or blood when the lungs are cut into. The external conformation cannot assist us in our in- quiry. It would seem that instances have occurred where the circu- lation has continued in infants who had never respired. Three cases are recorded by Bohn where infants had been deeply buried in the earth, and taken out alive after several hours; two cases are related by Wrisberg! where one infant lived seven, the other nine minutes, enclosed in their membranes, when he ruptured them. Ploucquet founded his celebrated test upon the principle that as the foetal lungs contained very little blood the vascularity and consequently the real weight of lungs which had respired must be considerably increased. From his numerous observations there- fore, he was induced to lay it down as a general rule, that the relative weight of the lungs of a still-born child, to his whole body, is as one to seventy; and those of a child which has res- pired as two to seventy; thus by the introduction of blood into * Beck's Inaugural Dissertation, p. 56. t Hutchinson on Infanticide, p. 356. 21 the pulmonary organs after the respiratory process has com- menced, we find that their absolute weight is doubled. This test has also had its objections. The child may die of haemorrhage, and it has been said that the loss of blood would alter the ratio. In such a case it is said that "the lungs would bear a greater proportionate weight."* It must be very evident that a congestion of the foetal lungs cannot take place to any extent, the blood must necessarily pass through the natural apertures of the ductus arteriosus and venosus, hence this objection cannot hold good. Should there be any disease of the lungs, as dropsy, scirrhus, &c. they will readily be discovered, and as they serve to increase the weight, of course this test will not be applicable in such cases ; these observations will also apply to putrefaction. Respecting the tests of Professor Daniel nothing need be said, as they are not considered, by writers on medical ju- risprudence, to be entitled to much confidence. It has been customary with the most approved writers on juridical medicine, to class the means by which the death of the child may have been caused, under the heads of omission and commission.—In the first class are included cases, where the cord has been divided without the proper precaution of tying it having been taken. Instances are on record, where it has been divided without this precaution, and no loss of blood has ensued, but it is the generally received opinion among medical practitioners, that great danger must re- sult from such neglect.—2d. The child may have been left exposed to the influence of the cold, and thus perish: " the signs of a child having perished in this manner, are a deter- mination of the blood from the superficies of the body to- wards the interior, leaving paleness of the skin and vacuity in the vessels of the surface."—3d. Neglecting to give the nourishment proper for its support. If death be thus occa- sioned, (which must be very rare) " the dissection of the body would ascertain the fact as to its having been fed or not, at least for some time before its death."—4th. The wo- man may be so situated during labour, that when the head is delivered, the face of the child rests upon the bed-clothes, and respiration being prevented, it may in this manner be suffocated ; it may be drowned in the uterine discharge,! or * Smith's Principles, p. 341. ! William Hunter on the Uncertainty of the Signs of Murder in the case of Bastard Children, Med. Observations and Inquiries, p. 289. 4 22 strangulated by the umbilical cord when of an unusual length.* In the second class, or under the head of commission, wc shall mention the manner in which a child is generally put < to death after birth. It may be effected by the various means which will come under consideration in the section on homi- cide, but the peculiar means, and those which cannot be em- ployed upon adults, are first, tying the umbilical cord too prematurely, whilst the foetal circulation still exists, and before the child has respired, which is indicated by its cry- ing ; this, however, generally takes place so soon, " that we are not to suppose a ligature will be often fixed with such fatal promptitude, nor indeed in ordinary cases even accom- plished where it might be intended." Secondly. The death of a child may be effected by pass- ing a long sharp needle or piece of wire into the brain through the fontanelles, or by thrusting it into other parts of the body ; instances are related, however, where a needle has been thrust into the most important organs, as the heart, stomach, &c. without any ill effect; this, together with wounds, bruises, and almost any sort of violence, may soon be detected by a minute examination. Should the child have been suffocated, no matter by what means, the pulmo- nary congestion will be evident; and where it has been co- vered with sand or earth, particles may in all probability be found in the mouth and nostrils. There is another circumstance which may come under the observation of the physician in a criminal court. The child having been found, it may be desirable to know the length of time that it lived. The cord is separated from the navel about the fifth day, but it is in general slightly detached on the fourth; at about the ninth day, the surface from whence it is detached, heals up. After a later period, if it should be important to know how long the child has been dead, our means of determining will depend on the extent of putrefac- tion. In making up his mind in cases of such deep interest, the i physician should avoid falling into the errors of popular prejudice; he should pursue his examination with the greatest care and attention, carefully noting every appear- ance ; he must bear in mind that upon his testimony aloner may depend the life of a fellow creature. The circumstan- * Burn's Midwifery, edited by Professor James,, p. 183. 23 tial evidence, in as much as it is not necessarily connected with his testimony, must be kept entirely out of view; and finally his opinion, the result of deliberation and knowledge, must be advanced in as delicate and precise a manner as pos- sible, at the same time that he carefully observes not to enter into any thing like argument or disquisition. The punishment inflicted on those found guilty of infanti- cide, in almost every civilized nation, from the most remote period, has been very severe. Previous to the year 1803, the law of England punished with death any woman who was convicted of having concealed the birth of her bastard child, " except she could prove, by one witness at least, that the child whose death was by her so intended to be conceal- ed, was born dead."* After this period, however, it was decreed " that women tried for the murder of bastard chil- dren, are to be tried by the same rules of evidence and pre- sumption, as by law are allowed to take place in other trials for murder: if acquitted, and it shall appear, on evidence, that the prisoner was delivered of a child, which by law would, if born alive, be a bastard, and that she did, by secret burying, or otherwise, endeavour to conceal the birth there- of, thereupon it shall be lawful for such court, before which such prisoner shall have been tried, to adjudge, that such person shall be committed to the common gaol, or house of correction, for any time, not exceeding two years."! In France, until the year 1791, "every woman convicted of having concealed her pregnancy, and put to death her bastard child, was condemned to death."^ In the new code for 1810, we find the following articles, relating to the con- cealment and death of bastard children : Art. 349. " Those who shall expose and abandon in a solitary place, a child under seven years of age, and those who may order it to be exposed, shall on that account alone, if such order be executed, be imprisoned for a term not less than six months, and not more than two years, and fined from sixteen to two hundred francs." Art. 350. " If a child has been exposed or abandoned by his guardians or tutors, or in consequence of their orders, the punishment shall be imprisonment for a term not less than five years, and not exceeding ten, and a fine of from fifty to one hundred francs." * East's Crown Law, p. 288 ; quoted by Dr. Beck. f Blackstone's Commentaries, vol. iv. p. 198. ± Beck's Dissertation, p. 89. 24 Art. 351. " If in consequence of such exposition or aban- donment as mentioned in art. 350, the child shall be muti- lated or crippled, the act shall be considered and punished as in the case of wounds voluntarily inflicted, and if the conse- quence be death it shall be considered and punished as mur- der."* Until the year 1790, concealment of the death of a child, was punished in this state, as a capital crime ; at that time it was altered, not being considered sufficient evidence to convict the party without probable presumptive proof, that the child was born alive. The act of 1794 declares, however, that " the concealment of the death of the child shall not be considered conclusive evidence to convict the party indicted of the murder of her child, unless the circumstances attend- ing it be such as shall satisfy the minds of the jury that she did wilfully and maliciously destroy and take away the life of such child." Concealment is punished with imprisonment at hard labour, providing that " if the grand jury shall in the same indictment, charge any woman with the murder of her bastard child, as well as with the offence of concealing its death, the jury, by whom such woman shall be tried, may either acquit or convict her of both offences, or find her guiltv of one and acquit her of the other, as the case may he."f §4. HOMICIDE. By the term homicide we understand the destruction of a human being by violent means. In as much as it may be more or less criminal, according to circumstances, it will be necessary to mention the various kinds, to each of which a different degree of punishment is attached : 1st. Culpable Homicide, where the life of a person may be destroyed without the least intention, although it may have been put in jeopardy, as for instance, by firing a gun with the intention of missing, or from not being aware that it was loaded. 2d. Manslaughter, the killing of a person without any ma- licious intention ; when death is thus occasioned, it is in fact little more than a mere accident. * Translation of the code of Napoleon for 1810. !Note to the laws of Pennsylvania, vol. 1. p. 114. 25 3d. Felonious Homicide, where one person is killed by ano- ther without such being his intention, but where he had de- signed to take away the life of an individual against whom he harboured some malignity; thus mistaking one of whom he entertained no unpleasant feelings, or of whom he per- haps had no knowledge, for the person that he had in- tended to destroy. In a case like this, he of course is con- sidered equally guilty of murder as if it had been the per- son against whom he had conceived such a diabolical design, and he will be punished accordingly. 4th. Murder. This is a crime of the greatest enormity. It is the wilfully and intentionally killing of a human being. There is also another species of homicide, where if a person is attacked, he may be forced in self-defence to kill another; to this, however, no punishment can be attached, it is called Justifiable Homicide. The means which are generally employed for the accom- plishment of this crime are various; they come under consi- deration in this section, and will be treated of in the follow- order, viz. wounds and bruises, suffocation and poisons. Wounds and Bruises. It is not to be supposed that we shall enter into a minute detail of the subjects now under consideration. In as much as they are the means by which violent death is commonly effected, they will consequently come frequently under the consideration of the surgeon. Supposing then a dead body to be found with wounds or bruises, the first object must be to ascertain if they were inflicted during the life of the per- son, and for this purpose, if the wound be deep we must look for traces of blood ;* if it has penetrated any of the large cavities, internal haemorrhage will inform us ; on the contrary, when no such appearances are presented, we must * See the singular case of Sir E. Godfrey,! m 1678, who was first stran- gled, and bruised on the breast by four men, his own sword passed through him, and then thrown into a ditch. On the body being found, the end of the sword projected two hands bn adth beyond the back ; no blood could be found about the place, nor was there any followed the sword when with- drawn. " The breast was discoloured and bruised, and the neck was so flexible that the chin could be turned from one shoulder to the other. His face during life had been remarkably pale ; but after death it became much suffused." ! Smith's Principles of Forensic Medicine, p. 225. 26 suppose the person to have been destroyed in some other way. With regard to bruises, it has been said that similar ap- pearances are sometimes presented in the skin after death, as are caused by bruises inflicted whilst the person lived. The former of these appearances has been called suggillation,and is an effusion of blood into the cellular substance from putre- faction ; or it may sometimes be found during life, generally in the most depending parts of the body, when it may be caused by disease or pressure. The latter, or ecchymosis, can be produced in the living body only, and is also an effusion of blood into the cellular substance ; it is soft, prominent, and of a dark colour. According to Zacchias and Fodere, upon making an incision into a suggillation, the blood will be found fluid ; and on cutting into an ecchymosis " a con- gestion of thick concrete blood will be found."* The next object will be to ascertain whether any injury inflicted on the body, was the cause of death or not. There are some wounds which are necessarily fatal, as where large blood-vessels have been divided ; where the injury has been extensive, or where an important organ is concerned. There are others, however, which are only fatal from peculiar cir- cumstances. Owing to some idiosyncrasy, a wound may be fatal to one person, which by another would scarcely be no- ticed ; or even to the same person under different circum- stances. The consequences of a wound or bruise, inflicted on a person in ill health, would perhaps be fatal, whilst the same inflicted during health would create little or no incon- venience ; hence the necessity ,of extreme caution in our de- cisions. The law formerly held amenable for the consequences, a year and a day, any person who had inflicted violence upon another. This law was founded on correct principles. That a person may die immediately on receiving a blow from other causes, whilst a person may live for years, and still die from the injury he may have received at a very remote period, there can be no doubt. The law, however, now re- gards the intent, " and when there has been a design to kill, or do some grievous bodily harm, the crime is made out though the design may have failed." An instance is relat- ed by Dr. Smith, where, by the testimony of the medical prac- * Smith's Forensic Medicine, p. 242. This is not universal; if an ecchy- mosis is recent, the blood is not coagulated, and in some instances it re- mains fluid for a long time. titioner, the complexion of the case was considerably changed. A boy was struck on the head with a stick and his skull fractured by a man, on whose grounds he was committing depredations ; on trial " it was not only proved that the boy was guilty of the provocation, and the man intended no more than chastisement; but that the stick was not of a size from which such mischief could have been anticipated ; and that the injury resulted from the circumstance, that the skull was thinner than ordinary. The third object must be to ascertain, if possible, whether the person came to his death by his own hands, or by the hands of others. For this purpose, we must notice the situa- tion of the deceased ; what sort of weapon was made use of, and whether it be found near him; the part of the body where the wound was inflicted. We must also inquire into the circumstances of his case, the state of his mind for some time previous; his general conduct, &c; by these means we may sometimes be enabled to decide, and perhaps, thus res- cue an innocent person from suspicion. On the other hand, great deceit is sometimes practised; for instance, " a man was found shot, and his own pistol discovered lying near him, from which circumstance, (and no person having been seen to enter or leave the house of the deceased) it was conclud- ed he had destroyed himself; but on examining the ball by which he had been killed, it was found to be too large ever to have entered that pistol; in consequence of which disco- very, suspicion fell upon the murderer."* In quarrelling, a kick over the region of the stomach is a very frequent occurrence, and not unfrequently causes im- mediate death; this is probably owing to the shock received by the par vagum and the great sympathetic nerves be- ing suddenly conveyed to the organs of respiration ; which are thereby prevented from performing their natural func- tions. From external violence, the large vessels of the ab- domen, the intestines, liver, &c. may be ruptured, and death be the consequence.—A case is mentioned by Dr. Male, where, from muscular action alone, in attempting to avoid falling from a horse, the liver was ruptured; and a case is recorded by Dr. Gordon Smith, where the right kidney was torn in two transversely, by a kick from a horse. The per- son survived but twenty minutes. It will be important to recollect that where death is supposed to have been caused * Male's Juridical Medicine, p. 120. 28 by external violence, that cases are on record where without any such means, the person may have died suddenly from some internal disease, which can only be discovered by dis- section. The following is a case of this kind which is taken from Smith's Forensic Medicine. " In the course of an altercation between a man and his wife, the woman died, and a clamour was raised that the husband had murdered her. An inquest being held, a verdict was returned against him, and he stood his trial at the following assizes. He was there acquitted ; for evidence was given that he had not touched his wife during the quarrel, at least such is now the belief in the neighbourhood. The deceased was a person of an ex- tremely violent temper; and on opening her body, it was found that she had been labouring under suppuration of the liver, and that an abscess had burst into the cavity of the abdomen, through the agitation into which she had been thrown. I do not conceive it necessary to enter into any account of wounds, their treatment, &c. This cannot be expected in a short essay on forensic medicine, but must be referred to the province of the surgeon. It should be particularly remem- bered that where a wound has been of long standing and the patient has finally sunk under it, the surgeon will perhaps be liable to be very minutely questioned respecting the mode of treatment, &c. pursued in the case, and if it be found that the patient died from improper treatment or neglect on his part, it will redound much to his discredit in a court of jus- tice, at the same time the prisoner must be acquitted. Care and attention, therefore, with a particular regard to the plan of treatment, cannot be too rigidly enforced in cases of this nature, upon which perhaps the reputation of a surgeon may depend. Suffocation. Under this head, we think, may with propriety be classed all the various means by which death is caused from an in- terruption of respiration. It is well known that an inter- ruption of this process for a short time only will cause death. Whether it be produced by mechanical means, by exposure to noxious gases, or by submersion under water; which ever of these may be the cause, the effect is the same, the circu- lation of the blood is impeded ; it becomes accumulated in the right side of the heart, the cavities of which, on dissec- 29 tion, will be found filled with dark venous blood ; the ves- sels of the lungs become turgid, of a peculiarly dark blue colour: they may perhaps be ruptured, when effusions will take place, from their proximity to the heart; those of the brain also become filled, and pressure is thus made on that important organ, hence also, the appearance of great disco- loration and lividity about the head, breast, and superior ex- tremities of persons who have died from these causes. The most frequent means by which suffocation is effected, are by hanging and drowning ; but there are others which are not of so frequent occurrence, as strangling, smothering, and noxi- ous inhalations, each of which will be separately considered in this section. Hanging. When a body is found suspended by the neck, by means of a rope or any other ligature, it is probable that a physican will be immediately called in, and if the person be dead, it will be his duty, first to examine if he came by his death from hanging or other means. Together with the appear- ances of suffocation before mentioned, the eyes are staring, and their vessels turgid with blood ; the tongue is some- times protruded out of the mouth and wounded by the teeth; this, however, can only happen when the rope has pressed under the cricoid cartilage, for where it has pressed above the thyroid, it will on the contrary be pushed back; there is sometimes a discharge of bloody mucus from the mouth, nostrils, or ears; the hands are clenched ; the shoulders ele- vated ; in some instances, urine, faeces, or semen are expel- led, and when the body has fallen from a height, the transverse ligament of the atlas, which confines the dentatus in its place, is ruptured and luxation of these bones is the consequence. Where many, or the most prominent of these appearances are found, our natural conclusion would be, that the person was alive when hanged. It will next be necessary to ascertain whether the person hung, has committed suicide or was strangled. For this purpose, the place where the body was found must be noticed, also if there be any appearance around the spot indicating that there had been resistance or scuffling ; in- quire into the previous mind of the person, his conduct, his character, &c. ; observe if robbery has been committed, the 5 30 dress and general appearance of the deceased. If the per- son has been found hanging in a room, with evident marks of external vioience about the body, it is not to be consider- ed as certain that he was murdered, he may have swung off with such violence as to break the rope or ligature, conse- quently, on falling he may have thus injured himself by striking against some of the articles of furniture, and after- wards suspended himself. A case is related by De Haen, where a suicide inflicted several wounds upon his face whilst he was suspended ;* and others have been known where the person had wounded himself under similar circum- stances-! The situation of the cord about the neck is also to be taken notice of, and if two distinct marks are found, the lower one most discoloured, we may conclude that the per- son was first strangled and afterwards suspended. In such a case, if the person was alive and strangled by others, as much force must have been used, consequently, we might expect the cervical vertebrae to be dislocated, and if on ex- amination such injury be found, our opinion would be con- * siderably strengthened. On dissection the same appearances will be presented to us as mentioned when speaking of suf- focation. Hanging has very seldom been resorted to as an act of homicide, nevertheless, some instances of this kind are re- lated ; it is evident that much force and some preparation will be required to effect it. It is, however, generally, an act of suicide. There have been instances where children have been hung by their play-fellows for amusement, not being aware of the consequence ; such cases have occurred in this country. Drowning. When called to a body in a drowning state, the physician will first resort to an employment of the means recommend- ed for its restoration. Should he fail, or should it be evi- dent from the appearance of putrefaction, &c. that such means are needless, two questions will immediately suggest themselves which will require solution. First. Did the person come to his death accidentally, or * Male's Juridical Medicine, 2d ed. p. 181. ! Smith's Forensic Mediciue, p. 219. 31 was it his own act, or the act of others? It must be evident that it will in general be a matter of no inconsiderable dif- ficulty to determine on these points. In many instances it will be quite impossible to clear up our doubts ; in others, only by the evidence of persons who witnessed it. Where, however, it has been committed on or near the banks of a river, the appearances which may be presented to us about the spot, will sometimes entitle us to the conclusion that the person came to his death by the violent means of others, as when it would seem to indicate that great resistance had been made ; marks of footsteps ; substances, &c. grasped in the hands of the deceased when the body is found. This is well exemplified in the case of Mr. Taylor, who was mur- dered at Hornsey, in December 1818 ; marks of footsteps, deep in the ground, were discovered near the New River, and on taking out the body, the hands were found clenched, and contained grass, which he had grasped from the side of the water.* We shall in some instances, be aided in no small degree, by taking into consideration the state of the person's mind, his previous conduct, circumstances, &c. Secondly. Was the person alive, or first killed and then thrown into the water ? To determine this point, we shall in general be consider- ably assisted by the external appearance of the body. Should there be any wounds or bruises, we must take into consider- ation their nature and extent, the particular parts probably injured by them, and whether it is likely they were the cause of the person's death. We should, at the same time, duly consider whether these wounds or bruises were the effects of criminal interference or of accident, for it will be recollect- ed that a person in falling, or even under water, may possi- bly strike against some hard substance, and thus cause ap- pearances, in all respects similar to those inflicted with crimi- nal intentions. In endeavouring to ascertain the length of time that a body has been in the water, the usual criterion for determining this point, in connexion with the circumstances of the case, is the degree of putrefaction. Since the experiments of Dr. Gibbs! of Bath, however, we are enabled to determine the point with much greater precision. He has demonstrated that by continuing in water for from four to six weeks, the • Smith's Principles, p. 215. f Philosophical Transactions, part II for 17